1.1                          A bill for an act 
  1.2             relating to state government; making changes to public 
  1.3             assistance programs, long-term care, continuing care 
  1.4             for persons with disabilities, children's services, 
  1.5             occupational licenses, human services licensing, 
  1.6             county initiatives, local public health grants, child 
  1.7             care provisions, child support provisions, and health 
  1.8             care; establishing the Community Services Act; 
  1.9             establishing alternative care liens; modifying 
  1.10            petroleum product specifications; conveying land in 
  1.11            Cass county; making forecast adjustments; 
  1.12            appropriating money; amending Minnesota Statutes 2002, 
  1.13            sections 13.69, subdivision 1; 41A.09, subdivision 2a; 
  1.14            61A.072, subdivision 6; 62A.31, subdivisions 1f, 1u, 
  1.15            by adding a subdivision; 62A.315; 62A.316; 62A.48, by 
  1.16            adding a subdivision; 62A.49, by adding a subdivision; 
  1.17            62A.65, subdivision 7; 62D.095, subdivision 2, by 
  1.18            adding a subdivision; 62E.06, subdivision 1; 62J.17, 
  1.19            subdivision 2; 62J.23, by adding a subdivision; 
  1.20            62J.52, subdivisions 1, 2; 62J.692, subdivisions 3, 4, 
  1.21            5, 7, 8; 62J.694, by adding a subdivision; 62L.05, 
  1.22            subdivision 4; 62Q.19, subdivisions 1, 2; 62S.22, 
  1.23            subdivision 1; 69.021, subdivision 11; 119B.011, 
  1.24            subdivisions 5, 6, 15, 19, 20, 21, by adding a 
  1.25            subdivision; 119B.02, subdivision 1; 119B.03, 
  1.26            subdivisions 4, 9; 119B.05, subdivision 1; 119B.08, 
  1.27            subdivision 3; 119B.09, subdivisions 1, 2, 7, by 
  1.28            adding subdivisions; 119B.11, subdivision 2a; 119B.12, 
  1.29            subdivision 2; 119B.13, subdivisions 1, 6, by adding a 
  1.30            subdivision; 119B.16, subdivision 2, by adding 
  1.31            subdivisions; 119B.19, subdivision 7; 119B.21, 
  1.32            subdivision 11; 119B.23, subdivision 3; 124D.23, 
  1.33            subdivision 1; 144.1222, by adding a subdivision; 
  1.34            144.125; 144.128; 144.1481, subdivision 1; 144.1483; 
  1.35            144.1488, subdivision 4; 144.1491, subdivision 1; 
  1.36            144.1502, subdivision 4; 144.396, subdivisions 1, 5, 
  1.37            7, 10, 11, 12; 144.414, subdivision 3; 144.551, 
  1.38            subdivision 1; 144A.04, subdivision 3, by adding a 
  1.39            subdivision; 144A.071, subdivision 4c, as added; 
  1.40            144A.10, by adding a subdivision; 144A.4605, 
  1.41            subdivision 4; 144E.11, subdivision 6; 144E.50, 
  1.42            subdivision 5; 145.88; 145.881, subdivisions 1, 2; 
  1.43            145.882, subdivisions 1, 2, 3, 7, by adding a 
  1.44            subdivision; 145.883, subdivisions 1, 9; 145A.02, 
  1.45            subdivisions 5, 6, 7; 145A.06, subdivision 1; 145A.09, 
  1.46            subdivisions 2, 4, 7; 145A.10, subdivisions 2, 10, by 
  2.1             adding a subdivision; 145A.11, subdivisions 2, 4; 
  2.2             145A.12, subdivisions 1, 2, by adding a subdivision; 
  2.3             145A.13, by adding a subdivision; 145A.14, subdivision 
  2.4             2, by adding a subdivision; 147A.08; 148.5194, 
  2.5             subdivisions 1, 2, 3, by adding a subdivision; 
  2.6             148.6445, subdivision 7; 148C.01, subdivisions 2, 12, 
  2.7             by adding subdivisions; 148C.03, subdivision 1; 
  2.8             148C.0351, subdivision 1, by adding a subdivision; 
  2.9             148C.04; 148C.05, subdivision 1, by adding 
  2.10            subdivisions; 148C.07; 148C.10, subdivisions 1, 2; 
  2.11            148C.11; 153A.17; 171.06, subdivision 3; 171.07, by 
  2.12            adding a subdivision; 174.30, subdivision 1; 239.761, 
  2.13            subdivisions 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13; 
  2.14            239.792; 245.0312; 245.4874; 245.493, subdivision 1a; 
  2.15            245A.035, subdivision 3; 245A.04, subdivisions 3, 3b, 
  2.16            3d; 245A.09, subdivision 7; 245A.10; 245A.11, 
  2.17            subdivisions 2a, 2b, by adding a subdivision; 245B.03, 
  2.18            subdivision 2, by adding a subdivision; 245B.04, 
  2.19            subdivision 2; 245B.06, subdivisions 2, 5, 8; 245B.07, 
  2.20            subdivisions 6, 9, 11; 245B.08, subdivision 1; 
  2.21            246.014; 246.015, subdivision 3; 246.018, subdivisions 
  2.22            2, 3, 4; 246.13; 246.15; 246.16; 246.54; 246.57, 
  2.23            subdivisions 1, 4, 6; 246.71, subdivisions 4, 5; 
  2.24            246B.02; 246B.03; 246B.04; 252.025, subdivision 7; 
  2.25            252.06; 252.27, subdivision 2a; 252.32, subdivisions 
  2.26            1, 1a, 3, 3c; 252.41, subdivision 3; 252.46, 
  2.27            subdivision 1; 253.015, subdivision 1; 253.017; 
  2.28            253.20; 253.26; 253B.02, subdivision 18a; 253B.04, 
  2.29            subdivision 1; 253B.05, subdivision 3; 253B.09, 
  2.30            subdivision 1; 256.01, subdivision 2; 256.012; 
  2.31            256.046, subdivision 1; 256.0471, subdivision 1; 
  2.32            256.476, subdivisions 1, 3, 4, 5, 11; 256.482, 
  2.33            subdivision 8; 256.955, subdivisions 2a, 3, by adding 
  2.34            a subdivision; 256.9657, subdivisions 1, 4, by adding 
  2.35            a subdivision; 256.969, subdivisions 2b, 3a, by adding 
  2.36            a subdivision; 256.975, by adding a subdivision; 
  2.37            256.98, subdivisions 3, 4, 8; 256.984, subdivision 1; 
  2.38            256B.055, by adding a subdivision; 256B.056, 
  2.39            subdivisions 1a, 1c, 3c, 6; 256B.057, subdivisions 1, 
  2.40            2, 3b, 9, 10; 256B.0595, subdivisions 1, 2, by adding 
  2.41            subdivisions; 256B.06, subdivision 4; 256B.061; 
  2.42            256B.0621, subdivisions 4, 7; 256B.0623, subdivisions 
  2.43            2, 4, 5, 6, 8; 256B.0625, subdivisions 5a, 9, 13, 17, 
  2.44            19c, 23, by adding subdivisions; 256B.0627, 
  2.45            subdivisions 1, 4, 9; 256B.0635, subdivisions 1, 2; 
  2.46            256B.064, subdivision 2; 256B.0911, subdivision 4d; 
  2.47            256B.0913, subdivisions 2, 4, 5, 6, 7, 8, 10, 12; 
  2.48            256B.0915, subdivision 3, by adding a subdivision; 
  2.49            256B.092, subdivisions 1a, 5, by adding a subdivision; 
  2.50            256B.0945, subdivisions 2, 4; 256B.095; 256B.0951, 
  2.51            subdivisions 1, 2, 3, 5, 7, 9; 256B.0952, subdivision 
  2.52            1; 256B.0953, subdivision 2; 256B.0955; 256B.15, 
  2.53            subdivisions 1, 1a, 2, 3, 4, by adding subdivisions; 
  2.54            256B.19, subdivision 1; 256B.195, subdivisions 3, 5; 
  2.55            256B.32, subdivision 1; 256B.431, subdivisions 2r, 32, 
  2.56            36, by adding subdivisions; 256B.434, subdivisions 4, 
  2.57            10; 256B.47, subdivision 2; 256B.49, subdivision 15; 
  2.58            256B.501, subdivision 1, by adding a subdivision; 
  2.59            256B.5012, by adding a subdivision; 256B.5013, by 
  2.60            adding a subdivision; 256B.5015; 256B.69, subdivisions 
  2.61            2, 4, 5, 5a, 5c, 6a, 6b, 8, by adding subdivisions; 
  2.62            256B.75; 256B.76; 256B.761; 256B.82; 256D.03, 
  2.63            subdivisions 3, 3a, 4; 256D.06, subdivision 2; 
  2.64            256D.44, subdivision 5; 256D.46, subdivisions 1, 3; 
  2.65            256D.48, subdivision 1; 256G.05, subdivision 2; 
  2.66            256I.02; 256I.04, subdivision 3; 256I.05, subdivisions 
  2.67            1, 1a, 7c; 256J.01, subdivision 5; 256J.02, 
  2.68            subdivision 2; 256J.021; 256J.08, subdivisions 35, 65, 
  2.69            82, 85, by adding subdivisions; 256J.09, subdivisions 
  2.70            2, 3, 3a, 3b, 8, 10; 256J.14; 256J.20, subdivision 3; 
  2.71            256J.21, subdivisions 1, 2; 256J.24, subdivisions 3, 
  3.1             5, 6, 7, 10; 256J.30, subdivision 9; 256J.32, 
  3.2             subdivisions 2, 4, 5a, by adding a subdivision; 
  3.3             256J.37, subdivision 9, by adding subdivisions; 
  3.4             256J.38, subdivisions 3, 4; 256J.40; 256J.42, 
  3.5             subdivisions 4, 5, 6; 256J.425, subdivisions 1, 1a, 2, 
  3.6             3, 4, 6, 7; 256J.45, subdivision 2; 256J.46, 
  3.7             subdivisions 1, 2, 2a; 256J.49, subdivisions 4, 5, 9, 
  3.8             13, by adding subdivisions; 256J.50, subdivisions 1, 
  3.9             9, 10; 256J.51, subdivisions 1, 2, 3, 4; 256J.53, 
  3.10            subdivisions 1, 2, 5; 256J.54, subdivisions 1, 2, 3, 
  3.11            5; 256J.55, subdivisions 1, 2; 256J.56; 256J.57; 
  3.12            256J.62, subdivision 9; 256J.645, subdivision 3; 
  3.13            256J.66, subdivision 2; 256J.69, subdivision 2; 
  3.14            256J.75, subdivision 3; 256J.751, subdivisions 1, 2, 
  3.15            5; 256L.03, subdivision 1; 256L.04, subdivisions 1, 
  3.16            10; 256L.05, subdivisions 3a, 4; 256L.06, subdivision 
  3.17            3; 256L.07, subdivisions 1, 3; 256L.12, subdivisions 
  3.18            6, 9, by adding a subdivision; 256L.15, subdivisions 
  3.19            1, 2, 3; 256L.17, subdivision 2; 257.05; 257.0769; 
  3.20            259.21, subdivision 6; 259.67, subdivisions 4, 7; 
  3.21            260B.157, subdivision 1; 260B.176, subdivision 2; 
  3.22            260B.178, subdivision 1; 260B.193, subdivision 2; 
  3.23            260B.235, subdivision 6; 260C.141, subdivision 2; 
  3.24            261.063; 295.53, subdivision 1; 295.55, subdivision 2; 
  3.25            296A.01, subdivisions 2, 7, 8, 14, 19, 20, 22, 23, 24, 
  3.26            25, 26, 28, by adding a subdivision; 297I.15, 
  3.27            subdivisions 1, 4; 326.42; 393.07, subdivisions 1, 5, 
  3.28            10; 471.59, subdivision 1; 514.981, subdivision 6; 
  3.29            518.167, subdivision 1; 518.551, subdivisions 7, 12, 
  3.30            13; 518.6111, subdivisions 2, 3, 4, 16; 524.3-805; 
  3.31            626.559, subdivision 5; 641.15, subdivision 2; Laws 
  3.32            1997, chapter 203, article 9, section 21, as amended; 
  3.33            Laws 1997, chapter 245, article 2, section 11; 2003 
  3.34            S.F. No. 1019, sections 2, 3, 7, if enacted; proposing 
  3.35            coding for new law in Minnesota Statutes, chapters 
  3.36            62J; 62Q; 62S; 97A; 119B; 144; 144A; 145; 145A; 148C; 
  3.37            245; 246; 256; 256B; 256I; 256J; 256L; 514; proposing 
  3.38            coding for new law as Minnesota Statutes, chapter 
  3.39            256M; repealing Minnesota Statutes 2002, sections 
  3.40            62J.15; 62J.152; 62J.451; 62J.452; 62J.66; 62J.68; 
  3.41            119B.061; 119B.13, subdivision 2; 144.126; 144.1484; 
  3.42            144.1494; 144.1495; 144.1496; 144.1497; 144.401; 
  3.43            144A.071, subdivision 5; 144A.35; 144A.36; 144A.38; 
  3.44            145.882, subdivisions 4, 5, 6, 8; 145.883, 
  3.45            subdivisions 4, 7; 145.884; 145.885; 145.886; 145.888; 
  3.46            145.889; 145.890; 145A.02, subdivisions 9, 10, 11, 12, 
  3.47            13, 14; 145A.09, subdivision 6; 145A.10, subdivisions 
  3.48            5, 6, 8; 145A.11, subdivision 3; 145A.12, subdivisions 
  3.49            3, 4, 5; 145A.14, subdivisions 3, 4; 145A.17, 
  3.50            subdivision 2; 148.5194, subdivision 3a; 148.6445, 
  3.51            subdivision 9; 148C.0351, subdivision 2; 148C.05, 
  3.52            subdivisions 2, 3, 4; 148C.06; 148C.10, subdivision 
  3.53            1a; 245.478; 245.4886; 245.4888; 245.496; 246.017, 
  3.54            subdivision 2; 246.022; 246.06; 246.07; 246.08; 
  3.55            246.11; 246.19; 246.42; 252.025, subdivisions 1, 2, 4, 
  3.56            5, 6; 252.032; 252.10; 252.32, subdivision 2; 253.015, 
  3.57            subdivisions 2, 3; 253.10; 253.19; 253.201; 253.202; 
  3.58            253.25; 253.27; 254A.17; 256.05; 256.06; 256.08; 
  3.59            256.09; 256.10; 256.955, subdivision 8; 256.973; 
  3.60            256.9772; 256B.055, subdivision 10a; 256B.057, 
  3.61            subdivision 1b; 256B.0625, subdivisions 35, 36; 
  3.62            256B.0945, subdivision 10; 256B.437, subdivision 2; 
  3.63            256B.5013, subdivision 4; 256E.01; 256E.02; 256E.03; 
  3.64            256E.04; 256E.05; 256E.06; 256E.07; 256E.08; 256E.081; 
  3.65            256E.09; 256E.10; 256E.11; 256E.115; 256E.13; 256E.14; 
  3.66            256E.15; 256F.01; 256F.02; 256F.03; 256F.04; 256F.05; 
  3.67            256F.06; 256F.07; 256F.08; 256F.11; 256F.12; 256F.14; 
  3.68            256J.02, subdivision 3; 256J.08, subdivisions 28, 70; 
  3.69            256J.24, subdivision 8; 256J.30, subdivision 10; 
  3.70            256J.462; 256J.47; 256J.48; 256J.49, subdivisions 1a, 
  3.71            2, 6, 7; 256J.50, subdivisions 2, 3, 3a, 5, 7; 
  4.1             256J.52; 256J.55, subdivision 5; 256J.62, subdivisions 
  4.2             1, 2a, 4, 6, 7, 8; 256J.625; 256J.655; 256J.74, 
  4.3             subdivision 3; 256J.751, subdivisions 3, 4; 256J.76; 
  4.4             256K.30; 257.075; 257.81; 260.152; 268A.08; 626.562; 
  4.5             Laws 1998, chapter 407, article 4, section 63; Laws 
  4.6             2000, chapter 488, article 10, section 29; Laws 2000, 
  4.7             chapter 489, article 1, section 36; Laws 2001, First 
  4.8             Special Session chapter 3, article 1, section 16; Laws 
  4.9             2001, First Special Session chapter 9, article 13, 
  4.10            section 24; Laws 2002, chapter 374, article 9, section 
  4.11            8; Laws 2003, chapter 55, sections 1, 4; Minnesota 
  4.12            Rules, parts 4705.0100; 4705.0200; 4705.0300; 
  4.13            4705.0400; 4705.0500; 4705.0600; 4705.0700; 4705.0800; 
  4.14            4705.0900; 4705.1000; 4705.1100; 4705.1200; 4705.1300; 
  4.15            4705.1400; 4705.1500; 4705.1600; 4736.0010; 4736.0020; 
  4.16            4736.0030; 4736.0040; 4736.0050; 4736.0060; 4736.0070; 
  4.17            4736.0080; 4736.0090; 4736.0120; 4736.0130; 4747.0030, 
  4.18            subparts 25, 28, 30; 4747.0040, subpart 3, item A; 
  4.19            4747.0060, subpart 1, items A, B, D; 4747.0070, 
  4.20            subparts 4, 5; 4747.0080; 4747.0090; 4747.0100; 
  4.21            4747.0300; 4747.0400, subparts 2, 3; 4747.0500; 
  4.22            4747.0600; 4747.1000; 4747.1100, subpart 3; 4747.1600; 
  4.23            4763.0100; 4763.0110; 4763.0125; 4763.0135; 4763.0140; 
  4.24            4763.0150; 4763.0160; 4763.0170; 4763.0180; 4763.0190; 
  4.25            4763.0205; 4763.0215; 4763.0220; 4763.0230; 4763.0240; 
  4.26            4763.0250; 4763.0260; 4763.0270; 4763.0285; 4763.0295; 
  4.27            4763.0300; 9505.0324; 9505.0326; 9505.0327; 9505.3045; 
  4.28            9505.3050; 9505.3055; 9505.3060; 9505.3068; 9505.3070; 
  4.29            9505.3075; 9505.3080; 9505.3090; 9505.3095; 9505.3100; 
  4.30            9505.3105; 9505.3107; 9505.3110; 9505.3115; 9505.3120; 
  4.31            9505.3125; 9505.3130; 9505.3138; 9505.3139; 9505.3140; 
  4.32            9505.3680; 9505.3690; 9505.3700; 9545.2000; 9545.2010; 
  4.33            9545.2020; 9545.2030; 9545.2040; 9550.0010; 9550.0020; 
  4.34            9550.0030; 9550.0040; 9550.0050; 9550.0060; 9550.0070; 
  4.35            9550.0080; 9550.0090; 9550.0091; 9550.0092; 9550.0093. 
  4.36  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  4.37                             ARTICLE 1 
  4.38                           WELFARE REFORM 
  4.39     Section 1.  Minnesota Statutes 2002, section 119B.03, 
  4.40  subdivision 4, is amended to read: 
  4.41     Subd. 4.  [FUNDING PRIORITY.] (a) First priority for child 
  4.42  care assistance under the basic sliding fee program must be 
  4.43  given to eligible non-MFIP families who do not have a high 
  4.44  school or general equivalency diploma or who need remedial and 
  4.45  basic skill courses in order to pursue employment or to pursue 
  4.46  education leading to employment and who need child care 
  4.47  assistance to participate in the education program.  Within this 
  4.48  priority, the following subpriorities must be used: 
  4.49     (1) child care needs of minor parents; 
  4.50     (2) child care needs of parents under 21 years of age; and 
  4.51     (3) child care needs of other parents within the priority 
  4.52  group described in this paragraph. 
  4.53     (b) Second priority must be given to parents who have 
  5.1   completed their MFIP or work first transition year, or parents 
  5.2   who are no longer receiving or eligible for diversionary work 
  5.3   program supports.  
  5.4      (c) Third priority must be given to families who are 
  5.5   eligible for portable basic sliding fee assistance through the 
  5.6   portability pool under subdivision 9. 
  5.7      Sec. 2.  Minnesota Statutes 2002, section 256.984, 
  5.8   subdivision 1, is amended to read: 
  5.9      Subdivision 1.  [DECLARATION.] Every application for public 
  5.10  assistance under this chapter ~~and/or~~ or chapters 256B, 256D, 
  5.11  ~~256K, MFIP program~~ 256J, and food stamps or food support under 
  5.12  chapter 393 shall be in writing or reduced to writing as 
  5.13  prescribed by the state agency and shall contain the following 
  5.14  declaration which shall be signed by the applicant: 
  5.15     "I declare under the penalties of perjury that this 
  5.16     application has been examined by me and to the best of my 
  5.17     knowledge is a true and correct statement of every material 
  5.18     point.  I understand that a person convicted of perjury may 
  5.19     be sentenced to imprisonment of not more than five years or 
  5.20     to payment of a fine of not more than $10,000, or both." 
  5.21     Sec. 3.  Minnesota Statutes 2002, section 256D.06, 
  5.22  subdivision 2, is amended to read: 
  5.23     Subd. 2.  [EMERGENCY NEED.] Notwithstanding the provisions 
  5.24  of subdivision 1, a grant of emergency general assistance shall, 
  5.25  to the extent funds are available, be made to an eligible single 
  5.26  adult, married couple, or family for an emergency need, as 
  5.27  defined in rules promulgated by the commissioner, where the 
  5.28  recipient requests temporary assistance not exceeding 30 days if 
  5.29  an emergency situation appears to exist and ~~(a) until March 31,~~ 
  5.30  ~~1998, the individual is ineligible for the program of emergency~~ 
  5.31  ~~assistance under aid to families with dependent children and is~~ 
  5.32  ~~not a recipient of aid to families with dependent children at~~ 
  5.33  ~~the time of application; or (b)~~ the individual or family is ~~(i)~~ 
  5.34  ineligible for MFIP or DWP or is not a participant of MFIP~~; and~~ 
  5.35  ~~(ii) is ineligible for emergency assistance under section~~ 
  5.36  ~~256J.48~~ or DWP.  If an applicant or recipient relates facts to 
  6.1   the county agency which may be sufficient to constitute an 
  6.2   emergency situation, the county agency shall, to the extent 
  6.3   funds are available, advise the person of the procedure for 
  6.4   applying for assistance according to this subdivision.  An 
  6.5   emergency general assistance grant is available to a recipient 
  6.6   not more than once in any 12-month period.  Funding for an 
  6.7   emergency general assistance program is limited to the 
  6.8   appropriation.  Each fiscal year, the commissioner shall 
  6.9   allocate to counties the money appropriated for emergency 
  6.10  general assistance grants based on each county agency's average 
  6.11  share of state's emergency general expenditures for the 
  6.12  immediate past three fiscal years as determined by the 
  6.13  commissioner, and may reallocate any unspent amounts to other 
  6.14  counties.  Any emergency general assistance expenditures by a 
  6.15  county above the amount of the commissioner's allocation to the 
  6.16  county must be made from county funds. 
  6.17     Sec. 4.  Minnesota Statutes 2002, section 256D.44, 
  6.18  subdivision 5, is amended to read: 
  6.19     Subd. 5.  [SPECIAL NEEDS.] In addition to the state 
  6.20  standards of assistance established in subdivisions 1 to 4, 
  6.21  payments are allowed for the following special needs of 
  6.22  recipients of Minnesota supplemental aid who are not residents 
  6.23  of a nursing home, a regional treatment center, or a group 
  6.24  residential housing facility. 
  6.25     (a) The county agency shall pay a monthly allowance for 
  6.26  medically prescribed diets ~~payable under the Minnesota family~~ 
  6.27  ~~investment program~~ if the cost of those additional dietary needs 
  6.28  cannot be met through some other maintenance benefit.  The need 
  6.29  for special diets or dietary items must be prescribed by a 
  6.30  licensed physician.  Costs for special diets shall be determined 
  6.31  as percentages of the allotment for a one-person household under 
  6.32  the thrifty food plan as defined by the United States Department 
  6.33  of Agriculture.  The types of diets and the percentages of the 
  6.34  thrifty food plan that are covered are as follows: 
  6.35     (1) high protein diet, at least 80 grams daily, 25 percent 
  6.36  of thrifty food plan; 
  7.1      (2) controlled protein diet, 40 to 60 grams and requires 
  7.2   special products, 100 percent of thrifty food plan; 
  7.3      (3) controlled protein diet, less than 40 grams and 
  7.4   requires special products, 125 percent of thrifty food plan; 
  7.5      (4) low cholesterol diet, 25 percent of thrifty food plan; 
  7.6      (5) high residue diet, 20 percent of thrifty food plan; 
  7.7      (6) pregnancy and lactation diet, 35 percent of thrifty 
  7.8   food plan; 
  7.9      (7) gluten-free diet, 25 percent of thrifty food plan; 
  7.10     (8) lactose-free diet, 25 percent of thrifty food plan; 
  7.11     (9) antidumping diet, 15 percent of thrifty food plan; 
  7.12     (10) hypoglycemic diet, 15 percent of thrifty food plan; or 
  7.13     (11) ketogenic diet, 25 percent of thrifty food plan. 
  7.14     (b) Payment for nonrecurring special needs must be allowed 
  7.15  for necessary home repairs or necessary repairs or replacement 
  7.16  of household furniture and appliances using the payment standard 
  7.17  of the AFDC program in effect on July 16, 1996, for these 
  7.18  expenses, as long as other funding sources are not available.  
  7.19     (c) A fee for guardian or conservator service is allowed at 
  7.20  a reasonable rate negotiated by the county or approved by the 
  7.21  court.  This rate shall not exceed five percent of the 
  7.22  assistance unit's gross monthly income up to a maximum of $100 
  7.23  per month.  If the guardian or conservator is a member of the 
  7.24  county agency staff, no fee is allowed. 
  7.25     (d) The county agency shall continue to pay a monthly 
  7.26  allowance of $68 for restaurant meals for a person who was 
  7.27  receiving a restaurant meal allowance on June 1, 1990, and who 
  7.28  eats two or more meals in a restaurant daily.  The allowance 
  7.29  must continue until the person has not received Minnesota 
  7.30  supplemental aid for one full calendar month or until the 
  7.31  person's living arrangement changes and the person no longer 
  7.32  meets the criteria for the restaurant meal allowance, whichever 
  7.33  occurs first. 
  7.34     (e) A fee of ten percent of the recipient's gross income or 
  7.35  $25, whichever is less, is allowed for representative payee 
  7.36  services provided by an agency that meets the requirements under 
  8.1   SSI regulations to charge a fee for representative payee 
  8.2   services.  This special need is available to all recipients of 
  8.3   Minnesota supplemental aid regardless of their living 
  8.4   arrangement.  
  8.5      (f) Notwithstanding the language in this subdivision, an 
  8.6   amount equal to the maximum allotment authorized by the federal 
  8.7   Food Stamp Program for a single individual which is in effect on 
  8.8   the first day of January of the previous year will be added to 
  8.9   the standards of assistance established in subdivisions 1 to 4 
  8.10  for individuals under the age of 65 who are relocating from an 
  8.11  institution and who are shelter needy.  An eligible individual 
  8.12  who receives this benefit prior to age 65 may continue to 
  8.13  receive the benefit after the age of 65. 
  8.14     "Shelter needy" means that the assistance unit incurs 
  8.15  monthly shelter costs that exceed 40 percent of the assistance 
  8.16  unit's gross income before the application of this special needs 
  8.17  standard.  "Gross income" for the purposes of this section is 
  8.18  the applicant's or recipient's income as defined in section 
  8.19  256D.35, subdivision 10, or the standard specified in 
  8.20  subdivision 3, whichever is greater.  A recipient of a federal 
  8.21  or state housing subsidy, that limits shelter costs to a 
  8.22  percentage of gross income, shall not be considered shelter 
  8.23  needy for purposes of this paragraph. 
  8.24     Sec. 5.  Minnesota Statutes 2002, section 256D.46, 
  8.25  subdivision 1, is amended to read: 
  8.26     Subdivision 1.  [ELIGIBILITY.] A county agency must grant 
  8.27  emergency Minnesota supplemental aid ~~must be granted~~, to the 
  8.28  extent funds are available, if the recipient is without adequate 
  8.29  resources to resolve an emergency that, if unresolved, will 
  8.30  threaten the health or safety of the recipient.  For the 
  8.31  purposes of this section, the term "recipient" includes persons 
  8.32  for whom a group residential housing benefit is being paid under 
  8.33  sections 256I.01 to 256I.06. 
  8.34     Sec. 6.  Minnesota Statutes 2002, section 256D.46, 
  8.35  subdivision 3, is amended to read: 
  8.36     Subd. 3.  [PAYMENT AMOUNT.] The amount of assistance 
  9.1   granted under emergency Minnesota supplemental aid is limited to 
  9.2   the amount necessary to resolve the emergency.  An emergency 
  9.3   Minnesota supplemental aid grant is available to a recipient no 
  9.4   more than once in any 12-month period.  Funding for emergency 
  9.5   Minnesota supplemental aid is limited to the appropriation.  
  9.6   Each fiscal year, the commissioner shall allocate to counties 
  9.7   the money appropriated for emergency Minnesota supplemental aid 
  9.8   grants based on each county agency's average share of state's 
  9.9   emergency Minnesota supplemental aid expenditures for the 
  9.10  immediate past three fiscal years as determined by the 
  9.11  commissioner, and may reallocate any unspent amounts to other 
  9.12  counties.  Any emergency Minnesota supplemental aid expenditures 
  9.13  by a county above the amount of the commissioner's allocation to 
  9.14  the county must be made from county funds. 
  9.15     Sec. 7.  Minnesota Statutes 2002, section 256D.48, 
  9.16  subdivision 1, is amended to read: 
  9.17     Subdivision 1.  [NEED FOR PROTECTIVE PAYEE.] The county 
  9.18  agency shall determine whether a recipient needs a protective 
  9.19  payee when a physical or mental condition renders the recipient 
  9.20  unable to manage funds and when payments to the recipient would 
  9.21  be contrary to the recipient's welfare.  Protective payments 
  9.22  must be issued when there is evidence of:  (1) repeated 
  9.23  inability to plan the use of income to meet necessary 
  9.24  expenditures; (2) repeated observation that the recipient is not 
  9.25  properly fed or clothed; (3) repeated failure to meet 
  9.26  obligations for rent, utilities, food, and other essentials; (4) 
  9.27  evictions or a repeated incurrence of debts; or (5) lost or 
  9.28  stolen checks~~; or (6) use of emergency Minnesota supplemental~~ 
  9.29  ~~aid more than twice in a calendar year~~.  The determination of 
  9.30  representative payment by the Social Security Administration for 
  9.31  the recipient is sufficient reason for protective payment of 
  9.32  Minnesota supplemental aid payments.  
  9.33     Sec. 8.  Minnesota Statutes 2002, section 256J.01, 
  9.34  subdivision 5, is amended to read: 
  9.35     Subd. 5.  [COMPLIANCE SYSTEM.] The commissioner shall 
  9.36  administer a compliance system for the state's temporary 
 10.1   assistance for needy families (TANF) program, the food stamp 
 10.2   program, ~~emergency assistance,~~ general assistance, medical 
 10.3   assistance, general assistance medical care, emergency general 
 10.4   assistance, Minnesota supplemental aid, preadmission screening, 
 10.5   child support program, and alternative care grants under the 
 10.6   powers and authorities named in section 256.01, subdivision 2.  
 10.7   The purpose of the compliance system is to permit the 
 10.8   commissioner to supervise the administration of public 
 10.9   assistance programs and to enforce timely and accurate 
 10.10  distribution of benefits, completeness of service and efficient 
 10.11  and effective program management and operations, to increase 
 10.12  uniformity and consistency in the administration and delivery of 
 10.13  public assistance programs throughout the state, and to reduce 
 10.14  the possibility of sanction and fiscal disallowances for 
 10.15  noncompliance with federal regulations and state statutes. 
 10.16     Sec. 9.  Minnesota Statutes 2002, section 256J.02, 
 10.17  subdivision 2, is amended to read: 
 10.18     Subd. 2.  [USE OF MONEY.] State money appropriated for 
 10.19  purposes of this section and TANF block grant money must be used 
 10.20  for: 
 10.21     (1) financial assistance to or on behalf of any minor child 
 10.22  who is a resident of this state under section 256J.12; 
 10.23     (2) ~~employment and training services under this chapter or~~ 
 10.24  ~~chapter 256K;~~ 
 10.25     ~~(3) emergency financial assistance and services under~~ 
 10.26  ~~section 256J.48;~~ 
 10.27     ~~(4) diversionary assistance under section 256J.47;~~ 
 10.28     ~~(5)~~ the health care and human services training and 
 10.29  retention program under chapter 116L, for costs associated with 
 10.30  families with children with incomes below 200 percent of the 
 10.31  federal poverty guidelines; 
 10.32     ~~(6)~~ (3) the pathways program under section 116L.04, 
 10.33  subdivision 1a; 
 10.34     ~~(7) welfare-to-work extended employment services for MFIP~~ 
 10.35  ~~participants with severe impairment to employment as defined in~~ 
 10.36  ~~section 268A.15, subdivision 1a;~~ 
 11.1      ~~(8) the family homeless prevention and assistance program~~ 
 11.2   ~~under section 462A.204;~~ 
 11.3      ~~(9) the rent assistance for family stabilization~~ 
 11.4   ~~demonstration project under section 462A.205;~~ 
 11.5      ~~(10)~~ (4) welfare to work transportation authorized under 
 11.6   Public Law ~~Number~~ 105-178; 
 11.7      ~~(11)~~ (5) reimbursements for the federal share of child 
 11.8   support collections passed through to the custodial parent; 
 11.9      ~~(12)~~ (6) reimbursements for the working family credit under 
 11.10  section 290.0671; 
 11.11     ~~(13) intensive ESL grants under Laws 2000, chapter 489,~~ 
 11.12  ~~article 1;~~ 
 11.13     ~~(14) transitional housing programs under section 119A.43;~~ 
 11.14     ~~(15) programs and pilot projects under chapter 256K; and~~ 
 11.15     ~~(16)~~ (7) program administration under this chapter; 
 11.16     (8) the diversionary work program under section 256J.95; 
 11.17     (9) the MFIP consolidated fund under section 256J.626; and 
 11.18     (10) the Minnesota department of health consolidated fund 
 11.19  under Laws 2001, First Special Session chapter 9, article 17, 
 11.20  section 3, subdivision 2. 
 11.21     Sec. 10.  Minnesota Statutes 2002, section 256J.021, is 
 11.22  amended to read: 
 11.23     256J.021 [SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.] 
 11.24     Beginning October 1, 2001, and each year thereafter, the 
 11.25  commissioner of human services must treat ~~financial assistance~~ 
 11.26  MFIP expenditures made to or on behalf of any minor child under 
 11.27  section 256J.02, subdivision 2, clause (1), who is a resident of 
 11.28  this state under section 256J.12, and who is part of a 
 11.29  two-parent eligible household as expenditures under a separately 
 11.30  funded state program and report those expenditures to the 
 11.31  federal Department of Health and Human Services as separate 
 11.32  state program expenditures under Code of Federal Regulations, 
 11.33  title 45, section 263.5. 
 11.34     Sec. 11.  Minnesota Statutes 2002, section 256J.08, is 
 11.35  amended by adding a subdivision to read: 
 11.36     Subd. 11a.  [CHILD ONLY CASE.] "Child only case" means a 
 12.1   case that would be part of the child only TANF program under 
 12.2   section 256J.88. 
 12.3      Sec. 12.  Minnesota Statutes 2002, section 256J.08, is 
 12.4   amended by adding a subdivision to read: 
 12.5      Subd. 24b.  [DIVERSIONARY WORK PROGRAM OR DWP.] 
 12.6   "Diversionary work program" or "DWP" has the meaning given in 
 12.7   section 256J.95. 
 12.8      Sec. 13.  Minnesota Statutes 2002, section 256J.08, is 
 12.9   amended by adding a subdivision to read: 
 12.10     Subd. 28b.  [EMPLOYABLE.] "Employable" means a person is 
 12.11  capable of performing existing positions in the local labor 
 12.12  market, regardless of the current availability of openings for 
 12.13  those positions. 
 12.14     Sec. 14.  Minnesota Statutes 2002, section 256J.08, is 
 12.15  amended by adding a subdivision to read: 
 12.16     Subd. 34a.  [FAMILY VIOLENCE.] (a) "Family violence" means 
 12.17  the following, if committed against a family or household member 
 12.18  by a family or household member: 
 12.19     (1) physical harm, bodily injury, or assault; 
 12.20     (2) the infliction of fear of imminent physical harm, 
 12.21  bodily injury, or assault; or 
 12.22     (3) terroristic threats, within the meaning of section 
 12.23  609.713, subdivision 1; criminal sexual conduct, within the 
 12.24  meaning of section 609.342, 609.343, 609.344, 609.345, or 
 12.25  609.3451; or interference with an emergency call within the 
 12.26  meaning of section 609.78, subdivision 2. 
 12.27     (b) For the purposes of family violence, "family or 
 12.28  household member" means:  
 12.29     (1) spouses and former spouses; 
 12.30     (2) parents and children; 
 12.31     (3) persons related by blood; 
 12.32     (4) persons who are residing together or who have resided 
 12.33  together in the past; 
 12.34     (5) persons who have a child in common regardless of 
 12.35  whether they have been married or have lived together at any 
 12.36  time; 
 13.1      (6) a man and woman if the woman is pregnant and the man is 
 13.2   alleged to be the father, regardless of whether they have been 
 13.3   married or have lived together at anytime; and 
 13.4      (7) persons involved in a current or past significant 
 13.5   romantic or sexual relationship. 
 13.6      Sec. 15.  Minnesota Statutes, section 256J.08, is amended 
 13.7   by adding a subdivision to read: 
 13.8      Subd. 34b.  [FAMILY VIOLENCE WAIVER.] "Family violence 
 13.9   waiver" means a waiver of the 60-month time limit for victims of 
 13.10  family violence who meet the criteria in section 256J.545 and 
 13.11  are complying with an employment plan in section 256J.521, 
 13.12  subdivision 3. 
 13.13     Sec. 16.  Minnesota Statutes 2002, section 256J.08, 
 13.14  subdivision 35, is amended to read: 
 13.15     Subd. 35.  [FAMILY WAGE LEVEL.] "Family wage level" means 
 13.16  110 percent of the transitional standard as specified in section 
 13.17  256J.24, subdivision 7. 
 13.18     Sec. 17.  Minnesota Statutes 2002, section 256J.08, is 
 13.19  amended by adding a subdivision to read: 
 13.20     Subd. 51b.  [LEARNING DISABLED.] "Learning disabled," for 
 13.21  purposes of an extension to the 60-month time limit under 
 13.22  section 256J.425, subdivision 3, clause (3), means the person 
 13.23  has a disorder in one or more of the psychological processes 
 13.24  involved in perceiving, understanding, or using concepts through 
 13.25  verbal language or nonverbal means.  Learning disabled does not 
 13.26  include learning problems that are primarily the result of 
 13.27  visual, hearing, or motor handicaps, mental retardation, 
 13.28  emotional disturbance, or due to environmental, cultural, or 
 13.29  economic disadvantage. 
 13.30     Sec. 18.  Minnesota Statutes 2002, section 256J.08, 
 13.31  subdivision 65, is amended to read: 
 13.32     Subd. 65.  [PARTICIPANT.] "Participant" means a person who 
 13.33  is currently receiving cash assistance or the food portion 
 13.34  available through MFIP ~~as funded by TANF and the food stamp~~ 
 13.35  ~~program~~.  A person who fails to withdraw or access 
 13.36  electronically any portion of the person's cash and food 
 14.1   assistance payment by the end of the payment month, who makes a 
 14.2   written request for closure before the first of a payment month 
 14.3   and repays cash and food assistance electronically issued for 
 14.4   that payment month within that payment month, or who returns any 
 14.5   uncashed assistance check and food coupons and withdraws from 
 14.6   the program is not a participant.  A person who withdraws a cash 
 14.7   or food assistance payment by electronic transfer or receives 
 14.8   and cashes an MFIP assistance check or food coupons and is 
 14.9   subsequently determined to be ineligible for assistance for that 
 14.10  period of time is a participant, regardless whether that 
 14.11  assistance is repaid.  The term "participant" includes the 
 14.12  caregiver relative and the minor child whose needs are included 
 14.13  in the assistance payment.  A person in an assistance unit who 
 14.14  does not receive a cash and food assistance payment because the 
 14.15  ~~person~~ case has been suspended from MFIP is a participant.  A 
 14.16  person who receives cash payments under the diversionary work 
 14.17  program under section 256J.95 is a participant. 
 14.18     Sec. 19.  Minnesota Statutes 2002, section 256J.08, is 
 14.19  amended by adding a subdivision to read: 
 14.20     Subd. 65a.  [PARTICIPATION REQUIREMENTS OF 
 14.21  TANF.] "Participation requirements of TANF" means activities and 
 14.22  hourly requirements allowed under title IV-A of the federal 
 14.23  Social Security Act. 
 14.24     Sec. 20.  Minnesota Statutes 2002, section 256J.08, is 
 14.25  amended by adding a subdivision to read: 
 14.26     Subd. 73a.  [QUALIFIED PROFESSIONAL.] (a) For physical 
 14.27  illness, injury, or incapacity, a "qualified professional" means 
 14.28  a licensed physician, a physician's assistant, a nurse 
 14.29  practitioner, or a licensed chiropractor. 
 14.30     (b) For mental retardation and intelligence testing, a 
 14.31  "qualified professional" means an individual qualified by 
 14.32  training and experience to administer the tests necessary to 
 14.33  make determinations, such as tests of intellectual functioning, 
 14.34  assessments of adaptive behavior, adaptive skills, and 
 14.35  developmental functioning.  These professionals include licensed 
 14.36  psychologists, certified school psychologists, or certified 
 15.1   psychometrists working under the supervision of a licensed 
 15.2   psychologist. 
 15.3      (c) For learning disabilities, a "qualified professional" 
 15.4   means a licensed psychologist or school psychologist with 
 15.5   experience determining learning disabilities.  
 15.6      (d) For mental health, a "qualified professional" means a 
 15.7   licensed physician or a qualified mental health professional.  A 
 15.8   "qualified mental health professional" means: 
 15.9      (1) for children, in psychiatric nursing, a registered 
 15.10  nurse who is licensed under sections 148.171 to 148.285, and who 
 15.11  is certified as a clinical specialist in child and adolescent 
 15.12  psychiatric or mental health nursing by a national nurse 
 15.13  certification organization or who has a master's degree in 
 15.14  nursing or one of the behavioral sciences or related fields from 
 15.15  an accredited college or university or its equivalent, with at 
 15.16  least 4,000 hours of post-master's supervised experience in the 
 15.17  delivery of clinical services in the treatment of mental 
 15.18  illness; 
 15.19     (2) for adults, in psychiatric nursing, a registered nurse 
 15.20  who is licensed under sections 148.171 to 148.285, and who is 
 15.21  certified as a clinical specialist in adult psychiatric and 
 15.22  mental health nursing by a national nurse certification 
 15.23  organization or who has a master's degree in nursing or one of 
 15.24  the behavioral sciences or related fields from an accredited 
 15.25  college or university or its equivalent, with at least 4,000 
 15.26  hours of post-master's supervised experience in the delivery of 
 15.27  clinical services in the treatment of mental illness; 
 15.28     (3) in clinical social work, a person licensed as an 
 15.29  independent clinical social worker under section 148B.21, 
 15.30  subdivision 6, or a person with a master's degree in social work 
 15.31  from an accredited college or university, with at least 4,000 
 15.32  hours of post-master's supervised experience in the delivery of 
 15.33  clinical services in the treatment of mental illness; 
 15.34     (4) in psychology, an individual licensed by the board of 
 15.35  psychology under sections 148.88 to 148.98, who has stated to 
 15.36  the board of psychology competencies in the diagnosis and 
 16.1   treatment of mental illness; 
 16.2      (5) in psychiatry, a physician licensed under chapter 147 
 16.3   and certified by the American Board of Psychiatry and Neurology 
 16.4   or eligible for board certification in psychiatry; and 
 16.5      (6) in marriage and family therapy, the mental health 
 16.6   professional must be a marriage and family therapist licensed 
 16.7   under sections 148B.29 to 148B.39, with at least two years of 
 16.8   post-master's supervised experience in the delivery of clinical 
 16.9   services in the treatment of mental illness. 
 16.10     Sec. 21.  Minnesota Statutes 2002, section 256J.08, 
 16.11  subdivision 82, is amended to read: 
 16.12     Subd. 82.  [SANCTION.] "Sanction" means the reduction of a 
 16.13  family's assistance payment by a specified percentage of the 
 16.14  MFIP standard of need because:  a nonexempt participant fails to 
 16.15  comply with the requirements of sections ~~256J.52~~ 256J.515 to 
 16.16  ~~256J.55~~ 256J.57; a parental caregiver fails without good cause 
 16.17  to cooperate with the child support enforcement requirements; or 
 16.18  a participant fails to comply with ~~the insurance, tort~~ 
 16.19  ~~liability, or~~ other requirements of this chapter. 
 16.20     Sec. 22.  Minnesota Statutes 2002, section 256J.08, is 
 16.21  amended by adding a subdivision to read: 
 16.22     Subd. 84a.  [SSI RECIPIENT.] "SSI recipient" means a person 
 16.23  who receives at least $1 in SSI benefits, or who is not 
 16.24  receiving an SSI benefit due to recoupment or a one month 
 16.25  suspension by the Social Security Administration due to excess 
 16.26  income. 
 16.27     Sec. 23.  Minnesota Statutes 2002, section 256J.08, 
 16.28  subdivision 85, is amended to read: 
 16.29     Subd. 85.  [TRANSITIONAL STANDARD.] "Transitional standard" 
 16.30  means the basic standard for a family ~~with no other income or a~~ 
 16.31  ~~nonworking family~~ without earned income and is a combination of 
 16.32  the cash ~~assistance needs~~ portion and food ~~assistance needs for~~ 
 16.33  ~~a family of that size~~ portion as specified in section 256J.24, 
 16.34  subdivision 5. 
 16.35     Sec. 24.  Minnesota Statutes 2002, section 256J.08, is 
 16.36  amended by adding a subdivision to read: 
 17.1      Subd. 90.  [SEVERE FORMS OF TRAFFICKING IN 
 17.2   PERSONS.] "Severe forms of trafficking in persons" means:  (1) 
 17.3   sex trafficking in which a commercial sex act is induced by 
 17.4   force, fraud, or coercion, or in which the person induced to 
 17.5   perform the act has not attained 18 years of age; or (2) the 
 17.6   recruitment, harboring, transportation, provision, or obtaining 
 17.7   of a person for labor or services through the use of force, 
 17.8   fraud, or coercion for the purposes of subjection to involuntary 
 17.9   servitude, peonage, debt bondage, or slavery. 
 17.10     Sec. 25.  Minnesota Statutes 2002, section 256J.09, 
 17.11  subdivision 2, is amended to read: 
 17.12     Subd. 2.  [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 
 17.13  INFORMATION.] When a person inquires about assistance, a county 
 17.14  agency must: 
 17.15     (1) explain the eligibility requirements of, and how to 
 17.16  apply for~~, diversionary assistance as provided in section~~ 
 17.17  ~~256J.47; emergency assistance as provided in section 256J.48;~~ 
 17.18  ~~MFIP as provided in section 256J.10; or~~ any ~~other~~ assistance for 
 17.19  which the person may be eligible; and 
 17.20     (2) offer the person brochures developed or approved by the 
 17.21  commissioner that describe how to apply for assistance. 
 17.22     Sec. 26.  Minnesota Statutes 2002, section 256J.09, 
 17.23  subdivision 3, is amended to read: 
 17.24     Subd. 3.  [SUBMITTING THE APPLICATION FORM.] (a) A county 
 17.25  agency must offer, in person or by mail, the application forms 
 17.26  prescribed by the commissioner as soon as a person makes a 
 17.27  written or oral inquiry.  At that time, the county agency must: 
 17.28     (1) inform the person that assistance begins with the date 
 17.29  the signed application is received by the county agency or the 
 17.30  date all eligibility criteria are met, whichever is later; 
 17.31     (2) inform the person that any delay in submitting the 
 17.32  application will reduce the amount of assistance paid for the 
 17.33  month of application; 
 17.34     (3) inform a person that the person may submit the 
 17.35  application before an interview; 
 17.36     (4) explain the information that will be verified during 
 18.1   the application process by the county agency as provided in 
 18.2   section 256J.32; 
 18.3      (5) inform a person about the county agency's average 
 18.4   application processing time and explain how the application will 
 18.5   be processed under subdivision 5; 
 18.6      (6) explain how to contact the county agency if a person's 
 18.7   application information changes and how to withdraw the 
 18.8   application; 
 18.9      (7) inform a person that the next step in the application 
 18.10  process is an interview and what a person must do if the 
 18.11  application is approved including, but not limited to, attending 
 18.12  orientation under section 256J.45 and complying with employment 
 18.13  and training services requirements in sections ~~256J.52~~ 256J.515 
 18.14  to ~~256J.55~~ 256J.57; 
 18.15     (8) explain the child care and transportation services that 
 18.16  are available under paragraph (c) to enable caregivers to attend 
 18.17  the interview, screening, and orientation; and 
 18.18     (9) identify any language barriers and arrange for 
 18.19  translation assistance during appointments, including, but not 
 18.20  limited to, screening under subdivision 3a, orientation under 
 18.21  section 256J.45, and ~~the initial~~ assessment under section 
 18.22  ~~256J.52~~ 256J.521.  
 18.23     (b) Upon receipt of a signed application, the county agency 
 18.24  must stamp the date of receipt on the face of the application.  
 18.25  The county agency must process the application within the time 
 18.26  period required under subdivision 5.  An applicant may withdraw 
 18.27  the application at any time by giving written or oral notice to 
 18.28  the county agency.  The county agency must issue a written 
 18.29  notice confirming the withdrawal.  The notice must inform the 
 18.30  applicant of the county agency's understanding that the 
 18.31  applicant has withdrawn the application and no longer wants to 
 18.32  pursue it.  When, within ten days of the date of the agency's 
 18.33  notice, an applicant informs a county agency, in writing, that 
 18.34  the applicant does not wish to withdraw the application, the 
 18.35  county agency must reinstate the application and finish 
 18.36  processing the application. 
 19.1      (c) Upon a participant's request, the county agency must 
 19.2   arrange for transportation and child care or reimburse the 
 19.3   participant for transportation and child care expenses necessary 
 19.4   to enable participants to attend the screening under subdivision 
 19.5   3a and orientation under section 256J.45.  
 19.6      Sec. 27.  Minnesota Statutes 2002, section 256J.09, 
 19.7   subdivision 3a, is amended to read: 
 19.8      Subd. 3a.  [SCREENING.] The county agency, or at county 
 19.9   option, the county's employment and training service provider as 
 19.10  defined in section 256J.49, must screen each applicant to 
 19.11  determine immediate needs and to determine if the applicant may 
 19.12  be eligible for~~:~~ 
 19.13     ~~(1)~~ another program that is not partially funded through 
 19.14  the federal temporary assistance to needy families block grant 
 19.15  under Title I of Public Law ~~Number~~ 104-193, including the 
 19.16  expedited issuance of food stamps under section 256J.28, 
 19.17  subdivision 1.  ~~If the applicant may be eligible for another~~ 
 19.18  ~~program, a county caseworker must provide the appropriate~~ 
 19.19  ~~referral to the program;~~ 
 19.20     ~~(2) the diversionary assistance program under section~~ 
 19.21  ~~256J.47; or~~ 
 19.22     ~~(3) the emergency assistance program under section~~ 
 19.23  ~~256J.48.~~  If the applicant appears eligible for another program, 
 19.24  including any program funded by the MFIP consolidated fund, the 
 19.25  county must make a referral to the appropriate program. 
 19.26     Sec. 28.  Minnesota Statutes 2002, section 256J.09, 
 19.27  subdivision 3b, is amended to read: 
 19.28     Subd. 3b.  [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 
 19.29  If the applicant is not diverted from applying for MFIP, and if 
 19.30  the applicant meets the MFIP eligibility requirements, then a 
 19.31  county agency must: 
 19.32     (1) identify an applicant who is under the age of 
 19.33  20 without a high school diploma or its equivalent and explain 
 19.34  to the applicant the assessment procedures and employment plan 
 19.35  requirements ~~for minor parents~~ under section 256J.54; 
 19.36     (2) explain to the applicant the eligibility criteria in 
 20.1   section 256J.545 for ~~an exemption under~~ the family violence 
 20.2   ~~provisions in section 256J.52, subdivision 6~~ waiver, and ~~explain~~ 
 20.3   what an applicant should do to develop an ~~alternative~~ employment 
 20.4   plan; 
 20.5      (3) determine if an applicant qualifies for an exemption 
 20.6   under section 256J.56 from employment and training services 
 20.7   requirements, explain how a person should report to the county 
 20.8   agency any status changes, and explain that an applicant who is 
 20.9   exempt may volunteer to participate in employment and training 
 20.10  services; 
 20.11     (4) for applicants who are not exempt from the requirement 
 20.12  to attend orientation, arrange for an orientation under section 
 20.13  256J.45 and an ~~initial~~ assessment under section ~~256J.52~~ 
 20.14  256J.521; 
 20.15     (5) inform an applicant who is not exempt from the 
 20.16  requirement to attend orientation that failure to attend the 
 20.17  orientation is considered an occurrence of noncompliance with 
 20.18  program requirements and will result in an imposition of a 
 20.19  sanction under section 256J.46; and 
 20.20     (6) explain how to contact the county agency if an 
 20.21  applicant has questions about compliance with program 
 20.22  requirements. 
 20.23     Sec. 29.  Minnesota Statutes 2002, section 256J.09, 
 20.24  subdivision 8, is amended to read: 
 20.25     Subd. 8.  [ADDITIONAL APPLICATIONS.] Until a county agency 
 20.26  issues notice of approval or denial, additional applications 
 20.27  submitted by an applicant are void.  However, an application for 
 20.28  monthly assistance or other benefits funded under section 
 20.29  256J.626 and an application for ~~emergency assistance or~~ 
 20.30  emergency general assistance may exist concurrently.  More than 
 20.31  one application for monthly assistance~~, emergency assistance,~~ or 
 20.32  emergency general assistance may exist concurrently when the 
 20.33  county agency decisions on one or more earlier applications have 
 20.34  been appealed to the commissioner, and the applicant asserts 
 20.35  that a change in circumstances has occurred that would allow 
 20.36  eligibility.  A county agency must require additional 
 21.1   application forms or supplemental forms as prescribed by the 
 21.2   commissioner when a payee's name changes, or when a caregiver 
 21.3   requests the addition of another person to the assistance unit.  
 21.4      Sec. 30.  Minnesota Statutes 2002, section 256J.09, 
 21.5   subdivision 10, is amended to read: 
 21.6      Subd. 10.  [APPLICANTS WHO DO NOT MEET ELIGIBILITY 
 21.7   REQUIREMENTS FOR MFIP OR THE DIVERSIONARY WORK PROGRAM.] When an 
 21.8   applicant is not eligible for MFIP or the diversionary work 
 21.9   program under section 256J.95 because the applicant does not 
 21.10  meet eligibility requirements, the county agency must determine 
 21.11  whether the applicant is eligible for food stamps~~, medical~~ 
 21.12  ~~assistance, diversionary assistance, or has a need for emergency~~ 
 21.13  ~~assistance when the applicant meets the eligibility requirements~~ 
 21.14  ~~for those programs~~ or health care programs.  The county must 
 21.15  also inform applicants about resources available through the 
 21.16  county or other agencies to meet short-term emergency needs. 
 21.17     Sec. 31.  Minnesota Statutes 2002, section 256J.14, is 
 21.18  amended to read: 
 21.19     256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 
 21.20     (a) The definitions in this paragraph only apply to this 
 21.21  subdivision. 
 21.22     (1) "Household of a parent, legal guardian, or other adult 
 21.23  relative" means the place of residence of: 
 21.24     (i) a natural or adoptive parent; 
 21.25     (ii) a legal guardian according to appointment or 
 21.26  acceptance under section 260C.325, 525.615, or 525.6165, and 
 21.27  related laws; 
 21.28     (iii) a caregiver as defined in section 256J.08, 
 21.29  subdivision 11; or 
 21.30     (iv) an appropriate adult relative designated by a county 
 21.31  agency. 
 21.32     (2) "Adult-supervised supportive living arrangement" means 
 21.33  a private family setting which assumes responsibility for the 
 21.34  care and control of the minor parent and minor child, or other 
 21.35  living arrangement, not including a public institution, licensed 
 21.36  by the commissioner of human services which ensures that the 
 22.1   minor parent receives adult supervision and supportive services, 
 22.2   such as counseling, guidance, independent living skills 
 22.3   training, or supervision. 
 22.4      (b) A minor parent and the minor child who is in the care 
 22.5   of the minor parent must reside in the household of a parent, 
 22.6   legal guardian, other adult relative, or in an adult-supervised 
 22.7   supportive living arrangement in order to receive MFIP unless: 
 22.8      (1) the minor parent has no living parent, other adult 
 22.9   relative, or legal guardian whose whereabouts is known; 
 22.10     (2) no living parent, other adult relative, or legal 
 22.11  guardian of the minor parent allows the minor parent to live in 
 22.12  the parent's, other adult relative's, or legal guardian's home; 
 22.13     (3) the minor parent lived apart from the minor parent's 
 22.14  own parent or legal guardian for a period of at least one year 
 22.15  before either the birth of the minor child or the minor parent's 
 22.16  application for MFIP; 
 22.17     (4) the physical or emotional health or safety of the minor 
 22.18  parent or minor child would be jeopardized if the minor parent 
 22.19  and the minor child resided in the same residence with the minor 
 22.20  parent's parent, other adult relative, or legal guardian; or 
 22.21     (5) an adult supervised supportive living arrangement is 
 22.22  not available for the minor parent and child in the county in 
 22.23  which the minor parent and child currently reside.  If an adult 
 22.24  supervised supportive living arrangement becomes available 
 22.25  within the county, the minor parent and child must reside in 
 22.26  that arrangement. 
 22.27     (c) The county agency shall inform minor applicants both 
 22.28  orally and in writing about the eligibility requirements, their 
 22.29  rights and obligations under the MFIP program, and any other 
 22.30  applicable orientation information.  The county must advise the 
 22.31  minor of the possible exemptions under section 256J.54, 
 22.32  subdivision 5, and specifically ask whether one or more of these 
 22.33  exemptions is applicable.  If the minor alleges one or more of 
 22.34  these exemptions, then the county must assist the minor in 
 22.35  obtaining the necessary verifications to determine whether or 
 22.36  not these exemptions apply. 
 23.1      (d) If the county worker has reason to suspect that the 
 23.2   physical or emotional health or safety of the minor parent or 
 23.3   minor child would be jeopardized if they resided with the minor 
 23.4   parent's parent, other adult relative, or legal guardian, then 
 23.5   the county worker must make a referral to child protective 
 23.6   services to determine if paragraph (b), clause (4), applies.  A 
 23.7   new determination by the county worker is not necessary if one 
 23.8   has been made within the last six months, unless there has been 
 23.9   a significant change in circumstances which justifies a new 
 23.10  referral and determination. 
 23.11     (e) If a minor parent is not living with a parent, legal 
 23.12  guardian, or other adult relative due to paragraph (b), clause 
 23.13  (1), (2), or (4), the minor parent must reside, when possible, 
 23.14  in a living arrangement that meets the standards of paragraph 
 23.15  (a), clause (2). 
 23.16     (f) Regardless of living arrangement, MFIP must be paid, 
 23.17  when possible, in the form of a protective payment on behalf of 
 23.18  the minor parent and minor child according to section 256J.39, 
 23.19  subdivisions 2 to 4. 
 23.20     Sec. 32.  Minnesota Statutes 2002, section 256J.20, 
 23.21  subdivision 3, is amended to read: 
 23.22     Subd. 3.  [OTHER PROPERTY LIMITATIONS.] To be eligible for 
 23.23  MFIP, the equity value of all nonexcluded real and personal 
 23.24  property of the assistance unit must not exceed $2,000 for 
 23.25  applicants and $5,000 for ongoing participants.  The value of 
 23.26  assets in clauses (1) to (19) must be excluded when determining 
 23.27  the equity value of real and personal property: 
 23.28     (1) a licensed vehicle up to a loan value of less than or 
 23.29  equal to $7,500.  The county agency shall apply any excess loan 
 23.30  value as if it were equity value to the asset limit described in 
 23.31  this section.  If the assistance unit owns more than one 
 23.32  licensed vehicle, the county agency shall determine the vehicle 
 23.33  with the highest loan value and count only the loan value over 
 23.34  $7,500, excluding:  (i) the value of one vehicle per physically 
 23.35  disabled person when the vehicle is needed to transport the 
 23.36  disabled unit member; this exclusion does not apply to mentally 
 24.1   disabled people; (ii) the value of special equipment for a 
 24.2   handicapped member of the assistance unit; and (iii) any vehicle 
 24.3   used for long-distance travel, other than daily commuting, for 
 24.4   the employment of a unit member. 
 24.5      The county agency shall count the loan value of all other 
 24.6   vehicles and apply this amount as if it were equity value to the 
 24.7   asset limit described in this section.  To establish the loan 
 24.8   value of vehicles, a county agency must use the N.A.D.A. 
 24.9   Official Used Car Guide, Midwest Edition, for newer model cars.  
 24.10  When a vehicle is not listed in the guidebook, or when the 
 24.11  applicant or participant disputes the loan value listed in the 
 24.12  guidebook as unreasonable given the condition of the particular 
 24.13  vehicle, the county agency may require the applicant or 
 24.14  participant document the loan value by securing a written 
 24.15  statement from a motor vehicle dealer licensed under section 
 24.16  168.27, stating the amount that the dealer would pay to purchase 
 24.17  the vehicle.  The county agency shall reimburse the applicant or 
 24.18  participant for the cost of a written statement that documents a 
 24.19  lower loan value; 
 24.20     (2) the value of life insurance policies for members of the 
 24.21  assistance unit; 
 24.22     (3) one burial plot per member of an assistance unit; 
 24.23     (4) the value of personal property needed to produce earned 
 24.24  income, including tools, implements, farm animals, inventory, 
 24.25  business loans, business checking and savings accounts used at 
 24.26  least annually and used exclusively for the operation of a 
 24.27  self-employment business, and any motor vehicles if at least 50 
 24.28  percent of the vehicle's use is to produce income and if the 
 24.29  vehicles are essential for the self-employment business; 
 24.30     (5) the value of personal property not otherwise specified 
 24.31  which is commonly used by household members in day-to-day living 
 24.32  such as clothing, necessary household furniture, equipment, and 
 24.33  other basic maintenance items essential for daily living; 
 24.34     (6) the value of real and personal property owned by a 
 24.35  recipient of Supplemental Security Income or Minnesota 
 24.36  supplemental aid; 
 25.1      (7) the value of corrective payments, but only for the 
 25.2   month in which the payment is received and for the following 
 25.3   month; 
 25.4      (8) a mobile home or other vehicle used by an applicant or 
 25.5   participant as the applicant's or participant's home; 
 25.6      (9) money in a separate escrow account that is needed to 
 25.7   pay real estate taxes or insurance and that is used for this 
 25.8   purpose; 
 25.9      (10) money held in escrow to cover employee FICA, employee 
 25.10  tax withholding, sales tax withholding, employee worker 
 25.11  compensation, business insurance, property rental, property 
 25.12  taxes, and other costs that are paid at least annually, but less 
 25.13  often than monthly; 
 25.14     (11) monthly assistance~~, emergency assistance, and~~ 
 25.15  ~~diversionary~~ payments for the current month's ~~needs~~ or 
 25.16  short-term emergency needs under section 256J.626, subdivision 
 25.17  2; 
 25.18     (12) the value of school loans, grants, or scholarships for 
 25.19  the period they are intended to cover; 
 25.20     (13) payments listed in section 256J.21, subdivision 2, 
 25.21  clause (9), which are held in escrow for a period not to exceed 
 25.22  three months to replace or repair personal or real property; 
 25.23     (14) income received in a budget month through the end of 
 25.24  the payment month; 
 25.25     (15) savings from earned income of a minor child or a minor 
 25.26  parent that are set aside in a separate account designated 
 25.27  specifically for future education or employment costs; 
 25.28     (16) the federal earned income credit, Minnesota working 
 25.29  family credit, state and federal income tax refunds, state 
 25.30  homeowners and renters credits under chapter 290A, property tax 
 25.31  rebates and other federal or state tax rebates in the month 
 25.32  received and the following month; 
 25.33     (17) payments excluded under federal law as long as those 
 25.34  payments are held in a separate account from any nonexcluded 
 25.35  funds; 
 25.36     (18) the assets of children ineligible to receive MFIP 
 26.1   benefits because foster care or adoption assistance payments are 
 26.2   made on their behalf; and 
 26.3      (19) the assets of persons whose income is excluded under 
 26.4   section 256J.21, subdivision 2, clause (43). 
 26.5      Sec. 33.  Minnesota Statutes 2002, section 256J.21, 
 26.6   subdivision 1, is amended to read: 
 26.7      Subdivision 1.  [INCOME INCLUSIONS.] To determine MFIP 
 26.8   eligibility, the county agency must evaluate income received by 
 26.9   members of an assistance unit, or by other persons whose income 
 26.10  is considered available to the assistance unit, and only count 
 26.11  income that is available to the member of the assistance unit.  
 26.12  Income is available if the individual has legal access to the 
 26.13  income.  All payments, unless specifically excluded in 
 26.14  subdivision 2, must be counted as income.  The county agency 
 26.15  shall verify the income of all MFIP recipients and applicants. 
 26.16     Sec. 34.  Minnesota Statutes 2002, section 256J.21, 
 26.17  subdivision 2, is amended to read: 
 26.18     Subd. 2.  [INCOME EXCLUSIONS.] The following must be 
 26.19  excluded in determining a family's available income: 
 26.20     (1) payments for basic care, difficulty of care, and 
 26.21  clothing allowances received for providing family foster care to 
 26.22  children or adults under Minnesota Rules, parts 9545.0010 to 
 26.23  9545.0260 and 9555.5050 to 9555.6265, and payments received and 
 26.24  used for care and maintenance of a third-party beneficiary who 
 26.25  is not a household member; 
 26.26     (2) reimbursements for employment training received through 
 26.27  the ~~Job Training Partnership~~ Workforce Investment Act 1998, 
 26.28  United States Code, title ~~29~~ 20, chapter ~~19~~ 73, ~~sections 1501~~ 
 26.29  ~~to 1792b~~ section 9201; 
 26.30     (3) reimbursement for out-of-pocket expenses incurred while 
 26.31  performing volunteer services, jury duty, employment, or 
 26.32  informal carpooling arrangements directly related to employment; 
 26.33     (4) all educational assistance, except the county agency 
 26.34  must count graduate student teaching assistantships, 
 26.35  fellowships, and other similar paid work as earned income and, 
 26.36  after allowing deductions for any unmet and necessary 
 27.1   educational expenses, shall count scholarships or grants awarded 
 27.2   to graduate students that do not require teaching or research as 
 27.3   unearned income; 
 27.4      (5) loans, regardless of purpose, from public or private 
 27.5   lending institutions, governmental lending institutions, or 
 27.6   governmental agencies; 
 27.7      (6) loans from private individuals, regardless of purpose, 
 27.8   provided an applicant or participant documents that the lender 
 27.9   expects repayment; 
 27.10     (7)(i) state income tax refunds; and 
 27.11     (ii) federal income tax refunds; 
 27.12     (8)(i) federal earned income credits; 
 27.13     (ii) Minnesota working family credits; 
 27.14     (iii) state homeowners and renters credits under chapter 
 27.15  290A; and 
 27.16     (iv) federal or state tax rebates; 
 27.17     (9) funds received for reimbursement, replacement, or 
 27.18  rebate of personal or real property when these payments are made 
 27.19  by public agencies, awarded by a court, solicited through public 
 27.20  appeal, or made as a grant by a federal agency, state or local 
 27.21  government, or disaster assistance organizations, subsequent to 
 27.22  a presidential declaration of disaster; 
 27.23     (10) the portion of an insurance settlement that is used to 
 27.24  pay medical, funeral, and burial expenses, or to repair or 
 27.25  replace insured property; 
 27.26     (11) reimbursements for medical expenses that cannot be 
 27.27  paid by medical assistance; 
 27.28     (12) payments by a vocational rehabilitation program 
 27.29  administered by the state under chapter 268A, except those 
 27.30  payments that are for current living expenses; 
 27.31     (13) in-kind income, including any payments directly made 
 27.32  by a third party to a provider of goods and services; 
 27.33     (14) assistance payments to correct underpayments, but only 
 27.34  for the month in which the payment is received; 
 27.35     (15) ~~emergency assistance~~ payments for short-term emergency 
 27.36  needs under section 256J.626, subdivision 2; 
 28.1      (16) funeral and cemetery payments as provided by section 
 28.2   256.935; 
 28.3      (17) nonrecurring cash gifts of $30 or less, not exceeding 
 28.4   $30 per participant in a calendar month; 
 28.5      (18) any form of energy assistance payment made through 
 28.6   Public Law ~~Number~~ 97-35, Low-Income Home Energy Assistance Act 
 28.7   of 1981, payments made directly to energy providers by other 
 28.8   public and private agencies, and any form of credit or rebate 
 28.9   payment issued by energy providers; 
 28.10     (19) Supplemental Security Income (SSI), including 
 28.11  retroactive SSI payments and other income of an SSI recipient, 
 28.12  except as described in section 256J.37, subdivision 3b; 
 28.13     (20) Minnesota supplemental aid, including retroactive 
 28.14  payments; 
 28.15     (21) proceeds from the sale of real or personal property; 
 28.16     (22) adoption assistance payments under section 259.67; 
 28.17     (23) state-funded family subsidy program payments made 
 28.18  under section 252.32 to help families care for children with 
 28.19  mental retardation or related conditions, consumer support grant 
 28.20  funds under section 256.476, and resources and services for a 
 28.21  disabled household member under one of the home and 
 28.22  community-based waiver services programs under chapter 256B; 
 28.23     (24) interest payments and dividends from property that is 
 28.24  not excluded from and that does not exceed the asset limit; 
 28.25     (25) rent rebates; 
 28.26     (26) income earned by a minor caregiver, minor child 
 28.27  through age 6, or a minor child who is at least a half-time 
 28.28  student in an approved elementary or secondary education 
 28.29  program; 
 28.30     (27) income earned by a caregiver under age 20 who is at 
 28.31  least a half-time student in an approved elementary or secondary 
 28.32  education program; 
 28.33     (28) MFIP child care payments under section 119B.05; 
 28.34     (29) all other payments made through MFIP to support a 
 28.35  caregiver's pursuit of greater ~~self-support~~ economic stability; 
 28.36     (30) income a participant receives related to shared living 
 29.1   expenses; 
 29.2      (31) reverse mortgages; 
 29.3      (32) benefits provided by the Child Nutrition Act of 1966, 
 29.4   United States Code, title 42, chapter 13A, sections 1771 to 
 29.5   1790; 
 29.6      (33) benefits provided by the women, infants, and children 
 29.7   (WIC) nutrition program, United States Code, title 42, chapter 
 29.8   13A, section 1786; 
 29.9      (34) benefits from the National School Lunch Act, United 
 29.10  States Code, title 42, chapter 13, sections 1751 to 1769e; 
 29.11     (35) relocation assistance for displaced persons under the 
 29.12  Uniform Relocation Assistance and Real Property Acquisition 
 29.13  Policies Act of 1970, United States Code, title 42, chapter 61, 
 29.14  subchapter II, section 4636, or the National Housing Act, United 
 29.15  States Code, title 12, chapter 13, sections 1701 to 1750jj; 
 29.16     (36) benefits from the Trade Act of 1974, United States 
 29.17  Code, title 19, chapter 12, part 2, sections 2271 to 2322; 
 29.18     (37) war reparations payments to Japanese Americans and 
 29.19  Aleuts under United States Code, title 50, sections 1989 to 
 29.20  1989d; 
 29.21     (38) payments to veterans or their dependents as a result 
 29.22  of legal settlements regarding Agent Orange or other chemical 
 29.23  exposure under Public Law ~~Number~~ 101-239, section 10405, 
 29.24  paragraph (a)(2)(E); 
 29.25     (39) income that is otherwise specifically excluded from 
 29.26  MFIP consideration in federal law, state law, or federal 
 29.27  regulation; 
 29.28     (40) security and utility deposit refunds; 
 29.29     (41) American Indian tribal land settlements excluded under 
 29.30  Public ~~Law Numbers~~ Laws 98-123, 98-124, and 99-377 to the 
 29.31  Mississippi Band Chippewa Indians of White Earth, Leech Lake, 
 29.32  and Mille Lacs reservations and payments to members of the White 
 29.33  Earth Band, under United States Code, title 25, chapter 9, 
 29.34  section 331, and chapter 16, section 1407; 
 29.35     (42) all income of the minor parent's parents and 
 29.36  stepparents when determining the grant for the minor parent in 
 30.1   households that include a minor parent living with parents or 
 30.2   stepparents on MFIP with other children; 
 30.3      (43) income of the minor parent's parents and stepparents 
 30.4   equal to 200 percent of the federal poverty guideline for a 
 30.5   family size not including the minor parent and the minor 
 30.6   parent's child in households that include a minor parent living 
 30.7   with parents or stepparents not on MFIP when determining the 
 30.8   grant for the minor parent.  The remainder of income is deemed 
 30.9   as specified in section 256J.37, subdivision 1b; 
 30.10     (44) payments made to children eligible for relative 
 30.11  custody assistance under section 257.85; 
 30.12     (45) vendor payments for goods and services made on behalf 
 30.13  of a client unless the client has the option of receiving the 
 30.14  payment in cash; and 
 30.15     (46) the principal portion of a contract for deed payment. 
 30.16     Sec. 35.  Minnesota Statutes 2002, section 256J.24, 
 30.17  subdivision 3, is amended to read: 
 30.18     Subd. 3.  [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 
 30.19  ASSISTANCE UNIT.] (a) The following individuals who are part of 
 30.20  the assistance unit determined under subdivision 2 are 
 30.21  ineligible to receive MFIP: 
 30.22     (1) individuals ~~receiving~~ who are recipients of 
 30.23  Supplemental Security Income or Minnesota supplemental aid; 
 30.24     (2) individuals disqualified from the food stamp program or 
 30.25  MFIP, until the disqualification ends; 
 30.26     (3) children on whose behalf federal, state or local foster 
 30.27  care payments are made, except as provided in sections 256J.13, 
 30.28  subdivision 2, and 256J.74, subdivision 2; and 
 30.29     (4) children receiving ongoing monthly adoption assistance 
 30.30  payments under section 259.67.  
 30.31     (b) The exclusion of a person under this subdivision does 
 30.32  not alter the mandatory assistance unit composition. 
 30.33     Sec. 36.  Minnesota Statutes 2002, section 256J.24, 
 30.34  subdivision 5, is amended to read: 
 30.35     Subd. 5.  [MFIP TRANSITIONAL STANDARD.] The ~~following table~~ 
 30.36  ~~represents the~~ MFIP transitional standard ~~table when all members~~ 
 31.1   ~~of~~ is based on the number of persons in the assistance unit ~~are~~ 
 31.2   eligible for both food and cash assistance unless the 
 31.3   restrictions in subdivision 6 on the birth of a child apply.  
 31.4   The following table represents the transitional standards 
 31.5   effective October 1, 2002. 
 31.6       Number of       Transitional         Cash       Food
 31.7    Eligible People     Standard           Portion    Portion
 31.8         1                ~~$351~~   $370:      $250       $120
 31.9         2                ~~$609~~   $658:      $437       $221
 31.10        3                ~~$763~~   $844:      $532       $312
 31.11        4                ~~$903~~   $998:      $621       $377
 31.12        5              ~~$1,025~~ $1,135:      $697       $438
 31.13        6              ~~$1,165~~ $1,296:      $773       $523
 31.14        7              ~~$1,273~~ $1,414:      $850       $564
 31.15        8              ~~$1,403~~ $1,558:      $916       $642
 31.16        9              ~~$1,530~~ $1,700:      $980       $720
 31.17       10              ~~$1,653~~ $1,836:    $1,035       $801
 31.18  over 10            add ~~$121~~   $136:       $53        $83
 31.19  per additional member.
 31.20     The commissioner shall annually publish in the State 
 31.21  Register the transitional standard for an assistance unit sizes 
 31.22  1 to 10 including a breakdown of the cash and food portions. 
 31.23     Sec. 37.  Minnesota Statutes 2002, section 256J.24, 
 31.24  subdivision 6, is amended to read: 
 31.25     Subd. 6.  [~~APPLICATION OF ASSISTANCE STANDARDS~~ FAMILY CAP.] 
 31.26  ~~The standards apply to the number of eligible persons in the~~ 
 31.27  ~~assistance unit.~~  (a) MFIP assistance units shall not receive an 
 31.28  increase in the cash portion of the transitional standard as a 
 31.29  result of the birth of a child, unless one of the conditions 
 31.30  under paragraph (b) is met.  The child shall be considered a 
 31.31  member of the assistance unit according to subdivisions 1 to 3, 
 31.32  but shall be excluded in determining family size for purposes of 
 31.33  determining the amount of the cash portion of the transitional 
 31.34  standard under subdivision 5.  The child shall be included in 
 31.35  determining family size for purposes of determining the food 
 31.36  portion of the transitional standard.  The transitional standard 
 32.1   under this subdivision shall be the total of the cash and food 
 32.2   portions as specified in this paragraph.  The family wage level 
 32.3   under this subdivision shall be based on the family size used to 
 32.4   determine the food portion of the transitional standard. 
 32.5      (b) A child shall be included in determining family size 
 32.6   for purposes of determining the amount of the cash portion of 
 32.7   the MFIP transitional standard when at least one of the 
 32.8   following conditions is met: 
 32.9      (1) for families receiving MFIP assistance on July 1, 2003, 
 32.10  the child is born to the adult parent before May 1, 2004; 
 32.11     (2) for families who apply for the diversionary work 
 32.12  program under section 256J.95 or MFIP assistance on or after 
 32.13  July 1, 2003, the child is born to the adult parent within ten 
 32.14  months of the date the family is eligible for assistance; 
 32.15     (3) the child was conceived as a result of a sexual assault 
 32.16  or incest, provided that the incident has been reported to a law 
 32.17  enforcement agency; 
 32.18     (4) the child's mother is a minor caregiver as defined in 
 32.19  section 256J.08, subdivision 59, and the child, or multiple 
 32.20  children, are the mother's first birth; or 
 32.21     (5) any child previously excluded in determining family 
 32.22  size under paragraph (a) shall be included if the adult parent 
 32.23  or parents have not received benefits from the diversionary work 
 32.24  program under section 256J.95 or MFIP assistance in the previous 
 32.25  ten months.  An adult parent or parents who reapply and have 
 32.26  received benefits from the diversionary work program or MFIP 
 32.27  assistance in the past ten months shall be under the ten-month 
 32.28  grace period of their previous application under clause (2). 
 32.29     (c) Income and resources of a child excluded under this 
 32.30  subdivision, except child support received or distributed on 
 32.31  behalf of this child, must be considered using the same policies 
 32.32  as for other children when determining the grant amount of the 
 32.33  assistance unit. 
 32.34     (d) The caregiver must assign support and cooperate with 
 32.35  the child support enforcement agency to establish paternity and 
 32.36  collect child support on behalf of the excluded child.  Failure 
 33.1   to cooperate results in the sanction specified in section 
 33.2   256J.46, subdivisions 2 and 2a.  Current support paid on behalf 
 33.3   of the excluded child shall be distributed according to section 
 33.4   256.741, subdivision 15. 
 33.5      (e) County agencies must inform applicants of the 
 33.6   provisions under this subdivision at the time of each 
 33.7   application and at recertification.  
 33.8      (f) Children excluded under this provision shall be deemed 
 33.9   MFIP recipients for purposes of child care under chapter 119B. 
 33.10     Sec. 38.  Minnesota Statutes 2002, section 256J.24, 
 33.11  subdivision 7, is amended to read: 
 33.12     Subd. 7.  [FAMILY WAGE LEVEL ~~STANDARD~~.] The family wage 
 33.13  level ~~standard~~ is 110 percent of the transitional standard under 
 33.14  subdivision 5 or 6, when applicable, and is the standard used 
 33.15  when there is earned income in the assistance unit.  As 
 33.16  specified in section 256J.21, earned income is subtracted from 
 33.17  the family wage level to determine the amount of the assistance 
 33.18  payment.  ~~Not including~~ The ~~family wage level standard,~~ 
 33.19  assistance ~~payments~~ payment may not exceed the ~~MFIP standard of~~ 
 33.20  ~~need~~ transitional standard under subdivision 5 or 6, or the 
 33.21  shared household standard under subdivision 9, whichever is 
 33.22  applicable, for the assistance unit. 
 33.23     Sec. 39.  Minnesota Statutes 2002, section 256J.24, 
 33.24  subdivision 10, is amended to read: 
 33.25     Subd. 10.  [MFIP EXIT LEVEL.] The commissioner shall adjust 
 33.26  the MFIP earned income disregard to ensure that most 
 33.27  participants do not lose eligibility for MFIP until their income 
 33.28  reaches at least ~~120~~ 115 percent of the federal poverty 
 33.29  guidelines in effect in October of each fiscal year.  The 
 33.30  adjustment to the disregard shall be based on a household size 
 33.31  of three, and the resulting earned income disregard percentage 
 33.32  must be applied to all household sizes.  The adjustment under 
 33.33  this subdivision must be implemented at the same time as the 
 33.34  October food stamp cost-of-living adjustment is reflected in the 
 33.35  food portion of MFIP transitional standard as required under 
 33.36  subdivision 5a. 
 34.1      Sec. 40.  Minnesota Statutes 2002, section 256J.30, 
 34.2   subdivision 9, is amended to read: 
 34.3      Subd. 9.  [CHANGES THAT MUST BE REPORTED.] A caregiver must 
 34.4   report the changes or anticipated changes specified in clauses 
 34.5   (1) to ~~(17)~~ (16) within ten days of the date they occur, at the 
 34.6   time of the periodic recertification of eligibility under 
 34.7   section 256J.32, subdivision 6, or within eight calendar days of 
 34.8   a reporting period as in subdivision 5 or 6, whichever occurs 
 34.9   first.  A caregiver must report other changes at the time of the 
 34.10  periodic recertification of eligibility under section 256J.32, 
 34.11  subdivision 6, or at the end of a reporting period under 
 34.12  subdivision 5 or 6, as applicable.  A caregiver must make these 
 34.13  reports in writing to the county agency.  When a county agency 
 34.14  could have reduced or terminated assistance for one or more 
 34.15  payment months if a delay in reporting a change specified under 
 34.16  clauses (1) to ~~(16)~~ (15) had not occurred, the county agency 
 34.17  must determine whether a timely notice under section 256J.31, 
 34.18  subdivision 4, could have been issued on the day that the change 
 34.19  occurred.  When a timely notice could have been issued, each 
 34.20  month's overpayment subsequent to that notice must be considered 
 34.21  a client error overpayment under section 256J.38.  Calculation 
 34.22  of overpayments for late reporting under clause ~~(17)~~ (16) is 
 34.23  specified in section 256J.09, subdivision 9.  Changes in 
 34.24  circumstances which must be reported within ten days must also 
 34.25  be reported on the MFIP household report form for the reporting 
 34.26  period in which those changes occurred.  Within ten days, a 
 34.27  caregiver must report: 
 34.28     (1) a change in initial employment; 
 34.29     (2) a change in initial receipt of unearned income; 
 34.30     (3) a recurring change in unearned income; 
 34.31     (4) a nonrecurring change of unearned income that exceeds 
 34.32  $30; 
 34.33     (5) the receipt of a lump sum; 
 34.34     (6) an increase in assets that may cause the assistance 
 34.35  unit to exceed asset limits; 
 34.36     (7) a change in the physical or mental status of an 
 35.1   incapacitated member of the assistance unit if the physical or 
 35.2   mental status is the basis of exemption from an MFIP employment 
 35.3   services program under section 256J.56, or as the basis for 
 35.4   reducing the hourly participation requirements under section 
 35.5   256J.55, subdivision 1, or the type of activities included in an 
 35.6   employment plan under section 256J.521, subdivision 2; 
 35.7      (8) a change in employment status; 
 35.8      (9) information affecting an exception under section 
 35.9   256J.24, subdivision 9; 
 35.10     (10) ~~a change in health insurance coverage;~~ 
 35.11     ~~(11)~~ the marriage or divorce of an assistance unit member; 
 35.12     ~~(12)~~ (11) the death of a parent, minor child, or 
 35.13  financially responsible person; 
 35.14     ~~(13)~~ (12) a change in address or living quarters of the 
 35.15  assistance unit; 
 35.16     ~~(14)~~ (13) the sale, purchase, or other transfer of 
 35.17  property; 
 35.18     ~~(15)~~ (14) a change in school attendance of a ~~custodial~~ 
 35.19  ~~parent~~ caregiver under age 20 or an employed child; 
 35.20     ~~(16)~~ (15) filing a lawsuit, a workers' compensation claim, 
 35.21  or a monetary claim against a third party; and 
 35.22     ~~(17)~~ (16) a change in household composition, including 
 35.23  births, returns to and departures from the home of assistance 
 35.24  unit members and financially responsible persons, or a change in 
 35.25  the custody of a minor child. 
 35.26     Sec. 41.  Minnesota Statutes 2002, section 256J.32, 
 35.27  subdivision 2, is amended to read: 
 35.28     Subd. 2.  [DOCUMENTATION.] The applicant or participant 
 35.29  must document the information required under subdivisions 4 to 6 
 35.30  or authorize the county agency to verify the information.  The 
 35.31  applicant or participant has the burden of providing documentary 
 35.32  evidence to verify eligibility.  The county agency shall assist 
 35.33  the applicant or participant in obtaining required documents 
 35.34  when the applicant or participant is unable to do so.  ~~When an~~ 
 35.35  ~~applicant or participant and the county agency are unable to~~ 
 35.36  ~~obtain documents needed to verify information, the county agency~~ 
 36.1   ~~may accept an affidavit from an applicant or participant as~~ 
 36.2   ~~sufficient documentation.~~  The county agency may accept an 
 36.3   affidavit only for factors specified under subdivision 8.  
 36.4      Sec. 42.  Minnesota Statutes 2002, section 256J.32, 
 36.5   subdivision 4, is amended to read: 
 36.6      Subd. 4.  [FACTORS TO BE VERIFIED.] The county agency shall 
 36.7   verify the following at application: 
 36.8      (1) identity of adults; 
 36.9      (2) presence of the minor child in the home, if 
 36.10  questionable; 
 36.11     (3) relationship of a minor child to caregivers in the 
 36.12  assistance unit; 
 36.13     (4) age, if necessary to determine MFIP eligibility; 
 36.14     (5) immigration status; 
 36.15     (6) social security number according to the requirements of 
 36.16  section 256J.30, subdivision 12; 
 36.17     (7) income; 
 36.18     (8) self-employment expenses used as a deduction; 
 36.19     (9) source and purpose of deposits and withdrawals from 
 36.20  business accounts; 
 36.21     (10) spousal support and child support payments made to 
 36.22  persons outside the household; 
 36.23     (11) real property; 
 36.24     (12) vehicles; 
 36.25     (13) checking and savings accounts; 
 36.26     (14) savings certificates, savings bonds, stocks, and 
 36.27  individual retirement accounts; 
 36.28     (15) pregnancy, if related to eligibility; 
 36.29     (16) inconsistent information, if related to eligibility; 
 36.30     (17) ~~medical insurance;~~ 
 36.31     ~~(18)~~ burial accounts; 
 36.32     ~~(19)~~ (18) school attendance, if related to eligibility; 
 36.33     ~~(20)~~ (19) residence; 
 36.34     ~~(21)~~ (20) a claim of family violence if used as a basis ~~for~~ 
 36.35  ~~a~~ to qualify for the family violence waiver ~~from the 60-month~~ 
 36.36  ~~time limit in section 256J.42 and regular employment and~~ 
 37.1   ~~training services requirements in section 256J.56~~; 
 37.2      ~~(22)~~ (21) disability if used as the basis for an exemption 
 37.3   from employment and training services requirements under section 
 37.4   256J.56 or as the basis for reducing the hourly participation 
 37.5   requirements under section 256J.55, subdivision 1, or the type 
 37.6   of activity included in an employment plan under section 
 37.7   256J.521, subdivision 2; and 
 37.8      ~~(23)~~ (22) information needed to establish an exception 
 37.9   under section 256J.24, subdivision 9. 
 37.10     Sec. 43.  Minnesota Statutes 2002, section 256J.32, 
 37.11  subdivision 5a, is amended to read: 
 37.12     Subd. 5a.  [INCONSISTENT INFORMATION.] When the county 
 37.13  agency verifies inconsistent information under subdivision 4, 
 37.14  clause (16), or 6, clause ~~(4)~~ (5), the reason for verifying the 
 37.15  information must be documented in the financial case record. 
 37.16     Sec. 44.  Minnesota Statutes 2002, section 256J.32, is 
 37.17  amended by adding a subdivision to read: 
 37.18     Subd. 8.  [AFFIDAVIT.] The county agency may accept an 
 37.19  affidavit from the applicant or recipient as sufficient 
 37.20  documentation at the time of application or recertification only 
 37.21  for the following factors: 
 37.22     (1) a claim of family violence if used as a basis to 
 37.23  qualify for the family violence waiver; 
 37.24     (2) information needed to establish an exception under 
 37.25  section 256J.24, subdivision 9; 
 37.26     (3) relationship of a minor child to caregivers in the 
 37.27  assistance unit; and 
 37.28     (4) citizenship status from a noncitizen who reports to be, 
 37.29  or is identified as, a victim of severe forms of trafficking in 
 37.30  persons, if the noncitizen reports that the noncitizen's 
 37.31  immigration documents are being held by an individual or group 
 37.32  of individuals against the noncitizen's will.  The noncitizen 
 37.33  must follow up with the Office of Refugee Resettlement (ORR) to 
 37.34  pursue certification.  If verification that certification is 
 37.35  being pursued is not received within 30 days, the MFIP case must 
 37.36  be closed and the agency shall pursue overpayments.  The ORR 
 38.1   documents certifying the noncitizen's status as a victim of 
 38.2   severe forms of trafficking in persons, or the reason for the 
 38.3   delay in processing, must be received within 90 days, or the 
 38.4   MFIP case must be closed and the agency shall pursue 
 38.5   overpayments. 
 38.6      Sec. 45.  Minnesota Statutes 2002, section 256J.37, is 
 38.7   amended by adding a subdivision to read: 
 38.8      Subd. 3a.  [RENTAL SUBSIDIES; UNEARNED INCOME.] (a) 
 38.9   Effective July 1, 2003, the county agency shall count $50 of the 
 38.10  value of public and assisted rental subsidies provided through 
 38.11  the Department of Housing and Urban Development (HUD) as 
 38.12  unearned income to the cash portion of the MFIP grant.  The full 
 38.13  amount of the subsidy must be counted as unearned income when 
 38.14  the subsidy is less than $50.  The income from this subsidy 
 38.15  shall be budgeted according to section 256J.34. 
 38.16     (b) The provisions of this subdivision shall not apply to 
 38.17  an MFIP assistance unit which includes a participant who is: 
 38.18     (1) age 60 or older; 
 38.19     (2) a caregiver who is suffering from an illness, injury, 
 38.20  or incapacity that has been certified by a qualified 
 38.21  professional when the illness, injury, or incapacity is expected 
 38.22  to continue for more than 30 days and prevents the person from 
 38.23  obtaining or retaining employment; or 
 38.24     (3) a caregiver whose presence in the home is required due 
 38.25  to the illness or incapacity of another member in the assistance 
 38.26  unit, a relative in the household, or a foster child in the 
 38.27  household when the illness or incapacity and the need for the 
 38.28  participant's presence in the home has been certified by a 
 38.29  qualified professional and is expected to continue for more than 
 38.30  30 days. 
 38.31     (c) The provisions of this subdivision shall not apply to 
 38.32  an MFIP assistance unit where the parental caregiver is an SSI 
 38.33  recipient. 
 38.34     (d) Prior to implementing this provision, the commissioner 
 38.35  must identify the MFIP participants subject to this provision 
 38.36  and provide written notice to these participants at least 30 
 39.1   days before the first grant reduction.  The notice must inform 
 39.2   the participant of the basis for the potential grant reduction, 
 39.3   the exceptions to the provision, if any, and inform the 
 39.4   participant of the steps necessary to claim an exception.  A 
 39.5   person who is found not to meet one of the exceptions to the 
 39.6   provision must be notified and informed of the right to a fair 
 39.7   hearing under section 256J.40.  The notice must also inform the 
 39.8   participant that the participant may be eligible for a rent 
 39.9   reduction resulting from a reduction in the MFIP grant, and 
 39.10  encourage the participant to contact the local housing authority.
 39.11     Sec. 46.  Minnesota Statutes 2002, section 256J.37, is 
 39.12  amended by adding a subdivision to read: 
 39.13     Subd. 3b.  [TREATMENT OF SUPPLEMENTAL SECURITY 
 39.14  INCOME.] Effective July 1, 2003, the county shall reduce the 
 39.15  cash portion of the MFIP grant by $125 per SSI recipient who 
 39.16  resides in the household, and who would otherwise be included in 
 39.17  the MFIP assistance unit under section 256J.24, subdivision 2, 
 39.18  but is excluded solely due to the SSI recipient status under 
 39.19  section 256J.24, subdivision 3, paragraph (a), clause (1).  If 
 39.20  the SSI recipient receives less than $125 of SSI, only the 
 39.21  amount received shall be used in calculating the MFIP cash 
 39.22  assistance payment.  This provision does not apply to relative 
 39.23  caregivers who could elect to be included in the MFIP assistance 
 39.24  unit under section 256J.24, subdivision 4, unless the 
 39.25  caregiver's children or stepchildren are included in the MFIP 
 39.26  assistance unit. 
 39.27     Sec. 47.  Minnesota Statutes 2002, section 256J.37, 
 39.28  subdivision 9, is amended to read: 
 39.29     Subd. 9.  [UNEARNED INCOME.] ~~(a)~~ The county agency must 
 39.30  apply unearned income to the MFIP standard of need.  When 
 39.31  determining the amount of unearned income, the county agency 
 39.32  must deduct the costs necessary to secure payments of unearned 
 39.33  income.  These costs include legal fees, medical fees, and 
 39.34  mandatory deductions such as federal and state income taxes. 
 39.35     ~~(b) Effective July 1, 2003, the county agency shall count~~ 
 39.36  ~~$100 of the value of public and assisted rental subsidies~~ 
 40.1   ~~provided through the Department of Housing and Urban Development~~ 
 40.2   ~~(HUD) as unearned income.  The full amount of the subsidy must~~ 
 40.3   ~~be counted as unearned income when the subsidy is less than $100.~~
 40.4      ~~(c) The provisions of paragraph (b) shall not apply to MFIP~~ 
 40.5   ~~participants who are exempt from the employment and training~~ 
 40.6   ~~services component because they are:~~ 
 40.7      ~~(i) individuals who are age 60 or older;~~ 
 40.8      ~~(ii) individuals who are suffering from a professionally~~ 
 40.9   ~~certified permanent or temporary illness, injury, or incapacity~~ 
 40.10  ~~which is expected to continue for more than 30 days and which~~ 
 40.11  ~~prevents the person from obtaining or retaining employment; or~~ 
 40.12     ~~(iii) caregivers whose presence in the home is required~~ 
 40.13  ~~because of the professionally certified illness or incapacity of~~ 
 40.14  ~~another member in the assistance unit, a relative in the~~ 
 40.15  ~~household, or a foster child in the household.~~ 
 40.16     ~~(d) The provisions of paragraph (b) shall not apply to an~~ 
 40.17  ~~MFIP assistance unit where the parental caregiver receives~~ 
 40.18  ~~supplemental security income.~~ 
 40.19     Sec. 48.  Minnesota Statutes 2002, section 256J.38, 
 40.20  subdivision 3, is amended to read: 
 40.21     Subd. 3.  [RECOVERING OVERPAYMENTS ~~FROM FORMER~~ 
 40.22  ~~PARTICIPANTS~~.] A county agency must initiate efforts to recover 
 40.23  overpayments paid to a former participant or caregiver.  ~~Adults~~ 
 40.24  Caregivers, both parental and nonparental, and minor caregivers 
 40.25  of an assistance unit at the time an overpayment occurs, whether 
 40.26  receiving assistance or not, are jointly and individually liable 
 40.27  for repayment of the overpayment.  The county agency must 
 40.28  request repayment from the former participants and caregivers.  
 40.29  When an agreement for repayment is not completed within six 
 40.30  months of the date of discovery or when there is a default on an 
 40.31  agreement for repayment after six months, the county agency must 
 40.32  initiate recovery consistent with chapter 270A, or section 
 40.33  541.05.  When a person has been convicted of fraud under section 
 40.34  256.98, recovery must be sought regardless of the amount of 
 40.35  overpayment.  When an overpayment is less than $35, and is not 
 40.36  the result of a fraud conviction under section 256.98, the 
 41.1   county agency must not seek recovery under this subdivision.  
 41.2   The county agency must retain information about all overpayments 
 41.3   regardless of the amount.  When an adult, adult caregiver, or 
 41.4   minor caregiver reapplies for assistance, the overpayment must 
 41.5   be recouped under subdivision 4. 
 41.6      Sec. 49.  Minnesota Statutes 2002, section 256J.38, 
 41.7   subdivision 4, is amended to read: 
 41.8      Subd. 4.  [RECOUPING OVERPAYMENTS FROM PARTICIPANTS.] A 
 41.9   participant may voluntarily repay, in part or in full, an 
 41.10  overpayment even if assistance is reduced under this 
 41.11  subdivision, until the total amount of the overpayment is 
 41.12  repaid.  When an overpayment occurs due to fraud, the county 
 41.13  agency must recover from the overpaid assistance unit, including 
 41.14  child only cases, ten percent of the applicable standard or the 
 41.15  amount of the monthly assistance payment, whichever is less.  
 41.16  When a nonfraud overpayment occurs, the county agency must 
 41.17  recover from the overpaid assistance unit, including child only 
 41.18  cases, three percent of the MFIP standard of need or the amount 
 41.19  of the monthly assistance payment, whichever is less.  
 41.20     Sec. 50.  Minnesota Statutes 2002, section 256J.40, is 
 41.21  amended to read: 
 41.22     256J.40 [FAIR HEARINGS.] 
 41.23     Caregivers receiving a notice of intent to sanction or a 
 41.24  notice of adverse action that includes a sanction, reduction in 
 41.25  benefits, suspension of benefits, denial of benefits, or 
 41.26  termination of benefits may request a fair hearing.  A request 
 41.27  for a fair hearing must be submitted in writing to the county 
 41.28  agency or to the commissioner and must be mailed within 30 days 
 41.29  after a participant or former participant receives written 
 41.30  notice of the agency's action or within 90 days when a 
 41.31  participant or former participant shows good cause for not 
 41.32  submitting the request within 30 days.  A former participant who 
 41.33  receives a notice of adverse action due to an overpayment may 
 41.34  appeal the adverse action according to the requirements in this 
 41.35  section.  Issues that may be appealed are: 
 41.36     (1) the amount of the assistance payment; 
 42.1      (2) a suspension, reduction, denial, or termination of 
 42.2   assistance; 
 42.3      (3) the basis for an overpayment, the calculated amount of 
 42.4   an overpayment, and the level of recoupment; 
 42.5      (4) the eligibility for an assistance payment; and 
 42.6      (5) the use of protective or vendor payments under section 
 42.7   256J.39, subdivision 2, clauses (1) to (3). 
 42.8      Except for benefits issued under section 256J.95, a county 
 42.9   agency must not reduce, suspend, or terminate payment when an 
 42.10  aggrieved participant requests a fair hearing prior to the 
 42.11  effective date of the adverse action or within ten days of the 
 42.12  mailing of the notice of adverse action, whichever is later, 
 42.13  unless the participant requests in writing not to receive 
 42.14  continued assistance pending a hearing decision.  An appeal 
 42.15  request cannot extend benefits for the diversionary work program 
 42.16  under section 256J.95 beyond the four-month time limit.  
 42.17  Assistance issued pending a fair hearing is subject to recovery 
 42.18  under section 256J.38 when as a result of the fair hearing 
 42.19  decision the participant is determined ineligible for assistance 
 42.20  or the amount of the assistance received.  A county agency may 
 42.21  increase or reduce an assistance payment while an appeal is 
 42.22  pending when the circumstances of the participant change and are 
 42.23  not related to the issue on appeal.  The commissioner's order is 
 42.24  binding on a county agency.  No additional notice is required to 
 42.25  enforce the commissioner's order. 
 42.26     A county agency shall reimburse appellants for reasonable 
 42.27  and necessary expenses of attendance at the hearing, such as 
 42.28  child care and transportation costs and for the transportation 
 42.29  expenses of the appellant's witnesses and representatives to and 
 42.30  from the hearing.  Reasonable and necessary expenses do not 
 42.31  include legal fees.  Fair hearings must be conducted at a 
 42.32  reasonable time and date by an impartial referee employed by the 
 42.33  department.  The hearing may be conducted by telephone or at a 
 42.34  site that is readily accessible to persons with disabilities. 
 42.35     The appellant may introduce new or additional evidence 
 42.36  relevant to the issues on appeal.  Recommendations of the 
 43.1   appeals referee and decisions of the commissioner must be based 
 43.2   on evidence in the hearing record and are not limited to a 
 43.3   review of the county agency action. 
 43.4      Sec. 51.  Minnesota Statutes 2002, section 256J.42, 
 43.5   subdivision 4, is amended to read: 
 43.6      Subd. 4.  [VICTIMS OF FAMILY VIOLENCE.] Any cash assistance 
 43.7   received by an assistance unit in a month when a caregiver 
 43.8   complied with a safety plan, an alternative employment plan, or 
 43.9   an employment plan ~~or after October 1, 2001, complied or is~~ 
 43.10  ~~complying with an alternative employment plan~~ under section 
 43.11  ~~256J.49~~ 256J.521, subdivision ~~1a~~ 3, does not count toward the 
 43.12  60-month limitation on assistance. 
 43.13     Sec. 52.  Minnesota Statutes 2002, section 256J.42, 
 43.14  subdivision 5, is amended to read: 
 43.15     Subd. 5.  [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 
 43.16  assistance received by an assistance unit does not count toward 
 43.17  the 60-month limit on assistance during a month in which the 
 43.18  caregiver is ~~in the category in~~ age 60 or older, including 
 43.19  months during which the caregiver was exempt under section 
 43.20  256J.56, paragraph (a), clause (1). 
 43.21     (b) From July 1, 1997, until the date MFIP is operative in 
 43.22  the caregiver's county of financial responsibility, any cash 
 43.23  assistance received by a caregiver who is complying with 
 43.24  Minnesota Statutes 1996, section 256.73, subdivision 5a, and 
 43.25  Minnesota Statutes 1998, section 256.736, if applicable, does 
 43.26  not count toward the 60-month limit on assistance.  Thereafter, 
 43.27  any cash assistance received by a minor caregiver who is 
 43.28  complying with the requirements of sections 256J.14 and 256J.54, 
 43.29  if applicable, does not count towards the 60-month limit on 
 43.30  assistance. 
 43.31     (c) Any diversionary assistance or emergency assistance 
 43.32  received prior to July 1, 2003, does not count toward the 
 43.33  60-month limit. 
 43.34     (d) Any cash assistance received by an 18- or 19-year-old 
 43.35  caregiver who is complying with ~~the requirements of~~ an 
 43.36  employment plan that includes an education option under section 
 44.1   256J.54 does not count toward the 60-month limit. 
 44.2      (e) Payments provided to meet short-term emergency needs 
 44.3   under section 256J.626 and diversionary work program benefits 
 44.4   provided under section 256J.95 do not count toward the 60-month 
 44.5   time limit. 
 44.6      Sec. 53.  Minnesota Statutes 2002, section 256J.42, 
 44.7   subdivision 6, is amended to read: 
 44.8      Subd. 6.  [CASE REVIEW.] (a) Within 180 days, but not less 
 44.9   than 60 days, before the end of the participant's 60th month on 
 44.10  assistance, the county agency or job counselor must review the 
 44.11  participant's case to determine if the employment plan is still 
 44.12  appropriate or if the participant is exempt under section 
 44.13  256J.56 from the employment and training services component, and 
 44.14  attempt to meet with the participant face-to-face. 
 44.15     (b) During the face-to-face meeting, a county agency or the 
 44.16  job counselor must: 
 44.17     (1) inform the participant how many months of counted 
 44.18  assistance the participant has accrued and when the participant 
 44.19  is expected to reach the 60th month; 
 44.20     (2) explain the hardship extension criteria under section 
 44.21  256J.425 and what the participant should do if the participant 
 44.22  thinks a hardship extension applies; 
 44.23     (3) identify other resources that may be available to the 
 44.24  participant to meet the needs of the family; and 
 44.25     (4) inform the participant of the right to appeal the case 
 44.26  closure under section 256J.40. 
 44.27     (c) If a face-to-face meeting is not possible, the county 
 44.28  agency must send the participant a notice of adverse action as 
 44.29  provided in section 256J.31, subdivisions 4 and 5. 
 44.30     (d) Before a participant's case is closed under this 
 44.31  section, the county must ensure that: 
 44.32     (1) the case has been reviewed by the job counselor's 
 44.33  supervisor or the review team designated ~~in~~ by the ~~county's~~ 
 44.34  ~~approved local service unit plan~~ county to determine if the 
 44.35  criteria for a hardship extension, if requested, were applied 
 44.36  appropriately; and 
 45.1      (2) the county agency or the job counselor attempted to 
 45.2   meet with the participant face-to-face. 
 45.3      Sec. 54.  Minnesota Statutes 2002, section 256J.425, 
 45.4   subdivision 1, is amended to read: 
 45.5      Subdivision 1.  [ELIGIBILITY.] (a) To be eligible for a 
 45.6   hardship extension, a participant in an assistance unit subject 
 45.7   to the time limit under section 256J.42, subdivision 1, ~~in which~~ 
 45.8   ~~any participant has received 60 counted months of assistance,~~ 
 45.9   must be in compliance in the participant's 60th counted month 
 45.10  ~~the participant is applying for the extension~~.  For purposes of 
 45.11  determining eligibility for a hardship extension, a participant 
 45.12  is in compliance in any month that the participant has not been 
 45.13  sanctioned. 
 45.14     (b) If one participant in a two-parent assistance unit is 
 45.15  determined to be ineligible for a hardship extension, the county 
 45.16  shall give the assistance unit the option of disqualifying the 
 45.17  ineligible participant from MFIP.  In that case, the assistance 
 45.18  unit shall be treated as a one-parent assistance unit and the 
 45.19  assistance unit's MFIP grant shall be calculated using the 
 45.20  shared household standard under section 256J.08, subdivision 82a.
 45.21     Sec. 55.  Minnesota Statutes 2002, section 256J.425, 
 45.22  subdivision 1a, is amended to read: 
 45.23     Subd. 1a.  [REVIEW.] If a county grants a hardship 
 45.24  extension under this section, a county agency shall review the 
 45.25  case every six or 12 months, whichever is appropriate based on 
 45.26  the participant's circumstances and the extension 
 45.27  category.  More frequent reviews shall be required if 
 45.28  eligibility for an extension is based on a condition that is 
 45.29  subject to change in less than six months. 
 45.30     Sec. 56.  Minnesota Statutes 2002, section 256J.425, 
 45.31  subdivision 2, is amended to read: 
 45.32     Subd. 2.  [ILL OR INCAPACITATED.] (a) An assistance unit 
 45.33  subject to the time limit in section 256J.42, subdivision 1, ~~in~~ 
 45.34  ~~which any participant has received 60 counted months of~~ 
 45.35  ~~assistance,~~ is eligible to receive months of assistance under a 
 45.36  hardship extension if the participant who reached the time limit 
 46.1   belongs to any of the following groups: 
 46.2      (1) participants who are suffering from ~~a professionally~~ 
 46.3   ~~certified~~ an illness, injury, or incapacity which has been 
 46.4   certified by a qualified professional when the illness, injury, 
 46.5   or incapacity is expected to continue for more than 30 days 
 46.6   and ~~which~~ prevents the person from obtaining or retaining 
 46.7   employment ~~and who are following~~.  These participants must 
 46.8   follow the treatment recommendations of the ~~health care provider~~ 
 46.9   qualified professional certifying the illness, injury, or 
 46.10  incapacity; 
 46.11     (2) participants whose presence in the home is required as 
 46.12  a caregiver because of ~~a professionally certified~~ the illness, 
 46.13  injury, or incapacity of another member in the assistance unit, 
 46.14  a relative in the household, or a foster child in the 
 46.15  household ~~and~~ when the illness or incapacity and the need for a 
 46.16  person to provide assistance in the home has been certified by a 
 46.17  qualified professional and is expected to continue for more than 
 46.18  30 days; or 
 46.19     (3) caregivers with a child or an adult in the household 
 46.20  who meets the disability or medical criteria for home care 
 46.21  services under section 256B.0627, subdivision 1, paragraph 
 46.22  ~~(c)~~ (f), or a home and community-based waiver services program 
 46.23  under chapter 256B, or meets the criteria for severe emotional 
 46.24  disturbance under section 245.4871, subdivision 6, or for 
 46.25  serious and persistent mental illness under section 245.462, 
 46.26  subdivision 20, paragraph (c).  Caregivers in this category are 
 46.27  presumed to be prevented from obtaining or retaining employment. 
 46.28     (b) An assistance unit receiving assistance under a 
 46.29  hardship extension under this subdivision may continue to 
 46.30  receive assistance as long as the participant meets the criteria 
 46.31  in paragraph (a), clause (1), (2), or (3). 
 46.32     Sec. 57.  Minnesota Statutes 2002, section 256J.425, 
 46.33  subdivision 3, is amended to read: 
 46.34     Subd. 3.  [HARD-TO-EMPLOY PARTICIPANTS.] An assistance unit 
 46.35  subject to the time limit in section 256J.42, subdivision 1, ~~in~~ 
 46.36  ~~which any participant has received 60 counted months of~~ 
 47.1   ~~assistance,~~ is eligible to receive months of assistance under a 
 47.2   hardship extension if the participant who reached the time limit 
 47.3   belongs to any of the following groups: 
 47.4      (1) a person who is diagnosed by a licensed physician, 
 47.5   psychological practitioner, or other qualified professional, as 
 47.6   mentally retarded or mentally ill, and that condition prevents 
 47.7   the person from obtaining or retaining unsubsidized employment; 
 47.8      (2) a person who: 
 47.9      (i) has been assessed by a vocational specialist or the 
 47.10  county agency to be unemployable for purposes of this 
 47.11  subdivision; or 
 47.12     (ii) has an IQ below 80 who has been assessed by a 
 47.13  vocational specialist or a county agency to be employable, but 
 47.14  not at a level that makes the participant eligible for an 
 47.15  extension under subdivision 4 ~~or,~~.  The determination of IQ 
 47.16  level must be made by a qualified professional.  In the case of 
 47.17  a non-English-speaking person ~~for whom it is not possible to~~ 
 47.18  ~~provide a determination due to language barriers or absence of~~ 
 47.19  ~~culturally appropriate assessment tools, is determined by a~~ 
 47.20  ~~qualified professional to have an IQ below 80.  A person is~~ 
 47.21  ~~considered employable if positions of employment in the local~~ 
 47.22  ~~labor market exist, regardless of the current availability of~~ 
 47.23  ~~openings for those positions, that the person is capable of~~ 
 47.24  ~~performing~~:  (A) the determination must be made by a qualified 
 47.25  professional with experience conducting culturally appropriate 
 47.26  assessments, whenever possible; (B) the county may accept 
 47.27  reports that identify an IQ range as opposed to a specific 
 47.28  score; (C) these reports must include a statement of confidence 
 47.29  in the results; 
 47.30     (3) a person who is determined by ~~the county agency~~ a 
 47.31  qualified professional to be learning disabled ~~or~~, and the 
 47.32  disability severely limits the person's ability to obtain, 
 47.33  perform, or maintain suitable employment.  For purposes of the 
 47.34  initial approval of a learning disability extension, the 
 47.35  determination must have been made or confirmed within the 
 47.36  previous 12 months.  In the case of a non-English-speaking 
 48.1   person ~~for whom it is not possible to provide a medical~~ 
 48.2   ~~diagnosis due to language barriers or absence of culturally~~ 
 48.3   ~~appropriate assessment tools, is determined by a qualified~~ 
 48.4   ~~professional to have a learning disability.  If a rehabilitation~~ 
 48.5   ~~plan for the person is developed or approved by the county~~ 
 48.6   ~~agency, the plan must be incorporated into the employment plan.~~  
 48.7   ~~However, a rehabilitation plan does not replace the requirement~~ 
 48.8   ~~to develop and comply with an employment plan under section~~ 
 48.9   ~~256J.52.  For purposes of this section, "learning disabled"~~ 
 48.10  ~~means the applicant or recipient has a disorder in one or more~~ 
 48.11  ~~of the psychological processes involved in perceiving,~~ 
 48.12  ~~understanding, or using concepts through verbal language or~~ 
 48.13  ~~nonverbal means.  The disability must severely limit the~~ 
 48.14  ~~applicant or recipient in obtaining, performing, or maintaining~~ 
 48.15  ~~suitable employment.  Learning disabled does not include~~ 
 48.16  ~~learning problems that are primarily the result of visual,~~ 
 48.17  ~~hearing, or motor handicaps; mental retardation; emotional~~ 
 48.18  ~~disturbance; or due to environmental, cultural, or economic~~ 
 48.19  ~~disadvantage~~:  (i) the determination must be made by a qualified 
 48.20  professional with experience conducting culturally appropriate 
 48.21  assessments, whenever possible; and (ii) these reports must 
 48.22  include a statement of confidence in the results.  If a 
 48.23  rehabilitation plan for a participant extended as learning 
 48.24  disabled is developed or approved by the county agency, the plan 
 48.25  must be incorporated into the employment plan.  However, a 
 48.26  rehabilitation plan does not replace the requirement to develop 
 48.27  and comply with an employment plan under section 256J.521; or 
 48.28     (4) a person who ~~is a victim of~~ has been granted a family 
 48.29  violence ~~as defined in section 256J.49, subdivision 2~~ waiver, 
 48.30  and who is ~~participating in~~ complying with an ~~alternative~~ 
 48.31  employment plan under section ~~256J.49~~ 256J.521, subdivision ~~1a~~ 
 48.32  3.  
 48.33     Sec. 58.  Minnesota Statutes 2002, section 256J.425, 
 48.34  subdivision 4, is amended to read: 
 48.35     Subd. 4.  [EMPLOYED PARTICIPANTS.] (a) An assistance unit 
 48.36  subject to the time limit under section 256J.42, subdivision 1, 
 49.1   ~~in which any participant has received 60 months of assistance,~~ 
 49.2   is eligible to receive assistance under a hardship extension if 
 49.3   the participant who reached the time limit belongs to: 
 49.4      (1) a one-parent assistance unit in which the participant 
 49.5   is participating in work activities for at least 30 hours per 
 49.6   week, of which an average of at least 25 hours per week every 
 49.7   month are spent participating in employment; 
 49.8      (2) a two-parent assistance unit in which the participants 
 49.9   are participating in work activities for at least 55 hours per 
 49.10  week, of which an average of at least 45 hours per week every 
 49.11  month are spent participating in employment; or 
 49.12     (3) an assistance unit in which a participant is 
 49.13  participating in employment for fewer hours than those specified 
 49.14  in clause (1), and the participant submits verification from a 
 49.15  ~~health care provider~~ qualified professional, in a form 
 49.16  acceptable to the commissioner, stating that the number of hours 
 49.17  the participant may work is limited due to illness or 
 49.18  disability, as long as the participant is participating in 
 49.19  employment for at least the number of hours specified by 
 49.20  the ~~health care provider~~ qualified professional.  The 
 49.21  participant must be following the treatment recommendations of 
 49.22  the ~~health care provider~~ qualified professional providing the 
 49.23  verification.  The commissioner shall develop a form to be 
 49.24  completed and signed by the ~~health care provider~~ qualified 
 49.25  professional, documenting the diagnosis and any additional 
 49.26  information necessary to document the functional limitations of 
 49.27  the participant that limit work hours.  If the participant is 
 49.28  part of a two-parent assistance unit, the other parent must be 
 49.29  treated as a one-parent assistance unit for purposes of meeting 
 49.30  the work requirements under this subdivision. 
 49.31     (b) For purposes of this section, employment means: 
 49.32     (1) unsubsidized employment under section 256J.49, 
 49.33  subdivision 13, clause (1); 
 49.34     (2) subsidized employment under section 256J.49, 
 49.35  subdivision 13, clause (2); 
 49.36     (3) on-the-job training under section 256J.49, subdivision 
 50.1   13, clause ~~(4)~~ (2); 
 50.2      (4) an apprenticeship under section 256J.49, subdivision 
 50.3   13, clause ~~(19)~~ (1); 
 50.4      (5) supported work~~.  For purposes of this section,~~ 
 50.5   ~~"supported work" means services supporting a participant on the~~ 
 50.6   ~~job which include, but are not limited to, supervision, job~~ 
 50.7   ~~coaching, and subsidized wages~~ under section 256J.49, 
 50.8   subdivision 13, clause (2); 
 50.9      (6) a combination of clauses (1) to (5); or 
 50.10     (7) child care under section 256J.49, subdivision 13, 
 50.11  clause ~~(25)~~ (7), if it is in combination with paid employment. 
 50.12     (c) If a participant is complying with a child protection 
 50.13  plan under chapter 260C, the number of hours required under the 
 50.14  child protection plan count toward the number of hours required 
 50.15  under this subdivision.  
 50.16     (d) The county shall provide the opportunity for subsidized 
 50.17  employment to participants needing that type of employment 
 50.18  within available appropriations. 
 50.19     (e) To be eligible for a hardship extension for employed 
 50.20  participants under this subdivision, a participant ~~in a~~ 
 50.21  ~~one-parent assistance unit or both parents in a two-parent~~ 
 50.22  ~~assistance unit~~ must be in compliance for at least ten out of 
 50.23  the 12 months immediately preceding the participant's 61st month 
 50.24  on assistance.  ~~If only one parent in a two-parent assistance~~ 
 50.25  ~~unit fails to be in compliance ten out of the 12 months~~ 
 50.26  ~~immediately preceding the participant's 61st month, the county~~ 
 50.27  ~~shall give the assistance unit the option of disqualifying the~~ 
 50.28  ~~noncompliant parent.  If the noncompliant participant is~~ 
 50.29  ~~disqualified, the assistance unit must be treated as a~~ 
 50.30  ~~one-parent assistance unit for the purposes of meeting the work~~ 
 50.31  ~~requirements under this subdivision and the assistance unit's~~ 
 50.32  ~~MFIP grant shall be calculated using the shared household~~ 
 50.33  ~~standard under section 256J.08, subdivision 82a.~~ 
 50.34     (f) The employment plan developed under section ~~256J.52~~ 
 50.35  256J.521, subdivision ~~5~~ 2, for participants under this 
 50.36  subdivision must contain the number of hours specified in 
 51.1   paragraph (a) related to employment and work activities.  The 
 51.2   job counselor and the participant must sign the employment plan 
 51.3   to indicate agreement between the job counselor and the 
 51.4   participant on the contents of the plan. 
 51.5      (g) Participants who fail to meet the requirements in 
 51.6   paragraph (a), without good cause under section 256J.57, shall 
 51.7   be sanctioned or permanently disqualified under subdivision 6.  
 51.8   Good cause may only be granted for that portion of the month for 
 51.9   which the good cause reason applies.  Participants must meet all 
 51.10  remaining requirements in the approved employment plan or be 
 51.11  subject to sanction or permanent disqualification.  
 51.12     (h) If the noncompliance with an employment plan is due to 
 51.13  the involuntary loss of employment, the participant is exempt 
 51.14  from the hourly employment requirement under this subdivision 
 51.15  for one month.  Participants must meet all remaining 
 51.16  requirements in the approved employment plan or be subject to 
 51.17  sanction or permanent disqualification.  This exemption is 
 51.18  available to ~~one-parent assistance units~~ a participant two times 
 51.19  in a 12-month period~~, and two-parent assistance units, two times~~ 
 51.20  ~~per parent in a 12-month period~~. 
 51.21     ~~(i) This subdivision expires on June 30, 2004.~~ 
 51.22     Sec. 59.  Minnesota Statutes 2002, section 256J.425, 
 51.23  subdivision 6, is amended to read: 
 51.24     Subd. 6.  [SANCTIONS FOR EXTENDED CASES.] (a) If one or 
 51.25  both participants in an assistance unit receiving assistance 
 51.26  under subdivision 3 or 4 are not in compliance with the 
 51.27  employment and training service requirements in sections ~~256J.52~~ 
 51.28  256J.521 to ~~256J.55~~ 256J.57, the sanctions under this 
 51.29  subdivision apply.  For a first occurrence of noncompliance, an 
 51.30  assistance unit must be sanctioned under section 256J.46, 
 51.31  subdivision 1, paragraph ~~(d)~~ (c), clause (1).  For a second or 
 51.32  third occurrence of noncompliance, the assistance unit must be 
 51.33  sanctioned under section 256J.46, subdivision 1, 
 51.34  paragraph ~~(d)~~ (c), clause (2).  For a fourth occurrence of 
 51.35  noncompliance, the assistance unit is disqualified from MFIP.  
 51.36  If a participant is determined to be out of compliance, the 
 52.1   participant may claim a good cause exception under section 
 52.2   256J.57, however, the participant may not claim an exemption 
 52.3   under section 256J.56.  
 52.4      (b) If both participants in a two-parent assistance unit 
 52.5   are out of compliance at the same time, it is considered one 
 52.6   occurrence of noncompliance.  
 52.7      Sec. 60.  Minnesota Statutes 2002, section 256J.425, 
 52.8   subdivision 7, is amended to read: 
 52.9      Subd. 7.  [STATUS OF DISQUALIFIED PARTICIPANTS.] (a) An 
 52.10  assistance unit that is disqualified under subdivision 6, 
 52.11  paragraph (a), may be approved for MFIP if the participant 
 52.12  complies with MFIP program requirements and demonstrates 
 52.13  compliance for up to one month.  No assistance shall be paid 
 52.14  during this period. 
 52.15     (b) An assistance unit that is disqualified under 
 52.16  subdivision 6, paragraph (a), and that reapplies under paragraph 
 52.17  (a) is subject to sanction under section 256J.46, subdivision 1, 
 52.18  paragraph ~~(d)~~ (c), clause (1), for a first occurrence of 
 52.19  noncompliance.  A subsequent occurrence of noncompliance results 
 52.20  in a permanent disqualification. 
 52.21     (c) If one participant in a two-parent assistance unit 
 52.22  receiving assistance under a hardship extension under 
 52.23  subdivision 3 or 4 is determined to be out of compliance with 
 52.24  the employment and training services requirements under sections 
 52.25  ~~256J.52~~ 256J.521 to ~~256J.55~~ 256J.57, the county shall give the 
 52.26  assistance unit the option of disqualifying the noncompliant 
 52.27  participant from MFIP.  In that case, the assistance unit shall 
 52.28  be treated as a one-parent assistance unit for the purposes of 
 52.29  meeting the work requirements under subdivision 4 and the 
 52.30  assistance unit's MFIP grant shall be calculated using the 
 52.31  shared household standard under section 256J.08, subdivision 
 52.32  82a.  An applicant who is disqualified from receiving assistance 
 52.33  under this paragraph may reapply under paragraph (a).  If a 
 52.34  participant is disqualified from MFIP under this subdivision a 
 52.35  second time, the participant is permanently disqualified from 
 52.36  MFIP. 
 53.1      (d) Prior to a disqualification under this subdivision, a 
 53.2   county agency must review the participant's case to determine if 
 53.3   the employment plan is still appropriate and attempt to meet 
 53.4   with the participant face-to-face.  If a face-to-face meeting is 
 53.5   not conducted, the county agency must send the participant a 
 53.6   notice of adverse action as provided in section 256J.31.  During 
 53.7   the face-to-face meeting, the county agency must: 
 53.8      (1) determine whether the continued noncompliance can be 
 53.9   explained and mitigated by providing a needed preemployment 
 53.10  activity, as defined in section 256J.49, subdivision 13, clause 
 53.11  ~~(16), or services under a local intervention grant for~~ 
 53.12  ~~self-sufficiency under section 256J.625~~ (9); 
 53.13     (2) determine whether the participant qualifies for a good 
 53.14  cause exception under section 256J.57; 
 53.15     (3) inform the participant of the family violence waiver 
 53.16  criteria and make appropriate referrals if the waiver is 
 53.17  requested; 
 53.18     (4) inform the participant of the participant's sanction 
 53.19  status and explain the consequences of continuing noncompliance; 
 53.20     ~~(4)~~ (5) identify other resources that may be available to 
 53.21  the participant to meet the needs of the family; and 
 53.22     ~~(5)~~ (6) inform the participant of the right to appeal under 
 53.23  section 256J.40. 
 53.24     Sec. 61.  Minnesota Statutes 2002, section 256J.45, 
 53.25  subdivision 2, is amended to read: 
 53.26     Subd. 2.  [GENERAL INFORMATION.] The MFIP orientation must 
 53.27  consist of a presentation that informs caregivers of: 
 53.28     (1) the necessity to obtain immediate employment; 
 53.29     (2) the work incentives under MFIP, including the 
 53.30  availability of the federal earned income tax credit and the 
 53.31  Minnesota working family tax credit; 
 53.32     (3) the requirement to comply with the employment plan and 
 53.33  other requirements of the employment and training services 
 53.34  component of MFIP, including a description of the range of work 
 53.35  and training activities that are allowable under MFIP to meet 
 53.36  the individual needs of participants; 
 54.1      (4) the consequences for failing to comply with the 
 54.2   employment plan and other program requirements, and that the 
 54.3   county agency may not impose a sanction when failure to comply 
 54.4   is due to the unavailability of child care or other 
 54.5   circumstances where the participant has good cause under 
 54.6   subdivision 3; 
 54.7      (5) the rights, responsibilities, and obligations of 
 54.8   participants; 
 54.9      (6) the types and locations of child care services 
 54.10  available through the county agency; 
 54.11     (7) the availability and the benefits of the early 
 54.12  childhood health and developmental screening under sections 
 54.13  121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10; 
 54.14     (8) the caregiver's eligibility for transition year child 
 54.15  care assistance under section 119B.05; 
 54.16     (9) ~~the caregiver's eligibility for extended medical~~ 
 54.17  ~~assistance when the caregiver loses eligibility for MFIP due to~~ 
 54.18  ~~increased earnings or increased child or spousal support~~ the 
 54.19  availability of all health care programs, including transitional 
 54.20  medical assistance; 
 54.21     (10) the caregiver's option to choose an employment and 
 54.22  training provider and information about each provider, including 
 54.23  but not limited to, services offered, program components, job 
 54.24  placement rates, job placement wages, and job retention rates; 
 54.25     (11) the caregiver's option to request approval of an 
 54.26  education and training plan according to section ~~256J.52~~ 
 54.27  256J.53; 
 54.28     (12) the work study programs available under the higher 
 54.29  education system; and 
 54.30     (13) ~~effective October 1, 2001,~~ information about the 
 54.31  60-month time limit ~~exemption and waivers of regular employment~~ 
 54.32  ~~and training requirements for family violence victims~~ exemptions 
 54.33  under the family violence waiver and referral information about 
 54.34  shelters and programs for victims of family violence. 
 54.35     Sec. 62.  Minnesota Statutes 2002, section 256J.46, 
 54.36  subdivision 1, is amended to read: 
 55.1      Subdivision 1.  [PARTICIPANTS NOT COMPLYING WITH PROGRAM 
 55.2   REQUIREMENTS.] (a) A participant who fails without good 
 55.3   cause under section 256J.57 to comply with the requirements of 
 55.4   this chapter, and who is not subject to a sanction under 
 55.5   subdivision 2, shall be subject to a sanction as provided in 
 55.6   this subdivision.  Prior to the imposition of a sanction, a 
 55.7   county agency shall provide a notice of intent to sanction under 
 55.8   section 256J.57, subdivision 2, and, when applicable, a notice 
 55.9   of adverse action as provided in section 256J.31. 
 55.10     (b) ~~A participant who fails to comply with an alternative~~ 
 55.11  ~~employment plan must have the plan reviewed by a person trained~~ 
 55.12  ~~in domestic violence and a job counselor or the county agency to~~ 
 55.13  ~~determine if components of the alternative employment plan are~~ 
 55.14  ~~still appropriate.  If the activities are no longer appropriate,~~ 
 55.15  ~~the plan must be revised with a person trained in domestic~~ 
 55.16  ~~violence and approved by a job counselor or the county agency.~~  
 55.17  ~~A participant who fails to comply with a plan that is determined~~ 
 55.18  ~~not to need revision will lose their exemption and be required~~ 
 55.19  ~~to comply with regular employment services activities.~~  
 55.20     ~~(c)~~ A sanction under this subdivision becomes effective the 
 55.21  month following the month in which a required notice is given.  
 55.22  A sanction must not be imposed when a participant comes into 
 55.23  compliance with the requirements for orientation under section 
 55.24  256J.45 ~~or third-party liability for medical services under~~ 
 55.25  ~~section 256J.30, subdivision 10,~~ prior to the effective date of 
 55.26  the sanction.  A sanction must not be imposed when a participant 
 55.27  comes into compliance with the requirements for employment and 
 55.28  training services under sections ~~256J.49~~ 256J.515 to 
 55.29  ~~256J.55~~ 256J.57 ten days prior to the effective date of the 
 55.30  sanction.  For purposes of this subdivision, each month that a 
 55.31  participant fails to comply with a requirement of this chapter 
 55.32  shall be considered a separate occurrence of noncompliance.  ~~A~~ 
 55.33  ~~participant who has had one or more sanctions imposed must~~ 
 55.34  ~~remain in compliance with the provisions of this chapter for six~~ 
 55.35  ~~months in order for a subsequent occurrence of noncompliance to~~ 
 55.36  ~~be considered a first occurrence.~~  If both participants in a 
 56.1   two-parent assistance unit are out of compliance at the same 
 56.2   time, it is considered one occurrence of noncompliance.  
 56.3      ~~(d)~~ (c) Sanctions for noncompliance shall be imposed as 
 56.4   follows: 
 56.5      (1) For the first occurrence of noncompliance by a 
 56.6   participant in an assistance unit, the assistance unit's grant 
 56.7   shall be reduced by ten percent of the MFIP standard of need for 
 56.8   an assistance unit of the same size with the residual grant paid 
 56.9   to the participant.  The reduction in the grant amount must be 
 56.10  in effect for a minimum of one month and shall be removed in the 
 56.11  month following the month that the participant returns to 
 56.12  compliance.  
 56.13     (2) For a second ~~or subsequent~~, third, fourth, fifth, or 
 56.14  sixth occurrence of noncompliance by a participant in an 
 56.15  assistance unit, ~~or when each of the participants in a~~ 
 56.16  ~~two-parent assistance unit have a first occurrence of~~ 
 56.17  ~~noncompliance at the same time,~~ the assistance unit's shelter 
 56.18  costs shall be vendor paid up to the amount of the cash portion 
 56.19  of the MFIP grant for which the assistance unit is eligible.  At 
 56.20  county option, the assistance unit's utilities may also be 
 56.21  vendor paid up to the amount of the cash portion of the MFIP 
 56.22  grant remaining after vendor payment of the assistance unit's 
 56.23  shelter costs.  The residual amount of the grant after vendor 
 56.24  payment, if any, must be reduced by an amount equal to 30 
 56.25  percent of the MFIP standard of need for an assistance unit of 
 56.26  the same size before the residual grant is paid to the 
 56.27  assistance unit.  The reduction in the grant amount must be in 
 56.28  effect for a minimum of one month and shall be removed in the 
 56.29  month following the month that the participant in a one-parent 
 56.30  assistance unit returns to compliance.  In a two-parent 
 56.31  assistance unit, the grant reduction must be in effect for a 
 56.32  minimum of one month and shall be removed in the month following 
 56.33  the month both participants return to compliance.  The vendor 
 56.34  payment of shelter costs and, if applicable, utilities shall be 
 56.35  removed six months after the month in which the participant or 
 56.36  participants return to compliance.  If an assistance unit is 
 57.1   sanctioned under this clause, the participant's case file must 
 57.2   be reviewed ~~as required under paragraph (e)~~ to determine if the 
 57.3   employment plan is still appropriate. 
 57.4      ~~(e) When a sanction under paragraph (d), clause (2), is in~~ 
 57.5   ~~effect~~ (d) For a seventh occurrence of noncompliance by a 
 57.6   participant in an assistance unit, or when the participants in a 
 57.7   two-parent assistance unit have a total of seven occurrences of 
 57.8   noncompliance, the county agency shall close the MFIP assistance 
 57.9   unit's financial assistance case, both the cash and food 
 57.10  portions.  The case must remain closed for a minimum of one full 
 57.11  month.  Closure under this paragraph does not make a participant 
 57.12  automatically ineligible for food support, if otherwise eligible.
 57.13  Before the case is closed, the county agency must review the 
 57.14  participant's case to determine if the employment plan is still 
 57.15  appropriate and attempt to meet with the participant 
 57.16  face-to-face.  The participant may bring an advocate to the 
 57.17  face-to-face meeting.  If a face-to-face meeting is not 
 57.18  conducted, the county agency must send the participant a written 
 57.19  notice that includes the information required under clause (1). 
 57.20     (1) During the face-to-face meeting, the county agency must:
 57.21     (i) determine whether the continued noncompliance can be 
 57.22  explained and mitigated by providing a needed preemployment 
 57.23  activity, as defined in section 256J.49, subdivision 13, clause 
 57.24  ~~(16), or services under a local intervention grant for~~ 
 57.25  ~~self-sufficiency under section 256J.625~~ (9); 
 57.26     (ii) determine whether the participant qualifies for a good 
 57.27  cause exception under section 256J.57, or if the sanction is for 
 57.28  noncooperation with child support requirements, determine if the 
 57.29  participant qualifies for a good cause exemption under section 
 57.30  256.741, subdivision 10; 
 57.31     (iii) determine whether the participant qualifies for an 
 57.32  exemption under section 256J.56 or the work activities in the 
 57.33  employment plan are appropriate based on the criteria in section 
 57.34  256J.521, subdivision 2 or 3; 
 57.35     (iv) ~~determine whether the participant qualifies for an~~ 
 57.36  ~~exemption from regular employment services requirements for~~ 
 58.1   ~~victims of family violence under section 256J.52, subdivision~~ 
 58.2   ~~6~~ determine whether the participant qualifies for the family 
 58.3   violence waiver; 
 58.4      (v) inform the participant of the participant's sanction 
 58.5   status and explain the consequences of continuing noncompliance; 
 58.6      (vi) identify other resources that may be available to the 
 58.7   participant to meet the needs of the family; and 
 58.8      (vii) inform the participant of the right to appeal under 
 58.9   section 256J.40. 
 58.10     (2) If the lack of an identified activity or service can 
 58.11  explain the noncompliance, the county must work with the 
 58.12  participant to provide the identified activity~~, and the county~~ 
 58.13  ~~must restore the participant's grant amount to the full amount~~ 
 58.14  ~~for which the assistance unit is eligible.  The grant must be~~ 
 58.15  ~~restored retroactively to the first day of the month in which~~ 
 58.16  ~~the participant was found to lack preemployment activities or to~~ 
 58.17  ~~qualify for an exemption under section 256J.56, a good cause~~ 
 58.18  ~~exception under section 256J.57, or an exemption for victims of~~ 
 58.19  ~~family violence under section 256J.52, subdivision 6~~. 
 58.20     (3) ~~If the participant is found to qualify for a good cause~~ 
 58.21  ~~exception or an exemption, the county must restore the~~ 
 58.22  ~~participant's grant to the full amount for which the assistance~~ 
 58.23  ~~unit is eligible.~~  The grant must be restored to the full amount 
 58.24  for which the assistance unit is eligible retroactively to the 
 58.25  first day of the month in which the participant was found to 
 58.26  lack preemployment activities or to qualify for an exemption 
 58.27  under section 256J.56, a family violence waiver, or for a good 
 58.28  cause exemption under section 256.741, subdivision 10, or 
 58.29  256J.57. 
 58.30     (e) For the purpose of applying sanctions under this 
 58.31  section, only occurrences of noncompliance that occur after the 
 58.32  effective date of this section shall be considered.  If the 
 58.33  participant is in 30 percent sanction in the month this section 
 58.34  takes effect, that month counts as the first occurrence for 
 58.35  purposes of applying the sanctions under this section, but the 
 58.36  sanction shall remain at 30 percent for that month. 
 59.1      (f) An assistance unit whose case is closed under paragraph 
 59.2   (d) or (g), or under an approved county option sanction plan 
 59.3   under section 256J.462 in effect June 30, 2003, or a county 
 59.4   pilot project under Laws 2000, chapter 488, article 10, section 
 59.5   29, in effect June 30, 2003, may reapply for MFIP and shall be 
 59.6   eligible if the participant complies with MFIP program 
 59.7   requirements and demonstrates compliance for up to one month.  
 59.8   No assistance shall be paid during this period. 
 59.9      (g) An assistance unit whose case has been closed for 
 59.10  noncompliance, that reapplies under paragraph (f) is subject to 
 59.11  sanction under paragraph (c), clause (2), for a first occurrence 
 59.12  of noncompliance.  Any subsequent occurrence of noncompliance 
 59.13  shall result in case closure under paragraph (d). 
 59.14     Sec. 63.  Minnesota Statutes 2002, section 256J.46, 
 59.15  subdivision 2, is amended to read: 
 59.16     Subd. 2.  [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 
 59.17  REQUIREMENTS.] The grant of an MFIP caregiver who refuses to 
 59.18  cooperate, as determined by the child support enforcement 
 59.19  agency, with support requirements under section 256.741, shall 
 59.20  be subject to sanction as specified in this subdivision and 
 59.21  subdivision 1.  For a first occurrence of noncooperation, the 
 59.22  assistance unit's grant must be reduced by ~~25~~ 30 percent of the 
 59.23  applicable MFIP standard of need.  Subsequent occurrences of 
 59.24  noncooperation shall be subject to sanction under subdivision 1, 
 59.25  paragraphs (c), clause (2), and (d).  The residual amount of the 
 59.26  grant, if any, must be paid to the caregiver.  A sanction under 
 59.27  this subdivision becomes effective the first month following the 
 59.28  month in which a required notice is given.  A sanction must not 
 59.29  be imposed when a caregiver comes into compliance with the 
 59.30  requirements under section 256.741 prior to the effective date 
 59.31  of the sanction.  The sanction shall be removed in the month 
 59.32  following the month that the caregiver cooperates with the 
 59.33  support requirements.  Each month that an MFIP caregiver fails 
 59.34  to comply with the requirements of section 256.741 must be 
 59.35  considered a separate occurrence of noncompliance for the 
 59.36  purpose of applying sanctions under subdivision 1, paragraphs 
 60.1   (c), clause (2), and (d).  ~~An MFIP caregiver who has had one or~~ 
 60.2   ~~more sanctions imposed must remain in compliance with the~~ 
 60.3   ~~requirements of section 256.741 for six months in order for a~~ 
 60.4   ~~subsequent sanction to be considered a first occurrence.~~ 
 60.5      Sec. 64.  Minnesota Statutes 2002, section 256J.46, 
 60.6   subdivision 2a, is amended to read: 
 60.7      Subd. 2a.  [DUAL SANCTIONS.] (a) Notwithstanding the 
 60.8   provisions of subdivisions 1 and 2, for a participant subject to 
 60.9   a sanction for refusal to comply with child support requirements 
 60.10  under subdivision 2 and subject to a concurrent sanction for 
 60.11  refusal to cooperate with other program requirements under 
 60.12  subdivision 1, sanctions shall be imposed in the manner 
 60.13  prescribed in this subdivision. 
 60.14     ~~A participant who has had one or more sanctions imposed~~ 
 60.15  ~~under this subdivision must remain in compliance with the~~ 
 60.16  ~~provisions of this chapter for six months in order for a~~ 
 60.17  ~~subsequent occurrence of noncompliance to be considered a first~~ 
 60.18  ~~occurrence.~~  Any vendor payment of shelter costs or utilities 
 60.19  under this subdivision must remain in effect for six months 
 60.20  after the month in which the participant is no longer subject to 
 60.21  sanction under subdivision 1. 
 60.22     (b) If the participant was subject to sanction for: 
 60.23     (i) noncompliance under subdivision 1 before being subject 
 60.24  to sanction for noncooperation under subdivision 2; or 
 60.25     (ii) noncooperation under subdivision 2 before being 
 60.26  subject to sanction for noncompliance under subdivision 1, the 
 60.27  participant is considered to have a second occurrence of 
 60.28  noncompliance and shall be sanctioned as provided in subdivision 
 60.29  1, paragraph ~~(d)~~ (c), clause (2).  Each subsequent occurrence of 
 60.30  noncompliance shall be considered one additional occurrence and 
 60.31  shall be subject to the applicable level of sanction under 
 60.32  subdivision 1~~, paragraph (d), or section 256J.462~~.  The 
 60.33  requirement that the county conduct a review as specified in 
 60.34  subdivision 1, paragraph ~~(e)~~ (d), remains in effect. 
 60.35     (c) A participant who first becomes subject to sanction 
 60.36  under both subdivisions 1 and 2 in the same month is subject to 
 61.1   sanction as follows: 
 61.2      (i) in the first month of noncompliance and noncooperation, 
 61.3   the participant's grant must be reduced by ~~25~~ 30 percent of the 
 61.4   applicable MFIP standard of need, with any residual amount paid 
 61.5   to the participant; 
 61.6      (ii) in the second and subsequent months of noncompliance 
 61.7   and noncooperation, the participant shall be subject to the 
 61.8   applicable level of sanction under subdivision 1~~, paragraph (d),~~ 
 61.9   ~~or section 256J.462~~. 
 61.10     The requirement that the county conduct a review as 
 61.11  specified in subdivision 1, paragraph ~~(e)~~ (d), remains in effect.
 61.12     (d) A participant remains subject to sanction under 
 61.13  subdivision 2 if the participant: 
 61.14     (i) returns to compliance and is no longer subject to 
 61.15  sanction ~~under subdivision 1 or section 256J.462~~ for 
 61.16  noncompliance with section 256J.45 or sections 256J.515 to 
 61.17  256J.57; or 
 61.18     (ii) has the sanction ~~under subdivision 1, paragraph (d),~~ 
 61.19  ~~or section 256J.462~~ for noncompliance with section 256J.45 or 
 61.20  sections 256J.515 to 256J.57 removed upon completion of the 
 61.21  review under subdivision 1, paragraph (e). 
 61.22     A participant remains subject to the applicable level of 
 61.23  sanction under subdivision 1~~, paragraph (d), or section 256J.462~~ 
 61.24  if the participant cooperates and is no longer subject to 
 61.25  sanction under subdivision 2. 
 61.26     Sec. 65.  Minnesota Statutes 2002, section 256J.49, 
 61.27  subdivision 4, is amended to read: 
 61.28     Subd. 4.  [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 
 61.29  "Employment and training service provider" means: 
 61.30     (1) a public, private, or nonprofit employment and training 
 61.31  agency certified by the commissioner of economic security under 
 61.32  sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 
 61.33  is approved under section 256J.51 and is included in the county 
 61.34  ~~plan~~ service agreement submitted under section ~~256J.50~~ 256J.626, 
 61.35  subdivision ~~7~~ 4; 
 61.36     (2) a public, private, or nonprofit agency that is not 
 62.1   certified by the commissioner under clause (1), but with which a 
 62.2   county has contracted to provide employment and training 
 62.3   services and which is included in the county's ~~plan~~ service 
 62.4   agreement submitted under section ~~256J.50~~ 256J.626, 
 62.5   subdivision ~~7~~ 4; or 
 62.6      (3) a county agency, if the county has opted to provide 
 62.7   employment and training services and the county has indicated 
 62.8   that fact in the ~~plan~~ service agreement submitted under section 
 62.9   ~~256J.50~~ 256J.626, subdivision ~~7~~ 4. 
 62.10     Notwithstanding section 268.871, an employment and training 
 62.11  services provider meeting this definition may deliver employment 
 62.12  and training services under this chapter. 
 62.13     Sec. 66.  Minnesota Statutes 2002, section 256J.49, 
 62.14  subdivision 5, is amended to read: 
 62.15     Subd. 5.  [EMPLOYMENT PLAN.] "Employment plan" means a plan 
 62.16  developed by the job counselor and the participant which 
 62.17  identifies the participant's most direct path to unsubsidized 
 62.18  employment, lists the specific steps that the caregiver will 
 62.19  take on that path, and includes a timetable for the completion 
 62.20  of each step.  The plan should also identify any subsequent 
 62.21  steps that support long-term economic stability.  For 
 62.22  participants who request and qualify for a family violence 
 62.23  waiver, an employment plan must be developed by the job 
 62.24  counselor and the participant, and in consultation with a person 
 62.25  trained in domestic violence and follow the employment plan 
 62.26  provisions in section 256J.521, subdivision 3. 
 62.27     Sec. 67.  Minnesota Statutes 2002, section 256J.49, is 
 62.28  amended by adding a subdivision to read: 
 62.29     Subd. 6a.  [FUNCTIONAL WORK LITERACY.] "Functional work 
 62.30  literacy" means an intensive English as a second language 
 62.31  program that is work focused and offers at least 20 hours of 
 62.32  class time per week. 
 62.33     Sec. 68.  Minnesota Statutes 2002, section 256J.49, 
 62.34  subdivision 9, is amended to read: 
 62.35     Subd. 9.  [PARTICIPANT.] "Participant" means a recipient of 
 62.36  MFIP assistance who participates or is required to participate 
 63.1   in employment and training services under sections 256J.515 to 
 63.2   256J.57 and 256J.95. 
 63.3      Sec. 69.  Minnesota Statutes 2002, section 256J.49, is 
 63.4   amended by adding a subdivision to read: 
 63.5      Subd. 12a.  [SUPPORTED WORK.] "Supported work" means a 
 63.6   subsidized or unsubsidized work experience placement with a 
 63.7   public or private sector employer, which may include services 
 63.8   such as individualized supervision and job coaching to support 
 63.9   the participant on the job. 
 63.10     Sec. 70.  Minnesota Statutes 2002, section 256J.49, 
 63.11  subdivision 13, is amended to read: 
 63.12     Subd. 13.  [WORK ACTIVITY.] "Work activity" means any 
 63.13  activity in a participant's approved employment plan that ~~is~~ 
 63.14  ~~tied to the participant's~~ leads to employment ~~goal~~.  For 
 63.15  purposes of the MFIP program, ~~any activity that is included in a~~ 
 63.16  ~~participant's approved employment plan meets~~ this includes 
 63.17  activities that meet the definition of work activity ~~as counted~~ 
 63.18  under the ~~federal~~ participation ~~standards~~ requirements of TANF.  
 63.19  Work activity includes~~, but is not limited to~~: 
 63.20     (1) unsubsidized employment, including work study and paid 
 63.21  apprenticeships or internships; 
 63.22     (2) subsidized private sector or public sector employment, 
 63.23  including grant diversion as specified in section 256J.69, 
 63.24  on-the-job training as specified in section 256J.66, the 
 63.25  self-employment investment demonstration program (SEID) as 
 63.26  specified in section 256J.65, paid work experience, and 
 63.27  supported work when a wage subsidy is provided; 
 63.28     (3) unpaid work experience, including ~~CWEP~~ community 
 63.29  service, volunteer work, the community work experience program 
 63.30  as specified in section 256J.67, unpaid apprenticeships or 
 63.31  internships, and ~~including work associated with the refurbishing~~ 
 63.32  ~~of publicly assisted housing if sufficient private sector~~ 
 63.33  ~~employment is not available~~ supported work when a wage subsidy 
 63.34  is not provided; 
 63.35     (4) ~~on-the-job training as specified in section 256J.66~~ job 
 63.36  search including job readiness assistance, job clubs, job 
 64.1   placement, job-related counseling, and job retention services; 
 64.2      ~~(5) job search, either supervised or unsupervised;~~ 
 64.3      ~~(6) job readiness assistance;~~ 
 64.4      ~~(7) job clubs, including job search workshops;~~ 
 64.5      ~~(8) job placement;~~ 
 64.6      ~~(9) job development;~~ 
 64.7      ~~(10) job-related counseling;~~ 
 64.8      ~~(11) job coaching;~~ 
 64.9      ~~(12) job retention services;~~ 
 64.10     ~~(13) job-specific training or education;~~ 
 64.11     ~~(14) job skills training directly related to employment;~~ 
 64.12     ~~(15) the self-employment investment demonstration (SEID),~~ 
 64.13  ~~as specified in section 256J.65;~~ 
 64.14     ~~(16) preemployment activities, based on availability and~~ 
 64.15  ~~resources, such as volunteer work, literacy programs and related~~ 
 64.16  ~~activities, citizenship classes, English as a second language~~ 
 64.17  ~~(ESL) classes as limited by the provisions of section 256J.52,~~ 
 64.18  ~~subdivisions 3, paragraph (d), and 5, paragraph (c), or~~ 
 64.19  ~~participation in dislocated worker services, chemical dependency~~ 
 64.20  ~~treatment, mental health services, peer group networks,~~ 
 64.21  ~~displaced homemaker programs, strength-based resiliency~~ 
 64.22  ~~training, parenting education, or other programs designed to~~ 
 64.23  ~~help families reach their employment goals and enhance their~~ 
 64.24  ~~ability to care for their children;~~ 
 64.25     ~~(17) community service programs;~~ 
 64.26     ~~(18) vocational educational training or educational~~ 
 64.27  ~~programs that can reasonably be expected to lead to employment,~~ 
 64.28  ~~as limited by the provisions of section 256J.53;~~ 
 64.29     ~~(19) apprenticeships;~~ 
 64.30     ~~(20) satisfactory attendance in general educational~~ 
 64.31  ~~development diploma classes or an adult diploma program;~~ 
 64.32     ~~(21) satisfactory attendance at secondary school, if the~~ 
 64.33  ~~participant has not received a high school diploma;~~ 
 64.34     ~~(22) adult basic education classes;~~ 
 64.35     ~~(23) internships;~~ 
 64.36     ~~(24) bilingual employment and training services;~~ 
 65.1      ~~(25) providing child care services to a participant who is~~ 
 65.2   ~~working in a community service program; and~~ 
 65.3      ~~(26) activities included in an alternative employment plan~~ 
 65.4   ~~that is developed under section 256J.52, subdivision 6.~~ 
 65.5      (5) job readiness education, including English as a second 
 65.6   language (ESL) or functional work literacy classes as limited by 
 65.7   the provisions of section 256J.531, subdivision 2, general 
 65.8   educational development (GED) course work, high school 
 65.9   completion, and adult basic education as limited by the 
 65.10  provisions of section 256J.531, subdivision 1; 
 65.11     (6) job skills training directly related to employment, 
 65.12  including education and training that can reasonably be expected 
 65.13  to lead to employment, as limited by the provisions of section 
 65.14  256J.53; 
 65.15     (7) providing child care services to a participant who is 
 65.16  working in a community service program; 
 65.17     (8) activities included in the employment plan that is 
 65.18  developed under section 256J.521, subdivision 3; and 
 65.19     (9) preemployment activities including chemical and mental 
 65.20  health assessments, treatment, and services; learning 
 65.21  disabilities services; child protective services; family 
 65.22  stabilization services; or other programs designed to enhance 
 65.23  employability. 
 65.24     Sec. 71.  Minnesota Statutes 2002, section 256J.50, 
 65.25  subdivision 1, is amended to read: 
 65.26     Subdivision 1.  [EMPLOYMENT AND TRAINING SERVICES COMPONENT 
 65.27  OF MFIP.] (a) ~~By January 1, 1998,~~ Each county must develop and 
 65.28  ~~implement~~ provide an employment and training services component 
 65.29  ~~of MFIP~~ which is designed to put participants on the most direct 
 65.30  path to unsubsidized employment.  Participation in these 
 65.31  services is mandatory for all MFIP caregivers, unless the 
 65.32  caregiver is exempt under section 256J.56. 
 65.33     (b) A county must provide employment and training services 
 65.34  under sections 256J.515 to 256J.74 within 30 days after 
 65.35  the ~~caregiver's participation becomes mandatory under~~ 
 65.36  ~~subdivision 5 or within 30 days of receipt of a request for~~ 
 66.1   ~~services from a caregiver who under section 256J.42 is no longer~~ 
 66.2   ~~eligible to receive MFIP but whose income is below 120 percent~~ 
 66.3   ~~of the federal poverty guidelines for a family of the same~~ 
 66.4   ~~size.  The request must be made within 12 months of the date the~~ 
 66.5   ~~caregivers' MFIP case was closed~~ caregiver is determined 
 66.6   eligible for MFIP, or within ten days when the caregiver 
 66.7   participated in the diversionary work program under section 
 66.8   256J.95 within the past 12 months. 
 66.9      Sec. 72.  Minnesota Statutes 2002, section 256J.50, 
 66.10  subdivision 9, is amended to read: 
 66.11     Subd. 9.  [EXCEPTION; FINANCIAL HARDSHIP.] Notwithstanding 
 66.12  subdivision 8, a county that explains in the ~~plan~~ service 
 66.13  agreement required under section 256J.626, subdivision ~~7~~ 4, that 
 66.14  the provision of alternative employment and training service 
 66.15  providers would result in financial hardship for the county is 
 66.16  not required to make available more than one employment and 
 66.17  training provider. 
 66.18     Sec. 73.  Minnesota Statutes 2002, section 256J.50, 
 66.19  subdivision 10, is amended to read: 
 66.20     Subd. 10.  [REQUIRED NOTIFICATION TO VICTIMS OF FAMILY 
 66.21  VIOLENCE.] (a) County agencies and their contractors must 
 66.22  provide universal notification to all applicants and recipients 
 66.23  of MFIP that: 
 66.24     (1) referrals to counseling and supportive services are 
 66.25  available for victims of family violence; 
 66.26     (2) nonpermanent resident battered individuals married to 
 66.27  United States citizens or permanent residents may be eligible to 
 66.28  petition for permanent residency under the federal Violence 
 66.29  Against Women Act, and that referrals to appropriate legal 
 66.30  services are available; 
 66.31     (3) victims of family violence are exempt from the 60-month 
 66.32  limit on assistance ~~while the individual is~~ if they are 
 66.33  complying with an ~~approved safety plan or, after October 1,~~ 
 66.34  ~~2001, an alternative~~ employment plan~~, as defined in~~ under 
 66.35  section ~~256J.49~~ 256J.521, subdivision ~~1a~~ 3; and 
 66.36     (4) victims of family violence may choose to have regular 
 67.1   work requirements waived while the individual is complying with 
 67.2   an ~~alternative~~ employment plan ~~as defined in~~ under section 
 67.3   ~~256J.49~~ 256J.521, subdivision ~~1a~~ 3.  
 67.4      (b) If an ~~alternative~~ employment plan under section 
 67.5   256J.521, subdivision 3, is denied, the county or a job 
 67.6   counselor must provide reasons why the plan is not approved and 
 67.7   document how the denial of the plan does not interfere with the 
 67.8   safety of the participant or children. 
 67.9      Notification must be in writing and orally at the time of 
 67.10  application and recertification, when the individual is referred 
 67.11  to the title IV-D child support agency, and at the beginning of 
 67.12  any job training or work placement assistance program. 
 67.13     Sec. 74.  Minnesota Statutes 2002, section 256J.51, 
 67.14  subdivision 1, is amended to read: 
 67.15     Subdivision 1.  [PROVIDER APPLICATION.] An employment and 
 67.16  training service provider that is not included in a county's 
 67.17  ~~plan~~ service agreement under section ~~256J.50~~ 256J.626, 
 67.18  subdivision ~~7~~ 4, because the county has demonstrated financial 
 67.19  hardship under section 256J.50, subdivision 9 ~~of that section~~, 
 67.20  may appeal its exclusion to the commissioner of economic 
 67.21  security under this section. 
 67.22     Sec. 75.  Minnesota Statutes 2002, section 256J.51, 
 67.23  subdivision 2, is amended to read: 
 67.24     Subd. 2.  [APPEAL; ALTERNATE APPROVAL.] (a) An employment 
 67.25  and training service provider that is not included by a county 
 67.26  agency in the ~~plan~~ service agreement under section 
 67.27  ~~256J.50~~ 256J.626, subdivision ~~7~~ 4, and that meets the criteria 
 67.28  in paragraph (b), may appeal its exclusion to the commissioner 
 67.29  of economic security, and may request alternative approval by 
 67.30  the commissioner of economic security to provide services in the 
 67.31  county.  
 67.32     (b) An employment and training services provider that is 
 67.33  requesting alternative approval must demonstrate to the 
 67.34  commissioner that the provider meets the standards specified in 
 67.35  section 268.871, subdivision 1, paragraph (b), except that the 
 67.36  provider's past experience may be in services and programs 
 68.1   similar to those specified in section 268.871, subdivision 1, 
 68.2   paragraph (b). 
 68.3      Sec. 76.  Minnesota Statutes 2002, section 256J.51, 
 68.4   subdivision 3, is amended to read: 
 68.5      Subd. 3.  [COMMISSIONER'S REVIEW.] (a) The commissioner 
 68.6   must act on a request for alternative approval under this 
 68.7   section within 30 days of the receipt of the request.  If after 
 68.8   reviewing the provider's request, and the county's ~~plan~~ service 
 68.9   agreement submitted under section ~~256J.50~~ 256J.626, 
 68.10  subdivision ~~7~~ 4, the commissioner determines that the provider 
 68.11  meets the criteria under subdivision 2, paragraph (b), and that 
 68.12  approval of the provider would not cause financial hardship to 
 68.13  the county, the county must submit a revised ~~plan~~ service 
 68.14  agreement under subdivision 4 that includes the approved 
 68.15  provider.  
 68.16     (b) If the commissioner determines that the approval of the 
 68.17  provider would cause financial hardship to the county, the 
 68.18  commissioner must notify the provider and the county of this 
 68.19  determination.  The alternate approval process under this 
 68.20  section shall be closed to other requests for alternate approval 
 68.21  to provide employment and training services in the county for up 
 68.22  to 12 months from the date that the commissioner makes a 
 68.23  determination under this paragraph. 
 68.24     Sec. 77.  Minnesota Statutes 2002, section 256J.51, 
 68.25  subdivision 4, is amended to read: 
 68.26     Subd. 4.  [REVISED ~~PLAN~~ SERVICE AGREEMENT REQUIRED.] The 
 68.27  commissioner of economic security must notify the county agency 
 68.28  when the commissioner grants an alternative approval to an 
 68.29  employment and training service provider under subdivision 2.  
 68.30  Upon receipt of the notice, the county agency must submit a 
 68.31  revised ~~plan~~ service agreement under section ~~256J.50~~ 256J.626, 
 68.32  subdivision ~~7~~ 4, that includes the approved provider.  The 
 68.33  county has 90 days from the receipt of the commissioner's notice 
 68.34  to submit the revised ~~plan~~ service agreement. 
 68.35     Sec. 78.  [256J.521] [ASSESSMENT; EMPLOYMENT PLANS.] 
 68.36     Subdivision 1.  [ASSESSMENTS.] (a) For purposes of MFIP 
 69.1   employment services, assessment is a continuing process of 
 69.2   gathering information related to employability for the purpose 
 69.3   of identifying both participant's strengths and strategies for 
 69.4   coping with issues that interfere with employment.  The job 
 69.5   counselor must use information from the assessment process to 
 69.6   develop and update the employment plan under subdivision 2. 
 69.7      (b) The scope of assessment must cover at least the 
 69.8   following areas: 
 69.9      (1) basic information about the participant's ability to 
 69.10  obtain and retain employment, including:  a review of the 
 69.11  participant's education level; interests, skills, and abilities; 
 69.12  prior employment or work experience; transferable work skills; 
 69.13  child care and transportation needs; 
 69.14     (2) identification of personal and family circumstances 
 69.15  that impact the participant's ability to obtain and retain 
 69.16  employment, including:  any special needs of the children, the 
 69.17  level of English proficiency, family violence issues, and any 
 69.18  involvement with social services or the legal system; 
 69.19     (3) the results of a mental and chemical health screening 
 69.20  tool designed by the commissioner and results of the brief 
 69.21  screening tool for special learning needs.  Screening tools for 
 69.22  mental and chemical health and special learning needs must be 
 69.23  approved by the commissioner and may only be administered by job 
 69.24  counselors or county staff trained in using such screening 
 69.25  tools.  The commissioner shall work with county agencies to 
 69.26  develop protocols for referrals and follow-up actions after 
 69.27  screens are administered to participants, including guidance on 
 69.28  how employment plans may be modified based upon outcomes of 
 69.29  certain screens.  Participants must be told of the purpose of 
 69.30  the screens and how the information will be used to assist the 
 69.31  participant in identifying and overcoming barriers to 
 69.32  employment.  Screening for mental and chemical health and 
 69.33  special learning needs must be completed by participants who are 
 69.34  unable to find suitable employment after six weeks of job search 
 69.35  under subdivision 2, paragraph (b), and participants who are 
 69.36  determined to have barriers to employment under subdivision 2, 
 70.1   paragraph (d).  Failure to complete the screens will result in 
 70.2   sanction under section 256J.46; and 
 70.3      (4) a comprehensive review of participation and progress 
 70.4   for participants who have received MFIP assistance and have not 
 70.5   worked in unsubsidized employment during the past 12 months.  
 70.6   The purpose of the review is to determine the need for 
 70.7   additional services and supports, including placement in 
 70.8   subsidized employment or unpaid work experience under section 
 70.9   256J.49, subdivision 13. 
 70.10     (c) Information gathered during a caregiver's participation 
 70.11  in the diversionary work program under section 256J.95 must be 
 70.12  incorporated into the assessment process. 
 70.13     (d) The job counselor may require the participant to 
 70.14  complete a professional chemical use assessment to be performed 
 70.15  according to the rules adopted under section 254A.03, 
 70.16  subdivision 3, including provisions in the administrative rules 
 70.17  which recognize the cultural background of the participant, or a 
 70.18  professional psychological assessment as a component of the 
 70.19  assessment process, when the job counselor has a reasonable 
 70.20  belief, based on objective evidence, that a participant's 
 70.21  ability to obtain and retain suitable employment is impaired by 
 70.22  a medical condition.  The job counselor may assist the 
 70.23  participant with arranging services, including child care 
 70.24  assistance and transportation, necessary to meet needs 
 70.25  identified by the assessment.  Data gathered as part of a 
 70.26  professional assessment must be classified and disclosed 
 70.27  according to the provisions in section 13.46. 
 70.28     Subd. 2.  [EMPLOYMENT PLAN; CONTENTS.] (a) Based on the 
 70.29  assessment under subdivision 1, the job counselor and the 
 70.30  participant must develop an employment plan that includes 
 70.31  participation in activities and hours that meet the requirements 
 70.32  of section 256J.55, subdivision 1.  The purpose of the 
 70.33  employment plan is to identify for each participant the most 
 70.34  direct path to unsubsidized employment and any subsequent steps 
 70.35  that support long-term economic stability.  The employment plan 
 70.36  should be developed using the highest level of activity 
 71.1   appropriate for the participant.  Activities must be chosen from 
 71.2   clauses (1) to (6), which are listed in order of preference.  
 71.3   The employment plan must also list the specific steps the 
 71.4   participant will take to obtain employment, including steps 
 71.5   necessary for the participant to progress from one level of 
 71.6   activity to another, and a timetable for completion of each 
 71.7   step.  Levels of activity include: 
 71.8      (1) unsubsidized employment; 
 71.9      (2) job search; 
 71.10     (3) subsidized employment or unpaid work experience; 
 71.11     (4) unsubsidized employment and job readiness education or 
 71.12  job skills training; 
 71.13     (5) unsubsidized employment or unpaid work experience, and 
 71.14  activities related to a family violence waiver or preemployment 
 71.15  needs; and 
 71.16     (6) activities related to a family violence waiver or 
 71.17  preemployment needs. 
 71.18     (b) Participants who are determined to possess sufficient 
 71.19  skills such that the participant is likely to succeed in 
 71.20  obtaining unsubsidized employment must job search at least 30 
 71.21  hours per week for up to six weeks, and accept any offer of 
 71.22  suitable employment.  The remaining hours necessary to meet the 
 71.23  requirements of section 256J.55, subdivision 1, may be met 
 71.24  through participation in other work activities under section 
 71.25  256J.49, subdivision 13.  The participant's employment plan must 
 71.26  specify, at a minimum:  (1) whether the job search is supervised 
 71.27  or unsupervised; (2) support services that will be provided; and 
 71.28  (3) how frequently the participant must report to the job 
 71.29  counselor.  Participants who are unable to find suitable 
 71.30  employment after six weeks must meet with the job counselor to 
 71.31  determine whether other activities in paragraph (a) should be 
 71.32  incorporated into the employment plan.  Job search activities 
 71.33  which are continued after six weeks must be structured and 
 71.34  supervised. 
 71.35     (c) Beginning July 1, 2004, activities and hourly 
 71.36  requirements in the employment plan may be adjusted as necessary 
 72.1   to accommodate the personal and family circumstances of 
 72.2   participants identified under section 256J.561, subdivision 2, 
 72.3   paragraph (d).  Participants who no longer meet the provisions 
 72.4   of section 256J.561, subdivision 2, paragraph (d), must meet 
 72.5   with the job counselor within ten days of the determination to 
 72.6   revise the employment plan. 
 72.7      (d) Participants who are determined to have barriers to 
 72.8   obtaining or retaining employment that will not be overcome 
 72.9   during six weeks of job search under paragraph (b) must work 
 72.10  with the job counselor to develop an employment plan that 
 72.11  addresses those barriers by incorporating appropriate activities 
 72.12  from paragraph (a), clauses (1) to (6).  The employment plan 
 72.13  must include enough hours to meet the participation requirements 
 72.14  in section 256J.55, subdivision 1, unless a compelling reason to 
 72.15  require fewer hours is noted in the participant's file. 
 72.16     (e) The job counselor and the participant must sign the 
 72.17  employment plan to indicate agreement on the contents.  Failure 
 72.18  to develop or comply with activities in the plan, or voluntarily 
 72.19  quitting suitable employment without good cause, will result in 
 72.20  the imposition of a sanction under section 256J.46. 
 72.21     (f) Employment plans must be reviewed at least every three 
 72.22  months to determine whether activities and hourly requirements 
 72.23  should be revised. 
 72.24     Subd. 3.  [EMPLOYMENT PLAN; FAMILY VIOLENCE WAIVER.] (a) A 
 72.25  participant who requests and qualifies for a family violence 
 72.26  waiver shall develop or revise the employment plan as specified 
 72.27  in this subdivision with a job counselor or county, and a person 
 72.28  trained in domestic violence.  The revised or new employment 
 72.29  plan must be approved by the county or the job counselor.  The 
 72.30  plan may address safety, legal, or emotional issues, and other 
 72.31  demands on the family as a result of the family violence.  
 72.32  Information in section 256J.515, clauses (1) to (8), must be 
 72.33  included as part of the development of the plan. 
 72.34     (b) The primary goal of an employment plan developed under 
 72.35  this subdivision is to ensure the safety of the caregiver and 
 72.36  children.  To the extent it is consistent with ensuring safety, 
 73.1   the plan shall also include activities that are designed to lead 
 73.2   to economic stability.  An activity is inconsistent with 
 73.3   ensuring safety if, in the opinion of a person trained in 
 73.4   domestic violence, the activity would endanger the safety of the 
 73.5   participant or children.  A plan under this subdivision may not 
 73.6   automatically include a provision that requires a participant to 
 73.7   obtain an order for protection or to attend counseling. 
 73.8      (c) If at any time there is a disagreement over whether the 
 73.9   activities in the plan are appropriate or the participant is not 
 73.10  complying with activities in the plan under this subdivision, 
 73.11  the participant must receive the assistance of a person trained 
 73.12  in domestic violence to help resolve the disagreement or 
 73.13  noncompliance with the county or job counselor.  If the person 
 73.14  trained in domestic violence recommends that the activities are 
 73.15  still appropriate, the county or a job counselor must approve 
 73.16  the activities in the plan or provide written reasons why 
 73.17  activities in the plan are not approved and document how denial 
 73.18  of the activities do not endanger the safety of the participant 
 73.19  or children. 
 73.20     Subd. 4.  [SELF-EMPLOYMENT.] (a) Self-employment activities 
 73.21  may be included in an employment plan contingent on the 
 73.22  development of a business plan which establishes a timetable and 
 73.23  earning goals that will result in the participant exiting MFIP 
 73.24  assistance.  Business plans must be developed with assistance 
 73.25  from an individual or organization with expertise in small 
 73.26  business as approved by the job counselor. 
 73.27     (b) Participants with an approved plan that includes 
 73.28  self-employment must meet the participation requirements in 
 73.29  section 256J.55, subdivision 1.  Only hours where the 
 73.30  participant earns at least minimum wage shall be counted toward 
 73.31  the requirement.  Additional activities and hours necessary to 
 73.32  meet the participation requirements in section 256J.55, 
 73.33  subdivision 1, must be included in the employment plan. 
 73.34     (c) Employment plans which include self-employment 
 73.35  activities must be reviewed every three months.  Participants 
 73.36  who fail, without good cause, to make satisfactory progress as 
 74.1   established in the business plan must revise the employment plan 
 74.2   to replace the self-employment with other approved work 
 74.3   activities. 
 74.4      (d) The requirements of this subdivision may be waived for 
 74.5   participants who are enrolled in the self-employment investment 
 74.6   demonstration program (SEID) under section 256J.65, and who make 
 74.7   satisfactory progress as determined by the job counselor and the 
 74.8   SEID provider. 
 74.9      Subd. 5.  [TRANSITION FROM THE DIVERSIONARY WORK 
 74.10  PROGRAM.] Participants who become eligible for MFIP assistance 
 74.11  after completing the diversionary work program under section 
 74.12  256J.95 must comply with all requirements of subdivisions 1 and 
 74.13  2.  Participants who become eligible for MFIP assistance after 
 74.14  being determined unable to benefit from the diversionary work 
 74.15  program must comply with the requirements of subdivisions 1 and 
 74.16  2, with the exception of subdivision 2, paragraph (b). 
 74.17     Subd. 6.  [LOSS OF EMPLOYMENT.] Participants who are laid 
 74.18  off, quit with good cause, or are terminated from employment 
 74.19  through no fault of their own must meet with the job counselor 
 74.20  within ten working days to ascertain the reason for the job loss 
 74.21  and to revise the employment plan as necessary to address the 
 74.22  problem. 
 74.23     Sec. 79.  Minnesota Statutes 2002, section 256J.53, 
 74.24  subdivision 1, is amended to read: 
 74.25     Subdivision 1.  [LENGTH OF PROGRAM.] In order for a 
 74.26  post-secondary education or training program to be an approved 
 74.27  work activity as defined in section 256J.49, subdivision 13, 
 74.28  clause ~~(18)~~ (6), it must be a program lasting 24 months or less, 
 74.29  and the participant must meet the requirements of subdivisions 2 
 74.30  ~~and~~, 3, and 5.  
 74.31     Sec. 80.  Minnesota Statutes 2002, section 256J.53, 
 74.32  subdivision 2, is amended to read: 
 74.33     Subd. 2.  [~~DOCUMENTATION SUPPORTING PROGRAM~~ APPROVAL OF 
 74.34  POSTSECONDARY EDUCATION OR TRAINING.] (a) In order for a 
 74.35  post-secondary education or training program to be an approved 
 74.36  activity in ~~a participant's~~ an employment plan, the participant 
 75.1   ~~or the employment and training service provider~~ must ~~provide~~ 
 75.2   ~~documentation that:~~ be working in unsubsidized employment at 
 75.3   least 20 hours per week. 
 75.4      (b) Participants seeking approval of a postsecondary 
 75.5   education or training plan must provide documentation that: 
 75.6      (1) the ~~participant's~~ employment ~~plan identifies specific~~ 
 75.7   ~~goals that~~ goal can only be met with the additional education or 
 75.8   training; 
 75.9      (2) there are suitable employment opportunities that 
 75.10  require the specific education or training in the area in which 
 75.11  the participant resides or is willing to reside; 
 75.12     (3) the education or training will result in significantly 
 75.13  higher wages for the participant than the participant could earn 
 75.14  without the education or training; 
 75.15     (4) the participant can meet the requirements for admission 
 75.16  into the program; and 
 75.17     (5) there is a reasonable expectation that the participant 
 75.18  will complete the training program based on such factors as the 
 75.19  participant's MFIP assessment, previous education, training, and 
 75.20  work history; current motivation; and changes in previous 
 75.21  circumstances. 
 75.22     (c) The hourly unsubsidized employment requirement may be 
 75.23  reduced for intensive education or training programs lasting 12 
 75.24  weeks or less when full-time attendance is required. 
 75.25     (d) Participants with an approved employment plan in place 
 75.26  on July 1, 2003, which includes more than 12 months of 
 75.27  postsecondary education or training shall be allowed to complete 
 75.28  that plan provided that hourly requirements in section 256J.55, 
 75.29  subdivision 1, and conditions specified in paragraph (b), and 
 75.30  subdivisions 3 and 5 are met. 
 75.31     Sec. 81.  Minnesota Statutes 2002, section 256J.53, 
 75.32  subdivision 5, is amended to read: 
 75.33     Subd. 5.  [~~JOB SEARCH AFTER COMPLETION OF WORK ACTIVITY~~ 
 75.34  REQUIREMENTS AFTER POSTSECONDARY EDUCATION OR TRAINING.] ~~If a~~ 
 75.35  ~~participant's employment plan includes a post-secondary~~ 
 75.36  ~~educational or training program, the plan must include an~~ 
 76.1   ~~anticipated completion date for those activities.  At the time~~ 
 76.2   ~~the education or training is completed, the participant must~~ 
 76.3   ~~participate in job search.  If, after three months of job~~ 
 76.4   ~~search, the participant does not find a job that is consistent~~ 
 76.5   ~~with the participant's employment goal, the participant must~~ 
 76.6   ~~accept any offer of suitable employment.~~  Upon completion of an 
 76.7   approved education or training program, a participant who does 
 76.8   not meet the participation requirements in section 256J.55, 
 76.9   subdivision 1, through unsubsidized employment must participate 
 76.10  in job search.  If, after six weeks of job search, the 
 76.11  participant does not find a full-time job consistent with the 
 76.12  employment goal, the participant must accept any offer of 
 76.13  full-time suitable employment, or meet with the job counselor to 
 76.14  revise the employment plan to include additional work activities 
 76.15  necessary to meet hourly requirements. 
 76.16     Sec. 82.  [256J.531] [BASIC EDUCATION; ENGLISH AS A SECOND 
 76.17  LANGUAGE.] 
 76.18     Subdivision 1.  [APPROVAL OF ADULT BASIC EDUCATION.] With 
 76.19  the exception of classes related to obtaining a general 
 76.20  educational development credential (GED), a participant must 
 76.21  have reading or mathematics proficiency below a ninth grade 
 76.22  level in order for adult basic education classes to be an 
 76.23  approved work activity.  The employment plan must also specify 
 76.24  that the participant fulfill no more than one-half of the 
 76.25  participation requirements in section 256J.55, subdivision 1, 
 76.26  through attending adult basic education or general educational 
 76.27  development classes. 
 76.28     Subd. 2.  [APPROVAL OF ENGLISH AS A SECOND LANGUAGE.] In 
 76.29  order for English as a second language (ESL) classes to be an 
 76.30  approved work activity in an employment plan, a participant must 
 76.31  be below a spoken language proficiency level of SPL6 or its 
 76.32  equivalent, as measured by a nationally recognized test.  In 
 76.33  approving ESL as a work activity, the job counselor must give 
 76.34  preference to enrollment in a functional work literacy program, 
 76.35  if one is available, over a regular ESL program.  A participant 
 76.36  may not be approved for more than a combined total of 24 months 
 77.1   of ESL classes while participating in the diversionary work 
 77.2   program and the employment and training services component of 
 77.3   MFIP.  The employment plan must also specify that the 
 77.4   participant fulfill no more than one-half of the participation 
 77.5   requirements in section 256J.55, subdivision 1, through 
 77.6   attending ESL classes.  For participants enrolled in functional 
 77.7   work literacy classes, no more than two-thirds of the 
 77.8   participation requirements in section 256J.55, subdivision 1, 
 77.9   may be met through attending functional work literacy classes. 
 77.10     Sec. 83.  Minnesota Statutes 2002, section 256J.54, 
 77.11  subdivision 1, is amended to read: 
 77.12     Subdivision 1.  [ASSESSMENT OF EDUCATIONAL PROGRESS AND 
 77.13  NEEDS.] (a) The county agency must document the educational 
 77.14  level of each MFIP caregiver who is under the age of 20 and 
 77.15  determine if the caregiver has obtained a high school diploma or 
 77.16  its equivalent.  If the caregiver has not obtained a high school 
 77.17  diploma or its equivalent, ~~and is not exempt from the~~ 
 77.18  ~~requirement to attend school under subdivision 5,~~ the county 
 77.19  agency must complete an individual assessment for the 
 77.20  caregiver unless the caregiver is exempt from the requirement to 
 77.21  attend school under subdivision 5 or has chosen to have an 
 77.22  employment plan under section 256J.521, subdivision 2, as 
 77.23  allowed in paragraph (b).  The assessment must be performed as 
 77.24  soon as possible but within 30 days of determining MFIP 
 77.25  eligibility for the caregiver.  The assessment must provide an 
 77.26  initial examination of the caregiver's educational progress and 
 77.27  needs, literacy level, child care and supportive service needs, 
 77.28  family circumstances, skills, and work experience.  In the case 
 77.29  of a caregiver under the age of 18, the assessment must also 
 77.30  consider the results of either the caregiver's or the 
 77.31  caregiver's minor child's child and teen checkup under Minnesota 
 77.32  Rules, parts 9505.0275 and 9505.1693 to 9505.1748, if available, 
 77.33  and the effect of a child's development and educational needs on 
 77.34  the caregiver's ability to participate in the program.  The 
 77.35  county agency must advise the caregiver that the caregiver's 
 77.36  first goal must be to complete an appropriate ~~educational~~ 
 78.1   education option if one is identified for the caregiver through 
 78.2   the assessment and, in consultation with educational agencies, 
 78.3   must review the various school completion options with the 
 78.4   caregiver and assist in selecting the most appropriate option.  
 78.5      (b) The county agency must give a caregiver, who is age 18 
 78.6   or 19 and has not obtained a high school diploma or its 
 78.7   equivalent, the option to choose an employment plan with an 
 78.8   education option under subdivision 3 or an employment plan under 
 78.9   section 256J.521, subdivision 2. 
 78.10     Sec. 84.  Minnesota Statutes 2002, section 256J.54, 
 78.11  subdivision 2, is amended to read: 
 78.12     Subd. 2.  [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 
 78.13  PLAN.] For caregivers who are under age 18 without a high school 
 78.14  diploma or its equivalent, the assessment under subdivision 1 
 78.15  and the employment plan under subdivision 3 must be completed by 
 78.16  the social services agency under section 257.33.  For caregivers 
 78.17  who are age 18 or 19 without a high school diploma or its 
 78.18  equivalent who choose to have an employment plan with an 
 78.19  education option under subdivision 3, the assessment under 
 78.20  subdivision 1 and the employment plan under subdivision 3 must 
 78.21  be completed by the job counselor or, at county option, by the 
 78.22  social services agency under section 257.33.  Upon reaching age 
 78.23  18 or 19 a caregiver who received social services under section 
 78.24  257.33 and is without a high school diploma or its equivalent 
 78.25  has the option to choose whether to continue receiving services 
 78.26  under the caregiver's plan from the social services agency or to 
 78.27  utilize an MFIP employment and training service provider.  The 
 78.28  social services agency or the job counselor shall consult with 
 78.29  representatives of educational agencies that are required to 
 78.30  assist in developing educational plans under section 124D.331. 
 78.31     Sec. 85.  Minnesota Statutes 2002, section 256J.54, 
 78.32  subdivision 3, is amended to read: 
 78.33     Subd. 3.  [~~EDUCATIONAL~~ EDUCATION OPTION DEVELOPED.] If the 
 78.34  job counselor or county social services agency identifies an 
 78.35  appropriate ~~educational~~ education option for a minor caregiver 
 78.36  ~~under the age of 20~~ without a high school diploma or its 
 79.1   equivalent, or a caregiver age 18 or 19 without a high school 
 79.2   diploma or its equivalent who chooses an employment plan with an 
 79.3   education option, the job counselor or agency must develop an 
 79.4   employment plan which reflects the identified option.  The plan 
 79.5   must specify that participation in an educational activity is 
 79.6   required, what school or educational program is most 
 79.7   appropriate, the services that will be provided, the activities 
 79.8   the caregiver will take part in, including child care and 
 79.9   supportive services, the consequences to the caregiver for 
 79.10  failing to participate or comply with the specified 
 79.11  requirements, and the right to appeal any adverse action.  The 
 79.12  employment plan must, to the extent possible, reflect the 
 79.13  preferences of the caregiver. 
 79.14     Sec. 86.  Minnesota Statutes 2002, section 256J.54, 
 79.15  subdivision 5, is amended to read: 
 79.16     Subd. 5.  [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 
 79.17  the provisions of section 256J.56, minor parents, or 18- or 
 79.18  19-year-old parents without a high school diploma or its 
 79.19  equivalent who chooses an employment plan with an education 
 79.20  option must attend school unless: 
 79.21     (1) transportation services needed to enable the caregiver 
 79.22  to attend school are not available; 
 79.23     (2) appropriate child care services needed to enable the 
 79.24  caregiver to attend school are not available; 
 79.25     (3) the caregiver is ill or incapacitated seriously enough 
 79.26  to prevent attendance at school; or 
 79.27     (4) the caregiver is needed in the home because of the 
 79.28  illness or incapacity of another member of the household.  This 
 79.29  includes a caregiver of a child who is younger than six weeks of 
 79.30  age. 
 79.31     (b) The caregiver must be enrolled in a secondary school 
 79.32  and meeting the school's attendance requirements.  The county, 
 79.33  social service agency, or job counselor must verify at least 
 79.34  once per quarter that the caregiver is meeting the school's 
 79.35  attendance requirements.  An enrolled caregiver is considered to 
 79.36  be meeting the attendance requirements when the school is not in 
 80.1   regular session, including during holiday and summer breaks.  
 80.2      Sec. 87.  [256J.545] [FAMILY VIOLENCE WAIVER CRITERIA.] 
 80.3      (a) In order to qualify for a family violence waiver, an 
 80.4   individual must provide documentation of past or current family 
 80.5   violence which may prevent the individual from participating in 
 80.6   certain employment activities.  A claim of family violence must 
 80.7   be documented by the applicant or participant providing a sworn 
 80.8   statement which is supported by collateral documentation. 
 80.9      (b) Collateral documentation may consist of: 
 80.10     (1) police, government agency, or court records; 
 80.11     (2) a statement from a battered women's shelter staff with 
 80.12  knowledge of the circumstances or credible evidence that 
 80.13  supports the sworn statement; 
 80.14     (3) a statement from a sexual assault or domestic violence 
 80.15  advocate with knowledge of the circumstances or credible 
 80.16  evidence that supports the sworn statement; 
 80.17     (4) a statement from professionals from whom the applicant 
 80.18  or recipient has sought assistance for the abuse; or 
 80.19     (5) a sworn statement from any other individual with 
 80.20  knowledge of circumstances or credible evidence that supports 
 80.21  the sworn statement. 
 80.22     Sec. 88.  Minnesota Statutes 2002, section 256J.55, 
 80.23  subdivision 1, is amended to read: 
 80.24     Subdivision 1.  [~~COMPLIANCE WITH JOB SEARCH OR EMPLOYMENT~~ 
 80.25  ~~PLAN; SUITABLE EMPLOYMENT~~ PARTICIPATION REQUIREMENTS.] ~~(a) Each~~ 
 80.26  ~~MFIP participant must comply with the terms of the participant's~~ 
 80.27  ~~job search support plan or employment plan.  When the~~ 
 80.28  ~~participant has completed the steps listed in the employment~~ 
 80.29  ~~plan, the participant must comply with section 256J.53,~~ 
 80.30  ~~subdivision 5, if applicable, and then the participant must not~~ 
 80.31  ~~refuse any offer of suitable employment.  The participant may~~ 
 80.32  ~~choose to accept an offer of suitable employment before the~~ 
 80.33  ~~participant has completed the steps of the employment plan.~~ 
 80.34     ~~(b) For a participant under the age of 20 who is without a~~ 
 80.35  ~~high school diploma or general educational development diploma,~~ 
 80.36  ~~the requirement to comply with the terms of the employment plan~~ 
 81.1   ~~means the participant must meet the requirements of section~~ 
 81.2   ~~256J.54.~~ 
 81.3      ~~(c) Failure to develop or comply with a job search support~~ 
 81.4   ~~plan or an employment plan, or quitting suitable employment~~ 
 81.5   ~~without good cause, shall result in the imposition of a sanction~~ 
 81.6   ~~as specified in sections 256J.46 and 256J.57.~~ 
 81.7      (a) All caregivers must participate in employment services 
 81.8   under sections 256J.515 to 256J.57 concurrent with receipt of 
 81.9   MFIP assistance. 
 81.10     (b) Until July 1, 2004, participants who meet the 
 81.11  requirements of section 256J.56 are exempt from participation 
 81.12  requirements. 
 81.13     (c) Participants under paragraph (a) must develop and 
 81.14  comply with an employment plan under section 256J.521, or 
 81.15  section 256J.54 in the case of a participant under the age of 20 
 81.16  who has not obtained a high school diploma or its equivalent. 
 81.17     (d) With the exception of participants under the age of 20 
 81.18  who must meet the education requirements of section 256J.54, all 
 81.19  participants must meet the hourly participation requirements of 
 81.20  TANF or the hourly requirements listed in clauses (1) to (3), 
 81.21  whichever is higher. 
 81.22     (1) In single-parent families with no children under six 
 81.23  years of age, the job counselor and the caregiver must develop 
 81.24  an employment plan that includes 30 to 35 hours per week of work 
 81.25  activities. 
 81.26     (2) In single-parent families with a child under six years 
 81.27  of age, the job counselor and the caregiver must develop an 
 81.28  employment plan that includes 20 to 35 hours per week of work 
 81.29  activities. 
 81.30     (3) In two-parent families, the job counselor and the 
 81.31  caregivers must develop employment plans which result in a 
 81.32  combined total of at least 55 hours per week of work activities. 
 81.33     (e) Failure to participate in employment services, 
 81.34  including the requirement to develop and comply with an 
 81.35  employment plan, including hourly requirements, without good 
 81.36  cause under section 256J.57, shall result in the imposition of a 
 82.1   sanction under section 256J.46. 
 82.2      Sec. 89.  Minnesota Statutes 2002, section 256J.55, 
 82.3   subdivision 2, is amended to read: 
 82.4      Subd. 2.  [DUTY TO REPORT.] The participant must inform the 
 82.5   job counselor within ~~three~~ ten working days regarding any 
 82.6   changes related to the participant's employment status. 
 82.7      Sec. 90.  Minnesota Statutes 2002, section 256J.56, is 
 82.8   amended to read: 
 82.9      256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 
 82.10  EXEMPTIONS.] 
 82.11     (a) An MFIP participant is exempt from the requirements of 
 82.12  sections ~~256J.52~~ 256J.515 to ~~256J.55~~ 256J.57 if the participant 
 82.13  belongs to any of the following groups: 
 82.14     (1) participants who are age 60 or older; 
 82.15     (2) participants who are suffering from a ~~professionally~~ 
 82.16  ~~certified~~ permanent or temporary illness, injury, or incapacity 
 82.17  which has been certified by a qualified professional when the 
 82.18  illness, injury, or incapacity is expected to continue for more 
 82.19  than 30 days and ~~which~~ prevents the person from obtaining or 
 82.20  retaining employment.  Persons in this category with a temporary 
 82.21  illness, injury, or incapacity must be reevaluated at least 
 82.22  quarterly; 
 82.23     (3) participants whose presence in the home is required as 
 82.24  a caregiver because of ~~a professionally certified~~ the illness, 
 82.25  injury, or incapacity of another member in the assistance unit, 
 82.26  a relative in the household, or a foster child in the 
 82.27  household ~~and~~ when the illness or incapacity and the need for a 
 82.28  person to provide assistance in the home has been certified by a 
 82.29  qualified professional and is expected to continue for more than 
 82.30  30 days; 
 82.31     (4) women who are pregnant, if the pregnancy has resulted 
 82.32  in ~~a professionally certified~~ an incapacity that prevents the 
 82.33  woman from obtaining or retaining employment, and the incapacity 
 82.34  has been certified by a qualified professional; 
 82.35     (5) caregivers of a child under the age of one year who 
 82.36  personally provide full-time care for the child.  This exemption 
 83.1   may be used for only 12 months in a lifetime.  In two-parent 
 83.2   households, only one parent or other relative may qualify for 
 83.3   this exemption; 
 83.4      (6) participants experiencing a personal or family crisis 
 83.5   that makes them incapable of participating in the program, as 
 83.6   determined by the county agency.  If the participant does not 
 83.7   agree with the county agency's determination, the participant 
 83.8   may seek ~~professional~~ certification from a qualified 
 83.9   professional, as defined in section 256J.08, that the 
 83.10  participant is incapable of participating in the program. 
 83.11     Persons in this exemption category must be reevaluated 
 83.12  every 60 days.  A personal or family crisis related to family 
 83.13  violence, as determined by the county or a job counselor with 
 83.14  the assistance of a person trained in domestic violence, should 
 83.15  not result in an exemption, but should be addressed through the 
 83.16  development or revision of an ~~alternative~~ employment plan under 
 83.17  section ~~256J.52~~ 256J.521, subdivision ~~6~~ 3; or 
 83.18     (7) caregivers with a child or an adult in the household 
 83.19  who meets the disability or medical criteria for home care 
 83.20  services under section 256B.0627, subdivision 1, 
 83.21  paragraph ~~(c)~~ (f), or a home and community-based waiver services 
 83.22  program under chapter 256B, or meets the criteria for severe 
 83.23  emotional disturbance under section 245.4871, subdivision 6, or 
 83.24  for serious and persistent mental illness under section 245.462, 
 83.25  subdivision 20, paragraph (c).  Caregivers in this exemption 
 83.26  category are presumed to be prevented from obtaining or 
 83.27  retaining employment. 
 83.28     A caregiver who is exempt under clause (5) must enroll in 
 83.29  and attend an early childhood and family education class, a 
 83.30  parenting class, or some similar activity, if available, during 
 83.31  the period of time the caregiver is exempt under this section.  
 83.32  Notwithstanding section 256J.46, failure to attend the required 
 83.33  activity shall not result in the imposition of a sanction. 
 83.34     (b) The county agency must provide employment and training 
 83.35  services to MFIP participants who are exempt under this section, 
 83.36  but who volunteer to participate.  Exempt volunteers may request 
 84.1   approval for any work activity under section 256J.49, 
 84.2   subdivision 13.  The hourly participation requirements for 
 84.3   nonexempt participants under section ~~256J.50~~ 256J.55, 
 84.4   subdivision ~~5~~ 1, do not apply to exempt participants who 
 84.5   volunteer to participate. 
 84.6      (c) This section expires on June 30, 2004. 
 84.7      Sec. 91.  [256J.561] [UNIVERSAL PARTICIPATION REQUIRED.] 
 84.8      Subdivision 1.  [IMPLEMENTATION OF UNIVERSAL PARTICIPATION 
 84.9   REQUIREMENTS.] (a) All caregivers whose applications were 
 84.10  received July 1, 2004, or after, are immediately subject to the 
 84.11  requirements in subdivision 2. 
 84.12     (b) For all MFIP participants who were exempt from 
 84.13  participating in employment services under section 256J.56 as of 
 84.14  June 30, 2004, between July 1, 2004, and June 30, 2005, the 
 84.15  county, as part of the participant's recertification under 
 84.16  section 256J.32, subdivision 6, shall determine whether a new 
 84.17  employment plan is required to meet the requirements in 
 84.18  subdivision 2.  Counties shall notify each participant who is in 
 84.19  need of an employment plan that the participant must meet with a 
 84.20  job counselor within ten days to develop an employment plan.  
 84.21  Until a participant's employment plan is developed, the 
 84.22  participant shall be considered in compliance with the 
 84.23  participation requirements in this section if the participant 
 84.24  continues to meet the criteria for an exemption under section 
 84.25  256J.56 as in effect on June 30, 2004, and is cooperating in the 
 84.26  development of the new plan. 
 84.27     Subd. 2.  [PARTICIPATION REQUIREMENTS.] (a) All MFIP 
 84.28  caregivers, except caregivers who meet the criteria in 
 84.29  subdivision 3, must participate in employment services.  Except 
 84.30  as specified in paragraphs (b) to (d), the employment plan must 
 84.31  meet the requirements of section 256J.521, subdivision 2, 
 84.32  contain allowable work activities, as defined in section 
 84.33  256J.49, subdivision 13, and, include at a minimum, the number 
 84.34  of participation hours required under section 256J.55, 
 84.35  subdivision 1. 
 84.36     (b) Minor caregivers and caregivers who are less than age 
 85.1   20 who have not completed high school or obtained a GED are 
 85.2   required to comply with section 256J.54. 
 85.3      (c) A participant who has a family violence waiver shall 
 85.4   develop and comply with an employment plan under section 
 85.5   256J.521, subdivision 3. 
 85.6      (d) As specified in section 256J.521, subdivision 2, 
 85.7   paragraph (c), a participant who meets any one of the following 
 85.8   criteria may work with the job counselor to develop an 
 85.9   employment plan that contains less than the number of 
 85.10  participation hours under section 256J.55, subdivision 1.  
 85.11  Employment plans for participants covered under this paragraph 
 85.12  must be tailored to recognize the special circumstances of 
 85.13  caregivers and families including limitations due to illness or 
 85.14  disability and caregiving needs: 
 85.15     (1) a participant who is age 60 or older; 
 85.16     (2) a participant who has been diagnosed by a qualified 
 85.17  professional as suffering from an illness or incapacity that is 
 85.18  expected to last for 30 days or more, including a pregnant 
 85.19  participant who is determined to be unable to obtain or retain 
 85.20  employment due to the pregnancy; or 
 85.21     (3) a participant who is determined by a qualified 
 85.22  professional as being needed in the home to care for an ill or 
 85.23  incapacitated family member, including caregivers with a child 
 85.24  or an adult in the household who meets the disability or medical 
 85.25  criteria for home care services under section 256B.0627, 
 85.26  subdivision 1, paragraph (f), or a home and community-based 
 85.27  waiver services program under chapter 256B, or meets the 
 85.28  criteria for severe emotional disturbance under section 
 85.29  245.4871, subdivision 6, or for serious and persistent mental 
 85.30  illness under section 245.462, subdivision 20, paragraph (c). 
 85.31     (e) For participants covered under paragraphs (c) and (d), 
 85.32  the county shall review the participant's employment services 
 85.33  status every three months to determine whether conditions have 
 85.34  changed.  When it is determined that the participant's status is 
 85.35  no longer covered under paragraph (c) or (d), the county shall 
 85.36  notify the participant that a new or revised employment plan is 
 86.1   needed.  The participant and job counselor shall meet within ten 
 86.2   days of the determination to revise the employment plan. 
 86.3      Subd. 3.  [CHILD UNDER 12 WEEKS OF AGE.] (a) A participant 
 86.4   who has a natural born child who is less than 12 weeks of age 
 86.5   who meets the criteria in clauses (1) and (2) is not required to 
 86.6   participate in employment services until the child reaches 12 
 86.7   weeks of age.  To be eligible for this provision, the following 
 86.8   conditions must be met: 
 86.9      (1) the child must have been born within ten months of the 
 86.10  caregiver's application for the diversionary work program or 
 86.11  MFIP; and 
 86.12     (2) the assistance unit must not have already used this 
 86.13  provision or the previously allowed child under age one 
 86.14  exemption.  However, an assistance unit that has an approved 
 86.15  child under age one exemption at the time this provision becomes 
 86.16  effective may continue to use that exemption until the child 
 86.17  reaches one year of age. 
 86.18     (b) The provision in paragraph (a) ends the first full 
 86.19  month after the child reaches 12 weeks of age.  This provision 
 86.20  is available only once in a caregiver's lifetime.  In a 
 86.21  two-parent household, only one parent shall be allowed to use 
 86.22  this provision.  The participant and job counselor must meet 
 86.23  within ten days after the child reaches 12 weeks of age to 
 86.24  revise the participant's employment plan. 
 86.25     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
 86.26     Sec. 92.  Minnesota Statutes 2002, section 256J.57, is 
 86.27  amended to read: 
 86.28     256J.57 [GOOD CAUSE; FAILURE TO COMPLY; NOTICE; 
 86.29  CONCILIATION CONFERENCE.] 
 86.30     Subdivision 1.  [GOOD CAUSE FOR FAILURE TO COMPLY.] The 
 86.31  county agency shall not impose the sanction under section 
 86.32  256J.46 if it determines that the participant has good cause for 
 86.33  failing to comply with the requirements of sections ~~256J.52~~ 
 86.34  256J.515 to ~~256J.55~~ 256J.57.  Good cause exists when: 
 86.35     (1) appropriate child care is not available; 
 86.36     (2) the job does not meet the definition of suitable 
 87.1   employment; 
 87.2      (3) the participant is ill or injured; 
 87.3      (4) a member of the assistance unit, a relative in the 
 87.4   household, or a foster child in the household is ill and needs 
 87.5   care by the participant that prevents the participant from 
 87.6   complying with the ~~job search support plan or~~ employment plan; 
 87.7      (5) the parental caregiver is unable to secure necessary 
 87.8   transportation; 
 87.9      (6) the parental caregiver is in an emergency situation 
 87.10  that prevents compliance with the ~~job search support plan or~~ 
 87.11  employment plan; 
 87.12     (7) the schedule of compliance with the ~~job search support~~ 
 87.13  ~~plan or~~ employment plan conflicts with judicial proceedings; 
 87.14     (8) a mandatory MFIP meeting is scheduled during a time 
 87.15  that conflicts with a judicial proceeding or a meeting related 
 87.16  to a juvenile court matter, or a participant's work schedule; 
 87.17     (9) the parental caregiver is already participating in 
 87.18  acceptable work activities; 
 87.19     (10) the employment plan requires an educational program 
 87.20  for a caregiver under age 20, but the educational program is not 
 87.21  available; 
 87.22     (11) activities identified in the ~~job search support plan~~ 
 87.23  ~~or~~ employment plan are not available; 
 87.24     (12) the parental caregiver is willing to accept suitable 
 87.25  employment, but suitable employment is not available; or 
 87.26     (13) the parental caregiver documents other verifiable 
 87.27  impediments to compliance with the ~~job search support plan or~~ 
 87.28  employment plan beyond the parental caregiver's control. 
 87.29     The job counselor shall work with the participant to 
 87.30  reschedule mandatory meetings for individuals who fall under 
 87.31  clauses (1), (3), (4), (5), (6), (7), and (8). 
 87.32     Subd. 2.  [NOTICE OF INTENT TO SANCTION.] (a) When a 
 87.33  participant fails without good cause to comply with the 
 87.34  requirements of sections ~~256J.52~~ 256J.515 to ~~256J.55~~ 256J.57, 
 87.35  the job counselor or the county agency must provide a notice of 
 87.36  intent to sanction to the participant specifying the program 
 88.1   requirements that were not complied with, informing the 
 88.2   participant that the county agency will impose the sanctions 
 88.3   specified in section 256J.46, and informing the participant of 
 88.4   the opportunity to request a conciliation conference as 
 88.5   specified in paragraph (b).  The notice must also state that the 
 88.6   participant's continuing noncompliance with the specified 
 88.7   requirements will result in additional sanctions under section 
 88.8   256J.46, without the need for additional notices or conciliation 
 88.9   conferences under this subdivision.  The notice, written in 
 88.10  English, must include the department of human services language 
 88.11  block, and must be sent to every applicable participant.  If the 
 88.12  participant does not request a conciliation conference within 
 88.13  ten calendar days of the mailing of the notice of intent to 
 88.14  sanction, the job counselor must notify the county agency that 
 88.15  the assistance payment should be reduced.  The county must then 
 88.16  send a notice of adverse action to the participant informing the 
 88.17  participant of the sanction that will be imposed, the reasons 
 88.18  for the sanction, the effective date of the sanction, and the 
 88.19  participant's right to have a fair hearing under section 256J.40.
 88.20     (b) The participant may request a conciliation conference 
 88.21  by sending a written request, by making a telephone request, or 
 88.22  by making an in-person request.  The request must be received 
 88.23  within ten calendar days of the date the county agency mailed 
 88.24  the ten-day notice of intent to sanction.  If a timely request 
 88.25  for a conciliation is received, the county agency's service 
 88.26  provider must conduct the conference within five days of the 
 88.27  request.  The job counselor's supervisor, or a designee of the 
 88.28  supervisor, must review the outcome of the conciliation 
 88.29  conference.  If the conciliation conference resolves the 
 88.30  noncompliance, the job counselor must promptly inform the county 
 88.31  agency and request withdrawal of the sanction notice. 
 88.32     (c) Upon receiving a sanction notice, the participant may 
 88.33  request a fair hearing under section 256J.40, without exercising 
 88.34  the option of a conciliation conference.  In such cases, the 
 88.35  county agency shall not require the participant to engage in a 
 88.36  conciliation conference prior to the fair hearing. 
 89.1      (d) If the participant requests a fair hearing or a 
 89.2   conciliation conference, sanctions will not be imposed until 
 89.3   there is a determination of noncompliance.  Sanctions must be 
 89.4   imposed as provided in section 256J.46. 
 89.5      Sec. 93.  Minnesota Statutes 2002, section 256J.62, 
 89.6   subdivision 9, is amended to read: 
 89.7      Subd. 9.  [CONTINUATION OF CERTAIN SERVICES.] Only if 
 89.8   services were approved as part of an employment plan prior to 
 89.9   June 30, 2003, at the request of the participant, the county may 
 89.10  continue to provide case management, counseling, or other 
 89.11  support services to a participant: 
 89.12     ~~(a)~~ (1) who has achieved the employment goal; or 
 89.13     ~~(b)~~ (2) who under section 256J.42 is no longer eligible to 
 89.14  receive MFIP but whose income is below 115 percent of the 
 89.15  federal poverty guidelines for a family of the same size. 
 89.16     These services may be provided for up to 12 months 
 89.17  following termination of the participant's eligibility for MFIP. 
 89.18     Sec. 94.  [256J.626] [MFIP CONSOLIDATED FUND.] 
 89.19     Subdivision 1.  [CONSOLIDATED FUND.] The consolidated fund 
 89.20  is established to support counties and tribes in meeting their 
 89.21  duties under this chapter.  Counties and tribes must use funds 
 89.22  from the consolidated fund to develop programs and services that 
 89.23  are designed to improve participant outcomes as measured in 
 89.24  section 256J.751, subdivision 2.  Counties may use the funds for 
 89.25  any allowable expenditures under subdivision 2.  Tribes may use 
 89.26  the funds for any allowable expenditures under subdivision 2, 
 89.27  except those in clauses (1) and (6). 
 89.28     Subd. 2.  [ALLOWABLE EXPENDITURES.] (a) The commissioner 
 89.29  must restrict expenditures under the consolidated fund to 
 89.30  benefits and services allowed under title IV-A of the federal 
 89.31  Social Security Act.  Allowable expenditures under the 
 89.32  consolidated fund may include, but are not limited to: 
 89.33     (1) short-term, nonrecurring shelter and utility needs that 
 89.34  are excluded from the definition of assistance under Code of 
 89.35  Federal Regulations, title 45, section 260.31, for families who 
 89.36  meet the residency requirement in section 256J.12, subdivisions 
 90.1   1 and 1a.  Payments under this subdivision are not considered 
 90.2   TANF cash assistance and are not counted towards the 60-month 
 90.3   time limit; 
 90.4      (2) transportation needed to obtain or retain employment or 
 90.5   to participate in other approved work activities; 
 90.6      (3) direct and administrative costs of staff to deliver 
 90.7   employment services for MFIP or the diversionary work program, 
 90.8   to administer financial assistance, and to provide specialized 
 90.9   services intended to assist hard-to-employ participants to 
 90.10  transition to work; 
 90.11     (4) costs of education and training including functional 
 90.12  work literacy and English as a second language; 
 90.13     (5) cost of work supports including tools, clothing, boots, 
 90.14  and other work-related expenses; 
 90.15     (6) county administrative expenses as defined in Code of 
 90.16  Federal Regulations, title 45, section 260(b); 
 90.17     (7) services to parenting and pregnant teens; 
 90.18     (8) supported work; 
 90.19     (9) wage subsidies; 
 90.20     (10) child care needed for MFIP or diversionary work 
 90.21  program participants to participate in social services; 
 90.22     (11) child care to ensure that families leaving MFIP or 
 90.23  diversionary work program will continue to receive child care 
 90.24  assistance from the time the family no longer qualifies for 
 90.25  transition year child care until an opening occurs under the 
 90.26  basic sliding fee child care program; and 
 90.27     (12) services to help noncustodial parents who live in 
 90.28  Minnesota and have minor children receiving MFIP or DWP 
 90.29  assistance, but do not live in the same household as the child, 
 90.30  obtain or retain employment. 
 90.31     (b) Administrative costs that are not matched with county 
 90.32  funds as provided in subdivision 8 may not exceed 7.5 percent of 
 90.33  a county's or 15 percent of a tribe's reimbursement under this 
 90.34  section.  The commissioner shall define administrative costs for 
 90.35  purposes of this subdivision. 
 90.36     Subd. 3.  [ELIGIBILITY FOR SERVICES.] Families with a minor 
 91.1   child, a pregnant woman, or a noncustodial parent of a minor 
 91.2   child receiving assistance, with incomes below 200 percent of 
 91.3   the federal poverty guideline for a family of the applicable 
 91.4   size, are eligible for services funded under the consolidated 
 91.5   fund.  Counties and tribes must give priority to families 
 91.6   currently receiving MFIP or diversionary work program, and 
 91.7   families at risk of receiving MFIP or diversionary work program. 
 91.8      Subd. 4.  [COUNTY AND TRIBAL BIENNIAL SERVICE 
 91.9   AGREEMENTS.] (a) Effective January 1, 2004, and each two-year 
 91.10  period thereafter, each county and tribe must have in place an 
 91.11  approved biennial service agreement related to the services and 
 91.12  programs in this chapter.  In counties with a city of the first 
 91.13  class with a population over 300,000, the county must consider a 
 91.14  service agreement that includes a jointly developed plan for the 
 91.15  delivery of employment services with the city.  Counties may 
 91.16  collaborate to develop multicounty, multitribal, or regional 
 91.17  service agreements. 
 91.18     (b) The service agreements will be completed in a form 
 91.19  prescribed by the commissioner.  The agreement must include: 
 91.20     (1) a statement of the needs of the service population and 
 91.21  strengths and resources in the community; 
 91.22     (2) numerical goals for participant outcomes measures to be 
 91.23  accomplished during the biennial period.  The commissioner may 
 91.24  identify outcomes from section 256J.751, subdivision 2, as core 
 91.25  outcomes for all counties and tribes; 
 91.26     (3) strategies the county or tribe will pursue to achieve 
 91.27  the outcome targets.  Strategies must include specification of 
 91.28  how funds under this section will be used and may include 
 91.29  community partnerships that will be established or strengthened; 
 91.30  and 
 91.31     (4) other items prescribed by the commissioner in 
 91.32  consultation with counties and tribes. 
 91.33     (c) The commissioner shall provide each county and tribe 
 91.34  with information needed to complete an agreement, including:  
 91.35  (1) information on MFIP cases in the county or tribe; (2) 
 91.36  comparisons with the rest of the state; (3) baseline performance 
 92.1   on outcome measures; and (4) promising program practices. 
 92.2      (d) The service agreement must be submitted to the 
 92.3   commissioner by October 15, 2003, and October 15 of each second 
 92.4   year thereafter.  The county or tribe must allow a period of not 
 92.5   less than 30 days prior to the submission of the agreement to 
 92.6   solicit comments from the public on the contents of the 
 92.7   agreement. 
 92.8      (e) The commissioner must, within 60 days of receiving each 
 92.9   county or tribal service agreement, inform the county or tribe 
 92.10  if the service agreement is approved.  If the service agreement 
 92.11  is not approved, the commissioner must inform the county or 
 92.12  tribe of any revisions needed prior to approval. 
 92.13     (f) The service agreement in this subdivision supersedes 
 92.14  the plan requirements of section 268.88. 
 92.15     Subd. 5.  [INNOVATION PROJECTS.] Beginning January 1, 2005, 
 92.16  no more than $3,000,000 of the funds annually appropriated to 
 92.17  the commissioner for use in the consolidated fund shall be 
 92.18  available to the commissioner for projects testing innovative 
 92.19  approaches to improving outcomes for MFIP participants, and 
 92.20  persons at risk of receiving MFIP as detailed in subdivision 3.  
 92.21  Projects shall be targeted to geographic areas with poor 
 92.22  outcomes as specified in section 256J.751, subdivision 5, or to 
 92.23  subgroups within the MFIP case load who are experiencing poor 
 92.24  outcomes. 
 92.25     Subd. 6.  [BASE ALLOCATION TO COUNTIES AND TRIBES.] (a) For 
 92.26  purposes of this section, the following terms have the meanings 
 92.27  given them: 
 92.28     (1) "2002 historic spending base" means the commissioner's 
 92.29  determination of the sum of the reimbursement related to fiscal 
 92.30  year 2002 of county or tribal agency expenditures for the base 
 92.31  programs listed in clause (4), items (i) through (iv), and 
 92.32  earnings related to calendar year 2002 in the base program 
 92.33  listed in clause (4), item (v), and the amount of spending in 
 92.34  fiscal year 2002 in the base program listed in clause (4), item 
 92.35  (vi), issued to or on behalf of persons residing in the county 
 92.36  or tribal service delivery area. 
 93.1      (2) "Initial allocation" means the amount potentially 
 93.2   available to each county or tribe based on the formula in 
 93.3   paragraphs (b) through (d). 
 93.4      (3) "Final allocation" means the amount available to each 
 93.5   county or tribe based on the formula in paragraphs (b) through 
 93.6   (d), after adjustment by subdivision 7. 
 93.7      (4) "Base programs" means the: 
 93.8      (i) MFIP employment and training services under section 
 93.9   256J.62, subdivision 1, in effect June 30, 2002; 
 93.10     (ii) bilingual employment and training services to refugees 
 93.11  under section 256J.62, subdivision 6, in effect June 30, 2002; 
 93.12     (iii) work literacy language programs under section 
 93.13  256J.62, subdivision 7, in effect June 30, 2002; 
 93.14     (iv) supported work program authorized in Laws 2001, First 
 93.15  Special Session chapter 9, article 17, section 2, in effect June 
 93.16  30, 2002; 
 93.17     (v) administrative aid program under section 256J.76 in 
 93.18  effect December 31, 2002; and 
 93.19     (vi) emergency assistance program under section 256J.48 in 
 93.20  effect June 30, 2002. 
 93.21     (b)(1) Beginning July 1, 2003, the commissioner shall 
 93.22  determine the initial allocation of funds available under this 
 93.23  section according to clause (2). 
 93.24     (2) All of the funds available for the period beginning 
 93.25  July 1, 2003, and ending December 31, 2004, shall be allocated 
 93.26  to each county or tribe in proportion to the county's or tribe's 
 93.27  share of the statewide 2002 historic spending base. 
 93.28     (c) For calendar year 2005, the commissioner shall 
 93.29  determine the initial allocation of funds to be made available 
 93.30  under this section in proportion to the county or tribe's 
 93.31  initial allocation for the period of July 1, 2003 to December 
 93.32  31, 2004. 
 93.33     (d) The formula under this subdivision sunsets December 31, 
 93.34  2005. 
 93.35     (e) Before November 30, 2003, a county or tribe may ask for 
 93.36  a review of the commissioner's determination of the historic 
 94.1   base spending when the county or tribe believes the 2002 
 94.2   information was inaccurate or incomplete.  By January 1, 2004, 
 94.3   the commissioner must adjust that county's or tribe's base when 
 94.4   the commissioner has determined that inaccurate or incomplete 
 94.5   information was used to develop that base.  The commissioner 
 94.6   shall adjust each county's or tribe's initial allocation under 
 94.7   paragraph (c) and final allocation under subdivision 7 to 
 94.8   reflect the base change. 
 94.9      (f) Effective January 1, 2005, counties and tribes will 
 94.10  have their final allocations adjusted based on the performance 
 94.11  provisions of subdivision 7. 
 94.12     Subd. 7.  [PERFORMANCE BASE FUNDS.] (a) Each county and 
 94.13  tribe will be allocated 95 percent of their initial calendar 
 94.14  year 2005 allocation.  Counties and tribes will be allocated 
 94.15  additional funds based on performance as follows: 
 94.16     (1) a county or tribe that achieves a 50 percent rate or 
 94.17  higher on the MFIP participation rate under section 256J.751, 
 94.18  subdivision 2, clause (8), as averaged across the four quarterly 
 94.19  measurements for the most recent year for which the measurements 
 94.20  are available, will receive an additional allocation equal to 
 94.21  2.5 percent of its initial allocation; and 
 94.22     (2) a county or tribe that performs above the top of its 
 94.23  range of expected performance on the three-year self-support 
 94.24  index under section 256J.751, subdivision 2, clause (7), in both 
 94.25  measurements in the preceding year will receive an additional 
 94.26  allocation equal to five percent of its initial allocation; or 
 94.27     (3) a county or tribe that performs within its range of 
 94.28  expected performance on the three-year self-support index under 
 94.29  section 256J.751, subdivision 2, clause (7), in both 
 94.30  measurements in the preceding year, or above the top of its 
 94.31  range of expected performance in one measurement and within its 
 94.32  expected range of performance in the other measurement, will 
 94.33  receive an additional allocation equal to 2.5 percent of its 
 94.34  initial allocation. 
 94.35     (b) Funds remaining unallocated after the performance-based 
 94.36  allocations in paragraph (a) are available to the commissioner 
 95.1   for innovation projects under subdivision 5. 
 95.2      (c)(1) If available funds are insufficient to meet county 
 95.3   and tribal allocations under paragraph (a), the commissioner may 
 95.4   make available for allocation funds that are unobligated and 
 95.5   available from the innovation projects through the end of the 
 95.6   current biennium. 
 95.7      (2) If after the application of clause (1) funds remain 
 95.8   insufficient to meet county and tribal allocations under 
 95.9   paragraph (a), the commissioner must proportionally reduce the 
 95.10  allocation of each county and tribe with respect to their 
 95.11  maximum allocation available under paragraph (a). 
 95.12     Subd. 8.  [REPORTING REQUIREMENT AND REIMBURSEMENT.] (a) 
 95.13  The commissioner shall specify requirements for reporting 
 95.14  according to section 256.01, subdivision 2, clause (17).  Each 
 95.15  county or tribe shall be reimbursed for eligible expenditures up 
 95.16  to the limit of its allocation and subject to availability of 
 95.17  funds. 
 95.18     (b) Reimbursements for county administrative-related 
 95.19  expenditures determined through the income maintenance random 
 95.20  moment time study shall be reimbursed at a rate of 50 percent of 
 95.21  eligible expenditures.  
 95.22     (c) The commissioner of human services shall review county 
 95.23  and tribal agency expenditures of the MFIP consolidated fund as 
 95.24  appropriate and may reallocate unencumbered or unexpended money 
 95.25  appropriated under this section to those county and tribal 
 95.26  agencies that can demonstrate a need for additional money. 
 95.27     Subd. 9.  [REPORT.] The commissioner shall, in consultation 
 95.28  with counties and tribes: 
 95.29     (1) determine how performance-based allocations under 
 95.30  subdivision 7, paragraph (a), clauses (2) and (3), will be 
 95.31  allocated to groupings of counties and tribes when groupings are 
 95.32  used to measure expected performance ranges for the self-support 
 95.33  index under section 256J.751, subdivision 2, clause (7); and 
 95.34     (2) determine how performance-based allocations under 
 95.35  subdivision 7, paragraph (a), clauses (2) and (3), will be 
 95.36  allocated to tribes. 
 96.1   The commissioner shall report to the legislature on the formulas 
 96.2   developed in clauses (1) and (2) by January 1, 2004. 
 96.3      Sec. 95.  Minnesota Statutes 2002, section 256J.645, 
 96.4   subdivision 3, is amended to read: 
 96.5      Subd. 3.  [FUNDING.] If the commissioner and an Indian 
 96.6   tribe are parties to an agreement under this subdivision, the 
 96.7   agreement shall annually provide to the Indian tribe the funding 
 96.8   allocated in section ~~256J.62, subdivisions 1 and 2a~~ 256J.626. 
 96.9      Sec. 96.  Minnesota Statutes 2002, section 256J.66, 
 96.10  subdivision 2, is amended to read: 
 96.11     Subd. 2.  [TRAINING AND PLACEMENT.] (a) County agencies 
 96.12  shall limit the length of training based on the complexity of 
 96.13  the job and the caregiver's previous experience and training.  
 96.14  Placement in an on-the-job training position with an employer is 
 96.15  for the purpose of training and employment with the same 
 96.16  employer who has agreed to retain the person upon satisfactory 
 96.17  completion of training. 
 96.18     (b) Placement of any participant in an on-the-job training 
 96.19  position must be compatible with the participant's assessment 
 96.20  and employment plan under section ~~256J.52~~ 256J.521. 
 96.21     Sec. 97.  Minnesota Statutes 2002, section 256J.69, 
 96.22  subdivision 2, is amended to read: 
 96.23     Subd. 2.  [TRAINING AND PLACEMENT.] (a) County agencies 
 96.24  shall limit the length of training to nine months.  Placement in 
 96.25  a grant diversion training position with an employer is for the 
 96.26  purpose of training and employment with the same employer who 
 96.27  has agreed to retain the person upon satisfactory completion of 
 96.28  training. 
 96.29     (b) Placement of any participant in a grant diversion 
 96.30  subsidized training position must be compatible with the 
 96.31  assessment and employment plan or employability development plan 
 96.32  established for the recipient under section ~~256J.52 or 256K.03,~~ 
 96.33  ~~subdivision 8~~ 256J.521. 
 96.34     Sec. 98.  Minnesota Statutes 2002, section 256J.75, 
 96.35  subdivision 3, is amended to read: 
 96.36     Subd. 3.  [RESPONSIBILITY FOR INCORRECT ASSISTANCE 
 97.1   PAYMENTS.] A county of residence, when different from the county 
 97.2   of financial responsibility, will be charged by the commissioner 
 97.3   for the value of incorrect assistance payments ~~and medical~~ 
 97.4   ~~assistance~~ paid to or on behalf of a person who was not eligible 
 97.5   to receive that amount.  Incorrect payments include payments to 
 97.6   an ineligible person or family resulting from decisions, 
 97.7   failures to act, miscalculations, or overdue recertification.  
 97.8   However, financial responsibility does not accrue for a county 
 97.9   when the recertification is overdue at the time the referral is 
 97.10  received by the county of residence or when the county of 
 97.11  financial responsibility does not act on the recommendation of 
 97.12  the county of residence.  ~~When federal or state law requires~~ 
 97.13  ~~that medical assistance continue after assistance ends, this~~ 
 97.14  ~~subdivision also governs financial responsibility for the~~ 
 97.15  ~~extended medical assistance.~~ 
 97.16     Sec. 99.  Minnesota Statutes 2002, section 256J.751, 
 97.17  subdivision 1, is amended to read: 
 97.18     Subdivision 1.  [~~QUARTERLY~~ MONTHLY COUNTY CASELOAD REPORT.] 
 97.19  The commissioner shall report ~~quarterly~~ monthly to each county 
 97.20  ~~on~~ the ~~county's performance on the following measures~~ following 
 97.21  caseload information: 
 97.22     ~~(1) number of cases receiving only the food portion of~~ 
 97.23  ~~assistance;~~ 
 97.24     ~~(2) number of child-only cases;~~ 
 97.25     ~~(3) number of minor caregivers;~~ 
 97.26     ~~(4) number of cases that are exempt from the 60-month time~~ 
 97.27  ~~limit by the exemption category under section 256J.42;~~ 
 97.28     ~~(5) number of participants who are exempt from employment~~ 
 97.29  ~~and training services requirements by the exemption category~~ 
 97.30  ~~under section 256J.56;~~ 
 97.31     ~~(6) number of assistance units receiving assistance under a~~ 
 97.32  ~~hardship extension under section 256J.425;~~ 
 97.33     ~~(7) number of participants and number of months spent in~~ 
 97.34  ~~each level of sanction under section 256J.46, subdivision 1;~~ 
 97.35     ~~(8) number of MFIP cases that have left assistance;~~ 
 97.36     ~~(9) federal participation requirements as specified in~~ 
 98.1   ~~title 1 of Public Law Number 104-193;~~ 
 98.2      ~~(10) median placement wage rate; and~~ 
 98.3      ~~(11) of each county's total MFIP caseload less the number~~ 
 98.4   ~~of cases in clauses (1) to (6):~~ 
 98.5      ~~(i) number of one-parent cases;~~ 
 98.6      ~~(ii) number of two-parent cases;~~ 
 98.7      ~~(iii) percent of one-parent cases that are working more~~ 
 98.8   ~~than 20 hours per week;~~ 
 98.9      ~~(iv) percent of two-parent cases that are working more than~~ 
 98.10  ~~20 hours per week; and~~ 
 98.11     ~~(v) percent of cases that have received more than 36 months~~ 
 98.12  ~~of assistance.~~ 
 98.13     (1) total number of cases receiving MFIP, and subtotals of 
 98.14  cases with one eligible parent, two eligible parents, and an 
 98.15  eligible caregiver who is not a parent; 
 98.16     (2) total number of child only assistance cases; 
 98.17     (3) total number of eligible adults and children receiving 
 98.18  an MFIP grant, and subtotals for cases with one eligible parent, 
 98.19  two eligible parents, an eligible caregiver who is not a parent, 
 98.20  and child only cases; 
 98.21     (4) number of cases with an exemption from the 60-month 
 98.22  time limit based on a family violence waiver; 
 98.23     (5) number of MFIP cases with work hours, and subtotals for 
 98.24  cases with one eligible parent, two eligible parents, and an 
 98.25  eligible caregiver who is not a parent; 
 98.26     (6) number of employed MFIP cases, and subtotals for cases 
 98.27  with one eligible parent, two eligible parents, and an eligible 
 98.28  caregiver who is not a parent; 
 98.29     (7) average monthly gross earnings, and averages for 
 98.30  subgroups of cases with one eligible parent, two eligible 
 98.31  parents, and an eligible caregiver who is not a parent; 
 98.32     (8) number of employed cases receiving only the food 
 98.33  portion of assistance; 
 98.34     (9) number of parents or caregivers exempt from work 
 98.35  activity requirements, with subtotals for each exemption type; 
 98.36  and 
 99.1      (10) number of cases with a sanction, with subtotals by 
 99.2   level of sanction for cases with one eligible parent, two 
 99.3   eligible parents, and an eligible caregiver who is not a parent. 
 99.4      Sec. 100.  Minnesota Statutes 2002, section 256J.751, 
 99.5   subdivision 2, is amended to read: 
 99.6      Subd. 2.  [QUARTERLY COMPARISON REPORT.] The commissioner 
 99.7   shall report quarterly to all counties on each county's 
 99.8   performance on the following measures: 
 99.9      (1) percent of MFIP caseload working in paid employment; 
 99.10     (2) percent of MFIP caseload receiving only the food 
 99.11  portion of assistance; 
 99.12     (3) number of MFIP cases that have left assistance; 
 99.13     (4) federal participation requirements as specified in 
 99.14  Title 1 of Public Law ~~Number~~ 104-193; 
 99.15     (5) median placement wage rate; ~~and~~ 
 99.16     (6) caseload by months of TANF assistance; 
 99.17     (7) percent of MFIP cases off cash assistance or working 30 
 99.18  or more hours per week at one-year, two-year, and three-year 
 99.19  follow-up points from a base line quarter.  This measure is 
 99.20  called the self-support index.  Twice annually, the commissioner 
 99.21  shall report an expected range of performance for each county, 
 99.22  county grouping, and tribe on the self-support index.  The 
 99.23  expected range shall be derived by a statistical methodology 
 99.24  developed by the commissioner in consultation with the counties 
 99.25  and tribes.  The statistical methodology shall control 
 99.26  differences across counties in economic conditions and 
 99.27  demographics of the MFIP case load; and 
 99.28     (8) the MFIP work participation rate, defined as the 
 99.29  participation requirements specified in title 1 of Public Law 
 99.30  104-193 applied to all MFIP cases except child only cases and 
 99.31  cases exempt under section 256J.56. 
 99.32     Sec. 101.  Minnesota Statutes 2002, section 256J.751, 
 99.33  subdivision 5, is amended to read: 
 99.34     Subd. 5.  [FAILURE TO MEET FEDERAL PERFORMANCE STANDARDS.] 
 99.35  (a) If sanctions occur for failure to meet the performance 
 99.36  standards specified in title 1 of Public Law ~~Number~~ 104-193 of 
100.1   the Personal Responsibility and Work Opportunity Act of 1996, 
100.2   the state shall pay 88 percent of the sanction.  The remaining 
100.3   12 percent of the sanction will be paid by the counties.  The 
100.4   county portion of the sanction will be distributed across all 
100.5   counties in proportion to each county's percentage of the MFIP 
100.6   average monthly caseload during the period for which the 
100.7   sanction was applied. 
100.8      (b) If a county fails to meet the performance standards 
100.9   specified in title 1 of Public Law ~~Number~~ 104-193 of the 
100.10  Personal Responsibility and Work Opportunity Act of 1996 for any 
100.11  year, the commissioner shall work with counties to organize a 
100.12  joint state-county technical assistance team to work with the 
100.13  county.  The commissioner shall coordinate any technical 
100.14  assistance with other departments and agencies including the 
100.15  departments of economic security and children, families, and 
100.16  learning as necessary to achieve the purpose of this paragraph. 
100.17     (c) For state performance measures, a low-performing county 
100.18  is one that: 
100.19     (1) performs below the bottom of their expected range for 
100.20  the measure in subdivision 2, clause (7), in both measurements 
100.21  during the year; or 
100.22     (2) performs below 40 percent for the measure in 
100.23  subdivision 2, clause (8), as averaged across the four quarterly 
100.24  measurements for the year, or the ten counties with the lowest 
100.25  rates if more than ten are below 40 percent. 
100.26     (d) Low-performing counties under paragraph (c) must engage 
100.27  in corrective action planning as defined by the commissioner.  
100.28  The commissioner may coordinate technical assistance as 
100.29  specified in paragraph (b) for low-performing counties under 
100.30  paragraph (c). 
100.31     Sec. 102.  [256J.95] [DIVERSIONARY WORK PROGRAM.] 
100.32     Subdivision 1.  [ESTABLISHING A DIVERSIONARY WORK PROGRAM 
100.33  (DWP).] (a) The Personal Responsibility and Work Opportunity 
100.34  Reconciliation Act of 1996, Public Law 104-193, establishes 
100.35  block grants to states for temporary assistance for needy 
100.36  families (TANF).  TANF provisions allow states to use TANF 
101.1   dollars for nonrecurrent, short-term diversionary benefits.  The 
101.2   diversionary work program established on July 1, 2003, is 
101.3   Minnesota's TANF program to provide short-term diversionary 
101.4   benefits to eligible recipients of the diversionary work program.
101.5      (b) The goal of the diversionary work program is to provide 
101.6   short-term, necessary services and supports to families which 
101.7   will lead to unsubsidized employment, increase economic 
101.8   stability, and reduce the risk of those families needing longer 
101.9   term assistance, under the Minnesota family investment program 
101.10  (MFIP). 
101.11     (c) When a family unit meets the eligibility criteria in 
101.12  this section, the family must receive a diversionary work 
101.13  program grant and is not eligible for MFIP. 
101.14     (d) A family unit is eligible for the diversionary work 
101.15  program for a maximum of four months only once in a 12-month 
101.16  period.  The 12-month period begins at the date of application 
101.17  or the date eligibility is met, whichever is later.  During the 
101.18  four-month period, family maintenance needs as defined in 
101.19  subdivision 2, shall be vendor paid, up to the cash portion of 
101.20  the MFIP standard of need for the same size household.  To the 
101.21  extent there is a balance available between the amount paid for 
101.22  family maintenance needs and the cash portion of the 
101.23  transitional standard, a personal needs allowance of up to $70 
101.24  per DWP recipient in the family unit shall be issued.  The 
101.25  personal needs allowance payment plus the family maintenance 
101.26  needs shall not exceed the cash portion of the MFIP standard of 
101.27  need.  Counties may provide supportive and other allowable 
101.28  services funded by the MFIP consolidated fund under section 
101.29  256J.626 to eligible participants during the four-month 
101.30  diversionary period. 
101.31     Subd. 2.  [DEFINITIONS.] The terms used in this section 
101.32  have the following meanings. 
101.33     (a) "Diversionary Work Program (DWP)" means the program 
101.34  established under this section. 
101.35     (b) "Employment plan" means a plan developed by the job 
101.36  counselor and the participant which identifies the participant's 
102.1   most direct path to unsubsidized employment, lists the specific 
102.2   steps that the caregiver will take on that path, and includes a 
102.3   timetable for the completion of each step.  For participants who 
102.4   request and qualify for a family violence waiver in section 
102.5   256J.521, subdivision 3, an employment plan must be developed by 
102.6   the job counselor, the participant and a person trained in 
102.7   domestic violence and follow the employment plan provisions in 
102.8   section 256J.521, subdivision 3.  Employment plans under this 
102.9   section shall be written for a period of time not to exceed four 
102.10  months. 
102.11     (c) "Employment services" means programs, activities, and 
102.12  services in this section that are designed to assist 
102.13  participants in obtaining and retaining employment. 
102.14     (d) "Family maintenance needs" means current housing costs 
102.15  including rent, manufactured home lot rental costs, or monthly 
102.16  principal, interest, insurance premiums, and property taxes due 
102.17  for mortgages or contracts for deed, association fees required 
102.18  for homeownership, utility costs for current month expenses of 
102.19  gas and electric, garbage, water and sewer, and a flat rate of 
102.20  $35 for telephone services. 
102.21     (e) "Family unit" means a group of people applying for or 
102.22  receiving DWP benefits together.  For the purposes of 
102.23  determining eligibility for this program, the unit includes the 
102.24  relationships in section 256J.24, subdivisions 2 and 4. 
102.25     (f) "Minnesota family investment program (MFIP)" means the 
102.26  assistance program as defined in section 256J.08, subdivision 57.
102.27     (g) "Personal needs allowance" means an allowance of up to 
102.28  $70 per month per DWP unit member to pay for expenses such as 
102.29  household products and personal products. 
102.30     (h) "Work activities" means allowable work activities as 
102.31  defined in section 256J.49, subdivision 13. 
102.32     Subd. 3.  [ELIGIBILITY FOR DIVERSIONARY WORK PROGRAM.] (a) 
102.33  Except for the categories of family units listed below, all 
102.34  family units who apply for cash benefits and who meet MFIP 
102.35  eligibility as required in sections 256J.11 to 256J.15 are 
102.36  eligible and must participate in the diversionary work program.  
103.1   Family units that are not eligible for the diversionary work 
103.2   program include: 
103.3      (1) child only cases; 
103.4      (2) a single-parent family unit that includes a child under 
103.5   12 weeks of age.  A parent is eligible for this exception once 
103.6   in a parent's lifetime and is not eligible if the parent has 
103.7   already used the previously allowed child under age one 
103.8   exemption from MFIP employment services; 
103.9      (3) a minor parent without a high school diploma or its 
103.10  equivalent; 
103.11     (4) a caregiver 18 or 19 years of age without a high school 
103.12  diploma or its equivalent who chooses to have an employment plan 
103.13  with an education option; 
103.14     (5) a caregiver age 60 or over; 
103.15     (6) family units with a parent who received DWP benefits 
103.16  within a 12-month period as defined in subdivision 1, paragraph 
103.17  (d); and 
103.18     (7) family units with a parent who received MFIP within the 
103.19  past 12 months. 
103.20     (b) A two-parent family must participate in DWP unless both 
103.21  parents meet the criteria for an exception under paragraph (a), 
103.22  clauses (1) through (5), or the family unit includes a parent 
103.23  who meets the criteria in paragraph (a), clause (6) or (7). 
103.24     Subd. 4.  [COOPERATION WITH PROGRAM REQUIREMENTS.] (a) To 
103.25  be eligible for DWP, an applicant must comply with the 
103.26  requirements of paragraphs (b) to (d). 
103.27     (b) Applicants and participants must cooperate with the 
103.28  requirements of the child support enforcement program, but will 
103.29  not be charged a fee under section 518.551, subdivision 7. 
103.30     (c) The applicant must provide each member of the family 
103.31  unit's social security number to the county agency.  This 
103.32  requirement is satisfied when each member of the family unit 
103.33  cooperates with the procedures for verification of numbers, 
103.34  issuance of duplicate cards, and issuance of new numbers which 
103.35  have been established jointly between the Social Security 
103.36  Administration and the commissioner. 
104.1      (d) Before DWP benefits can be issued to a family unit, the 
104.2   caregiver must, in conjunction with a job counselor, develop and 
104.3   sign an employment plan.  In two-parent family units, both 
104.4   parents must develop and sign employment plans before benefits 
104.5   can be issued.  Food support and health care benefits are not 
104.6   contingent on the requirement for a signed employment plan. 
104.7      Subd. 5.  [SUBMITTING APPLICATION FORM.] The eligibility 
104.8   date for the diversionary work program begins with the date the 
104.9   signed combined application form (CAF) is received by the county 
104.10  agency or the date diversionary work program eligibility 
104.11  criteria are met, whichever is later.  The county agency must 
104.12  inform the applicant that any delay in submitting the 
104.13  application will reduce the benefits paid for the month of 
104.14  application.  The county agency must inform a person that an 
104.15  application may be submitted before the person has an interview 
104.16  appointment.  Upon receipt of a signed application, the county 
104.17  agency must stamp the date of receipt on the face of the 
104.18  application.  The applicant may withdraw the application at any 
104.19  time prior to approval by giving written or oral notice to the 
104.20  county agency.  The county agency must follow the notice 
104.21  requirements in section 256J.09, subdivision 3, when issuing a 
104.22  notice confirming the withdrawal. 
104.23     Subd. 6.  [INITIAL SCREENING OF APPLICATIONS.] Upon receipt 
104.24  of the application, the county agency must determine if the 
104.25  applicant may be eligible for other benefits as required in 
104.26  sections 256J.09, subdivision 3a, and 256J.28, subdivisions 1 
104.27  and 5.  The county must also follow the provisions in section 
104.28  256J.09, subdivision 3b, clause (2). 
104.29     Subd. 7.  [PROGRAM AND PROCESSING STANDARDS.] (a) The 
104.30  interview to determine financial eligibility for the 
104.31  diversionary work program must be conducted within five working 
104.32  days of the receipt of the cash application form.  During the 
104.33  intake interview the financial worker must discuss: 
104.34     (1) the goals, requirements, and services of the 
104.35  diversionary work program; 
104.36     (2) the availability of child care assistance.  If child 
105.1   care is needed, the worker must obtain a completed application 
105.2   for child care from the applicant before the interview is 
105.3   terminated.  The same day the application for child care is 
105.4   received, the application must be forwarded to the appropriate 
105.5   child care worker.  For purposes of eligibility for child care 
105.6   assistance under chapter 119B, DWP participants shall be 
105.7   eligible for the same benefits as MFIP recipients; and 
105.8      (3) if the applicant has not requested food support and 
105.9   health care assistance on the application, the county agency 
105.10  shall, during the interview process, talk with the applicant 
105.11  about the availability of these benefits. 
105.12     (b) The county shall follow section 256J.74, subdivision 2, 
105.13  paragraph (b), clauses (1) and (2), when an applicant or a 
105.14  recipient of DWP has a person who is a member of more than one 
105.15  assistance unit in a given payment month. 
105.16     (c) If within 30 days the county agency cannot determine 
105.17  eligibility for the diversionary work program, the county must 
105.18  deny the application and inform the applicant of the decision 
105.19  according to the notice provisions in section 256J.31.  A family 
105.20  unit is eligible for a fair hearing under section 256J.40.  
105.21     Subd. 8.  [VERIFICATION REQUIREMENTS.] (a) A county agency 
105.22  must only require verification of information necessary to 
105.23  determine DWP eligibility and the amount of the payment.  The 
105.24  applicant or participant must document the information required 
105.25  or authorize the county agency to verify the information.  The 
105.26  applicant or participant has the burden of providing documentary 
105.27  evidence to verify eligibility.  The county agency shall assist 
105.28  the applicant or participant in obtaining required documents 
105.29  when the applicant or participant is unable to do so. 
105.30     (b) A county agency must not request information about an 
105.31  applicant or participant that is not a matter of public record 
105.32  from a source other than county agencies, the department of 
105.33  human services, or the United States Department of Health and 
105.34  Human Services without the person's prior written consent.  An 
105.35  applicant's signature on an application form constitutes consent 
105.36  for contact with the sources specified on the application.  A 
106.1   county agency may use a single consent form to contact a group 
106.2   of similar sources, but the sources to be contacted must be 
106.3   identified by the county agency prior to requesting an 
106.4   applicant's consent. 
106.5      (c) Factors to be verified shall follow section 256J.32, 
106.6   subdivision 4.  Except for personal needs, family maintenance 
106.7   needs must be verified before the expense can be allowed in the 
106.8   calculation of the DWP grant. 
106.9      Subd. 9.  [PROPERTY AND INCOME LIMITATIONS.] The asset 
106.10  limits and exclusions in section 256J.20, apply to applicants 
106.11  and recipients of DWP.  All payments, unless excluded in section 
106.12  256J.21, must be counted as income to determine eligibility for 
106.13  the diversionary work program.  The county shall treat income as 
106.14  outlined in section 256J.37, except for subdivision 3a.  The 
106.15  initial income test and the disregards in section 256J.21, 
106.16  subdivision 3, shall be followed for determining eligibility for 
106.17  the diversionary work program. 
106.18     Subd. 10.  [DIVERSIONARY WORK PROGRAM GRANT.] (a) The 
106.19  amount of cash benefits that a family unit is eligible for under 
106.20  the diversionary work program is based on the number of persons 
106.21  in the family unit, the family maintenance needs, personal needs 
106.22  allowance, and countable income.  The county agency shall 
106.23  evaluate the income of the family unit that is requesting 
106.24  payments under the diversionary work program.  Countable income 
106.25  means gross earned and unearned income not excluded or 
106.26  disregarded under MFIP.  The same disregards for earned income 
106.27  that are allowed under MFIP are allowed for the diversionary 
106.28  work program. 
106.29     (b) The DWP grant is based on the family maintenance needs 
106.30  for which the DWP family unit is responsible plus a personal 
106.31  needs allowance.  Housing and utilities, except for telephone 
106.32  service, shall be vendor paid.  Unless otherwise stated in this 
106.33  section, actual housing and utility expenses shall be used when 
106.34  determining the amount of the DWP grant. 
106.35     (c) The maximum monthly benefit amount available under the 
106.36  diversionary work program is the difference between the family 
107.1   unit's needs under paragraph (b) and the family unit's countable 
107.2   income not to exceed the cash portion of the MFIP standard of 
107.3   need as defined in section 256J.08, subdivision 55a, for the 
107.4   family unit's size.  
107.5      (d) Once the county has determined a grant amount, the DWP 
107.6   grant amount will not be decreased if the determination is based 
107.7   on the best information available at the time of approval and 
107.8   shall not be decreased because of any additional income to the 
107.9   family unit.  The grant must be increased if a participant later 
107.10  verifies an increase in family maintenance needs or family unit 
107.11  size.  The minimum cash benefit amount, if income and asset 
107.12  tests are met, is $10.  Benefits of $10 shall not be vendor paid.
107.13     (e) When all criteria are met, including the development of 
107.14  an employment plan as described in subdivision 14 and 
107.15  eligibility exists for the month of application, the amount of 
107.16  benefits for the diversionary work program retroactive to the 
107.17  date of application is as specified in section 256J.35, 
107.18  paragraph (a). 
107.19     (f) Any month during the four-month DWP period that a 
107.20  person receives a DWP benefit directly or through a vendor 
107.21  payment made on the person's behalf, that person is ineligible 
107.22  for MFIP or any other TANF cash assistance program except for 
107.23  benefits defined in section 256J.626, subdivision 2, clause (1). 
107.24     If during the four-month period a family unit that receives 
107.25  DWP benefits moves to a county that has not established a 
107.26  diversionary work program, the family unit may be eligible for 
107.27  MFIP the month following the last month of the issuance of the 
107.28  DWP benefit. 
107.29     Subd. 11.  [UNIVERSAL PARTICIPATION REQUIRED.] (a) All DWP 
107.30  caregivers, except caregivers who meet the criteria in paragraph 
107.31  (d), are required to participate in DWP employment services.  
107.32  Except as specified in paragraphs (b) and (c), employment plans 
107.33  under DWP must, at a minimum, meet the requirements in section 
107.34  256J.55, subdivision 1. 
107.35     (b) A caregiver who is a member of a two-parent family that 
107.36  is required to participate in DWP who would otherwise be 
108.1   ineligible for DWP under subdivision 3 may be allowed to develop 
108.2   an employment plan under section 256J.521, subdivision 2, 
108.3   paragraph (c), that may contain alternate activities and reduced 
108.4   hours.  
108.5      (c) A participant who has a family violence waiver shall be 
108.6   allowed to develop an employment plan under section 256J.521, 
108.7   subdivision 3. 
108.8      (d) One parent in a two-parent family unit that has a 
108.9   natural born child under 12 weeks of age is not required to have 
108.10  an employment plan until the child reaches 12 weeks of age 
108.11  unless the family unit has already used the exclusion under 
108.12  section 256J.561, subdivision 2, or the previously allowed child 
108.13  under age one exemption under section 256J.56, paragraph (a), 
108.14  clause (5). 
108.15     (e) The provision in paragraph (d) ends the first full 
108.16  month after the child reaches 12 weeks of age.  This provision 
108.17  is allowable only once in a caregiver's lifetime.  In a 
108.18  two-parent household, only one parent shall be allowed to use 
108.19  this category. 
108.20     (f) The participant and job counselor must meet within ten 
108.21  working days after the child reaches 12 weeks of age to revise 
108.22  the participant's employment plan.  The employment plan for a 
108.23  family unit that has a child under 12 weeks of age that has 
108.24  already used the exclusion in section 256J.561 or the previously 
108.25  allowed child under age one exemption under section 256J.56, 
108.26  paragraph (a), clause (5), must be tailored to recognize the 
108.27  caregiving needs of the parent. 
108.28     Subd. 12.  [CONVERSION OR REFERRAL TO MFIP.] (a) If at any 
108.29  time during the DWP application process or during the four-month 
108.30  DWP eligibility period, it is determined that a participant is 
108.31  unlikely to benefit from the diversionary work program, the 
108.32  county shall convert or refer the participant to MFIP as 
108.33  specified in paragraph (d).  Participants who are determined to 
108.34  be unlikely to benefit from the diversionary work program must 
108.35  develop and sign an employment plan.  Participants who meet any 
108.36  one of the criteria in paragraph (b) shall be considered to be 
109.1   unlikely to benefit from DWP, provided the necessary 
109.2   documentation is available to support the determination. 
109.3      (b) A participant who: 
109.4      (1) has been determined by a qualified professional as 
109.5   being unable to obtain or retain employment due to an illness, 
109.6   injury, or incapacity that is expected to last at least 60 days; 
109.7      (2) is required in the home as a caregiver because of the 
109.8   illness, injury, or incapacity, of a family member, or a 
109.9   relative in the household, or a foster child, and the illness, 
109.10  injury, or incapacity and the need for a person to provide 
109.11  assistance in the home has been certified by a qualified 
109.12  professional and is expected to continue more than 60 days; 
109.13     (3) is determined by a qualified professional as being 
109.14  needed in the home to care for a child meeting the special 
109.15  medical criteria in section 256J.425, subdivision 2, clause (3); 
109.16     (4) is pregnant and is determined by a qualified 
109.17  professional as being unable to obtain or retain employment due 
109.18  to the pregnancy; or 
109.19     (5) has applied for SSI or RSDI. 
109.20     (c) In a two-parent family unit, both parents must be 
109.21  determined to be unlikely to benefit from the diversionary work 
109.22  program before the family unit can be converted or referred to 
109.23  MFIP. 
109.24     (d) A participant who is determined to be unlikely to 
109.25  benefit from the diversionary work program shall be converted to 
109.26  MFIP and, if the determination was made within 30 days of the 
109.27  initial application for benefits, no additional application form 
109.28  is required.  A participant who is determined to be unlikely to 
109.29  benefit from the diversionary work program shall be referred to 
109.30  MFIP and, if the determination is made more than 30 days after 
109.31  the initial application, the participant must submit a program 
109.32  change request form.  The county agency shall process the 
109.33  program change request form by the first of the following month 
109.34  to ensure that no gap in benefits is due to delayed action by 
109.35  the county agency.  In processing the program change request 
109.36  form, the county must follow section 256J.32, subdivision 1, 
110.1   except that the county agency shall not require additional 
110.2   verification of the information in the case file from the DWP 
110.3   application unless the information in the case file is 
110.4   inaccurate, questionable, or no longer current. 
110.5      (e) The county shall not request a combined application 
110.6   form for a participant who has exhausted the four months of the 
110.7   diversionary work program, has continued need for cash and food 
110.8   assistance, and has completed, signed, and submitted a program 
110.9   change request form within 30 days of the fourth month of the 
110.10  diversionary work program.  The county must process the program 
110.11  change request according to section 256J.32, subdivision 1, 
110.12  except that the county agency shall not require additional 
110.13  verification of information in the case file unless the 
110.14  information is inaccurate, questionable, or no longer current.  
110.15  When a participant does not request MFIP within 30 days of the 
110.16  diversionary work program benefits being exhausted, a new 
110.17  combined application form must be completed for any subsequent 
110.18  request for MFIP. 
110.19     Subd. 13.  [IMMEDIATE REFERRAL TO EMPLOYMENT SERVICES.] 
110.20  Within one working day of determination that the applicant is 
110.21  eligible for the diversionary work program, but before benefits 
110.22  are issued to or on behalf of the family unit, the county shall 
110.23  refer all caregivers to employment services.  The referral to 
110.24  the DWP employment services must be in writing and must contain 
110.25  the following information: 
110.26     (1) notification that, as part of the application process, 
110.27  applicants are required to develop an employment plan or the DWP 
110.28  application will be denied; 
110.29     (2) the employment services provider name and phone number; 
110.30     (3) the date, time, and location of the scheduled 
110.31  employment services interview; 
110.32     (4) the immediate availability of supportive services, 
110.33  including, but not limited to, child care, transportation, and 
110.34  other work-related aid; and 
110.35     (5) the rights, responsibilities, and obligations of 
110.36  participants in the program, including, but not limited to, the 
111.1   grounds for good cause, the consequences of refusing or failing 
111.2   to participate fully with program requirements, and the appeal 
111.3   process. 
111.4      Subd. 14.  [EMPLOYMENT PLAN; DWP BENEFITS.] As soon as 
111.5   possible, but no later than ten working days of being notified 
111.6   that a participant is financially eligible for the diversionary 
111.7   work program, the employment services provider shall provide the 
111.8   participant with an opportunity to meet to develop an initial 
111.9   employment plan.  Once the initial employment plan has been 
111.10  developed and signed by the participant and the job counselor, 
111.11  the employment services provider shall notify the county within 
111.12  one working day that the employment plan has been signed.  The 
111.13  county shall issue DWP benefits within one working day after 
111.14  receiving notice that the employment plan has been signed. 
111.15     Subd. 15.  [LIMITATIONS ON CERTAIN WORK ACTIVITIES.] (a) 
111.16  Except as specified in paragraphs (b) to (d), employment 
111.17  activities listed in section 256J.49, subdivision 13, are 
111.18  allowable under the diversionary work program. 
111.19     (b) Work activities under section 256J.49, subdivision 13, 
111.20  clause (5), shall be allowable only when in combination with 
111.21  approved work activities under section 256J.49, subdivision 13, 
111.22  clauses (1) to (4), and shall be limited to no more than 
111.23  one-half of the hours required in the employment plan. 
111.24     (c) In order for an English as a second language (ESL) 
111.25  class to be an approved work activity, a participant must: 
111.26     (1) be below a spoken language proficiency level of SPL6 or 
111.27  its equivalent, as measured by a nationally recognized test; and 
111.28     (2) not have been enrolled in ESL for more than 24 months 
111.29  while previously participating in MFIP or DWP.  A participant 
111.30  who has been enrolled in ESL for 20 or more months may be 
111.31  approved for ESL until the participant has received 24 total 
111.32  months. 
111.33     (d) Work activities under section 256J.49, subdivision 13, 
111.34  clause (6), shall be allowable only when the training or 
111.35  education program will be completed within the four-month DWP 
111.36  period.  Training or education programs that will not be 
112.1   completed within the four-month DWP period shall not be approved.
112.2      Subd. 16.  [FAILURE TO COMPLY WITH REQUIREMENTS.] A family 
112.3   unit that includes a participant who fails to comply with DWP 
112.4   employment service or child support enforcement requirements, 
112.5   without good cause as defined in sections 256.741 and 256J.57, 
112.6   shall be disqualified from the diversionary work program.  The 
112.7   county shall provide written notice as specified in section 
112.8   256J.31 to the participant prior to disqualifying the family 
112.9   unit due to noncompliance with employment service or child 
112.10  support.  The disqualification does not apply to food support or 
112.11  health care benefits. 
112.12     Subd. 17.  [GOOD CAUSE FOR NOT COMPLYING WITH 
112.13  REQUIREMENTS.] A participant who fails to comply with the 
112.14  requirements of the diversionary work program may claim good 
112.15  cause for reasons listed in sections 256.741 and 256J.57, 
112.16  subdivision 1, clauses (1) to (13).  The county shall not impose 
112.17  a disqualification if good cause exists. 
112.18     Subd. 18.  [REINSTATEMENT FOLLOWING DISQUALIFICATION.] A 
112.19  participant who has been disqualified from the diversionary work 
112.20  program due to noncompliance with employment services may regain 
112.21  eligibility for the diversionary work program by complying with 
112.22  program requirements.  A participant who has been disqualified 
112.23  from the diversionary work program due to noncooperation with 
112.24  child support enforcement requirements may regain eligibility by 
112.25  complying with child support requirements under section 
112.26  256.741.  Once a participant has been reinstated, the county 
112.27  shall issue prorated benefits for the remaining portion of the 
112.28  month.  A family unit that has been disqualified from the 
112.29  diversionary work program due to noncompliance shall not be 
112.30  eligible for MFIP or any other TANF cash program during the 
112.31  period of time the participant remains noncompliant.  In a 
112.32  two-parent family, both parents must be in compliance before the 
112.33  family unit can regain eligibility for benefits. 
112.34     Subd. 19.  [RECOVERY OF OVERPAYMENTS.] When an overpayment 
112.35  or an ATM error is determined, the overpayment shall be recouped 
112.36  or recovered as specified in section 256J.38. 
113.1      Subd. 20.  [IMPLEMENTATION OF DWP.] Counties may establish 
113.2   a diversionary work program according to this section any time 
113.3   on or after July 1, 2003.  Prior to establishing a diversionary 
113.4   work program, the county must notify the commissioner.  All 
113.5   counties must implement the provisions of this section no later 
113.6   than July 1, 2004. 
113.7      Sec. 103.  Minnesota Statutes 2002, section 261.063, is 
113.8   amended to read: 
113.9      261.063 [TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY; 
113.10  PENALTY.] 
113.11     (a) The board of county commissioners of each county shall 
113.12  annually levy taxes and fix a rate sufficient to produce the 
113.13  full amount required for poor relief, general assistance, 
113.14  Minnesota family investment program, diversionary work program, 
113.15  county share of county and state supplemental aid to 
113.16  supplemental security income applicants or recipients, and any 
113.17  other social security measures wherein there is now or may 
113.18  hereafter be county participation, sufficient to produce the 
113.19  full amount necessary for each such item, including 
113.20  administrative expenses, for the ensuing year, within the time 
113.21  fixed by law in addition to all other tax levies and tax rates, 
113.22  however fixed or determined, and any commissioner who shall fail 
113.23  to comply herewith shall be guilty of a gross misdemeanor and 
113.24  shall be immediately removed from office by the governor.  For 
113.25  the purposes of this paragraph, "poor relief" means county 
113.26  services provided under sections 261.035~~, 261.04,~~ and 261.21 to 
113.27  261.231. 
113.28     (b) Nothing within the provisions of this section shall be 
113.29  construed as requiring a county agency to provide income support 
113.30  or cash assistance to needy persons when they are no longer 
113.31  eligible for assistance under general assistance, ~~the Minnesota~~ 
113.32  ~~family investment program~~ chapter 256J, or Minnesota 
113.33  supplemental aid. 
113.34     Sec. 104.  Minnesota Statutes 2002, section 393.07, 
113.35  subdivision 10, is amended to read: 
113.36     Subd. 10.  [FEDERAL FOOD STAMP PROGRAM AND THE MATERNAL AND 
114.1   CHILD NUTRITION ACT.] (a) The local social services agency shall 
114.2   establish and administer the food stamp or support program 
114.3   according to rules of the commissioner of human services, the 
114.4   supervision of the commissioner as specified in section 256.01, 
114.5   and all federal laws and regulations.  The commissioner of human 
114.6   services shall monitor food stamp or support program delivery on 
114.7   an ongoing basis to ensure that each county complies with 
114.8   federal laws and regulations.  Program requirements to be 
114.9   monitored include, but are not limited to, number of 
114.10  applications, number of approvals, number of cases pending, 
114.11  length of time required to process each application and deliver 
114.12  benefits, number of applicants eligible for expedited issuance, 
114.13  length of time required to process and deliver expedited 
114.14  issuance, number of terminations and reasons for terminations, 
114.15  client profiles by age, household composition and income level 
114.16  and sources, and the use of phone certification and home 
114.17  visits.  The commissioner shall determine the county-by-county 
114.18  and statewide participation rate.  
114.19     (b) On July 1 of each year, the commissioner of human 
114.20  services shall determine a statewide and county-by-county food 
114.21  stamp program participation rate.  The commissioner may 
114.22  designate a different agency to administer the food stamp 
114.23  program in a county if the agency administering the program 
114.24  fails to increase the food stamp program participation rate 
114.25  among families or eligible individuals, or comply with all 
114.26  federal laws and regulations governing the food stamp program.  
114.27  The commissioner shall review agency performance annually to 
114.28  determine compliance with this paragraph. 
114.29     (c) A person who commits any of the following acts has 
114.30  violated section 256.98 or 609.821, or both, and is subject to 
114.31  both the criminal and civil penalties provided under those 
114.32  sections: 
114.33     (1) obtains or attempts to obtain, or aids or abets any 
114.34  person to obtain by means of a willful statement or 
114.35  misrepresentation, or intentional concealment of a material 
114.36  fact, food stamps or vouchers issued according to sections 
115.1   145.891 to 145.897 to which the person is not entitled or in an 
115.2   amount greater than that to which that person is entitled or 
115.3   which specify nutritional supplements to which that person is 
115.4   not entitled; or 
115.5      (2) presents or causes to be presented, coupons or vouchers 
115.6   issued according to sections 145.891 to 145.897 for payment or 
115.7   redemption knowing them to have been received, transferred or 
115.8   used in a manner contrary to existing state or federal law; or 
115.9      (3) willfully uses, possesses, or transfers food stamp 
115.10  coupons, authorization to purchase cards or vouchers issued 
115.11  according to sections 145.891 to 145.897 in any manner contrary 
115.12  to existing state or federal law, rules, or regulations; or 
115.13     (4) buys or sells food stamp coupons, authorization to 
115.14  purchase cards, other assistance transaction devices, vouchers 
115.15  issued according to sections 145.891 to 145.897, or any food 
115.16  obtained through the redemption of vouchers issued according to 
115.17  sections 145.891 to 145.897 for cash or consideration other than 
115.18  eligible food. 
115.19     (d) A peace officer or welfare fraud investigator may 
115.20  confiscate food stamps, authorization to purchase cards, or 
115.21  other assistance transaction devices found in the possession of 
115.22  any person who is neither a recipient of the food stamp program 
115.23  nor otherwise authorized to possess and use such materials.  
115.24  Confiscated property shall be disposed of as the commissioner 
115.25  may direct and consistent with state and federal food stamp 
115.26  law.  The confiscated property must be retained for a period of 
115.27  not less than 30 days to allow any affected person to appeal the 
115.28  confiscation under section 256.045. 
115.29     (e) Food stamp overpayment claims which are due in whole or 
115.30  in part to client error shall be established by the county 
115.31  agency for a period of six years from the date of any resultant 
115.32  overpayment.  
115.33     (f) With regard to the federal tax revenue offset program 
115.34  only, recovery incentives authorized by the federal food and 
115.35  consumer service shall be retained at the rate of 50 percent by 
115.36  the state agency and 50 percent by the certifying county agency. 
116.1      (g) A peace officer, welfare fraud investigator, federal 
116.2   law enforcement official, or the commissioner of health may 
116.3   confiscate vouchers found in the possession of any person who is 
116.4   neither issued vouchers under sections 145.891 to 145.897, nor 
116.5   otherwise authorized to possess and use such vouchers.  
116.6   Confiscated property shall be disposed of as the commissioner of 
116.7   health may direct and consistent with state and federal law.  
116.8   The confiscated property must be retained for a period of not 
116.9   less than 30 days. 
116.10     (h) The commissioner of human services may seek a waiver 
116.11  from the United States Department of Agriculture to allow the 
116.12  state to specify foods that may and may not be purchased in 
116.13  Minnesota with benefits funded by the federal Food Stamp 
116.14  Program.  The commissioner shall consult with the members of the 
116.15  house of representatives and senate policy committees having 
116.16  jurisdiction over food support issues in developing the waiver.  
116.17  The commissioner, in consultation with the commissioners of 
116.18  health and education, shall develop a broad public health policy 
116.19  related to improved nutrition and health status.  The 
116.20  commissioner must seek legislative approval prior to 
116.21  implementing the waiver. 
116.22     Sec. 105.  Laws 1997, chapter 203, article 9, section 21, 
116.23  as amended by Laws 1998, chapter 407, article 6, section 111, 
116.24  Laws 2000, chapter 488, article 10, section 28, and Laws 2001, 
116.25  First Special Session chapter 9, article 10, section 62, is 
116.26  amended to read: 
116.27     Sec. 21.  [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 
116.28     ~~(a) Effective on the date specified, the following~~ 
116.29  ~~persons~~ Beginning July 1, 2007, legal noncitizens ineligible for 
116.30  federally funded cash or food benefits due to 1996 changes in 
116.31  federal law and subsequent relevant enactments, who are eligible 
116.32  for state-funded MFIP cash or food assistance, will be 
116.33  ineligible for ~~general assistance and general assistance medical~~ 
116.34  ~~care under Minnesota Statutes, chapter 256D, group residential~~ 
116.35  ~~housing under Minnesota Statutes, chapter 256I, and~~ state-funded 
116.36  MFIP ~~assistance~~ under Minnesota Statutes, chapter 256J~~, funded~~ 
117.1   ~~with state money:~~. 
117.2      ~~(1) Beginning July 1, 2002, persons who are terminated from~~ 
117.3   ~~or denied Supplemental Security Income due to the 1996 changes~~ 
117.4   ~~in the federal law making persons whose alcohol or drug~~ 
117.5   ~~addiction is a material factor contributing to the person's~~ 
117.6   ~~disability ineligible for Supplemental Security Income, and are~~ 
117.7   ~~eligible for general assistance under Minnesota Statutes,~~ 
117.8   ~~section 256D.05, subdivision 1, paragraph (a), clause (15),~~ 
117.9   ~~general assistance medical care under Minnesota Statutes,~~ 
117.10  ~~chapter 256D, or group residential housing under Minnesota~~ 
117.11  ~~Statutes, chapter 256I; and~~ 
117.12     ~~(2) Beginning July 1, 2002, legal noncitizens who are~~ 
117.13  ~~ineligible for Supplemental Security Income due to the 1996~~ 
117.14  ~~changes in federal law making certain noncitizens ineligible for~~ 
117.15  ~~these programs due to their noncitizen status; and~~ 
117.16     ~~(3) beginning July 1, 2003, legal noncitizens who are~~ 
117.17  ~~eligible for MFIP assistance, either the cash assistance portion~~ 
117.18  ~~or the food assistance portion, funded entirely with state money.~~
117.19     ~~(b) State money that remains unspent due to changes in~~ 
117.20  ~~federal law enacted after May 12, 1997, that reduce state~~ 
117.21  ~~spending for legal noncitizens or for persons whose alcohol or~~ 
117.22  ~~drug addiction is a material factor contributing to the person's~~ 
117.23  ~~disability, or enacted after February 1, 1998, that reduce state~~ 
117.24  ~~spending for food benefits for legal noncitizens shall not~~ 
117.25  ~~cancel and shall be deposited in the TANF reserve account.~~ 
117.26     Sec. 106.  [REVISOR'S INSTRUCTION.] 
117.27     (a) In the next publication of Minnesota Statutes, the 
117.28  revisor of statutes shall codify section 108 of this act. 
117.29     (b) Wherever "food stamp" or "food stamps" appears in 
117.30  Minnesota Statutes and Rules, the revisor of statutes shall 
117.31  insert "food support" or "or food support" except for instances 
117.32  where federal code or federal law is referenced. 
117.33     (c) For sections in Minnesota Statutes and Minnesota Rules 
117.34  affected by the repealed sections in this article, the revisor 
117.35  shall delete internal cross-references where appropriate and 
117.36  make changes necessary to correct the punctuation, grammar, or 
118.1   structure of the remaining text and preserve its meaning. 
118.2      Sec. 107.  [REPEALER.] 
118.3      (a) Minnesota Statutes 2002, sections 256J.02, subdivision 
118.4   3; 256J.08, subdivisions 28 and 70; 256J.24, subdivision 8; 
118.5   256J.30, subdivision 10; 256J.462; 256J.47; 256J.48; 256J.49, 
118.6   subdivisions 1a, 2, 6, and 7; 256J.50, subdivisions 2, 3, 3a, 5, 
118.7   and 7; 256J.52; 256J.55, subdivision 5; 256J.62, subdivisions 1, 
118.8   2a, 4, 6, 7, and 8; 256J.625; 256J.655; 256J.74, subdivision 3; 
118.9   256J.751, subdivisions 3 and 4; 256J.76; and 256K.30, are 
118.10  repealed. 
118.11     (b) Laws 2000, chapter 488, article 10, section 29, is 
118.12  repealed. 
118.13                             ARTICLE 2 
118.14                           LONG-TERM CARE 
118.15     Section 1.  Minnesota Statutes 2002, section 61A.072, 
118.16  subdivision 6, is amended to read: 
118.17     Subd. 6.  [ACCELERATED BENEFITS.] (a) "Accelerated 
118.18  benefits" covered under this section are benefits payable under 
118.19  the life insurance contract: 
118.20     (1) to a policyholder or certificate holder, during the 
118.21  lifetime of the insured, ~~in anticipation of death~~ upon the 
118.22  occurrence of a specified life-threatening or catastrophic 
118.23  condition as defined by the policy or rider; 
118.24     (2) that reduce the death benefit otherwise payable under 
118.25  the life insurance contract; and 
118.26     (3) that are payable upon the occurrence of a single 
118.27  qualifying event that results in the payment of a benefit amount 
118.28  fixed at the time of acceleration. 
118.29     (b) "Qualifying event" means one or more of the following: 
118.30     (1) a medical condition that would result in a drastically 
118.31  limited life span as specified in the contract; 
118.32     (2) a medical condition that has required or requires 
118.33  extraordinary medical intervention, such as, but not limited to, 
118.34  major organ transplant or continuous artificial life support 
118.35  without which the insured would die; ~~or~~ 
118.36     (3) a condition that requires continuous confinement in an 
119.1   eligible institution as defined in the contract if the insured 
119.2   is expected to remain there for the rest of the insured's life; 
119.3      (4) a long-term care illness or physical condition that 
119.4   results in cognitive impairment or the inability to perform the 
119.5   activities of daily life or the substantial and material duties 
119.6   of any occupation; or 
119.7      (5) other qualifying events that the commissioner approves 
119.8   for a particular filing. 
119.9      <b>[EFFECTIVE DATE.]</b> This section is effective the day 
119.10  following final enactment and applies to policies issued on or 
119.11  after that date. 
119.12     Sec. 2.  Minnesota Statutes 2002, section 62A.315, is 
119.13  amended to read: 
119.14     62A.315 [EXTENDED BASIC MEDICARE SUPPLEMENT PLAN; 
119.15  COVERAGE.] 
119.16     The extended basic Medicare supplement plan must have a 
119.17  level of coverage so that it will be certified as a qualified 
119.18  plan pursuant to section 62E.07, and will provide: 
119.19     (1) coverage for all of the Medicare part A inpatient 
119.20  hospital deductible and coinsurance amounts, and 100 percent of 
119.21  all Medicare part A eligible expenses for hospitalization not 
119.22  covered by Medicare; 
119.23     (2) coverage for the daily copayment amount of Medicare 
119.24  part A eligible expenses for the calendar year incurred for 
119.25  skilled nursing facility care; 
119.26     (3) coverage for the copayment amount of Medicare eligible 
119.27  expenses under Medicare part B regardless of hospital 
119.28  confinement, and the Medicare part B deductible amount; 
119.29     (4) 80 percent of the usual and customary hospital and 
119.30  medical expenses and supplies described in section 62E.06, 
119.31  subdivision 1, not to exceed any charge limitation established 
119.32  by the Medicare program or state law, the usual and customary 
119.33  hospital and medical expenses and supplies, described in section 
119.34  62E.06, subdivision 1, while in a foreign country, and 
119.35  prescription drug expenses, not covered by Medicare; 
119.36     (5) coverage for the reasonable cost of the first three 
120.1   pints of blood, or equivalent quantities of packed red blood 
120.2   cells as defined under federal regulations under Medicare parts 
120.3   A and B, unless replaced in accordance with federal regulations; 
120.4      (6) 100 percent of the cost of immunizations and routine 
120.5   screening procedures for cancer, including mammograms and pap 
120.6   smears; 
120.7      (7) preventive medical care benefit:  coverage for the 
120.8   following preventive health services: 
120.9      (i) an annual clinical preventive medical history and 
120.10  physical examination that may include tests and services from 
120.11  clause (ii) and patient education to address preventive health 
120.12  care measures; 
120.13     (ii) any one or a combination of the following preventive 
120.14  screening tests or preventive services, the frequency of which 
120.15  is considered medically appropriate: 
120.16     (A) fecal occult blood test and/or digital rectal 
120.17  examination; 
120.18     (B) dipstick urinalysis for hematuria, bacteriuria, and 
120.19  proteinuria; 
120.20     (C) pure tone (air only) hearing screening test 
120.21  administered or ordered by a physician; 
120.22     (D) serum cholesterol screening every five years; 
120.23     (E) thyroid function test; 
120.24     (F) diabetes screening; 
120.25     (iii) any other tests or preventive measures determined 
120.26  appropriate by the attending physician.  
120.27     Reimbursement shall be for the actual charges up to 100 
120.28  percent of the Medicare-approved amount for each service as if 
120.29  Medicare were to cover the service as identified in American 
120.30  Medical Association current procedural terminology (AMA CPT) 
120.31  codes to a maximum of $120 annually under this benefit.  This 
120.32  benefit shall not include payment for any procedure covered by 
120.33  Medicare; 
120.34     (8) at-home recovery benefit:  coverage for services to 
120.35  provide short-term at-home assistance with activities of daily 
120.36  living for those recovering from an illness, injury, or surgery: 
121.1      (i) for purposes of this benefit, the following definitions 
121.2   shall apply: 
121.3      (A) "activities of daily living" include, but are not 
121.4   limited to, bathing, dressing, personal hygiene, transferring, 
121.5   eating, ambulating, assistance with drugs that are normally 
121.6   self-administered, and changing bandages or other dressings; 
121.7      (B) "care provider" means a duly qualified or licensed home 
121.8   health aide/homemaker, personal care aide, or nurse provided 
121.9   through a licensed home health care agency or referred by a 
121.10  licensed referral agency or licensed nurses registry; 
121.11     (C) "home" means a place used by the insured as a place of 
121.12  residence, provided that the place would qualify as a residence 
121.13  for home health care services covered by Medicare.  A hospital 
121.14  or skilled nursing facility shall not be considered the 
121.15  insured's place of residence; 
121.16     (D) "at-home recovery visit" means the period of a visit 
121.17  required to provide at-home recovery care, without limit on the 
121.18  duration of the visit, except each consecutive four hours in a 
121.19  24-hour period of services provided by a care provider is one 
121.20  visit; 
121.21     (ii) coverage requirements and limitations: 
121.22     (A) at-home recovery services provided must be primarily 
121.23  services that assist in activities of daily living; 
121.24     (B) the insured's attending physician must certify that the 
121.25  specific type and frequency of at-home recovery services are 
121.26  necessary because of a condition for which a home care plan of 
121.27  treatment was approved by Medicare; 
121.28     (C) coverage is limited to: 
121.29     (I) no more than the number and type of at-home recovery 
121.30  visits certified as medically necessary by the insured's 
121.31  attending physician.  The total number of at-home recovery 
121.32  visits shall not exceed the number of Medicare-approved home 
121.33  health care visits under a Medicare-approved home care plan of 
121.34  treatment; 
121.35     (II) the actual charges for each visit up to a maximum 
121.36  reimbursement of ~~$40~~ $100 per visit; 
122.1      (III) ~~$1,600~~ $4,000 per calendar year; 
122.2      (IV) seven visits in any one week; 
122.3      (V) care furnished on a visiting basis in the insured's 
122.4   home; 
122.5      (VI) services provided by a care provider as defined in 
122.6   this section; 
122.7      (VII) at-home recovery visits while the insured is covered 
122.8   under the policy or certificate and not otherwise excluded; 
122.9      (VIII) at-home recovery visits received during the period 
122.10  the insured is receiving Medicare-approved home care services or 
122.11  no more than eight weeks after the service date of the last 
122.12  Medicare-approved home health care visit; 
122.13     (iii) coverage is excluded for: 
122.14     (A) home care visits paid for by Medicare or other 
122.15  government programs; and 
122.16     (B) care provided by ~~family members,~~ unpaid volunteers~~,~~ or 
122.17  providers who are not care providers. 
122.18     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 
122.19  2004, and applies to policies issued on or after that date. 
122.20     Sec. 3.  Minnesota Statutes 2002, section 62A.48, is 
122.21  amended by adding a subdivision to read: 
122.22     Subd. 12.  [REGULATORY FLEXIBILITY.] The commissioner may 
122.23  upon written request issue an order to modify or suspend a 
122.24  specific provision or provisions of sections 62A.46 to 62A.56 
122.25  with respect to a specific long-term care insurance policy or 
122.26  certificate upon a written finding that: 
122.27     (1) the modification or suspension is in the best interest 
122.28  of the insureds; 
122.29     (2) the purpose to be achieved could not be effectively or 
122.30  efficiently achieved without the modifications or suspension; 
122.31  and 
122.32     (3)(i) the modification or suspension is necessary to the 
122.33  development of an innovative and reasonable approach for 
122.34  insuring long-term care; 
122.35     (ii) the policy or certificate is to be issued to residents 
122.36  of a life care or continuing care retirement community or some 
123.1   other residential community for the elderly and the modification 
123.2   or suspension is reasonably related to the special needs or 
123.3   nature of such a community; or 
123.4      (iii) the modification or suspension is necessary to permit 
123.5   long-term care insurance to be sold as part of, or in 
123.6   conjunction with, another insurance product. 
123.7      <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 
123.8   2004, and applies to policies issued on or after that date. 
123.9      Sec. 4.  Minnesota Statutes 2002, section 62A.49, is 
123.10  amended by adding a subdivision to read: 
123.11     Subd. 3.  [PROHIBITED LIMITATIONS.] A long-term care 
123.12  insurance policy or certificate shall not, if it provides 
123.13  benefits for home health care or community care services, limit 
123.14  or exclude benefits by: 
123.15     (1) requiring that the insured would need care in a skilled 
123.16  nursing facility if home health care services were not provided; 
123.17     (2) requiring that the insured first or simultaneously 
123.18  receive nursing or therapeutic services in a home, community, or 
123.19  institutional setting before home health care services are 
123.20  covered; 
123.21     (3) limiting eligible services to services provided by a 
123.22  registered nurse or licensed practical nurse; 
123.23     (4) requiring that a nurse or therapist provide services 
123.24  covered by the policy that can be provided by a home health aide 
123.25  or other licensed or certified home care worker acting within 
123.26  the scope of licensure or certification; 
123.27     (5) excluding coverage for personal care services provided 
123.28  by a home health aide; 
123.29     (6) requiring that the provision of home health care 
123.30  services be at a level of certification or licensure greater 
123.31  than that required by the eligible service; 
123.32     (7) requiring that the insured have an acute condition 
123.33  before home health care services are covered; 
123.34     (8) limiting benefits to services provided by 
123.35  Medicare-certified agencies or providers; 
123.36     (9) excluding coverage for adult day care services; or 
124.1      (10) excluding coverage based upon location or type of 
124.2   residence in which the home health care services would be 
124.3   provided. 
124.4      <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 
124.5   2004, and applies to policies issued on or after that date. 
124.6      Sec. 5.  Minnesota Statutes 2002, section 62S.22, 
124.7   subdivision 1, is amended to read: 
124.8      Subdivision 1.  [PROHIBITED LIMITATIONS.] A long-term care 
124.9   insurance policy or certificate shall not, if it provides 
124.10  benefits for home health care or community care services, limit 
124.11  or exclude benefits by: 
124.12     (1) requiring that the insured would need care in a skilled 
124.13  nursing facility if home health care services were not provided; 
124.14     (2) requiring that the insured first or simultaneously 
124.15  receive nursing or therapeutic services in a home, community, or 
124.16  institutional setting before home health care services are 
124.17  covered; 
124.18     (3) limiting eligible services to services provided by a 
124.19  registered nurse or licensed practical nurse; 
124.20     (4) requiring that a nurse or therapist provide services 
124.21  covered by the policy that can be provided by a home health aide 
124.22  or other licensed or certified home care worker acting within 
124.23  the scope of licensure or certification; 
124.24     (5) excluding coverage for personal care services provided 
124.25  by a home health aide; 
124.26     (6) requiring that the provision of home health care 
124.27  services be at a level of certification or licensure greater 
124.28  than that required by the eligible service; 
124.29     (7) requiring that the insured have an acute condition 
124.30  before home health care services are covered; 
124.31     (8) limiting benefits to services provided by 
124.32  Medicare-certified agencies or providers; ~~or~~ 
124.33     (9) excluding coverage for adult day care services; or 
124.34     (10) excluding coverage based upon location or type of 
124.35  residence in which the home health care services would be 
124.36  provided. 
125.1      <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 
125.2   2004, and applies to policies issued on or after that date. 
125.3      Sec. 6.  [62S.34] [REGULATORY FLEXIBILITY.] 
125.4      The commissioner may upon written request issue an order to 
125.5   modify or suspend a specific provision or provisions of this 
125.6   chapter with respect to a specific long-term care insurance 
125.7   policy or certificate upon a written finding that: 
125.8      (1) the modification or suspension is in the best interest 
125.9   of the insureds; 
125.10     (2) the purpose to be achieved could not be effectively or 
125.11  efficiently achieved without the modifications or suspension; 
125.12  and 
125.13     (3)(i) the modification or suspension is necessary to the 
125.14  development of an innovative and reasonable approach for 
125.15  insuring long-term care; 
125.16     (ii) the policy or certificate is to be issued to residents 
125.17  of a life care or continuing care retirement community or some 
125.18  other residential community for the elderly and the modification 
125.19  or suspension is reasonably related to the special needs or 
125.20  nature of such a community; or 
125.21     (iii) the modification or suspension is necessary to permit 
125.22  long-term care insurance to be sold as part of, or in 
125.23  conjunction with, another insurance product. 
125.24     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 
125.25  2004, and applies to policies issued on or after that date. 
125.26     Sec. 7.  Minnesota Statutes 2002, section 144A.04, 
125.27  subdivision 3, is amended to read: 
125.28     Subd. 3.  [STANDARDS.] (a) The facility must meet the 
125.29  minimum health, sanitation, safety and comfort standards 
125.30  prescribed by the rules of the commissioner of health with 
125.31  respect to the construction, equipment, maintenance and 
125.32  operation of a nursing home.  The commissioner of health may 
125.33  temporarily waive compliance with one or more of the standards 
125.34  if the commissioner determines that: 
125.35     ~~(a)~~ (1) temporary noncompliance with the standard will not 
125.36  create an imminent risk of harm to a nursing home resident; and 
126.1      ~~(b)~~ (2) a controlling person on behalf of all other 
126.2   controlling persons: 
126.3      ~~(1)~~ (i) has entered into a contract to obtain the materials 
126.4   or labor necessary to meet the standard set by the commissioner 
126.5   of health, but the supplier or other contractor has failed to 
126.6   perform the terms of the contract and the inability of the 
126.7   nursing home to meet the standard is due solely to that failure; 
126.8   or 
126.9      ~~(2)~~ (ii) is otherwise making a diligent good faith effort 
126.10  to meet the standard. 
126.11     The commissioner shall make available to other nursing 
126.12  homes information on facility-specific waivers related to 
126.13  technology or physical plant that are granted.  The commissioner 
126.14  shall, upon the request of a facility, extend a waiver granted 
126.15  to a specific facility related to technology or physical plant 
126.16  to the facility making the request, if the commissioner 
126.17  determines that the facility also satisfies clauses (1) and (2) 
126.18  and any other terms and conditions of the waiver.  
126.19     The commissioner of health shall allow, by rule, a nursing 
126.20  home to provide fewer hours of nursing care to intermediate care 
126.21  residents of a nursing home than required by the present rules 
126.22  of the commissioner if the commissioner determines that the 
126.23  needs of the residents of the home will be adequately met by a 
126.24  lesser amount of nursing care. 
126.25     (b) A facility is not required to seek a waiver for room 
126.26  furniture or equipment under paragraph (a) when responding to 
126.27  resident-specific requests, if the facility has discussed health 
126.28  and safety concerns with the resident and the resident request 
126.29  and discussion of health and safety concerns are documented in 
126.30  the resident's patient record. 
126.31     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
126.32  following final enactment. 
126.33     Sec. 8.  Minnesota Statutes 2002, section 144A.04, is 
126.34  amended by adding a subdivision to read: 
126.35     Subd. 11.  [INCONTINENT RESIDENTS.] Notwithstanding 
126.36  Minnesota Rules, part 4658.0520, an incontinent resident must be 
127.1   checked according to a specific time interval written in the 
127.2   resident's care plan.  The resident's attending physician must 
127.3   authorize in writing any interval longer than two hours unless 
127.4   the resident, if competent, or a family member or legally 
127.5   appointed conservator, guardian, or health care agent of a 
127.6   resident who is not competent, agrees in writing to waive 
127.7   physician involvement in determining this interval, and this 
127.8   waiver is documented in the resident's care plan. 
127.9      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
127.10     Sec. 9.  Minnesota Statutes 2002, section 144A.071, 
127.11  subdivision 4c, as added by Laws 2003, chapter 16, section 1, is 
127.12  amended to read: 
127.13     Subd. 4c.  [EXCEPTIONS FOR REPLACEMENT BEDS AFTER JUNE 30, 
127.14  2003.] (a) The commissioner of health, in coordination with the 
127.15  commissioner of human services, may approve the renovation, 
127.16  replacement, upgrading, or relocation of a nursing home or 
127.17  boarding care home, under the following conditions: 
127.18     (1) to license and certify an 80-bed city-owned facility in 
127.19  Nicollet county to be constructed on the site of a new 
127.20  city-owned hospital to replace an existing 85-bed facility 
127.21  attached to a hospital that is also being replaced.  The 
127.22  threshold allowed for this project under section 144A.073 shall 
127.23  be the maximum amount available to pay the additional medical 
127.24  assistance costs of the new facility; and 
127.25     (2) to license and certify 29 beds to be added to an 
127.26  existing 69-bed facility in St. Louis county, provided that the 
127.27  29 beds must be transferred from active or layaway status at an 
127.28  existing facility in St. Louis county that had 235 beds on April 
127.29  1, 2003. 
127.30  The licensed capacity at the 235-bed facility must be reduced to 
127.31  206 beds, but the payment rate at that facility shall not be 
127.32  adjusted as a result of this transfer.  The operating payment 
127.33  rate of the facility adding beds after completion of this 
127.34  project shall be the same as it was on the day prior to the day 
127.35  the beds are licensed and certified.  This project shall not 
127.36  proceed unless it is approved and financed under the provisions 
128.1   of section 144A.073.  
128.2      (b) Projects approved under this subdivision shall be 
128.3   treated in a manner equivalent to projects approved under 
128.4   subdivision 4a. 
128.5      Sec. 10.  Minnesota Statutes 2002, section 144A.10, is 
128.6   amended by adding a subdivision to read: 
128.7      Subd. 16.  [INDEPENDENT INFORMAL DISPUTE RESOLUTION.] (a) 
128.8   Notwithstanding subdivision 15, a facility certified under the 
128.9   federal Medicare or Medicaid programs may request from the 
128.10  commissioner, in writing, an independent informal dispute 
128.11  resolution process regarding any deficiency citation issued to 
128.12  the facility.  The facility must specify in its written request 
128.13  each deficiency citation that it disputes.  The commissioner 
128.14  shall provide a hearing under sections 14.57 to 14.62.  Upon the 
128.15  written request of the facility, the parties must submit the 
128.16  issues raised to arbitration by an administrative law judge. 
128.17     (b) Upon receipt of a written request for an arbitration 
128.18  proceeding, the commissioner shall file with the office of 
128.19  administrative hearings a request for the appointment of an 
128.20  arbitrator and simultaneously serve the facility with notice of 
128.21  the request.  The arbitrator for the dispute shall be an 
128.22  administrative law judge appointed by the office of 
128.23  administrative hearings.  The disclosure provisions of section 
128.24  572.10 and the notice provisions of section 572.12 apply.  The 
128.25  facility and the commissioner have the right to be represented 
128.26  by an attorney. 
128.27     (c) The commissioner and the facility may present written 
128.28  evidence, depositions, and oral statements and arguments at the 
128.29  arbitration proceeding.  Oral statements and arguments may be 
128.30  made by telephone. 
128.31     (d) Within ten working days of the close of the arbitration 
128.32  proceeding, the administrative law judge shall issue findings 
128.33  regarding each of the deficiencies in dispute.  The findings 
128.34  shall be one or more of the following: 
128.35     (1) Supported in full.  The citation is supported in full, 
128.36  with no deletion of findings and no change in the scope or 
129.1   severity assigned to the deficiency citation. 
129.2      (2) Supported in substance.  The citation is supported, but 
129.3   one or more findings are deleted without any change in the scope 
129.4   or severity assigned to the deficiency. 
129.5      (3) Deficient practice cited under wrong requirement of 
129.6   participation.  The citation is amended by moving it to the 
129.7   correct requirement of participation. 
129.8      (4) Scope not supported.  The citation is amended through a 
129.9   change in the scope assigned to the citation. 
129.10     (5) Severity not supported.  The citation is amended 
129.11  through a change in the severity assigned to the citation. 
129.12     (6) No deficient practice.  The citation is deleted because 
129.13  the findings did not support the citation or the negative 
129.14  resident outcome was unavoidable.  The findings of the 
129.15  arbitrator are not binding on the commissioner.  
129.16     (e) The commissioner shall reimburse the office of 
129.17  administrative hearings for the costs incurred by that office 
129.18  for the arbitration proceeding.  The facility shall reimburse 
129.19  the commissioner for the proportion of the costs that represent 
129.20  the sum of deficiency citations supported in full under 
129.21  paragraph (d), clause (1), or in substance under paragraph (d), 
129.22  clause (2), divided by the total number of deficiencies 
129.23  disputed.  A deficiency citation for which the administrative 
129.24  law judge's sole finding is that the deficient practice was 
129.25  cited under the wrong requirements of participation shall not be 
129.26  counted in the numerator or denominator in the calculation of 
129.27  the proportion of costs. 
129.28     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
129.29     Sec. 11.  [144A.351] [BALANCING LONG-TERM CARE:  REPORT 
129.30  REQUIRED.] 
129.31     The commissioners of health and human services, with the 
129.32  cooperation of counties and regional entities, shall prepare a 
129.33  report to the legislature by January 15, 2004, and biennially 
129.34  thereafter, regarding the status of the full range of long-term 
129.35  care services for the elderly in Minnesota.  The report shall 
129.36  address: 
130.1      (1) demographics and need for long-term care in Minnesota; 
130.2      (2) summary of county and regional reports on long-term 
130.3   care gaps, surpluses, imbalances, and corrective action plans; 
130.4      (3) status of long-term care services by county and region 
130.5   including: 
130.6      (i) changes in availability of the range of long-term care 
130.7   services and housing options; 
130.8      (ii) access problems regarding long-term care; and 
130.9      (iii) comparative measures of long-term care availability 
130.10  and progress over time; and 
130.11     (4) recommendations regarding goals for the future of 
130.12  long-term care services, policy changes, and resource needs. 
130.13     Sec. 12.  Minnesota Statutes 2002, section 144A.4605, 
130.14  subdivision 4, is amended to read: 
130.15     Subd. 4.  [LICENSE REQUIRED.] (a) A housing with services 
130.16  establishment registered under chapter 144D that is required to 
130.17  obtain a home care license must obtain an assisted living home 
130.18  care license according to this section or a class A or class E 
130.19  license according to rule.  A housing with services 
130.20  establishment that obtains a class E license under this 
130.21  subdivision remains subject to the payment limitations in 
130.22  sections 256B.0913, subdivision ~~5~~ 5f, paragraph ~~(h)~~ (b), and 
130.23  256B.0915, subdivision ~~3, paragraph (g)~~ 3d. 
130.24     (b) A board and lodging establishment registered for 
130.25  special services as of December 31, 1996, and also registered as 
130.26  a housing with services establishment under chapter 144D, must 
130.27  deliver home care services according to sections 144A.43 to 
130.28  144A.47, and may apply for a waiver from requirements under 
130.29  Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 
130.30  licensed agency under the standards of section 157.17.  Such 
130.31  waivers as may be granted by the department will expire upon 
130.32  promulgation of home care rules implementing section 144A.4605. 
130.33     (c) An adult foster care provider licensed by the 
130.34  department of human services and registered under chapter 144D 
130.35  may continue to provide health-related services under its foster 
130.36  care license until the promulgation of home care rules 
131.1   implementing this section. 
131.2      (d) An assisted living home care provider licensed under 
131.3   this section must comply with the disclosure provisions of 
131.4   section 325F.72 to the extent they are applicable. 
131.5      Sec. 13.  Minnesota Statutes 2002, section 256.9657, 
131.6   subdivision 1, is amended to read: 
131.7      Subdivision 1.  [NURSING HOME LICENSE SURCHARGE.] (a) 
131.8   Effective July 1, 1993, each non-state-operated nursing home 
131.9   licensed under chapter 144A shall pay to the commissioner an 
131.10  annual surcharge according to the schedule in subdivision 4.  
131.11  The surcharge shall be calculated as $620 per licensed bed.  If 
131.12  the number of licensed beds is reduced, the surcharge shall be 
131.13  based on the number of remaining licensed beds the second month 
131.14  following the receipt of timely notice by the commissioner of 
131.15  human services that beds have been delicensed.  The nursing home 
131.16  must notify the commissioner of health in writing when beds are 
131.17  delicensed.  The commissioner of health must notify the 
131.18  commissioner of human services within ten working days after 
131.19  receiving written notification.  If the notification is received 
131.20  by the commissioner of human services by the 15th of the month, 
131.21  the invoice for the second following month must be reduced to 
131.22  recognize the delicensing of beds.  Beds on layaway status 
131.23  continue to be subject to the surcharge.  The commissioner of 
131.24  human services must acknowledge a medical care surcharge appeal 
131.25  within 30 days of receipt of the written appeal from the 
131.26  provider. 
131.27     (b) Effective July 1, 1994, the surcharge in paragraph (a) 
131.28  shall be increased to $625. 
131.29     (c) Effective August 15, 2002, the surcharge under 
131.30  paragraph (b) shall be increased to $990. 
131.31     (d) Effective July 15, 2003, the surcharge under paragraph 
131.32  (c) shall be increased to $2,815. 
131.33     (e) The commissioner may reduce, and may subsequently 
131.34  restore, the surcharge under paragraph (d) based on the 
131.35  commissioner's determination of a permissible surcharge. 
131.36     (f) Between April 1, 2002, and August 15, ~~2003~~ 2004, a 
132.1   facility governed by this subdivision may elect to assume full 
132.2   participation in the medical assistance program by agreeing to 
132.3   comply with all of the requirements of the medical assistance 
132.4   program, including the rate equalization law in section 256B.48, 
132.5   subdivision 1, paragraph (a), and all other requirements 
132.6   established in law or rule, and to begin intake of new medical 
132.7   assistance recipients.  Rates will be determined under Minnesota 
132.8   Rules, parts 9549.0010 to 9549.0080.  Notwithstanding section 
132.9   256B.431, subdivision 27, paragraph (i), rate calculations will 
132.10  be subject to limits as prescribed in rule and law.  Other than 
132.11  the adjustments in sections 256B.431, subdivisions 30 and 32; 
132.12  256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 
132.13  9549.0057, and any other applicable legislation enacted prior to 
132.14  the finalization of rates, facilities assuming full 
132.15  participation in medical assistance under this paragraph are not 
132.16  eligible for any rate adjustments until the July 1 following 
132.17  their settle-up period. 
132.18     <b>[EFFECTIVE DATE.]</b> This section is effective June 30, 2003. 
132.19     Sec. 14.  Minnesota Statutes 2002, section 256.9657, is 
132.20  amended by adding a subdivision to read: 
132.21     Subd. 3a.  [ICF/MR LICENSE SURCHARGE.] Effective July 1, 
132.22  2003, each nonstate-operated facility as defined under section 
132.23  256B.501, subdivision 1, shall pay to the commissioner an annual 
132.24  surcharge according to the schedule in subdivision 4, paragraph 
132.25  (d).  The annual surcharge shall be $1,040 per licensed bed.  If 
132.26  the number of licensed beds is reduced, the surcharge shall be 
132.27  based on the number of remaining licensed beds the second month 
132.28  following the receipt of timely notice by the commissioner of 
132.29  human services that beds have been delicensed.  The facility 
132.30  must notify the commissioner of health in writing when beds are 
132.31  delicensed.  The commissioner of health must notify the 
132.32  commissioner of human services within ten working days after 
132.33  receiving written notification.  If the notification is received 
132.34  by the commissioner of human services by the 15th of the month, 
132.35  the invoice for the second following month must be reduced to 
132.36  recognize the delicensing of beds.  The commissioner may reduce, 
133.1   and may subsequently restore, the surcharge under this 
133.2   subdivision based on the commissioner's determination of a 
133.3   permissible surcharge. 
133.4      <b>[EFFECTIVE DATE.]</b> This section is effective the day 
133.5   following final enactment. 
133.6      Sec. 15.  Minnesota Statutes 2002, section 256.9657, 
133.7   subdivision 4, is amended to read: 
133.8      Subd. 4.  [PAYMENTS INTO THE ACCOUNT.] (a) Payments to the 
133.9   commissioner under subdivisions 1 to 3 must be paid in monthly 
133.10  installments due on the 15th of the month beginning October 15, 
133.11  1992.  The monthly payment must be equal to the annual surcharge 
133.12  divided by 12.  Payments to the commissioner under subdivisions 
133.13  2 and 3 for fiscal year 1993 must be based on calendar year 1990 
133.14  revenues.  Effective July 1 of each year, beginning in 1993, 
133.15  payments under subdivisions 2 and 3 must be based on revenues 
133.16  earned in the second previous calendar year. 
133.17     (b) Effective October 1, 1995, and each October 1 
133.18  thereafter, the payments in subdivisions 2 and 3 must be based 
133.19  on revenues earned in the previous calendar year. 
133.20     (c) If the commissioner of health does not provide by 
133.21  August 15 of any year data needed to update the base year for 
133.22  the hospital and health maintenance organization surcharges, the 
133.23  commissioner of human services may estimate base year revenue 
133.24  and use that estimate for the purposes of this section until 
133.25  actual data is provided by the commissioner of health. 
133.26     (d) Payments to the commissioner under subdivision 3a must 
133.27  be paid in monthly installments due on the 15th of the month 
133.28  beginning July 15, 2003.  The monthly payment must be equal to 
133.29  the annual surcharge divided by 12. 
133.30     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
133.31  following final enactment. 
133.32     Sec. 16.  Minnesota Statutes 2002, section 256B.056, 
133.33  subdivision 6, is amended to read: 
133.34     Subd. 6.  [ASSIGNMENT OF BENEFITS.] To be eligible for 
133.35  medical assistance a person must have applied or must agree to 
133.36  apply all proceeds received or receivable by the person or the 
134.1   person's ~~spouse~~ legal representative from any third ~~person~~ party 
134.2   liable for the costs of medical care ~~for the person, the spouse,~~ 
134.3   ~~and children~~.  ~~The state agency shall require from any applicant~~ 
134.4   ~~or recipient of medical assistance the assignment of any rights~~ 
134.5   ~~to medical support and third party payments.~~  By accepting or 
134.6   receiving assistance, the person is deemed to have assigned the 
134.7   person's rights to medical support and third party payments as 
134.8   required by Title 19 of the Social Security Act.  Persons must 
134.9   cooperate with the state in establishing paternity and obtaining 
134.10  third party payments.  By ~~signing an application for~~ accepting 
134.11  medical assistance, a person assigns to the department of human 
134.12  services all rights the person may have to medical support or 
134.13  payments for medical expenses from any other person or entity on 
134.14  their own or their dependent's behalf and agrees to cooperate 
134.15  with the state in establishing paternity and obtaining third 
134.16  party payments.  Any rights or amounts so assigned shall be 
134.17  applied against the cost of medical care paid for under this 
134.18  chapter.  Any assignment takes effect upon the determination 
134.19  that the applicant is eligible for medical assistance and up to 
134.20  three months prior to the date of application if the applicant 
134.21  is determined eligible for and receives medical assistance 
134.22  benefits.  The application must contain a statement explaining 
134.23  this assignment.  ~~Any assignment shall not be effective as to~~ 
134.24  ~~benefits paid or provided under automobile accident coverage and~~ 
134.25  ~~private health care coverage prior to notification of the~~ 
134.26  ~~assignment by the person or organization providing the~~ 
134.27  ~~benefits.~~  For the purposes of this section, "the department of 
134.28  human services or the state" includes prepaid health plans under 
134.29  contract with the commissioner according to sections 256B.031, 
134.30  256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 
134.31  children's mental health collaboratives under section 245.493; 
134.32  demonstration projects for persons with disabilities under 
134.33  section 256B.77; nursing facilities under the alternative 
134.34  payment demonstration project under section 256B.434; and the 
134.35  county-based purchasing entities under section 256B.692.  
134.36     Sec. 17.  Minnesota Statutes 2002, section 256B.064, 
135.1   subdivision 2, is amended to read: 
135.2      Subd. 2.  [IMPOSITION OF MONETARY RECOVERY AND SANCTIONS.] 
135.3   (a) The commissioner shall determine any monetary amounts to be 
135.4   recovered and sanctions to be imposed upon a vendor of medical 
135.5   care under this section.  Except as provided in 
135.6   ~~paragraph~~ paragraphs (b) and (d), neither a monetary recovery 
135.7   nor a sanction will be imposed by the commissioner without prior 
135.8   notice and an opportunity for a hearing, according to chapter 
135.9   14, on the commissioner's proposed action, provided that the 
135.10  commissioner may suspend or reduce payment to a vendor of 
135.11  medical care, except a nursing home or convalescent care 
135.12  facility, after notice and prior to the hearing if in the 
135.13  commissioner's opinion that action is necessary to protect the 
135.14  public welfare and the interests of the program. 
135.15     (b) Except for a nursing home or convalescent care 
135.16  facility, the commissioner may withhold or reduce payments to a 
135.17  vendor of medical care without providing advance notice of such 
135.18  withholding or reduction if either of the following occurs: 
135.19     (1) the vendor is convicted of a crime involving the 
135.20  conduct described in subdivision 1a; or 
135.21     (2) the commissioner receives reliable evidence of fraud or 
135.22  willful misrepresentation by the vendor. 
135.23     (c) The commissioner must send notice of the withholding or 
135.24  reduction of payments under paragraph (b) within five days of 
135.25  taking such action.  The notice must: 
135.26     (1) state that payments are being withheld according to 
135.27  paragraph (b); 
135.28     (2) except in the case of a conviction for conduct 
135.29  described in subdivision 1a, state that the withholding is for a 
135.30  temporary period and cite the circumstances under which 
135.31  withholding will be terminated; 
135.32     (3) identify the types of claims to which the withholding 
135.33  applies; and 
135.34     (4) inform the vendor of the right to submit written 
135.35  evidence for consideration by the commissioner. 
135.36     The withholding or reduction of payments will not continue 
136.1   after the commissioner determines there is insufficient evidence 
136.2   of fraud or willful misrepresentation by the vendor, or after 
136.3   legal proceedings relating to the alleged fraud or willful 
136.4   misrepresentation are completed, unless the commissioner has 
136.5   sent notice of intention to impose monetary recovery or 
136.6   sanctions under paragraph (a). 
136.7      (d) The commissioner may suspend or terminate a vendor's 
136.8   participation in the program without providing advance notice 
136.9   and an opportunity for a hearing when the suspension or 
136.10  termination is required because of the vendor's exclusion from 
136.11  participation in Medicare.  Within five days of taking such 
136.12  action, the commissioner must send notice of the suspension or 
136.13  termination.  The notice must: 
136.14     (1) state that suspension or termination is the result of 
136.15  the vendor's exclusion from Medicare; 
136.16     (2) identify the effective date of the suspension or 
136.17  termination; 
136.18     (3) inform the vendor of the need to be reinstated to 
136.19  Medicare before reapplying for participation in the program; and 
136.20     (4) inform the vendor of the right to submit written 
136.21  evidence for consideration by the commissioner. 
136.22     (e) Upon receipt of a notice under paragraph (a) that a 
136.23  monetary recovery or sanction is to be imposed, a vendor may 
136.24  request a contested case, as defined in section 14.02, 
136.25  subdivision 3, by filing with the commissioner a written request 
136.26  of appeal.  The appeal request must be received by the 
136.27  commissioner no later than 30 days after the date the 
136.28  notification of monetary recovery or sanction was mailed to the 
136.29  vendor.  The appeal request must specify: 
136.30     (1) each disputed item, the reason for the dispute, and an 
136.31  estimate of the dollar amount involved for each disputed item; 
136.32     (2) the computation that the vendor believes is correct; 
136.33     (3) the authority in statute or rule upon which the vendor 
136.34  relies for each disputed item; 
136.35     (4) the name and address of the person or entity with whom 
136.36  contacts may be made regarding the appeal; and 
137.1      (5) other information required by the commissioner. 
137.2      Sec. 18.  Minnesota Statutes 2002, section 256B.0913, 
137.3   subdivision 2, is amended to read: 
137.4      Subd. 2.  [ELIGIBILITY FOR SERVICES.] Alternative care 
137.5   services are available to Minnesotans age 65 or older ~~who are~~ 
137.6   ~~not eligible for medical assistance without a spenddown or~~ 
137.7   ~~waiver obligation but~~ who would be eligible for medical 
137.8   assistance within 180 days of admission to a nursing facility 
137.9   and subject to subdivisions 4 to 13. 
137.10     Sec. 19.  Minnesota Statutes 2002, section 256B.0913, 
137.11  subdivision 4, is amended to read: 
137.12     Subd. 4.  [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 
137.13  NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 
137.14  under the alternative care program is available to persons who 
137.15  meet the following criteria: 
137.16     (1) the person has been determined by a community 
137.17  assessment under section 256B.0911 to be a person who would 
137.18  require the level of care provided in a nursing facility, but 
137.19  for the provision of services under the alternative care 
137.20  program; 
137.21     (2) the person is age 65 or older; 
137.22     (3) the person would be eligible for medical assistance 
137.23  within 180 days of admission to a nursing facility; 
137.24     (4) the person is not ineligible for the medical assistance 
137.25  program due to an asset transfer penalty; 
137.26     (5) the person needs services that are not funded through 
137.27  other state or federal funding; ~~and~~ 
137.28     (6) the monthly cost of the alternative care services 
137.29  funded by the program for this person does not exceed 75 percent 
137.30  of the ~~statewide weighted average monthly nursing facility rate~~ 
137.31  ~~of the case mix resident class to which the individual~~ 
137.32  ~~alternative care client would be assigned under Minnesota Rules,~~ 
137.33  ~~parts 9549.0050 to 9549.0059, less the recipient's maintenance~~ 
137.34  ~~needs allowance as described in section 256B.0915, subdivision~~ 
137.35  ~~1d, paragraph (a), until the first day of the state fiscal year~~ 
137.36  ~~in which the resident assessment system, under section 256B.437,~~ 
138.1   ~~for nursing home rate determination is implemented.  Effective~~ 
138.2   ~~on the first day of the state fiscal year in which a resident~~ 
138.3   ~~assessment system, under section 256B.437, for nursing home rate~~ 
138.4   ~~determination is implemented and the first day of each~~ 
138.5   ~~subsequent state fiscal year, the monthly cost of alternative~~ 
138.6   ~~care services for this person shall not exceed the alternative~~ 
138.7   ~~care monthly cap for the case mix resident class to which the~~ 
138.8   ~~alternative care client would be assigned under Minnesota Rules,~~ 
138.9   ~~parts 9549.0050 to 9549.0059, which was in effect on the last~~ 
138.10  ~~day of the previous state fiscal year, and adjusted by the~~ 
138.11  ~~greater of any legislatively adopted home and community-based~~ 
138.12  ~~services cost-of-living percentage increase or any legislatively~~ 
138.13  ~~adopted statewide percent rate increase for nursing~~ 
138.14  ~~facilities~~ monthly limit described under section 256B.0915, 
138.15  subdivision 3a.  This monthly limit does not prohibit the 
138.16  alternative care client from payment for additional services, 
138.17  but in no case may the cost of additional services purchased 
138.18  under this section exceed the difference between the client's 
138.19  monthly service limit defined under section 256B.0915, 
138.20  subdivision 3, and the alternative care program monthly service 
138.21  limit defined in this paragraph.  If medical supplies and 
138.22  equipment or environmental modifications are or will be 
138.23  purchased for an alternative care services recipient, the costs 
138.24  may be prorated on a monthly basis for up to 12 consecutive 
138.25  months beginning with the month of purchase.  If the monthly 
138.26  cost of a recipient's other alternative care services exceeds 
138.27  the monthly limit established in this paragraph, the annual cost 
138.28  of the alternative care services shall be determined.  In this 
138.29  event, the annual cost of alternative care services shall not 
138.30  exceed 12 times the monthly limit described in this paragraph~~.~~; 
138.31  and 
138.32     (7) the person is making timely payments of the assessed 
138.33  monthly fee. 
138.34  A person is ineligible if payment of the fee is over 60 days 
138.35  past due, unless the person agrees to: 
138.36     (i) the appointment of a representative payee; 
139.1      (ii) automatic payment from a financial account; 
139.2      (iii) the establishment of greater family involvement in 
139.3   the financial management of payments; or 
139.4      (iv) another method acceptable to the county to ensure 
139.5   prompt fee payments. 
139.6      The county shall extend the client's eligibility as 
139.7   necessary while making arrangements to facilitate payment of 
139.8   past-due amounts and future premium payments.  Following 
139.9   disenrollment due to nonpayment of a monthly fee, eligibility 
139.10  shall not be reinstated for a period of 30 days. 
139.11     (b) Alternative care funding under this subdivision is not 
139.12  available for a person who is a medical assistance recipient or 
139.13  who would be eligible for medical assistance without a spenddown 
139.14  or waiver obligation.  A person whose initial application for 
139.15  medical assistance and the elderly waiver program is being 
139.16  processed may be served under the alternative care program for a 
139.17  period up to 60 days.  If the individual is found to be eligible 
139.18  for medical assistance, medical assistance must be billed for 
139.19  services payable under the federally approved elderly waiver 
139.20  plan and delivered from the date the individual was found 
139.21  eligible for the federally approved elderly waiver plan.  
139.22  Notwithstanding this provision, ~~upon federal approval,~~ 
139.23  alternative care funds may not be used to pay for any service 
139.24  the cost of which:  (i) is payable by medical assistance ~~or~~ 
139.25  ~~which~~; (ii) is used by a recipient to meet a ~~medical assistance~~ 
139.26  ~~income spenddown or~~ waiver obligation; or (iii) is used to pay a 
139.27  medical assistance income spenddown for a person who is eligible 
139.28  to participate in the federally approved elderly waiver program 
139.29  under the special income standard provision. 
139.30     (c) Alternative care funding is not available for a person 
139.31  who resides in a licensed nursing home, certified boarding care 
139.32  home, hospital, or intermediate care facility, except for case 
139.33  management services which are provided in support of the 
139.34  discharge planning process ~~to~~ for a nursing home resident or 
139.35  certified boarding care home resident to assist with a 
139.36  relocation process to a community-based setting. 
140.1      (d) Alternative care funding is not available for a person 
140.2   whose income is greater than the maintenance needs allowance 
140.3   under section 256B.0915, subdivision 1d, but equal to or less 
140.4   than 120 percent of the federal poverty guideline effective July 
140.5   1, in the year for which alternative care eligibility is 
140.6   determined, who would be eligible for the elderly waiver with a 
140.7   waiver obligation. 
140.8      Sec. 20.  Minnesota Statutes 2002, section 256B.0913, 
140.9   subdivision 5, is amended to read: 
140.10     Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] ~~(a)~~ 
140.11  Alternative care funding may be used for payment of costs of: 
140.12     (1) adult foster care; 
140.13     (2) adult day care; 
140.14     (3) home health aide; 
140.15     (4) homemaker services; 
140.16     (5) personal care; 
140.17     (6) case management; 
140.18     (7) respite care; 
140.19     (8) assisted living; 
140.20     (9) residential care services; 
140.21     (10) care-related supplies and equipment; 
140.22     (11) meals delivered to the home; 
140.23     (12) transportation; 
140.24     (13) nursing services; 
140.25     (14) chore services; 
140.26     (15) companion services; 
140.27     (16) nutrition services; 
140.28     (17) training for direct informal caregivers; 
140.29     (18) telehome care ~~devices~~ to ~~monitor recipients~~ provide 
140.30  services in their own homes ~~as an alternative to hospital care,~~ 
140.31  ~~nursing home care, or home~~ in conjunction with in-home visits; 
140.32     (19) ~~other services which includes~~ discretionary ~~funds and~~ 
140.33  ~~direct cash payments to clients,~~ services, for which counties 
140.34  may make payment from their alternative care program allocation 
140.35  or services not otherwise defined in this section or section 
140.36  256B.0625, following approval by the commissioner~~, subject to~~ 
141.1   ~~the provisions of paragraph (j).  Total annual payments for~~ 
141.2   ~~"other services" for all clients within a county may not exceed~~ 
141.3   ~~25 percent of that county's annual alternative care program base~~ 
141.4   ~~allocation~~; ~~and~~ 
141.5      (20) environmental modifications~~.~~; and 
141.6      (21) direct cash payments for which counties may make 
141.7   payment from their alternative care program allocation to 
141.8   clients for the purpose of purchasing services, following 
141.9   approval by the commissioner, and subject to the provisions of 
141.10  subdivision 5h, until approval and implementation of 
141.11  consumer-directed services through the federally approved 
141.12  elderly waiver plan.  Upon implementation, consumer-directed 
141.13  services under the alternative care program are available 
141.14  statewide and limited to the average monthly expenditures 
141.15  representative of all alternative care program participants for 
141.16  the same case mix resident class assigned in the most recent 
141.17  fiscal year for which complete expenditure data is available. 
141.18     Total annual payments for discretionary services and direct 
141.19  cash payments, until the federally approved consumer-directed 
141.20  service option is implemented statewide, for all clients within 
141.21  a county may not exceed 25 percent of that county's annual 
141.22  alternative care program base allocation.  Thereafter, 
141.23  discretionary services are limited to 25 percent of the county's 
141.24  annual alternative care program base allocation. 
141.25     Subd. 5a.  [SERVICES; SERVICE DEFINITIONS; SERVICE 
141.26  STANDARDS.] (a) Unless specified in statute, the services, 
141.27  service definitions, and standards for alternative care services 
141.28  shall be the same as the services, service definitions, and 
141.29  standards specified in the federally approved elderly waiver 
141.30  plan, except for transitional support services. 
141.31     (b) The county agency must ensure that the funds are not 
141.32  used to supplant services available through other public 
141.33  assistance or services programs. 
141.34     ~~(c) Unless specified in statute, the services, service~~ 
141.35  ~~definitions, and standards for alternative care services shall~~ 
141.36  ~~be the same as the services, service definitions, and standards~~ 
142.1   ~~specified in the federally approved elderly waiver plan.  Except~~ 
142.2   ~~for the county agencies' approval of direct cash payments to~~ 
142.3   ~~clients as described in paragraph (j) or~~ For a provider of 
142.4   supplies and equipment when the monthly cost of the supplies and 
142.5   equipment is less than $250, persons or agencies must be 
142.6   employed by or under a contract with the county agency or the 
142.7   public health nursing agency of the local board of health in 
142.8   order to receive funding under the alternative care program.  
142.9   Supplies and equipment may be purchased from a vendor not 
142.10  certified to participate in the Medicaid program if the cost for 
142.11  the item is less than that of a Medicaid vendor.  
142.12     (c) Personal care services must meet the service standards 
142.13  defined in the federally approved elderly waiver plan, except 
142.14  that a county agency may contract with a client's relative who 
142.15  meets the relative hardship waiver requirements or a relative 
142.16  who meets the criteria and is also the responsible party under 
142.17  an individual service plan that ensures the client's health and 
142.18  safety and supervision of the personal care services by a 
142.19  qualified professional as defined in section 256B.0625, 
142.20  subdivision 19c.  Relative hardship is established by the county 
142.21  when the client's care causes a relative caregiver to do any of 
142.22  the following:  resign from a paying job, reduce work hours 
142.23  resulting in lost wages, obtain a leave of absence resulting in 
142.24  lost wages, incur substantial client-related expenses, provide 
142.25  services to address authorized, unstaffed direct care time, or 
142.26  meet special needs of the client unmet in the formal service 
142.27  plan. 
142.28     ~~(d)~~ Subd. 5b.  [ADULT FOSTER CARE RATE.] The adult foster 
142.29  care rate shall be considered a difficulty of care payment and 
142.30  shall not include room and board.  The adult foster care rate 
142.31  shall be negotiated between the county agency and the foster 
142.32  care provider.  The alternative care payment for the foster care 
142.33  service in combination with the payment for other alternative 
142.34  care services, including case management, must not exceed the 
142.35  limit specified in subdivision 4, paragraph (a), clause (6). 
142.36     ~~(e) Personal care services must meet the service standards~~ 
143.1   ~~defined in the federally approved elderly waiver plan, except~~ 
143.2   ~~that a county agency may contract with a client's relative who~~ 
143.3   ~~meets the relative hardship waiver requirement as defined in~~ 
143.4   ~~section 256B.0627, subdivision 4, paragraph (b), clause (10), to~~ 
143.5   ~~provide personal care services if the county agency ensures~~ 
143.6   ~~supervision of this service by a qualified professional as~~ 
143.7   ~~defined in section 256B.0625, subdivision 19c.~~  
143.8      ~~(f)~~  Subd. 5c.  [RESIDENTIAL CARE SERVICES; SUPPORTIVE 
143.9   SERVICES; HEALTH-RELATED SERVICES.] For purposes of this 
143.10  section, residential care services are services which are 
143.11  provided to individuals living in residential care homes.  
143.12  Residential care homes are currently licensed as board and 
143.13  lodging establishments under section 157.16, and are registered 
143.14  with the department of health as providing special services 
143.15  under section 157.17 ~~and are not subject to registration~~ except 
143.16  settings that are currently registered under chapter 144D.  
143.17  Residential care services are defined as "supportive services" 
143.18  and "health-related services."  "Supportive services" means ~~the~~ 
143.19  ~~provision of up to 24-hour supervision and oversight.~~  
143.20  ~~Supportive services includes:  (1) transportation, when provided~~ 
143.21  ~~by the residential care home only; (2) socialization, when~~ 
143.22  ~~socialization is part of the plan of care, has specific goals~~ 
143.23  ~~and outcomes established, and is not diversional or recreational~~ 
143.24  ~~in nature; (3) assisting clients in setting up meetings and~~ 
143.25  ~~appointments; (4) assisting clients in setting up medical and~~ 
143.26  ~~social services; (5) providing assistance with personal laundry,~~ 
143.27  ~~such as carrying the client's laundry to the laundry room.~~  
143.28  ~~Assistance with personal laundry does not include any laundry,~~ 
143.29  ~~such as bed linen, that is included in the room and board rate~~ 
143.30  services as defined in section 157.17, subdivision 1, paragraph 
143.31  (a).  "Health-related services" ~~are limited to minimal~~ 
143.32  ~~assistance with dressing, grooming, and bathing and providing~~ 
143.33  ~~reminders to residents to take medications that are~~ 
143.34  ~~self-administered or providing storage for medications, if~~ 
143.35  ~~requested~~ means services covered in section 157.17, subdivision 
143.36  1, paragraph (b).  Individuals receiving residential care 
144.1   services cannot receive homemaking services funded under this 
144.2   section.  
144.3      ~~(g)~~ Subd. 5d.  [ASSISTED LIVING SERVICES.] For the purposes 
144.4   of this section, "assisted living" refers to supportive services 
144.5   provided by a single vendor to clients who reside in the same 
144.6   apartment building of three or more units which are not subject 
144.7   to registration under chapter 144D and are licensed by the 
144.8   department of health as a class A home care provider or a class 
144.9   E home care provider.  Assisted living services are defined as 
144.10  up to 24-hour supervision, ~~and~~ oversight, and supportive 
144.11  services as defined in ~~clause (1)~~ section 157.17, subdivision 1, 
144.12  paragraph (a), individualized home care aide tasks as defined in 
144.13  ~~clause (2)~~ Minnesota Rules, part 4668.0110, and individualized 
144.14  home management tasks as defined in ~~clause (3)~~ Minnesota Rules, 
144.15  part 4668.0120 provided to residents of a residential center 
144.16  living in their units or apartments with a full kitchen and 
144.17  bathroom.  A full kitchen includes a stove, oven, refrigerator, 
144.18  food preparation counter space, and a kitchen utensil storage 
144.19  compartment.  Assisted living services must be provided by the 
144.20  management of the residential center or by providers under 
144.21  contract with the management or with the county. 
144.22     ~~(1) Supportive services include:~~  
144.23     ~~(i) socialization, when socialization is part of the plan~~ 
144.24  ~~of care, has specific goals and outcomes established, and is not~~ 
144.25  ~~diversional or recreational in nature;~~ 
144.26     ~~(ii) assisting clients in setting up meetings and~~ 
144.27  ~~appointments; and~~ 
144.28     ~~(iii) providing transportation, when provided by the~~ 
144.29  ~~residential center only.~~  
144.30     ~~(2) Home care aide tasks means:~~  
144.31     ~~(i) preparing modified diets, such as diabetic or low~~ 
144.32  ~~sodium diets;~~ 
144.33     ~~(ii) reminding residents to take regularly scheduled~~ 
144.34  ~~medications or to perform exercises;~~ 
144.35     ~~(iii) household chores in the presence of technically~~ 
144.36  ~~sophisticated medical equipment or episodes of acute illness or~~ 
145.1   ~~infectious disease;~~ 
145.2      ~~(iv) household chores when the resident's care requires the~~ 
145.3   ~~prevention of exposure to infectious disease or containment of~~ 
145.4   ~~infectious disease; and~~ 
145.5      ~~(v) assisting with dressing, oral hygiene, hair care,~~ 
145.6   ~~grooming, and bathing, if the resident is ambulatory, and if the~~ 
145.7   ~~resident has no serious acute illness or infectious disease.~~  
145.8   ~~Oral hygiene means care of teeth, gums, and oral prosthetic~~ 
145.9   ~~devices.~~  
145.10     ~~(3) Home management tasks means:~~  
145.11     ~~(i) housekeeping;~~ 
145.12     ~~(ii) laundry;~~ 
145.13     ~~(iii) preparation of regular snacks and meals; and~~ 
145.14     ~~(iv) shopping.~~  
145.15     Subd. 5e.  [FURTHER ASSISTED LIVING REQUIREMENTS.] (a) 
145.16  Individuals receiving assisted living services shall not receive 
145.17  both assisted living services and homemaking services.  
145.18  Individualized means services are chosen and designed 
145.19  specifically for each resident's needs, rather than provided or 
145.20  offered to all residents regardless of their illnesses, 
145.21  disabilities, or physical conditions.  Assisted living services 
145.22  as defined in this section shall not be authorized in boarding 
145.23  and lodging establishments licensed according to sections 
145.24  157.011 and 157.15 to 157.22. 
145.25     ~~(h)~~ (b) For establishments registered under chapter 144D, 
145.26  assisted living services under this section means either the 
145.27  services described in ~~paragraph (g)~~ subdivision 5d and delivered 
145.28  by a class E home care provider licensed by the department of 
145.29  health or the services described under section 144A.4605 and 
145.30  delivered by an assisted living home care provider or a class A 
145.31  home care provider licensed by the commissioner of health. 
145.32     ~~(i)~~ Subd. 5f.  [PAYMENT RATES FOR ASSISTED LIVING SERVICES 
145.33  AND RESIDENTIAL CARE.] (a) Payment for assisted living services 
145.34  and residential care services shall be a monthly rate negotiated 
145.35  and authorized by the county agency based on an individualized 
145.36  service plan for each resident and may not cover direct rent or 
146.1   food costs.  
146.2      ~~(1)~~ (b) The individualized monthly negotiated payment for 
146.3   assisted living services as described in ~~paragraph~~ 
146.4   ~~(g)~~ subdivision 5d or ~~(h)~~ 5e, paragraph (b), and residential 
146.5   care services as described in ~~paragraph (f)~~ subdivision 5c, 
146.6   shall not exceed the nonfederal share in effect on July 1 of the 
146.7   state fiscal year for which the rate limit is being calculated 
146.8   of the greater of either the statewide or any of the geographic 
146.9   ~~groups' weighted average monthly nursing facility payment rate~~ 
146.10  ~~of the case mix resident class to which the alternative care~~ 
146.11  ~~eligible client would be assigned under Minnesota Rules, parts~~ 
146.12  ~~9549.0050 to 9549.0059, less the maintenance needs allowance as~~ 
146.13  ~~described in section 256B.0915, subdivision 1d, paragraph (a),~~ 
146.14  ~~until the first day of the state fiscal year in which a resident~~ 
146.15  ~~assessment system, under section 256B.437, of nursing home rate~~ 
146.16  ~~determination is implemented.  Effective on the first day of the~~ 
146.17  ~~state fiscal year in which a resident assessment system, under~~ 
146.18  ~~section 256B.437, of nursing home rate determination is~~ 
146.19  ~~implemented and the first day of each subsequent state fiscal~~ 
146.20  ~~year, the individualized monthly negotiated payment for the~~ 
146.21  ~~services described in this clause shall not exceed the limit~~ 
146.22  ~~described in this clause which was in effect on the last day of~~ 
146.23  ~~the previous state fiscal year and which has been adjusted by~~ 
146.24  ~~the greater of any legislatively adopted home and~~ 
146.25  ~~community-based services cost-of-living percentage increase or~~ 
146.26  ~~any legislatively adopted statewide percent rate increase for~~ 
146.27  ~~nursing facilities~~ groups according to subdivision 4, paragraph 
146.28  (a), clause (6). 
146.29     ~~(2)~~ (c) The individualized monthly negotiated payment for 
146.30  assisted living services described under section 144A.4605 and 
146.31  delivered by a provider licensed by the department of health as 
146.32  a class A home care provider or an assisted living home care 
146.33  provider and provided in a building that is registered as a 
146.34  housing with services establishment under chapter 144D and that 
146.35  provides 24-hour supervision in combination with the payment for 
146.36  other alternative care services, including case management, must 
147.1   not exceed the limit specified in subdivision 4, paragraph (a), 
147.2   clause (6). 
147.3      ~~(j)~~ Subd. 5g.  [PROVISIONS GOVERNING DIRECT CASH PAYMENTS.] 
147.4   A county agency may make payment from their alternative care 
147.5   program allocation for ~~"other services" which include use of~~ 
147.6   ~~"discretionary funds" for services that are not otherwise~~ 
147.7   ~~defined in this section and~~ direct cash payments to the client 
147.8   for the purpose of purchasing the services.  The following 
147.9   provisions apply to payments under this ~~paragraph~~ subdivision: 
147.10     (1) a cash payment to a client under this provision cannot 
147.11  exceed the monthly payment limit for that client as specified in 
147.12  subdivision 4, paragraph (a), clause (6); and 
147.13     (2) a county may not approve any cash payment for a client 
147.14  who meets either of the following: 
147.15     (i) has been assessed as having a dependency in 
147.16  orientation, unless the client has an authorized 
147.17  representative.  An "authorized representative" means an 
147.18  individual who is at least 18 years of age and is designated by 
147.19  the person or the person's legal representative to act on the 
147.20  person's behalf.  This individual may be a family member, 
147.21  guardian, representative payee, or other individual designated 
147.22  by the person or the person's legal representative, if any, to 
147.23  assist in purchasing and arranging for supports; or 
147.24     (ii) is concurrently receiving adult foster care, 
147.25  residential care, or assisted living services~~;~~. 
147.26     ~~(3)~~  Subd. 5h.  [CASH PAYMENTS TO PERSONS.] (a) Cash 
147.27  payments to a person or a person's family will be provided 
147.28  through a monthly payment and be in the form of cash, voucher, 
147.29  or direct county payment to a vendor.  Fees or premiums assessed 
147.30  to the person for eligibility for health and human services are 
147.31  not reimbursable through this service option.  Services and 
147.32  goods purchased through cash payments must be identified in the 
147.33  person's individualized care plan and must meet all of the 
147.34  following criteria: 
147.35     ~~(i)~~ (1) they must be over and above the normal cost of 
147.36  caring for the person if the person did not have functional 
148.1   limitations; 
148.2      ~~(ii)~~ (2) they must be directly attributable to the person's 
148.3   functional limitations; 
148.4      ~~(iii)~~ (3) they must have the potential to be effective at 
148.5   meeting the goals of the program; and 
148.6      ~~(iv)~~ (4) they must be consistent with the needs identified 
148.7   in the individualized service plan.  The service plan shall 
148.8   specify the needs of the person and family, the form and amount 
148.9   of payment, the items and services to be reimbursed, and the 
148.10  arrangements for management of the individual grant~~; and~~. 
148.11     ~~(v)~~ (b) The person, the person's family, or the legal 
148.12  representative shall be provided sufficient information to 
148.13  ensure an informed choice of alternatives.  The local agency 
148.14  shall document this information in the person's care plan, 
148.15  including the type and level of expenditures to be reimbursed~~;~~. 
148.16     (c) Persons receiving grants under this section shall have 
148.17  the following responsibilities: 
148.18     (1) spend the grant money in a manner consistent with their 
148.19  individualized service plan with the local agency; 
148.20     (2) notify the local agency of any necessary changes in the 
148.21  grant expenditures; 
148.22     (3) arrange and pay for supports; and 
148.23     (4) inform the local agency of areas where they have 
148.24  experienced difficulty securing or maintaining supports. 
148.25     (d) The county shall report client outcomes, services, and 
148.26  costs under this paragraph in a manner prescribed by the 
148.27  commissioner. 
148.28     ~~(4)~~ Subd. 5i.  [IMMUNITY.] The state of Minnesota, county, 
148.29  lead agency under contract, or tribal government under contract 
148.30  to administer the alternative care program shall not be liable 
148.31  for damages, injuries, or liabilities sustained through the 
148.32  purchase of direct supports or goods by the person, the person's 
148.33  family, or the authorized representative with funds received 
148.34  through the cash payments under this section.  Liabilities 
148.35  include, but are not limited to, workers' compensation, the 
148.36  Federal Insurance Contributions Act (FICA), or the Federal 
149.1   Unemployment Tax Act (FUTA)~~;~~. 
149.2      ~~(5) persons receiving grants under this section shall have~~ 
149.3   ~~the following responsibilities:~~ 
149.4      ~~(i) spend the grant money in a manner consistent with their~~ 
149.5   ~~individualized service plan with the local agency;~~ 
149.6      ~~(ii) notify the local agency of any necessary changes in~~ 
149.7   ~~the grant expenditures;~~ 
149.8      ~~(iii) arrange and pay for supports; and~~ 
149.9      ~~(iv) inform the local agency of areas where they have~~ 
149.10  ~~experienced difficulty securing or maintaining supports; and~~ 
149.11     ~~(6) the county shall report client outcomes, services, and~~ 
149.12  ~~costs under this paragraph in a manner prescribed by the~~ 
149.13  ~~commissioner.~~ 
149.14     Sec. 21.  Minnesota Statutes 2002, section 256B.0913, 
149.15  subdivision 6, is amended to read: 
149.16     Subd. 6.  [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] (a) 
149.17  The alternative care program is administered by the county 
149.18  agency.  This agency is the lead agency responsible for the 
149.19  local administration of the alternative care program as 
149.20  described in this section.  However, it may contract with the 
149.21  public health nursing service to be the lead agency.  The 
149.22  commissioner may contract with federally recognized Indian 
149.23  tribes with a reservation in Minnesota to serve as the lead 
149.24  agency responsible for the local administration of the 
149.25  alternative care program as described in the contract. 
149.26     (b) Alternative care pilot projects operate according to 
149.27  this section and the provisions of Laws 1993, First Special 
149.28  Session chapter 1, article 5, section 133, under agreement with 
149.29  the commissioner.  Each pilot project agreement period shall 
149.30  begin no later than the first payment cycle of the state fiscal 
149.31  year and continue through the last payment cycle of the state 
149.32  fiscal year. 
149.33     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
149.34     Sec. 22.  Minnesota Statutes 2002, section 256B.0913, 
149.35  subdivision 7, is amended to read: 
149.36     Subd. 7.  [CASE MANAGEMENT.] ~~Providers of case management~~ 
150.1   ~~services for persons receiving services funded by the~~ 
150.2   ~~alternative care program must meet the qualification~~ 
150.3   ~~requirements and standards specified in section 256B.0915,~~ 
150.4   ~~subdivision 1b.~~  The case manager must not approve alternative 
150.5   care funding for a client in any setting in which the case 
150.6   manager cannot reasonably ensure the client's health and 
150.7   safety.  The case manager is responsible for the 
150.8   cost-effectiveness of the alternative care individual care plan 
150.9   and must not approve any care plan in which the cost of services 
150.10  funded by alternative care and client contributions exceeds the 
150.11  limit specified in section 256B.0915, subdivision 3, paragraph 
150.12  (b).  ~~The county may allow a case manager employed by the county~~ 
150.13  ~~to delegate certain aspects of the case management activity to~~ 
150.14  ~~another individual employed by the county provided there is~~ 
150.15  ~~oversight of the individual by the case manager.  The case~~ 
150.16  ~~manager may not delegate those aspects which require~~ 
150.17  ~~professional judgment including assessments, reassessments, and~~ 
150.18  ~~care plan development.~~ 
150.19     Sec. 23.  Minnesota Statutes 2002, section 256B.0913, 
150.20  subdivision 8, is amended to read: 
150.21     Subd. 8.  [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 
150.22  case manager shall implement the plan of care for each 
150.23  alternative care client and ensure that a client's service needs 
150.24  and eligibility are reassessed at least every 12 months.  The 
150.25  plan shall include any services prescribed by the individual's 
150.26  attending physician as necessary to allow the individual to 
150.27  remain in a community setting.  In developing the individual's 
150.28  care plan, the case manager should include the use of volunteers 
150.29  from families and neighbors, religious organizations, social 
150.30  clubs, and civic and service organizations to support the formal 
150.31  home care services.  The county shall be held harmless for 
150.32  damages or injuries sustained through the use of volunteers 
150.33  under this subdivision including workers' compensation 
150.34  liability.  The lead agency shall provide documentation in each 
150.35  individual's plan of care and, if requested, to the commissioner 
150.36  that the most cost-effective alternatives available have been 
151.1   offered to the individual and that the individual was free to 
151.2   choose among available qualified providers, both public and 
151.3   private, including qualified case management or service 
151.4   coordination providers other than those employed by the lead 
151.5   agency when the lead agency maintains responsibility for prior 
151.6   authorizing services in accordance with statutory and 
151.7   administrative requirements.  The case manager must give the 
151.8   individual a ten-day written notice of any denial, termination, 
151.9   or reduction of alternative care services. 
151.10     (b) If the county administering alternative care services 
151.11  is different than the county of financial responsibility, the 
151.12  care plan may be implemented without the approval of the county 
151.13  of financial responsibility. 
151.14     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2005. 
151.15     Sec. 24.  Minnesota Statutes 2002, section 256B.0913, 
151.16  subdivision 10, is amended to read: 
151.17     Subd. 10.  [ALLOCATION FORMULA.] (a) The alternative care 
151.18  appropriation for fiscal years 1992 and beyond shall cover only 
151.19  alternative care eligible clients.  By July 1 of each year, the 
151.20  commissioner shall allocate to county agencies the state funds 
151.21  available for alternative care for persons eligible under 
151.22  subdivision 2. 
151.23     (b) The adjusted base for each county is the county's 
151.24  current fiscal year base allocation plus any targeted funds 
151.25  approved during the current fiscal year.  Calculations for 
151.26  paragraphs (c) and (d) are to be made as follows:  for each 
151.27  county, the determination of alternative care program 
151.28  expenditures shall be based on payments for services rendered 
151.29  from April 1 through March 31 in the base year, to the extent 
151.30  that claims have been submitted and paid by June 1 of that year. 
151.31     (c) If the alternative care program expenditures as defined 
151.32  in paragraph (b) are 95 percent or more of the county's adjusted 
151.33  base allocation, the allocation for the next fiscal year is 100 
151.34  percent of the adjusted base, plus inflation to the extent that 
151.35  inflation is included in the state budget. 
151.36     (d) If the alternative care program expenditures as defined 
152.1   in paragraph (b) are less than 95 percent of the county's 
152.2   adjusted base allocation, the allocation for the next fiscal 
152.3   year is the adjusted base allocation less the amount of unspent 
152.4   funds below the 95 percent level. 
152.5      (e) If the annual legislative appropriation for the 
152.6   alternative care program is inadequate to fund the combined 
152.7   county allocations for a biennium, the commissioner shall 
152.8   distribute to each county the entire annual appropriation as 
152.9   that county's percentage of the computed base as calculated in 
152.10  paragraphs (c) and (d). 
152.11     (f) On agreement between the commissioner and the lead 
152.12  agency, the commissioner may have discretion to reallocate 
152.13  alternative care base allocations distributed to lead agencies 
152.14  in which the base amount exceeds program expenditures. 
152.15     Sec. 25.  Minnesota Statutes 2002, section 256B.0913, 
152.16  subdivision 12, is amended to read: 
152.17     Subd. 12.  [CLIENT ~~PREMIUMS~~ FEES.] (a) A ~~premium~~ fee is 
152.18  required for all alternative care eligible clients to help pay 
152.19  for the cost of participating in the program.  The amount of the 
152.20  ~~premium~~ fee for the alternative care client shall be determined 
152.21  as follows: 
152.22     (1) when the alternative care client's income less 
152.23  recurring and predictable medical expenses is ~~greater than the~~ 
152.24  ~~recipient's maintenance needs allowance as defined in section~~ 
152.25  ~~256B.0915, subdivision 1d, paragraph (a), but~~ less than ~~150~~ 100 
152.26  percent of the federal poverty guideline effective on July 1 of 
152.27  the state fiscal year in which the ~~premium~~ fee is being 
152.28  computed, and total assets are less than $10,000, the fee is 
152.29  zero; 
152.30     (2) when the alternative care client's income less 
152.31  recurring and predictable medical expenses is equal to or 
152.32  greater than 100 percent but less than 150 percent of the 
152.33  federal poverty guideline effective on July 1 of the state 
152.34  fiscal year in which the ~~premium~~ fee is being computed, and 
152.35  total assets are less than $10,000, the fee is ~~25~~ five percent 
152.36  of the cost of alternative care services ~~or the difference~~ 
153.1   ~~between 150 percent of the federal poverty guideline effective~~ 
153.2   ~~on July 1 of the state fiscal year in which the premium is being~~ 
153.3   ~~computed and the client's income less recurring and predictable~~ 
153.4   ~~medical expenses, whichever is less~~; ~~and~~ 
153.5      (3) when the alternative care client's ~~total assets are~~ 
153.6   ~~greater~~ income less recurring and predictable medical expenses 
153.7   is equal to or greater than 150 percent but less than 200 
153.8   percent of the federal poverty guidelines effective on July 1 of 
153.9   the state fiscal year in which the fee is being computed and 
153.10  assets are less than $10,000, the fee is ~~25~~ 15 percent of the 
153.11  cost of alternative care services; 
153.12     (4) when the alternative care client's income less 
153.13  recurring and predictable medical expenses is equal to or 
153.14  greater than 200 percent of the federal poverty guidelines 
153.15  effective on July 1 of the state fiscal year in which the fee is 
153.16  being computed and assets are less than $10,000, the fee is 30 
153.17  percent of the cost of alternative care services; and 
153.18     (5) when the alternative care client's assets are equal to 
153.19  or greater than $10,000, the fee is 30 percent of the cost of 
153.20  alternative care services.  
153.21     For married persons, total assets are defined as the total 
153.22  marital assets less the estimated community spouse asset 
153.23  allowance, under section 256B.059, if applicable.  For married 
153.24  persons, total income is defined as the client's income less the 
153.25  monthly spousal allotment, under section 256B.058. 
153.26     All alternative care services ~~except case management~~ shall 
153.27  be included in the estimated costs for the purpose of 
153.28  determining ~~25 percent of~~ the ~~costs~~ fee. 
153.29     ~~Premiums~~ Fees are due and payable each month alternative 
153.30  care services are received unless the actual cost of the 
153.31  services is less than the ~~premium~~ fee, in which case the fee is 
153.32  the lesser amount. 
153.33     (b) The fee shall be waived by the commissioner when: 
153.34     (1) a person who is residing in a nursing facility is 
153.35  receiving case management only; 
153.36     (2) ~~a person is applying for medical assistance;~~ 
154.1      ~~(3)~~ a married couple is requesting an asset assessment 
154.2   under the spousal impoverishment provisions; 
154.3      ~~(4)~~ (3) a person is found eligible for alternative care, 
154.4   but is not yet receiving alternative care services; or 
154.5      ~~(5) a person's fee under paragraph (a) is less than $25~~ 
154.6      (4) a person has chosen to participate in a 
154.7   consumer-directed service plan for which the cost is no greater 
154.8   than the total cost of the person's alternative care service 
154.9   plan less the monthly fee amount that would otherwise be 
154.10  assessed. 
154.11     (c) The county agency must record in the state's receivable 
154.12  system the client's assessed ~~premium~~ fee amount or the reason 
154.13  the ~~premium~~ fee has been waived.  The commissioner will bill and 
154.14  collect the ~~premium~~ fee from the client.  Money collected must 
154.15  be deposited in the general fund and is appropriated to the 
154.16  commissioner for the alternative care program.  The client must 
154.17  supply the county with the client's social security number at 
154.18  the time of application.  The county shall supply the 
154.19  commissioner with the client's social security number and other 
154.20  information the commissioner requires to collect the ~~premium~~ fee 
154.21  from the client.  The commissioner shall collect unpaid ~~premiums~~ 
154.22  fees using the Revenue Recapture Act in chapter 270A and other 
154.23  methods available to the commissioner.  The commissioner may 
154.24  require counties to inform clients of the collection procedures 
154.25  that may be used by the state if a ~~premium~~ fee is not paid.  
154.26  This paragraph does not apply to alternative care pilot projects 
154.27  authorized in Laws 1993, First Special Session chapter 1, 
154.28  article 5, section 133, if a county operating under the pilot 
154.29  project reports the following dollar amounts to the commissioner 
154.30  quarterly: 
154.31     (1) total ~~premiums~~ fees billed to clients; 
154.32     (2) total collections of ~~premiums~~ fees billed; and 
154.33     (3) balance of ~~premiums~~ fees owed by clients. 
154.34  If a county does not adhere to these reporting requirements, the 
154.35  commissioner may terminate the billing, collecting, and 
154.36  remitting portions of the pilot project and require the county 
155.1   involved to operate under the procedures set forth in this 
155.2   paragraph. 
155.3      Sec. 26.  Minnesota Statutes 2002, section 256B.0915, 
155.4   subdivision 3, is amended to read: 
155.5      Subd. 3.  [LIMITS OF CASES~~, RATES, PAYMENTS, AND~~ 
155.6   ~~FORECASTING~~.] ~~(a)~~ The number of medical assistance waiver 
155.7   recipients that a county may serve must be allocated according 
155.8   to the number of medical assistance waiver cases open on July 1 
155.9   of each fiscal year.  Additional recipients may be served with 
155.10  the approval of the commissioner. 
155.11     ~~(b)~~ Subd. 3a.  [ELDERLY WAIVER COST LIMITS.] (a) The 
155.12  monthly limit for the cost of waivered services to an individual 
155.13  elderly waiver client shall be the weighted average monthly 
155.14  nursing facility rate of the case mix resident class to which 
155.15  the elderly waiver client would be assigned under Minnesota 
155.16  Rules, parts 9549.0050 to 9549.0059, less the recipient's 
155.17  maintenance needs allowance as described in subdivision 1d, 
155.18  paragraph (a), until the first day of the state fiscal year in 
155.19  which the resident assessment system as described in section 
155.20  256B.437 for nursing home rate determination is implemented.  
155.21  Effective on the first day of the state fiscal year in which the 
155.22  resident assessment system as described in section 256B.437 for 
155.23  nursing home rate determination is implemented and the first day 
155.24  of each subsequent state fiscal year, the monthly limit for the 
155.25  cost of waivered services to an individual elderly waiver client 
155.26  shall be the rate of the case mix resident class to which the 
155.27  waiver client would be assigned under Minnesota Rules, parts 
155.28  9549.0050 to 9549.0059, in effect on the last day of the 
155.29  previous state fiscal year, adjusted by the greater of any 
155.30  legislatively adopted home and community-based services 
155.31  cost-of-living percentage increase or any legislatively adopted 
155.32  statewide percent rate increase for nursing facilities. 
155.33     ~~(c)~~ (b) If extended medical supplies and equipment or 
155.34  environmental modifications are or will be purchased for an 
155.35  elderly waiver client, the costs may be prorated for up to 12 
155.36  consecutive months beginning with the month of purchase.  If the 
156.1   monthly cost of a recipient's waivered services exceeds the 
156.2   monthly limit established in paragraph ~~(b)~~ (a), the annual cost 
156.3   of all waivered services shall be determined.  In this event, 
156.4   the annual cost of all waivered services shall not exceed 12 
156.5   times the monthly limit of waivered services as described in 
156.6   paragraph ~~(b)~~ (a).  
156.7      ~~(d)~~ Subd. 3b.  [COST LIMITS FOR ELDERLY WAIVER APPLICANTS 
156.8   WHO RESIDE IN A NURSING FACILITY.] (a) For a person who is a 
156.9   nursing facility resident at the time of requesting a 
156.10  determination of eligibility for elderly waivered services, a 
156.11  monthly conversion limit for the cost of elderly waivered 
156.12  services may be requested.  The monthly conversion limit for the 
156.13  cost of elderly waiver services shall be the resident class 
156.14  assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 
156.15  for that resident in the nursing facility where the resident 
156.16  currently resides until July 1 of the state fiscal year in which 
156.17  the resident assessment system as described in section 256B.437 
156.18  for nursing home rate determination is implemented.  Effective 
156.19  on July 1 of the state fiscal year in which the resident 
156.20  assessment system as described in section 256B.437 for nursing 
156.21  home rate determination is implemented, the monthly conversion 
156.22  limit for the cost of elderly waiver services shall be the per 
156.23  diem nursing facility rate as determined by the resident 
156.24  assessment system as described in section 256B.437 for that 
156.25  resident in the nursing facility where the resident currently 
156.26  resides multiplied by 365 and divided by 12, less the 
156.27  recipient's maintenance needs allowance as described in 
156.28  subdivision 1d.  The initially approved conversion rate may be 
156.29  adjusted by the greater of any subsequent legislatively adopted 
156.30  home and community-based services cost-of-living percentage 
156.31  increase or any subsequent legislatively adopted statewide 
156.32  percentage rate increase for nursing facilities.  The limit 
156.33  under this ~~clause~~ subdivision only applies to persons discharged 
156.34  from a nursing facility after a minimum 30-day stay and found 
156.35  eligible for waivered services on or after July 1, 1997.  
156.36     (b) The following costs must be included in determining the 
157.1   total monthly costs for the waiver client: 
157.2      (1) cost of all waivered services, including extended 
157.3   medical supplies and equipment and environmental modifications; 
157.4   and 
157.5      (2) cost of skilled nursing, home health aide, and personal 
157.6   care services reimbursable by medical assistance.  
157.7      ~~(e)~~ Subd. 3c.  [SERVICE APPROVAL AND CONTRACTING 
157.8   PROVISIONS.] (a) Medical assistance funding for skilled nursing 
157.9   services, private duty nursing, home health aide, and personal 
157.10  care services for waiver recipients must be approved by the case 
157.11  manager and included in the individual care plan. 
157.12     ~~(f)~~ (b) A county is not required to contract with a 
157.13  provider of supplies and equipment if the monthly cost of the 
157.14  supplies and equipment is less than $250.  
157.15     ~~(g)~~ Subd. 3d.  [ADULT FOSTER CARE RATE.] The adult foster 
157.16  care rate shall be considered a difficulty of care payment and 
157.17  shall not include room and board.  The adult foster care service 
157.18  rate shall be negotiated between the county agency and the 
157.19  foster care provider.  The elderly waiver payment for the foster 
157.20  care service in combination with the payment for all other 
157.21  elderly waiver services, including case management, must not 
157.22  exceed the limit specified in subdivision 3a, paragraph ~~(b)~~ (a). 
157.23     ~~(h)~~ Subd. 3e.  [ASSISTED LIVING SERVICE RATE.] (a) Payment 
157.24  for assisted living service shall be a monthly rate negotiated 
157.25  and authorized by the county agency based on an individualized 
157.26  service plan for each resident and may not cover direct rent or 
157.27  food costs. 
157.28     ~~(1)~~ (b) The individualized monthly negotiated payment for 
157.29  assisted living services as described in section 256B.0913, 
157.30  ~~subdivision 5, paragraph (g) or (h)~~ subdivisions 5d to 5f, and 
157.31  residential care services as described in section 256B.0913, 
157.32  subdivision ~~5, paragraph (f)~~ 5c, shall not exceed the nonfederal 
157.33  share, in effect on July 1 of the state fiscal year for which 
157.34  the rate limit is being calculated, of the greater of either the 
157.35  statewide or any of the geographic groups' weighted average 
157.36  monthly nursing facility rate of the case mix resident class to 
158.1   which the elderly waiver eligible client would be assigned under 
158.2   Minnesota Rules, parts 9549.0050 to 9549.0059, less the 
158.3   maintenance needs allowance as described in subdivision 1d, 
158.4   paragraph (a), until the July 1 of the state fiscal year in 
158.5   which the resident assessment system as described in section 
158.6   256B.437 for nursing home rate determination is implemented.  
158.7   Effective on July 1 of the state fiscal year in which the 
158.8   resident assessment system as described in section 256B.437 for 
158.9   nursing home rate determination is implemented and July 1 of 
158.10  each subsequent state fiscal year, the individualized monthly 
158.11  negotiated payment for the services described in this clause 
158.12  shall not exceed the limit described in this clause which was in 
158.13  effect on June 30 of the previous state fiscal year and which 
158.14  has been adjusted by the greater of any legislatively adopted 
158.15  home and community-based services cost-of-living percentage 
158.16  increase or any legislatively adopted statewide percent rate 
158.17  increase for nursing facilities. 
158.18     ~~(2)~~ (c) The individualized monthly negotiated payment for 
158.19  assisted living services described in section 144A.4605 and 
158.20  delivered by a provider licensed by the department of health as 
158.21  a class A home care provider or an assisted living home care 
158.22  provider and provided in a building that is registered as a 
158.23  housing with services establishment under chapter 144D and that 
158.24  provides 24-hour supervision in combination with the payment for 
158.25  other elderly waiver services, including case management, must 
158.26  not exceed the limit specified in ~~paragraph (b)~~ subdivision 3a. 
158.27     ~~(i)~~ Subd. 3f.  [INDIVIDUAL SERVICE RATES; EXPENDITURE 
158.28  FORECASTS.] (a) The county shall negotiate individual service 
158.29  rates with vendors and may authorize payment for actual costs up 
158.30  to the county's current approved rate.  Persons or agencies must 
158.31  be employed by or under a contract with the county agency or the 
158.32  public health nursing agency of the local board of health in 
158.33  order to receive funding under the elderly waiver program, 
158.34  except as a provider of supplies and equipment when the monthly 
158.35  cost of the supplies and equipment is less than $250.  
158.36     ~~(j)~~ (b) Reimbursement for the medical assistance recipients 
159.1   under the approved waiver shall be made from the medical 
159.2   assistance account through the invoice processing procedures of 
159.3   the department's Medicaid Management Information System (MMIS), 
159.4   only with the approval of the client's case manager.  The budget 
159.5   for the state share of the Medicaid expenditures shall be 
159.6   forecasted with the medical assistance budget, and shall be 
159.7   consistent with the approved waiver.  
159.8      ~~(k)~~ Subd. 3g.  [SERVICE RATE LIMITS; STATE ASSUMPTION OF 
159.9   COSTS.] (a) To improve access to community services and 
159.10  eliminate payment disparities between the alternative care 
159.11  program and the elderly waiver, the commissioner shall establish 
159.12  statewide maximum service rate limits and eliminate 
159.13  county-specific service rate limits. 
159.14     ~~(1)~~ (b) Effective July 1, 2001, for service rate limits, 
159.15  except those described or defined in ~~paragraphs (g) and~~ 
159.16  ~~(h)~~ subdivisions 3d and 3e, the rate limit for each service 
159.17  shall be the greater of the alternative care statewide maximum 
159.18  rate or the elderly waiver statewide maximum rate. 
159.19     ~~(2)~~ (c) Counties may negotiate individual service rates 
159.20  with vendors for actual costs up to the statewide maximum 
159.21  service rate limit. 
159.22     Sec. 27.  Minnesota Statutes 2002, section 256B.15, 
159.23  subdivision 1, is amended to read: 
159.24     Subdivision 1.  [DEFINITION.] For purposes of this section, 
159.25  "medical assistance" includes the medical assistance program 
159.26  under this chapter and the general assistance medical care 
159.27  program under chapter 256D~~, but does not include the alternative~~ 
159.28  ~~care program for nonmedical assistance recipients under section~~ 
159.29  ~~256B.0913, subdivision 4~~ and alternative care for nonmedical 
159.30  assistance recipients under section 256B.0913. 
159.31     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
159.32  for decedents dying on or after that date. 
159.33     Sec. 28.  Minnesota Statutes 2002, section 256B.15, 
159.34  subdivision 1a, is amended to read: 
159.35     Subd. 1a.  [ESTATES SUBJECT TO CLAIMS.] If a person 
159.36  receives any medical assistance hereunder, on the person's 
160.1   death, if single, or on the death of the survivor of a married 
160.2   couple, either or both of whom received medical assistance, or 
160.3   as otherwise provided for in this section, the total amount paid 
160.4   for medical assistance rendered for the person and spouse shall 
160.5   be filed as a claim against the estate of the person or the 
160.6   estate of the surviving spouse in the court having jurisdiction 
160.7   to probate the estate or to issue a decree of descent according 
160.8   to sections 525.31 to 525.313.  
160.9      A claim shall be filed if medical assistance was rendered 
160.10  for either or both persons under one of the following 
160.11  circumstances: 
160.12     (a) the person was over 55 years of age, and received 
160.13  services under this chapter~~, excluding alternative care~~; 
160.14     (b) the person resided in a medical institution for six 
160.15  months or longer, received services under this chapter ~~excluding~~ 
160.16  ~~alternative care~~, and, at the time of institutionalization or 
160.17  application for medical assistance, whichever is later, the 
160.18  person could not have reasonably been expected to be discharged 
160.19  and returned home, as certified in writing by the person's 
160.20  treating physician.  For purposes of this section only, a 
160.21  "medical institution" means a skilled nursing facility, 
160.22  intermediate care facility, intermediate care facility for 
160.23  persons with mental retardation, nursing facility, or inpatient 
160.24  hospital; or 
160.25     (c) the person received general assistance medical care 
160.26  services under chapter 256D.  
160.27     The claim shall be considered an expense of the last 
160.28  illness of the decedent for the purpose of section 524.3-805.  
160.29  Any statute of limitations that purports to limit any county 
160.30  agency or the state agency, or both, to recover for medical 
160.31  assistance granted hereunder shall not apply to any claim made 
160.32  hereunder for reimbursement for any medical assistance granted 
160.33  hereunder.  Notice of the claim shall be given to all heirs and 
160.34  devisees of the decedent whose identity can be ascertained with 
160.35  reasonable diligence.  The notice must include procedures and 
160.36  instructions for making an application for a hardship waiver 
161.1   under subdivision 5; time frames for submitting an application 
161.2   and determination; and information regarding appeal rights and 
161.3   procedures.  Counties are entitled to one-half of the nonfederal 
161.4   share of medical assistance collections from estates that are 
161.5   directly attributable to county effort.  Counties are entitled 
161.6   to ten percent of the collections for alternative care directly 
161.7   attributable to county effort. 
161.8      <b>[EFFECTIVE DATE.]</b> The amendments in this section relating 
161.9   to the alternative care program are effective July 1, 2003, and 
161.10  apply to the estates of decedents who die on or after that 
161.11  date.  The remaining amendments in this section are effective 
161.12  August 1, 2003, and apply to the estates of decedents who die on 
161.13  and after that date. 
161.14     Sec. 29.  Minnesota Statutes 2002, section 256B.15, 
161.15  subdivision 2, is amended to read: 
161.16     Subd. 2.  [LIMITATIONS ON CLAIMS.] The claim shall include 
161.17  only the total amount of medical assistance rendered after age 
161.18  55 or during a period of institutionalization described in 
161.19  subdivision 1a, clause (b), and the total amount of general 
161.20  assistance medical care rendered, and shall not include 
161.21  interest.  Claims that have been allowed but not paid shall bear 
161.22  interest according to section 524.3-806, paragraph (d).  A claim 
161.23  against the estate of a surviving spouse who did not receive 
161.24  medical assistance, for medical assistance rendered for the 
161.25  predeceased spouse, is limited to the value of the assets of the 
161.26  estate that were marital property or jointly owned property at 
161.27  any time during the marriage.  Claims for alternative care shall 
161.28  be net of all premiums paid under section 256B.0913, subdivision 
161.29  12, on or after July 1, 2003, and shall be limited to services 
161.30  provided on or after July 1, 2003. 
161.31     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
161.32  for decedents dying on or after that date. 
161.33     Sec. 30.  Minnesota Statutes 2002, section 256B.431, 
161.34  subdivision 2r, is amended to read: 
161.35     Subd. 2r.  [PAYMENT RESTRICTIONS ON LEAVE DAYS.] Effective 
161.36  July 1, 1993, the commissioner shall limit payment for leave 
162.1   days in a nursing facility to 79 percent of that nursing 
162.2   facility's total payment rate for the involved resident.  For 
162.3   services rendered on or after July 1, 2003, for facilities 
162.4   reimbursed under this section or section 256B.434, the 
162.5   commissioner shall limit payment for leave days in a nursing 
162.6   facility to 60 percent of that nursing facility's total payment 
162.7   rate for the involved resident. 
162.8      Sec. 31.  Minnesota Statutes 2002, section 256B.431, is 
162.9   amended by adding a subdivision to read: 
162.10     Subd. 2t.  [PAYMENT LIMITATION.] For services rendered on 
162.11  or after July 1, 2003, for facilities reimbursed under this 
162.12  section or section 256B.434, the Medicaid program shall only pay 
162.13  a co-payment during a Medicare-covered skilled nursing facility 
162.14  stay if the Medicare rate less the resident's co-payment 
162.15  responsibility is less than the Medicaid RUG-III case-mix 
162.16  payment rate.  The amount that shall be paid by the Medicaid 
162.17  program is equal to the amount by which the Medicaid RUG-III 
162.18  case-mix payment rate exceeds the Medicare rate less the 
162.19  co-payment responsibility.  Health plans paying for nursing home 
162.20  services under section 256B.69, subdivision 6a, may limit 
162.21  payments as allowed under this subdivision. 
162.22     Sec. 32.  Minnesota Statutes 2002, section 256B.431, 
162.23  subdivision 32, is amended to read: 
162.24     Subd. 32.  [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 
162.25  years beginning on or after July 1, 2001, the total payment rate 
162.26  for a facility reimbursed under this section, section 256B.434, 
162.27  or any other section for the first 90 paid days after admission 
162.28  shall be: 
162.29     (1) for the first 30 paid days, the rate shall be 120 
162.30  percent of the facility's medical assistance rate for each case 
162.31  mix class; ~~and~~ 
162.32     (2) for the next 60 paid days after the first 30 paid days, 
162.33  the rate shall be 110 percent of the facility's medical 
162.34  assistance rate for each case mix class~~.~~; 
162.35     ~~(b)~~ (3) beginning with the 91st paid day after admission, 
162.36  the payment rate shall be the rate otherwise determined under 
163.1   this section, section 256B.434, or any other section~~.~~; and 
163.2      ~~(c)~~ (4) payments under this ~~subdivision applies~~ paragraph 
163.3   apply to admissions occurring on or after July 1, 2001, and 
163.4   before July 1, 2003, and to resident days occurring before July 
163.5   30, 2003. 
163.6      (b) For rate years beginning on or after July 1, 2003, the 
163.7   total payment rate for a facility reimbursed under this section, 
163.8   section 256B.434, or any other section shall be: 
163.9      (1) for the first 30 calendar days after admission, the 
163.10  rate shall be 120 percent of the facility's medical assistance 
163.11  rate for each RUG class; 
163.12     (2) beginning with the 31st calendar day after admission, 
163.13  the payment rate shall be the rate otherwise determined under 
163.14  this section, section 256B.434, or any other section; and 
163.15     (3) payments under this paragraph apply to admissions 
163.16  occurring on or after July 1, 2003. 
163.17     (c) Effective January 1, 2004, the enhanced rates under 
163.18  this subdivision shall not be allowed if a resident has resided 
163.19  during the previous 30 calendar days in: 
163.20     (1) the same nursing facility; 
163.21     (2) a nursing facility owned or operated by a related 
163.22  party; or 
163.23     (3) a nursing facility or part of a facility that closed. 
163.24     Sec. 33.  Minnesota Statutes 2002, section 256B.431, 
163.25  subdivision 36, is amended to read: 
163.26     Subd. 36.  [EMPLOYEE SCHOLARSHIP COSTS AND TRAINING IN 
163.27  ENGLISH AS A SECOND LANGUAGE.] (a) For the period between July 
163.28  1, 2001, and June 30, 2003, the commissioner shall provide to 
163.29  each nursing facility reimbursed under this section, section 
163.30  256B.434, or any other section, a scholarship per diem of 25 
163.31  cents to the total operating payment rate to be used: 
163.32     (1) for employee scholarships that satisfy the following 
163.33  requirements: 
163.34     (i) scholarships are available to all employees who work an 
163.35  average of at least 20 hours per week at the facility except the 
163.36  administrator, department supervisors, and registered nurses; 
164.1   and 
164.2      (ii) the course of study is expected to lead to career 
164.3   advancement with the facility or in long-term care, including 
164.4   medical care interpreter services and social work; and 
164.5      (2) to provide job-related training in English as a second 
164.6   language. 
164.7      (b) A facility receiving a rate adjustment under this 
164.8   subdivision may submit to the commissioner on a schedule 
164.9   determined by the commissioner and on a form supplied by the 
164.10  commissioner a calculation of the scholarship per diem, 
164.11  including:  the amount received from this rate adjustment; the 
164.12  amount used for training in English as a second language; the 
164.13  number of persons receiving the training; the name of the person 
164.14  or entity providing the training; and for each scholarship 
164.15  recipient, the name of the recipient, the amount awarded, the 
164.16  educational institution attended, the nature of the educational 
164.17  program, the program completion date, and a determination of the 
164.18  per diem amount of these costs based on actual resident days. 
164.19     (c) On July 1, 2003, the commissioner shall remove the 25 
164.20  cent scholarship per diem from the total operating payment rate 
164.21  of each facility. 
164.22     (d) For rate years beginning after June 30, 2003, the 
164.23  commissioner shall provide to each facility the scholarship per 
164.24  diem determined in paragraph (b).  In calculating the per diem 
164.25  under paragraph (b), the commissioner shall allow only costs 
164.26  related to tuition and direct educational expenses. 
164.27     Sec. 34.  Minnesota Statutes 2002, section 256B.431, is 
164.28  amended by adding a subdivision to read: 
164.29     Subd. 38.  [NURSING HOME RATE INCREASES EFFECTIVE IN FISCAL 
164.30  YEAR 2003.] Effective June 1, 2003, the commissioner shall 
164.31  provide to each nursing home reimbursed under this section or 
164.32  section 256B.434, an increase in each case mix payment rate 
164.33  equal to the increase in the per-bed surcharge paid under 
164.34  section 256.9657, subdivision 1, paragraph (d), divided by 365 
164.35  and further divided by .90.  The increase shall not be subject 
164.36  to any annual percentage increase.  The 30-day advance notice 
165.1   requirement in section 256B.47, subdivision 2, shall not apply 
165.2   to rate increases resulting from this section.  The commissioner 
165.3   shall not adjust the rate increase under this subdivision unless 
165.4   the adjustment is greater than 1.5 percent of the monthly 
165.5   surcharge payment amount under section 256.9657, subdivision 4. 
165.6      <b>[EFFECTIVE DATE.]</b> This section is effective May 31, 2003. 
165.7      Sec. 35.  Minnesota Statutes 2002, section 256B.431, is 
165.8   amended by adding a subdivision to read: 
165.9      Subd. 39.  [FACILITY RATES BEGINNING ON OR AFTER JULY 1, 
165.10  2003.] For rate years beginning on or after July 1, 2003, 
165.11  nursing facilities reimbursed under this section shall have 
165.12  their July 1 operating payment rate be equal to their operating 
165.13  payment rate in effect on the prior June 30th. 
165.14     Sec. 36.  Minnesota Statutes 2002, section 256B.434, 
165.15  subdivision 4, is amended to read: 
165.16     Subd. 4.  [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 
165.17  nursing facilities which have their payment rates determined 
165.18  under this section rather than section 256B.431, the 
165.19  commissioner shall establish a rate under this subdivision.  The 
165.20  nursing facility must enter into a written contract with the 
165.21  commissioner. 
165.22     (b) A nursing facility's case mix payment rate for the 
165.23  first rate year of a facility's contract under this section is 
165.24  the payment rate the facility would have received under section 
165.25  256B.431. 
165.26     (c) A nursing facility's case mix payment rates for the 
165.27  second and subsequent years of a facility's contract under this 
165.28  section are the previous rate year's contract payment rates plus 
165.29  an inflation adjustment and, for facilities reimbursed under 
165.30  this section or section 256B.431, an adjustment to include the 
165.31  cost of any increase in health department licensing fees for the 
165.32  facility taking effect on or after July 1, 2001.  The index for 
165.33  the inflation adjustment must be based on the change in the 
165.34  Consumer Price Index-All Items (United States City average) 
165.35  (CPI-U) forecasted by ~~Data Resources, Inc.~~ the commissioner of 
165.36  finance's national economic consultant, as forecasted in the 
166.1   fourth quarter of the calendar year preceding the rate year.  
166.2   The inflation adjustment must be based on the 12-month period 
166.3   from the midpoint of the previous rate year to the midpoint of 
166.4   the rate year for which the rate is being determined.  For the 
166.5   rate years beginning on July 1, 1999, July 1, 2000, July 1, 
166.6   2001, ~~and~~ July 1, 2002, July 1, 2003, and July 1, 2004, this 
166.7   paragraph shall apply only to the property-related payment rate, 
166.8   except that adjustments to include the cost of any increase in 
166.9   health department licensing fees taking effect on or after July 
166.10  1, 2001, shall be provided.  In determining the amount of the 
166.11  property-related payment rate adjustment under this paragraph, 
166.12  the commissioner shall determine the proportion of the 
166.13  facility's rates that are property-related based on the 
166.14  facility's most recent cost report. 
166.15     (d) The commissioner shall develop additional 
166.16  incentive-based payments of up to five percent above the 
166.17  standard contract rate for achieving outcomes specified in each 
166.18  contract.  The specified facility-specific outcomes must be 
166.19  measurable and approved by the commissioner.  The commissioner 
166.20  may establish, for each contract, various levels of achievement 
166.21  within an outcome.  After the outcomes have been specified the 
166.22  commissioner shall assign various levels of payment associated 
166.23  with achieving the outcome.  Any incentive-based payment cancels 
166.24  if there is a termination of the contract.  In establishing the 
166.25  specified outcomes and related criteria the commissioner shall 
166.26  consider the following state policy objectives: 
166.27     (1) improved cost effectiveness and quality of life as 
166.28  measured by improved clinical outcomes; 
166.29     (2) successful diversion or discharge to community 
166.30  alternatives; 
166.31     (3) decreased acute care costs; 
166.32     (4) improved consumer satisfaction; 
166.33     (5) the achievement of quality; or 
166.34     (6) any additional outcomes proposed by a nursing facility 
166.35  that the commissioner finds desirable. 
166.36     Sec. 37.  Minnesota Statutes 2002, section 256B.434, 
167.1   subdivision 10, is amended to read: 
167.2      Subd. 10.  [EXEMPTIONS.] (a) To the extent permitted by 
167.3   federal law, (1) a facility that has entered into a contract 
167.4   under this section is not required to file a cost report, as 
167.5   defined in Minnesota Rules, part 9549.0020, subpart 13, for any 
167.6   year after the base year that is the basis for the calculation 
167.7   of the contract payment rate for the first rate year of the 
167.8   alternative payment demonstration project contract; and (2) a 
167.9   facility under contract is not subject to audits of historical 
167.10  costs or revenues, or paybacks or retroactive adjustments based 
167.11  on these costs or revenues, except audits, paybacks, or 
167.12  adjustments relating to the cost report that is the basis for 
167.13  calculation of the first rate year under the contract. 
167.14     (b) A facility that is under contract with the commissioner 
167.15  under this section is not subject to the moratorium on licensure 
167.16  or certification of new nursing home beds in section 144A.071, 
167.17  unless the project results in a net increase in bed capacity or 
167.18  involves relocation of beds from one site to another.  Contract 
167.19  payment rates must not be adjusted to reflect any additional 
167.20  costs that a nursing facility incurs as a result of a 
167.21  construction project undertaken under this paragraph.  In 
167.22  addition, as a condition of entering into a contract under this 
167.23  section, a nursing facility must agree that any future medical 
167.24  assistance payments for nursing facility services will not 
167.25  reflect any additional costs attributable to the sale of a 
167.26  nursing facility under this section and to construction 
167.27  undertaken under this paragraph that otherwise would not be 
167.28  authorized under the moratorium in section 144A.073.  Nothing in 
167.29  this section prevents a nursing facility participating in the 
167.30  alternative payment demonstration project under this section 
167.31  from seeking approval of an exception to the moratorium through 
167.32  the process established in section 144A.073, and if approved the 
167.33  facility's rates shall be adjusted to reflect the cost of the 
167.34  project.  Nothing in this section prevents a nursing facility 
167.35  participating in the alternative payment demonstration project 
167.36  from seeking legislative approval of an exception to the 
168.1   moratorium under section 144A.071, and, if enacted, the 
168.2   facility's rates shall be adjusted to reflect the cost of the 
168.3   project. 
168.4      (c) Notwithstanding section 256B.48, subdivision 6, 
168.5   paragraphs (c), (d), and (e), and pursuant to any terms and 
168.6   conditions contained in the facility's contract, a nursing 
168.7   facility that is under contract with the commissioner under this 
168.8   section is in compliance with section 256B.48, subdivision 6, 
168.9   paragraph (b), if the facility is Medicare certified. 
168.10     (d) Notwithstanding paragraph (a), if by April 1, 1996, the 
168.11  health care financing administration has not approved a required 
168.12  waiver, or the Centers for Medicare and Medicaid Services 
168.13  otherwise requires cost reports to be filed prior to the 
168.14  waiver's approval, the commissioner shall require a cost report 
168.15  for the rate year. 
168.16     (e) A facility that is under contract with the commissioner 
168.17  under this section shall be allowed to change therapy 
168.18  arrangements from an unrelated vendor to a related vendor during 
168.19  the term of the contract.  The commissioner may develop 
168.20  reasonable requirements designed to prevent an increase in 
168.21  therapy utilization for residents enrolled in the medical 
168.22  assistance program. 
168.23     (f) Nursing facilities participating in the alternative 
168.24  payment system demonstration project must either participate in 
168.25  the alternative payment system quality improvement program 
168.26  established by the commissioner or submit information on their 
168.27  own quality improvement process to the commissioner for 
168.28  approval.  Nursing facilities that have had their own quality 
168.29  improvement process approved by the commissioner must report 
168.30  results for at least one key area of quality improvement 
168.31  annually to the commissioner.  
168.32     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
168.33  following final enactment. 
168.34     Sec. 38.  Minnesota Statutes 2002, section 256B.5012, is 
168.35  amended by adding a subdivision to read: 
168.36     Subd. 5.  [RATE INCREASE EFFECTIVE JUNE 1, 2003.] For rate 
169.1   periods beginning on or after June 1, 2003, the commissioner 
169.2   shall increase the total operating payment rate for each 
169.3   facility reimbursed under this section by $3 per day.  The 
169.4   increase shall not be subject to any annual percentage increase. 
169.5      <b>[EFFECTIVE DATE.]</b> This section is effective the day 
169.6   following final enactment. 
169.7      Sec. 39.  Minnesota Statutes 2002, section 256B.76, is 
169.8   amended to read: 
169.9      256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
169.10     (a) Effective for services rendered on or after October 1, 
169.11  1992, the commissioner shall make payments for physician 
169.12  services as follows: 
169.13     (1) payment for level one Centers for Medicare and Medicaid 
169.14  Services' common procedural coding system codes titled "office 
169.15  and other outpatient services," "preventive medicine new and 
169.16  established patient," "delivery, antepartum, and postpartum 
169.17  care," "critical care," cesarean delivery and pharmacologic 
169.18  management provided to psychiatric patients, and level three 
169.19  codes for enhanced services for prenatal high risk, shall be 
169.20  paid at the lower of (i) submitted charges, or (ii) 25 percent 
169.21  above the rate in effect on June 30, 1992.  If the rate on any 
169.22  procedure code within these categories is different than the 
169.23  rate that would have been paid under the methodology in section 
169.24  256B.74, subdivision 2, then the larger rate shall be paid; 
169.25     (2) payments for all other services shall be paid at the 
169.26  lower of (i) submitted charges, or (ii) 15.4 percent above the 
169.27  rate in effect on June 30, 1992; 
169.28     (3) all physician rates shall be converted from the 50th 
169.29  percentile of 1982 to the 50th percentile of 1989, less the 
169.30  percent in aggregate necessary to equal the above increases 
169.31  except that payment rates for home health agency services shall 
169.32  be the rates in effect on September 30, 1992; 
169.33     (4) effective for services rendered on or after January 1, 
169.34  2000, payment rates for physician and professional services 
169.35  shall be increased by three percent over the rates in effect on 
169.36  December 31, 1999, except for home health agency and family 
170.1   planning agency services; and 
170.2      (5) the increases in clause (4) shall be implemented 
170.3   January 1, 2000, for managed care. 
170.4      (b) Effective for services rendered on or after October 1, 
170.5   1992, the commissioner shall make payments for dental services 
170.6   as follows: 
170.7      (1) dental services shall be paid at the lower of (i) 
170.8   submitted charges, or (ii) 25 percent above the rate in effect 
170.9   on June 30, 1992; 
170.10     (2) dental rates shall be converted from the 50th 
170.11  percentile of 1982 to the 50th percentile of 1989, less the 
170.12  percent in aggregate necessary to equal the above increases; 
170.13     (3) effective for services rendered on or after January 1, 
170.14  2000, payment rates for dental services shall be increased by 
170.15  three percent over the rates in effect on December 31, 1999; 
170.16     (4) the commissioner shall award grants to community 
170.17  clinics or other nonprofit community organizations, political 
170.18  subdivisions, professional associations, or other organizations 
170.19  that demonstrate the ability to provide dental services 
170.20  effectively to public program recipients.  Grants may be used to 
170.21  fund the costs related to coordinating access for recipients, 
170.22  developing and implementing patient care criteria, upgrading or 
170.23  establishing new facilities, acquiring furnishings or equipment, 
170.24  recruiting new providers, or other development costs that will 
170.25  improve access to dental care in a region.  In awarding grants, 
170.26  the commissioner shall give priority to applicants that plan to 
170.27  serve areas of the state in which the number of dental providers 
170.28  is not currently sufficient to meet the needs of recipients of 
170.29  public programs or uninsured individuals.  The commissioner 
170.30  shall consider the following in awarding the grants: 
170.31     (i) potential to successfully increase access to an 
170.32  underserved population; 
170.33     (ii) the ability to raise matching funds; 
170.34     (iii) the long-term viability of the project to improve 
170.35  access beyond the period of initial funding; 
170.36     (iv) the efficiency in the use of the funding; and 
171.1      (v) the experience of the proposers in providing services 
171.2   to the target population. 
171.3      The commissioner shall monitor the grants and may terminate 
171.4   a grant if the grantee does not increase dental access for 
171.5   public program recipients.  The commissioner shall consider 
171.6   grants for the following: 
171.7      (i) implementation of new programs or continued expansion 
171.8   of current access programs that have demonstrated success in 
171.9   providing dental services in underserved areas; 
171.10     (ii) a pilot program for utilizing hygienists outside of a 
171.11  traditional dental office to provide dental hygiene services; 
171.12  and 
171.13     (iii) a program that organizes a network of volunteer 
171.14  dentists, establishes a system to refer eligible individuals to 
171.15  volunteer dentists, and through that network provides donated 
171.16  dental care services to public program recipients or uninsured 
171.17  individuals; 
171.18     (5) beginning October 1, 1999, the payment for tooth 
171.19  sealants and fluoride treatments shall be the lower of (i) 
171.20  submitted charge, or (ii) 80 percent of median 1997 charges; 
171.21     (6) the increases listed in clauses (3) and (5) shall be 
171.22  implemented January 1, 2000, for managed care; and 
171.23     (7) effective for services provided on or after January 1, 
171.24  2002, payment for diagnostic examinations and dental x-rays 
171.25  provided to children under age 21 shall be the lower of (i) the 
171.26  submitted charge, or (ii) 85 percent of median 1999 charges.  
171.27     (c) Effective for dental services rendered on or after 
171.28  January 1, 2002, the commissioner may, within the limits of 
171.29  available appropriation, increase reimbursements to dentists and 
171.30  dental clinics deemed by the commissioner to be critical access 
171.31  dental providers.  Reimbursement to a critical access dental 
171.32  provider may be increased by not more than 50 percent above the 
171.33  reimbursement rate that would otherwise be paid to the 
171.34  provider.  Payments to health plan companies shall be adjusted 
171.35  to reflect increased reimbursements to critical access dental 
171.36  providers as approved by the commissioner.  In determining which 
172.1   dentists and dental clinics shall be deemed critical access 
172.2   dental providers, the commissioner shall review: 
172.3      (1) the utilization rate in the service area in which the 
172.4   dentist or dental clinic operates for dental services to 
172.5   patients covered by medical assistance, general assistance 
172.6   medical care, or MinnesotaCare as their primary source of 
172.7   coverage; 
172.8      (2) the level of services provided by the dentist or dental 
172.9   clinic to patients covered by medical assistance, general 
172.10  assistance medical care, or MinnesotaCare as their primary 
172.11  source of coverage; and 
172.12     (3) whether the level of services provided by the dentist 
172.13  or dental clinic is critical to maintaining adequate levels of 
172.14  patient access within the service area. 
172.15  In the absence of a critical access dental provider in a service 
172.16  area, the commissioner may designate a dentist or dental clinic 
172.17  as a critical access dental provider if the dentist or dental 
172.18  clinic is willing to provide care to patients covered by medical 
172.19  assistance, general assistance medical care, or MinnesotaCare at 
172.20  a level which significantly increases access to dental care in 
172.21  the service area. 
172.22     (d) ~~Effective July 1, 2001, the medical assistance rates~~ 
172.23  ~~for outpatient mental health services provided by an entity that~~ 
172.24  ~~operates:~~ 
172.25     ~~(1) a Medicare-certified comprehensive outpatient~~ 
172.26  ~~rehabilitation facility; and~~ 
172.27     ~~(2) a facility that was certified prior to January 1, 1993,~~ 
172.28  ~~with at least 33 percent of the clients receiving rehabilitation~~ 
172.29  ~~services in the most recent calendar year who are medical~~ 
172.30  ~~assistance recipients, will be increased by 38 percent, when~~ 
172.31  ~~those services are provided within the comprehensive outpatient~~ 
172.32  ~~rehabilitation facility and provided to residents of nursing~~ 
172.33  ~~facilities owned by the entity.~~ 
172.34     ~~(e)~~ An entity that operates both a Medicare certified 
172.35  comprehensive outpatient rehabilitation facility and a facility 
172.36  which was certified prior to January 1, 1993, that is licensed 
173.1   under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
173.2   whom at least 33 percent of the clients receiving rehabilitation 
173.3   services in the most recent calendar year are medical assistance 
173.4   recipients, shall be reimbursed by the commissioner for 
173.5   rehabilitation services at rates that are 38 percent greater 
173.6   than the maximum reimbursement rate allowed under paragraph (a), 
173.7   clause (2), when those services are (1) provided within the 
173.8   comprehensive outpatient rehabilitation facility and (2) 
173.9   provided to residents of nursing facilities owned by the entity. 
173.10     Sec. 40.  Minnesota Statutes 2002, section 256B.761, is 
173.11  amended to read: 
173.12     256B.761 [REIMBURSEMENT FOR MENTAL HEALTH SERVICES.] 
173.13     (a) Effective for services rendered on or after July 1, 
173.14  2001, payment for medication management provided to psychiatric 
173.15  patients, outpatient mental health services, day treatment 
173.16  services, home-based mental health services, and family 
173.17  community support services shall be paid at the lower of (1) 
173.18  submitted charges, or (2) 75.6 percent of the 50th percentile of 
173.19  1999 charges. 
173.20     (b) Effective July 1, 2001, the medical assistance rates 
173.21  for outpatient mental health services provided by an entity that 
173.22  operates:  (1) a Medicare-certified comprehensive outpatient 
173.23  rehabilitation facility; and (2) a facility that was certified 
173.24  prior to January 1, 1993, with at least 33 percent of the 
173.25  clients receiving rehabilitation services in the most recent 
173.26  calendar year who are medical assistance recipients, will be 
173.27  increased by 38 percent, when those services are provided within 
173.28  the comprehensive outpatient rehabilitation facility and 
173.29  provided to residents of nursing facilities owned by the entity. 
173.30     Sec. 41.  Minnesota Statutes 2002, section 256D.03, 
173.31  subdivision 3a, is amended to read: 
173.32     Subd. 3a.  [CLAIMS; ASSIGNMENT OF BENEFITS.] Claims must be 
173.33  filed pursuant to section 256D.16.  General assistance medical 
173.34  care applicants and recipients must apply or agree to apply 
173.35  third party health and accident benefits to the costs of medical 
173.36  care.  They must cooperate with the state in establishing 
174.1   paternity and obtaining third party payments.  By ~~signing an~~ 
174.2   ~~application for~~ accepting general assistance, a person assigns 
174.3   to the department of human services all rights to medical 
174.4   support or payments for medical expenses from another person or 
174.5   entity on their own or their dependent's behalf and agrees to 
174.6   cooperate with the state in establishing paternity and obtaining 
174.7   third party payments.  The application shall contain a statement 
174.8   explaining the assignment.  Any rights or amounts assigned shall 
174.9   be applied against the cost of medical care paid for under this 
174.10  chapter.  An assignment is effective on the date general 
174.11  assistance medical care eligibility takes effect.  ~~The~~ 
174.12  ~~assignment shall not affect benefits paid or provided under~~ 
174.13  ~~automobile accident coverage and private health care coverage~~ 
174.14  ~~until the person or organization providing the benefits has~~ 
174.15  ~~received notice of the assignment.~~  
174.16     Sec. 42.  Minnesota Statutes 2002, section 256I.02, is 
174.17  amended to read: 
174.18     256I.02 [PURPOSE.] 
174.19     The Group Residential Housing Act establishes a 
174.20  comprehensive system of rates and payments for persons who 
174.21  reside in ~~a group residence~~ the community and who meet the 
174.22  eligibility criteria under section 256I.04, subdivision 1. 
174.23     Sec. 43.  Minnesota Statutes 2002, section 256I.04, 
174.24  subdivision 3, is amended to read: 
174.25     Subd. 3.  [MORATORIUM ON THE DEVELOPMENT OF GROUP 
174.26  RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 
174.27  into agreements for new group residential housing beds with 
174.28  total rates in excess of the MSA equivalent rate except:  (1) 
174.29  ~~for group residential housing establishments meeting the~~ 
174.30  ~~requirements of subdivision 2a, clause (2) with department~~ 
174.31  ~~approval; (2)~~ for group residential housing establishments 
174.32  licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 
174.33  provided the facility is needed to meet the census reduction 
174.34  targets for persons with mental retardation or related 
174.35  conditions at regional treatment centers; ~~(3)~~ (2) to ensure 
174.36  compliance with the federal Omnibus Budget Reconciliation Act 
175.1   alternative disposition plan requirements for inappropriately 
175.2   placed persons with mental retardation or related conditions or 
175.3   mental illness; ~~(4)~~ (3) up to 80 beds in a single, specialized 
175.4   facility located in Hennepin county that will provide housing 
175.5   for chronic inebriates who are repetitive users of 
175.6   detoxification centers and are refused placement in emergency 
175.7   shelters because of their state of intoxication, and planning 
175.8   for the specialized facility must have been initiated before 
175.9   July 1, 1991, in anticipation of receiving a grant from the 
175.10  housing finance agency under section 462A.05, subdivision 20a, 
175.11  paragraph (b); ~~(5)~~ (4) notwithstanding the provisions of 
175.12  subdivision 2a, for up to 190 supportive housing units in Anoka, 
175.13  Dakota, Hennepin, or Ramsey county for homeless adults with a 
175.14  mental illness, a history of substance abuse, or human 
175.15  immunodeficiency virus or acquired immunodeficiency syndrome.  
175.16  For purposes of this section, "homeless adult" means a person 
175.17  who is living on the street or in a shelter or discharged from a 
175.18  regional treatment center, community hospital, or residential 
175.19  treatment program and has no appropriate housing available and 
175.20  lacks the resources and support necessary to access appropriate 
175.21  housing.  At least 70 percent of the supportive housing units 
175.22  must serve homeless adults with mental illness, substance abuse 
175.23  problems, or human immunodeficiency virus or acquired 
175.24  immunodeficiency syndrome who are about to be or, within the 
175.25  previous six months, has been discharged from a regional 
175.26  treatment center, or a state-contracted psychiatric bed in a 
175.27  community hospital, or a residential mental health or chemical 
175.28  dependency treatment program.  If a person meets the 
175.29  requirements of subdivision 1, paragraph (a), and receives a 
175.30  federal or state housing subsidy, the group residential housing 
175.31  rate for that person is limited to the supplementary rate under 
175.32  section 256I.05, subdivision 1a, and is determined by 
175.33  subtracting the amount of the person's countable income that 
175.34  exceeds the MSA equivalent rate from the group residential 
175.35  housing supplementary rate.  A resident in a demonstration 
175.36  project site who no longer participates in the demonstration 
176.1   program shall retain eligibility for a group residential housing 
176.2   payment in an amount determined under section 256I.06, 
176.3   subdivision 8, using the MSA equivalent rate.  Service funding 
176.4   under section 256I.05, subdivision 1a, will end June 30, 1997, 
176.5   if federal matching funds are available and the services can be 
176.6   provided through a managed care entity.  If federal matching 
176.7   funds are not available, then service funding will continue 
176.8   under section 256I.05, subdivision 1a; or (6) for group 
176.9   residential housing beds in settings meeting the requirements of 
176.10  subdivision 2a, clauses (1) and (3), which are used exclusively 
176.11  for recipients receiving home and community-based waiver 
176.12  services under sections 256B.0915, 256B.092, subdivision 5, 
176.13  256B.093, and 256B.49, and who resided in a nursing facility for 
176.14  the six months immediately prior to the month of entry into the 
176.15  group residential housing setting.  The group residential 
176.16  housing rate for these beds must be set so that the monthly 
176.17  group residential housing payment for an individual occupying 
176.18  the bed when combined with the nonfederal share of services 
176.19  delivered under the waiver for that person does not exceed the 
176.20  nonfederal share of the monthly medical assistance payment made 
176.21  for the person to the nursing facility in which the person 
176.22  resided prior to entry into the group residential housing 
176.23  establishment.  The rate may not exceed the MSA equivalent rate 
176.24  plus $426.37 for any case. 
176.25     (b) A county agency may enter into a group residential 
176.26  housing agreement for beds with rates in excess of the MSA 
176.27  equivalent rate in addition to those currently covered under a 
176.28  group residential housing agreement if the additional beds are 
176.29  only a replacement of beds with rates in excess of the MSA 
176.30  equivalent rate which have been made available due to closure of 
176.31  a setting, a change of licensure or certification which removes 
176.32  the beds from group residential housing payment, or as a result 
176.33  of the downsizing of a group residential housing setting.  The 
176.34  transfer of available beds from one county to another can only 
176.35  occur by the agreement of both counties. 
176.36     Sec. 44.  Minnesota Statutes 2002, section 256I.05, 
177.1   subdivision 1, is amended to read: 
177.2      Subdivision 1.  [MAXIMUM RATES.] ~~(a)~~ Monthly room and board 
177.3   rates negotiated by a county agency for a recipient living in 
177.4   group residential housing must not exceed the MSA equivalent 
177.5   rate specified under section 256I.03, subdivision 5~~,~~. ~~with the~~ 
177.6   ~~exception that a county agency may negotiate a supplementary~~ 
177.7   ~~room and board rate that exceeds the MSA equivalent rate for~~ 
177.8   ~~recipients of waiver services under title XIX of the Social~~ 
177.9   ~~Security Act.  This exception is subject to the following~~ 
177.10  ~~conditions:~~ 
177.11     ~~(1) the setting is licensed by the commissioner of human~~ 
177.12  ~~services under Minnesota Rules, parts 9555.5050 to 9555.6265;~~ 
177.13     ~~(2) the setting is not the primary residence of the license~~ 
177.14  ~~holder and in which the license holder is not the primary~~ 
177.15  ~~caregiver; and~~ 
177.16     ~~(3) the average supplementary room and board rate in a~~ 
177.17  ~~county for a calendar year may not exceed the average~~ 
177.18  ~~supplementary room and board rate for that county in effect on~~ 
177.19  ~~January 1, 2000.  For calendar years beginning on or after~~ 
177.20  ~~January 1, 2002, within the limits of appropriations~~ 
177.21  ~~specifically for this purpose, the commissioner shall increase~~ 
177.22  ~~each county's supplemental room and board rate average on an~~ 
177.23  ~~annual basis by a factor consisting of the percentage change in~~ 
177.24  ~~the Consumer Price Index-All items, United States city average~~ 
177.25  ~~(CPI-U) for that calendar year compared to the preceding~~ 
177.26  ~~calendar year as forecasted by Data Resources, Inc., in the~~ 
177.27  ~~third quarter of the preceding calendar year.  If a county has~~ 
177.28  ~~not negotiated supplementary room and board rates for any~~ 
177.29  ~~facilities located in the county as of January 1, 2000, or has~~ 
177.30  ~~an average supplemental room and board rate under $100 per~~ 
177.31  ~~person as of January 1, 2000, it may submit a supplementary room~~ 
177.32  ~~and board rate request with budget information for a facility to~~ 
177.33  ~~the commissioner for approval.~~ 
177.34  ~~The county agency may at any time negotiate a higher or lower~~ 
177.35  ~~room and board rate than the average supplementary room and~~ 
177.36  ~~board rate.~~ 
178.1      ~~(b) Notwithstanding paragraph (a), clause (3), county~~ 
178.2   ~~agencies may negotiate a supplementary room and board rate that~~ 
178.3   ~~exceeds the MSA equivalent rate by up to $426.37 for up to five~~ 
178.4   ~~facilities, serving not more than 20 individuals in total, that~~ 
178.5   ~~were established to replace an intermediate care facility for~~ 
178.6   ~~persons with mental retardation and related conditions located~~ 
178.7   ~~in the city of Roseau that became uninhabitable due to flood~~ 
178.8   ~~damage in June 2002.~~ 
178.9      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004, 
178.10  or upon receipt of federal approval of waiver amendment, 
178.11  whichever is later. 
178.12     Sec. 45.  Minnesota Statutes 2002, section 256I.05, 
178.13  subdivision 1a, is amended to read: 
178.14     Subd. 1a.  [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 
178.15  the provisions of section 256I.04, subdivision 3, ~~in addition to~~ 
178.16  ~~the room and board rate specified in subdivision 1,~~ the county 
178.17  agency may negotiate a payment not to exceed $426.37 for other 
178.18  services necessary to provide room and board provided by the 
178.19  group residence if the residence is licensed by or registered by 
178.20  the department of health, or licensed by the department of human 
178.21  services to provide services in addition to room and board, and 
178.22  if the provider of services is not also concurrently receiving 
178.23  funding for services for a recipient under a home and 
178.24  community-based waiver under title XIX of the Social Security 
178.25  Act; or funding from the medical assistance program under 
178.26  section 256B.0627, subdivision 4, for personal care services for 
178.27  residents in the setting; or residing in a setting which 
178.28  receives funding under Minnesota Rules, parts 9535.2000 to 
178.29  9535.3000.  If funding is available for other necessary services 
178.30  through a home and community-based waiver, or personal care 
178.31  services under section 256B.0627, subdivision 4, then the GRH 
178.32  rate is limited to the rate set in subdivision 1.  Unless 
178.33  otherwise provided in law, in no case may the supplementary 
178.34  service rate ~~plus the supplementary room and board rate~~ exceed 
178.35  $426.37.  The registration and licensure requirement does not 
178.36  apply to establishments which are exempt from state licensure 
179.1   because they are located on Indian reservations and for which 
179.2   the tribe has prescribed health and safety requirements.  
179.3   Service payments under this section may be prohibited under 
179.4   rules to prevent the supplanting of federal funds with state 
179.5   funds.  The commissioner shall pursue the feasibility of 
179.6   obtaining the approval of the Secretary of Health and Human 
179.7   Services to provide home and community-based waiver services 
179.8   under title XIX of the Social Security Act for residents who are 
179.9   not eligible for an existing home and community-based waiver due 
179.10  to a primary diagnosis of mental illness or chemical dependency 
179.11  and shall apply for a waiver if it is determined to be 
179.12  cost-effective.  
179.13     (b) The commissioner is authorized to make cost-neutral 
179.14  transfers from the GRH fund for beds under this section to other 
179.15  funding programs administered by the department after 
179.16  consultation with the county or counties in which the affected 
179.17  beds are located.  The commissioner may also make cost-neutral 
179.18  transfers from the GRH fund to county human service agencies for 
179.19  beds permanently removed from the GRH census under a plan 
179.20  submitted by the county agency and approved by the 
179.21  commissioner.  The commissioner shall report the amount of any 
179.22  transfers under this provision annually to the legislature. 
179.23     (c) The provisions of paragraph (b) do not apply to a 
179.24  facility that has its reimbursement rate established under 
179.25  section 256B.431, subdivision 4, paragraph (c). 
179.26     Sec. 46.  Minnesota Statutes 2002, section 256I.05, 
179.27  subdivision 7c, is amended to read: 
179.28     Subd. 7c.  [DEMONSTRATION PROJECT.] The commissioner is 
179.29  authorized to pursue a demonstration project under federal food 
179.30  stamp regulation for the purpose of gaining federal 
179.31  reimbursement of food and nutritional costs currently paid by 
179.32  the state group residential housing program.  The commissioner 
179.33  shall seek approval no later than January 1, 2004.  Any 
179.34  reimbursement received is nondedicated revenue to the general 
179.35  fund. 
179.36     Sec. 47.  [514.991] [ALTERNATIVE CARE LIENS; DEFINITIONS.] 
180.1      Subdivision 1.  [APPLICABILITY.] The definitions in this 
180.2   section apply to sections 514.991 to 514.995. 
180.3      Subd. 2.  [ALTERNATIVE CARE AGENCY, AGENCY, OR 
180.4   DEPARTMENT.] "Alternative care agency," "agency," or "department"
180.5   means the department of human services when it pays for or 
180.6   provides alternative care benefits for a nonmedical assistance 
180.7   recipient directly or through a county social services agency 
180.8   under chapter 256B according to section 256B.0913. 
180.9      Subd. 3.  [ALTERNATIVE CARE BENEFIT OR 
180.10  BENEFITS.] "Alternative care benefit" or "benefits" means a 
180.11  benefit provided to a nonmedical assistance recipient under 
180.12  chapter 256B according to section 256B.0913. 
180.13     Subd. 4.  [ALTERNATIVE CARE RECIPIENT OR 
180.14  RECIPIENT.] "Alternative care recipient" or "recipient" means a 
180.15  person who receives alternative care grant benefits. 
180.16     Subd. 5.  [ALTERNATIVE CARE LIEN OR LIEN.] "Alternative 
180.17  care lien" or "lien" means a lien filed under sections 514.992 
180.18  to 514.995. 
180.19     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
180.20  for services for persons first enrolling in the alternative care 
180.21  program on or after that date and on the first day of the first 
180.22  eligibility renewal period for persons enrolled in the 
180.23  alternative care program prior to July 1, 2003. 
180.24     Sec. 48.  [514.992] [ALTERNATIVE CARE LIEN.] 
180.25     Subdivision 1.  [PROPERTY SUBJECT TO LIEN; LIEN AMOUNT.] (a)
180.26  Subject to sections 514.991 to 514.995, payments made by an 
180.27  alternative care agency to provide benefits to a recipient or to 
180.28  the recipient's spouse who owns property in this state 
180.29  constitute a lien in favor of the agency on all real property 
180.30  the recipient owns at and after the time the benefits are first 
180.31  paid. 
180.32     (b) The amount of the lien is limited to benefits paid for 
180.33  services provided to recipients over 55 years of age and 
180.34  provided on and after July 1, 2003. 
180.35     Subd. 2.  [ATTACHMENT.] (a) A lien attaches to and becomes 
180.36  enforceable against specific real property as of the date when 
181.1   all of the following conditions are met: 
181.2      (1) the agency has paid benefits for a recipient; 
181.3      (2) the recipient has been given notice and an opportunity 
181.4   for a hearing under paragraph (b); 
181.5      (3) the lien has been filed as provided for in section 
181.6   514.993 or memorialized on the certificate of title for the 
181.7   property it describes; and 
181.8      (4) all restrictions against enforcement have ceased to 
181.9   apply. 
181.10     (b) An agency may not file a lien until it has sent the 
181.11  recipient, their authorized representative, or their legal 
181.12  representative written notice of its lien rights by certified 
181.13  mail, return receipt requested, or registered mail and there has 
181.14  been an opportunity for a hearing under section 256.045.  No 
181.15  person other than the recipient shall have a right to a hearing 
181.16  under section 256.045 prior to the time the lien is filed.  The 
181.17  hearing shall be limited to whether the agency has met all of 
181.18  the prerequisites for filing the lien and whether any of the 
181.19  exceptions in this section apply. 
181.20     (c) An agency may not file a lien against the recipient's 
181.21  homestead when any of the following exceptions apply: 
181.22     (1) while the recipient's spouse is also physically present 
181.23  and lawfully and continuously residing in the homestead; 
181.24     (2) a child of the recipient who is under age 21 or who is 
181.25  blind or totally and permanently disabled according to 
181.26  supplemental security income criteria is also physically present 
181.27  on the property and lawfully and continuously residing on the 
181.28  property from and after the date the recipient first receives 
181.29  benefits; 
181.30     (3) a child of the recipient who has also lawfully and 
181.31  continuously resided on the property for a period beginning at 
181.32  least two years before the first day of the month in which the 
181.33  recipient began receiving alternative care, and who provided 
181.34  uncompensated care to the recipient which enabled the recipient 
181.35  to live without alternative care services for the two-year 
181.36  period; 
182.1      (4) a sibling of the recipient who has an ownership 
182.2   interest in the property of record in the office of the county 
182.3   recorder or registrar of titles for the county in which the real 
182.4   property is located and who has also continuously occupied the 
182.5   homestead for a period of at least one year immediately prior to 
182.6   the first day of the first month in which the recipient received 
182.7   benefits and continuously since that date. 
182.8      (d) A lien only applies to the real property it describes. 
182.9      Subd. 3.  [CONTINUATION OF LIEN.] A lien remains effective 
182.10  from the time it is filed until it is paid, satisfied, 
182.11  discharged, or becomes unenforceable under sections 514.991 to 
182.12  514.995. 
182.13     Subd. 4.  [PRIORITY OF LIEN.] (a) A lien which attaches to 
182.14  the real property it describes is subject to the rights of 
182.15  anyone else whose interest in the real property is perfected of 
182.16  record before the lien has been recorded or filed under section 
182.17  514.993, including: 
182.18     (1) an owner, other than the recipient or the recipient's 
182.19  spouse; 
182.20     (2) a good faith purchaser for value without notice of the 
182.21  lien; 
182.22     (3) a holder of a mortgage or security interest; or 
182.23     (4) a judgment lien creditor whose judgment lien has 
182.24  attached to the recipient's interest in the real property. 
182.25     (b) The rights of the other person have the same 
182.26  protections against an alternative care lien as are afforded 
182.27  against a judgment lien that arises out of an unsecured 
182.28  obligation and arises as of the time of the filing of an 
182.29  alternative care grant lien under section 514.993.  The lien 
182.30  shall be inferior to a lien for property taxes and special 
182.31  assessments and shall be superior to all other matters first 
182.32  appearing of record after the time and date the lien is filed or 
182.33  recorded. 
182.34     Subd. 5.  [SETTLEMENT, SUBORDINATION, AND RELEASE.] (a) An 
182.35  agency may, with absolute discretion, settle or subordinate the 
182.36  lien to any other lien or encumbrance of record upon the terms 
183.1   and conditions it deems appropriate. 
183.2      (b) The agency filing the lien shall release and discharge 
183.3   the lien: 
183.4      (1) if it has been paid, discharged, or satisfied; 
183.5      (2) if it has received reimbursement for the amounts 
183.6   secured by the lien, has entered into a binding and legally 
183.7   enforceable agreement under which it is reimbursed for the 
183.8   amount of the lien, or receives other collateral sufficient to 
183.9   secure payment of the lien; 
183.10     (3) against some, but not all, of the property it describes 
183.11  upon the terms, conditions, and circumstances the agency deems 
183.12  appropriate; 
183.13     (4) to the extent it cannot be lawfully enforced against 
183.14  the property it describes because of an error, omission, or 
183.15  other material defect in the legal description contained in the 
183.16  lien or a necessary prerequisite to enforcement of the lien; and 
183.17     (5) if, in its discretion, it determines the filing or 
183.18  enforcement of the lien is contrary to the public interest. 
183.19     (c) The agency executing the lien shall execute and file 
183.20  the release as provided for in section 514.993, subdivision 2. 
183.21     Subd. 6.  [LENGTH OF LIEN.] (a) A lien shall be a lien on 
183.22  the real property it describes for a period of ten years from 
183.23  the date it attaches according to subdivision 2, paragraph (a), 
183.24  except as otherwise provided for in sections 514.992 to 
183.25  514.995.  The agency filing the lien may renew the lien for one 
183.26  additional ten-year period from the date it would otherwise 
183.27  expire by recording or filing a certificate of renewal before 
183.28  the lien expires.  The certificate of renewal shall be recorded 
183.29  or filed in the office of the county recorder or registrar of 
183.30  titles for the county in which the lien is recorded or filed.  
183.31  The certificate must refer to the recording or filing data for 
183.32  the lien it renews.  The certificate need not be attested, 
183.33  certified, or acknowledged as a condition for recording or 
183.34  filing.  The recorder or registrar of titles shall record, file, 
183.35  index, and return the certificate of renewal in the same manner 
183.36  provided for liens in section 514.993, subdivision 2. 
184.1      (b) An alternative care lien is not enforceable against the 
184.2   real property of an estate to the extent there is a 
184.3   determination by a court of competent jurisdiction, or by an 
184.4   officer of the court designated for that purpose, that there are 
184.5   insufficient assets in the estate to satisfy the lien in whole 
184.6   or in part because of the homestead exemption under section 
184.7   256B.15, subdivision 4, the rights of a surviving spouse or a 
184.8   minor child under section 524.2-403, paragraphs (a) and (b), or 
184.9   claims with a priority under section 524.3-805, paragraph (a), 
184.10  clauses (1) to (4).  For purposes of this section, the rights of 
184.11  the decedent's adult children to exempt property under section 
184.12  524.2-403, paragraph (b), shall not be considered costs of 
184.13  administration under section 524.3-805, paragraph (a), clause 
184.14  (1). 
184.15     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
184.16  for services for persons first enrolling in the alternative care 
184.17  program on or after that date and on the first day of the first 
184.18  eligibility renewal period for persons enrolled in the 
184.19  alternative care program prior to July 1, 2003. 
184.20     Sec. 49.  [514.993] [LIEN; CONTENTS AND FILING.] 
184.21     Subdivision 1.  [CONTENTS.] A lien shall be dated and must 
184.22  contain: 
184.23     (1) the recipient's full name, last known address, and 
184.24  social security number; 
184.25     (2) a statement that benefits have been paid to or for the 
184.26  recipient's benefit; 
184.27     (3) a statement that all of the recipient's interests in 
184.28  the real property described in the lien may be subject to or 
184.29  affected by the agency's right to reimbursement for benefits; 
184.30     (4) a legal description of the real property subject to the 
184.31  lien and whether it is registered or abstract property; and 
184.32     (5) such other contents, if any, as the agency deems 
184.33  appropriate. 
184.34     Subd. 2.  [FILING.] Any lien, release, or other document 
184.35  required or permitted to be filed under sections 514.991 to 
184.36  514.995 must be recorded or filed in the office of the county 
185.1   recorder or registrar of titles, as appropriate, in the county 
185.2   where the real property is located.  Notwithstanding section 
185.3   386.77, the agency shall pay the applicable filing fee for any 
185.4   documents filed under sections 514.991 to 514.995.  An 
185.5   attestation, certification, or acknowledgment is not required as 
185.6   a condition of filing.  If the property described in the lien is 
185.7   registered property, the registrar of titles shall record it on 
185.8   the certificate of title for each parcel of property described 
185.9   in the lien.  If the property described in the lien is abstract 
185.10  property, the recorder shall file the lien in the county's 
185.11  grantor-grantee indexes and any tract indexes the county 
185.12  maintains for each parcel of property described in the lien.  
185.13  The recorder or registrar shall return the recorded or filed 
185.14  lien to the agency at no cost.  If the agency provides a 
185.15  duplicate copy of the lien, the recorder or registrar of titles 
185.16  shall show the recording or filing data on the copy and return 
185.17  it to the agency at no cost.  The agency is responsible for 
185.18  filing any lien, release, or other documents under sections 
185.19  514.991 to 514.995. 
185.20     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
185.21  for services for persons first enrolling in the alternative care 
185.22  program on or after that date and on the first day of the first 
185.23  eligibility renewal period for persons enrolled in the 
185.24  alternative care program prior to July 1, 2003. 
185.25     Sec. 50.  [514.994] [ENFORCEMENT; OTHER REMEDIES.] 
185.26     Subdivision 1.  [FORECLOSURE OR ENFORCEMENT OF LIEN.] The 
185.27  agency may enforce or foreclose a lien filed under sections 
185.28  514.991 to 514.995 in the manner provided for by law for 
185.29  enforcement of judgment liens against real estate or by a 
185.30  foreclosure by action under chapter 581.  The lien shall remain 
185.31  enforceable as provided for in sections 514.991 to 514.995 
185.32  notwithstanding any laws limiting the enforceability of 
185.33  judgments. 
185.34     Subd. 2.  [HOMESTEAD EXEMPTION.] The lien may not be 
185.35  enforced against the homestead property of the recipient or the 
185.36  spouse while they physically occupy it as their lawful residence.
186.1      Subd. 3.  [AGENCY CLAIM OR REMEDY.] Sections 514.992 to 
186.2   514.995 do not limit the agency's right to file a claim against 
186.3   the recipient's estate or the estate of the recipient's spouse, 
186.4   do not limit any other claims for reimbursement the agency may 
186.5   have, and do not limit the availability of any other remedy to 
186.6   the agency. 
186.7      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
186.8   for services for persons first enrolling in the alternative care 
186.9   program on or after that date and on the first day of the first 
186.10  eligibility renewal period for persons enrolled in the 
186.11  alternative care program prior to July 1, 2003. 
186.12     Sec. 51.  [514.995] [AMOUNTS RECEIVED TO SATISFY LIEN.] 
186.13     Amounts the agency receives to satisfy the lien must be 
186.14  deposited in the state treasury and credited to the fund from 
186.15  which the benefits were paid. 
186.16     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
186.17  for services for persons first enrolling in the alternative care 
186.18  program on or after that date and on the first day of the first 
186.19  eligibility renewal period for persons enrolled in the 
186.20  alternative care program prior to July 1, 2003. 
186.21     Sec. 52.  Minnesota Statutes 2002, section 524.3-805, is 
186.22  amended to read: 
186.23     524.3-805 [CLASSIFICATION OF CLAIMS.] 
186.24     (a) If the applicable assets of the estate are insufficient 
186.25  to pay all claims in full, the personal representative shall 
186.26  make payment in the following order: 
186.27     (1) costs and expenses of administration; 
186.28     (2) reasonable funeral expenses; 
186.29     (3) debts and taxes with preference under federal law; 
186.30     (4) reasonable and necessary medical, hospital, or nursing 
186.31  home expenses of the last illness of the decedent, including 
186.32  compensation of persons attending the decedent, a claim filed 
186.33  under section 256B.15 for recovery of expenditures for 
186.34  alternative care for nonmedical assistance recipients under 
186.35  section 256B.0913, and including a claim filed pursuant to 
186.36  section 256B.15; 
187.1      (5) reasonable and necessary medical, hospital, and nursing 
187.2   home expenses for the care of the decedent during the year 
187.3   immediately preceding death; 
187.4      (6) debts with preference under other laws of this state, 
187.5   and state taxes; 
187.6      (7) all other claims. 
187.7      (b) No preference shall be given in the payment of any 
187.8   claim over any other claim of the same class, and a claim due 
187.9   and payable shall not be entitled to a preference over claims 
187.10  not due, except that if claims for expenses of the last illness 
187.11  involve only claims filed under section 256B.15 for recovery of 
187.12  expenditures for alternative care for nonmedical assistance 
187.13  recipients under section 256B.0913, section 246.53 for costs of 
187.14  state hospital care and claims filed under section 256B.15, 
187.15  claims filed to recover expenditures for alternative care for 
187.16  nonmedical assistance recipients under section 256B.0913 shall 
187.17  have preference over claims filed under both sections 246.53 and 
187.18  other claims filed under section 256B.15, and claims filed under 
187.19  section 246.53 have preference over claims filed under section 
187.20  256B.15 for recovery of amounts other than those for 
187.21  expenditures for alternative care for nonmedical assistance 
187.22  recipients under section 256B.0913. 
187.23     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
187.24  for decedents dying on or after that date. 
187.25     Sec. 53.  [IMPOSITION OF FEDERAL CERTIFICATION REMEDIES.] 
187.26     The commissioner of health shall seek changes in the 
187.27  federal policy that mandates the imposition of federal sanctions 
187.28  without providing an opportunity for a nursing facility to 
187.29  correct deficiencies, solely as the result of previous 
187.30  deficiencies issued to the nursing facility.  
187.31     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
187.32     Sec. 54.  [REPORT ON LONG-TERM CARE.] 
187.33     The report on long-term care services required under 
187.34  Minnesota Statutes, section 144A.351, that is presented to the 
187.35  legislature by January 15, 2004, must also address the 
187.36  feasibility of offering government or private sector loans or 
188.1   lines of credit to individuals age 65 and over, for the purchase 
188.2   of long-term care services. 
188.3      Sec. 55.  [REPORTS; POTENTIAL SAVINGS TO STATE FROM CERTAIN 
188.4   LONG-TERM CARE INSURANCE PURCHASE INCENTIVES.] 
188.5      The commissioner of human services shall report to the 
188.6   legislature by January 15, 2005, on long-term care financing 
188.7   reform.  The report must include a new mix of public and private 
188.8   approaches to the financing of long-term care.  The report shall 
188.9   examine strategies and financing options that will increase the 
188.10  availability and use of nongovernment resources to pay for 
188.11  long-term care, including new ways of using limited government 
188.12  funds for long-term care.  The report shall examine the 
188.13  feasibility of: 
188.14     (1) initiating a long-term care insurance partnership 
188.15  program, similar to those adopted in other states, under which 
188.16  the state would encourage the purchase of private long-term care 
188.17  insurance by permitting the insured to retain assets in excess 
188.18  of those otherwise permitted for medical assistance eligibility, 
188.19  if the insured later exhausts the private long-term care 
188.20  insurance benefits.  The report must include the feasibility of 
188.21  obtaining any necessary federal waiver; 
188.22     (2) using state medical assistance funds to subsidize the 
188.23  purchase of private long-term care insurance by individuals who 
188.24  would be unlikely to purchase it without a subsidy, in order to 
188.25  generate long-term medical assistance savings; and 
188.26     (3) adding a nursing facility benefit to Medicare-related 
188.27  coverage, as defined in Minnesota Statutes, section 62Q.01, 
188.28  subdivision 6.  The report must quantify the costs or savings 
188.29  resulting from adding a nursing facility benefit. 
188.30     The report must comply with Minnesota Statutes, sections 
188.31  3.195 and 3.197. 
188.32     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
188.33     Sec. 56.  [REVISOR'S INSTRUCTION.] 
188.34     For sections in Minnesota Statutes and Minnesota Rules 
188.35  affected by the repealed sections in this article, the revisor 
188.36  shall delete internal cross-references where appropriate and 
189.1   make changes necessary to correct the punctuation, grammar, or 
189.2   structure of the remaining text and preserve its meaning. 
189.3      Sec. 57.  [REPEALER.] 
189.4      (a) Minnesota Statutes 2002, sections 256.973; 256.9772; 
189.5   and 256B.437, subdivision 2, are repealed effective July 1, 2003.
189.6      (b) Minnesota Statutes 2002, sections 62J.66; 62J.68; 
189.7   144A.071, subdivision 5; and 144A.35, are repealed. 
189.8      (c) Laws 1998, chapter 407, article 4, section 63, is 
189.9   repealed. 
189.10     (d) Minnesota Rules, parts 9505.3045; 9505.3050; 9505.3055; 
189.11  9505.3060; 9505.3068; 9505.3070; 9505.3075; 9505.3080; 
189.12  9505.3090; 9505.3095; 9505.3100; 9505.3105; 9505.3107; 
189.13  9505.3110; 9505.3115; 9505.3120; 9505.3125; 9505.3130; 
189.14  9505.3138; 9505.3139; 9505.3140; 9505.3680; 9505.3690; and 
189.15  9505.3700, are repealed effective July 1, 2003. 
189.16     (e) Laws 2003, chapter 55, sections 1 and 4, are repealed 
189.17  effective the day following final enactment. 
189.18                             ARTICLE 3 
189.19           CONTINUING CARE FOR PERSONS WITH DISABILITIES 
189.20     Section 1.  Minnesota Statutes 2002, section 174.30, 
189.21  subdivision 1, is amended to read: 
189.22     Subdivision 1.  [APPLICABILITY.] (a) The operating 
189.23  standards for special transportation service adopted under this 
189.24  section do not apply to special transportation provided by:  
189.25     (1) a common carrier operating on fixed routes and 
189.26  schedules; 
189.27     (2) a volunteer driver using a private automobile; 
189.28     (3) a school bus as defined in section 169.01, subdivision 
189.29  6; or 
189.30     (4) an emergency ambulance regulated under chapter 144. 
189.31     (b) The operating standards adopted under this section only 
189.32  apply to providers of special transportation service who receive 
189.33  grants or other financial assistance from either the state or 
189.34  the federal government, or both, to provide or assist in 
189.35  providing that service; except that the operating standards 
189.36  adopted under this section do not apply to any nursing home 
190.1   licensed under section 144A.02, to any board and care facility 
190.2   licensed under section 144.50, or to any day training and 
190.3   habilitation services, day care, or group home facility licensed 
190.4   under sections 245A.01 to 245A.19 unless the facility or program 
190.5   provides transportation to nonresidents on a regular basis and 
190.6   the facility receives reimbursement, other than per diem 
190.7   payments, for that service under rules promulgated by the 
190.8   commissioner of human services.  
190.9      (c) Notwithstanding paragraph (b), the operating standards 
190.10  adopted under this section do not apply to any vendor of 
190.11  services licensed under chapter 245B that provides 
190.12  transportation services to consumers or residents of other 
190.13  vendors licensed under chapter 245B and transports 15 or fewer 
190.14  persons, including consumers or residents and the driver. 
190.15     Sec. 2.  Minnesota Statutes 2002, section 245B.06, 
190.16  subdivision 8, is amended to read: 
190.17     Subd. 8.  [LEAVING THE RESIDENCE.] ~~As specified in each~~ 
190.18  ~~consumer's individual service plan,~~ Each consumer requiring a 
190.19  24-hour plan of care ~~must leave the residence to participate in~~ 
190.20  ~~regular education, employment, or community activities~~ shall 
190.21  receive services during the day outside the residence unless 
190.22  otherwise specified in the individual's service plan.  License 
190.23  holders, providing services to consumers living in a licensed 
190.24  site, shall ensure that they are prepared to care for consumers 
190.25  whenever they are at the residence during the day because of 
190.26  illness, work schedules, or other reasons. 
190.27     Sec. 3.  Minnesota Statutes 2002, section 245B.07, 
190.28  subdivision 11, is amended to read: 
190.29     Subd. 11.  [TRAVEL TIME TO AND FROM A DAY TRAINING AND 
190.30  HABILITATION SITE.] Except in unusual circumstances, the license 
190.31  holder must not transport a consumer receiving services for 
190.32  longer than ~~one hour~~ 90 minutes per one-way trip.  Nothing in 
190.33  this subdivision relieves the provider of the obligation to 
190.34  provide the number of program hours as identified in the 
190.35  individualized service plan. 
190.36     Sec. 4.  Minnesota Statutes 2002, section 246.54, is 
191.1   amended to read: 
191.2      246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.] 
191.3      Subdivision 1.  [COUNTY PORTION FOR COST OF CARE.] Except 
191.4   for chemical dependency services provided under sections 254B.01 
191.5   to 254B.09, the client's county shall pay to the state of 
191.6   Minnesota a portion of the cost of care provided in a regional 
191.7   treatment center or a state nursing facility to a client legally 
191.8   settled in that county.  A county's payment shall be made from 
191.9   the county's own sources of revenue and payments shall be paid 
191.10  as follows:  payments to the state from the county shall 
191.11  equal ~~ten~~ 20 percent of the cost of care, as determined by the 
191.12  commissioner, for each day, or the portion thereof, that the 
191.13  client spends at a regional treatment center or a state nursing 
191.14  facility.  If payments received by the state under sections 
191.15  246.50 to 246.53 exceed ~~90~~ 80 percent of the cost of care, the 
191.16  county shall be responsible for paying the state only the 
191.17  remaining amount.  The county shall not be entitled to 
191.18  reimbursement from the client, the client's estate, or from the 
191.19  client's relatives, except as provided in section 246.53.  No 
191.20  such payments shall be made for any client who was last 
191.21  committed prior to July 1, 1947. 
191.22     Subd. 2.  [EXCEPTIONS.] Subdivision 1 does not apply to 
191.23  services provided at the Minnesota security hospital, the 
191.24  Minnesota sex offender program, or the Minnesota extended 
191.25  treatment options program.  For services at these facilities, a 
191.26  county's payment shall be made from the county's own sources of 
191.27  revenue and payments shall be paid as follows:  payments to the 
191.28  state from the county shall equal ten percent of the cost of 
191.29  care, as determined by the commissioner, for each day, or the 
191.30  portion thereof, that the client spends at the facility.  If 
191.31  payments received by the state under sections 246.50 to 246.53 
191.32  exceed 90 percent of the cost of care, the county shall be 
191.33  responsible for paying the state only the remaining amount.  The 
191.34  county shall not be entitled to reimbursement from the client, 
191.35  the client's estate, or from the client's relatives, except as 
191.36  provided in section 246.53. 
192.1      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
192.2      Sec. 5.  Minnesota Statutes 2002, section 252.32, 
192.3   subdivision 1, is amended to read: 
192.4      Subdivision 1.  [PROGRAM ESTABLISHED.] In accordance with 
192.5   state policy established in section 256F.01 that all children 
192.6   are entitled to live in families that offer safe, nurturing, 
192.7   permanent relationships, and that public services be directed 
192.8   toward preventing the unnecessary separation of children from 
192.9   their families, and because many families who have children with 
192.10  ~~mental retardation or related conditions~~ disabilities have 
192.11  special needs and expenses that other families do not have, the 
192.12  commissioner of human services shall establish a program to 
192.13  assist families who have ~~dependents~~ dependent children with 
192.14  ~~mental retardation or related conditions~~ disabilities living in 
192.15  their home.  The program shall make support grants available to 
192.16  the families. 
192.17     Sec. 6.  Minnesota Statutes 2002, section 252.32, 
192.18  subdivision 1a, is amended to read: 
192.19     Subd. 1a.  [SUPPORT GRANTS.] (a) Provision of support 
192.20  grants must be limited to families who require support and whose 
192.21  dependents are under the age of ~~22 and who have mental~~ 
192.22  ~~retardation or who have a related condition~~ 21 and who have been 
192.23  ~~determined by a screening team established~~ certified disabled 
192.24  under section ~~256B.092 to be at risk of~~ 
192.25  ~~institutionalization~~ 256B.055, subdivision 12, paragraphs (a), 
192.26  (b), (c), (d), and (e).  Families who are receiving home and 
192.27  community-based waivered services for persons with mental 
192.28  retardation or related conditions are not eligible for support 
192.29  grants. 
192.30     ~~Families receiving grants who will be receiving home and~~ 
192.31  ~~community-based waiver services for persons with mental~~ 
192.32  ~~retardation or a related condition for their family member~~ 
192.33  ~~within the grant year, and who have ongoing payments for~~ 
192.34  ~~environmental or vehicle modifications which have been approved~~ 
192.35  ~~by the county as a grant expense and would have qualified for~~ 
192.36  ~~payment under this waiver may receive a onetime grant payment~~ 
193.1   ~~from the commissioner to reduce or eliminate the principal of~~ 
193.2   ~~the remaining debt for the modifications, not to exceed the~~ 
193.3   ~~maximum amount allowable for the remaining years of eligibility~~ 
193.4   ~~for a family support grant.  The commissioner is authorized to~~ 
193.5   ~~use up to $20,000 annually from the grant appropriation for this~~ 
193.6   ~~purpose.  Any amount unexpended at the end of the grant year~~ 
193.7   ~~shall be allocated by the commissioner in accordance with~~ 
193.8   ~~subdivision 3a, paragraph (b), clause (2).~~  Families whose 
193.9   annual adjusted gross income is $60,000 or more are not eligible 
193.10  for support grants except in cases where extreme hardship is 
193.11  demonstrated.  Beginning in state fiscal year 1994, the 
193.12  commissioner shall adjust the income ceiling annually to reflect 
193.13  the projected change in the average value in the United States 
193.14  Department of Labor Bureau of Labor Statistics consumer price 
193.15  index (all urban) for that year. 
193.16     (b) Support grants may be made available as monthly subsidy 
193.17  grants and lump sum grants. 
193.18     (c) Support grants may be issued in the form of cash, 
193.19  voucher, and direct county payment to a vendor.  
193.20     (d) Applications for the support grant shall be made by the 
193.21  legal guardian to the county social service agency.  The 
193.22  application shall specify the needs of the families, the form of 
193.23  the grant requested by the families, and ~~that~~ the ~~families have~~ 
193.24  ~~agreed to use the support grant for~~ items and services ~~within~~ 
193.25  ~~the designated reimbursable expense categories and~~ 
193.26  ~~recommendations of the county~~ to be reimbursed.  
193.27     ~~(e) Families who were receiving subsidies on the date of~~ 
193.28  ~~implementation of the $60,000 income limit in paragraph (a)~~ 
193.29  ~~continue to be eligible for a family support grant until~~ 
193.30  ~~December 31, 1991, if all other eligibility criteria are met.~~  
193.31  ~~After December 31, 1991, these families are eligible for a grant~~ 
193.32  ~~in the amount of one-half the grant they would otherwise~~ 
193.33  ~~receive, for as long as they remain eligible under other~~ 
193.34  ~~eligibility criteria.~~  
193.35     Sec. 7.  Minnesota Statutes 2002, section 252.32, 
193.36  subdivision 3, is amended to read: 
194.1      Subd. 3.  [AMOUNT OF SUPPORT GRANT; USE.] Support grant 
194.2   amounts shall be determined by the county social service 
194.3   agency.  ~~Each service~~ Services and ~~item~~ items purchased with a 
194.4   support grant must: 
194.5      (1) be over and above the normal costs of caring for the 
194.6   dependent if the dependent did not have a disability; 
194.7      (2) be directly attributable to the dependent's disabling 
194.8   condition; and 
194.9      (3) enable the family to delay or prevent the out-of-home 
194.10  placement of the dependent. 
194.11     The design and delivery of services and items purchased 
194.12  under this section must suit the dependent's chronological age 
194.13  and be provided in the least restrictive environment possible, 
194.14  consistent with the needs identified in the individual service 
194.15  plan. 
194.16     Items and services purchased with support grants must be 
194.17  those for which there are no other public or private funds 
194.18  available to the family.  Fees assessed to parents for health or 
194.19  human services that are funded by federal, state, or county 
194.20  dollars are not reimbursable through this program. 
194.21     In approving or denying applications, the county shall 
194.22  consider the following factors:  
194.23     (1) the extent and areas of the functional limitations of 
194.24  the disabled child; 
194.25     (2) the degree of need in the home environment for 
194.26  additional support; and 
194.27     (3) the potential effectiveness of the grant to maintain 
194.28  and support the person in the family environment. 
194.29     The maximum monthly grant amount shall be $250 per eligible 
194.30  dependent, or $3,000 per eligible dependent per state fiscal 
194.31  year, within the limits of available funds.  The county social 
194.32  service agency may consider the dependent's supplemental 
194.33  security income in determining the amount of the support grant.  
194.34  ~~The county social service agency may exceed $3,000 per state~~ 
194.35  ~~fiscal year per eligible dependent for emergency circumstances~~ 
194.36  ~~in cases where exceptional resources of the family are required~~ 
195.1   ~~to meet the health, welfare-safety needs of the child.~~  
195.2      ~~County social service agencies shall continue to provide~~ 
195.3   ~~funds to families receiving state grants on June 30, 1997, if~~ 
195.4   ~~eligibility criteria continue to be met.~~  Any adjustments to 
195.5   their monthly grant amount must be based on the needs of the 
195.6   family and funding availability. 
195.7      Sec. 8.  Minnesota Statutes 2002, section 252.32, 
195.8   subdivision 3c, is amended to read: 
195.9      Subd. 3c.  [COUNTY BOARD RESPONSIBILITIES.] County boards 
195.10  receiving funds under this section shall:  
195.11     (1) ~~determine the needs of families for services in~~ 
195.12  ~~accordance with section 256B.092 or 256E.08 and any rules~~ 
195.13  ~~adopted under those sections;~~ submit a plan to the department 
195.14  for the management of the family support grant program.  The 
195.15  plan must include the projected number of families the county 
195.16  will serve and policies and procedures for:  
195.17     (i) identifying potential families for the program; 
195.18     (ii) grant distribution; 
195.19     (iii) waiting list procedures; and 
195.20     (iv) prioritization of families to receive grants; 
195.21     (2) determine the eligibility of all persons proposed for 
195.22  program participation; 
195.23     (3) approve a plan for items and services to be reimbursed 
195.24  and inform families of the county's approval decision; 
195.25     (4) issue support grants directly to, or on behalf of, 
195.26  eligible families; 
195.27     (5) inform recipients of their right to appeal under 
195.28  subdivision 3e; 
195.29     (6) submit quarterly financial reports under subdivision 3b 
195.30  and indicate ~~on the screening documents~~ the annual grant level 
195.31  for each family, the families denied grants, and the families 
195.32  eligible but waiting for funding; and 
195.33     (7) coordinate services with other programs offered by the 
195.34  county. 
195.35     Sec. 9.  Minnesota Statutes 2002, section 252.41, 
195.36  subdivision 3, is amended to read: 
196.1      Subd. 3.  [DAY TRAINING AND HABILITATION SERVICES FOR 
196.2   ADULTS WITH MENTAL RETARDATION, RELATED CONDITIONS.] "Day 
196.3   training and habilitation services for adults with mental 
196.4   retardation and related conditions" means services that: 
196.5      (1) include supervision, training, assistance, and 
196.6   supported employment, work-related activities, or other 
196.7   community-integrated activities designed and implemented in 
196.8   accordance with the individual service and individual 
196.9   habilitation plans required under Minnesota Rules, parts 
196.10  9525.0015 to 9525.0165, to help an adult reach and maintain the 
196.11  highest possible level of independence, productivity, and 
196.12  integration into the community; and 
196.13     (2) are provided under contract with the county where the 
196.14  services are delivered by a vendor licensed under sections 
196.15  245A.01 to 245A.16 and 252.28, subdivision 2, to provide day 
196.16  training and habilitation services~~; and~~ 
196.17     ~~(3) are regularly provided to one or more adults with~~ 
196.18  ~~mental retardation or related conditions in a place other than~~ 
196.19  ~~the adult's own home or residence unless medically~~ 
196.20  ~~contraindicated~~. 
196.21     Day training and habilitation services reimbursable under 
196.22  this section do not include special education and related 
196.23  services as defined in the Education of the Handicapped Act, 
196.24  United States Code, title 20, chapter 33, section 1401, clauses 
196.25  (6) and (17), or vocational services funded under section 110 of 
196.26  the Rehabilitation Act of 1973, United States Code, title 29, 
196.27  section 720, as amended. 
196.28     Sec. 10.  Minnesota Statutes 2002, section 252.46, 
196.29  subdivision 1, is amended to read: 
196.30     Subdivision 1.  [RATES.] (a) Payment rates to vendors, 
196.31  except regional centers, for county-funded day training and 
196.32  habilitation services and transportation provided to persons 
196.33  receiving day training and habilitation services established by 
196.34  a county board are governed by subdivisions 2 to 19.  The 
196.35  commissioner shall approve the following three payment rates for 
196.36  services provided by a vendor: 
197.1      (1) a full-day service rate for persons who receive at 
197.2   least six service hours a day, including the time it takes to 
197.3   transport the person to and from the service site; 
197.4      (2) a partial-day service rate that must not exceed 75 
197.5   percent of the full-day service rate for persons who receive 
197.6   less than a full day of service; and 
197.7      (3) a transportation rate for providing, or arranging and 
197.8   paying for, transportation of a person to and from the person's 
197.9   residence to the service site.  
197.10     ~~(b) The commissioner may also approve an hourly job-coach,~~ 
197.11  ~~follow-along rate for services provided by one employee at or en~~ 
197.12  ~~route to or from community locations to supervise, support, and~~ 
197.13  ~~assist one person receiving the vendor's services to learn~~ 
197.14  ~~job-related skills necessary to obtain or retain employment when~~ 
197.15  ~~and where no other persons receiving services are present and~~ 
197.16  ~~when all the following criteria are met:~~ 
197.17     ~~(1) the vendor requests and the county recommends the~~ 
197.18  ~~optional rate;~~ 
197.19     ~~(2) the service is prior authorized by the county on the~~ 
197.20  ~~Medicaid Management Information System for no more than 414~~ 
197.21  ~~hours in a 12-month period and the daily per person charge to~~ 
197.22  ~~medical assistance does not exceed the vendor's approved full~~ 
197.23  ~~day plus transportation rates;~~ 
197.24     ~~(3) separate full day, partial day, and transportation~~ 
197.25  ~~rates are not billed for the same person on the same day;~~ 
197.26     ~~(4) the approved hourly rate does not exceed the sum of the~~ 
197.27  ~~vendor's current average hourly direct service wage, including~~ 
197.28  ~~fringe benefits and taxes, plus a component equal to the~~ 
197.29  ~~vendor's average hourly nondirect service wage expenses; and~~ 
197.30     ~~(5) the actual revenue received for provision of hourly~~ 
197.31  ~~job-coach, follow-along services is subtracted from the vendor's~~ 
197.32  ~~total expenses for the same time period and those adjusted~~ 
197.33  ~~expenses are used for determining recommended full day and~~ 
197.34  ~~transportation payment rates under subdivision 5 in accordance~~ 
197.35  ~~with the limitations in subdivision 3.~~ 
197.36     (b) Notwithstanding any law or rule to the contrary, the 
198.1   commissioner may authorize county participation in a voluntary 
198.2   individualized payment rate structure for day training and 
198.3   habilitation services to allow a county the flexibility to 
198.4   change, after consulting with providers, from a site-based 
198.5   payment rate structure to an individual payment rate structure 
198.6   for the providers of day training and habilitation services in 
198.7   the county.  The commissioner shall seek input from providers 
198.8   and consumers in establishing procedures for determining the 
198.9   structure of voluntary individualized payment rates to ensure 
198.10  that there is no additional cost to the state or counties and 
198.11  that the rate structure is cost-neutral to providers of day 
198.12  training and habilitation services, on July 1, 2004, or on day 
198.13  one of the individual rate structure, whichever is later. 
198.14     (c) Medical assistance rates for home and community-based 
198.15  service provided under section 256B.501, subdivision 4, by 
198.16  licensed vendors of day training and habilitation services must 
198.17  not be greater than the rates for the same services established 
198.18  by counties under sections 252.40 to 252.46.  For very dependent 
198.19  persons with special needs the commissioner may approve an 
198.20  exception to the approved payment rate under section 256B.501, 
198.21  subdivision 4 or 8. 
198.22     Sec. 11.  Minnesota Statutes 2002, section 256.476, 
198.23  subdivision 1, is amended to read: 
198.24     Subdivision 1.  [PURPOSE AND GOALS.] The commissioner of 
198.25  human services shall establish a consumer support grant program 
198.26  for individuals with functional limitations and their families 
198.27  who wish to purchase and secure their own supports.  The 
198.28  commissioner and local agencies shall jointly develop an 
198.29  implementation plan which must include a way to resolve the 
198.30  issues related to county liability.  The program shall: 
198.31     (1) make support grants ~~or exception grants described in~~ 
198.32  ~~subdivision 11~~ available to individuals or families as an 
198.33  effective alternative to ~~existing programs and services, such as~~ 
198.34  the developmental disability family support program, personal 
198.35  care attendant services, home health aide services, and private 
198.36  duty nursing services; 
199.1      (2) provide consumers more control, flexibility, and 
199.2   responsibility over their services and supports; 
199.3      (3) promote local program management and decision making; 
199.4   and 
199.5      (4) encourage the use of informal and typical community 
199.6   supports. 
199.7      <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2004.
199.8      Sec. 12.  Minnesota Statutes 2002, section 256.476, 
199.9   subdivision 3, is amended to read: 
199.10     Subd. 3.  [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 
199.11  is eligible to apply for a consumer support grant if the person 
199.12  meets all of the following criteria: 
199.13     (1) the person is eligible for and has been approved to 
199.14  receive services under medical assistance as determined under 
199.15  sections 256B.055 and 256B.056 or the person has been approved 
199.16  to receive a grant under the developmental disability family 
199.17  support program under section 252.32; 
199.18     (2) the person is able to direct and purchase the person's 
199.19  own care and supports, or the person has a family member, legal 
199.20  representative, or other authorized representative who can 
199.21  purchase and arrange supports on the person's behalf; 
199.22     (3) the person has functional limitations, requires ongoing 
199.23  supports to live in the community, and is at risk of or would 
199.24  continue institutionalization without such supports; and 
199.25     (4) the person will live in a home.  For the purpose of 
199.26  this section, "home" means the person's own home or home of a 
199.27  person's family member.  These homes are natural home settings 
199.28  and are not licensed by the department of health or human 
199.29  services. 
199.30     (b) Persons may not concurrently receive a consumer support 
199.31  grant if they are: 
199.32     (1) receiving ~~home and community-based services under~~ 
199.33  ~~United States Code, title 42, section 1396h(c);~~ personal care 
199.34  attendant and home health aide services, or private duty nursing 
199.35  under section 256B.0625; a developmental disability family 
199.36  support grant; or alternative care services under section 
200.1   256B.0913; or 
200.2      (2) residing in an institutional or congregate care setting.
200.3      (c) A person or person's family receiving a consumer 
200.4   support grant shall not be charged a fee or premium by a local 
200.5   agency for participating in the program.  
200.6      (d) ~~The commissioner may limit the participation of~~ 
200.7   ~~recipients of services from federal waiver programs in the~~ 
200.8   ~~consumer support grant program if the participation of these~~ 
200.9   ~~individuals will result in an increase in the cost to the~~ 
200.10  ~~state.~~  Individuals receiving home and community-based waivers 
200.11  under United States Code, title 42, section 1396h(c), are not 
200.12  eligible for the consumer support grant, except for individuals 
200.13  receiving consumer support grants before July 1, 2003, as long 
200.14  as other eligibility criteria are met. 
200.15     (e) The commissioner shall establish a budgeted 
200.16  appropriation each fiscal year for the consumer support grant 
200.17  program.  The number of individuals participating in the program 
200.18  will be adjusted so the total amount allocated to counties does 
200.19  not exceed the amount of the budgeted appropriation.  The 
200.20  budgeted appropriation will be adjusted annually to accommodate 
200.21  changes in demand for the consumer support grants. 
200.22     Sec. 13.  Minnesota Statutes 2002, section 256.476, 
200.23  subdivision 4, is amended to read: 
200.24     Subd. 4.  [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 
200.25  county board may choose to participate in the consumer support 
200.26  grant program.  If a county has not chosen to participate by 
200.27  July 1, 2002, the commissioner shall contract with another 
200.28  county or other entity to provide access to residents of the 
200.29  nonparticipating county who choose the consumer support grant 
200.30  option.  The commissioner shall notify the county board in a 
200.31  county that has declined to participate of the commissioner's 
200.32  intent to enter into a contract with another county or other 
200.33  entity at least 30 days in advance of entering into the 
200.34  contract.  The local agency shall establish written procedures 
200.35  and criteria to determine the amount and use of support grants.  
200.36  These procedures must include, at least, the availability of 
201.1   respite care, assistance with daily living, and adaptive aids.  
201.2   The local agency may establish monthly or annual maximum amounts 
201.3   for grants and procedures where exceptional resources may be 
201.4   required to meet the health and safety needs of the person on a 
201.5   time-limited basis, however, the total amount awarded to each 
201.6   individual may not exceed the limits established in subdivision 
201.7   11. 
201.8      (b) Support grants to a person or a person's family will be 
201.9   provided through a monthly subsidy payment and be in the form of 
201.10  cash, voucher, or direct county payment to vendor.  Support 
201.11  grant amounts must be determined by the local agency.  Each 
201.12  service and item purchased with a support grant must meet all of 
201.13  the following criteria:  
201.14     (1) it must be over and above the normal cost of caring for 
201.15  the person if the person did not have functional limitations; 
201.16     (2) it must be directly attributable to the person's 
201.17  functional limitations; 
201.18     (3) it must enable the person or the person's family to 
201.19  delay or prevent out-of-home placement of the person; and 
201.20     (4) it must be consistent with the needs identified in the 
201.21  service ~~plan~~ agreement, when applicable. 
201.22     (c) Items and services purchased with support grants must 
201.23  be those for which there are no other public or private funds 
201.24  available to the person or the person's family.  Fees assessed 
201.25  to the person or the person's family for health and human 
201.26  services are not reimbursable through the grant. 
201.27     (d) In approving or denying applications, the local agency 
201.28  shall consider the following factors:  
201.29     (1) the extent and areas of the person's functional 
201.30  limitations; 
201.31     (2) the degree of need in the home environment for 
201.32  additional support; and 
201.33     (3) the potential effectiveness of the grant to maintain 
201.34  and support the person in the family environment or the person's 
201.35  own home. 
201.36     (e) At the time of application to the program or screening 
202.1   for other services, the person or the person's family shall be 
202.2   provided sufficient information to ensure an informed choice of 
202.3   alternatives by the person, the person's legal representative, 
202.4   if any, or the person's family.  The application shall be made 
202.5   to the local agency and shall specify the needs of the person 
202.6   and family, the form and amount of grant requested, the items 
202.7   and services to be reimbursed, and evidence of eligibility for 
202.8   medical assistance. 
202.9      (f) Upon approval of an application by the local agency and 
202.10  agreement on a support plan for the person or person's family, 
202.11  the local agency shall make grants to the person or the person's 
202.12  family.  The grant shall be in an amount for the direct costs of 
202.13  the services or supports outlined in the service agreement.  
202.14     (g) Reimbursable costs shall not include costs for 
202.15  resources already available, such as special education classes, 
202.16  day training and habilitation, case management, other services 
202.17  to which the person is entitled, medical costs covered by 
202.18  insurance or other health programs, or other resources usually 
202.19  available at no cost to the person or the person's family. 
202.20     (h) The state of Minnesota, the county boards participating 
202.21  in the consumer support grant program, or the agencies acting on 
202.22  behalf of the county boards in the implementation and 
202.23  administration of the consumer support grant program shall not 
202.24  be liable for damages, injuries, or liabilities sustained 
202.25  through the purchase of support by the individual, the 
202.26  individual's family, or the authorized representative under this 
202.27  section with funds received through the consumer support grant 
202.28  program.  Liabilities include but are not limited to:  workers' 
202.29  compensation liability, the Federal Insurance Contributions Act 
202.30  (FICA), or the Federal Unemployment Tax Act (FUTA).  For 
202.31  purposes of this section, participating county boards and 
202.32  agencies acting on behalf of county boards are exempt from the 
202.33  provisions of section 268.04. 
202.34     Sec. 14.  Minnesota Statutes 2002, section 256.476, 
202.35  subdivision 5, is amended to read: 
202.36     Subd. 5.  [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 
203.1   For the purpose of transferring persons to the consumer support 
203.2   grant program from ~~specific programs or services, such as~~ the 
203.3   developmental disability family support program and personal 
203.4   care assistant services, home health aide services, or private 
203.5   duty nursing services, the amount of funds transferred by the 
203.6   commissioner between the developmental disability family support 
203.7   program account, the medical assistance account, or the consumer 
203.8   support grant account shall be based on each county's 
203.9   participation in transferring persons to the consumer support 
203.10  grant program from those programs and services. 
203.11     (b) At the beginning of each fiscal year, county 
203.12  allocations for consumer support grants shall be based on: 
203.13     (1) the number of persons to whom the county board expects 
203.14  to provide consumer supports grants; 
203.15     (2) their eligibility for current program and services; 
203.16     (3) the amount of nonfederal dollars allowed under 
203.17  subdivision 11; and 
203.18     (4) projected dates when persons will start receiving 
203.19  grants.  County allocations shall be adjusted periodically by 
203.20  the commissioner based on the actual transfer of persons or 
203.21  service openings, and the nonfederal dollars associated with 
203.22  those persons or service openings, to the consumer support grant 
203.23  program. 
203.24     (c) The amount of funds transferred by the commissioner 
203.25  from the medical assistance account for an individual may be 
203.26  changed if it is determined by the county or its agent that the 
203.27  individual's need for support has changed. 
203.28     (d) The authority to utilize funds transferred to the 
203.29  consumer support grant account for the purposes of implementing 
203.30  and administering the consumer support grant program will not be 
203.31  limited or constrained by the spending authority provided to the 
203.32  program of origination. 
203.33     (e) The commissioner may use up to five percent of each 
203.34  county's allocation, as adjusted, for payments for 
203.35  administrative expenses, to be paid as a proportionate addition 
203.36  to reported direct service expenditures. 
204.1      (f) The county allocation for each individual or 
204.2   individual's family cannot exceed the amount allowed under 
204.3   subdivision 11. 
204.4      (g) The commissioner may recover, suspend, or withhold 
204.5   payments if the county board, local agency, or grantee does not 
204.6   comply with the requirements of this section. 
204.7      (h) Grant funds unexpended by consumers shall return to the 
204.8   state once a year.  The annual return of unexpended grant funds 
204.9   shall occur in the quarter following the end of the state fiscal 
204.10  year. 
204.11     Sec. 15.  Minnesota Statutes 2002, section 256.476, 
204.12  subdivision 11, is amended to read: 
204.13     Subd. 11.  [CONSUMER SUPPORT GRANT PROGRAM AFTER JULY 1, 
204.14  2001.] (a) Effective July 1, 2001, the commissioner shall 
204.15  allocate consumer support grant resources to serve additional 
204.16  individuals based on a review of Medicaid authorization and 
204.17  payment information of persons eligible for a consumer support 
204.18  grant from the most recent fiscal year.  The commissioner shall 
204.19  use the following methodology to calculate maximum allowable 
204.20  monthly consumer support grant levels: 
204.21     (1) For individuals whose program of origination is medical 
204.22  assistance home care under section 256B.0627, the maximum 
204.23  allowable monthly grant levels are calculated by: 
204.24     (i) determining the nonfederal share of the average service 
204.25  authorization for each home care rating; 
204.26     (ii) calculating the overall ratio of actual payments to 
204.27  service authorizations by program; 
204.28     (iii) applying the overall ratio to the average service 
204.29  authorization level of each home care rating; 
204.30     (iv) adjusting the result for any authorized rate increases 
204.31  provided by the legislature; and 
204.32     (v) adjusting the result for the average monthly 
204.33  utilization per recipient~~; and~~. 
204.34     (2) ~~for persons with programs of origination other than the~~ 
204.35  ~~program described in clause (1), the maximum grant level for an~~ 
204.36  ~~individual shall not exceed the total of the nonfederal dollars~~ 
205.1   ~~expended on the individual by the program of origination~~ The 
205.2   commissioner may review and evaluate the methodology to reflect 
205.3   changes in the home care programs overall ratio of actual 
205.4   payments to service authorizations. 
205.5      (b) Effective January 1, 2004, persons previously receiving 
205.6   ~~consumer support~~ exception grants ~~prior to July 1, 2001, may~~ 
205.7   ~~continue to receive the grant amount established prior to July~~ 
205.8   ~~1, 2001~~ will have their grants calculated using the methodology 
205.9   in paragraph (a), clause (1).  If a person currently receiving 
205.10  an exception grant wishes to have their home care rating 
205.11  reevaluated, they may request an assessment as defined in 
205.12  section 256B.0627, subdivision 1, paragraph (b). 
205.13     ~~(c) The commissioner may provide up to 200 exception~~ 
205.14  ~~grants, including grants in use under paragraph (b).  Eligible~~ 
205.15  ~~persons shall be provided an exception grant in priority order~~ 
205.16  ~~based upon the date of the commissioner's receipt of the county~~ 
205.17  ~~request.  The maximum allowable grant level for an exception~~ 
205.18  ~~grant shall be based upon the nonfederal share of the average~~ 
205.19  ~~service authorization from the most recent fiscal year for each~~ 
205.20  ~~home care rating category.  The amount of each exception grant~~ 
205.21  ~~shall be based upon the commissioner's determination of the~~ 
205.22  ~~nonfederal dollars that would have been expended if services had~~ 
205.23  ~~been available for an individual who is unable to obtain the~~ 
205.24  ~~support needed from the program of origination due to the~~ 
205.25  ~~unavailability of qualified service providers at the time or the~~ 
205.26  ~~location where the supports are needed.~~ 
205.27     Sec. 16.  Minnesota Statutes 2002, section 256.482, 
205.28  subdivision 8, is amended to read: 
205.29     Subd. 8.  [SUNSET.] Notwithstanding section 15.059, 
205.30  subdivision 5, the council on disability shall not sunset until 
205.31  June 30, ~~2003~~ 2007. 
205.32     <b>[EFFECTIVE DATE.]</b> This section is effective May 30, 2003. 
205.33     Sec. 17.  Minnesota Statutes 2002, section 256B.0621, 
205.34  subdivision 4, is amended to read: 
205.35     Subd. 4.  [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 
205.36  QUALIFICATIONS.] ~~The following qualifications and certification~~ 
206.1   ~~standards must be met by providers of relocation targeted case~~ 
206.2   ~~management:~~ 
206.3      ~~(a) The commissioner must certify each provider of~~ 
206.4   ~~relocation targeted case management before enrollment.  The~~ 
206.5   ~~certification process shall examine the provider's ability to~~ 
206.6   ~~meet the requirements in this subdivision and other federal and~~ 
206.7   ~~state requirements of this service.  A certified relocation~~ 
206.8   ~~targeted case management provider may subcontract with another~~ 
206.9   ~~provider to deliver relocation targeted case management~~ 
206.10  ~~services.  Subcontracted providers must demonstrate the ability~~ 
206.11  ~~to provide the services outlined in subdivision 6.~~ 
206.12     ~~(b)~~ (a) A relocation targeted case management provider is 
206.13  an enrolled medical assistance provider who is determined by the 
206.14  commissioner to have all of the following characteristics: 
206.15     (1) the legal authority to provide public welfare under 
206.16  sections 393.01, subdivision 7; and 393.07; or a federally 
206.17  recognized Indian tribe; 
206.18     (2) the demonstrated capacity and experience to provide the 
206.19  components of case management to coordinate and link community 
206.20  resources needed by the eligible population; 
206.21     (3) the administrative capacity and experience to serve the 
206.22  target population for whom it will provide services and ensure 
206.23  quality of services under state and federal requirements; 
206.24     (4) the legal authority to provide complete investigative 
206.25  and protective services under section 626.556, subdivision 10; 
206.26  and child welfare and foster care services under section 393.07, 
206.27  subdivisions 1 and 2; or a federally recognized Indian tribe; 
206.28     (5) a financial management system that provides accurate 
206.29  documentation of services and costs under state and federal 
206.30  requirements; and 
206.31     (6) the capacity to document and maintain individual case 
206.32  records under state and federal requirements. 
206.33     (b) A provider of targeted case management under section 
206.34  256B.0625, subdivision 20, may be deemed a certified provider of 
206.35  relocation targeted case management. 
206.36     (c) A relocation targeted case management provider may 
207.1   subcontract with another provider to deliver relocation targeted 
207.2   case management services.  Subcontracted providers must 
207.3   demonstrate the ability to provide the services outlined in 
207.4   subdivision 6, and have a procedure in place that notifies the 
207.5   recipient and the recipient's legal representative of any 
207.6   conflict of interest if the contracted targeted case management 
207.7   provider also provides, or will provide, the recipient's 
207.8   services and supports.  Contracted providers must provide 
207.9   information on all conflicts of interest and obtain the 
207.10  recipient's informed consent or provide the recipient with 
207.11  alternatives.  
207.12     Sec. 18.  Minnesota Statutes 2002, section 256B.0621, 
207.13  subdivision 7, is amended to read: 
207.14     Subd. 7.  [TIME LINES.] The following time lines must be 
207.15  met for assigning a case manager: 
207.16     ~~(1)~~ (a) For relocation targeted case management, an 
207.17  eligible recipient must be assigned a case manager who visits 
207.18  the person within 20 working days of requesting a case manager 
207.19  from their county of financial responsibility as determined 
207.20  under chapter 256G.  
207.21     (1) If a county agency, its contractor, or federally 
207.22  recognized tribe does not provide case management services as 
207.23  required, the recipient may~~, after written notice to the county~~ 
207.24  ~~agency,~~ obtain targeted relocation case management services from 
207.25  ~~a home care targeted case management provider, as defined in~~ 
207.26  ~~subdivision 5; and~~ an alternative provider of targeted case 
207.27  management services enrolled by the commissioner. 
207.28     (2) The commissioner may waive the provider requirements in 
207.29  subdivision 4, paragraph (a), clauses (1) and (4), to ensure 
207.30  recipient access to the assistance necessary to move from an 
207.31  institution to the community.  The recipient or the recipient's 
207.32  legal guardian shall provide written notice to the county or 
207.33  tribe of the decision to obtain services from an alternative 
207.34  provider. 
207.35     (3) Providers of relocation targeted case management 
207.36  enrolled under this subdivision shall: 
208.1      (i) meet the provider requirements under subdivision 4 that 
208.2   are not waived by the commissioner; 
208.3      (ii) be qualified to provide the services specified in 
208.4   subdivision 6; 
208.5      (iii) coordinate efforts with local social service agencies 
208.6   and tribes; and 
208.7      (iv) comply with the conflict of interest provisions 
208.8   established under subdivision 4, paragraph (c). 
208.9      (4) Local social service agencies and federally recognized 
208.10  tribes shall cooperate with providers certified by the 
208.11  commissioner under this subdivision to facilitate the 
208.12  recipient's successful relocation from an institution to the 
208.13  community. 
208.14     (b) For home care targeted case management, an eligible 
208.15  recipient must be assigned a case manager within 20 working days 
208.16  of requesting a case manager from a home care targeted case 
208.17  management provider, as defined in subdivision 5. 
208.18     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
208.19  following final enactment. 
208.20     Sec. 19.  [256B.0622] [INTENSIVE REHABILITATIVE MENTAL 
208.21  HEALTH SERVICES.] 
208.22     Subdivision 1.  [SCOPE.] Subject to federal approval, 
208.23  medical assistance covers medically necessary, intensive 
208.24  nonresidential and residential rehabilitative mental health 
208.25  services as defined in subdivision 2, for recipients as defined 
208.26  in subdivision 3, when the services are provided by an entity 
208.27  meeting the standards in this section. 
208.28     Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
208.29  following terms have the meanings given them.  
208.30     (a) "Intensive nonresidential rehabilitative mental health 
208.31  services" means adult rehabilitative mental health services as 
208.32  defined in section 256B.0623, subdivision 2, paragraph (a), 
208.33  except that these services are provided by a multidisciplinary 
208.34  staff using a total team approach consistent with assertive 
208.35  community treatment, the Fairweather Lodge treatment model, and 
208.36  other evidence-based practices, and directed to recipients with 
209.1   a serious mental illness who require intensive services. 
209.2      (b) "Intensive residential rehabilitative mental health 
209.3   services" means short-term, time-limited services provided in a 
209.4   residential setting to recipients who are in need of more 
209.5   restrictive settings and are at risk of significant functional 
209.6   deterioration if they do not receive these services.  Services 
209.7   are designed to develop and enhance psychiatric stability, 
209.8   personal and emotional adjustment, self-sufficiency, and skills 
209.9   to live in a more independent setting.  Services must be 
209.10  directed toward a targeted discharge date with specified client 
209.11  outcomes and must be consistent with evidence-based practices. 
209.12     (c) "Evidence-based practices" are nationally recognized 
209.13  mental health services that are proven by substantial research 
209.14  to be effective in helping individuals with serious mental 
209.15  illness obtain specific treatment goals. 
209.16     (d) "Overnight staff" means a member of the intensive 
209.17  residential rehabilitative mental health treatment team who is 
209.18  responsible during hours when recipients are typically asleep. 
209.19     (e) "Treatment team" means all staff who provide services 
209.20  under this section to recipients.  At a minimum, this includes 
209.21  the clinical supervisor, mental health professionals, mental 
209.22  health practitioners, and mental health rehabilitation workers. 
209.23     Subd. 3.  [ELIGIBILITY.] An eligible recipient is an 
209.24  individual who: 
209.25     (1) is age 18 or older; 
209.26     (2) is eligible for medical assistance; 
209.27     (3) is diagnosed with a mental illness; 
209.28     (4) because of a mental illness, has substantial disability 
209.29  and functional impairment in three or more of the areas listed 
209.30  in section 245.462, subdivision 11a, so that self-sufficiency is 
209.31  markedly reduced; 
209.32     (5) has one or more of the following:  a history of two or 
209.33  more inpatient hospitalizations in the past year, significant 
209.34  independent living instability, homelessness, or very frequent 
209.35  use of mental health and related services yielding poor 
209.36  outcomes; and 
210.1      (6) in the written opinion of a licensed mental health 
210.2   professional, has the need for mental health services that 
210.3   cannot be met with other available community-based services, or 
210.4   is likely to experience a mental health crisis or require a more 
210.5   restrictive setting if intensive rehabilitative mental health 
210.6   services are not provided. 
210.7      Subd. 4.  [PROVIDER CERTIFICATION AND CONTRACT 
210.8   REQUIREMENTS.] (a) The intensive nonresidential rehabilitative 
210.9   mental health services provider must: 
210.10     (1) have a contract with the host county to provide 
210.11  intensive adult rehabilitative mental health services; and 
210.12     (2) be certified by the commissioner as being in compliance 
210.13  with this section and section 256B.0623. 
210.14     (b) The intensive residential rehabilitative mental health 
210.15  services provider must: 
210.16     (1) be licensed under Minnesota Rules, parts 9520.0500 to 
210.17  9520.0670; 
210.18     (2) not exceed 16 beds per site; 
210.19     (3) comply with the additional standards in this section; 
210.20  and 
210.21     (4) have a contract with the host county to provide these 
210.22  services. 
210.23     (c) The commissioner shall develop procedures for counties 
210.24  and providers to submit contracts and other documentation as 
210.25  needed to allow the commissioner to determine whether the 
210.26  standards in this section are met. 
210.27     Subd. 5.  [STANDARDS APPLICABLE TO BOTH NONRESIDENTIAL AND 
210.28  RESIDENTIAL PROVIDERS.] (a) Services must be provided by 
210.29  qualified staff as defined in section 256B.0623, subdivision 5, 
210.30  who are trained and supervised according to section 256B.0623, 
210.31  subdivision 6, except that mental health rehabilitation workers 
210.32  acting as overnight staff are not required to comply with 
210.33  section 256B.0623, subdivision 5, clause (3)(iv). 
210.34     (b) The clinical supervisor must be an active member of the 
210.35  treatment team.  The treatment team must meet with the clinical 
210.36  supervisor at least weekly to discuss recipients' progress and 
211.1   make rapid adjustments to meet recipients' needs.  The team 
211.2   meeting shall include recipient-specific case reviews and 
211.3   general treatment discussions among team members.  
211.4   Recipient-specific case reviews and planning must be documented 
211.5   in the individual recipient's treatment record. 
211.6      (c) Treatment staff must have prompt access in person or by 
211.7   telephone to a mental health practitioner or mental health 
211.8   professional.  The provider must have the capacity to promptly 
211.9   and appropriately respond to emergent needs and make any 
211.10  necessary staffing adjustments to assure the health and safety 
211.11  of recipients. 
211.12     (d) The initial functional assessment must be completed 
211.13  within ten days of intake and updated at least every three 
211.14  months or prior to discharge from the service, whichever comes 
211.15  first. 
211.16     (e) The initial individual treatment plan must be completed 
211.17  within ten days of intake and reviewed and updated at least 
211.18  monthly with the recipient.  
211.19     Subd. 6.  [ADDITIONAL STANDARDS APPLICABLE ONLY TO 
211.20  INTENSIVE RESIDENTIAL REHABILITATIVE MENTAL HEALTH 
211.21  SERVICES.] (a) The provider of intensive residential services 
211.22  must have sufficient staff to provide 24 hour per day coverage 
211.23  to deliver the rehabilitative services described in the 
211.24  treatment plan and to safely supervise and direct the activities 
211.25  of recipients given the recipient's level of behavioral and 
211.26  psychiatric stability, cultural needs, and vulnerability.  The 
211.27  provider must have the capacity within the facility to provide 
211.28  integrated services for chemical dependency, illness management 
211.29  services, and family education when appropriate. 
211.30     (b) At a minimum: 
211.31     (1) staff must be available and provide direction and 
211.32  supervision whenever recipients are present in the facility; 
211.33     (2) staff must remain awake during all work hours; 
211.34     (3) there must be a staffing ratio of at least one to nine 
211.35  recipients for each day and evening shift.  If more than nine 
211.36  recipients are present at the residential site, there must be a 
212.1   minimum of two staff during day and evening shifts, one of whom 
212.2   must be a mental health practitioner or mental health 
212.3   professional; 
212.4      (4) if services are provided to recipients who need the 
212.5   services of a medical professional, the provider shall assure 
212.6   that these services are provided either by the provider's own 
212.7   medical staff or through referral to a medical professional; and 
212.8      (5) the provider must assure the timely availability of a 
212.9   licensed registered nurse, either directly employed or under 
212.10  contract, who is responsible for ensuring the effectiveness and 
212.11  safety of medication administration in the facility and 
212.12  assessing patients for medication side effects and drug 
212.13  interactions. 
212.14     Subd. 7.  [ADDITIONAL STANDARDS FOR NONRESIDENTIAL 
212.15  SERVICES.] The standards in this subdivision apply to intensive 
212.16  nonresidential rehabilitative mental health services. 
212.17     (1) The treatment team must use team treatment, not an 
212.18  individual treatment model. 
212.19     (2) The clinical supervisor must function as a practicing 
212.20  clinician at least on a part-time basis. 
212.21     (3) The staffing ratio must not exceed ten recipients to 
212.22  one full-time equivalent treatment team position. 
212.23     (4) Services must be available at times that meet client 
212.24  needs.  
212.25     (5) The treatment team must actively and assertively engage 
212.26  and reach out to the recipient's family members and significant 
212.27  others, after obtaining the recipient's permission.  
212.28     (6) The treatment team must establish ongoing communication 
212.29  and collaboration between the team, family, and significant 
212.30  others and educate the family and significant others about 
212.31  mental illness, symptom management, and the family's role in 
212.32  treatment. 
212.33     (7) The treatment team must provide interventions to 
212.34  promote positive interpersonal relationships. 
212.35     Subd. 8.  [MEDICAL ASSISTANCE PAYMENT FOR INTENSIVE 
212.36  REHABILITATIVE MENTAL HEALTH SERVICES.] (a) Payment for 
213.1   residential and nonresidential services in this section shall be 
213.2   based on one daily rate per provider inclusive of the following 
213.3   services received by an eligible recipient in a given calendar 
213.4   day:  all rehabilitative services under this section and crisis 
213.5   stabilization services under section 256B.0624. 
213.6      (b) Except as indicated in paragraph (c), payment will not 
213.7   be made to more than one entity for each recipient for services 
213.8   provided under this section on a given day.  If services under 
213.9   this section are provided by a team that includes staff from 
213.10  more than one entity, the team must determine how to distribute 
213.11  the payment among the members. 
213.12     (c) The host county shall recommend to the commissioner one 
213.13  rate for each entity that will bill medical assistance for 
213.14  residential services under this section and two rates for each 
213.15  nonresidential provider.  The first nonresidential rate is for 
213.16  recipients who are not receiving residential services.  The 
213.17  second nonresidential rate is for recipients who are temporarily 
213.18  receiving residential services and need continued contact with 
213.19  the nonresidential team to assure timely discharge from 
213.20  residential services.  In developing these rates, the host 
213.21  county shall consider and document: 
213.22     (1) the cost for similar services in the local trade area; 
213.23     (2) actual costs incurred by entities providing the 
213.24  services; 
213.25     (3) the intensity and frequency of services to be provided 
213.26  to each recipient; 
213.27     (4) the degree to which recipients will receive services 
213.28  other than services under this section; 
213.29     (5) the costs of other services, such as case management, 
213.30  that will be separately reimbursed; and 
213.31     (6) input from the local planning process authorized by the 
213.32  adult mental health initiative under section 245.4661, regarding 
213.33  recipients' service needs. 
213.34     (d) The rate for intensive rehabilitative mental health 
213.35  services must exclude room and board, as defined in section 
213.36  256I.03, subdivision 6, and services not covered under this 
214.1   section, such as case management, partial hospitalization, home 
214.2   care, and inpatient services.  Physician services that are not 
214.3   separately billed may be included in the rate to the extent that 
214.4   a psychiatrist is a member of the treatment team.  The county's 
214.5   recommendation shall specify the period for which the rate will 
214.6   be applicable, not to exceed two years. 
214.7      (e) When services under this section are provided by an 
214.8   assertive community team, case management functions must be an 
214.9   integral part of the team.  The county must allocate costs which 
214.10  are reimbursable under this section versus costs which are 
214.11  reimbursable through case management or other reimbursement, so 
214.12  that payment is not duplicated. 
214.13     (f) The rate for a provider must not exceed the rate 
214.14  charged by that provider for the same service to other payors. 
214.15     (g) The commissioner shall approve or reject the county's 
214.16  rate recommendation, based on the commissioner's own analysis of 
214.17  the criteria in paragraph (c). 
214.18     Subd. 9.  [PROVIDER ENROLLMENT; RATE SETTING FOR 
214.19  COUNTY-OPERATED ENTITIES.] Counties that employ their own staff 
214.20  to provide services under this section shall apply directly to 
214.21  the commissioner for enrollment and rate setting.  In this case, 
214.22  a county contract is not required and the commissioner shall 
214.23  perform the program review and rate setting duties which would 
214.24  otherwise be required of counties under this section. 
214.25     Subd. 10.  [PROVIDER ENROLLMENT; RATE SETTING FOR 
214.26  SPECIALIZED PROGRAM.] A provider proposing to serve a 
214.27  subpopulation of eligible recipients may bypass the county 
214.28  approval procedures in this section and receive approval for 
214.29  provider enrollment and rate setting directly from the 
214.30  commissioner under the following circumstances: 
214.31     (1) the provider demonstrates that the subpopulation to be 
214.32  served requires a specialized program which is not available 
214.33  from county-approved entities; and 
214.34     (2) the subpopulation to be served is of such a low 
214.35  incidence that it is not feasible to develop a program serving a 
214.36  single county or regional group of counties. 
215.1      For providers meeting the criteria in clauses (1) and (2), 
215.2   the commissioner shall perform the program review and rate 
215.3   setting duties which would otherwise be required of counties 
215.4   under this section. 
215.5      Sec. 20.  Minnesota Statutes 2002, section 256B.0623, 
215.6   subdivision 2, is amended to read: 
215.7      Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
215.8   following terms have the meanings given them. 
215.9      (a) "Adult rehabilitative mental health services" means 
215.10  mental health services which are rehabilitative and enable the 
215.11  recipient to develop and enhance psychiatric stability, social 
215.12  competencies, personal and emotional adjustment, and independent 
215.13  living and community skills, when these abilities are impaired 
215.14  by the symptoms of mental illness.  Adult rehabilitative mental 
215.15  health services are also appropriate when provided to enable a 
215.16  recipient to retain stability and functioning, if the recipient 
215.17  would be at risk of significant functional decompensation or 
215.18  more restrictive service settings without these services. 
215.19     (1) Adult rehabilitative mental health services instruct, 
215.20  assist, and support the recipient in areas such as:  
215.21  interpersonal communication skills, community resource 
215.22  utilization and integration skills, crisis assistance, relapse 
215.23  prevention skills, health care directives, budgeting and 
215.24  shopping skills, healthy lifestyle skills and practices, cooking 
215.25  and nutrition skills, transportation skills, medication 
215.26  education and monitoring, mental illness symptom management 
215.27  skills, household management skills, employment-related skills, 
215.28  and transition to community living services. 
215.29     (2) These services shall be provided to the recipient on a 
215.30  one-to-one basis in the recipient's home or another community 
215.31  setting or in groups. 
215.32     (b) "Medication education services" means services provided 
215.33  individually or in groups which focus on educating the recipient 
215.34  about mental illness and symptoms; the role and effects of 
215.35  medications in treating symptoms of mental illness; and the side 
215.36  effects of medications.  Medication education is coordinated 
216.1   with medication management services and does not duplicate it.  
216.2   Medication education services are provided by physicians, 
216.3   pharmacists, physician's assistants, or registered nurses. 
216.4      (c) "Transition to community living services" means 
216.5   services which maintain continuity of contact between the 
216.6   rehabilitation services provider and the recipient and which 
216.7   facilitate discharge from a hospital, residential treatment 
216.8   program under Minnesota Rules, chapter 9505, board and lodging 
216.9   facility, or nursing home.  Transition to community living 
216.10  services are not intended to provide other areas of adult 
216.11  rehabilitative mental health services.  
216.12     Sec. 21.  Minnesota Statutes 2002, section 256B.0623, 
216.13  subdivision 4, is amended to read: 
216.14     Subd. 4.  [PROVIDER ENTITY STANDARDS.] (a) The provider 
216.15  entity must be~~:~~ 
216.16     ~~(1) a county operated entity certified by the state; or~~ 
216.17     ~~(2) a noncounty entity certified by the entity's host~~ 
216.18  ~~county~~ certified by the state following the certification 
216.19  process and procedures developed by the commissioner. 
216.20     (b) The certification process is a determination as to 
216.21  whether the entity meets the standards in this subdivision.  The 
216.22  certification must specify which adult rehabilitative mental 
216.23  health services the entity is qualified to provide. 
216.24     (c) ~~If an entity seeks to provide services outside its host~~ 
216.25  ~~county, it~~ A noncounty provider entity must obtain additional 
216.26  certification from each county in which it will provide 
216.27  services.  The additional certification must be based on the 
216.28  adequacy of the entity's knowledge of that county's local health 
216.29  and human service system, and the ability of the entity to 
216.30  coordinate its services with the other services available in 
216.31  that county.  A county-operated entity must obtain this 
216.32  additional certification from any other county in which it will 
216.33  provide services. 
216.34     (d) Recertification must occur at least every ~~two~~ three 
216.35  years. 
216.36     (e) The commissioner may intervene at any time and 
217.1   decertify providers with cause.  The decertification is subject 
217.2   to appeal to the state.  A county board may recommend that the 
217.3   state decertify a provider for cause. 
217.4      (f) The adult rehabilitative mental health services 
217.5   provider entity must meet the following standards: 
217.6      (1) have capacity to recruit, hire, manage, and train 
217.7   mental health professionals, mental health practitioners, and 
217.8   mental health rehabilitation workers; 
217.9      (2) have adequate administrative ability to ensure 
217.10  availability of services; 
217.11     (3) ensure adequate preservice and inservice and ongoing 
217.12  training for staff; 
217.13     (4) ensure that mental health professionals, mental health 
217.14  practitioners, and mental health rehabilitation workers are 
217.15  skilled in the delivery of the specific adult rehabilitative 
217.16  mental health services provided to the individual eligible 
217.17  recipient; 
217.18     (5) ensure that staff is capable of implementing culturally 
217.19  specific services that are culturally competent and appropriate 
217.20  as determined by the recipient's culture, beliefs, values, and 
217.21  language as identified in the individual treatment plan; 
217.22     (6) ensure enough flexibility in service delivery to 
217.23  respond to the changing and intermittent care needs of a 
217.24  recipient as identified by the recipient and the individual 
217.25  treatment plan; 
217.26     (7) ensure that the mental health professional or mental 
217.27  health practitioner, who is under the clinical supervision of a 
217.28  mental health professional, involved in a recipient's services 
217.29  participates in the development of the individual treatment 
217.30  plan; 
217.31     (8) assist the recipient in arranging needed crisis 
217.32  assessment, intervention, and stabilization services; 
217.33     (9) ensure that services are coordinated with other 
217.34  recipient mental health services providers and the county mental 
217.35  health authority and the federally recognized American Indian 
217.36  authority and necessary others after obtaining the consent of 
218.1   the recipient.  Services must also be coordinated with the 
218.2   recipient's case manager or care coordinator if the recipient is 
218.3   receiving case management or care coordination services; 
218.4      (10) develop and maintain recipient files, individual 
218.5   treatment plans, and contact charting; 
218.6      (11) develop and maintain staff training and personnel 
218.7   files; 
218.8      (12) submit information as required by the state; 
218.9      (13) establish and maintain a quality assurance plan to 
218.10  evaluate the outcome of services provided; 
218.11     (14) keep all necessary records required by law; 
218.12     (15) deliver services as required by section 245.461; 
218.13     (16) comply with all applicable laws; 
218.14     (17) be an enrolled Medicaid provider; 
218.15     (18) maintain a quality assurance plan to determine 
218.16  specific service outcomes and the recipient's satisfaction with 
218.17  services; and 
218.18     (19) develop and maintain written policies and procedures 
218.19  regarding service provision and administration of the provider 
218.20  entity. 
218.21     ~~(g) The commissioner shall develop statewide procedures for~~ 
218.22  ~~provider certification, including timelines for counties to~~ 
218.23  ~~certify qualified providers.~~ 
218.24     Sec. 22.  Minnesota Statutes 2002, section 256B.0623, 
218.25  subdivision 5, is amended to read: 
218.26     Subd. 5.  [QUALIFICATIONS OF PROVIDER STAFF.] Adult 
218.27  rehabilitative mental health services must be provided by 
218.28  qualified individual provider staff of a certified provider 
218.29  entity.  Individual provider staff must be qualified under one 
218.30  of the following criteria: 
218.31     (1) a mental health professional as defined in section 
218.32  245.462, subdivision 18, clauses (1) to (5).  If the recipient 
218.33  has a current diagnostic assessment by a licensed mental health 
218.34  professional as defined in section 245.462, subdivision 18, 
218.35  clauses (1) to (5), recommending receipt of adult mental health 
218.36  rehabilitative services, the definition of mental health 
219.1   professional for purposes of this section includes a person who 
219.2   is qualified under section 245.462, subdivision 18, clause (6), 
219.3   and who holds a current and valid national certification as a 
219.4   certified rehabilitation counselor or certified psychosocial 
219.5   rehabilitation practitioner; 
219.6      (2) a mental health practitioner as defined in section 
219.7   245.462, subdivision 17.  The mental health practitioner must 
219.8   work under the clinical supervision of a mental health 
219.9   professional; or 
219.10     (3) a mental health rehabilitation worker.  A mental health 
219.11  rehabilitation worker means a staff person working under the 
219.12  direction of a mental health practitioner or mental health 
219.13  professional and under the clinical supervision of a mental 
219.14  health professional in the implementation of rehabilitative 
219.15  mental health services as identified in the recipient's 
219.16  individual treatment plan who: 
219.17     (i) is at least 21 years of age; 
219.18     (ii) has a high school diploma or equivalent; 
219.19     (iii) has successfully completed 30 hours of training 
219.20  during the past two years in all of the following areas:  
219.21  recipient rights, recipient-centered individual treatment 
219.22  planning, behavioral terminology, mental illness, co-occurring 
219.23  mental illness and substance abuse, psychotropic medications and 
219.24  side effects, functional assessment, local community resources, 
219.25  adult vulnerability, recipient confidentiality; and 
219.26     (iv) meets the qualifications in subitem (A) or (B): 
219.27     (A) has an associate of arts degree in one of the 
219.28  behavioral sciences or human services, or is a registered nurse 
219.29  without a bachelor's degree, or who within the previous ten 
219.30  years has:  
219.31     (1) three years of personal life experience with serious 
219.32  and persistent mental illness; 
219.33     (2) three years of life experience as a primary caregiver 
219.34  to an adult with a serious mental illness or traumatic brain 
219.35  injury; or 
219.36     (3) 4,000 hours of supervised paid work experience in the 
220.1   delivery of mental health services to adults with a serious 
220.2   mental illness or traumatic brain injury; or 
220.3      (B)(1) is fluent in the non-English language or competent 
220.4   in the culture of the ethnic group to which at least ~~50~~ 20 
220.5   percent of the mental health rehabilitation worker's clients 
220.6   belong; 
220.7      (2) receives during the first 2,000 hours of work, monthly 
220.8   documented individual clinical supervision by a mental health 
220.9   professional; 
220.10     (3) has 18 hours of documented field supervision by a 
220.11  mental health professional or practitioner during the first 160 
220.12  hours of contact work with recipients, and at least six hours of 
220.13  field supervision quarterly during the following year; 
220.14     (4) has review and cosignature of charting of recipient 
220.15  contacts during field supervision by a mental health 
220.16  professional or practitioner; and 
220.17     (5) has 40 hours of additional continuing education on 
220.18  mental health topics during the first year of employment. 
220.19     Sec. 23.  Minnesota Statutes 2002, section 256B.0623, 
220.20  subdivision 6, is amended to read: 
220.21     Subd. 6.  [REQUIRED TRAINING AND SUPERVISION.] (a) Mental 
220.22  health rehabilitation workers must receive ongoing continuing 
220.23  education training of at least 30 hours every two years in areas 
220.24  of mental illness and mental health services and other areas 
220.25  specific to the population being served.  Mental health 
220.26  rehabilitation workers must also be subject to the ongoing 
220.27  direction and clinical supervision standards in paragraphs (c) 
220.28  and (d). 
220.29     (b) Mental health practitioners must receive ongoing 
220.30  continuing education training as required by their professional 
220.31  license; or if the practitioner is not licensed, the 
220.32  practitioner must receive ongoing continuing education training 
220.33  of at least 30 hours every two years in areas of mental illness 
220.34  and mental health services.  Mental health practitioners must 
220.35  meet the ongoing clinical supervision standards in paragraph (c).
220.36     (c) Clinical supervision may be provided by a full- or 
221.1   part-time qualified professional employed by or under contract 
221.2   with the provider entity.  Clinical supervision may be provided 
221.3   by interactive videoconferencing according to procedures 
221.4   developed by the commissioner.  A mental health professional 
221.5   providing clinical supervision of staff delivering adult 
221.6   rehabilitative mental health services must provide the following 
221.7   guidance: 
221.8      (1) review the information in the recipient's file; 
221.9      (2) review and approve initial and updates of individual 
221.10  treatment plans; 
221.11     (3) meet with mental health rehabilitation workers and 
221.12  practitioners, individually or in small groups, at least monthly 
221.13  to discuss treatment topics of interest to the workers and 
221.14  practitioners; 
221.15     (4) meet with mental health rehabilitation workers and 
221.16  practitioners, individually or in small groups, at least monthly 
221.17  to discuss treatment plans of recipients, and approve by 
221.18  signature and document in the recipient's file any resulting 
221.19  plan updates; 
221.20     (5) meet at least ~~twice a month~~ monthly with the directing 
221.21  mental health practitioner, if there is one, to review needs of 
221.22  the adult rehabilitative mental health services program, review 
221.23  staff on-site observations and evaluate mental health 
221.24  rehabilitation workers, plan staff training, review program 
221.25  evaluation and development, and consult with the directing 
221.26  practitioner; and 
221.27     (6) be available for urgent consultation as the individual 
221.28  recipient needs or the situation necessitates~~; and~~ 
221.29     ~~(7) provide clinical supervision by full- or part-time~~ 
221.30  ~~mental health professionals employed by or under contract with~~ 
221.31  ~~the provider entity~~. 
221.32     (d) An adult rehabilitative mental health services provider 
221.33  entity must have a treatment director who is a mental health 
221.34  practitioner or mental health professional.  The treatment 
221.35  director must ensure the following: 
221.36     (1) while delivering direct services to recipients, a newly 
222.1   hired mental health rehabilitation worker must be directly 
222.2   observed delivering services to recipients by ~~the~~ a mental 
222.3   health practitioner or mental health professional for at least 
222.4   six hours per 40 hours worked during the first 160 hours that 
222.5   the mental health rehabilitation worker works; 
222.6      (2) the mental health rehabilitation worker must receive 
222.7   ongoing on-site direct service observation by a mental health 
222.8   professional or mental health practitioner for at least six 
222.9   hours for every six months of employment; 
222.10     (3) progress notes are reviewed from on-site service 
222.11  observation prepared by the mental health rehabilitation worker 
222.12  and mental health practitioner for accuracy and consistency with 
222.13  actual recipient contact and the individual treatment plan and 
222.14  goals; 
222.15     (4) immediate availability by phone or in person for 
222.16  consultation by a mental health professional or a mental health 
222.17  practitioner to the mental health rehabilitation services worker 
222.18  during service provision; 
222.19     (5) oversee the identification of changes in individual 
222.20  recipient treatment strategies, revise the plan, and communicate 
222.21  treatment instructions and methodologies as appropriate to 
222.22  ensure that treatment is implemented correctly; 
222.23     (6) model service practices which:  respect the recipient, 
222.24  include the recipient in planning and implementation of the 
222.25  individual treatment plan, recognize the recipient's strengths, 
222.26  collaborate and coordinate with other involved parties and 
222.27  providers; 
222.28     (7) ensure that mental health practitioners and mental 
222.29  health rehabilitation workers are able to effectively 
222.30  communicate with the recipients, significant others, and 
222.31  providers; and 
222.32     (8) oversee the record of the results of on-site 
222.33  observation and charting evaluation and corrective actions taken 
222.34  to modify the work of the mental health practitioners and mental 
222.35  health rehabilitation workers. 
222.36     (e) A mental health practitioner who is providing treatment 
223.1   direction for a provider entity must receive supervision at 
223.2   least monthly from a mental health professional to: 
223.3      (1) identify and plan for general needs of the recipient 
223.4   population served; 
223.5      (2) identify and plan to address provider entity program 
223.6   needs and effectiveness; 
223.7      (3) identify and plan provider entity staff training and 
223.8   personnel needs and issues; and 
223.9      (4) plan, implement, and evaluate provider entity quality 
223.10  improvement programs.  
223.11     Sec. 24.  Minnesota Statutes 2002, section 256B.0623, 
223.12  subdivision 8, is amended to read: 
223.13     Subd. 8.  [DIAGNOSTIC ASSESSMENT.] Providers of adult 
223.14  rehabilitative mental health services must complete a diagnostic 
223.15  assessment as defined in section 245.462, subdivision 9, within 
223.16  five days after the recipient's second visit or within 30 days 
223.17  after intake, whichever occurs first.  In cases where a 
223.18  diagnostic assessment is available that reflects the recipient's 
223.19  current status, and has been completed within 180 days preceding 
223.20  admission, an update must be completed.  An update shall include 
223.21  a written summary by a mental health professional of the 
223.22  recipient's current mental health status and service needs.  If 
223.23  the recipient's mental health status has changed significantly 
223.24  since the adult's most recent diagnostic assessment, a new 
223.25  diagnostic assessment is required.  For initial implementation 
223.26  of adult rehabilitative mental health services, until June 30, 
223.27  2005, a diagnostic assessment that reflects the recipient's 
223.28  current status and has been completed within the past three 
223.29  years preceding admission is acceptable. 
223.30     Sec. 25.  Minnesota Statutes 2002, section 256B.0625, 
223.31  subdivision 19c, is amended to read: 
223.32     Subd. 19c.  [PERSONAL CARE.] Medical assistance covers 
223.33  personal care assistant services provided by an individual who 
223.34  is qualified to provide the services according to subdivision 
223.35  19a and section 256B.0627, where the services are prescribed by 
223.36  a physician in accordance with a plan of treatment and are 
224.1   supervised by the recipient or a qualified professional.  
224.2   "Qualified professional" means a mental health professional as 
224.3   defined in section 245.462, subdivision 18, or 245.4871, 
224.4   subdivision 27; or a registered nurse as defined in sections 
224.5   148.171 to 148.285, or a licensed social worker as defined in 
224.6   section 148B.21.  As part of the assessment, the county public 
224.7   health nurse will assist the recipient or responsible party to 
224.8   identify the most appropriate person to provide supervision of 
224.9   the personal care assistant.  The qualified professional shall 
224.10  perform the duties described in Minnesota Rules, part 9505.0335, 
224.11  subpart 4.  
224.12     Sec. 26.  Minnesota Statutes 2002, section 256B.0627, 
224.13  subdivision 1, is amended to read: 
224.14     Subdivision 1.  [DEFINITION.] (a) "Activities of daily 
224.15  living" includes eating, toileting, grooming, dressing, bathing, 
224.16  transferring, mobility, and positioning.  
224.17     (b) "Assessment" means a review and evaluation of a 
224.18  recipient's need for home care services conducted in person.  
224.19  Assessments for private duty nursing shall be conducted by a 
224.20  registered private duty nurse.  Assessments for home health 
224.21  agency services shall be conducted by a home health agency 
224.22  nurse.  Assessments for personal care assistant services shall 
224.23  be conducted by the county public health nurse or a certified 
224.24  public health nurse under contract with the county.  A 
224.25  face-to-face assessment must include:  documentation of health 
224.26  status, determination of need, evaluation of service 
224.27  effectiveness, identification of appropriate services, service 
224.28  plan development or modification, coordination of services, 
224.29  referrals and follow-up to appropriate payers and community 
224.30  resources, completion of required reports, recommendation of 
224.31  service authorization, and consumer education.  Once the need 
224.32  for personal care assistant services is determined under this 
224.33  section, the county public health nurse or certified public 
224.34  health nurse under contract with the county is responsible for 
224.35  communicating this recommendation to the commissioner and the 
224.36  recipient.  A face-to-face assessment for personal care 
225.1   assistant services is conducted on those recipients who have 
225.2   never had a county public health nurse assessment.  A 
225.3   face-to-face assessment must occur at least annually or when 
225.4   there is a significant change in the recipient's condition or 
225.5   when there is a change in the need for personal care assistant 
225.6   services.  A service update may substitute for the annual 
225.7   face-to-face assessment when there is not a significant change 
225.8   in recipient condition or a change in the need for personal care 
225.9   assistant service.  A service update or review for temporary 
225.10  increase includes a review of initial baseline data, evaluation 
225.11  of service effectiveness, redetermination of service need, 
225.12  modification of service plan and appropriate referrals, update 
225.13  of initial forms, obtaining service authorization, and on going 
225.14  consumer education.  Assessments for medical assistance home 
225.15  care services for mental retardation or related conditions and 
225.16  alternative care services for developmentally disabled home and 
225.17  community-based waivered recipients may be conducted by the 
225.18  county public health nurse to ensure coordination and avoid 
225.19  duplication.  Assessments must be completed on forms provided by 
225.20  the commissioner within 30 days of a request for home care 
225.21  services by a recipient or responsible party. 
225.22     (c) "Care plan" means a written description of personal 
225.23  care assistant services developed by the qualified professional 
225.24  or the recipient's physician with the recipient or responsible 
225.25  party to be used by the personal care assistant with a copy 
225.26  provided to the recipient or responsible party. 
225.27     (d) "Complex and regular private duty nursing care" means: 
225.28     (1) complex care is private duty nursing provided to 
225.29  recipients who are ventilator dependent or for whom a physician 
225.30  has certified that were it not for private duty nursing the 
225.31  recipient would meet the criteria for inpatient hospital 
225.32  intensive care unit (ICU) level of care; and 
225.33     (2) regular care is private duty nursing provided to all 
225.34  other recipients. 
225.35     (e) "Health-related functions" means functions that can be 
225.36  delegated or assigned by a licensed health care professional 
226.1   under state law to be performed by a personal care attendant. 
226.2      (f) "Home care services" means a health service, determined 
226.3   by the commissioner as medically necessary, that is ordered by a 
226.4   physician and documented in a service plan that is reviewed by 
226.5   the physician at least once every 60 days for the provision of 
226.6   home health services, or private duty nursing, or at least once 
226.7   every 365 days for personal care.  Home care services are 
226.8   provided to the recipient at the recipient's residence that is a 
226.9   place other than a hospital or long-term care facility or as 
226.10  specified in section 256B.0625.  
226.11     (g) "Instrumental activities of daily living" includes meal 
226.12  planning and preparation, managing finances, shopping for food, 
226.13  clothing, and other essential items, performing essential 
226.14  household chores, communication by telephone and other media, 
226.15  and getting around and participating in the community. 
226.16     (h) "Medically necessary" has the meaning given in 
226.17  Minnesota Rules, parts 9505.0170 to 9505.0475.  
226.18     (i) "Personal care assistant" means a person who:  
226.19     (1) is at least 18 years old, except for persons 16 to 18 
226.20  years of age who participated in a related school-based job 
226.21  training program or have completed a certified home health aide 
226.22  competency evaluation; 
226.23     (2) is able to effectively communicate with the recipient 
226.24  and personal care provider organization; 
226.25     (3) effective July 1, 1996, has completed one of the 
226.26  training requirements as specified in Minnesota Rules, part 
226.27  9505.0335, subpart 3, items A to D; 
226.28     (4) has the ability to, and provides covered personal care 
226.29  assistant services according to the recipient's care plan, 
226.30  responds appropriately to recipient needs, and reports changes 
226.31  in the recipient's condition to the supervising qualified 
226.32  professional or physician; 
226.33     (5) is not a consumer of personal care assistant services; 
226.34  and 
226.35     (6) is subject to criminal background checks and procedures 
226.36  specified in section 245A.04.  
227.1      (j) "Personal care provider organization" means an 
227.2   organization enrolled to provide personal care assistant 
227.3   services under the medical assistance program that complies with 
227.4   the following:  (1) owners who have a five percent interest or 
227.5   more, and managerial officials are subject to a background study 
227.6   as provided in section 245A.04.  This applies to currently 
227.7   enrolled personal care provider organizations and those agencies 
227.8   seeking enrollment as a personal care provider organization.  An 
227.9   organization will be barred from enrollment if an owner or 
227.10  managerial official of the organization has been convicted of a 
227.11  crime specified in section 245A.04, or a comparable crime in 
227.12  another jurisdiction, unless the owner or managerial official 
227.13  meets the reconsideration criteria specified in section 245A.04; 
227.14  (2) the organization must maintain a surety bond and liability 
227.15  insurance throughout the duration of enrollment and provides 
227.16  proof thereof.  The insurer must notify the department of human 
227.17  services of the cancellation or lapse of policy; and (3) the 
227.18  organization must maintain documentation of services as 
227.19  specified in Minnesota Rules, part 9505.2175, subpart 7, as well 
227.20  as evidence of compliance with personal care assistant training 
227.21  requirements. 
227.22     (k) "Responsible party" means an individual ~~residing with a~~ 
227.23  ~~recipient of personal care assistant services~~ who is capable of 
227.24  providing the ~~supportive care~~ support necessary to assist the 
227.25  recipient to live in the community, is at least 18 years 
227.26  old, actively participates in planning and directing of personal 
227.27  care assistant services, and is not ~~a~~ the personal care 
227.28  assistant.  The responsible party must be accessible to the 
227.29  recipient and the personal care assistant when personal care 
227.30  services are being provided and monitor the services at least 
227.31  weekly according to the plan of care.  The responsible party 
227.32  must be identified at the time of assessment and listed on the 
227.33  recipient's service agreement and care plan.  Responsible 
227.34  parties ~~who are parents of minors or guardians of minors or~~ 
227.35  ~~incapacitated persons~~ may delegate the responsibility to another 
227.36  adult ~~during a temporary absence of at least 24 hours but not~~ 
228.1   ~~more than six months.  The person delegated as a responsible~~ 
228.2   ~~party must be able to meet the definition of responsible party,~~ 
228.3   ~~except that the delegated responsible party is required to~~ 
228.4   ~~reside with the recipient only while serving as the responsible~~ 
228.5   ~~party~~ who is not the personal care assistant.  The responsible 
228.6   party must assure that the delegate performs the functions of 
228.7   the responsible party, is identified at the time of the 
228.8   assessment, and is listed on the service agreement and the care 
228.9   plan.  Foster care license holders may be designated the 
228.10  responsible party for residents of the foster care home if case 
228.11  management is provided as required in section 256B.0625, 
228.12  subdivision 19a.  For persons who, as of April 1, 1992, are 
228.13  sharing personal care assistant services in order to obtain the 
228.14  availability of 24-hour coverage, an employee of the personal 
228.15  care provider organization may be designated as the responsible 
228.16  party if case management is provided as required in section 
228.17  256B.0625, subdivision 19a. 
228.18     (l) "Service plan" means a written description of the 
228.19  services needed based on the assessment developed by the nurse 
228.20  who conducts the assessment together with the recipient or 
228.21  responsible party.  The service plan shall include a description 
228.22  of the covered home care services, frequency and duration of 
228.23  services, and expected outcomes and goals.  The recipient and 
228.24  the provider chosen by the recipient or responsible party must 
228.25  be given a copy of the completed service plan within 30 calendar 
228.26  days of the request for home care services by the recipient or 
228.27  responsible party. 
228.28     (m) "Skilled nurse visits" are provided in a recipient's 
228.29  residence under a plan of care or service plan that specifies a 
228.30  level of care which the nurse is qualified to provide.  These 
228.31  services are: 
228.32     (1) nursing services according to the written plan of care 
228.33  or service plan and accepted standards of medical and nursing 
228.34  practice in accordance with chapter 148; 
228.35     (2) services which due to the recipient's medical condition 
228.36  may only be safely and effectively provided by a registered 
229.1   nurse or a licensed practical nurse; 
229.2      (3) assessments performed only by a registered nurse; and 
229.3      (4) teaching and training the recipient, the recipient's 
229.4   family, or other caregivers requiring the skills of a registered 
229.5   nurse or licensed practical nurse. 
229.6      (n) "Telehomecare" means the use of telecommunications 
229.7   technology by a home health care professional to deliver home 
229.8   health care services, within the professional's scope of 
229.9   practice, to a patient located at a site other than the site 
229.10  where the practitioner is located. 
229.11     Sec. 27.  Minnesota Statutes 2002, section 256B.0627, 
229.12  subdivision 4, is amended to read: 
229.13     Subd. 4.  [PERSONAL CARE ASSISTANT SERVICES.] (a) The 
229.14  personal care assistant services that are eligible for payment 
229.15  are services and supports furnished to an individual, as needed, 
229.16  to assist in accomplishing activities of daily living; 
229.17  instrumental activities of daily living; health-related 
229.18  functions through hands-on assistance, supervision, and cuing; 
229.19  and redirection and intervention for behavior including 
229.20  observation and monitoring.  
229.21     (b) Payment for services will be made within the limits 
229.22  approved using the prior authorized process established in 
229.23  subdivision 5. 
229.24     (c) The amount and type of services authorized shall be 
229.25  based on an assessment of the recipient's needs in these areas: 
229.26     (1) bowel and bladder care; 
229.27     (2) skin care to maintain the health of the skin; 
229.28     (3) repetitive maintenance range of motion, muscle 
229.29  strengthening exercises, and other tasks specific to maintaining 
229.30  a recipient's optimal level of function; 
229.31     (4) respiratory assistance; 
229.32     (5) transfers and ambulation; 
229.33     (6) bathing, grooming, and hairwashing necessary for 
229.34  personal hygiene; 
229.35     (7) turning and positioning; 
229.36     (8) assistance with furnishing medication that is 
230.1   self-administered; 
230.2      (9) application and maintenance of prosthetics and 
230.3   orthotics; 
230.4      (10) cleaning medical equipment; 
230.5      (11) dressing or undressing; 
230.6      (12) assistance with eating and meal preparation and 
230.7   necessary grocery shopping; 
230.8      (13) accompanying a recipient to obtain medical diagnosis 
230.9   or treatment; 
230.10     (14) assisting, monitoring, or prompting the recipient to 
230.11  complete the services in clauses (1) to (13); 
230.12     (15) redirection, monitoring, and observation that are 
230.13  medically necessary and an integral part of completing the 
230.14  personal care assistant services described in clauses (1) to 
230.15  (14); 
230.16     (16) redirection and intervention for behavior, including 
230.17  observation and monitoring; 
230.18     (17) interventions for seizure disorders, including 
230.19  monitoring and observation if the recipient has had a seizure 
230.20  that requires intervention within the past three months; 
230.21     (18) tracheostomy suctioning using a clean procedure if the 
230.22  procedure is properly delegated by a registered nurse.  Before 
230.23  this procedure can be delegated to a personal care assistant, a 
230.24  registered nurse must determine that the tracheostomy suctioning 
230.25  can be accomplished utilizing a clean rather than a sterile 
230.26  procedure and must ensure that the personal care assistant has 
230.27  been taught the proper procedure; and 
230.28     (19) incidental household services that are an integral 
230.29  part of a personal care service described in clauses (1) to (18).
230.30  For purposes of this subdivision, monitoring and observation 
230.31  means watching for outward visible signs that are likely to 
230.32  occur and for which there is a covered personal care service or 
230.33  an appropriate personal care intervention.  For purposes of this 
230.34  subdivision, a clean procedure refers to a procedure that 
230.35  reduces the numbers of microorganisms or prevents or reduces the 
230.36  transmission of microorganisms from one person or place to 
231.1   another.  A clean procedure may be used beginning 14 days after 
231.2   insertion. 
231.3      (d) The personal care assistant services that are not 
231.4   eligible for payment are the following:  
231.5      (1) services not ordered by the physician; 
231.6      (2) assessments by personal care assistant provider 
231.7   organizations or by independently enrolled registered nurses; 
231.8      (3) services that are not in the service plan; 
231.9      (4) services provided by the recipient's spouse, legal 
231.10  guardian for an adult or child recipient, or parent of a 
231.11  recipient under age 18; 
231.12     (5) services provided by a foster care provider of a 
231.13  recipient who cannot direct the recipient's own care, unless 
231.14  monitored by a county or state case manager under section 
231.15  256B.0625, subdivision 19a; 
231.16     (6) services provided by the residential or program license 
231.17  holder in a residence for more than four persons; 
231.18     (7) services that are the responsibility of a residential 
231.19  or program license holder under the terms of a service agreement 
231.20  and administrative rules; 
231.21     (8) sterile procedures; 
231.22     (9) injections of fluids into veins, muscles, or skin; 
231.23     (10) ~~services provided by parents of adult recipients,~~ 
231.24  ~~adult children, or siblings of the recipient, unless these~~ 
231.25  ~~relatives meet one of the following hardship criteria and the~~ 
231.26  ~~commissioner waives this requirement:~~ 
231.27     ~~(i) the relative resigns from a part-time or full-time job~~ 
231.28  ~~to provide personal care for the recipient;~~ 
231.29     ~~(ii) the relative goes from a full-time to a part-time job~~ 
231.30  ~~with less compensation to provide personal care for the~~ 
231.31  ~~recipient;~~ 
231.32     ~~(iii) the relative takes a leave of absence without pay to~~ 
231.33  ~~provide personal care for the recipient;~~ 
231.34     ~~(iv) the relative incurs substantial expenses by providing~~ 
231.35  ~~personal care for the recipient; or~~ 
231.36     ~~(v) because of labor conditions, special language needs, or~~ 
232.1   ~~intermittent hours of care needed, the relative is needed in~~ 
232.2   ~~order to provide an adequate number of qualified personal care~~ 
232.3   ~~assistants to meet the medical needs of the recipient;~~ 
232.4      ~~(11)~~ homemaker services that are not an integral part of a 
232.5   personal care assistant services; 
232.6      ~~(12)~~ (11) home maintenance, or chore services; 
232.7      ~~(13)~~ (12) services not specified under paragraph (a); and 
232.8      ~~(14)~~ (13) services not authorized by the commissioner or 
232.9   the commissioner's designee. 
232.10     (e) The recipient or responsible party may choose to 
232.11  supervise the personal care assistant or to have a qualified 
232.12  professional, as defined in section 256B.0625, subdivision 19c, 
232.13  provide the supervision.  As required under section 256B.0625, 
232.14  subdivision 19c, the county public health nurse, as a part of 
232.15  the assessment, will assist the recipient or responsible party 
232.16  to identify the most appropriate person to provide supervision 
232.17  of the personal care assistant.  Health-related delegated tasks 
232.18  performed by the personal care assistant will be under the 
232.19  supervision of a qualified professional or the direction of the 
232.20  recipient's physician.  If the recipient has a qualified 
232.21  professional, Minnesota Rules, part 9505.0335, subpart 4, 
232.22  applies. 
232.23     Sec. 28.  Minnesota Statutes 2002, section 256B.0627, 
232.24  subdivision 9, is amended to read: 
232.25     Subd. 9.  [FLEXIBLE USE OF PERSONAL CARE ASSISTANT HOURS.] 
232.26  (a) ~~The commissioner may allow for the flexible use of personal~~ 
232.27  ~~care assistant hours.~~  "Flexible use" means the scheduled use of 
232.28  authorized hours of personal care assistant services, which vary 
232.29  within the length of the service authorization in order to more 
232.30  effectively meet the needs and schedule of the recipient.  
232.31  Recipients may use their approved hours flexibly within the 
232.32  service authorization period for medically necessary covered 
232.33  services specified in the assessment required in subdivision 1.  
232.34  The flexible use of authorized hours does not increase the total 
232.35  amount of authorized hours available to a recipient as 
232.36  determined under subdivision 5.  The commissioner shall not 
233.1   authorize additional personal care assistant services to 
233.2   supplement a service authorization that is exhausted before the 
233.3   end date under a flexible service use plan, unless the county 
233.4   public health nurse determines a change in condition and a need 
233.5   for increased services is established. 
233.6      (b) ~~The recipient or responsible party, together with the~~ 
233.7   ~~county public health nurse, shall determine whether flexible use~~ 
233.8   ~~is an appropriate option based on the needs and preferences of~~ 
233.9   ~~the recipient or responsible party, and, if appropriate, must~~ 
233.10  ~~ensure that the allocation of hours covers the ongoing needs of~~ 
233.11  ~~the recipient over the entire service authorization period.  As~~ 
233.12  ~~part of the assessment and service planning process, the~~ 
233.13  ~~recipient or responsible party must work with the county public~~ 
233.14  ~~health nurse to develop a written month-to-month plan of the~~ 
233.15  ~~projected use of personal care assistant services that is part~~ 
233.16  ~~of the service plan and ensures that the:~~ 
233.17     ~~(1) health and safety needs of the recipient will be met;~~ 
233.18     ~~(2) total annual authorization will not exceed before the~~ 
233.19  ~~end date; and~~ 
233.20     ~~(3) how actual use of hours will be monitored.~~  
233.21     ~~(c) If the actual use of personal care assistant service~~ 
233.22  ~~varies significantly from the use projected in the plan, the~~ 
233.23  ~~written plan must be promptly updated by the recipient or~~ 
233.24  ~~responsible party and the county public health nurse.~~ 
233.25     ~~(d)~~ The recipient or responsible party, together with the 
233.26  provider, must work to monitor and document the use of 
233.27  authorized hours and ensure that a recipient is able to manage 
233.28  services effectively throughout the authorized period.  ~~The~~ 
233.29  ~~provider must ensure that the month-to-month plan is~~ 
233.30  ~~incorporated into the care plan.~~  Upon request of the recipient 
233.31  or responsible party, the provider must furnish regular updates 
233.32  to the recipient or responsible party on the amount of personal 
233.33  care assistant services used.  
233.34     ~~(e) The recipient or responsible party may revoke the~~ 
233.35  ~~authorization for flexible use of hours by notifying the~~ 
233.36  ~~provider and county public health nurse in writing.~~ 
234.1      ~~(f) If the requirements in paragraphs (a) to (e) have not~~ 
234.2   ~~substantially been met, the commissioner shall deny, revoke, or~~ 
234.3   ~~suspend the authorization to use authorized hours flexibly.  The~~ 
234.4   ~~recipient or responsible party may appeal the commissioner's~~ 
234.5   ~~action according to section 256.045.  The denial, revocation, or~~ 
234.6   ~~suspension to use the flexible hours option shall not affect the~~ 
234.7   ~~recipient's authorized level of personal care assistant services~~ 
234.8   ~~as determined under subdivision 5.~~ 
234.9      Sec. 29.  Minnesota Statutes 2002, section 256B.0911, 
234.10  subdivision 4d, is amended to read: 
234.11     Subd. 4d.  [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 
234.12  YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 
234.13  ensure that individuals with disabilities or chronic illness are 
234.14  served in the most integrated setting appropriate to their needs 
234.15  and have the necessary information to make informed choices 
234.16  about home and community-based service options. 
234.17     (b) Individuals under 65 years of age who are admitted to a 
234.18  nursing facility from a hospital must be screened prior to 
234.19  admission as outlined in subdivisions 4a through 4c. 
234.20     (c) Individuals under 65 years of age who are admitted to 
234.21  nursing facilities with only a telephone screening must receive 
234.22  a face-to-face assessment from the long-term care consultation 
234.23  team member of the county in which the facility is located or 
234.24  from the recipient's county case manager within ~~20 working~~ 40 
234.25  calendar days of admission. 
234.26     (d) Individuals under 65 years of age who are admitted to a 
234.27  nursing facility without preadmission screening according to the 
234.28  exemption described in subdivision 4b, paragraph (a), clause 
234.29  (3), and who remain in the facility longer than 30 days must 
234.30  receive a face-to-face assessment within 40 days of admission.  
234.31     (e) At the face-to-face assessment, the long-term care 
234.32  consultation team member or county case manager must perform the 
234.33  activities required under subdivision 3b. 
234.34     (f) For individuals under 21 years of age, a screening 
234.35  interview which recommends nursing facility admission must be 
234.36  face-to-face and approved by the commissioner before the 
235.1   individual is admitted to the nursing facility. 
235.2      (g) In the event that an individual under 65 years of age 
235.3   is admitted to a nursing facility on an emergency basis, the 
235.4   county must be notified of the admission on the next working 
235.5   day, and a face-to-face assessment as described in paragraph (c) 
235.6   must be conducted within ~~20 working days~~ 40 calendar days of 
235.7   admission. 
235.8      (h) At the face-to-face assessment, the long-term care 
235.9   consultation team member or the case manager must present 
235.10  information about home and community-based options so the 
235.11  individual can make informed choices.  If the individual chooses 
235.12  home and community-based services, the long-term care 
235.13  consultation team member or case manager must complete a written 
235.14  relocation plan within 20 working days of the visit.  The plan 
235.15  shall describe the services needed to move out of the facility 
235.16  and a time line for the move which is designed to ensure a 
235.17  smooth transition to the individual's home and community. 
235.18     (i) An individual under 65 years of age residing in a 
235.19  nursing facility shall receive a face-to-face assessment at 
235.20  least every 12 months to review the person's service choices and 
235.21  available alternatives unless the individual indicates, in 
235.22  writing, that annual visits are not desired.  In this case, the 
235.23  individual must receive a face-to-face assessment at least once 
235.24  every 36 months for the same purposes. 
235.25     (j) Notwithstanding the provisions of subdivision 6, the 
235.26  commissioner may pay county agencies directly for face-to-face 
235.27  assessments for individuals under 65 years of age who are being 
235.28  considered for placement or residing in a nursing facility. 
235.29     Sec. 30.  Minnesota Statutes 2002, section 256B.0915, is 
235.30  amended by adding a subdivision to read: 
235.31     Subd. 9.  [TRIBAL MANAGEMENT OF ELDERLY WAIVER.] 
235.32  Notwithstanding contrary provisions of this section, or those in 
235.33  other state laws or rules, the commissioner and White Earth 
235.34  reservation may develop a model for tribal management of the 
235.35  elderly waiver program and implement this model through a 
235.36  contract between the state and White Earth reservation.  The 
236.1   model shall include the provision of tribal waiver case 
236.2   management, assessment for personal care assistance, and 
236.3   administrative requirements otherwise carried out by counties 
236.4   but shall not include tribal financial eligibility determination 
236.5   for medical assistance. 
236.6      Sec. 31.  Minnesota Statutes 2002, section 256B.092, 
236.7   subdivision 1a, is amended to read: 
236.8      Subd. 1a.  [CASE MANAGEMENT ADMINISTRATION AND SERVICES.] 
236.9   (a) The administrative functions of case management provided to 
236.10  or arranged for a person include: 
236.11     (1) ~~intake~~ review of eligibility for services; 
236.12     (2) ~~diagnosis~~ screening; 
236.13     (3) ~~screening~~ intake; 
236.14     (4) ~~service authorization~~ diagnosis; 
236.15     (5) ~~review of eligibility for services~~ the review and 
236.16  authorization of services based upon an individualized service 
236.17  plan; and 
236.18     (6) responding to requests for conciliation conferences and 
236.19  appeals according to section 256.045 made by the person, the 
236.20  person's legal guardian or conservator, or the parent if the 
236.21  person is a minor. 
236.22     (b) Case management service activities provided to or 
236.23  arranged for a person include: 
236.24     (1) development of the individual service plan~~;~~ 
236.25     (2) informing the individual or the individual's legal 
236.26  guardian or conservator, or parent if the person is a minor, of 
236.27  service options; 
236.28     (3) consulting with relevant medical experts or service 
236.29  providers; 
236.30     ~~(3)~~ (4) assisting the person in the identification of 
236.31  potential providers; 
236.32     ~~(4)~~ (5) assisting the person to access services; 
236.33     ~~(5)~~ (6) coordination of services, if coordination is not 
236.34  provided by another service provider; 
236.35     ~~(6)~~ (7) evaluation and monitoring of the services 
236.36  identified in the plan; and 
237.1      ~~(7)~~ (8) annual reviews of service plans and services 
237.2   provided. 
237.3      (c) Case management administration and service activities 
237.4   that are provided to the person with mental retardation or a 
237.5   related condition shall be provided directly by county agencies 
237.6   or under contract.  
237.7      (d) Case managers are responsible for the administrative 
237.8   duties and service provisions listed in paragraphs (a) and (b).  
237.9   Case managers shall collaborate with consumers, families, legal 
237.10  representatives, and relevant medical experts and service 
237.11  providers in the development and annual review of the 
237.12  individualized service and habilitation plans. 
237.13     (e) The department of human services shall offer ongoing 
237.14  education in case management to case managers.  Case managers 
237.15  shall receive no less than ten hours of case management 
237.16  education and disability-related training each year. 
237.17     Sec. 32.  Minnesota Statutes 2002, section 256B.092, 
237.18  subdivision 5, is amended to read: 
237.19     Subd. 5.  [FEDERAL WAIVERS.] (a) The commissioner shall 
237.20  apply for any federal waivers necessary to secure, to the extent 
237.21  allowed by law, federal financial participation under United 
237.22  States Code, title 42, sections 1396 et seq., as amended, for 
237.23  the provision of services to persons who, in the absence of the 
237.24  services, would need the level of care provided in a regional 
237.25  treatment center or a community intermediate care facility for 
237.26  persons with mental retardation or related conditions.  The 
237.27  commissioner may seek amendments to the waivers or apply for 
237.28  additional waivers under United States Code, title 42, sections 
237.29  1396 et seq., as amended, to contain costs.  The commissioner 
237.30  shall ensure that payment for the cost of providing home and 
237.31  community-based alternative services under the federal waiver 
237.32  plan shall not exceed the cost of intermediate care services 
237.33  including day training and habilitation services that would have 
237.34  been provided without the waivered services.  
237.35     (b) The commissioner, in administering home and 
237.36  community-based waivers for persons with mental retardation and 
238.1   related conditions, shall ensure that day services for eligible 
238.2   persons are not provided by the person's residential service 
238.3   provider, unless the person or the person's legal representative 
238.4   is offered a choice of providers and agrees in writing to 
238.5   provision of day services by the residential service provider.  
238.6   The individual service plan for individuals who choose to have 
238.7   their residential service provider provide their day services 
238.8   must describe how health, safety, ~~and~~ protection, and 
238.9   habilitation needs will be met ~~by~~, including how frequent and 
238.10  regular contact with persons other than the residential service 
238.11  provider will occur.  The individualized service plan must 
238.12  address the provision of services during the day outside the 
238.13  residence on weekdays.  
238.14     (c) When a county is evaluating denials, reductions, or 
238.15  terminations of home and community-based services under section 
238.16  256B.0916 for an individual, the case manager shall offer to 
238.17  meet with the individual or the individual's guardian in order 
238.18  to discuss the prioritization of service needs within the 
238.19  individualized service plan.  The reduction in the authorized 
238.20  services for an individual due to changes in funding for 
238.21  waivered services may not exceed the amount needed to ensure 
238.22  medically necessary services to meet the individual's health, 
238.23  safety, and welfare. 
238.24     Sec. 33.  Minnesota Statutes 2002, section 256B.095, is 
238.25  amended to read: 
238.26     256B.095 [QUALITY ASSURANCE ~~PROJECT~~ SYSTEM ESTABLISHED.] 
238.27     (a) Effective July 1, 1998, ~~an alternative~~ a quality 
238.28  assurance ~~licensing~~ system ~~project~~ for persons with 
238.29  developmental disabilities, which includes an alternative 
238.30  quality assurance licensing system for programs ~~for persons with~~ 
238.31  ~~developmental disabilities~~, is established in Dodge, Fillmore, 
238.32  Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, 
238.33  Wabasha, and Winona counties for the purpose of improving the 
238.34  quality of services provided to persons with developmental 
238.35  disabilities.  A county, at its option, may choose to have all 
238.36  programs for persons with developmental disabilities located 
239.1   within the county licensed under chapter 245A using standards 
239.2   determined under the alternative quality assurance licensing 
239.3   system ~~project~~ or may continue regulation of these programs 
239.4   under the licensing system operated by the commissioner.  The 
239.5   project expires on June 30, ~~2005~~ 2007. 
239.6      (b) Effective July 1, 2003, a county not listed in 
239.7   paragraph (a) may apply to participate in the quality assurance 
239.8   system established under paragraph (a).  The commission 
239.9   established under section 256B.0951 may, at its option, allow 
239.10  additional counties to participate in the system. 
239.11     (c) Effective July 1, 2003, any county or group of counties 
239.12  not listed in paragraph (a) may establish a quality assurance 
239.13  system under this section.  A new system established under this 
239.14  section shall have the same rights and duties as the system 
239.15  established under paragraph (a).  A new system shall be governed 
239.16  by a commission under section 256B.0951.  The commissioner shall 
239.17  appoint the initial commission members based on recommendations 
239.18  from advocates, families, service providers, and counties in the 
239.19  geographic area included in the new system.  Counties that 
239.20  choose to participate in a new system shall have the duties 
239.21  assigned under section 256B.0952.  The new system shall 
239.22  establish a quality assurance process under section 256B.0953.  
239.23  The provisions of section 256B.0954 shall apply to a new system 
239.24  established under this paragraph.  The commissioner shall 
239.25  delegate authority to a new system established under this 
239.26  paragraph according to section 256B.0955. 
239.27     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
239.28     Sec. 34.  Minnesota Statutes 2002, section 256B.0951, 
239.29  subdivision 1, is amended to read: 
239.30     Subdivision 1.  [MEMBERSHIP.] The ~~region 10~~ quality 
239.31  assurance commission is established.  The commission consists of 
239.32  at least 14 but not more than 21 members as follows:  at least 
239.33  three but not more than five members representing advocacy 
239.34  organizations; at least three but not more than five members 
239.35  representing consumers, families, and their legal 
239.36  representatives; at least three but not more than five members 
240.1   representing service providers; at least three but not more than 
240.2   five members representing counties; and the commissioner of 
240.3   human services or the commissioner's designee.  ~~Initial~~ 
240.4   ~~membership of the commission shall be recruited and approved by~~ 
240.5   ~~the region 10 stakeholders group.  Prior to approving the~~ 
240.6   ~~commission's membership, the stakeholders group shall provide to~~ 
240.7   ~~the commissioner a list of the membership in the stakeholders~~ 
240.8   ~~group, as of February 1, 1997, a brief summary of meetings held~~ 
240.9   ~~by the group since July 1, 1996, and copies of any materials~~ 
240.10  ~~prepared by the group for public distribution.~~  The first 
240.11  commission shall establish membership guidelines for the 
240.12  transition and recruitment of membership for the commission's 
240.13  ongoing existence.  Members of the commission who do not receive 
240.14  a salary or wages from an employer for time spent on commission 
240.15  duties may receive a per diem payment when performing commission 
240.16  duties and functions.  All members may be reimbursed for 
240.17  expenses related to commission activities.  Notwithstanding the 
240.18  provisions of section 15.059, subdivision 5, the commission 
240.19  expires on June 30, ~~2005~~ 2007. 
240.20     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
240.21     Sec. 35.  Minnesota Statutes 2002, section 256B.0951, 
240.22  subdivision 2, is amended to read: 
240.23     Subd. 2.  [AUTHORITY TO HIRE STAFF; CHARGE FEES; PROVIDE 
240.24  TECHNICAL ASSISTANCE.] (a) The commission may hire staff to 
240.25  perform the duties assigned in this section.  
240.26     (b) The commission may charge fees for its services. 
240.27     (c) The commission may provide technical assistance to 
240.28  other counties, families, providers, and advocates interested in 
240.29  participating in a quality assurance system under section 
240.30  256B.095, paragraph (b) or (c). 
240.31     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
240.32     Sec. 36.  Minnesota Statutes 2002, section 256B.0951, 
240.33  subdivision 3, is amended to read: 
240.34     Subd. 3.  [COMMISSION DUTIES.] (a) By October 1, 1997, the 
240.35  commission, in cooperation with the commissioners of human 
240.36  services and health, shall do the following:  (1) approve an 
241.1   alternative quality assurance licensing system based on the 
241.2   evaluation of outcomes; (2) approve measurable outcomes in the 
241.3   areas of health and safety, consumer evaluation, education and 
241.4   training, providers, and systems that shall be evaluated during 
241.5   the alternative licensing process; and (3) establish variable 
241.6   licensure periods not to exceed three years based on outcomes 
241.7   achieved.  For purposes of this subdivision, "outcome" means the 
241.8   behavior, action, or status of a person that can be observed or 
241.9   measured and can be reliably and validly determined. 
241.10     (b) By January 15, 1998, the commission shall approve, in 
241.11  cooperation with the commissioner of human services, a training 
241.12  program for members of the quality assurance teams established 
241.13  under section 256B.0952, subdivision 4. 
241.14     (c) The commission and the commissioner shall establish an 
241.15  ongoing review process for the alternative quality assurance 
241.16  licensing system.  The review shall take into account the 
241.17  comprehensive nature of the alternative system, which is 
241.18  designed to evaluate the broad spectrum of licensed and 
241.19  unlicensed entities that provide services to clients~~, as~~ 
241.20  ~~compared to the current licensing system~~.  
241.21     (d) ~~The commission shall contract with an independent~~ 
241.22  ~~entity to conduct a financial review of the alternative quality~~ 
241.23  ~~assurance project.  The review shall take into account the~~ 
241.24  ~~comprehensive nature of the alternative system, which is~~ 
241.25  ~~designed to evaluate the broad spectrum of licensed and~~ 
241.26  ~~unlicensed entities that provide services to clients, as~~ 
241.27  ~~compared to the current licensing system.  The review shall~~ 
241.28  ~~include an evaluation of possible budgetary savings within the~~ 
241.29  ~~department of human services as a result of implementation of~~ 
241.30  ~~the alternative quality assurance project.  If a federal waiver~~ 
241.31  ~~is approved under subdivision 7, the financial review shall also~~ 
241.32  ~~evaluate possible savings within the department of health.  This~~ 
241.33  ~~review must be completed by December 15, 2000.~~ 
241.34     ~~(e) The commission shall submit a report to the legislature~~ 
241.35  ~~by January 15, 2001, on the results of the review process for~~ 
241.36  ~~the alternative quality assurance project, a summary of the~~ 
242.1   ~~results of the independent financial review, and a~~ 
242.2   ~~recommendation on whether the project should be extended beyond~~ 
242.3   ~~June 30, 2001.~~ 
242.4      ~~(f)~~ The ~~commissioner~~ commission, in consultation with 
242.5   the ~~commission~~ commissioner, shall ~~examine the feasibility of~~ 
242.6   ~~expanding~~ work cooperatively with other populations to expand 
242.7   the ~~project~~ system to ~~other~~ those populations ~~or geographic~~ 
242.8   ~~areas~~ and identify barriers to expansion.  The commissioner 
242.9   shall report findings and recommendations to the legislature by 
242.10  December 15, 2004. 
242.11     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
242.12     Sec. 37.  Minnesota Statutes 2002, section 256B.0951, 
242.13  subdivision 5, is amended to read: 
242.14     Subd. 5.  [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The 
242.15  safety standards, rights, or procedural protections under 
242.16  sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a, 
242.17  3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2) 
242.18  and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, 
242.19  subdivisions 1b, clause (7), and 10; 626.556; 626.557, and 
242.20  procedures for the monitoring of psychotropic medications shall 
242.21  not be varied under the alternative ~~licensing~~ quality assurance 
242.22  licensing system ~~project~~.  The commission may make 
242.23  recommendations to the commissioners of human services and 
242.24  health or to the legislature regarding alternatives to or 
242.25  modifications of the rules and procedures referenced in this 
242.26  subdivision. 
242.27     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
242.28     Sec. 38.  Minnesota Statutes 2002, section 256B.0951, 
242.29  subdivision 7, is amended to read: 
242.30     Subd. 7.  [WAIVER OF RULES.] If a federal waiver is 
242.31  approved under subdivision 8, the commissioner of health may 
242.32  exempt residents of intermediate care facilities for persons 
242.33  with mental retardation (ICFs/MR) who participate in the 
242.34  alternative quality assurance ~~project~~ system established in 
242.35  section 256B.095 from the requirements of Minnesota Rules, 
242.36  chapter 4665. 
243.1      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
243.2      Sec. 39.  Minnesota Statutes 2002, section 256B.0951, 
243.3   subdivision 9, is amended to read: 
243.4      Subd. 9.  [EVALUATION.] The commission, in consultation 
243.5   with the commissioner of human services, shall conduct an 
243.6   evaluation of the ~~alternative~~ quality assurance system, and 
243.7   present a report to the commissioner by June 30, 2004. 
243.8      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
243.9      Sec. 40.  Minnesota Statutes 2002, section 256B.0952, 
243.10  subdivision 1, is amended to read: 
243.11     Subdivision 1.  [NOTIFICATION.] ~~For each year of the~~ 
243.12  ~~project, region 10~~ Counties shall give notice to the commission 
243.13  and commissioners of human services and health ~~by March 15~~ of 
243.14  intent to join the ~~quality assurance~~ alternative quality 
243.15  assurance licensing system~~, effective July 1 of that year~~.  A 
243.16  county choosing to participate in the alternative quality 
243.17  assurance licensing system commits to participate ~~until June 30,~~ 
243.18  ~~2005.  Counties participating in the quality assurance~~ 
243.19  ~~alternative licensing system as of January 1, 2001, shall notify~~ 
243.20  ~~the commission and the commissioners of human services and~~ 
243.21  ~~health by March 15, 2001, of intent to continue participation.~~  
243.22  ~~Counties that elect to continue participation must participate~~ 
243.23  ~~in the alternative licensing system until June 30, 2005~~ for 
243.24  three years. 
243.25     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
243.26     Sec. 41.  Minnesota Statutes 2002, section 256B.0953, 
243.27  subdivision 2, is amended to read: 
243.28     Subd. 2.  [LICENSURE PERIODS.] (a) In order to be licensed 
243.29  under the alternative quality assurance ~~process~~ licensing 
243.30  system, a facility, program, or service must satisfy the health 
243.31  and safety outcomes approved for the ~~pilot project~~ alternative 
243.32  quality assurance licensing system. 
243.33     (b) Licensure shall be approved for periods of one to three 
243.34  years for a facility, program, or service that satisfies the 
243.35  requirements of paragraph (a) and achieves the outcome 
243.36  measurements in the categories of consumer evaluation, education 
244.1   and training, providers, and systems. 
244.2      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
244.3      Sec. 42.  Minnesota Statutes 2002, section 256B.0955, is 
244.4   amended to read: 
244.5      256B.0955 [DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.] 
244.6      (a) Effective July 1, 1998, the commissioner of human 
244.7   services shall delegate authority to perform licensing functions 
244.8   and activities, in accordance with section 245A.16, to counties 
244.9   participating in the alternative quality assurance licensing 
244.10  system.  The commissioner shall not license or reimburse a 
244.11  facility, program, or service for persons with developmental 
244.12  disabilities in a county that participates in the 
244.13  alternative quality assurance licensing system if the 
244.14  commissioner has received from the appropriate county 
244.15  notification that the facility, program, or service has been 
244.16  reviewed by a quality assurance team and has failed to qualify 
244.17  for licensure. 
244.18     (b) The commissioner may conduct random licensing 
244.19  inspections based on outcomes adopted under section 256B.0951 at 
244.20  facilities, programs, and services governed by the alternative 
244.21  quality assurance licensing system.  The role of such random 
244.22  inspections shall be to verify that the alternative quality 
244.23  assurance licensing system protects the safety and well-being of 
244.24  consumers and maintains the availability of high-quality 
244.25  services for persons with developmental disabilities.  
244.26     ~~(c) The commissioner shall provide technical assistance and~~ 
244.27  ~~support or training to the alternative licensing system pilot~~ 
244.28  ~~project.~~ 
244.29     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
244.30     Sec. 43.  Minnesota Statutes 2002, section 256B.19, 
244.31  subdivision 1, is amended to read: 
244.32     Subdivision 1.  [DIVISION OF COST.] The state and county 
244.33  share of medical assistance costs not paid by federal funds 
244.34  shall be as follows:  
244.35     (1) beginning January 1, 1992, 50 percent state funds and 
244.36  50 percent county funds for the cost of placement of severely 
245.1   emotionally disturbed children in regional treatment centers; 
245.2   ~~and~~ 
245.3      (2) beginning January 1, 2003, 80 percent state funds and 
245.4   20 percent county funds for the costs of nursing facility 
245.5   placements of persons with disabilities under the age of 65 that 
245.6   have exceeded 90 days.  This clause shall be subject to chapter 
245.7   256G and shall not apply to placements in facilities not 
245.8   certified to participate in medical assistance~~.~~; 
245.9      (3) beginning July 1, 2004, 80 percent state funds and 20 
245.10  percent county funds for the costs of placements that have 
245.11  exceeded 90 days in intermediate care facilities for persons 
245.12  with mental retardation or a related condition that have seven 
245.13  or more beds.  This provision includes pass-through payments 
245.14  made under section 256B.5015; and 
245.15     (4) beginning July 1, 2004, when state funds are used to 
245.16  pay for a nursing facility placement due to the facility's 
245.17  status as an institution for mental diseases (IMD), the county 
245.18  shall pay 20 percent of the nonfederal share of costs that have 
245.19  exceeded 90 days.  This clause is subject to chapter 256G. 
245.20     For counties that participate in a Medicaid demonstration 
245.21  project under sections 256B.69 and 256B.71, the division of the 
245.22  nonfederal share of medical assistance expenses for payments 
245.23  made to prepaid health plans or for payments made to health 
245.24  maintenance organizations in the form of prepaid capitation 
245.25  payments, this division of medical assistance expenses shall be 
245.26  95 percent by the state and five percent by the county of 
245.27  financial responsibility.  
245.28     In counties where prepaid health plans are under contract 
245.29  to the commissioner to provide services to medical assistance 
245.30  recipients, the cost of court ordered treatment ordered without 
245.31  consulting the prepaid health plan that does not include 
245.32  diagnostic evaluation, recommendation, and referral for 
245.33  treatment by the prepaid health plan is the responsibility of 
245.34  the county of financial responsibility. 
245.35     Sec. 44.  Minnesota Statutes 2002, section 256B.47, 
245.36  subdivision 2, is amended to read: 
246.1      Subd. 2.  [NOTICE TO RESIDENTS.] (a) No increase in nursing 
246.2   facility rates for private paying residents shall be effective 
246.3   unless the nursing facility notifies the resident or person 
246.4   responsible for payment of the increase in writing 30 days 
246.5   before the increase takes effect.  
246.6      A nursing facility may adjust its rates without giving the 
246.7   notice required by this subdivision when the purpose of the rate 
246.8   adjustment is to reflect a ~~necessary~~ change in the ~~level of care~~ 
246.9   ~~provided to a~~ case-mix classification of the resident.  If the 
246.10  state fails to set rates as required by section 
246.11  256B.431, subdivision 1, the time required for giving notice is 
246.12  decreased by the number of days by which the state was late in 
246.13  setting the rates. 
246.14     (b) If the state does not set rates by the date required in 
246.15  section 256B.431, subdivision 1, nursing facilities shall meet 
246.16  the requirement for advance notice by informing the resident or 
246.17  person responsible for payments, on or before the effective date 
246.18  of the increase, that a rate increase will be effective on that 
246.19  date.  If the exact amount has not yet been determined, the 
246.20  nursing facility may raise the rates by the amount anticipated 
246.21  to be allowed.  Any amounts collected from private pay residents 
246.22  in excess of the allowable rate must be repaid to private pay 
246.23  residents with interest at the rate used by the commissioner of 
246.24  revenue for the late payment of taxes and in effect on the date 
246.25  the rate increase is effective. 
246.26     Sec. 45.  Minnesota Statutes 2002, section 256B.47, 
246.27  subdivision 2, is amended to read: 
246.28     Subd. 2.  [NOTICE TO RESIDENTS.] (a) No increase in nursing 
246.29  facility rates for private paying residents shall be effective 
246.30  unless the nursing facility notifies the resident or person 
246.31  responsible for payment of the increase in writing 30 days 
246.32  before the increase takes effect.  
246.33     A nursing facility may adjust its rates without giving the 
246.34  notice required by this subdivision when the purpose of the rate 
246.35  adjustment is to reflect a ~~necessary~~ change in the ~~level of care~~ 
246.36  ~~provided to a~~ case-mix classification of the resident.  If the 
247.1   state fails to set rates as required by section 
247.2   256B.431, subdivision 1, the time required for giving notice is 
247.3   decreased by the number of days by which the state was late in 
247.4   setting the rates. 
247.5      (b) If the state does not set rates by the date required in 
247.6   section 256B.431, subdivision 1, nursing facilities shall meet 
247.7   the requirement for advance notice by informing the resident or 
247.8   person responsible for payments, on or before the effective date 
247.9   of the increase, that a rate increase will be effective on that 
247.10  date.  If the exact amount has not yet been determined, the 
247.11  nursing facility may raise the rates by the amount anticipated 
247.12  to be allowed.  Any amounts collected from private pay residents 
247.13  in excess of the allowable rate must be repaid to private pay 
247.14  residents with interest at the rate used by the commissioner of 
247.15  revenue for the late payment of taxes and in effect on the date 
247.16  the rate increase is effective. 
247.17     Sec. 46.  Minnesota Statutes 2002, section 256B.49, 
247.18  subdivision 15, is amended to read: 
247.19     Subd. 15.  [INDIVIDUALIZED SERVICE PLAN.] (a) Each 
247.20  recipient of home and community-based waivered services shall be 
247.21  provided a copy of the written service plan which: 
247.22     (1) is developed and signed by the recipient within ten 
247.23  working days of the completion of the assessment; 
247.24     (2) meets the assessed needs of the recipient; 
247.25     (3) reasonably ensures the health and safety of the 
247.26  recipient; 
247.27     (4) promotes independence; 
247.28     (5) allows for services to be provided in the most 
247.29  integrated settings; and 
247.30     (6) provides for an informed choice, as defined in section 
247.31  256B.77, subdivision 2, paragraph (p), of service and support 
247.32  providers. 
247.33     (b) When a county is evaluating denials, reductions, or 
247.34  terminations of home and community-based services under section 
247.35  256B.49 for an individual, the case manager shall offer to meet 
247.36  with the individual or the individual's guardian in order to 
248.1   discuss the prioritization of service needs within the 
248.2   individualized service plan.  The reduction in the authorized 
248.3   services for an individual due to changes in funding for 
248.4   waivered services may not exceed the amount needed to ensure 
248.5   medically necessary services to meet the individual's health, 
248.6   safety, and welfare. 
248.7      Sec. 47.  Minnesota Statutes 2002, section 256B.501, 
248.8   subdivision 1, is amended to read: 
248.9      Subdivision 1.  [DEFINITIONS.] For the purposes of this 
248.10  section, the following terms have the meaning given them.  
248.11     (a) "Commissioner" means the commissioner of human services.
248.12     (b) "Facility" means a facility licensed as a mental 
248.13  retardation residential facility under section 252.28, licensed 
248.14  as a supervised living facility under chapter 144, and certified 
248.15  as an intermediate care facility for persons with mental 
248.16  retardation or related conditions.  The term does not include a 
248.17  state regional treatment center. 
248.18     (c) "Habilitation services" means health and social 
248.19  services directed toward increasing and maintaining the 
248.20  physical, intellectual, emotional, and social functioning of 
248.21  persons with mental retardation or related conditions.  
248.22  Habilitation services include therapeutic activities, 
248.23  assistance, training, supervision, and monitoring in the areas 
248.24  of self-care, sensory and motor development, interpersonal 
248.25  skills, communication, socialization, reduction or elimination 
248.26  of maladaptive behavior, community living and mobility, health 
248.27  care, leisure and recreation, money management, and household 
248.28  chores. 
248.29     (d) "Services during the day" means services or supports 
248.30  provided to a person that enables the person to be fully 
248.31  integrated into the community.  Services during the day must 
248.32  include habilitation services, and may include a variety of 
248.33  supports to enable the person to exercise choices for community 
248.34  integration and inclusion activities.  Services during the day 
248.35  may include, but are not limited to:  supported work, support 
248.36  during community activities, community volunteer opportunities, 
249.1   adult day care, recreational activities, and other 
249.2   individualized integrated supports. 
249.3      (e) "Waivered service" means home or community-based 
249.4   service authorized under United States Code, title 42, section 
249.5   1396n(c), as amended through December 31, 1987, and defined in 
249.6   the Minnesota state plan for the provision of medical assistance 
249.7   services.  Waivered services include, at a minimum, case 
249.8   management, family training and support, developmental training 
249.9   homes, supervised living arrangements, semi-independent living 
249.10  services, respite care, and training and habilitation services. 
249.11     Sec. 48.  Minnesota Statutes 2002, section 256B.501, is 
249.12  amended by adding a subdivision to read: 
249.13     Subd. 3m.  [SERVICES DURING THE DAY.] When establishing a 
249.14  rate for services during the day, the commissioner shall ensure 
249.15  that these services comply with active treatment requirements 
249.16  for persons residing in an ICF/MR as defined under federal 
249.17  regulations and shall ensure that services during the day for 
249.18  eligible persons are not provided by the person's residential 
249.19  service provider, unless the person or the person's legal 
249.20  representative is offered a choice of providers and agrees in 
249.21  writing to provision of services during the day by the 
249.22  residential service provider, consistent with the individual 
249.23  service plan.  The individual service plan for individuals who 
249.24  choose to have their residential service provider provide their 
249.25  services during the day must describe how health, safety, 
249.26  protection, and habilitation needs will be met, including how 
249.27  frequent and regular contact with persons other than the 
249.28  residential service provider will occur.  The individualized 
249.29  service plan must address the provision of services during the 
249.30  day outside the residence.  
249.31     Sec. 49.  Minnesota Statutes 2002, section 256B.5013, is 
249.32  amended by adding a subdivision to read: 
249.33     Subd. 7.  [RATE ADJUSTMENTS FOR SHORT-TERM ADMISSIONS FOR 
249.34  CRISIS OR SPECIALIZED MEDICAL CARE.] Beginning July 1, 2003, the 
249.35  commissioner may designate up to 25 beds in ICF/MR facilities 
249.36  statewide for short-term admissions due to crisis care needs or 
250.1   care for medically fragile individuals.  The commissioner shall 
250.2   adjust the monthly facility rate to provide payment for 
250.3   vacancies in designated short-term beds by an amount equal to 
250.4   the rate for each recipient residing in a designated bed for up 
250.5   to 15 days per bed per month.  The commissioner may designate 
250.6   short-term beds in ICF/MR facilities based on the short-term 
250.7   care needs of a region or county as provided in section 252.28.  
250.8   Nothing in this section shall be construed as limiting payments 
250.9   for short-term admissions of eligible recipients to an ICF/MR 
250.10  that is not designated for short-term admissions for crisis or 
250.11  specialized medical care under this subdivision and does not 
250.12  receive a temporary rate adjustment. 
250.13     Sec. 50.  Minnesota Statutes 2002, section 256B.5015, is 
250.14  amended to read: 
250.15     256B.5015 [PASS-THROUGH OF ~~TRAINING AND HABILITATION~~ OTHER 
250.16  SERVICES COSTS.] 
250.17     Subdivision 1.  [DAY TRAINING AND HABILITATION SERVICES.] 
250.18  Day training and habilitation services costs shall be paid as a 
250.19  pass-through payment at the lowest rate paid for the comparable 
250.20  services at that site under sections 252.40 to 252.46.  The 
250.21  pass-through payments for training and habilitation services 
250.22  shall be paid separately by the commissioner and shall not be 
250.23  included in the computation of the ICF/MR facility total payment 
250.24  rate. 
250.25     Subd. 2.  [SERVICES DURING THE DAY.] Services during the 
250.26  day, as defined in section 256B.501, but excluding day training 
250.27  and habilitation services, shall be paid as a pass-through 
250.28  payment no later than January 1, 2004.  The commissioner shall 
250.29  establish rates for these services, other than day training and 
250.30  habilitation services, at levels that do not exceed 75 percent 
250.31  of a recipient's day training and habilitation service costs 
250.32  prior to the service change. 
250.33     When establishing a rate for these services, the 
250.34  commissioner shall also consider an individual recipient's needs 
250.35  as identified in the individualized service plan and the 
250.36  person's need for active treatment as defined under federal 
251.1   regulations.  The pass-through payments for services during the 
251.2   day shall be paid separately by the commissioner and shall not 
251.3   be included in the computation of the ICF/MR facility total 
251.4   payment rate.  
251.5      Sec. 51.  Minnesota Statutes 2002, section 256B.82, is 
251.6   amended to read: 
251.7      256B.82 [PREPAID PLANS AND MENTAL HEALTH REHABILITATIVE 
251.8   SERVICES.] 
251.9      Medical assistance and MinnesotaCare prepaid health plans 
251.10  may include coverage for adult mental health rehabilitative 
251.11  services under section 256B.0623, intensive rehabilitative 
251.12  services under section 256B.0622, and adult mental health crisis 
251.13  response services under section 256B.0624, beginning January 1, 
251.14  ~~2004~~ 2005. 
251.15     By January 15, ~~2003~~ 2004, the commissioner shall report to 
251.16  the legislature how these services should be included in prepaid 
251.17  plans.  The commissioner shall consult with mental health 
251.18  advocates, health plans, and counties in developing this 
251.19  report.  The report recommendations must include a plan to 
251.20  ensure coordination of these services between health plans and 
251.21  counties, assure recipient access to essential community 
251.22  providers, and monitor the health plans' delivery of services 
251.23  through utilization review and quality standards. 
251.24     Sec. 52.  [256I.08] [COUNTY SHARE FOR CERTAIN NURSING 
251.25  FACILITY STAYS.] 
251.26     Beginning July 1, 2004, if group residential housing is 
251.27  used to pay for a nursing facility placement due to the 
251.28  facility's status as an Institution for Mental Diseases, the 
251.29  county is liable for 20 percent of the nonfederal share of costs 
251.30  for persons under the age of 65 that have exceeded 90 days. 
251.31     Sec. 53.  [CASE MANAGEMENT ACCESS FOR PERSONS SEEKING 
251.32  COMMUNITY-BASED SERVICES.] 
251.33     When a person requests services authorized under Minnesota 
251.34  Statutes, section 256B.0621, 256B.092, or 256B.49, subdivision 
251.35  13, the county must determine whether the person qualifies, 
251.36  begin the screening process, begin individualized service plan 
252.1   development, and provide mandated case management services or 
252.2   relocation service coordination to those eligible within a 
252.3   reasonable time.  If a county is unable to provide case 
252.4   management services within the required time period under 
252.5   Minnesota Statutes, sections 256B.0621, subdivision 7; 256B.49, 
252.6   subdivision 13; and Minnesota Rules, parts 9525.0004 to 
252.7   9525.0036, the county shall contract for case management 
252.8   services to meet the obligation.  
252.9      Sec. 54.  [CASE MANAGEMENT SERVICES REDESIGN.] 
252.10     The commissioner shall report to the legislature on the 
252.11  redesign of case management services.  In preparing the report, 
252.12  the commissioner shall consult with representatives for 
252.13  consumers, consumer advocates, counties, and service providers.  
252.14  The report shall include draft legislation for case management 
252.15  changes that will (1) streamline administration, (2) improve 
252.16  consumer access to case management services, (3) address the use 
252.17  of a comprehensive universal assessment protocol for persons 
252.18  seeking community supports, (4) establish case management 
252.19  performance measures, (5) provide for consumer choice of the 
252.20  case management service vendor, and (6) provide a method of 
252.21  payment for case management services that is cost-effective and 
252.22  best supports the draft legislation in clauses (1) to (5).  The 
252.23  proposed legislation shall be provided to the legislative 
252.24  committees with jurisdiction over health and human services 
252.25  issues by January 15, 2005. 
252.26     Sec. 55.  [VACANCY LISTINGS.] 
252.27     The commissioner of human services shall work with 
252.28  interested stakeholders on how provider and industry specific 
252.29  Web sites can provide useful information to consumers on bed 
252.30  vacancies for group residential housing providers and 
252.31  intermediate care facilities for persons with mental retardation 
252.32  and related conditions.  Providers and industry trade 
252.33  organizations are responsible for all costs related to 
252.34  maintaining Web sites listing bed vacancies. 
252.35     Sec. 56.  [HOMELESS SERVICES; STATE CONTRACTS.] 
252.36     The commissioner of human services may contract directly 
253.1   with nonprofit organizations providing homeless services in two 
253.2   or more counties.  
253.3      Sec. 57.  [GOVERNOR'S COUNCIL ON DEVELOPMENTAL DISABILITY, 
253.4   OMBUDSMAN FOR MENTAL HEALTH AND MENTAL RETARDATION, AND COUNCIL 
253.5   ON DISABILITIES.] 
253.6      The governor's council on developmental disability under 
253.7   Minnesota Statutes, section 16B.053, the ombudsman for mental 
253.8   health and mental retardation under Minnesota Statutes, section 
253.9   245.92, the centers for independent living, and the council on 
253.10  disability under Minnesota Statutes, section 256.482, must study 
253.11  the feasibility of reducing costs and increasing effectiveness 
253.12  through (1) space coordination, (2) shared use of technology, 
253.13  (3) coordination of resource priorities, and (4) consolidation 
253.14  and make recommendations to the house and senate committees with 
253.15  jurisdiction over these entities by January 15, 2004. 
253.16     Sec. 58.  [LICENSING CHANGE.] 
253.17     Notwithstanding Minnesota Statutes, sections 245A.11 and 
253.18  252.291, the commissioner of human services shall allow an 
253.19  existing intermediate care facility for persons with mental 
253.20  retardation or related conditions located in Goodhue county 
253.21  serving 39 children to be converted to four separately licensed 
253.22  or certified cottages serving up to six children each. 
253.23     Sec. 59.  [REVISOR'S INSTRUCTION.] 
253.24     For sections in Minnesota Statutes and Minnesota Rules 
253.25  affected by the repealed sections in this article, the revisor 
253.26  shall delete internal cross-references where appropriate and 
253.27  make changes necessary to correct the punctuation, grammar, or 
253.28  structure of the remaining text and preserve its meaning. 
253.29     Sec. 60.  [REPEALER.] 
253.30     (a) Minnesota Statutes 2002, sections 252.32, subdivision 
253.31  2; and 256B.5013, subdivision 4, are repealed July 1, 2003. 
253.32     (b) Laws 2001, First Special Session chapter 9, article 13, 
253.33  section 24, is repealed July 1, 2003. 
253.34                             ARTICLE 4 
253.35                        CHILDREN'S SERVICES 
253.36     Section 1.  Minnesota Statutes 2002, section 124D.23, 
254.1   subdivision 1, is amended to read: 
254.2      Subdivision 1.  [ESTABLISHMENT.] (a) In order to qualify as 
254.3   a family services collaborative, a minimum of one school 
254.4   district, one county, one public health entity, one community 
254.5   action agency as defined in section 119A.375, and one Head Start 
254.6   grantee if the community action agency is not the designated 
254.7   federal grantee for the Head Start program must agree in writing 
254.8   to provide coordinated family services and commit resources to 
254.9   an integrated fund.  Collaboratives are expected to have broad 
254.10  community representation, which may include other local 
254.11  providers, including additional school districts, counties, and 
254.12  public health entities, other municipalities, public libraries, 
254.13  existing culturally specific community organizations, tribal 
254.14  entities, local health organizations, private and nonprofit 
254.15  service providers, child care providers, local foundations, 
254.16  community-based service groups, businesses, local transit 
254.17  authorities or other transportation providers, community action 
254.18  agencies under section 119A.375, senior citizen volunteer 
254.19  organizations, parent organizations, parents, and sectarian 
254.20  organizations that provide nonsectarian services. 
254.21     (b) Members of the governing bodies of political 
254.22  subdivisions involved in the establishment of a family services 
254.23  collaborative shall select representatives of the 
254.24  nongovernmental entities listed in paragraph (a) to serve on the 
254.25  governing board of a collaborative.  The governing body members 
254.26  of the political subdivisions shall select one or more 
254.27  representatives of the nongovernmental entities within the 
254.28  family service collaborative. 
254.29     (c) Two or more family services collaboratives or 
254.30  children's mental health collaboratives may consolidate 
254.31  decision-making, pool resources, and collectively act on behalf 
254.32  of the individual collaboratives, based on a written agreement 
254.33  among the participating collaboratives. 
254.34     Sec. 2.  Minnesota Statutes 2002, section 245.4874, is 
254.35  amended to read: 
254.36     245.4874 [DUTIES OF COUNTY BOARD.] 
255.1      The county board in each county shall use its share of 
255.2   mental health and Community Social Services Act funds allocated 
255.3   by the commissioner according to a biennial children's mental 
255.4   health component of the community social services plan required 
255.5   under section 245.4888, and approved by the commissioner.  The 
255.6   county board must: 
255.7      (1) develop a system of affordable and locally available 
255.8   children's mental health services according to sections 245.487 
255.9   to 245.4888; 
255.10     (2) establish a mechanism providing for interagency 
255.11  coordination as specified in section 245.4875, subdivision 6; 
255.12     (3) develop a biennial children's mental health component 
255.13  of the community social services plan required under section 
255.14  256E.09 which considers the assessment of unmet needs in the 
255.15  county as reported by the local children's mental health 
255.16  advisory council under section 245.4875, subdivision 5, 
255.17  paragraph (b), clause (3).  The county shall provide, upon 
255.18  request of the local children's mental health advisory council, 
255.19  readily available data to assist in the determination of unmet 
255.20  needs; 
255.21     (4) assure that parents and providers in the county receive 
255.22  information about how to gain access to services provided 
255.23  according to sections 245.487 to 245.4888; 
255.24     (5) coordinate the delivery of children's mental health 
255.25  services with services provided by social services, education, 
255.26  corrections, health, and vocational agencies to improve the 
255.27  availability of mental health services to children and the 
255.28  cost-effectiveness of their delivery; 
255.29     (6) assure that mental health services delivered according 
255.30  to sections 245.487 to 245.4888 are delivered expeditiously and 
255.31  are appropriate to the child's diagnostic assessment and 
255.32  individual treatment plan; 
255.33     (7) provide the community with information about predictors 
255.34  and symptoms of emotional disturbances and how to access 
255.35  children's mental health services according to sections 245.4877 
255.36  and 245.4878; 
256.1      (8) provide for case management services to each child with 
256.2   severe emotional disturbance according to sections 245.486; 
256.3   245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 1, 3, 
256.4   and 5; 
256.5      (9) provide for screening of each child under section 
256.6   245.4885 upon admission to a residential treatment facility, 
256.7   acute care hospital inpatient treatment, or informal admission 
256.8   to a regional treatment center; 
256.9      (10) prudently administer grants and purchase-of-service 
256.10  contracts that the county board determines are necessary to 
256.11  fulfill its responsibilities under sections 245.487 to 245.4888; 
256.12     (11) assure that mental health professionals, mental health 
256.13  practitioners, and case managers employed by or under contract 
256.14  to the county to provide mental health services are qualified 
256.15  under section 245.4871; 
256.16     (12) assure that children's mental health services are 
256.17  coordinated with adult mental health services specified in 
256.18  sections 245.461 to 245.486 so that a continuum of mental health 
256.19  services is available to serve persons with mental illness, 
256.20  regardless of the person's age; ~~and~~ 
256.21     (13) assure that culturally informed mental health 
256.22  consultants are used as necessary to assist the county board in 
256.23  assessing and providing appropriate treatment for children of 
256.24  cultural or racial minority heritage; and 
256.25     (14) arrange for or provide a children's mental health 
256.26  screening to a child receiving child protective services or a 
256.27  child in out-of-home placement, a child for whom parental rights 
256.28  have been terminated, a child found to be delinquent, and a 
256.29  child found to have committed a juvenile petty offense for the 
256.30  third or subsequent time, unless a screening has been performed 
256.31  within the previous 180 days, or the child is currently under 
256.32  the care of a mental health professional.  The court or county 
256.33  agency must notify a parent or guardian whose parental rights 
256.34  have not been terminated of the potential mental health 
256.35  screening and the option to prevent the screening by notifying 
256.36  the court or county agency in writing.  The screening shall be 
257.1   conducted with a screening instrument approved by the 
257.2   commissioner of human services according to criteria that are 
257.3   updated and issued annually to ensure that approved screening 
257.4   instruments are valid and useful for child welfare and juvenile 
257.5   justice populations, and shall be conducted by a mental health 
257.6   practitioner as defined in section 245.4871, subdivision 26, or 
257.7   a probation officer or local social services agency staff person 
257.8   who is trained in the use of the screening instrument.  Training 
257.9   in the use of the instrument shall include training in the 
257.10  administration of the instrument, the interpretation of its 
257.11  validity given the child's current circumstances, the state and 
257.12  federal data practices laws and confidentiality standards, the 
257.13  parental consent requirement, and providing respect for families 
257.14  and cultural values.  If the screen indicates a need for 
257.15  assessment, the child's family, or if the family lacks mental 
257.16  health insurance, the local social services agency, in 
257.17  consultation with the child's family, shall have conducted a 
257.18  diagnostic assessment, including a functional assessment, as 
257.19  defined in section 245.4871.  The administration of the 
257.20  screening shall safeguard the privacy of children receiving the 
257.21  screening and their families and shall comply with the Minnesota 
257.22  Government Data Practices Act, chapter 13, and the federal 
257.23  Health Insurance Portability and Accountability Act of 1996, 
257.24  Public Law 104-191.  Screening results shall be considered 
257.25  private data and the commissioner shall not collect individual 
257.26  screening results. 
257.27     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
257.28     Sec. 3.  Minnesota Statutes 2002, section 245.493, 
257.29  subdivision 1a, is amended to read: 
257.30     Subd. 1a.  [DUTIES OF CERTAIN COORDINATING BODIES.] (a) By 
257.31  mutual agreement of the collaborative and a coordinating body 
257.32  listed in this subdivision, a children's mental health 
257.33  collaborative or a collaborative established by the merger of a 
257.34  children's mental health collaborative and a family services 
257.35  collaborative under section 124D.23, may assume the duties of a 
257.36  community transition interagency committee established under 
258.1   section 125A.22; an interagency early intervention committee 
258.2   established under section 125A.30; a local advisory council 
258.3   established under section 245.4875, subdivision 5; or a local 
258.4   coordinating council established under section 245.4875, 
258.5   subdivision 6. 
258.6      (b) Two or more family services collaboratives or 
258.7   children's mental health collaboratives may consolidate 
258.8   decision-making, pool resources, and collectively act on behalf 
258.9   of the individual collaboratives, based on a written agreement 
258.10  among the participating collaboratives. 
258.11     Sec. 4.  Minnesota Statutes 2002, section 256B.0625, 
258.12  subdivision 23, is amended to read: 
258.13     Subd. 23.  [DAY TREATMENT SERVICES.] Medical assistance 
258.14  covers day treatment services as specified in sections 245.462, 
258.15  subdivision 8, and 245.4871, subdivision 10, that are provided 
258.16  under contract with the county board.  Notwithstanding Minnesota 
258.17  Rules, part 9505.0323, subpart 15, the commissioner may set 
258.18  authorization thresholds for day treatment for adults according 
258.19  to section 256B.0625, subdivision 25.  Effective July 1, 2004, 
258.20  medical assistance covers day treatment services for children as 
258.21  specified under section 256B.0943.  
258.22     Sec. 5.  Minnesota Statutes 2002, section 256B.0625, is 
258.23  amended by adding a subdivision to read: 
258.24     Subd. 35a.  [CHILDREN'S MENTAL HEALTH CRISIS RESPONSE 
258.25  SERVICES.] Medical assistance covers children's mental health 
258.26  crisis response services according to section 256B.0944. 
258.27     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
258.28     Sec. 6.  Minnesota Statutes 2002, section 256B.0625, is 
258.29  amended by adding a subdivision to read: 
258.30     Subd. 35b.  [CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.] 
258.31  Medical assistance covers children's therapeutic services and 
258.32  supports according to section 256B.0943. 
258.33     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
258.34     Sec. 7.  Minnesota Statutes 2002, section 256B.0625, is 
258.35  amended by adding a subdivision to read: 
258.36     Subd. 45.  [SUBACUTE PSYCHIATRIC CARE FOR PERSONS UNDER 21 
259.1   YEARS OF AGE.] Medical assistance covers subacute psychiatric 
259.2   care for person under 21 years of age when: 
259.3      (1) the services meet the requirements of Code of Federal 
259.4   Regulations, title 42, section 440.160; 
259.5      (2) the facility is accredited as a psychiatric treatment 
259.6   facility by the joint commission on accreditation of healthcare 
259.7   organizations, the commission on accreditation of rehabilitation 
259.8   facilities, or the council on accreditation; and 
259.9      (3) the facility is licensed by the commissioner of health 
259.10  under section 144.50. 
259.11     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
259.12     Sec. 8.  [256B.0943] [CHILDREN'S THERAPEUTIC SERVICES AND 
259.13  SUPPORTS.] 
259.14     Subdivision 1.  [DEFINITIONS.] For purposes of this 
259.15  section, the following terms have the meanings given them. 
259.16     (a) "Children's therapeutic services and supports" means 
259.17  the flexible package of mental health services for children who 
259.18  require varying therapeutic and rehabilitative levels of 
259.19  intervention.  The services are time-limited interventions that 
259.20  are delivered using various treatment modalities and 
259.21  combinations of services designed to reach treatment outcomes 
259.22  identified in the individual treatment plan. 
259.23     (b) "Clinical supervision" means the overall responsibility 
259.24  of the mental health professional for the control and direction 
259.25  of individualized treatment planning, service delivery, and 
259.26  treatment review for each client.  A mental health professional 
259.27  who is an enrolled Minnesota health care program provider 
259.28  accepts full professional responsibility for a supervisee's 
259.29  actions and decisions, instructs the supervisee in the 
259.30  supervisee's work, and oversees or directs the supervisee's work.
259.31     (c) "County board" means the county board of commissioners 
259.32  or board established under sections 402.01 to 402.10 or 471.59. 
259.33     (d) "Crisis assistance" has the meaning given in section 
259.34  245.4871, subdivision 9a. 
259.35     (e) "Culturally competent provider" means a provider who 
259.36  understands and can utilize to a client's benefit the client's 
260.1   culture when providing services to the client.  A provider may 
260.2   be culturally competent because the provider is of the same 
260.3   cultural or ethnic group as the client or the provider has 
260.4   developed the knowledge and skills through training and 
260.5   experience to provide services to culturally diverse clients. 
260.6      (f) "Day treatment program" for children means a site-based 
260.7   structured program consisting of group psychotherapy for more 
260.8   than three individuals and other intensive therapeutic services 
260.9   provided by a multidisciplinary team, under the clinical 
260.10  supervision of a mental health professional. 
260.11     (g) "Diagnostic assessment" has the meaning given in 
260.12  section 245.4871, subdivision 11. 
260.13     (h) "Direct service time" means the time that a mental 
260.14  health professional, mental health practitioner, or mental 
260.15  health behavioral aide spends face-to-face with a client and the 
260.16  client's family.  Direct service time includes time in which the 
260.17  provider obtains a client's history or provides service 
260.18  components of children's therapeutic services and supports.  
260.19  Direct service time does not include time doing work before and 
260.20  after providing direct services, including scheduling, 
260.21  maintaining clinical records, consulting with others about the 
260.22  client's mental health status, preparing reports, receiving 
260.23  clinical supervision directly related to the client's 
260.24  psychotherapy session, and revising the client's individual 
260.25  treatment plan. 
260.26     (i) "Direction of mental health behavioral aide" means the 
260.27  activities of a mental health professional or mental health 
260.28  practitioner in guiding the mental health behavioral aide in 
260.29  providing services to a client.  The direction of a mental 
260.30  health behavioral aide must be based on the client's 
260.31  individualized treatment plan and meet the requirements in 
260.32  subdivision 6, paragraph (b), clause (5). 
260.33     (j) "Emotional disturbance" has the meaning given in 
260.34  section 245.4871, subdivision 15.  For persons at least age 18 
260.35  but under age 21, mental illness has the meaning given in 
260.36  section 245.462, subdivision 20, paragraph (a). 
261.1      (k) "Individual behavioral plan" means a plan of 
261.2   intervention, treatment, and services for a child written by a 
261.3   mental health professional or mental health practitioner, under 
261.4   the clinical supervision of a mental health professional, to 
261.5   guide the work of the mental health behavioral aide. 
261.6      (l) "Individual treatment plan" has the meaning given in 
261.7   section 245.4871, subdivision 21. 
261.8      (m) "Mental health professional" means an individual as 
261.9   defined in section 245.4871, subdivision 27, clauses (1) to (5), 
261.10  or tribal vendor as defined in section 256B.02, subdivision 7, 
261.11  paragraph (b). 
261.12     (n) "Preschool program" means a day program licensed under 
261.13  Minnesota Rules, parts 9503.0005 to 9503.0175, and enrolled as a 
261.14  children's therapeutic services and supports provider to provide 
261.15  a structured treatment program to a child who is at least 33 
261.16  months old but who has not yet attended the first day of 
261.17  kindergarten. 
261.18     (o) "Skills training" means individual, family, or group 
261.19  training designed to improve the basic functioning of the child 
261.20  with emotional disturbance and the child's family in the 
261.21  activities of daily living and community living, and to improve 
261.22  the social functioning of the child and the child's family in 
261.23  areas important to the child's maintaining or reestablishing 
261.24  residency in the community.  Individual, family, and group 
261.25  skills training must: 
261.26     (1) consist of activities designed to promote skill 
261.27  development of the child and the child's family in the use of 
261.28  age-appropriate daily living skills, interpersonal and family 
261.29  relationships, and leisure and recreational services; 
261.30     (2) consist of activities that will assist the family's 
261.31  understanding of normal child development and to use parenting 
261.32  skills that will help the child with emotional disturbance 
261.33  achieve the goals outlined in the child's individual treatment 
261.34  plan; and 
261.35     (3) promote family preservation and unification, promote 
261.36  the family's integration with the community, and reduce the use 
262.1   of unnecessary out-of-home placement or institutionalization of 
262.2   children with emotional disturbance. 
262.3      Subd. 2.  [COVERED SERVICE COMPONENTS OF CHILDREN'S 
262.4   THERAPEUTIC SERVICES AND SUPPORTS.] (a) Subject to federal 
262.5   approval, medical assistance covers medically necessary 
262.6   children's therapeutic services and supports as defined in this 
262.7   section that an eligible provider entity under subdivisions 4 
262.8   and 5 provides to a client eligible under subdivision 3. 
262.9      (b) The service components of children's therapeutic 
262.10  services and supports are: 
262.11     (1) individual, family, and group psychotherapy; 
262.12     (2) individual, family, or group skills training provided 
262.13  by a mental health professional or mental health practitioner; 
262.14     (3) crisis assistance; 
262.15     (4) mental health behavioral aide services; and 
262.16     (5) direction of a mental health behavioral aide. 
262.17     (c) Service components may be combined to constitute 
262.18  therapeutic programs, including day treatment programs and 
262.19  preschool programs.  Although day treatment and preschool 
262.20  programs have specific client and provider eligibility 
262.21  requirements, medical assistance only pays for the service 
262.22  components listed in paragraph (b). 
262.23     Subd. 3.  [DETERMINATION OF CLIENT ELIGIBILITY.] A client's 
262.24  eligibility to receive children's therapeutic services and 
262.25  supports under this section shall be determined based on a 
262.26  diagnostic assessment by a mental health professional that is 
262.27  performed within 180 days of the initial start of service.  The 
262.28  diagnostic assessment must: 
262.29     (1) include current diagnoses on all five axes of the 
262.30  client's current mental health status; 
262.31     (2) determine whether a child under age 18 has a diagnosis 
262.32  of emotional disturbance or, if the person is between the ages 
262.33  of 18 and 21, whether the person has a mental illness; 
262.34     (3) document children's therapeutic services and supports 
262.35  as medically necessary to address an identified disability, 
262.36  functional impairment, and the individual client's needs and 
263.1   goals; 
263.2      (4) be used in the development of the individualized 
263.3   treatment plan; and 
263.4      (5) be completed annually until age 18.  For individuals 
263.5   between age 18 and 21, unless a client's mental health condition 
263.6   has changed markedly since the client's most recent diagnostic 
263.7   assessment, annual updating is necessary.  For the purpose of 
263.8   this section, "updating" means a written summary, including 
263.9   current diagnoses on all five axes, by a mental health 
263.10  professional of the client's current mental health status and 
263.11  service needs. 
263.12     Subd. 4.  [PROVIDER ENTITY CERTIFICATION.] (a) Effective 
263.13  July 1, 2003, the commissioner shall establish an initial 
263.14  provider entity application and certification process and 
263.15  recertification process to determine whether a provider entity 
263.16  has an administrative and clinical infrastructure that meets the 
263.17  requirements in subdivisions 5 and 6.  The commissioner shall 
263.18  recertify a provider entity at least every three years.  The 
263.19  commissioner shall establish a process for decertification of a 
263.20  provider entity that no longer meets the requirements in this 
263.21  section.  The county, tribe, and the commissioner shall be 
263.22  mutually responsible and accountable for the county's, tribe's, 
263.23  and state's part of the certification, recertification, and 
263.24  decertification processes. 
263.25     (b) For purposes of this section, a provider entity must be:
263.26     (1) an Indian health services facility or a facility owned 
263.27  and operated by a tribe or tribal organization operating as a 
263.28  638 facility under Public Law 93-368 certified by the state; 
263.29     (2) a county-operated entity certified by the state; or 
263.30     (3) a noncounty entity recommended for certification by the 
263.31  provider's host county and certified by the state. 
263.32     Subd. 5.  [PROVIDER ENTITY ADMINISTRATIVE INFRASTRUCTURE 
263.33  REQUIREMENTS.] (a) To be an eligible provider entity under this 
263.34  section, a provider entity must have an administrative 
263.35  infrastructure that establishes authority and accountability for 
263.36  decision making and oversight of functions, including finance, 
264.1   personnel, system management, clinical practice, and performance 
264.2   measurement.  The provider must have written policies and 
264.3   procedures that it reviews and updates every three years and 
264.4   distributes to staff initially and upon each subsequent update. 
264.5      (b) The administrative infrastructure written policies and 
264.6   procedures must include: 
264.7      (1) personnel procedures, including a process for:  (i) 
264.8   recruiting, hiring, training, and retention of culturally and 
264.9   linguistically competent providers; (ii) conducting a criminal 
264.10  background check on all direct service providers and volunteers; 
264.11  (iii) investigating, reporting, and acting on violations of 
264.12  ethical conduct standards; (iv) investigating, reporting, and 
264.13  acting on violations of data privacy policies that are compliant 
264.14  with federal and state laws; (v) utilizing volunteers, including 
264.15  screening applicants, training and supervising volunteers, and 
264.16  providing liability coverage for volunteers; and (vi) 
264.17  documenting that a mental health professional, mental health 
264.18  practitioner, or mental health behavioral aide meets the 
264.19  applicable provider qualification criteria, training criteria 
264.20  under subdivision 8, and clinical supervision or direction of a 
264.21  mental health behavioral aide requirements under subdivision 6; 
264.22     (2) fiscal procedures, including internal fiscal control 
264.23  practices and a process for collecting revenue that is compliant 
264.24  with federal and state laws; 
264.25     (3) if a client is receiving services from a case manager 
264.26  or other provider entity, a service coordination process that 
264.27  ensures services are provided in the most appropriate manner to 
264.28  achieve maximum benefit to the client.  The provider entity must 
264.29  ensure coordination and nonduplication of services consistent 
264.30  with county board coordination procedures established under 
264.31  section 245.4881, subdivision 5; 
264.32     (4) a performance measurement system, including monitoring 
264.33  to determine cultural appropriateness of services identified in 
264.34  the individual treatment plan, as determined by the client's 
264.35  culture, beliefs, values, and language, and family-driven 
264.36  services; and 
265.1      (5) a process to establish and maintain individual client 
265.2   records.  The client's records must include:  (i) the client's 
265.3   personal information; (ii) forms applicable to data privacy; 
265.4   (iii) the client's diagnostic assessment, updates, tests, 
265.5   individual treatment plan, and individual behavior plan, if 
265.6   necessary; (iv) documentation of service delivery as specified 
265.7   under subdivision 6; (v) telephone contacts; (vi) discharge 
265.8   plan; and (vii) if applicable, insurance information. 
265.9      Subd. 6.  [PROVIDER ENTITY CLINICAL INFRASTRUCTURE 
265.10  REQUIREMENTS.] (a) To be an eligible provider entity under this 
265.11  section, a provider entity must have a clinical infrastructure 
265.12  that utilizes diagnostic assessment, an individualized treatment 
265.13  plan, service delivery, and individual treatment plan review 
265.14  that are culturally competent, child-centered, and family-driven 
265.15  to achieve maximum benefit for the client.  The provider entity 
265.16  must review and update the clinical policies and procedures 
265.17  every three years and must distribute the policies and 
265.18  procedures to staff initially and upon each subsequent update. 
265.19     (b) The clinical infrastructure written policies and 
265.20  procedures must include policies and procedures for: 
265.21     (1) providing or obtaining a client's diagnostic assessment 
265.22  that identifies acute and chronic clinical disorders, 
265.23  co-occurring medical conditions, sources of psychological and 
265.24  environmental problems, and a functional assessment.  The 
265.25  functional assessment must clearly summarize the client's 
265.26  individual strengths and needs; 
265.27     (2) developing an individual treatment plan that is:  (i) 
265.28  based on the information in the client's diagnostic assessment; 
265.29  (ii) developed no later than the end of the first psychotherapy 
265.30  session after the completion of the client's diagnostic 
265.31  assessment by the mental health professional who provides the 
265.32  client's psychotherapy; (iii) developed through a 
265.33  child-centered, family-driven planning process that identifies 
265.34  service needs and individualized, planned, and culturally 
265.35  appropriate interventions that contain specific treatment goals 
265.36  and objectives for the client and the client's family or foster 
266.1   family; (iv) reviewed at least once every 90 days and revised, 
266.2   if necessary; and (v) signed by the client or, if appropriate, 
266.3   by the client's parent or other person authorized by statute to 
266.4   consent to mental health services for the client; 
266.5      (3) developing an individual behavior plan that documents 
266.6   services to be provided by the mental health behavioral aide.  
266.7   The individual behavior plan must include:  (i) detailed 
266.8   instructions on the service to be provided; (ii) time allocated 
266.9   to each service; (iii) methods of documenting the child's 
266.10  behavior; (iv) methods of monitoring the child's progress in 
266.11  reaching objectives; and (v) goals to increase or decrease 
266.12  targeted behavior as identified in the individual treatment 
266.13  plan; 
266.14     (4) clinical supervision of the mental health practitioner 
266.15  and mental health behavioral aide.  A mental health professional 
266.16  must document the clinical supervision the professional provides 
266.17  by cosigning individual treatment plans and making entries in 
266.18  the client's record on supervisory activities.  Clinical 
266.19  supervision does not include the authority to make or terminate 
266.20  court-ordered placements of the child.  A clinical supervisor 
266.21  must be available for urgent consultation as required by the 
266.22  individual client's needs or the situation.  Clinical 
266.23  supervision may occur individually or in a small group to 
266.24  discuss treatment and review progress toward goals.  The focus 
266.25  of clinical supervision must be the client's treatment needs and 
266.26  progress and the mental health practitioner's or behavioral 
266.27  aide's ability to provide services; 
266.28     (5) providing direction to a mental health behavioral 
266.29  aide.  For entities that employ mental health behavioral aides, 
266.30  the clinical supervisor must be employed by the provider entity 
266.31  to ensure necessary and appropriate oversight for the client's 
266.32  treatment and continuity of care.  The mental health 
266.33  professional or mental health practitioner giving direction must 
266.34  begin with the goals on the individualized treatment plan, and 
266.35  instruct the mental health behavioral aide on how to construct 
266.36  therapeutic activities and interventions that will lead to goal 
267.1   attainment.  The professional or practitioner giving direction 
267.2   must also instruct the mental health behavioral aide about the 
267.3   client's diagnosis, functional status, and other characteristics 
267.4   that are likely to affect service delivery.  Direction must also 
267.5   include determining that the mental health behavioral aide has 
267.6   the skills to interact with the client and the client's family 
267.7   in ways that convey personal and cultural respect and that the 
267.8   aide actively solicits information relevant to treatment from 
267.9   the family.  The aide must be able to clearly explain the 
267.10  activities the aide is doing with the client and the activities' 
267.11  relationship to treatment goals.  Direction is more didactic 
267.12  than is supervision and requires the professional or 
267.13  practitioner providing it to continuously evaluate the mental 
267.14  health behavioral aide's ability to carry out the activities of 
267.15  the individualized treatment plan and the individualized 
267.16  behavior plan.  When providing direction, the professional or 
267.17  practitioner must:  (i) review progress notes prepared by the 
267.18  mental health behavioral aide for accuracy and consistency with 
267.19  diagnostic assessment, treatment plan, and behavior goals and 
267.20  the professional or practitioner must approve and sign the 
267.21  progress notes; (ii) identify changes in treatment strategies, 
267.22  revise the individual behavior plan, and communicate treatment 
267.23  instructions and methodologies as appropriate to ensure that 
267.24  treatment is implemented correctly; (iii) demonstrate 
267.25  family-friendly behaviors that support healthy collaboration 
267.26  among the child, the child's family, and providers as treatment 
267.27  is planned and implemented; (iv) ensure that the mental health 
267.28  behavioral aide is able to effectively communicate with the 
267.29  child, the child's family, and the provider; and (v) record the 
267.30  results of any evaluation and corrective actions taken to modify 
267.31  the work of the mental health behavioral aide; 
267.32     (6) providing service delivery that implements the 
267.33  individual treatment plan and meets the requirements under 
267.34  subdivision 9; and 
267.35     (7) individual treatment plan review.  The review must 
267.36  determine the extent to which the services have met the goals 
268.1   and objectives in the previous treatment plan.  The review must 
268.2   assess the client's progress and ensure that services and 
268.3   treatment goals continue to be necessary and appropriate to the 
268.4   client and the client's family or foster family.  Revision of 
268.5   the individual treatment plan does not require a new diagnostic 
268.6   assessment unless the client's mental health status has changed 
268.7   markedly.  The updated treatment plan must be signed by the 
268.8   client, if appropriate, and by the client's parent or other 
268.9   person authorized by statute to give consent to the mental 
268.10  health services for the child. 
268.11     Subd. 7.  [QUALIFICATIONS OF INDIVIDUAL AND TEAM 
268.12  PROVIDERS.] (a) An individual or team provider working within 
268.13  the scope of the provider's practice or qualifications may 
268.14  provide service components of children's therapeutic services 
268.15  and supports that are identified as medically necessary in a 
268.16  client's individual treatment plan. 
268.17     (b) An individual provider and multidisciplinary team 
268.18  include: 
268.19     (1) a mental health professional as defined in subdivision 
268.20  1, paragraph (m); 
268.21     (2) a mental health practitioner as defined in section 
268.22  245.4871, subdivision 26.  The mental health practitioner must 
268.23  work under the clinical supervision of a mental health 
268.24  professional; 
268.25     (3) a mental health behavioral aide working under the 
268.26  direction of a mental health professional to implement the 
268.27  rehabilitative mental health services identified in the client's 
268.28  individual treatment plan.  A level I mental health behavioral 
268.29  aide must:  (i) be at least 18 years old; (ii) have a high 
268.30  school diploma or general equivalency diploma (GED) or two years 
268.31  of experience as a primary caregiver to a child with severe 
268.32  emotional disturbance within the previous ten years; and (iii) 
268.33  meet preservices and continuing education requirements under 
268.34  subdivision 8.  A level II mental health behavioral aide must: 
268.35  (i) be at least 18 years old; (ii) have an associate or 
268.36  bachelor's degree or 4,000 hours of experience in delivering 
269.1   clinical services in the treatment of mental illness concerning 
269.2   children or adolescents; and (iii) meet preservice and 
269.3   continuing education requirements in subdivision 8; 
269.4      (4) a preschool program multidisciplinary team that 
269.5   includes at least one mental health professional and one or more 
269.6   of the following individuals under the clinical supervision of a 
269.7   mental health professional:  (i) a mental health practitioner; 
269.8   or (ii) a program person, including a teacher, assistant 
269.9   teacher, or aide, who meets the qualifications and training 
269.10  standards of a level I mental health behavioral aide; or 
269.11     (5) a day treatment multidisciplinary team that includes at 
269.12  least one mental health professional and one mental health 
269.13  practitioner. 
269.14     Subd. 8.  [REQUIRED PRESERVICE AND CONTINUING 
269.15  EDUCATION.] (a) A provider entity shall establish a plan to 
269.16  provide preservice and continuing education for staff.  The plan 
269.17  must clearly describe the type of training necessary to maintain 
269.18  current skills and obtain new skills, and that relates to the 
269.19  provider entity's goals and objectives for services offered. 
269.20     (b) A provider that employs a mental health behavioral aide 
269.21  under this section must require the mental health behavioral 
269.22  aide to complete 30 hours of preservice training.  The 
269.23  preservice training must include topics specified in Minnesota 
269.24  Rules, part 9535.4068, subparts 1 and 2, and parent team 
269.25  training.  The preservice training must include 15 hours of 
269.26  in-person training of a mental health behavioral aide in mental 
269.27  health services delivery and eight hours of parent team 
269.28  training.  Components of parent team training include:  
269.29     (1) partnering with parents; 
269.30     (2) fundamentals of family support; 
269.31     (3) fundamentals of policy and decision making; 
269.32     (4) defining equal partnership; 
269.33     (5) complexities of the parent and service provider 
269.34  partnership in multiple service delivery systems due to system 
269.35  strengths and weaknesses; 
269.36     (6) sibling impacts; 
270.1      (7) support networks; and 
270.2      (8) community resources. 
270.3      (c) A provider entity that employs a mental health 
270.4   practitioner and a mental health behavioral aide to provide 
270.5   children's therapeutic services and supports under this section 
270.6   must require the mental health practitioner and mental health 
270.7   behavioral aide to complete 20 hours of continuing education 
270.8   every two calendar years.  The continuing education must be 
270.9   related to serving the needs of a child with emotional 
270.10  disturbance in the child's home environment and the child's 
270.11  family.  The topics covered in orientation and training must 
270.12  conform to Minnesota Rules, part 9535.4068. 
270.13     (d) The provider entity must document the mental health 
270.14  practitioner's or mental health behavioral aide's annual 
270.15  completion of the required continuing education.  The 
270.16  documentation must include the date, subject, and number of 
270.17  hours of the continuing education, and attendance records, as 
270.18  verified by the staff member's signature, job title, and the 
270.19  instructor's name.  The provider entity must keep documentation 
270.20  for each employee, including records of attendance at 
270.21  professional workshops and conferences, at a central location 
270.22  and in the employee's personnel file. 
270.23     Subd. 9.  [SERVICE DELIVERY CRITERIA.] (a) In delivering 
270.24  services under this section, a certified provider entity must 
270.25  ensure that: 
270.26     (1) each individual provider's caseload size permits the 
270.27  provider to deliver services to both clients with severe, 
270.28  complex needs and clients with less intensive needs.  The 
270.29  provider's caseload size should reasonably enable the provider 
270.30  to play an active role in service planning, monitoring, and 
270.31  delivering services to meet the client's and client's family's 
270.32  needs, as specified in each client's individual treatment plan; 
270.33     (2) site-based programs, including day treatment and 
270.34  preschool programs, provide staffing and facilities to ensure 
270.35  the client's health, safety, and protection of rights, and that 
270.36  the programs are able to implement each client's individual 
271.1   treatment plan; 
271.2      (3) a day treatment program is provided to a group of 
271.3   clients by a multidisciplinary staff under the clinical 
271.4   supervision of a mental health professional.  The day treatment 
271.5   program must be provided in and by:  (i) an outpatient hospital 
271.6   accredited by the joint commission on accreditation of health 
271.7   organizations and licensed under sections 144.50 to 144.55; (ii) 
271.8   a community mental health center under section 245.62; and (iii) 
271.9   an entity that is under contract with the county board to 
271.10  operate a program that meets the requirements of sections 
271.11  245.4712, subdivision 2, and 245.4884, subdivision 2, and 
271.12  Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment 
271.13  program must stabilize the client's mental health status while 
271.14  developing and improving the client's independent living and 
271.15  socialization skills.  The goal of the day treatment program 
271.16  must be to reduce or relieve the effects of mental illness and 
271.17  provide training to enable the client to live in the community.  
271.18  The program must be available at least one day a week for a 
271.19  minimum three-hour time block.  The three-hour time block must 
271.20  include at least one hour, but no more than two hours, of 
271.21  individual or group psychotherapy.  The remainder of the 
271.22  three-hour time block may include recreation therapy, 
271.23  socialization therapy, or independent living skills therapy, but 
271.24  only if the therapies are included in the client's individual 
271.25  treatment plan.  Day treatment programs are not part of 
271.26  inpatient or residential treatment services; and 
271.27     (4) a preschool program is a structured treatment program 
271.28  offered to a child who is at least 33 months old, but who has 
271.29  not yet reached the first day of kindergarten, by a preschool 
271.30  multidisciplinary team in a day program licensed under Minnesota 
271.31  Rules, parts 9503.0005 to 9503.0175.  The program must be 
271.32  available at least one day a week for a minimum two-hour time 
271.33  block.  The structured treatment program may include individual 
271.34  or group psychotherapy and recreation therapy, socialization 
271.35  therapy, or independent living skills therapy, if included in 
271.36  the client's individual treatment plan. 
272.1      (b) A provider entity must delivery the service components 
272.2   of children's therapeutic services and supports in compliance 
272.3   with the following requirements: 
272.4      (1) individual, family, and group psychotherapy must be 
272.5   delivered as specified in Minnesota Rules, parts 9505.0523; 
272.6      (2) individual, family, or group skills training must be 
272.7   provided by a mental health professional or a mental health 
272.8   practitioner who has a consulting relationship with a mental 
272.9   health professional who accepts full professional responsibility 
272.10  for the training; 
272.11     (3) crisis assistance must be an intense, time-limited, and 
272.12  designed to resolve or stabilize crisis through arrangements for 
272.13  direct intervention and support services to the child and the 
272.14  child's family.  Crisis assistance must utilize resources 
272.15  designed to address abrupt or substantial changes in the 
272.16  functioning of the child or the child's family as evidenced by a 
272.17  sudden change in behavior with negative consequences for well 
272.18  being, a loss of usual coping mechanisms, or the presentation of 
272.19  danger to self or others; 
272.20     (4) medically necessary services that are provided by a 
272.21  mental health behavioral aide must be designed to improve the 
272.22  functioning of the child and support the family in activities of 
272.23  daily and community living.  A mental health behavioral aide 
272.24  must document the delivery of services in written progress 
272.25  notes.  The mental health behavioral aide must implement goals 
272.26  in the treatment plan for the child's emotional disturbance that 
272.27  allow the child to acquire developmentally and therapeutically 
272.28  appropriate daily living skills, social skills, and leisure and 
272.29  recreational skills through targeted activities.  These 
272.30  activities may include: 
272.31     (i) assisting a child as needed with skills development in 
272.32  dressing, eating, and toileting; 
272.33     (ii) assisting, monitoring, and guiding the child to 
272.34  complete tasks, including facilitating the child's participation 
272.35  in medical appointments; 
272.36     (iii) observing the child and intervening to redirect the 
273.1   child's inappropriate behavior; 
273.2      (iv) assisting the child in using age-appropriate 
273.3   self-management skills as related to the child's emotional 
273.4   disorder or mental illness, including problem solving, decision 
273.5   making, communication, conflict resolution, anger management, 
273.6   social skills, and recreational skills; 
273.7      (v) implementing deescalation techniques as recommended by 
273.8   the mental health professional; 
273.9      (vi) implementing any other mental health service that the 
273.10  mental health professional has approved as being within the 
273.11  scope of the behavioral aide's duties; or 
273.12     (vii) assisting the parents to develop and use parenting 
273.13  skills that help the child achieve the goals outlined in the 
273.14  child's individual treatment plan or individual behavioral 
273.15  plan.  Parenting skills must be directed exclusively to the 
273.16  child's treatment; and 
273.17     (5) direction of a mental health behavioral aide must 
273.18  include the following: 
273.19     (i) a total of one hour of on-site observation by a mental 
273.20  health professional during the first 12 hours of service 
273.21  provided to a child; 
273.22     (ii) ongoing on-site observation by a mental health 
273.23  professional or mental health practitioner for at least a total 
273.24  of one hour during every 40 hours of service provided to a 
273.25  child; and 
273.26     (iii) immediate accessibility of the mental health 
273.27  professional or mental health practitioner to the mental health 
273.28  behavioral aide during service provision. 
273.29     Subd. 10.  [SERVICE AUTHORIZATION.] The commissioner shall 
273.30  publish in the State Register a list of health services that 
273.31  require prior authorization, as well as the criteria and 
273.32  standards used to select health services on the list.  The list 
273.33  and the criteria and standards used to formulate the list are 
273.34  not subject to the requirements of sections 14.001 to 14.69.  
273.35  The commissioner's decision on whether prior authorization is 
273.36  required for a health service is not subject to administrative 
274.1   appeal. 
274.2      Subd. 11.  [DOCUMENTATION AND BILLING.] (a) A provider 
274.3   entity must document the services it provides under this 
274.4   section.  The provider entity must ensure that the entity's 
274.5   documentation standards meet the requirements of federal and 
274.6   state laws.  Services billed under this section that are not 
274.7   documented according to this subdivision shall be subject to 
274.8   monetary recovery by the commissioner. 
274.9      (b) An individual mental health provider must promptly 
274.10  document the following in a client's record after providing 
274.11  services to the client: 
274.12     (1) each occurrence of the client's mental health service, 
274.13  including the date, type, length, and scope of the service; 
274.14     (2) the name of the person who gave the service; 
274.15     (3) contact made with other persons interested in the 
274.16  client, including representatives of the courts, corrections 
274.17  systems, or schools.  The provider must document the name and 
274.18  date of each contact; 
274.19     (4) any contact made with the client's other mental health 
274.20  providers, case manager, family members, primary caregiver, 
274.21  legal representative, or the reason the provider did not contact 
274.22  the client's family members, primary caregiver, or legal 
274.23  representative, if applicable; and 
274.24     (5) required clinical supervision, as appropriate. 
274.25     Subd. 12.  [EXCLUDED SERVICES.] The following services are 
274.26  not eligible for medical assistance payment as children's 
274.27  therapeutic services and supports: 
274.28     (1) service components of children's therapeutic services 
274.29  and supports simultaneously provided by more than one provider 
274.30  entity unless prior authorization is obtained; 
274.31     (2) children's therapeutic services and supports provided 
274.32  in violation of medical assistance policy in Minnesota Rules, 
274.33  part 9505.0220; 
274.34     (3) mental health behavioral aide services provided by a 
274.35  personal care assistant who is not qualified as a mental health 
274.36  behavioral aide and employed by a certified children's 
275.1   therapeutic services and supports provider entity; 
275.2      (4) services that are the responsibility of a residential 
275.3   or program license holder, including foster care providers under 
275.4   the terms of a service agreement or administrative rules 
275.5   governing licensure; 
275.6      (5) up to 15 hours of children's therapeutic services and 
275.7   supports provided within a six-month period to a child with 
275.8   severe emotional disturbance who is residing in a hospital, a 
275.9   group home as defined in Minnesota Rules, part 9560.0520, 
275.10  subpart 4, a residential treatment facility licensed under 
275.11  Minnesota Rules, parts 9545.0900 to 9545.1090, a regional 
275.12  treatment center, or other institutional group setting or who is 
275.13  participating in a program of partial hospitalization are 
275.14  eligible for medical assistance payment if part of the discharge 
275.15  plan; and 
275.16     (6) adjunctive activities that may be offered by a provider 
275.17  entity but are not otherwise covered by medical assistance, 
275.18  including: 
275.19     (i) a service that is primarily recreation oriented or that 
275.20  is provided in a setting that is not medically supervised.  This 
275.21  includes sports activities, exercise groups, activities such as 
275.22  craft hours, leisure time, social hours, meal or snack time, 
275.23  trips to community activities, and tours; 
275.24     (ii) a social or educational service that does not have or 
275.25  cannot reasonably be expected to have a therapeutic outcome 
275.26  related to the client's emotional disturbance; 
275.27     (iii) consultation with other providers or service agency 
275.28  staff about the care or progress of a client; 
275.29     (iv) prevention or education programs provided to the 
275.30  community; and 
275.31     (v) treatment for clients with primary diagnoses of alcohol 
275.32  or other drug abuse. 
275.33     <b>[EFFECTIVE DATE.]</b> Unless otherwise specified, this section 
275.34  is effective July 1, 2004. 
275.35     Sec. 9.  [256B.0944] [COVERED SERVICES; CHILDREN'S MENTAL 
275.36  HEALTH CRISIS RESPONSE SERVICES.] 
276.1      Subdivision 1.  [DEFINITIONS.] For purposes of this 
276.2   section, the following terms have the meanings given them. 
276.3      (a) "Mental health crisis" means a child's behavioral, 
276.4   emotional, or psychiatric situation that, but for the provision 
276.5   of crisis response services to the child, would likely result in 
276.6   significantly reduced levels of functioning in primary 
276.7   activities of daily living, an emergency situation, or the 
276.8   child's placement in a more restrictive setting, including, but 
276.9   not limited to, inpatient hospitalization. 
276.10     (b) "Mental health emergency" means a child's behavioral, 
276.11  emotional, or psychiatric situation that causes an immediate 
276.12  need for mental health services and is consistent with section 
276.13  62Q.55.  A physician, mental health professional, or crisis 
276.14  mental health practitioner determines a mental health crisis or 
276.15  emergency for medical assistance reimbursement with input from 
276.16  the client and the client's family, if possible. 
276.17     (c) "Mental health crisis assessment" means an immediate 
276.18  face-to-face assessment by a physician, mental health 
276.19  professional, or mental health practitioner under the clinical 
276.20  supervision of a mental health professional, following a 
276.21  screening that suggests the child may be experiencing a mental 
276.22  health crisis or mental health emergency situation. 
276.23     (d) "Mental health mobile crisis intervention services" 
276.24  means face-to-face, short-term intensive mental health services 
276.25  initiated during a mental health crisis or mental health 
276.26  emergency.  Mental health mobile crisis services must help the 
276.27  recipient cope with immediate stressors, identify and utilize 
276.28  available resources and strengths, and begin to return to the 
276.29  recipient's baseline level of functioning.  Mental health mobile 
276.30  services must be provided on-site by a mobile crisis 
276.31  intervention team outside of an emergency room, urgent care, or 
276.32  an inpatient hospital setting. 
276.33     (e) "Mental health crisis stabilization services" means 
276.34  individualized mental health services provided to a recipient 
276.35  following crisis intervention services that are designed to 
276.36  restore the recipient to the recipient's prior functional 
277.1   level.  The individual treatment plan recommending mental health 
277.2   crisis stabilization must be completed by the intervention team 
277.3   or by staff after an inpatient or urgent care visit.  Mental 
277.4   health crisis stabilization services may be provided in the 
277.5   recipient's home, the home of a family member or friend of the 
277.6   recipient, schools, another community setting, or a short-term 
277.7   supervised, licensed residential program if the service is not 
277.8   included in the facility's cost pool or per diem.  Mental health 
277.9   crisis stabilization is not reimbursable when provided as part 
277.10  of a partial hospitalization or day treatment program. 
277.11     Subd. 2.  [MEDICAL ASSISTANCE COVERAGE.] Medical assistance 
277.12  covers medically necessary children's mental health crisis 
277.13  response services, subject to federal approval, if provided to 
277.14  an eligible recipient under subdivision 3, by a qualified 
277.15  provider entity under subdivision 4 or a qualified individual 
277.16  provider working within the provider's scope of practice, and 
277.17  identified in the recipient's individual crisis treatment plan 
277.18  under subdivision 8. 
277.19     Subd. 3.  [ELIGIBILITY.] An eligible recipient is an 
277.20  individual who: 
277.21     (1) is eligible for medical assistance; 
277.22     (2) is under age 18 or between the ages of 18 and 21; 
277.23     (3) is screened as possibly experiencing a mental health 
277.24  crisis or mental health emergency where a mental health crisis 
277.25  assessment is needed; 
277.26     (4) is assessed as experiencing a mental health crisis or 
277.27  mental health emergency, and mental health mobile crisis 
277.28  intervention or mental health crisis stabilization services are 
277.29  determined to be medically necessary; and 
277.30     (5) meets the criteria for emotional disturbance or mental 
277.31  illness. 
277.32     Subd. 4.  [PROVIDER ENTITY STANDARDS.] (a) A crisis 
277.33  intervention and crisis stabilization provider entity must meet 
277.34  the administrative and clinical standards specified in section 
277.35  256B.0943, subdivisions 5 and 6, meet the standards listed in 
277.36  paragraph (b), and be: 
278.1      (1) an Indian health service facility or facility owned and 
278.2   operated by a tribe or a tribal organization operating under 
278.3   Public Law 93-638 as a 638 facility; 
278.4      (2) a county board-operated entity; or 
278.5      (3) a provider entity that is under contract with the 
278.6   county board in the county where the potential crisis or 
278.7   emergency is occurring. 
278.8      (b) The children's mental health crisis response services 
278.9   provider entity must: 
278.10     (1) ensure that mental health crisis assessment and mobile 
278.11  crisis intervention services are available 24 hours a day, seven 
278.12  days a week; 
278.13     (2) directly provide the services or, if services are 
278.14  subcontracted, the provider entity must maintain clinical 
278.15  responsibility for services and billing; 
278.16     (3) ensure that crisis intervention services are provided 
278.17  in a manner consistent with sections 245.487 to 245.4888; and 
278.18     (4) develop and maintain written policies and procedures 
278.19  regarding service provision that include safety of staff and 
278.20  recipients in high-risk situations. 
278.21     Subd. 5.  [MOBILE CRISIS INTERVENTION STAFF 
278.22  QUALIFICATIONS.] (a) To provide children's mental health mobile 
278.23  crisis intervention services, a mobile crisis intervention team 
278.24  must include: 
278.25     (1) at least two mental health professionals as defined in 
278.26  section 256B.0943, subdivision 1, paragraph (m); or 
278.27     (2) a combination of at least one mental health 
278.28  professional and one mental health practitioner as defined in 
278.29  section 245.4871, subdivision 26, with the required mental 
278.30  health crisis training and under the clinical supervision of a 
278.31  mental health professional on the team. 
278.32     (b) The team must have at least two people with at least 
278.33  one member providing on-site crisis intervention services when 
278.34  needed.  Team members must be experienced in mental health 
278.35  assessment, crisis intervention techniques, and clinical 
278.36  decision making under emergency conditions and have knowledge of 
279.1   local services and resources.  The team must recommend and 
279.2   coordinate the team's services with appropriate local resources, 
279.3   including as the county social services agency, mental health 
279.4   service providers, and local law enforcement, if necessary. 
279.5      Subd. 6.  [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 
279.6   INTERVENTION TREATMENT PLANNING.] (a) Before initiating mobile 
279.7   crisis intervention services, a screening of the potential 
279.8   crisis situation must be conducted.  The screening may use the 
279.9   resources of crisis assistance and emergency services as defined 
279.10  in sections 245.4871, subdivision 14, and 245.4879, subdivisions 
279.11  1 and 2.  The screening must gather information, determine 
279.12  whether a crisis situation exists, identify the parties 
279.13  involved, and determine an appropriate response. 
279.14     (b) If a crisis exists, a crisis assessment must be 
279.15  completed.  A crisis assessment must evaluate any immediate 
279.16  needs for which emergency services are needed and, as time 
279.17  permits, the recipient's current life situation, sources of 
279.18  stress, mental health problems and symptoms, strengths, cultural 
279.19  considerations, support network, vulnerabilities, and current 
279.20  functioning. 
279.21     (c) If the crisis assessment determines mobile crisis 
279.22  intervention services are needed, the intervention services must 
279.23  be provided promptly.  As the opportunity presents itself during 
279.24  the intervention, at least two members of the mobile crisis 
279.25  intervention team must confer directly or by telephone about the 
279.26  assessment, treatment plan, and actions taken and needed.  At 
279.27  least one of the team members must be on site providing crisis 
279.28  intervention services.  If providing on-site crisis intervention 
279.29  services, a mental health practitioner must seek clinical 
279.30  supervision as required under subdivision 9. 
279.31     (d) The mobile crisis intervention team must develop an 
279.32  initial, brief crisis treatment plan as soon as appropriate but 
279.33  no later than 24 hours after the initial face-to-face 
279.34  intervention.  The plan must address the needs and problems 
279.35  noted in the crisis assessment and include measurable short-term 
279.36  goals, cultural considerations, and frequency and type of 
280.1   services to be provided to achieve the goals and reduce or 
280.2   eliminate the crisis.  The crisis treatment plan must be updated 
280.3   as needed to reflect current goals and services.  The team must 
280.4   involve the client and the client's family in developing and 
280.5   implementing the plan. 
280.6      (e) The team must document in progress notes which 
280.7   short-term goals have been met and when no further crisis 
280.8   intervention services are required. 
280.9      (f) If the client's crisis is stabilized, but the client 
280.10  needs a referral for mental health crisis stabilization services 
280.11  or to other services, the team must provide a referral to these 
280.12  services.  If the recipient has a case manager, planning for 
280.13  other services must be coordinated with the case manager. 
280.14     Subd. 7.  [CRISIS STABILIZATION SERVICES.] (a) Crisis 
280.15  stabilization services must be provided by a mental health 
280.16  professional or a mental health practitioner who works under the 
280.17  clinical supervision of a mental health professional and for a 
280.18  crisis stabilization services provider entity, and must meet the 
280.19  following standards: 
280.20     (1) a crisis stabilization treatment plan must be developed 
280.21  which meets the criteria in subdivision 8; 
280.22     (2) services must be delivered according to the treatment 
280.23  plan and include face-to-face contact with the recipient by 
280.24  qualified staff for further assessment, help with referrals, 
280.25  updating the crisis stabilization treatment plan, supportive 
280.26  counseling, skills training, and collaboration with other 
280.27  service providers in the community; and 
280.28     (3) mental health practitioners must have completed at 
280.29  least 30 hours of training in crisis intervention and 
280.30  stabilization during the past two years. 
280.31     Subd. 8.  [TREATMENT PLAN.] (a) The individual crisis 
280.32  stabilization treatment plan must include, at a minimum: 
280.33     (1) a list of problems identified in the assessment; 
280.34     (2) a list of the recipient's strengths and resources; 
280.35     (3) concrete, measurable short-term goals and tasks to be 
280.36  achieved, including time frames for achievement of the goals; 
281.1      (4) specific objectives directed toward the achievement of 
281.2   each goal; 
281.3      (5) documentation of the participants involved in the 
281.4   service planning; 
281.5      (6) planned frequency and type of services initiated; 
281.6      (7) a crisis response action plan if a crisis should occur; 
281.7   and 
281.8      (8) clear progress notes on the outcome of goals. 
281.9      (b) The client, if clinically appropriate, must be a 
281.10  participant in the development of the crisis stabilization 
281.11  treatment plan.  The client or the client's legal guardian must 
281.12  sign the service plan or documentation must be provided why this 
281.13  was not possible.  A copy of the plan must be given to the 
281.14  client and the client's legal guardian.  The plan should include 
281.15  services arranged, including specific providers where applicable.
281.16     (c) A treatment plan must be developed by a mental health 
281.17  professional or mental health practitioner under the clinical 
281.18  supervision of a mental health professional.  A written plan 
281.19  must be completed within 24 hours of beginning services with the 
281.20  client. 
281.21     Subd. 9.  [SUPERVISION.] (a) A mental health practitioner 
281.22  may provide crisis assessment and mobile crisis intervention 
281.23  services if the following clinical supervision requirements are 
281.24  met: 
281.25     (1) the mental health provider entity must accept full 
281.26  responsibility for the services provided; 
281.27     (2) the mental health professional of the provider entity, 
281.28  who is an employee or under contract with the provider entity, 
281.29  must be immediately available by telephone or in person for 
281.30  clinical supervision; 
281.31     (3) the mental health professional is consulted, in person 
281.32  or by telephone, during the first three hours when a mental 
281.33  health practitioner provides on-site service; and 
281.34     (4) the mental health professional must review and approve 
281.35  the tentative crisis assessment and crisis treatment plan, 
281.36  document the consultation, and sign the crisis assessment and 
282.1   treatment plan within the next business day. 
282.2      (b) If the mobile crisis intervention services continue 
282.3   into a second calendar day, a mental health professional must 
282.4   contact the client face-to-face on the second day to provide 
282.5   services and update the crisis treatment plan.  The on-site 
282.6   observation must be documented in the client's record and signed 
282.7   by the mental health professional. 
282.8      Subd. 10.  [CLIENT RECORD.] The provider must maintain a 
282.9   file for each client that complies with the requirements under 
282.10  section 256B.0943, subdivision 11, and contains the following 
282.11  information: 
282.12     (1) individual crisis treatment plans signed by the 
282.13  recipient, mental health professional, and mental health 
282.14  practitioner who developed the crisis treatment plan, or if the 
282.15  recipient refused to sign the plan, the date and reason stated 
282.16  by the recipient for not signing the plan; 
282.17     (2) signed release of information forms; 
282.18     (3) recipient health information and current medications; 
282.19     (4) emergency contacts for the recipient; 
282.20     (5) case records that document the date of service, place 
282.21  of service delivery, signature of the person providing the 
282.22  service, and the nature, extent, and units of service.  Direct 
282.23  or telephone contact with the recipient's family or others 
282.24  should be documented; 
282.25     (6) required clinical supervision by mental health 
282.26  professionals; 
282.27     (7) summary of the recipient's case reviews by staff; and 
282.28     (8) any written information by the recipient that the 
282.29  recipient wants in the file. 
282.30     Subd. 11.  [EXCLUDED SERVICES.] The following services are 
282.31  excluded from reimbursement under this section: 
282.32     (1) room and board services; 
282.33     (2) services delivered to a recipient while admitted to an 
282.34  inpatient hospital; 
282.35     (3) transportation services under children's mental health 
282.36  crisis response service; 
283.1      (4) services provided and billed by a provider who is not 
283.2   enrolled under medical assistance to provide children's mental 
283.3   health crisis response services; 
283.4      (5) crisis response services provided by a residential 
283.5   treatment center to clients in their facility; 
283.6      (6) services performed by volunteers; 
283.7      (7) direct billing of time spent "on call" when not 
283.8   delivering services to a recipient; 
283.9      (8) provider service time included in case management 
283.10  reimbursement; 
283.11     (9) outreach services to potential recipients; and 
283.12     (10) a mental health service that is not medically 
283.13  necessary. 
283.14     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
283.15     Sec. 10.  Minnesota Statutes 2002, section 256B.0945, 
283.16  subdivision 2, is amended to read: 
283.17     Subd. 2.  [COVERED SERVICES.] All services must be included 
283.18  in a child's individualized treatment or multiagency plan of 
283.19  care as defined in chapter 245.  
283.20     ~~(a) For facilities that are institutions for mental~~ 
283.21  ~~diseases according to statute and regulation or are not~~ 
283.22  ~~institutions for mental diseases but are approved by the~~ 
283.23  ~~commissioner to provide services under this paragraph, medical~~ 
283.24  ~~assistance covers the full contract rate, including room and~~ 
283.25  ~~board if the services meet the requirements of Code of Federal~~ 
283.26  ~~Regulations, title 42, section 440.160.~~  
283.27     ~~(b)~~ For facilities that are not institutions for mental 
283.28  diseases according to federal statute and regulation ~~and are not~~ 
283.29  ~~providing services under paragraph (a)~~, medical assistance 
283.30  covers mental health related services that are required to be 
283.31  provided by a residential facility under section 245.4882 and 
283.32  administrative rules promulgated thereunder, except for room and 
283.33  board. 
283.34     Sec. 11.  Minnesota Statutes 2002, section 256B.0945, 
283.35  subdivision 4, is amended to read: 
283.36     Subd. 4.  [PAYMENT RATES.] (a) Notwithstanding sections 
284.1   256B.19 and 256B.041, payments to counties for residential 
284.2   services provided by a residential facility shall only be made 
284.3   of federal earnings for services provided under this section, 
284.4   and the nonfederal share of costs for services provided under 
284.5   this section shall be paid by the county from sources other than 
284.6   federal funds or funds used to match other federal funds.  
284.7   ~~Payment to counties for services provided according to~~ 
284.8   ~~subdivision 2, paragraph (a), shall be the federal share of the~~ 
284.9   ~~contract rate.~~  Payment to counties for services provided 
284.10  according to ~~subdivision 2, paragraph (b),~~ this section shall be 
284.11  a proportion of the per day contract rate that relates to 
284.12  rehabilitative mental health services and shall not include 
284.13  payment for costs or services that are billed to the IV-E 
284.14  program as room and board.  
284.15     (b) The commissioner shall set aside a portion not to 
284.16  exceed five percent of the federal funds earned under this 
284.17  section to cover the state costs of administering this section.  
284.18  Any unexpended funds from the set-aside shall be distributed to 
284.19  the counties in proportion to their earnings under this section. 
284.20     Sec. 12.  Minnesota Statutes 2002, section 257.05, is 
284.21  amended to read: 
284.22     257.05 [IMPORTATION.] 
284.23     Subdivision 1.  [NOTIFICATION AND DUTIES OF COMMISSIONER.] 
284.24  No person, except as provided by ~~subdivision~~ subdivisions 2 and 
284.25  3, shall bring or send into the state any child for the purpose 
284.26  of placing the child out or procuring the child's adoption 
284.27  without first obtaining the consent of the commissioner of human 
284.28  services, and such person shall conform to all rules of the 
284.29  commissioner of human services and laws of the state of 
284.30  Minnesota relating to protection of children in foster care.  
284.31  Before any child shall be brought or sent into the state for the 
284.32  purpose of being placed in foster care, the person bringing or 
284.33  sending the child into the state shall first notify the 
284.34  commissioner of human services of the person's intention, and 
284.35  shall obtain from the commissioner of human services a 
284.36  certificate stating that the home in which the child is to be 
285.1   placed is, in the opinion of the commissioner of human services, 
285.2   a suitable adoptive home for the child if legal adoption is 
285.3   contemplated or that the home meets the commissioner's 
285.4   requirements for licensing of foster homes if legal adoption is 
285.5   not contemplated.  The commissioner is responsible for 
285.6   protecting the child's interests so long as the child remains 
285.7   within the state and until the child reaches the age of 18 or is 
285.8   legally adopted.  Notice to the commissioner shall state the 
285.9   name, age, and personal description of the child, and the name 
285.10  and address of the person with whom the child is to be placed, 
285.11  and such other information about the child and the foster home 
285.12  as may be required by the commissioner. 
285.13     Subd. 2.  [EXEMPT RELATIVES.] A parent, stepparent, 
285.14  grandparent, brother, sister and aunt or uncle in the first 
285.15  degree of the minor child who bring a child into the state for 
285.16  placement within their own home shall be exempt from the 
285.17  provisions of subdivision 1.  This relationship may be by blood 
285.18  or marriage.  
285.19     Subd. 3.  [INTERNATIONAL ADOPTIONS.] Subject to state and 
285.20  federal laws and rules, adoption agencies licensed under chapter 
285.21  245A and Minnesota Rules, parts 9545.0755 to 9545.0845, and 
285.22  county social services agencies are authorized to certify that 
285.23  the prospective adoptive home of a child brought into the state 
285.24  from another country for the purpose of adoption is a suitable 
285.25  home, or that the home meets the commissioner's requirements for 
285.26  licensing of foster homes if legal adoption is not contemplated. 
285.27     Sec. 13.  Minnesota Statutes 2002, section 259.67, 
285.28  subdivision 4, is amended to read: 
285.29     Subd. 4.  [ELIGIBILITY CONDITIONS.] (a) The placing agency 
285.30  shall use the AFDC requirements as specified in federal law as 
285.31  of July 16, 1996, when determining the child's eligibility for 
285.32  adoption assistance under title IV-E of the Social Security 
285.33  Act.  If the child does not qualify, the placing agency shall 
285.34  certify a child as eligible for state funded adoption assistance 
285.35  only if the following criteria are met:  
285.36     (1) Due to the child's characteristics or circumstances it 
286.1   would be difficult to provide the child an adoptive home without 
286.2   adoption assistance.  
286.3      (2)(i) A placement agency has made reasonable efforts to 
286.4   place the child for adoption without adoption assistance, but 
286.5   has been unsuccessful; or 
286.6      (ii) the child's licensed foster parents desire to adopt 
286.7   the child and it is determined by the placing agency that the 
286.8   adoption is in the best interest of the child. 
286.9      (3) The child has been a ward of the commissioner ~~or~~, a 
286.10  Minnesota-licensed child-placing agency, or a tribal social 
286.11  service agency of Minnesota recognized by the Secretary of the 
286.12  Interior.  
286.13     (b) For purposes of this subdivision, the characteristics 
286.14  or circumstances that may be considered in determining whether a 
286.15  child is a child with special needs under United States Code, 
286.16  title 42, chapter 7, subchapter IV, part E, or meets the 
286.17  requirements of paragraph (a), clause (1), are the following: 
286.18     (1) The child is a member of a sibling group to be placed 
286.19  as one unit in which at least one sibling is older than 15 
286.20  months of age or is described in clause (2) or (3). 
286.21     (2) The child has documented physical, mental, emotional, 
286.22  or behavioral disabilities. 
286.23     (3) The child has a high risk of developing physical, 
286.24  mental, emotional, or behavioral disabilities. 
286.25     (4) The child is adopted according to tribal law without a 
286.26  termination of parental rights or relinquishment, provided that 
286.27  the tribe has documented the valid reason why the child cannot 
286.28  or should not be returned to the home of the child's parent. 
286.29     (c) When a child's eligibility for adoption assistance is 
286.30  based upon the high risk of developing physical, mental, 
286.31  emotional, or behavioral disabilities, payments shall not be 
286.32  made under the adoption assistance agreement unless and until 
286.33  the potential disability manifests itself as documented by an 
286.34  appropriate health care professional. 
286.35     Sec. 14.  Minnesota Statutes 2002, section 260B.157, 
286.36  subdivision 1, is amended to read: 
287.1      Subdivision 1.  [INVESTIGATION.] Upon request of the court 
287.2   the local social services agency or probation officer shall 
287.3   investigate the personal and family history and environment of 
287.4   any minor coming within the jurisdiction of the court under 
287.5   section 260B.101 and shall report its findings to the court.  
287.6   The court may order any minor coming within its jurisdiction to 
287.7   be examined by a duly qualified physician, psychiatrist, or 
287.8   psychologist appointed by the court.  
287.9      The court shall have a chemical use assessment conducted 
287.10  when a child is (1) found to be delinquent for violating a 
287.11  provision of chapter 152, or for committing a felony-level 
287.12  violation of a provision of chapter 609 if the probation officer 
287.13  determines that alcohol or drug use was a contributing factor in 
287.14  the commission of the offense, or (2) alleged to be delinquent 
287.15  for violating a provision of chapter 152, if the child is being 
287.16  held in custody under a detention order.  The assessor's 
287.17  qualifications and the assessment criteria shall comply with 
287.18  Minnesota Rules, parts 9530.6600 to 9530.6655.  If funds under 
287.19  chapter 254B are to be used to pay for the recommended 
287.20  treatment, the assessment and placement must comply with all 
287.21  provisions of Minnesota Rules, parts 9530.6600 to 9530.6655 and 
287.22  9530.7000 to 9530.7030.  The commissioner of human services 
287.23  shall reimburse the court for the cost of the chemical use 
287.24  assessment, up to a maximum of $100. 
287.25     The court shall have a children's mental health screening 
287.26  conducted when a child is found to be delinquent.  The screening 
287.27  shall be conducted with a screening instrument approved by the 
287.28  commissioner of human services and shall be conducted by a 
287.29  mental health practitioner as defined in section 245.4871, 
287.30  subdivision 26, or a probation officer who is trained in the use 
287.31  of the screening instrument.  If the screening indicates a need 
287.32  for assessment, the local social services agency, in 
287.33  consultation with the child's family, shall have a diagnostic 
287.34  assessment conducted, including a functional assessment, as 
287.35  defined in section 245.4871. 
287.36     With the consent of the commissioner of corrections and 
288.1   agreement of the county to pay the costs thereof, the court may, 
288.2   by order, place a minor coming within its jurisdiction in an 
288.3   institution maintained by the commissioner for the detention, 
288.4   diagnosis, custody and treatment of persons adjudicated to be 
288.5   delinquent, in order that the condition of the minor be given 
288.6   due consideration in the disposition of the case.  Any funds 
288.7   received under the provisions of this subdivision shall not 
288.8   cancel until the end of the fiscal year immediately following 
288.9   the fiscal year in which the funds were received.  The funds are 
288.10  available for use by the commissioner of corrections during that 
288.11  period and are hereby appropriated annually to the commissioner 
288.12  of corrections as reimbursement of the costs of providing these 
288.13  services to the juvenile courts.  
288.14     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
288.15     Sec. 15.  Minnesota Statutes 2002, section 260B.176, 
288.16  subdivision 2, is amended to read: 
288.17     Subd. 2.  [REASONS FOR DETENTION.] (a) If the child is not 
288.18  released as provided in subdivision 1, the person taking the 
288.19  child into custody shall notify the court as soon as possible of 
288.20  the detention of the child and the reasons for detention.  
288.21     (b) No child may be detained in a juvenile secure detention 
288.22  facility or shelter care facility longer than 36 hours, 
288.23  excluding Saturdays, Sundays, and holidays, after being taken 
288.24  into custody for a delinquent act as defined in section 
288.25  260B.007, subdivision 6, unless a petition has been filed and 
288.26  the judge or referee determines pursuant to section 260B.178 
288.27  that the child shall remain in detention.  
288.28     (c) No child may be detained in an adult jail or municipal 
288.29  lockup longer than 24 hours, excluding Saturdays, Sundays, and 
288.30  holidays, or longer than six hours in an adult jail or municipal 
288.31  lockup in a standard metropolitan statistical area, after being 
288.32  taken into custody for a delinquent act as defined in section 
288.33  260B.007, subdivision 6, unless: 
288.34     (1) a petition has been filed under section 260B.141; and 
288.35     (2) a judge or referee has determined under section 
288.36  260B.178 that the child shall remain in detention. 
289.1      After August 1, 1991, no child described in this paragraph 
289.2   may be detained in an adult jail or municipal lockup longer than 
289.3   24 hours, excluding Saturdays, Sundays, and holidays, or longer 
289.4   than six hours in an adult jail or municipal lockup in a 
289.5   standard metropolitan statistical area, unless the requirements 
289.6   of this paragraph have been met and, in addition, a motion to 
289.7   refer the child for adult prosecution has been made under 
289.8   section 260B.125.  Notwithstanding this paragraph, continued 
289.9   detention of a child in an adult detention facility outside of a 
289.10  standard metropolitan statistical area county is permissible if: 
289.11     (i) the facility in which the child is detained is located 
289.12  where conditions of distance to be traveled or other ground 
289.13  transportation do not allow for court appearances within 24 
289.14  hours.  A delay not to exceed 48 hours may be made under this 
289.15  clause; or 
289.16     (ii) the facility is located where conditions of safety 
289.17  exist.  Time for an appearance may be delayed until 24 hours 
289.18  after the time that conditions allow for reasonably safe 
289.19  travel.  "Conditions of safety" include adverse life-threatening 
289.20  weather conditions that do not allow for reasonably safe travel. 
289.21     The continued detention of a child under clause (i) or (ii) 
289.22  must be reported to the commissioner of corrections. 
289.23     (d) If a child described in paragraph (c) is to be detained 
289.24  in a jail beyond 24 hours, excluding Saturdays, Sundays, and 
289.25  holidays, the judge or referee, in accordance with rules and 
289.26  procedures established by the commissioner of corrections, shall 
289.27  notify the commissioner of the place of the detention and the 
289.28  reasons therefor.  The commissioner shall thereupon assist the 
289.29  court in the relocation of the child in an appropriate juvenile 
289.30  secure detention facility or approved jail within the county or 
289.31  elsewhere in the state, or in determining suitable 
289.32  alternatives.  The commissioner shall direct that a child 
289.33  detained in a jail be detained after eight days from and 
289.34  including the date of the original detention order in an 
289.35  approved juvenile secure detention facility with the approval of 
289.36  the administrative authority of the facility.  If the court 
290.1   refers the matter to the prosecuting authority pursuant to 
290.2   section 260B.125, notice to the commissioner shall not be 
290.3   required.  
290.4      (e) When a child is detained for an alleged delinquent act 
290.5   in a state licensed juvenile facility or program, or when a 
290.6   child is detained in an adult jail or municipal lockup as 
290.7   provided in paragraph (c), the supervisor of the facility shall, 
290.8   if the child's parent or legal guardian consents, have a 
290.9   children's mental health screening conducted with a screening 
290.10  instrument approved by the commissioner of human services, 
290.11  unless a screening has been performed within the previous 180 
290.12  days or the child is currently under the care of a mental health 
290.13  professional.  The screening shall be conducted by a mental 
290.14  health practitioner as defined in section 245.4871, subdivision 
290.15  26, or a probation officer who is trained in the use of the 
290.16  screening instrument.  The screening shall be conducted after 
290.17  the initial detention hearing has been held and the court has 
290.18  ordered the child continued in detention.  The results of the 
290.19  screening may only be presented to the court at the 
290.20  dispositional phase of the court proceedings on the matter 
290.21  unless the parent or legal guardian consents to presentation at 
290.22  a different time.  If the screening indicates a need for 
290.23  assessment, the local social services agency or probation 
290.24  officer, with the approval of the child's parent or legal 
290.25  guardian, shall have a diagnostic assessment conducted, 
290.26  including a functional assessment, as defined in section 
290.27  245.4871. 
290.28     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
290.29     Sec. 16.  Minnesota Statutes 2002, section 260B.178, 
290.30  subdivision 1, is amended to read: 
290.31     Subdivision 1.  [HEARING AND RELEASE REQUIREMENTS.] (a) The 
290.32  court shall hold a detention hearing: 
290.33     (1) within 36 hours of the time the child was taken into 
290.34  custody, excluding Saturdays, Sundays, and holidays, if the 
290.35  child is being held at a juvenile secure detention facility or 
290.36  shelter care facility; or 
291.1      (2) within 24 hours of the time the child was taken into 
291.2   custody, excluding Saturdays, Sundays, and holidays, if the 
291.3   child is being held at an adult jail or municipal lockup.  
291.4      (b) Unless there is reason to believe that the child would 
291.5   endanger self or others, not return for a court hearing, run 
291.6   away from the child's parent, guardian, or custodian or 
291.7   otherwise not remain in the care or control of the person to 
291.8   whose lawful custody the child is released, or that the child's 
291.9   health or welfare would be immediately endangered, the child 
291.10  shall be released to the custody of a parent, guardian, 
291.11  custodian, or other suitable person, subject to reasonable 
291.12  conditions of release including, but not limited to, a 
291.13  requirement that the child undergo a chemical use assessment as 
291.14  provided in section 260B.157, subdivision 1, and a children's 
291.15  mental health screening as provided in section 260B.176, 
291.16  subdivision 2, paragraph (e).  In determining whether the 
291.17  child's health or welfare would be immediately endangered, the 
291.18  court shall consider whether the child would reside with a 
291.19  perpetrator of domestic child abuse.  
291.20     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
291.21     Sec. 17.  Minnesota Statutes 2002, section 260B.193, 
291.22  subdivision 2, is amended to read: 
291.23     Subd. 2.  [CONSIDERATION OF REPORTS.] Before making a 
291.24  disposition in a case, or appointing a guardian for a child, the 
291.25  court may consider any report or recommendation made by the 
291.26  local social services agency, probation officer, licensed 
291.27  child-placing agency, foster parent, guardian ad litem, tribal 
291.28  representative, or other authorized advocate for the child or 
291.29  child's family, a school district concerning the effect on 
291.30  student transportation of placing a child in a school district 
291.31  in which the child is not a resident, or any other information 
291.32  deemed material by the court.  In addition, the court may 
291.33  consider the results of the children's mental health screening 
291.34  provided in section 260B.157, subdivision 1. 
291.35     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
291.36     Sec. 18.  Minnesota Statutes 2002, section 260B.235, 
292.1   subdivision 6, is amended to read: 
292.2      Subd. 6.  [ALTERNATIVE DISPOSITION.] In addition to 
292.3   dispositional alternatives authorized by subdivision ~~3~~ 4, in the 
292.4   case of a third or subsequent finding by the court pursuant to 
292.5   an admission in court or after trial that a child has committed 
292.6   a juvenile alcohol or controlled substance offense, the juvenile 
292.7   court shall order a chemical dependency evaluation of the child 
292.8   and if warranted by the evaluation, the court may order 
292.9   participation by the child in an inpatient or outpatient 
292.10  chemical dependency treatment program, or any other treatment 
292.11  deemed appropriate by the court.  In the case of a third or 
292.12  subsequent finding that a child has committed any juvenile petty 
292.13  offense, the court shall order a children's mental health 
292.14  screening be conducted as provided in section 260B.157, 
292.15  subdivision 1, and if indicated by the screening, to undergo a 
292.16  diagnostic assessment, including a functional assessment, as 
292.17  defined in section 245.4871. 
292.18     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
292.19     Sec. 19.  Minnesota Statutes 2002, section 260C.141, 
292.20  subdivision 2, is amended to read: 
292.21     Subd. 2.  [REVIEW OF FOSTER CARE STATUS.] The social 
292.22  services agency responsible for the placement of a child in a 
292.23  residential facility, as defined in section 260C.212, 
292.24  subdivision 1, pursuant to a voluntary release by the child's 
292.25  parent or parents must proceed in juvenile court to review the 
292.26  foster care status of the child in the manner provided in this 
292.27  section.  
292.28     (a) Except for a child in placement due solely to the 
292.29  child's developmental disability or emotional disturbance, when 
292.30  a child continues in voluntary placement according to section 
292.31  260C.212, subdivision 8, a petition shall be filed alleging the 
292.32  child to be in need of protection or services or seeking 
292.33  termination of parental rights or other permanent placement of 
292.34  the child away from the parent within 90 days of the date of the 
292.35  voluntary placement agreement.  The petition shall state the 
292.36  reasons why the child is in placement, the progress on the 
293.1   out-of-home placement plan required under section 260C.212, 
293.2   subdivision 1, and the statutory basis for the petition under 
293.3   section 260C.007, subdivision 6, 260C.201, subdivision 11, or 
293.4   260C.301. 
293.5      (1) In the case of a petition alleging the child to be in 
293.6   need of protection or services filed under this paragraph, if 
293.7   all parties agree and the court finds it is in the best 
293.8   interests of the child, the court may find the petition states a 
293.9   prima facie case that: 
293.10     (i) the child's needs are being met; 
293.11     (ii) the placement of the child in foster care is in the 
293.12  best interests of the child; 
293.13     (iii) reasonable efforts to reunify the child and the 
293.14  parent or guardian are being made; and 
293.15     (iv) the child will be returned home in the next three 
293.16  months. 
293.17     (2) If the court makes findings under paragraph (1), the 
293.18  court shall approve the voluntary arrangement and continue the 
293.19  matter for up to three more months to ensure the child returns 
293.20  to the parents' home.  The responsible social services agency 
293.21  shall: 
293.22     (i) report to the court when the child returns home and the 
293.23  progress made by the parent on the out-of-home placement plan 
293.24  required under section 260C.212, in which case the court shall 
293.25  dismiss jurisdiction; 
293.26     (ii) report to the court that the child has not returned 
293.27  home, in which case the matter shall be returned to the court 
293.28  for further proceedings under section 260C.163; or 
293.29     (iii) if any party does not agree to continue the matter 
293.30  under paragraph (1) and this paragraph, the matter shall proceed 
293.31  under section 260C.163. 
293.32     (b) In the case of a child in voluntary placement due 
293.33  solely to the child's developmental disability or emotional 
293.34  disturbance according to section 260C.212, subdivision 9, the 
293.35  following procedures apply: 
293.36     (1)  [REPORT TO COURT.] (i) Unless the county attorney 
294.1   determines that a petition under subdivision 1 is appropriate, 
294.2   without filing a petition, a written report shall be forwarded 
294.3   to the court within 165 days of the date of the voluntary 
294.4   placement agreement.  The written report shall contain necessary 
294.5   identifying information for the court to proceed, a copy of the 
294.6   out-of-home placement plan required under section 260C.212, 
294.7   subdivision 1, a written summary of the proceedings of any 
294.8   administrative review required under section 260C.212, 
294.9   subdivision 7, and any other information the responsible social 
294.10  services agency, parent or guardian, the child or the foster 
294.11  parent or other residential facility wants the court to consider.
294.12     (ii) The responsible social services agency, where 
294.13  appropriate, must advise the child, parent or guardian, the 
294.14  foster parent, or representative of the residential facility of 
294.15  the requirements of this section and of their right to submit 
294.16  information to the court.  If the child, parent or guardian, 
294.17  foster parent, or representative of the residential facility 
294.18  wants to send information to the court, the responsible social 
294.19  services agency shall advise those persons of the reporting date 
294.20  and the identifying information necessary for the court 
294.21  administrator to accept the information and submit it to a judge 
294.22  with the agency's report.  The responsible social services 
294.23  agency must also notify those persons that they have the right 
294.24  to be heard in person by the court and how to exercise that 
294.25  right.  The responsible social services agency must also provide 
294.26  notice that an in-court hearing will not be held unless 
294.27  requested by a parent or guardian, foster parent, or the child. 
294.28     (iii) After receiving the required report, the court has 
294.29  jurisdiction to make the following determinations and must do so 
294.30  within ten days of receiving the forwarded report:  (A) whether 
294.31  or not the placement of the child is in the child's best 
294.32  interests; and (B) whether the parent and agency are 
294.33  appropriately planning for the child.  Unless requested by a 
294.34  parent or guardian, foster parent, or child, no in-court hearing 
294.35  need be held in order for the court to make findings and issue 
294.36  an order under this paragraph. 
295.1      (iv) If the court finds the placement is in the child's 
295.2   best interests and that the agency and parent are appropriately 
295.3   planning for the child, the court shall issue an order 
295.4   containing explicit, individualized findings to support its 
295.5   determination.  The court shall send a copy of the order to the 
295.6   county attorney, the responsible social services agency, the 
295.7   parent or guardian, the child, and the foster parents.  The 
295.8   court shall also send the parent or guardian, the child, and the 
295.9   foster parent notice of the required review under clause (2).  
295.10     (v) If the court finds continuing the placement not to be 
295.11  in the child's best interests or that the agency or the parent 
295.12  or guardian is not appropriately planning for the child, the 
295.13  court shall notify the county attorney, the responsible social 
295.14  services agency, the parent or guardian, the foster parent, the 
295.15  child, and the county attorney of the court's determinations and 
295.16  the basis for the court's determinations. 
295.17     (2)  [PERMANENCY REVIEW BY PETITION.] If a child with a 
295.18  developmental disability or an emotional disturbance continues 
295.19  in out-of-home placement for 13 months from the date of a 
295.20  voluntary placement, a petition alleging the child to be in need 
295.21  of protection or services, for termination of parental rights, 
295.22  or for permanent placement of the child away from the parent 
295.23  under section 260C.201 shall be filed.  The court shall conduct 
295.24  a permanency hearing on the petition no later than 14 months 
295.25  after the date of the voluntary placement.  At the permanency 
295.26  hearing, the court shall determine the need for an order 
295.27  permanently placing the child away from the parent or determine 
295.28  whether there are compelling reasons that continued voluntary 
295.29  placement is in the child's best interests.  A petition alleging 
295.30  the child to be in need of protection or services shall state 
295.31  the date of the voluntary placement agreement, the nature of the 
295.32  child's developmental disability or emotional disturbance, the 
295.33  plan for the ongoing care of the child, the parents' 
295.34  participation in the plan, the responsible social services 
295.35  agency's efforts to finalize a plan for the permanent placement 
295.36  of the child, and the statutory basis for the petition. 
296.1      (i) If a petition alleging the child to be in need of 
296.2   protection or services is filed under this paragraph, the court 
296.3   may find, based on the contents of the sworn petition, and the 
296.4   agreement of all parties, including the child, where 
296.5   appropriate, that there are compelling reasons that the 
296.6   voluntary arrangement is in the best interests of the child and 
296.7   that the responsible social services agency has made reasonable 
296.8   efforts to finalize a plan for the permanent placement of the 
296.9   child, approve the continued voluntary placement, and continue 
296.10  the matter under the court's jurisdiction for the purpose of 
296.11  reviewing the child's placement as a continued voluntary 
296.12  arrangement every 12 months as long as the child continues in 
296.13  out-of-home placement.  The matter must be returned to the court 
296.14  for further review every 12 months as long as the child remains 
296.15  in placement.  The court shall give notice to the parent or 
296.16  guardian of the continued review requirements under this 
296.17  section.  Nothing in this paragraph shall be construed to mean 
296.18  the court must order permanent placement for the child under 
296.19  section 260C.201, subdivision 11, as long as the court finds 
296.20  compelling reasons at the first review required under this 
296.21  section. 
296.22     (ii) If a petition for termination of parental rights, for 
296.23  transfer of permanent legal and physical custody to a relative, 
296.24  for long-term foster care, or for foster care for a specified 
296.25  period of time is filed, the court must proceed under section 
296.26  260C.201, subdivision 11. 
296.27     (3) If any party, including the child, disagrees with the 
296.28  voluntary arrangement, the court shall proceed under section 
296.29  260C.163. 
296.30     Sec. 20.  Minnesota Statutes 2002, section 626.559, 
296.31  subdivision 5, is amended to read: 
296.32     Subd. 5.  [REVENUE.] The commissioner of human services 
296.33  shall add the following funds to the funds appropriated under 
296.34  section 626.5591, subdivision 2, to develop and support training:
296.35     (a) The commissioner of human services shall submit claims 
296.36  for federal reimbursement earned through the activities and 
297.1   services supported through department of human services child 
297.2   protection or child welfare training funds.  Federal revenue 
297.3   earned must be used to improve and expand training services by 
297.4   the department.  The department expenditures eligible for 
297.5   federal reimbursement under this section must not be made from 
297.6   federal funds or funds used to match other federal funds. 
297.7      (b) Each year, the commissioner of human services shall 
297.8   withhold from funds distributed to each county under Minnesota 
297.9   Rules, parts 9550.0300 to 9550.0370, an amount equivalent to 1.5 
297.10  percent of each county's annual title XX allocation under 
297.11  section ~~256E.07~~ 256M.50.  The commissioner must use these funds 
297.12  to ensure decentralization of training. 
297.13     (c) The federal revenue under this subdivision is available 
297.14  for these purposes until the funds are expended. 
297.15     Sec. 21.  [MEDICAL ASSISTANCE FOR MENTAL HEALTH SERVICES 
297.16  PROVIDED IN OUT-OF-HOME PLACEMENT SETTINGS.] 
297.17     The commissioner of human services shall develop a plan in 
297.18  conjunction with the commissioner of corrections and 
297.19  representatives from counties, provider groups, and other 
297.20  stakeholders, to secure medical assistance funding for mental 
297.21  health-related services provided in out-of-home placement 
297.22  settings, including treatment foster care, group homes, and 
297.23  residential programs licensed under Minnesota Statutes, chapters 
297.24  241 and 245A.  The plan must include proposed legislation, 
297.25  fiscal implications, and other pertinent information. 
297.26     Treatment foster care services must be provided by a child 
297.27  placing agency licensed under Minnesota Rules, parts 9543.0010 
297.28  to 9543.0150 or 9545.0755 to 9545.0845.  
297.29     The commissioner shall report to the legislature by January 
297.30  15, 2004. 
297.31     Sec. 22.  [TRANSITION TO CHILDREN'S THERAPEUTIC SERVICES 
297.32  AND SUPPORTS.] 
297.33     Beginning July 1, 2003, the commissioner shall use the 
297.34  provider certification process under Minnesota Statutes, section 
297.35  256B.0943, instead of the provider certification process 
297.36  required in Minnesota Rules, parts 9505.0324; 9505.0326; and 
298.1   9505.0327. 
298.2      Sec. 23.  [REVISOR'S INSTRUCTION.] 
298.3      For sections in Minnesota Statutes and Minnesota Rules 
298.4   affected by the repealed sections in this article, the revisor 
298.5   shall delete internal cross-references where appropriate and 
298.6   make changes necessary to correct the punctuation, grammar, or 
298.7   structure of the remaining text and preserve its meaning. 
298.8      Sec. 24.  [REPEALER.] 
298.9      (a) Minnesota Statutes 2002, sections 256B.0945, 
298.10  subdivision 10, is repealed. 
298.11     (b) Minnesota Statutes 2002, section 256B.0625, 
298.12  subdivisions 35 and 36, are repealed effective July 1, 2004. 
298.13     (c) Minnesota Rules, parts 9505.0324; 9505.0326; and 
298.14  9505.0327, are repealed effective July 1, 2004. 
298.15                             ARTICLE 5 
298.16                       OCCUPATIONAL LICENSES
298.17     Section 1.  Minnesota Statutes 2002, section 148C.01, is 
298.18  amended by adding a subdivision to read: 
298.19     Subd. 1a.  [ACCREDITING ASSOCIATION.] "Accrediting 
298.20  association" means an organization recognized by the 
298.21  commissioner that evaluates schools and education programs of 
298.22  alcohol and drug counseling or is listed in Nationally 
298.23  Recognized Accrediting Agencies and Associations, Criteria and 
298.24  Procedures for Listing by the U.S. Secretary of Education and 
298.25  Current List (1996), which is incorporated by reference.  
298.26     Sec. 2.  Minnesota Statutes 2002, section 148C.01, 
298.27  subdivision 2, is amended to read: 
298.28     Subd. 2.  [ALCOHOL AND DRUG COUNSELOR.] "Alcohol and drug 
298.29  counselor" or "counselor" means a person who: 
298.30     (1) uses, as a representation to the public, any title, 
298.31  initials, or description of services incorporating the words 
298.32  "alcohol and drug counselor"; 
298.33     (2) offers to render professional alcohol and drug 
298.34  counseling services relative to the abuse of or the dependency 
298.35  on alcohol or other drugs to the general public or groups, 
298.36  organizations, corporations, institutions, or government 
299.1   agencies for compensation, implying that the person is licensed 
299.2   and trained, experienced or expert in alcohol and drug 
299.3   counseling; 
299.4      (3) holds a valid license issued under ~~sections 148C.01 to~~ 
299.5   ~~148C.11~~ this chapter to engage in the practice of alcohol and 
299.6   drug counseling; or 
299.7      (4) is an applicant for an alcohol and drug counseling 
299.8   license.  
299.9      Sec. 3.  Minnesota Statutes 2002, section 148C.01, is 
299.10  amended by adding a subdivision to read: 
299.11     Subd. 2a.  [ALCOHOL AND DRUG COUNSELOR ACADEMIC COURSE 
299.12  WORK.] "Alcohol and drug counselor academic course work" means 
299.13  classroom education, which is directly related to alcohol and 
299.14  drug counseling and meets the requirements of section 148C.04, 
299.15  subdivision 5a, and is taken through an accredited school or 
299.16  educational program.  
299.17     Sec. 4.  Minnesota Statutes 2002, section 148C.01, is 
299.18  amended by adding a subdivision to read: 
299.19     Subd. 2b.  [ALCOHOL AND DRUG COUNSELOR CONTINUING EDUCATION 
299.20  ACTIVITY.] "Alcohol and drug counselor continuing education 
299.21  activity" means clock hours that meet the requirements of 
299.22  section 148C.075 and Minnesota Rules, part 4747.1100, and are 
299.23  obtained by a licensee at educational programs of annual 
299.24  conferences, lectures, panel discussions, workshops, seminars, 
299.25  symposiums, employer-sponsored inservices, or courses taken 
299.26  through accredited schools or education programs, including home 
299.27  study courses.  A home study course need not be provided by an 
299.28  accredited school or education program to meet continuing 
299.29  education requirements.  
299.30     Sec. 5.  Minnesota Statutes 2002, section 148C.01, is 
299.31  amended by adding a subdivision to read: 
299.32     Subd. 2c.  [ALCOHOL AND DRUG COUNSELOR 
299.33  TECHNICIAN.] "Alcohol and drug counselor technician" means a 
299.34  person not licensed as an alcohol and drug counselor who is 
299.35  performing acts authorized under section 148C.045.  
299.36     Sec. 6.  Minnesota Statutes 2002, section 148C.01, is 
300.1   amended by adding a subdivision to read: 
300.2      Subd. 2d.  [ALCOHOL AND DRUG COUNSELOR TRAINING.] "Alcohol 
300.3   and drug counselor training" means clock hours obtained by an 
300.4   applicant at educational programs of annual conferences, 
300.5   lectures, panel discussions, workshops, seminars, symposiums, 
300.6   employer-sponsored inservices, or courses taken through 
300.7   accredited schools or education programs, including home study 
300.8   courses.  Clock hours obtained from accredited schools or 
300.9   education programs must be measured under Minnesota Rules, part 
300.10  4747.1100, subpart 5.  
300.11     Sec. 7.  Minnesota Statutes 2002, section 148C.01, is 
300.12  amended by adding a subdivision to read: 
300.13     Subd. 2f.  [CLOCK HOUR.] "Clock hour" means an 
300.14  instructional session of 50 consecutive minutes, excluding 
300.15  coffee breaks, registration, meals without a speaker, and social 
300.16  activities.  
300.17     Sec. 8.  Minnesota Statutes 2002, section 148C.01, is 
300.18  amended by adding a subdivision to read: 
300.19     Subd. 2g.  [CREDENTIAL.] "Credential" means a license, 
300.20  permit, certification, registration, or other evidence of 
300.21  qualification or authorization to engage in the practice of an 
300.22  occupation.  
300.23     Sec. 9.  Minnesota Statutes 2002, section 148C.01, is 
300.24  amended by adding a subdivision to read: 
300.25     Subd. 4a.  [LICENSEE.] "Licensee" means a person who holds 
300.26  a valid license under this chapter.  
300.27     Sec. 10.  Minnesota Statutes 2002, section 148C.01, is 
300.28  amended by adding a subdivision to read: 
300.29     Subd. 11a.  [STUDENT.] "Student" means a person enrolled in 
300.30  an alcohol and drug counselor education program at an accredited 
300.31  school or educational program and earning a minimum of nine 
300.32  semester credits per calendar year towards completion of an 
300.33  associate's, bachelor's, master's, or doctorate degree 
300.34  requirements that include an additional 18 semester credits or 
300.35  270 clock hours of alcohol and drug counseling specific course 
300.36  work and 440 clock hours of practicum.  
301.1      Sec. 11.  Minnesota Statutes 2002, section 148C.01, 
301.2   subdivision 12, is amended to read: 
301.3      Subd. 12.  [SUPERVISED ALCOHOL AND DRUG ~~COUNSELING~~ 
301.4   ~~EXPERIENCE~~ COUNSELOR.] ~~Except during the transition period,~~ 
301.5   "Supervised alcohol and drug ~~counseling experience~~ counselor" 
301.6   means ~~practical experience gained by~~ a student, ~~volunteer, or~~ 
301.7   either before, during, or after the student completes a program 
301.8   from an accredited school or educational program of alcohol and 
301.9   drug counseling, an intern, ~~and~~ or a person issued a temporary 
301.10  permit under section 148C.04, subdivision 4, and who is 
301.11  supervised by a person either licensed under this chapter or 
301.12  exempt under its provisions~~; either before, during, or after the~~ 
301.13  ~~student completes a program from an accredited school or~~ 
301.14  ~~educational program of alcohol and drug counseling~~. 
301.15     Sec. 12.  Minnesota Statutes 2002, section 148C.01, is 
301.16  amended by adding a subdivision to read: 
301.17     Subd. 12a.  [SUPERVISOR.] "Supervisor" means a licensed 
301.18  alcohol and drug counselor licensed under this chapter or other 
301.19  licensed professional practicing alcohol and drug counseling 
301.20  under section 148C.11 who monitors activities of and accepts 
301.21  legal liability for the person practicing under supervision.  A 
301.22  supervisor shall supervise no more than three trainees 
301.23  practicing under section 148C.04, subdivision 6.  
301.24     Sec. 13.  Minnesota Statutes 2002, section 148C.03, 
301.25  subdivision 1, is amended to read: 
301.26     Subdivision 1.  [GENERAL.] The commissioner shall, after 
301.27  consultation with the advisory council or a committee 
301.28  established by rule: 
301.29     (a) adopt and enforce rules for licensure of alcohol and 
301.30  drug counselors, including establishing standards and methods of 
301.31  determining whether applicants and licensees are qualified under 
301.32  section 148C.04.  The rules must provide for examinations and 
301.33  establish standards for the regulation of professional conduct.  
301.34  The rules must be designed to protect the public; 
301.35     (b) develop and, at least twice a year, administer an 
301.36  examination to assess applicants' knowledge and skills.  The 
302.1   commissioner may contract for the administration of an 
302.2   examination with an entity designated by the commissioner.  The 
302.3   examinations must be psychometrically valid and reliable; must 
302.4   be written and oral, with the oral examination based on a 
302.5   written case presentation; must minimize cultural bias; and must 
302.6   be balanced in various theories relative to the practice of 
302.7   alcohol and drug counseling; 
302.8      (c) issue licenses to individuals qualified under sections 
302.9   148C.01 to 148C.11; 
302.10     (d) issue copies of the rules for licensure to all 
302.11  applicants; 
302.12     (e) adopt rules to establish and implement procedures, 
302.13  including a standard disciplinary process and rules of 
302.14  professional conduct; 
302.15     (f) carry out disciplinary actions against licensees; 
302.16     (g) establish, with the advice and recommendations of the 
302.17  advisory council, written internal operating procedures for 
302.18  receiving and investigating complaints and for taking 
302.19  disciplinary actions as appropriate; 
302.20     (h) educate the public about the existence and content of 
302.21  the rules for alcohol and drug counselor licensing to enable 
302.22  consumers to file complaints against licensees who may have 
302.23  violated the rules; 
302.24     (i) evaluate the rules in order to refine and improve the 
302.25  methods used to enforce the commissioner's standards; and 
302.26     (j) ~~set,~~ collect~~, and adjust~~ license fees for alcohol and 
302.27  drug counselors ~~so that the total fees collected will as closely~~ 
302.28  ~~as possible equal anticipated expenditures during the biennium,~~ 
302.29  ~~as provided in section 16A.1285; fees for initial and renewal~~ 
302.30  ~~application and examinations; late fees for counselors who~~ 
302.31  ~~submit license renewal applications after the renewal deadline;~~ 
302.32  ~~and a surcharge fee.  The surcharge fee must include an amount~~ 
302.33  ~~necessary to recover, over a five-year period, the~~ 
302.34  ~~commissioner's direct expenditures for the adoption of the rules~~ 
302.35  ~~providing for the licensure of alcohol and drug counselors.  All~~ 
302.36  ~~fees received shall be deposited in the state treasury and~~ 
303.1   ~~credited to the special revenue fund~~. 
303.2      Sec. 14.  Minnesota Statutes 2002, section 148C.0351, 
303.3   subdivision 1, is amended to read: 
303.4      Subdivision 1.  [APPLICATION FORMS.] Unless exempted under 
303.5   section 148C.11, a person who practices alcohol and drug 
303.6   counseling in Minnesota must: 
303.7      (1) apply to the commissioner for a license to practice 
303.8   alcohol and drug counseling on forms provided by the 
303.9   commissioner; 
303.10     (2) include with the application a statement that the 
303.11  statements in the application are true and correct to the best 
303.12  of the applicant's knowledge and belief; 
303.13     (3) include with the application a nonrefundable 
303.14  application fee specified ~~by the commissioner~~ in section 
303.15  148C.12; 
303.16     (4) include with the application information describing the 
303.17  applicant's experience, including the number of years and months 
303.18  the applicant has practiced alcohol and drug counseling as 
303.19  defined in section 148C.01; 
303.20     (5) include with the application the applicant's business 
303.21  address and telephone number, or home address and telephone 
303.22  number if the applicant conducts business out of the home, and 
303.23  if applicable, the name of the applicant's supervisor, manager, 
303.24  and employer; 
303.25     (6) include with the application a written and signed 
303.26  authorization for the commissioner to make inquiries to 
303.27  appropriate state regulatory agencies and private credentialing 
303.28  organizations in this or any other state where the applicant has 
303.29  practiced alcohol and drug counseling; and 
303.30     (7) complete the application in sufficient detail for the 
303.31  commissioner to determine whether the applicant meets the 
303.32  requirements for filing.  The commissioner may ask the applicant 
303.33  to provide additional information necessary to clarify 
303.34  incomplete or ambiguous information submitted in the application.
303.35     Sec. 15.  Minnesota Statutes 2002, section 148C.0351, is 
303.36  amended by adding a subdivision to read: 
304.1      Subd. 4.  [INITIAL LICENSE; TERM.] (a) An initial license 
304.2   is effective on the date the commissioner indicates on the 
304.3   license certificate, with the license number, sent to the 
304.4   applicant upon approval of the application.  
304.5      (b) An initial license is valid for a period beginning with 
304.6   the effective date in paragraph (a) and ending on the date 
304.7   specified by the commissioner on the license certificate placing 
304.8   the applicant in an existing two-year renewal cycle, as 
304.9   established under section 148C.05, subdivision 1.  
304.10     Sec. 16.  [148C.0355] [COMMISSIONER ACTION ON APPLICATIONS 
304.11  FOR LICENSURE.] 
304.12     The commissioner shall act on each application for 
304.13  licensure within 90 days from the date the completed application 
304.14  and all required information is received by the commissioner.  
304.15  The commissioner shall determine if the applicant meets the 
304.16  requirements for licensure and whether there are grounds for 
304.17  denial of licensure under this chapter.  If the commissioner 
304.18  denies an application on grounds other than the applicant's 
304.19  failure of an examination, the commissioner shall:  
304.20     (1) notify the applicant, in writing, of the denial and the 
304.21  reason for the denial and provide the applicant 30 days from the 
304.22  date of the letter informing the applicant of the denial in 
304.23  which the applicant may provide additional information to 
304.24  address the reasons for the denial.  If the applicant does not 
304.25  respond in writing to the commissioner within the 30-day period, 
304.26  the denial is final.  If the commissioner receives additional 
304.27  information, the commissioner shall review it and make a final 
304.28  determination thereafter; 
304.29     (2) notify the applicant that an application submitted 
304.30  following denial is a new application and must be accompanied by 
304.31  the appropriate fee as specified in section 148C.12; and 
304.32     (3) notify the applicant of the right to request a hearing 
304.33  under chapter 14.  
304.34     Sec. 17.  Minnesota Statutes 2002, section 148C.04, is 
304.35  amended to read: 
304.36     148C.04 [REQUIREMENTS FOR LICENSURE.] 
305.1      Subdivision 1.  [GENERAL REQUIREMENTS.] The commissioner 
305.2   shall issue licenses to the individuals qualified under ~~sections~~ 
305.3   ~~148C.01 to 148C.11~~ this chapter to practice alcohol and drug 
305.4   counseling. 
305.5      Subd. 2.  [FEE.] Each applicant shall pay a nonrefundable 
305.6   fee ~~set by the commissioner pursuant to section 148C.03~~ as 
305.7   specified in section 148C.12.  Fees paid to the commissioner 
305.8   shall be deposited in the special revenue fund. 
305.9      Subd. 3.  [~~LICENSING~~ REQUIREMENTS FOR ~~THE FIRST FIVE~~ 
305.10  ~~YEARS~~ LICENSURE BEFORE JULY 1, 2008.] ~~For five years after the~~ 
305.11  ~~effective date of the rules authorized in section 148C.03,~~ 
305.12  ~~the~~ An applicant~~, unless qualified under section 148C.06 during~~ 
305.13  ~~the 25-month period authorized therein, under section 148C.07,~~ 
305.14  ~~or under subdivision 4,~~ for a license must furnish evidence 
305.15  satisfactory to the commissioner that the applicant has met all 
305.16  the requirements in clauses (1) to (3). The applicant must have: 
305.17     (1) received an associate degree, or an equivalent number 
305.18  of credit hours, and a certificate in alcohol and drug 
305.19  counseling, including 18 semester credits or 270 clock hours of 
305.20  ~~alcohol and drug counseling classroom education~~ academic course 
305.21  work in accordance with subdivision 5a, paragraph (a), from an 
305.22  accredited school or educational program and 880 clock hours of 
305.23  supervised alcohol and drug counseling practicum; 
305.24     (2) completed a written case presentation and 
305.25  satisfactorily passed an oral examination established by the 
305.26  commissioner that demonstrates competence in the core functions; 
305.27  and 
305.28     (3) satisfactorily passed a written examination as 
305.29  established by the commissioner. 
305.30     Subd. 4.  [~~LICENSING~~ REQUIREMENTS ~~AFTER FIVE YEARS~~ FOR 
305.31  LICENSURE AFTER JULY 1, 2008.] ~~Beginning five years after the~~ 
305.32  ~~effective date of the rules authorized in section 148C.03,~~ 
305.33  ~~subdivision 1 ,~~ An applicant for ~~licensure~~ a license must submit 
305.34  evidence to the commissioner that the applicant has met one of 
305.35  the following requirements: 
305.36     (1) the applicant must have: 
306.1      (i) received a bachelor's degree from an accredited school 
306.2   or educational program, including ~~480~~ 18 semester credits or 270 
306.3   clock hours of ~~alcohol and drug counseling education~~ academic 
306.4   course work in accordance with subdivision 5a, paragraph (a), 
306.5   from an accredited school or educational program and 880 clock 
306.6   hours of supervised alcohol and drug counseling practicum; 
306.7      (ii) completed a written case presentation and 
306.8   satisfactorily passed an oral examination established by the 
306.9   commissioner that demonstrates competence in the core functions; 
306.10  and 
306.11     (iii) satisfactorily passed a written examination as 
306.12  established by the commissioner; or 
306.13     (2) the applicant must meet the requirements of section 
306.14  148C.07. 
306.15     Subd. 5a.  [ACADEMIC COURSE WORK.] (a) Minimum academic 
306.16  course work requirements for licensure as referred to under 
306.17  subdivision 3, clause (1), and subdivision 4, clause (1), item 
306.18  (i), must be in the following areas: 
306.19     (1) overview of alcohol and drug counseling focusing on the 
306.20  transdisciplinary foundations of alcohol and drug counseling and 
306.21  providing an understanding of theories of chemical dependency, 
306.22  the continuum of care, and the process of change; 
306.23     (2) pharmacology of substance abuse disorders and the 
306.24  dynamics of addiction; 
306.25     (3) screening, intake, assessment, and treatment planning; 
306.26     (4) counseling theory and practice, crisis intervention, 
306.27  orientation, and client education; 
306.28     (5) case management, consultation, referral, treatment 
306.29  planning, reporting, record keeping, and professional and 
306.30  ethical responsibilities; and 
306.31     (6) multicultural aspects of chemical dependency to include 
306.32  awareness of learning outcomes described in Minnesota Rules, 
306.33  part 4747.1100, subpart 2, and the ability to know when 
306.34  consultation is needed.  
306.35     (b) Advanced academic course work includes, at a minimum, 
306.36  the course work required in paragraph (a) and additional course 
307.1   work in the following areas:  
307.2      (1) advanced study in the areas listed in paragraph (a); 
307.3      (2) chemical dependency and the family; 
307.4      (3) treating substance abuse disorders in culturally 
307.5   diverse and identified populations; 
307.6      (4) dual diagnoses/co-occurring disorders with substance 
307.7   abuse disorders; and 
307.8      (5) ethics and chemical dependency. 
307.9      Subd. 6.  [TEMPORARY ~~PRACTICE~~ PERMIT REQUIREMENTS.] (a) ~~A~~ 
307.10  ~~person may temporarily~~ The commissioner shall issue a temporary 
307.11  permit to practice alcohol and drug counseling prior to being 
307.12  licensed under this chapter if the person: 
307.13     (1) either: 
307.14     (i) ~~meets the associate degree education and practicum~~ 
307.15  ~~requirements of subdivision 3, clause (1);~~ 
307.16     ~~(ii) meets the bachelor's degree education and practicum~~ 
307.17  ~~requirements of subdivision 4, clause (1), item (i); or~~ 
307.18     ~~(iii)~~ submits verification of a current and unrestricted 
307.19  credential for the practice of alcohol and drug counseling from 
307.20  a national certification body or a certification or licensing 
307.21  body from another state, United States territory, or federally 
307.22  recognized tribal authority; 
307.23     (ii) submits verification of the completion of at least 64 
307.24  semester credits, including 270 clock hours or 18 semester 
307.25  credits of formal classroom education in alcohol and drug 
307.26  counseling and at least 880 clock hours of alcohol and drug 
307.27  counseling practicum from an accredited school or educational 
307.28  program; or 
307.29     (iii) meets the requirements of section 148C.11, 
307.30  subdivision 6, clauses (1), (2), and (5); 
307.31     (2) ~~requests~~ applies, in writing, ~~temporary practice status~~ 
307.32  ~~with the commissioner~~ on an application form ~~according to~~ 
307.33  ~~section 148C.0351~~ provided by the commissioner, which includes 
307.34  the nonrefundable ~~license~~ temporary permit fee as specified in 
307.35  section 148C.12 and an affirmation by the person's supervisor, 
307.36  as defined in paragraph ~~(b)~~ (c), clause (1), ~~and~~ which is signed 
308.1   and dated by the person and the person's supervisor; and 
308.2      (3) has not been disqualified to practice temporarily on 
308.3   the basis of a background investigation under section 148C.09, 
308.4   subdivision 1a~~; and~~.  
308.5      ~~(4) has been notified~~ (b) The commissioner must notify the 
308.6   person in writing within 90 days from the date the completed 
308.7   application and all required information is received by the 
308.8   commissioner ~~that~~ whether the person is qualified to practice 
308.9   under this subdivision. 
308.10     ~~(b)~~ (c) A person practicing under this subdivision: 
308.11     (1) may practice ~~only in a program licensed by the~~ 
308.12  ~~department of human services and~~ under tribal jurisdiction or 
308.13  under the direct~~, on-site~~ supervision of a person who is 
308.14  licensed under this chapter ~~and employed in that licensed~~ 
308.15  ~~program~~; 
308.16     (2) is subject to the rules of professional conduct set by 
308.17  rule; and 
308.18     (3) is not subject to the continuing education requirements 
308.19  of section ~~148C.05~~ 148C.075. 
308.20     ~~(c)~~ (d) A person practicing under this subdivision ~~may not~~ 
308.21  must use ~~with the public any~~ the title or description stating or 
308.22  implying that the person is ~~licensed to engage~~ a trainee engaged 
308.23  in the practice of alcohol and drug counseling. 
308.24     ~~(d)~~ (e) ~~The temporary status of~~ A person ~~applying for~~ 
308.25  ~~temporary practice~~ practicing under this subdivision ~~expires on~~ 
308.26  ~~the date the commissioner grants or denies licensing~~ must 
308.27  annually submit a renewal application on forms provided by the 
308.28  commissioner with the renewal fee required in section 148C.12, 
308.29  subdivision 3, and the commissioner may renew the temporary 
308.30  permit if the trainee meets the requirements of this 
308.31  subdivision.  A trainee may renew a practice permit no more than 
308.32  five times. 
308.33     ~~(e)~~ (f) A temporary permit expires if not renewed, upon a 
308.34  change of employment of the trainee or upon a change in 
308.35  supervision, or upon the granting or denial by the commissioner 
308.36  of a license.  
309.1      Subd. 7.  [EFFECT AND SUSPENSION OF TEMPORARY ~~PRACTICE~~ 
309.2   PERMIT.] Approval of a person's application for 
309.3   temporary ~~practice~~ permit creates no rights to or expectation of 
309.4   approval from the commissioner for licensure as an alcohol and 
309.5   drug counselor.  The commissioner may suspend or restrict a 
309.6   person's temporary ~~practice~~ permit status according to section 
309.7   148C.09. 
309.8      <b>[EFFECTIVE DATE.]</b> Subdivisions 1, 2, 3, 4, and 5a are 
309.9   effective January 28, 2003.  Subdivision 6 is effective July 1, 
309.10  2003.  
309.11     Sec. 18.  [148C.045] [ALCOHOL AND DRUG COUNSELOR 
309.12  TECHNICIAN.] 
309.13     An alcohol and drug counselor technician may perform the 
309.14  services described in section 148C.01, subdivision 9, paragraphs 
309.15  (1), (2), and (3), while under the direct supervision of a 
309.16  licensed alcohol and drug counselor.  
309.17     Sec. 19.  Minnesota Statutes 2002, section 148C.05, 
309.18  subdivision 1, is amended to read: 
309.19     Subdivision 1.  [BIENNIAL RENEWAL ~~REQUIREMENTS~~.] ~~To renew a~~ 
309.20  ~~license, an applicant must:~~ 
309.21     ~~(1) complete a renewal application every two years on a~~ 
309.22  ~~form provided by the commissioner and submit the biennial~~ 
309.23  ~~renewal fee by the deadline; and~~ 
309.24     ~~(2) submit additional information if requested by the~~ 
309.25  ~~commissioner to clarify information presented in the renewal~~ 
309.26  ~~application.  This information must be submitted within 30 days~~ 
309.27  ~~of the commissioner's request.~~  A license must be renewed every 
309.28  two years.  
309.29     Sec. 20.  Minnesota Statutes 2002, section 148C.05, is 
309.30  amended by adding a subdivision to read: 
309.31     Subd. 1a.  [RENEWAL REQUIREMENTS.] To renew a license, an 
309.32  applicant must submit to the commissioner: 
309.33     (1) a completed and signed application for license renewal, 
309.34  including a signed consent authorizing the commissioner to 
309.35  obtain information about the applicant from third parties, 
309.36  including, but not limited to, employers, former employers, and 
310.1   law enforcement agencies; 
310.2      (2) the renewal fee required under section 148C.12; and 
310.3      (3) additional information as requested by the commissioner 
310.4   to clarify information presented in the renewal application.  
310.5   The licensee must submit information within 30 days of the date 
310.6   of the commissioner's request.  
310.7      Sec. 21.  Minnesota Statutes 2002, section 148C.05, is 
310.8   amended by adding a subdivision to read: 
310.9      Subd. 5.  [LICENSE RENEWAL NOTICE.] At least 60 calendar 
310.10  days before the renewal deadline date in subdivision 6, the 
310.11  commissioner shall mail a renewal notice to the licensee's last 
310.12  known address on file with the commissioner.  The notice must 
310.13  include an application for license renewal, the renewal 
310.14  deadline, and notice of fees required for renewal.  The 
310.15  licensee's failure to receive notice does not relieve the 
310.16  licensee of the obligation to meet the renewal deadline and 
310.17  other requirements for license renewal.  
310.18     Sec. 22.  Minnesota Statutes 2002, section 148C.05, is 
310.19  amended by adding a subdivision to read: 
310.20     Subd. 6.  [RENEWAL DEADLINE AND LAPSE OF LICENSURE.] (a) 
310.21  Licensees must comply with paragraphs (b) to (d).  
310.22     (b) Each license certificate must state an expiration 
310.23  date.  An application for license renewal must be received by 
310.24  the commissioner or postmarked at least 30 calendar days before 
310.25  the expiration date.  If the postmark is illegible, the 
310.26  application must be considered timely if received at least 21 
310.27  calendar days before the expiration date.  
310.28     (c) An application for license renewal not received within 
310.29  the time required under paragraph (b) must be accompanied by a 
310.30  late fee in addition to the renewal fee required in section 
310.31  148C.12.  
310.32     (d) A licensee's license lapses if the licensee fails to 
310.33  submit to the commissioner a license renewal application by the 
310.34  licensure expiration date.  A licensee shall not engage in the 
310.35  practice of alcohol and drug counseling while the license is 
310.36  lapsed.  A licensee whose license has lapsed may renew the 
311.1   license by complying with section 148C.055.  
311.2      Sec. 23.  [148C.055] [INACTIVE OR LAPSED LICENSE.] 
311.3      Subdivision 1.  [INACTIVE LICENSE STATUS.] Unless a 
311.4   complaint is pending against the licensee, a licensee whose 
311.5   license is in good standing may request, in writing, that the 
311.6   license be placed on the inactive list.  If a complaint is 
311.7   pending against a licensee, a license may not be placed on the 
311.8   inactive list until action relating to the complaint is 
311.9   concluded.  The commissioner must receive the request for 
311.10  inactive status before expiration of the license.  A request for 
311.11  inactive status received after the license expiration date must 
311.12  be denied.  A licensee may renew a license that is inactive 
311.13  under this subdivision by meeting the renewal requirements of 
311.14  subdivision 2, except that payment of a late renewal fee is not 
311.15  required.  A licensee must not practice alcohol and drug 
311.16  counseling while the license is inactive.  
311.17     Subd. 2.  [RENEWAL OF INACTIVE LICENSE.] A licensee whose 
311.18  license is inactive shall renew the inactive status by the 
311.19  inactive status expiration date determined by the commissioner 
311.20  or the license will lapse.  An application for renewal of 
311.21  inactive status must include evidence satisfactory to the 
311.22  commissioner that the licensee has completed 40 clock hours of 
311.23  continuing professional education required in section 148C.075, 
311.24  and be received by the commissioner at least 30 calendar days 
311.25  before the expiration date.  If the postmark is illegible, the 
311.26  application must be considered timely if received at least 21 
311.27  calendar days before the expiration date.  Late renewal of 
311.28  inactive status must be accompanied by a late fee as required in 
311.29  section 148C.12.  
311.30     Subd. 3.  [RENEWAL OF LAPSED LICENSE.] An individual whose 
311.31  license has lapsed for less than two years may renew the license 
311.32  by submitting:  
311.33     (1) a completed and signed license renewal application; 
311.34     (2) the inactive license renewal fee or the renewal fee and 
311.35  the late fee as required under section 148C.12; and 
311.36     (3) proof of having met the continuing education 
312.1   requirements in section 148C.075 since the individual's initial 
312.2   licensure or last license renewal.  The license issued is then 
312.3   effective for the remainder of the next two-year license cycle.  
312.4      Subd. 4.  [LICENSE RENEWAL FOR TWO YEARS OR MORE AFTER 
312.5   LICENSE EXPIRATION DATE.] An individual who submitted a license 
312.6   renewal two years or more after the license expiration date must 
312.7   submit the following:  
312.8      (1) a completed and signed application for licensure, as 
312.9   required by section 148C.0351; 
312.10     (2) the initial license fee as required in section 148C.12; 
312.11  and 
312.12     (3) verified documentation of having achieved a passing 
312.13  score within the past year on an examination required by the 
312.14  commissioner.  
312.15     Sec. 24.  Minnesota Statutes 2002, section 148C.07, is 
312.16  amended to read: 
312.17     148C.07 [RECIPROCITY.] 
312.18     ~~The commissioner shall issue an appropriate license to~~ (a) 
312.19  An individual who holds a current license or ~~other credential to~~ 
312.20  ~~engage in alcohol and drug counseling~~ national certification as 
312.21  an alcohol and drug counselor from another jurisdiction ~~if the~~ 
312.22  ~~commissioner finds that the requirements for that credential are~~ 
312.23  ~~substantially similar to the requirements in sections 148C.01 to~~ 
312.24  ~~148C.11~~ must file with the commissioner a completed application 
312.25  for licensure by reciprocity containing the information required 
312.26  under this section.  
312.27     (b) The applicant must request the credentialing authority 
312.28  of the jurisdiction in which the credential is held to send 
312.29  directly to the commissioner a statement that the credential is 
312.30  current and in good standing, the applicant's qualifications 
312.31  that entitled the applicant to the credential, and a copy of the 
312.32  jurisdiction's credentialing laws and rules that were in effect 
312.33  at the time the applicant obtained the credential.  
312.34     (c) The commissioner shall issue a license if the 
312.35  commissioner finds that the requirements, which the applicant 
312.36  had to meet to obtain the credential from the other jurisdiction 
313.1   were substantially similar to the current requirements for 
313.2   licensure in this chapter, and the applicant is not otherwise 
313.3   disqualified under section 148C.09.  
313.4      Sec. 25.  [148C.075] [CONTINUING EDUCATION REQUIREMENTS.] 
313.5      Subdivision 1.  [GENERAL REQUIREMENTS.] The commissioner 
313.6   shall establish a two-year continuing education reporting 
313.7   schedule requiring licensees to report completion of the 
313.8   requirements of this section.  Licensees must document 
313.9   completion of a minimum of 40 clock hours of continuing 
313.10  education activities each reporting period.  A licensee may be 
313.11  given credit only for activities that directly relate to the 
313.12  practice of alcohol and drug counseling, the core functions, or 
313.13  the rules of professional conduct in Minnesota Rules, part 
313.14  4747.1400.  The continuing education reporting form must require 
313.15  reporting of the following information:  
313.16     (1) the continuing education activity title; 
313.17     (2) a brief description of the continuing education 
313.18  activity; 
313.19     (3) the sponsor, presenter, or author; 
313.20     (4) the location and attendance dates; 
313.21     (5) the number of clock hours; and 
313.22     (6) a statement that the information is true and correct to 
313.23  the best knowledge of the licensee.  
313.24     Only continuing education obtained during the previous 
313.25  two-year reporting period may be considered at the time of 
313.26  reporting.  Clock hours must be earned and reported in 
313.27  increments of one-half clock hour with a minimum of one clock 
313.28  hour for each continuing education activity.  
313.29     Subd. 2.  [CONTINUING EDUCATION REQUIREMENTS FOR LICENSEE'S 
313.30  FIRST FOUR YEARS.] A licensee must, as part of meeting the clock 
313.31  hour requirement of this section, obtain and document 18 hours 
313.32  of cultural diversity training within the first four years after 
313.33  the licensee's initial license effective date according to the 
313.34  commissioner's reporting schedule.  
313.35     Subd. 3.  [CONTINUING EDUCATION REQUIREMENTS AFTER 
313.36  LICENSEE'S INITIAL FOUR YEARS.] Beginning four years following a 
314.1   licensee's initial license effective date and according to the 
314.2   board's reporting schedule, a licensee must document completion 
314.3   of a minimum of six clock hours each reporting period of 
314.4   cultural diversity training.  Licensees must also document 
314.5   completion of six clock hours in courses directly related to the 
314.6   rules of professional conduct in Minnesota Rules, part 4747.1400.
314.7      Subd. 4.  [STANDARDS FOR APPROVAL.] In order to obtain 
314.8   clock hour credit for a continuing education activity, the 
314.9   activity must: 
314.10     (1) constitute an organized program of learning; 
314.11     (2) reasonably be expected to advance the knowledge and 
314.12  skills of the alcohol and drug counselor; 
314.13     (3) pertain to subjects that directly relate to the 
314.14  practice of alcohol and drug counseling and the core functions 
314.15  of an alcohol and drug counselor, or the rules of professional 
314.16  conduct in Minnesota Rules, part 4747.1400; 
314.17     (4) be conducted by individuals who have education, 
314.18  training, and experience and are knowledgeable about the subject 
314.19  matter; and 
314.20     (5) be presented by a sponsor who has a system to verify 
314.21  participation and maintains attendance records for three years, 
314.22  unless the sponsor provides dated evidence to each participant 
314.23  with the number of clock hours awarded.  
314.24     Sec. 26.  Minnesota Statutes 2002, section 148C.10, 
314.25  subdivision 1, is amended to read: 
314.26     Subdivision 1.  [PRACTICE.] ~~After the commissioner adopts~~ 
314.27  ~~rules,~~ No ~~individual~~ person, other than those individuals 
314.28  exempted under section 148C.11, or 148C.045, shall engage in 
314.29  alcohol and drug counseling ~~practice unless that individual~~ 
314.30  ~~holds a valid license~~ without first being licensed under this 
314.31  chapter as an alcohol and drug counselor.  For purposes of this 
314.32  chapter, an individual engages in the practice of alcohol and 
314.33  drug counseling if the individual performs or offers to perform 
314.34  alcohol and drug counseling services as defined in section 
314.35  148C.01, subdivision 10, or if the individual is held out as 
314.36  able to perform those services.  
315.1      Sec. 27.  Minnesota Statutes 2002, section 148C.10, 
315.2   subdivision 2, is amended to read: 
315.3      Subd. 2.  [USE OF TITLES.] ~~After the commissioner adopts~~ 
315.4   ~~rules,~~ No ~~individual~~ person shall present themselves or any 
315.5   other individual to the public by any title incorporating the 
315.6   words "licensed alcohol and drug counselor" or otherwise hold 
315.7   themselves out to the public by any title or description stating 
315.8   or implying that they are licensed or otherwise qualified to 
315.9   practice alcohol and drug counseling unless that individual 
315.10  holds a valid license.  ~~City, county, and state agency alcohol~~ 
315.11  ~~and drug counselors who are not licensed under sections 148C.01~~ 
315.12  ~~to 148C.11 may use the title "city agency alcohol and drug~~ 
315.13  ~~counselor," "county agency alcohol and drug counselor," or~~ 
315.14  ~~"state agency alcohol and drug counselor."  Hospital alcohol and~~ 
315.15  ~~drug counselors who are not licensed under sections 148C.01 to~~ 
315.16  ~~148C.11 may use the title "hospital alcohol and drug counselor"~~ 
315.17  ~~while acting within the scope of their employment~~ Persons issued 
315.18  a temporary permit must use titles consistent with section 
315.19  148C.04, subdivision 6, paragraph (c). 
315.20     Sec. 28.  Minnesota Statutes 2002, section 148C.11, is 
315.21  amended to read: 
315.22     148C.11 [EXCEPTIONS TO LICENSE REQUIREMENT.] 
315.23     Subdivision 1.  [OTHER PROFESSIONALS.] (a) Nothing in 
315.24  ~~sections 148C.01 to 148C.10 shall prevent~~ this chapter prevents 
315.25  members of other professions or occupations from performing 
315.26  functions for which they are qualified or licensed.  This 
315.27  exception includes, but is not limited to, licensed physicians, 
315.28  registered nurses, licensed practical nurses, licensed 
315.29  psychological practitioners, members of the clergy, American 
315.30  Indian medicine men and women, licensed attorneys, probation 
315.31  officers, licensed marriage and family therapists, licensed 
315.32  social workers, licensed professional counselors, licensed 
315.33  school counselors, and registered occupational therapists or 
315.34  occupational therapy assistants. 
315.35     (b) Nothing in this chapter prohibits technicians and 
315.36  resident managers in programs licensed by the department of 
316.1   human services from discharging their duties as provided in 
316.2   Minnesota Rules, chapter 9530.  
316.3      (c) Any person who is exempt under this section but who 
316.4   elects to obtain a license under this chapter is subject to this 
316.5   chapter to the same extent as other licensees.  
316.6      (d) These persons must not, however, use a title 
316.7   incorporating the words "alcohol and drug counselor" or 
316.8   "licensed alcohol and drug counselor" or otherwise hold 
316.9   themselves out to the public by any title or description stating 
316.10  or implying that they are engaged in the practice of alcohol and 
316.11  drug counseling, or that they are licensed to engage in the 
316.12  practice of alcohol and drug counseling.  Persons engaged in the 
316.13  practice of alcohol and drug counseling are not exempt from the 
316.14  commissioner's jurisdiction solely by the use of one of the 
316.15  above titles. 
316.16     Subd. 2.  [STUDENTS.] Nothing in sections 148C.01 to 
316.17  148C.10 shall prevent students enrolled in an accredited school 
316.18  of alcohol and drug counseling from engaging in the practice of 
316.19  alcohol and drug counseling while under qualified supervision in 
316.20  an accredited school of alcohol and drug counseling.  
316.21     Subd. 3.  [FEDERALLY RECOGNIZED TRIBES; ETHNIC MINORITIES.] 
316.22  (a) Alcohol and drug counselors ~~licensed to practice~~ practicing 
316.23  alcohol and drug counseling according to standards established 
316.24  by federally recognized tribes, while practicing under tribal 
316.25  jurisdiction, are exempt from the requirements of this chapter.  
316.26  In practicing alcohol and drug counseling under tribal 
316.27  jurisdiction, individuals ~~licensed~~ practicing under that 
316.28  authority shall be afforded the same rights, responsibilities, 
316.29  and recognition as persons licensed pursuant to this chapter. 
316.30     (b) The commissioner shall develop special licensing 
316.31  criteria for issuance of a license to alcohol and drug 
316.32  counselors who:  (1) practice alcohol and drug counseling with a 
316.33  member of an ethnic minority population or with a person with a 
316.34  disability as defined by rule; or (2) are employed by agencies 
316.35  whose primary agency service focus addresses ethnic minority 
316.36  populations or persons with a disability as defined by rule.  
317.1   These licensing criteria may differ from the licensing 
317.2   ~~criteria~~ requirements specified in section 148C.04.  To develop, 
317.3   implement, and evaluate the effect of these criteria, the 
317.4   commissioner shall establish a committee comprised of, but not 
317.5   limited to, representatives from the Minnesota commission 
317.6   serving deaf and hard-of-hearing people, the council on affairs 
317.7   of Chicano/Latino people, the council on Asian-Pacific 
317.8   Minnesotans, the council on Black Minnesotans, the council on 
317.9   disability, and the Indian affairs council.  The committee does 
317.10  not expire. 
317.11     (c) The commissioner shall issue a license to an applicant 
317.12  who (1) is an alcohol and drug counselor who is exempt under 
317.13  paragraph (a) from the requirements of this chapter; (2) has at 
317.14  least 2,000 hours of alcohol and drug counselor experience as 
317.15  defined by the core functions; and (3) meets the licensing 
317.16  requirements that are in effect on the date of application under 
317.17  section 148C.04, subdivision 3 or 4, except the written case 
317.18  presentation and oral examination component under section 
317.19  148C.04, subdivision 3, clause (2), or 4, clause (1), item 
317.20  (ii).  When applying for a license under this paragraph, an 
317.21  applicant must follow the procedures for admission to licensure 
317.22  specified under section 148C.0351.  A person who receives a 
317.23  license under this paragraph must complete the written case 
317.24  presentation and satisfactorily pass the oral examination 
317.25  component under section 148C.04, subdivision 3, clause (2), or 
317.26  4, clause (1), item (ii), at the earliest available opportunity 
317.27  after the commissioner begins administering oral examinations.  
317.28  The commissioner may suspend or restrict a person's license 
317.29  according to section 148C.09 if the person fails to complete the 
317.30  written case presentation and satisfactorily pass the oral 
317.31  examination.  This paragraph expires July 1, 2004. 
317.32     Subd. 4.  [HOSPITAL ALCOHOL AND DRUG COUNSELORS.] ~~The~~ 
317.33  ~~licensing of hospital alcohol and drug counselors shall be~~ 
317.34  ~~voluntary, while the counselor is employed by the hospital.~~  
317.35  Effective January 1, 2006, hospitals employing alcohol and drug 
317.36  counselors shall ~~not~~ be required to employ licensed alcohol and 
318.1   drug counselors~~, nor shall they require their alcohol and drug~~ 
318.2   ~~counselors to be licensed, however, nothing in this chapter will~~ 
318.3   ~~prohibit hospitals from requiring their counselors to be~~ 
318.4   ~~eligible for licensure~~.  An alcohol or drug counselor employed 
318.5   by a hospital must be licensed as an alcohol and drug counselor 
318.6   in accordance with this chapter.  
318.7      Subd. 5.  [CITY, COUNTY, AND STATE AGENCY ALCOHOL AND DRUG 
318.8   COUNSELORS.] ~~The licensing of city, county, and state agency~~ 
318.9   ~~alcohol and drug counselors shall be voluntary, while the~~ 
318.10  ~~counselor is employed by the city, county, or state agency.~~  
318.11  Effective January 1, 2006, city, county, and state agencies 
318.12  employing alcohol and drug counselors shall ~~not~~ be required to 
318.13  employ licensed alcohol and drug counselors~~, nor shall they~~ 
318.14  ~~require their drug and alcohol counselors to be licensed~~.  An 
318.15  alcohol and drug counselor employed by a city, county, or state 
318.16  agency must be licensed as an alcohol and drug counselor in 
318.17  accordance with this chapter.  
318.18     Subd. 6.  [TRANSITION PERIOD FOR HOSPITAL AND CITY, COUNTY, 
318.19  AND STATE AGENCY ALCOHOL AND DRUG COUNSELORS.] For the period 
318.20  between July 1, 2003, and January 1, 2006, the commissioner 
318.21  shall grant a license to an individual who is employed as an 
318.22  alcohol and drug counselor at a Minnesota hospital or a city, 
318.23  county, or state agency in Minnesota if the individual:  
318.24     (1) was employed as an alcohol and drug counselor at a 
318.25  hospital or a city, county, or state agency before August 1, 
318.26  2002; 
318.27     (2) has 8,000 hours of alcohol and drug counselor work 
318.28  experience; 
318.29     (3) has completed a written case presentation and 
318.30  satisfactorily passed an oral examination established by the 
318.31  commissioner; 
318.32     (4) has satisfactorily passed a written examination as 
318.33  established by the commissioner; and 
318.34     (5) meets the requirements in section 148C.0351. 
318.35     Sec. 29.  [148C.12] [FEES.] 
318.36     Subdivision 1.  [APPLICATION FEE.] The application fee is 
319.1   $295.  
319.2      Subd. 2.  [BIENNIAL RENEWAL FEE.] The license renewal fee 
319.3   is $295.  If the commissioner changes the renewal schedule and 
319.4   the expiration date is less than two years, the fee must be 
319.5   prorated.  
319.6      Subd. 3.  [TEMPORARY PERMIT FEE.] The initial fee for 
319.7   applicants under section 148C.04, subdivision 6, paragraph (a), 
319.8   is $100.  The fee for annual renewal of a temporary permit is 
319.9   $100.  
319.10     Subd. 4.  [EXAMINATION FEE.] The examination fee for the 
319.11  written examination is $95 and for the oral examination is $200. 
319.12     Subd. 5.  [INACTIVE RENEWAL FEE.] The inactive renewal fee 
319.13  is $150.  
319.14     Subd. 6.  [LATE FEE.] The late fee is 25 percent of the 
319.15  biennial renewal fee, the inactive renewal fee, or the annual 
319.16  fee for renewal of temporary practice status.  
319.17     Subd. 7.  [FEE TO RENEW AFTER EXPIRATION OF LICENSE.] The 
319.18  fee for renewal of a license that has expired for less than two 
319.19  years is the total of the biennial renewal fee, the late fee, 
319.20  and a fee of $100 for review and approval of the continuing 
319.21  education report.  
319.22     Subd. 8.  [FEE FOR LICENSE VERIFICATIONS.] The fee for 
319.23  license verification to institutions and other jurisdictions is 
319.24  $25.  
319.25     Subd. 9.  [SURCHARGE FEE.] Notwithstanding section 
319.26  16A.1285, subdivision 2, a surcharge of $99 shall be paid at the 
319.27  time of initial application for or renewal of an alcohol and 
319.28  drug counselor license until June 30, 2013.  
319.29     Subd. 10.  [NONREFUNDABLE FEES.] All fees are nonrefundable.
319.30     Sec. 30.  [REPEALER.] 
319.31     (a) Minnesota Statutes 2002, sections 148C.0351, 
319.32  subdivision 2; 148C.05, subdivisions 2, 3, and 4; 148C.06; and 
319.33  148C.10, subdivision 1a, are repealed.  
319.34     (b) Minnesota Rules, parts 4747.0030, subparts 25, 28, and 
319.35  30; 4747.0040, subpart 3, item A; 4747.0060, subpart 1, items A, 
319.36  B, and D; 4747.0070, subparts 4 and 5; 4747.0080; 4747.0090; 
320.1   4747.0100; 4747.0300; 4747.0400, subparts 2 and 3; 4747.0500; 
320.2   4747.0600; 4747.1000; 4747.1100, subpart 3; and 4747.1600, are 
320.3   repealed. 
320.4                              ARTICLE 6 
320.5            HUMAN SERVICES LICENSING, COUNTY INITIATIVES, 
320.6                           AND MISCELLANEOUS 
320.7      Section 1.  Minnesota Statutes 2002, section 69.021, 
320.8   subdivision 11, is amended to read: 
320.9      Subd. 11.  [EXCESS POLICE STATE-AID HOLDING ACCOUNT.] (a) 
320.10  The excess police state-aid holding account is established in 
320.11  the general fund.  The excess police state-aid holding account 
320.12  must be administered by the commissioner. 
320.13     (b) Excess police state aid determined according to 
320.14  subdivision 10, must be deposited in the excess police state-aid 
320.15  holding account. 
320.16     (c) From the balance in the excess police state-aid holding 
320.17  account, ~~$1,000,000~~ $900,000 is appropriated to and must be 
320.18  transferred annually to the ambulance service personnel 
320.19  longevity award and incentive suspense account established by 
320.20  section 144E.42, subdivision 2. 
320.21     (d) If a police officer stress reduction program is created 
320.22  by law and money is appropriated for that program, an amount 
320.23  equal to that appropriation must be transferred from the balance 
320.24  in the excess police state-aid holding account. 
320.25     (e) On October 1, 1997, and annually on each subsequent 
320.26  October 1, one-half of the balance of the excess police 
320.27  state-aid holding account remaining after the deductions under 
320.28  paragraphs (c) and (d) is appropriated for additional 
320.29  amortization aid under section 423A.02, subdivision 1b. 
320.30     (f) Annually, the remaining balance in the excess police 
320.31  state-aid holding account, after the deductions under paragraphs 
320.32  (c), (d), and (e), cancels to the general fund. 
320.33     Sec. 2.  Minnesota Statutes 2002, section 245.0312, is 
320.34  amended to read: 
320.35     245.0312 [DESIGNATING SPECIAL UNITS AND REGIONAL CENTERS.] 
320.36     Notwithstanding any provision of law to the contrary, 
321.1   during the biennium, the commissioner of human services, upon 
321.2   the approval of the governor after consulting with the 
321.3   legislative advisory commission, may designate portions of 
321.4   ~~hospitals for the mentally ill~~ state-operated services 
321.5   facilities under the commissioner's control as special care 
321.6   units ~~for mentally retarded or inebriate persons, or as nursing~~ 
321.7   ~~homes for persons over the age of 65, and may designate portions~~ 
321.8   ~~of the hospitals designated in Minnesota Statutes 1969, section~~ 
321.9   ~~252.025, subdivision 1, as special care units for mentally ill~~ 
321.10  ~~or inebriate persons, and may plan to develop all hospitals for~~ 
321.11  ~~mentally ill, mentally retarded, or inebriate persons under the~~ 
321.12  ~~commissioner's control as multipurpose regional centers for~~ 
321.13  ~~programs related to all of the said problems~~.  
321.14     ~~If approved by the governor, the commissioner may rename~~ 
321.15  ~~the state hospital as a state regional center and appoint the~~ 
321.16  ~~hospital administrator as administrator of the center, in~~ 
321.17  ~~accordance with section 246.0251.~~  
321.18     ~~The directors of the separate program units of regional~~ 
321.19  ~~centers shall be responsible directly to the commissioner at the~~ 
321.20  ~~discretion of the commissioner.~~ 
321.21     Sec. 3.  [245.945] [REIMBURSEMENT TO OMBUDSMAN FOR MENTAL 
321.22  HEALTH AND MENTAL RETARDATION.] 
321.23     The commissioner shall obtain federal financial 
321.24  participation for eligible activity by the ombudsman for mental 
321.25  health and mental retardation.  The ombudsman shall maintain and 
321.26  transmit to the department of human services documentation that 
321.27  is necessary in order to obtain federal funds. 
321.28     Sec. 4.  Minnesota Statutes 2002, section 245A.035, 
321.29  subdivision 3, is amended to read: 
321.30     Subd. 3.  [REQUIREMENTS FOR EMERGENCY LICENSE.] Before an 
321.31  emergency license may be issued, the following requirements must 
321.32  be met: 
321.33     (1) the county agency must conduct an initial inspection of 
321.34  the premises where the foster care is to be provided to ensure 
321.35  the health and safety of any child placed in the home.  The 
321.36  county agency shall conduct the inspection using a form 
322.1   developed by the commissioner; 
322.2      (2) at the time of the inspection or placement, whichever 
322.3   is earlier, the relative being considered for an emergency 
322.4   license shall receive an application form for a child foster 
322.5   care license; 
322.6      (3) whenever possible, prior to placing the child in the 
322.7   relative's home, the relative being considered for an emergency 
322.8   license shall provide the information required by section 
322.9   245A.04, subdivision 3, paragraph ~~(b)~~ (k); and 
322.10     (4) if the county determines, prior to the issuance of an 
322.11  emergency license, that anyone requiring a background study may 
322.12  be disqualified under section 245A.04, and the disqualification 
322.13  is one which the commissioner cannot set aside, an emergency 
322.14  license shall not be issued. 
322.15     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
322.16  following final enactment. 
322.17     Sec. 5.  Minnesota Statutes 2002, section 245A.04, 
322.18  subdivision 3, is amended to read: 
322.19     Subd. 3.  [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 
322.20  (a) Individuals and organizations that are required in statute 
322.21  to initiate background studies under this section shall comply 
322.22  with the following requirements: 
322.23     (1) Applicants for licensure, license holders, and other 
322.24  entities as provided in this section must submit completed 
322.25  background study forms to the commissioner before individuals 
322.26  specified in paragraph (c), clauses (1) to (4), (6), and (7), 
322.27  begin positions allowing direct contact in any licensed program. 
322.28     (2) Applicants and license holders under the jurisdiction 
322.29  of other state agencies who are required in other statutory 
322.30  sections to initiate background studies under this section must 
322.31  submit completed background study forms to the commissioner 
322.32  prior to the background study subject beginning in a position 
322.33  allowing direct contact in the licensed program, or where 
322.34  applicable, prior to being employed. 
322.35     (3) Organizations required to initiate background studies 
322.36  under section 256B.0627 for individuals described in paragraph 
323.1   (c), clause (5), must submit a completed background study form 
323.2   to the commissioner before those individuals begin a position 
323.3   allowing direct contact with persons served by the 
323.4   organization.  The commissioner shall recover the cost of these 
323.5   background studies through a fee of no more than $12 per study 
323.6   charged to the organization responsible for submitting the 
323.7   background study form.  The fees collected under this paragraph 
323.8   are appropriated to the commissioner for the purpose of 
323.9   conducting background studies.  
323.10     Upon receipt of the background study forms from the 
323.11  entities in clauses (1) to (3), the commissioner shall complete 
323.12  the background study as specified under this section and provide 
323.13  notices required in subdivision 3a.  Unless otherwise specified, 
323.14  the subject of a background study may have direct contact with 
323.15  persons served by a program after the background study form is 
323.16  mailed or submitted to the commissioner pending notification of 
323.17  the study results under subdivision 3a.  A county agency may 
323.18  accept a background study completed by the commissioner under 
323.19  this section in place of the background study required under 
323.20  section 245A.16, subdivision 3, in programs with joint licensure 
323.21  as home and community-based services and adult foster care for 
323.22  people with developmental disabilities when the license holder 
323.23  does not reside in the foster care residence and the subject of 
323.24  the study has been continuously affiliated with the license 
323.25  holder since the date of the commissioner's study. 
323.26     (b) The definitions in this paragraph apply only to 
323.27  subdivisions 3 to 3e. 
323.28     (1) "Background study" means the review of records 
323.29  conducted by the commissioner to determine whether a subject is 
323.30  disqualified from direct contact with persons served by a 
323.31  program, and where specifically provided in statutes, whether a 
323.32  subject is disqualified from having access to persons served by 
323.33  a program. 
323.34     (2) "Continuous, direct supervision" means an individual is 
323.35  within sight or hearing of the supervising person to the extent 
323.36  that supervising person is capable at all times of intervening 
324.1   to protect the health and safety of the persons served by the 
324.2   program. 
324.3      (3) "Contractor" means any person, regardless of employer, 
324.4   who is providing program services for hire under the control of 
324.5   the provider. 
324.6      (4) "Direct contact" means providing face-to-face care, 
324.7   training, supervision, counseling, consultation, or medication 
324.8   assistance to persons served by the program. 
324.9      (5) "Reasonable cause" means information or circumstances 
324.10  exist which provide the commissioner with articulable suspicion 
324.11  that further pertinent information may exist concerning a 
324.12  subject.  The commissioner has reasonable cause when, but not 
324.13  limited to, the commissioner has received a report from the 
324.14  subject, the license holder, or a third party indicating that 
324.15  the subject has a history that would disqualify the person or 
324.16  that may pose a risk to the health or safety of persons 
324.17  receiving services. 
324.18     (6) "Subject of a background study" means an individual on 
324.19  whom a background study is required or completed. 
324.20     (c) The applicant, license holder, registrant under section 
324.21  144A.71, subdivision 1, bureau of criminal apprehension, 
324.22  commissioner of health, and county agencies, after written 
324.23  notice to the individual who is the subject of the study, shall 
324.24  help with the study by giving the commissioner criminal 
324.25  conviction data and reports about the maltreatment of adults 
324.26  substantiated under section 626.557 and the maltreatment of 
324.27  minors in licensed programs substantiated under section 
324.28  626.556.  If a background study is initiated by an applicant or 
324.29  license holder and the applicant or license holder receives 
324.30  information about the possible criminal or maltreatment history 
324.31  of an individual who is the subject of the background study, the 
324.32  applicant or license holder must immediately provide the 
324.33  information to the commissioner.  The individuals to be studied 
324.34  shall include: 
324.35     (1) the applicant; 
324.36     (2) persons age 13 and over living in the household where 
325.1   the licensed program will be provided; 
325.2      (3) current employees or contractors of the applicant who 
325.3   will have direct contact with persons served by the facility, 
325.4   agency, or program; 
325.5      (4) volunteers or student volunteers who have direct 
325.6   contact with persons served by the program to provide program 
325.7   services, if the contact is not under the continuous, direct 
325.8   supervision by an individual listed in clause (1) or (3); 
325.9      (5) any person required under section 256B.0627 to have a 
325.10  background study completed under this section; 
325.11     (6) persons ages 10 to 12 living in the household where the 
325.12  licensed services will be provided when the commissioner has 
325.13  reasonable cause; and 
325.14     (7) persons who, without providing direct contact services 
325.15  at a licensed program, may have unsupervised access to children 
325.16  or vulnerable adults receiving services from the program 
325.17  licensed to provide family child care for children, foster care 
325.18  for children in the provider's own home, or foster care or day 
325.19  care services for adults in the provider's own home when the 
325.20  commissioner has reasonable cause. 
325.21     (d) According to paragraph (c), clauses (2) and (6), the 
325.22  commissioner shall review records from the juvenile courts.  For 
325.23  persons under paragraph (c), clauses (1), (3), (4), (5), and 
325.24  (7), who are ages 13 to 17, the commissioner shall review 
325.25  records from the juvenile courts when the commissioner has 
325.26  reasonable cause.  The juvenile courts shall help with the study 
325.27  by giving the commissioner existing juvenile court records on 
325.28  individuals described in paragraph (c), clauses (2), (6), and 
325.29  (7), relating to delinquency proceedings held within either the 
325.30  five years immediately preceding the background study or the 
325.31  five years immediately preceding the individual's 18th birthday, 
325.32  whichever time period is longer.  The commissioner shall destroy 
325.33  juvenile records obtained pursuant to this subdivision when the 
325.34  subject of the records reaches age 23. 
325.35     (e) Beginning August 1, 2001, the commissioner shall 
325.36  conduct all background studies required under this chapter and 
326.1   initiated by supplemental nursing services agencies registered 
326.2   under section 144A.71, subdivision 1.  Studies for the agencies 
326.3   must be initiated annually by each agency.  The commissioner 
326.4   shall conduct the background studies according to this chapter.  
326.5   The commissioner shall recover the cost of the background 
326.6   studies through a fee of no more than $8 per study, charged to 
326.7   the supplemental nursing services agency.  The fees collected 
326.8   under this paragraph are appropriated to the commissioner for 
326.9   the purpose of conducting background studies. 
326.10     (f) For purposes of this section, a finding that a 
326.11  delinquency petition is proven in juvenile court shall be 
326.12  considered a conviction in state district court. 
326.13     (g) A study of an individual in paragraph (c), clauses (1) 
326.14  to (7), shall be conducted at least upon application for initial 
326.15  license for all license types or registration under section 
326.16  144A.71, subdivision 1, and at reapplication for a license for 
326.17  family child care, child foster care, and adult foster care.  
326.18  The commissioner is not required to conduct a study of an 
326.19  individual at the time of reapplication for a license or if the 
326.20  individual has been continuously affiliated with a foster care 
326.21  provider licensed by the commissioner of human services and 
326.22  registered under chapter 144D, other than a family day care or 
326.23  foster care license, if:  (i) a study of the individual was 
326.24  conducted either at the time of initial licensure or when the 
326.25  individual became affiliated with the license holder; (ii) the 
326.26  individual has been continuously affiliated with the license 
326.27  holder since the last study was conducted; and (iii) the 
326.28  procedure described in paragraph (j) has been implemented and 
326.29  was in effect continuously since the last study was conducted.  
326.30  For the purposes of this section, a physician licensed under 
326.31  chapter 147 is considered to be continuously affiliated upon the 
326.32  license holder's receipt from the commissioner of health or 
326.33  human services of the physician's background study results.  For 
326.34  individuals who are required to have background studies under 
326.35  paragraph (c) and who have been continuously affiliated with a 
326.36  foster care provider that is licensed in more than one county, 
327.1   criminal conviction data may be shared among those counties in 
327.2   which the foster care programs are licensed.  A county agency's 
327.3   receipt of criminal conviction data from another county agency 
327.4   shall meet the criminal data background study requirements of 
327.5   this section. 
327.6      (h) The commissioner may also conduct studies on 
327.7   individuals specified in paragraph (c), clauses (3) and (4), 
327.8   when the studies are initiated by: 
327.9      (i) personnel pool agencies; 
327.10     (ii) temporary personnel agencies; 
327.11     (iii) educational programs that train persons by providing 
327.12  direct contact services in licensed programs; and 
327.13     (iv) professional services agencies that are not licensed 
327.14  and which contract with licensed programs to provide direct 
327.15  contact services or individuals who provide direct contact 
327.16  services. 
327.17     (i) Studies on individuals in paragraph (h), items (i) to 
327.18  (iv), must be initiated annually by these agencies, programs, 
327.19  and individuals.  Except as provided in paragraph (a), clause 
327.20  (3), no applicant, license holder, or individual who is the 
327.21  subject of the study shall pay any fees required to conduct the 
327.22  study. 
327.23     (1) At the option of the licensed facility, rather than 
327.24  initiating another background study on an individual required to 
327.25  be studied who has indicated to the licensed facility that a 
327.26  background study by the commissioner was previously completed, 
327.27  the facility may make a request to the commissioner for 
327.28  documentation of the individual's background study status, 
327.29  provided that: 
327.30     (i) the facility makes this request using a form provided 
327.31  by the commissioner; 
327.32     (ii) in making the request the facility informs the 
327.33  commissioner that either: 
327.34     (A) the individual has been continuously affiliated with a 
327.35  licensed facility since the individual's previous background 
327.36  study was completed, or since October 1, 1995, whichever is 
328.1   shorter; or 
328.2      (B) the individual is affiliated only with a personnel pool 
328.3   agency, a temporary personnel agency, an educational program 
328.4   that trains persons by providing direct contact services in 
328.5   licensed programs, or a professional services agency that is not 
328.6   licensed and which contracts with licensed programs to provide 
328.7   direct contact services or individuals who provide direct 
328.8   contact services; and 
328.9      (iii) the facility provides notices to the individual as 
328.10  required in paragraphs (a) to (j), and that the facility is 
328.11  requesting written notification of the individual's background 
328.12  study status from the commissioner.  
328.13     (2) The commissioner shall respond to each request under 
328.14  paragraph (1) with a written or electronic notice to the 
328.15  facility and the study subject.  If the commissioner determines 
328.16  that a background study is necessary, the study shall be 
328.17  completed without further request from a licensed agency or 
328.18  notifications to the study subject.  
328.19     (3) When a background study is being initiated by a 
328.20  licensed facility or a foster care provider that is also 
328.21  registered under chapter 144D, a study subject affiliated with 
328.22  multiple licensed facilities may attach to the background study 
328.23  form a cover letter indicating the additional facilities' names, 
328.24  addresses, and background study identification numbers.  When 
328.25  the commissioner receives such notices, each facility identified 
328.26  by the background study subject shall be notified of the study 
328.27  results.  The background study notice sent to the subsequent 
328.28  agencies shall satisfy those facilities' responsibilities for 
328.29  initiating a background study on that individual. 
328.30     (j) If an individual who is affiliated with a program or 
328.31  facility regulated by the department of human services or 
328.32  department of health, a facility serving children or youth 
328.33  licensed by the department of corrections, or ~~who is affiliated~~ 
328.34  with any type of home care agency or provider of personal care 
328.35  assistance services, is convicted of a crime constituting a 
328.36  disqualification under subdivision 3d, the probation officer or 
329.1   corrections agent shall notify the commissioner of the 
329.2   conviction.  For the purpose of this paragraph, "conviction" has 
329.3   the meaning given it in section 609.02, subdivision 5.  The 
329.4   commissioner, in consultation with the commissioner of 
329.5   corrections, shall develop forms and information necessary to 
329.6   implement this paragraph and shall provide the forms and 
329.7   information to the commissioner of corrections for distribution 
329.8   to local probation officers and corrections agents.  The 
329.9   commissioner shall inform individuals subject to a background 
329.10  study that criminal convictions for disqualifying crimes will be 
329.11  reported to the commissioner by the corrections system.  A 
329.12  probation officer, corrections agent, or corrections agency is 
329.13  not civilly or criminally liable for disclosing or failing to 
329.14  disclose the information required by this paragraph.  Upon 
329.15  receipt of disqualifying information, the commissioner shall 
329.16  provide the notifications required in subdivision 3a, as 
329.17  appropriate to agencies on record as having initiated a 
329.18  background study or making a request for documentation of the 
329.19  background study status of the individual.  This paragraph does 
329.20  not apply to family day care and child foster care programs. 
329.21     (k) The individual who is the subject of the study must 
329.22  provide the applicant or license holder with sufficient 
329.23  information to ensure an accurate study including the 
329.24  individual's first, middle, and last name and all other names by 
329.25  which the individual has been known; home address, city, county, 
329.26  and state of residence for the past five years; zip code; sex; 
329.27  date of birth; and driver's license number or state 
329.28  identification number.  The applicant or license holder shall 
329.29  provide this information about an individual in paragraph (c), 
329.30  clauses (1) to (7), on forms prescribed by the commissioner.  By 
329.31  January 1, 2000, for background studies conducted by the 
329.32  department of human services, the commissioner shall implement a 
329.33  system for the electronic transmission of:  (1) background study 
329.34  information to the commissioner; and (2) background study 
329.35  results to the license holder.  The commissioner may request 
329.36  additional information of the individual, which shall be 
330.1   optional for the individual to provide, such as the individual's 
330.2   social security number or race. 
330.3      (l) For programs directly licensed by the commissioner, a 
330.4   study must include information related to names of substantiated 
330.5   perpetrators of maltreatment of vulnerable adults that has been 
330.6   received by the commissioner as required under section 626.557, 
330.7   subdivision 9c, paragraph (i), and the commissioner's records 
330.8   relating to the maltreatment of minors in licensed programs, 
330.9   information from juvenile courts as required in paragraph (c) 
330.10  for persons listed in paragraph (c), clauses (2), (6), and (7), 
330.11  and information from the bureau of criminal apprehension.  For 
330.12  child foster care, adult foster care, and family day care homes, 
330.13  the study must include information from the county agency's 
330.14  record of substantiated maltreatment of adults, and the 
330.15  maltreatment of minors, information from juvenile courts as 
330.16  required in paragraph (c) for persons listed in paragraph (c), 
330.17  clauses (2), (6), and (7), and information from the bureau of 
330.18  criminal apprehension.  For any background study completed under 
330.19  this section, the commissioner may also review arrest and 
330.20  investigative information from the bureau of criminal 
330.21  apprehension, the commissioner of health, a county attorney, 
330.22  county sheriff, county agency, local chief of police, other 
330.23  states, the courts, or the Federal Bureau of Investigation if 
330.24  the commissioner has reasonable cause to believe the information 
330.25  is pertinent to the disqualification of an individual listed in 
330.26  paragraph (c), clauses (1) to (7).  The commissioner is not 
330.27  required to conduct more than one review of a subject's records 
330.28  from the Federal Bureau of Investigation if a review of the 
330.29  subject's criminal history with the Federal Bureau of 
330.30  Investigation has already been completed by the commissioner and 
330.31  there has been no break in the subject's affiliation with the 
330.32  license holder who initiated the background study. 
330.33     (m) For any background study completed under this section, 
330.34  when the commissioner has reasonable cause to believe that 
330.35  further pertinent information may exist on the subject, the 
330.36  subject shall provide a set of classifiable fingerprints 
331.1   obtained from an authorized law enforcement agency.  For 
331.2   purposes of requiring fingerprints, the commissioner shall be 
331.3   considered to have reasonable cause under, but not limited to, 
331.4   the following circumstances: 
331.5      (1) information from the bureau of criminal apprehension 
331.6   indicates that the subject is a multistate offender; 
331.7      (2) information from the bureau of criminal apprehension 
331.8   indicates that multistate offender status is undetermined; or 
331.9      (3) the commissioner has received a report from the subject 
331.10  or a third party indicating that the subject has a criminal 
331.11  history in a jurisdiction other than Minnesota. 
331.12     (n) The failure or refusal of an applicant, license holder, 
331.13  or registrant under section 144A.71, subdivision 1, to cooperate 
331.14  with the commissioner is reasonable cause to disqualify a 
331.15  subject, deny a license application or immediately suspend, 
331.16  suspend, or revoke a license or registration.  Failure or 
331.17  refusal of an individual to cooperate with the study is just 
331.18  cause for denying or terminating employment of the individual if 
331.19  the individual's failure or refusal to cooperate could cause the 
331.20  applicant's application to be denied or the license holder's 
331.21  license to be immediately suspended, suspended, or revoked. 
331.22     (o) The commissioner shall not consider an application to 
331.23  be complete until all of the information required to be provided 
331.24  under this subdivision has been received.  
331.25     (p) No person in paragraph (c), clauses (1) to (7), who is 
331.26  disqualified as a result of this section may be retained by the 
331.27  agency in a position involving direct contact with persons 
331.28  served by the program and no person in paragraph (c), clauses 
331.29  (2), (6), and (7), or as provided elsewhere in statute who is 
331.30  disqualified as a result of this section may be allowed access 
331.31  to persons served by the program, unless the commissioner has 
331.32  provided written notice to the agency stating that: 
331.33     (1) the individual may remain in direct contact during the 
331.34  period in which the individual may request reconsideration as 
331.35  provided in subdivision 3a, paragraph (b), clause (2) or (3); 
331.36     (2) the individual's disqualification has been set aside 
332.1   for that agency as provided in subdivision 3b, paragraph (b); or 
332.2      (3) the license holder has been granted a variance for the 
332.3   disqualified individual under subdivision 3e. 
332.4      (q) Termination of affiliation with persons in paragraph 
332.5   (c), clauses (1) to (7), made in good faith reliance on a notice 
332.6   of disqualification provided by the commissioner shall not 
332.7   subject the applicant or license holder to civil liability. 
332.8      (r) The commissioner may establish records to fulfill the 
332.9   requirements of this section. 
332.10     (s) The commissioner may not disqualify an individual 
332.11  subject to a study under this section because that person has, 
332.12  or has had, a mental illness as defined in section 245.462, 
332.13  subdivision 20. 
332.14     (t) An individual subject to disqualification under this 
332.15  subdivision has the applicable rights in subdivision 3a, 3b, or 
332.16  3c. 
332.17     (u) For the purposes of background studies completed by 
332.18  tribal organizations performing licensing activities otherwise 
332.19  required of the commissioner under this chapter, after obtaining 
332.20  consent from the background study subject, tribal licensing 
332.21  agencies shall have access to criminal history data in the same 
332.22  manner as county licensing agencies and private licensing 
332.23  agencies under this chapter. 
332.24     (v) County agencies shall have access to the criminal 
332.25  history data in the same manner as county licensing agencies 
332.26  under this chapter for purposes of background studies completed 
332.27  by county agencies on legal nonlicensed child care providers to 
332.28  determine eligibility for child care funds under chapter 119B. 
332.29     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
332.30  following final enactment. 
332.31     Sec. 6.  Minnesota Statutes 2002, section 245A.04, 
332.32  subdivision 3b, is amended to read: 
332.33     Subd. 3b.  [RECONSIDERATION OF DISQUALIFICATION.] (a) The 
332.34  individual who is the subject of the disqualification may 
332.35  request a reconsideration of the disqualification.  
332.36     The individual must submit the request for reconsideration 
333.1   to the commissioner in writing.  A request for reconsideration 
333.2   for an individual who has been sent a notice of disqualification 
333.3   under subdivision 3a, paragraph (b), clause (1) or (2), must be 
333.4   submitted within 30 calendar days of the disqualified 
333.5   individual's receipt of the notice of disqualification.  Upon 
333.6   showing that the information in clause (1) or (2) cannot be 
333.7   obtained within 30 days, the disqualified individual may request 
333.8   additional time, not to exceed 30 days, to obtain that 
333.9   information.  A request for reconsideration for an individual 
333.10  who has been sent a notice of disqualification under subdivision 
333.11  3a, paragraph (b), clause (3), must be submitted within 15 
333.12  calendar days of the disqualified individual's receipt of the 
333.13  notice of disqualification.  An individual who was determined to 
333.14  have maltreated a child under section 626.556 or a vulnerable 
333.15  adult under section 626.557, and who was disqualified under this 
333.16  section on the basis of serious or recurring maltreatment, may 
333.17  request reconsideration of both the maltreatment and the 
333.18  disqualification determinations.  The request for 
333.19  reconsideration of the maltreatment determination and the 
333.20  disqualification must be submitted within 30 calendar days of 
333.21  the individual's receipt of the notice of disqualification.  
333.22  Removal of a disqualified individual from direct contact shall 
333.23  be ordered if the individual does not request reconsideration 
333.24  within the prescribed time, and for an individual who submits a 
333.25  timely request for reconsideration, if the disqualification is 
333.26  not set aside.  The individual must present information showing 
333.27  that: 
333.28     (1) the information the commissioner relied upon in 
333.29  determining that the underlying conduct giving rise to the 
333.30  disqualification occurred, and for maltreatment, that the 
333.31  maltreatment was serious or recurring, is incorrect; or 
333.32     (2) the subject of the study does not pose a risk of harm 
333.33  to any person served by the applicant, license holder, or 
333.34  registrant under section 144A.71, subdivision 1. 
333.35     (b) The commissioner shall rescind the disqualification if 
333.36  the commissioner finds that the information relied on to 
334.1   disqualify the subject is incorrect.  The commissioner may set 
334.2   aside the disqualification under this section if the 
334.3   commissioner finds that the individual does not pose a risk of 
334.4   harm to any person served by the applicant, license holder, or 
334.5   registrant under section 144A.71, subdivision 1.  In determining 
334.6   that an individual does not pose a risk of harm, the 
334.7   commissioner shall consider the nature, severity, and 
334.8   consequences of the event or events that lead to 
334.9   disqualification, whether there is more than one disqualifying 
334.10  event, the age and vulnerability of the victim at the time of 
334.11  the event, the harm suffered by the victim, the similarity 
334.12  between the victim and persons served by the program, the time 
334.13  elapsed without a repeat of the same or similar event, 
334.14  documentation of successful completion by the individual studied 
334.15  of training or rehabilitation pertinent to the event, and any 
334.16  other information relevant to reconsideration.  In reviewing a 
334.17  disqualification under this section, the commissioner shall give 
334.18  preeminent weight to the safety of each person to be served by 
334.19  the license holder, applicant, or registrant under section 
334.20  144A.71, subdivision 1, over the interests of the license 
334.21  holder, applicant, or registrant under section 144A.71, 
334.22  subdivision 1.  If the commissioner sets aside a 
334.23  disqualification under this section, the disqualified individual 
334.24  remains disqualified, but may hold a license and have direct 
334.25  contact with or access to persons receiving services.  The 
334.26  commissioner's set aside of a disqualification is limited solely 
334.27  to the licensed program, applicant, or agency specified in the 
334.28  set aside notice, unless otherwise specified in the notice.  The 
334.29  commissioner may rescind a previous set aside of a 
334.30  disqualification under this section based on new information 
334.31  that indicates the individual may pose a risk of harm to persons 
334.32  served by the applicant, license holder, or registrant.  If the 
334.33  commissioner rescinds a set aside of a disqualification under 
334.34  this paragraph, the appeal rights under paragraphs (a) and (e) 
334.35  shall apply. 
334.36     (c) Unless the information the commissioner relied on in 
335.1   disqualifying an individual is incorrect, the commissioner may 
335.2   not set aside the disqualification of an individual in 
335.3   connection with a license to provide family day care for 
335.4   children, foster care for children in the provider's own home, 
335.5   or foster care or day care services for adults in the provider's 
335.6   own home if: 
335.7      (1) less than ten years have passed since the discharge of 
335.8   the sentence imposed for the offense; and the individual has 
335.9   been convicted of a violation of any offense listed in sections 
335.10  609.165 (felon ineligible to possess firearm), criminal 
335.11  vehicular homicide under 609.21 (criminal vehicular homicide and 
335.12  injury), 609.215 (aiding suicide or aiding attempted suicide), 
335.13  felony violations under 609.223 or 609.2231 (assault in the 
335.14  third or fourth degree), 609.713 (terroristic threats), 609.235 
335.15  (use of drugs to injure or to facilitate crime), 609.24 (simple 
335.16  robbery), 609.255 (false imprisonment), 609.562 (arson in the 
335.17  second degree), 609.71 (riot), 609.498, subdivision 1 or ~~1a~~ 1b 
335.18  (aggravated first degree or first degree tampering with a 
335.19  witness), burglary in the first or second degree under 609.582 
335.20  (burglary), 609.66 (dangerous weapon), 609.665 (spring guns), 
335.21  609.67 (machine guns and short-barreled shotguns), 609.749, 
335.22  subdivision 2 (gross misdemeanor harassment; stalking), 152.021 
335.23  or 152.022 (controlled substance crime in the first or second 
335.24  degree), 152.023, subdivision 1, clause (3) or (4), or 
335.25  subdivision 2, clause (4) (controlled substance crime in the 
335.26  third degree), 152.024, subdivision 1, clause (2), (3), or (4) 
335.27  (controlled substance crime in the fourth degree), 609.224, 
335.28  subdivision 2, paragraph (c) (fifth-degree assault by a 
335.29  caregiver against a vulnerable adult), 609.23 (mistreatment of 
335.30  persons confined), 609.231 (mistreatment of residents or 
335.31  patients), 609.2325 (criminal abuse of a vulnerable adult), 
335.32  609.233 (criminal neglect of a vulnerable adult), 609.2335 
335.33  (financial exploitation of a vulnerable adult), 609.234 (failure 
335.34  to report), 609.265 (abduction), 609.2664 to 609.2665 
335.35  (manslaughter of an unborn child in the first or second degree), 
335.36  609.267 to 609.2672 (assault of an unborn child in the first, 
336.1   second, or third degree), 609.268 (injury or death of an unborn 
336.2   child in the commission of a crime), 617.293 (disseminating or 
336.3   displaying harmful material to minors), a felony level 
336.4   conviction involving alcohol or drug use, a gross misdemeanor 
336.5   offense under 609.324, subdivision 1 (other prohibited acts), a 
336.6   gross misdemeanor offense under 609.378 (neglect or endangerment 
336.7   of a child), a gross misdemeanor offense under 609.377 
336.8   (malicious punishment of a child), 609.72, subdivision 3 
336.9   (disorderly conduct against a vulnerable adult); or an attempt 
336.10  or conspiracy to commit any of these offenses, as each of these 
336.11  offenses is defined in Minnesota Statutes; or an offense in any 
336.12  other state, the elements of which are substantially similar to 
336.13  the elements of any of the foregoing offenses; 
336.14     (2) regardless of how much time has passed since the 
336.15  involuntary termination of parental rights under section 
336.16  260C.301 or the discharge of the sentence imposed for the 
336.17  offense, the individual was convicted of a violation of any 
336.18  offense listed in sections 609.185 to 609.195 (murder in the 
336.19  first, second, or third degree), 609.20 (manslaughter in the 
336.20  first degree), 609.205 (manslaughter in the second degree), 
336.21  609.245 (aggravated robbery), 609.25 (kidnapping), 609.561 
336.22  (arson in the first degree), 609.749, subdivision 3, 4, or 5 
336.23  (felony-level harassment; stalking), 609.228 (great bodily harm 
336.24  caused by distribution of drugs), 609.221 or 609.222 (assault in 
336.25  the first or second degree), 609.66, subdivision 1e (drive-by 
336.26  shooting), 609.855, subdivision 5 (shooting in or at a public 
336.27  transit vehicle or facility), 609.2661 to 609.2663 (murder of an 
336.28  unborn child in the first, second, or third degree), a felony 
336.29  offense under 609.377 (malicious punishment of a child), a 
336.30  felony offense under 609.324, subdivision 1 (other prohibited 
336.31  acts), a felony offense under 609.378 (neglect or endangerment 
336.32  of a child), 609.322 (solicitation, inducement, and promotion of 
336.33  prostitution), 609.342 to 609.345 (criminal sexual conduct in 
336.34  the first, second, third, or fourth degree), 609.352 
336.35  (solicitation of children to engage in sexual conduct), 617.246 
336.36  (use of minors in a sexual performance), 617.247 (possession of 
337.1   pictorial representations of a minor), 609.365 (incest), a 
337.2   felony offense under sections 609.2242 and 609.2243 (domestic 
337.3   assault), a felony offense of spousal abuse, a felony offense of 
337.4   child abuse or neglect, a felony offense of a crime against 
337.5   children, or an attempt or conspiracy to commit any of these 
337.6   offenses as defined in Minnesota Statutes, or an offense in any 
337.7   other state, the elements of which are substantially similar to 
337.8   any of the foregoing offenses; 
337.9      (3) within the seven years preceding the study, the 
337.10  individual committed an act that constitutes maltreatment of a 
337.11  child under section 626.556, subdivision 10e, and that resulted 
337.12  in substantial bodily harm as defined in section 609.02, 
337.13  subdivision 7a, or substantial mental or emotional harm as 
337.14  supported by competent psychological or psychiatric evidence; or 
337.15     (4) within the seven years preceding the study, the 
337.16  individual was determined under section 626.557 to be the 
337.17  perpetrator of a substantiated incident of maltreatment of a 
337.18  vulnerable adult that resulted in substantial bodily harm as 
337.19  defined in section 609.02, subdivision 7a, or substantial mental 
337.20  or emotional harm as supported by competent psychological or 
337.21  psychiatric evidence. 
337.22     In the case of any ground for disqualification under 
337.23  clauses (1) to (4), if the act was committed by an individual 
337.24  other than the applicant, license holder, or registrant under 
337.25  section 144A.71, subdivision 1, residing in the applicant's or 
337.26  license holder's home, or the home of a registrant under section 
337.27  144A.71, subdivision 1, the applicant, license holder, or 
337.28  registrant under section 144A.71, subdivision 1, may seek 
337.29  reconsideration when the individual who committed the act no 
337.30  longer resides in the home.  
337.31     The disqualification periods provided under clauses (1), 
337.32  (3), and (4) are the minimum applicable disqualification 
337.33  periods.  The commissioner may determine that an individual 
337.34  should continue to be disqualified from licensure or 
337.35  registration under section 144A.71, subdivision 1, because the 
337.36  license holder, applicant, or registrant under section 144A.71, 
338.1   subdivision 1, poses a risk of harm to a person served by that 
338.2   individual after the minimum disqualification period has passed. 
338.3      (d) The commissioner shall respond in writing or by 
338.4   electronic transmission to all reconsideration requests for 
338.5   which the basis for the request is that the information relied 
338.6   upon by the commissioner to disqualify is incorrect or 
338.7   inaccurate within 30 working days of receipt of a request and 
338.8   all relevant information.  If the basis for the request is that 
338.9   the individual does not pose a risk of harm, the commissioner 
338.10  shall respond to the request within 15 working days after 
338.11  receiving the request for reconsideration and all relevant 
338.12  information.  If the request is based on both the correctness or 
338.13  accuracy of the information relied on to disqualify the 
338.14  individual and the risk of harm, the commissioner shall respond 
338.15  to the request within 45 working days after receiving the 
338.16  request for reconsideration and all relevant information.  If 
338.17  the disqualification is set aside, the commissioner shall notify 
338.18  the applicant or license holder in writing or by electronic 
338.19  transmission of the decision. 
338.20     (e) Except as provided in subdivision 3c, if a 
338.21  disqualification for which reconsideration was requested is not 
338.22  set aside or is not rescinded, an individual who was 
338.23  disqualified on the basis of a preponderance of evidence that 
338.24  the individual committed an act or acts that meet the definition 
338.25  of any of the crimes listed in subdivision 3d, paragraph (a), 
338.26  clauses (1) to (4); for a determination under section 626.556 or 
338.27  626.557 of substantiated maltreatment that was serious or 
338.28  recurring under subdivision 3d, paragraph (a), clause (4); or 
338.29  for failure to make required reports under section 626.556, 
338.30  subdivision 3, or 626.557, subdivision 3, pursuant to 
338.31  subdivision 3d, paragraph (a), clause (4), may request a fair 
338.32  hearing under section 256.045.  Except as provided under 
338.33  subdivision 3c, the fair hearing is the only administrative 
338.34  appeal of the final agency determination for purposes of appeal 
338.35  by the disqualified individual, specifically, including a 
338.36  challenge to the accuracy and completeness of data under section 
339.1   13.04.  If the individual was disqualified based on a conviction 
339.2   or admission to any crimes listed in subdivision 3d, paragraph 
339.3   (a), clauses (1) to (4), the reconsideration decision under this 
339.4   subdivision is the final agency determination for purposes of 
339.5   appeal by the disqualified individual and is not subject to a 
339.6   hearing under section 256.045. 
339.7      (f) Except as provided under subdivision 3c, if an 
339.8   individual was disqualified on the basis of a determination of 
339.9   maltreatment under section 626.556 or 626.557, which was serious 
339.10  or recurring, and the individual has requested reconsideration 
339.11  of the maltreatment determination under section 626.556, 
339.12  subdivision 10i, or 626.557, subdivision 9d, and also requested 
339.13  reconsideration of the disqualification under this subdivision, 
339.14  reconsideration of the maltreatment determination and 
339.15  reconsideration of the disqualification shall be consolidated 
339.16  into a single reconsideration.  For maltreatment and 
339.17  disqualification determinations made by county agencies, the 
339.18  consolidated reconsideration shall be conducted by the county 
339.19  agency.  If the county agency has disqualified an individual on 
339.20  multiple bases, one of which is a county maltreatment 
339.21  determination for which the individual has a right to request 
339.22  reconsideration, the county shall conduct the reconsideration of 
339.23  all disqualifications.  Except as provided under subdivision 3c, 
339.24  if an individual who was disqualified on the basis of serious or 
339.25  recurring maltreatment requests a fair hearing on the 
339.26  maltreatment determination under section 626.556, subdivision 
339.27  10i, or 626.557, subdivision 9d, and requests a fair hearing on 
339.28  the disqualification, which has not been set aside or rescinded 
339.29  under this subdivision, the scope of the fair hearing under 
339.30  section 256.045 shall include the maltreatment determination and 
339.31  the disqualification.  Except as provided under subdivision 3c, 
339.32  a fair hearing is the only administrative appeal of the final 
339.33  agency determination, specifically, including a challenge to the 
339.34  accuracy and completeness of data under section 13.04. 
339.35     (g) In the notice from the commissioner that a 
339.36  disqualification has been set aside, the license holder must be 
340.1   informed that information about the nature of the 
340.2   disqualification and which factors under paragraph (b) were the 
340.3   bases of the decision to set aside the disqualification is 
340.4   available to the license holder upon request without consent of 
340.5   the background study subject.  With the written consent of a 
340.6   background study subject, the commissioner may release to the 
340.7   license holder copies of all information related to the 
340.8   background study subject's disqualification and the 
340.9   commissioner's decision to set aside the disqualification as 
340.10  specified in the written consent. 
340.11     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
340.12  following final enactment. 
340.13     Sec. 7.  Minnesota Statutes 2002, section 245A.04, 
340.14  subdivision 3d, is amended to read: 
340.15     Subd. 3d.  [DISQUALIFICATION.] (a) Upon receipt of 
340.16  information showing, or when a background study completed under 
340.17  subdivision 3 shows any of the following:  a conviction of one 
340.18  or more crimes listed in clauses (1) to (4); the individual has 
340.19  admitted to or a preponderance of the evidence indicates the 
340.20  individual has committed an act or acts that meet the definition 
340.21  of any of the crimes listed in clauses (1) to (4); or an 
340.22  investigation results in an administrative determination listed 
340.23  under clause (4), the individual shall be disqualified from any 
340.24  position allowing direct contact with persons receiving services 
340.25  from the license holder, entity identified in subdivision 3, 
340.26  paragraph (a), or registrant under section 144A.71, subdivision 
340.27  1, and for individuals studied under section 245A.04, 
340.28  subdivision 3, paragraph (c), clauses (2), (6), and (7), the 
340.29  individual shall also be disqualified from access to a person 
340.30  receiving services from the license holder: 
340.31     (1) regardless of how much time has passed since the 
340.32  involuntary termination of parental rights under section 
340.33  260C.301 or the discharge of the sentence imposed for the 
340.34  offense, and unless otherwise specified, regardless of the level 
340.35  of the conviction, the individual was convicted of any of the 
340.36  following offenses:  sections 609.185 (murder in the first 
341.1   degree); 609.19 (murder in the second degree); 609.195 (murder 
341.2   in the third degree); 609.2661 (murder of an unborn child in the 
341.3   first degree); 609.2662 (murder of an unborn child in the second 
341.4   degree); 609.2663 (murder of an unborn child in the third 
341.5   degree); 609.20 (manslaughter in the first degree); 609.205 
341.6   (manslaughter in the second degree); 609.221 or 609.222 (assault 
341.7   in the first or second degree); 609.228 (great bodily harm 
341.8   caused by distribution of drugs); 609.245 (aggravated robbery); 
341.9   609.25 (kidnapping); 609.561 (arson in the first degree); 
341.10  609.749, subdivision 3, 4, or 5 (felony-level harassment; 
341.11  stalking); 609.66, subdivision 1e (drive-by shooting); 609.855, 
341.12  subdivision 5 (shooting at or in a public transit vehicle or 
341.13  facility); 609.322 (solicitation, inducement, and promotion of 
341.14  prostitution); 609.342 (criminal sexual conduct in the first 
341.15  degree); 609.343 (criminal sexual conduct in the second degree); 
341.16  609.344 (criminal sexual conduct in the third degree); 609.345 
341.17  (criminal sexual conduct in the fourth degree); 609.352 
341.18  (solicitation of children to engage in sexual conduct); 609.365 
341.19  (incest); felony offense under 609.377 (malicious punishment of 
341.20  a child); a felony offense under 609.378 (neglect or 
341.21  endangerment of a child); a felony offense under 609.324, 
341.22  subdivision 1 (other prohibited acts); 617.246 (use of minors in 
341.23  sexual performance prohibited); 617.247 (possession of pictorial 
341.24  representations of minors); a felony offense under sections 
341.25  609.2242 and 609.2243 (domestic assault), a felony offense of 
341.26  spousal abuse, a felony offense of child abuse or neglect, a 
341.27  felony offense of a crime against children; or attempt or 
341.28  conspiracy to commit any of these offenses as defined in 
341.29  Minnesota Statutes, or an offense in any other state or country, 
341.30  where the elements are substantially similar to any of the 
341.31  offenses listed in this clause; 
341.32     (2) if less than 15 years have passed since the discharge 
341.33  of the sentence imposed for the offense; and the individual has 
341.34  received a felony conviction for a violation of any of these 
341.35  offenses:  sections 609.21 (criminal vehicular homicide and 
341.36  injury); 609.165 (felon ineligible to possess firearm); 609.215 
342.1   (suicide); 609.223 or 609.2231 (assault in the third or fourth 
342.2   degree); repeat offenses under 609.224 (assault in the fifth 
342.3   degree); repeat offenses under 609.3451 (criminal sexual conduct 
342.4   in the fifth degree); 609.498, subdivision 1 or ~~1a~~ 
342.5   1b (aggravated first degree or first degree tampering with a 
342.6   witness); 609.713 (terroristic threats); 609.235 (use of drugs 
342.7   to injure or facilitate crime); 609.24 (simple robbery); 609.255 
342.8   (false imprisonment); 609.562 (arson in the second degree); 
342.9   609.563 (arson in the third degree); repeat offenses under 
342.10  617.23 (indecent exposure; penalties); repeat offenses under 
342.11  617.241 (obscene materials and performances; distribution and 
342.12  exhibition prohibited; penalty); 609.71 (riot); 609.66 
342.13  (dangerous weapons); 609.67 (machine guns and short-barreled 
342.14  shotguns); 609.2325 (criminal abuse of a vulnerable adult); 
342.15  609.2664 (manslaughter of an unborn child in the first degree); 
342.16  609.2665 (manslaughter of an unborn child in the second degree); 
342.17  609.267 (assault of an unborn child in the first degree); 
342.18  609.2671 (assault of an unborn child in the second degree); 
342.19  609.268 (injury or death of an unborn child in the commission of 
342.20  a crime); 609.52 (theft); 609.2335 (financial exploitation of a 
342.21  vulnerable adult); 609.521 (possession of shoplifting gear); 
342.22  609.582 (burglary); 609.625 (aggravated forgery); 609.63 
342.23  (forgery); 609.631 (check forgery; offering a forged check); 
342.24  609.635 (obtaining signature by false pretense); 609.27 
342.25  (coercion); 609.275 (attempt to coerce); 609.687 (adulteration); 
342.26  260C.301 (grounds for termination of parental rights); chapter 
342.27  152 (drugs; controlled substance); and a felony level conviction 
342.28  involving alcohol or drug use.  An attempt or conspiracy to 
342.29  commit any of these offenses, as each of these offenses is 
342.30  defined in Minnesota Statutes; or an offense in any other state 
342.31  or country, the elements of which are substantially similar to 
342.32  the elements of the offenses in this clause.  If the individual 
342.33  studied is convicted of one of the felonies listed in this 
342.34  clause, but the sentence is a gross misdemeanor or misdemeanor 
342.35  disposition, the lookback period for the conviction is the 
342.36  period applicable to the disposition, that is the period for 
343.1   gross misdemeanors or misdemeanors; 
343.2      (3) if less than ten years have passed since the discharge 
343.3   of the sentence imposed for the offense; and the individual has 
343.4   received a gross misdemeanor conviction for a violation of any 
343.5   of the following offenses:  sections 609.224 (assault in the 
343.6   fifth degree); 609.2242 and 609.2243 (domestic assault); 
343.7   violation of an order for protection under 518B.01, subdivision 
343.8   14; 609.3451 (criminal sexual conduct in the fifth degree); 
343.9   repeat offenses under 609.746 (interference with privacy); 
343.10  repeat offenses under 617.23 (indecent exposure); 617.241 
343.11  (obscene materials and performances); 617.243 (indecent 
343.12  literature, distribution); 617.293 (harmful materials; 
343.13  dissemination and display to minors prohibited); 609.71 (riot); 
343.14  609.66 (dangerous weapons); 609.749, subdivision 2 (harassment; 
343.15  stalking); 609.224, subdivision 2, paragraph (c) (assault in the 
343.16  fifth degree by a caregiver against a vulnerable adult); 609.23 
343.17  (mistreatment of persons confined); 609.231 (mistreatment of 
343.18  residents or patients); 609.2325 (criminal abuse of a vulnerable 
343.19  adult); 609.233 (criminal neglect of a vulnerable adult); 
343.20  609.2335 (financial exploitation of a vulnerable adult); 609.234 
343.21  (failure to report maltreatment of a vulnerable adult); 609.72, 
343.22  subdivision 3 (disorderly conduct against a vulnerable adult); 
343.23  609.265 (abduction); 609.378 (neglect or endangerment of a 
343.24  child); 609.377 (malicious punishment of a child); 609.324, 
343.25  subdivision 1a (other prohibited acts; minor engaged in 
343.26  prostitution); 609.33 (disorderly house); 609.52 (theft); 
343.27  609.582 (burglary); 609.631 (check forgery; offering a forged 
343.28  check); 609.275 (attempt to coerce); or an attempt or conspiracy 
343.29  to commit any of these offenses, as each of these offenses is 
343.30  defined in Minnesota Statutes; or an offense in any other state 
343.31  or country, the elements of which are substantially similar to 
343.32  the elements of any of the offenses listed in this clause.  If 
343.33  the defendant is convicted of one of the gross misdemeanors 
343.34  listed in this clause, but the sentence is a misdemeanor 
343.35  disposition, the lookback period for the conviction is the 
343.36  period applicable to misdemeanors; or 
344.1      (4) if less than seven years have passed since the 
344.2   discharge of the sentence imposed for the offense; and the 
344.3   individual has received a misdemeanor conviction for a violation 
344.4   of any of the following offenses:  sections 609.224 (assault in 
344.5   the fifth degree); 609.2242 (domestic assault); violation of an 
344.6   order for protection under 518B.01 (Domestic Abuse Act); 
344.7   violation of an order for protection under 609.3232 (protective 
344.8   order authorized; procedures; penalties); 609.746 (interference 
344.9   with privacy); 609.79 (obscene or harassing phone calls); 
344.10  609.795 (letter, telegram, or package; opening; harassment); 
344.11  617.23 (indecent exposure; penalties); 609.2672 (assault of an 
344.12  unborn child in the third degree); 617.293 (harmful materials; 
344.13  dissemination and display to minors prohibited); 609.66 
344.14  (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 
344.15  exploitation of a vulnerable adult); 609.234 (failure to report 
344.16  maltreatment of a vulnerable adult); 609.52 (theft); 609.27 
344.17  (coercion); or an attempt or conspiracy to commit any of these 
344.18  offenses, as each of these offenses is defined in Minnesota 
344.19  Statutes; or an offense in any other state or country, the 
344.20  elements of which are substantially similar to the elements of 
344.21  any of the offenses listed in this clause; a determination or 
344.22  disposition of failure to make required reports under section 
344.23  626.556, subdivision 3, or 626.557, subdivision 3, for incidents 
344.24  in which:  (i) the final disposition under section 626.556 or 
344.25  626.557 was substantiated maltreatment, and (ii) the 
344.26  maltreatment was recurring or serious; or a determination or 
344.27  disposition of substantiated serious or recurring maltreatment 
344.28  of a minor under section 626.556 or of a vulnerable adult under 
344.29  section 626.557 for which there is a preponderance of evidence 
344.30  that the maltreatment occurred, and that the subject was 
344.31  responsible for the maltreatment. 
344.32     For the purposes of this section, "serious maltreatment" 
344.33  means sexual abuse; maltreatment resulting in death; or 
344.34  maltreatment resulting in serious injury which reasonably 
344.35  requires the care of a physician whether or not the care of a 
344.36  physician was sought; or abuse resulting in serious injury.  For 
345.1   purposes of this section, "abuse resulting in serious injury" 
345.2   means:  bruises, bites, skin laceration or tissue damage; 
345.3   fractures; dislocations; evidence of internal injuries; head 
345.4   injuries with loss of consciousness; extensive second-degree or 
345.5   third-degree burns and other burns for which complications are 
345.6   present; extensive second-degree or third-degree frostbite, and 
345.7   others for which complications are present; irreversible 
345.8   mobility or avulsion of teeth; injuries to the eyeball; 
345.9   ingestion of foreign substances and objects that are harmful; 
345.10  near drowning; and heat exhaustion or sunstroke.  For purposes 
345.11  of this section, "care of a physician" is treatment received or 
345.12  ordered by a physician, but does not include diagnostic testing, 
345.13  assessment, or observation.  For the purposes of this section, 
345.14  "recurring maltreatment" means more than one incident of 
345.15  maltreatment for which there is a preponderance of evidence that 
345.16  the maltreatment occurred, and that the subject was responsible 
345.17  for the maltreatment.  For purposes of this section, "access" 
345.18  means physical access to an individual receiving services or the 
345.19  individual's personal property without continuous, direct 
345.20  supervision as defined in section 245A.04, subdivision 3.  
345.21     (b) Except for background studies related to child foster 
345.22  care, adult foster care, or family child care licensure, when 
345.23  the subject of a background study is regulated by a 
345.24  health-related licensing board as defined in chapter 214, and 
345.25  the regulated person has been determined to have been 
345.26  responsible for substantiated maltreatment under section 626.556 
345.27  or 626.557, instead of the commissioner making a decision 
345.28  regarding disqualification, the board shall make a determination 
345.29  whether to impose disciplinary or corrective action under 
345.30  chapter 214. 
345.31     (1) The commissioner shall notify the health-related 
345.32  licensing board: 
345.33     (i) upon completion of a background study that produces a 
345.34  record showing that the individual was determined to have been 
345.35  responsible for substantiated maltreatment; 
345.36     (ii) upon the commissioner's completion of an investigation 
346.1   that determined the individual was responsible for substantiated 
346.2   maltreatment; or 
346.3      (iii) upon receipt from another agency of a finding of 
346.4   substantiated maltreatment for which the individual was 
346.5   responsible. 
346.6      (2) The commissioner's notice shall indicate whether the 
346.7   individual would have been disqualified by the commissioner for 
346.8   the substantiated maltreatment if the individual were not 
346.9   regulated by the board.  The commissioner shall concurrently 
346.10  send this notice to the individual. 
346.11     (3) Notwithstanding the exclusion from this subdivision for 
346.12  individuals who provide child foster care, adult foster care, or 
346.13  family child care, when the commissioner or a local agency has 
346.14  reason to believe that the direct contact services provided by 
346.15  the individual may fall within the jurisdiction of a 
346.16  health-related licensing board, a referral shall be made to the 
346.17  board as provided in this section. 
346.18     (4) If, upon review of the information provided by the 
346.19  commissioner, a health-related licensing board informs the 
346.20  commissioner that the board does not have jurisdiction to take 
346.21  disciplinary or corrective action, the commissioner shall make 
346.22  the appropriate disqualification decision regarding the 
346.23  individual as otherwise provided in this chapter. 
346.24     (5) The commissioner has the authority to monitor the 
346.25  facility's compliance with any requirements that the 
346.26  health-related licensing board places on regulated persons 
346.27  practicing in a facility either during the period pending a 
346.28  final decision on a disciplinary or corrective action or as a 
346.29  result of a disciplinary or corrective action.  The commissioner 
346.30  has the authority to order the immediate removal of a regulated 
346.31  person from direct contact or access when a board issues an 
346.32  order of temporary suspension based on a determination that the 
346.33  regulated person poses an immediate risk of harm to persons 
346.34  receiving services in a licensed facility. 
346.35     (6) A facility that allows a regulated person to provide 
346.36  direct contact services while not complying with the 
347.1   requirements imposed by the health-related licensing board is 
347.2   subject to action by the commissioner as specified under 
347.3   sections 245A.06 and 245A.07. 
347.4      (7) The commissioner shall notify a health-related 
347.5   licensing board immediately upon receipt of knowledge of 
347.6   noncompliance with requirements placed on a facility or upon a 
347.7   person regulated by the board. 
347.8      <b>[EFFECTIVE DATE.]</b> This section is effective the day 
347.9   following final enactment. 
347.10     Sec. 8.  Minnesota Statutes 2002, section 245A.09, 
347.11  subdivision 7, is amended to read: 
347.12     Subd. 7.  [REGULATORY METHODS.] (a) Where appropriate and 
347.13  feasible the commissioner shall identify and implement 
347.14  alternative methods of regulation and enforcement to the extent 
347.15  authorized in this subdivision.  These methods shall include: 
347.16     (1) expansion of the types and categories of licenses that 
347.17  may be granted; 
347.18     (2) when the standards of another state or federal 
347.19  governmental agency or an independent accreditation body have 
347.20  been shown to ~~predict compliance with the rules~~ require the same 
347.21  standards, methods, or alternative methods to achieve 
347.22  substantially the same intended outcomes as the licensing 
347.23  standards, the commissioner shall consider compliance with the 
347.24  governmental or accreditation standards to be equivalent to 
347.25  partial compliance with the ~~rules~~ licensing standards; and 
347.26     (3) use of an abbreviated inspection that employs key 
347.27  standards that have been shown to predict full compliance with 
347.28  the rules. 
347.29     (b) If the commissioner accepts accreditation as 
347.30  documentation of compliance with a licensing standard under 
347.31  paragraph (a), the commissioner shall continue to investigate 
347.32  complaints related to noncompliance with all licensing standards.
347.33  The commissioner may take a licensing action for noncompliance 
347.34  under this chapter and shall recognize all existing appeal 
347.35  rights regarding any licensing actions taken under this chapter. 
347.36     (c) The commissioner shall work with the commissioners of 
348.1   health, public safety, administration, and children, families, 
348.2   and learning in consolidating duplicative licensing and 
348.3   certification rules and standards if the commissioner determines 
348.4   that consolidation is administratively feasible, would 
348.5   significantly reduce the cost of licensing, and would not reduce 
348.6   the protection given to persons receiving services in licensed 
348.7   programs.  Where administratively feasible and appropriate, the 
348.8   commissioner shall work with the commissioners of health, public 
348.9   safety, administration, and children, families, and learning in 
348.10  conducting joint agency inspections of programs. 
348.11     ~~(c)~~ (d) The commissioner shall work with the commissioners 
348.12  of health, public safety, administration, and children, 
348.13  families, and learning in establishing a single point of 
348.14  application for applicants who are required to obtain concurrent 
348.15  licensure from more than one of the commissioners listed in this 
348.16  clause. 
348.17     ~~(d)~~ (e) Unless otherwise specified in statute, the 
348.18  commissioner may ~~specify in rule periods of licensure up to two~~ 
348.19  ~~years~~ conduct routine inspections biennially. 
348.20     Sec. 9.  Minnesota Statutes 2002, section 245A.10, is 
348.21  amended to read: 
348.22     245A.10 [FEES.] 
348.23     Subdivision 1.  [APPLICATION OR LICENSE FEE REQUIRED, 
348.24  PROGRAMS EXEMPT FROM FEE.] (a) Unless exempt under paragraph 
348.25  (b), the commissioner shall charge a fee for evaluation of 
348.26  applications and inspection of programs~~, other than family day~~ 
348.27  ~~care and foster care,~~ which are licensed under this chapter.  
348.28  ~~The commissioner may charge a fee for the licensing of school~~ 
348.29  ~~age child care programs, in an amount sufficient to cover the~~ 
348.30  ~~cost to the state agency of processing the license.~~ 
348.31     (b) Except as provided under subdivision 2, no application 
348.32  or license fee shall be charged for child foster care, adult 
348.33  foster care, family and group family child care or 
348.34  state-operated programs, unless the state-operated program is an 
348.35  intermediate care facility for persons with mental retardation 
348.36  or related conditions (ICF/MR). 
349.1      Subd. 2.  [COUNTY FEES FOR BACKGROUND STUDIES AND LICENSING 
349.2   INSPECTIONS IN FAMILY AND GROUP FAMILY CHILD CARE.] (a) For 
349.3   purposes of family and group family child care licensing under 
349.4   this chapter, a county agency may charge a fee to an applicant 
349.5   or license holder to recover the actual cost of background 
349.6   studies, but in any case not to exceed $100 annually.  A county 
349.7   agency may also charge a fee to an applicant or license holder 
349.8   to recover the actual cost of licensing inspections, but in any 
349.9   case not to exceed $150 annually. 
349.10     (b) A county agency may charge a fee to a legal nonlicensed 
349.11  child care provider or applicant for authorization to recover 
349.12  the actual cost of background studies completed under section 
349.13  119B.125, but in any case not to exceed $100 annually. 
349.14     (c) Counties may elect to reduce or waive the fees in 
349.15  paragraph (a) or (b):  
349.16     (1) in cases of financial hardship; 
349.17     (2) if the county has a shortage of providers in the 
349.18  county's area; 
349.19     (3) for new providers; or 
349.20     (4) for providers who have attained at least 16 hours of 
349.21  training before seeking initial licensure. 
349.22     (d) Counties may allow providers to pay the applicant fees 
349.23  in paragraph (a) or (b) on an installment basis for up to one 
349.24  year.  If the provider is receiving child care assistance 
349.25  payments from the state, the provider may have the fees under 
349.26  paragraph (a) or (b) deducted from the child care assistance 
349.27  payments for up to one year and the state shall reimburse the 
349.28  county for the county fees collected in this manner. 
349.29     Subd. 3.  [APPLICATION FEE FOR INITIAL LICENSE OR 
349.30  CERTIFICATION.] (a) For fees required under subdivision 1, an 
349.31  applicant for an initial license or certification issued by the 
349.32  commissioner shall submit a $500 application fee with each new 
349.33  application required under this subdivision.  The application 
349.34  fee shall not be prorated, is nonrefundable, and is in lieu of 
349.35  the annual license or certification fee that expires on December 
349.36  31.  The commissioner shall not process an application until the 
350.1   application fee is paid.  
350.2      (b) Except as provided in clauses (1) to (3), an applicant 
350.3   shall apply for a license to provide services at a specific 
350.4   location.  
350.5      (1) For a license to provide waivered services to persons 
350.6   with developmental disabilities or related conditions, an 
350.7   applicant shall submit an application for each county in which 
350.8   the waivered services will be provided.  
350.9      (2) For a license to provide semi-independent living 
350.10  services to persons with developmental disabilities or related 
350.11  conditions, an applicant shall submit a single application to 
350.12  provide services statewide. 
350.13     (3) For a license to provide independent living assistance 
350.14  for youth under section 245A.22, an applicant shall submit a 
350.15  single application to provide services statewide.  
350.16     Subd. 4.  [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 
350.17  WITH LICENSED CAPACITY.] (a) Child care centers and programs 
350.18  with a licensed capacity shall pay an annual nonrefundable 
350.19  license or certification fee based on the following schedule: 
350.20      Licensed Capacity          Child Care         Other
350.21                                 Center             Program
350.22                                 License Fee        License Fee
350.23       1 to 24 persons               $300               $400
350.24       25 to 49 persons              $450               $600
350.25       50 to 74 persons              $600               $800
350.26       75 to 99 persons              $750             $1,000
350.27       100 to 124 persons            $900             $1,200
350.28       125 to 149 persons          $1,200             $1,400
350.29       150 to 174 persons          $1,400             $1,600
350.30       175 to 199 persons          $1,600             $1,800
350.31       200 to 224 persons          $1,800             $2,000
350.32       225 or more persons         $2,000             $2,500
350.33     (b) A day training and habilitation program serving persons 
350.34  with developmental disabilities or related conditions shall be 
350.35  assessed a license fee based on the schedule in paragraph (a) 
350.36  unless the license holder serves more than 50 percent of the 
351.1   same persons at two or more locations in the community.  When a 
351.2   day training and habilitation program serves more than 50 
351.3   percent of the same persons in two or more locations in a 
351.4   community, the day training and habilitation program shall pay a 
351.5   license fee based on the licensed capacity of the largest 
351.6   facility and the other facility or facilities shall be charged a 
351.7   license fee based on a licensed capacity of a residential 
351.8   program serving one to 24 persons. 
351.9      Subd. 5.  [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 
351.10  WITHOUT A LICENSED CAPACITY.] (a) Except as provided in 
351.11  paragraph (b), a program without a stated licensed capacity 
351.12  shall pay a license or certification fee of $400.  
351.13     (b) A mental health center or mental health clinic 
351.14  requesting certification for purposes of insurance and 
351.15  subscriber contract reimbursement under Minnesota Rules, parts 
351.16  9520.0750 to 9520.0870 shall pay a certification fee of $1,000 
351.17  per year.  If the mental health center or mental health clinic 
351.18  provides services at a primary location with satellite 
351.19  facilities, the satellite facilities shall be certified with the 
351.20  primary location without an additional charge. 
351.21     Subd. 6.  [LICENSE NOT ISSUED UNTIL LICENSE OR 
351.22  CERTIFICATION FEE IS PAID.] The commissioner shall not issue a 
351.23  license or certification until the license or certification fee 
351.24  is paid.  The commissioner shall send a bill for the license or 
351.25  certification fee to the billing address identified by the 
351.26  license holder.  If the license holder does not submit the 
351.27  license or certification fee payment by the due date, the 
351.28  commissioner shall send the license holder a past due notice.  
351.29  If the license holder fails to pay the license or certification 
351.30  fee by the due date on the past due notice, the commissioner 
351.31  shall send a final notice to the license holder informing the 
351.32  license holder that the program license will expire on December 
351.33  31 unless the license fee is paid before December 31.  If a 
351.34  license expires, the program is no longer licensed and, unless 
351.35  exempt from licensure under section 245A.03, subdivision 2, must 
351.36  not operate after the expiration date.  After a license expires, 
352.1   if the former license holder wishes to provide licensed 
352.2   services, the former license holder must submit a new license 
352.3   application and application fee under subdivision 3. 
352.4      Sec. 10.  Minnesota Statutes 2002, section 245A.11, 
352.5   subdivision 2a, is amended to read: 
352.6      Subd. 2a.  [ADULT FOSTER CARE LICENSE CAPACITY.] (a) An 
352.7   adult foster care license holder may have a maximum license 
352.8   capacity of five if all persons in care are age 55 or over and 
352.9   do not have a serious and persistent mental illness or a 
352.10  developmental disability.  
352.11     (b) The commissioner may grant variances to paragraph (a) 
352.12  to allow a foster care provider with a licensed capacity of five 
352.13  persons to admit an individual under the age of 55 if the 
352.14  variance complies with section 245A.04, subdivision 9, and 
352.15  approval of the variance is recommended by the county in which 
352.16  the licensed foster care provider is located. 
352.17     (c) The commissioner may grant variances to paragraph (a) 
352.18  to allow the use of a fifth bed for emergency crisis services 
352.19  for a person with serious and persistent mental illness or a 
352.20  developmental disability, regardless of age, if the variance 
352.21  complies with section 245A.04, subdivision 9, and approval of 
352.22  the variance is recommended by the county in which the licensed 
352.23  foster care provider is located. 
352.24     (d) Notwithstanding paragraph (a), the commissioner may 
352.25  issue an adult foster care license with a capacity of five 
352.26  adults when the capacity is recommended by the county licensing 
352.27  agency of the county in which the facility is located and if the 
352.28  recommendation verifies that: 
352.29     (1) the facility meets the physical environment 
352.30  requirements in the adult foster care licensing rule; 
352.31     (2) the five-bed living arrangement is specified for each 
352.32  resident in the resident's: 
352.33     (i) individualized plan of care; 
352.34     (ii) individual service plan under section 256B.092, 
352.35  subdivision 1b, if required; or 
352.36     (iii) individual resident placement agreement under 
353.1   Minnesota Rules, part 9555.5105, subpart 19, if required; 
353.2      (3) the license holder obtains written and signed informed 
353.3   consent from each resident or resident's legal representative 
353.4   documenting the resident's informed choice to living in the home 
353.5   and that the resident's refusal to consent would not have 
353.6   resulted in service termination; and 
353.7      (4) the facility was licensed for adult foster care before 
353.8   March 1, 2003. 
353.9      (e) The commissioner shall not issue a new adult foster 
353.10  care license under paragraph (d) after June 30, 2005.  The 
353.11  commissioner shall allow a facility with an adult foster care 
353.12  license issued under paragraph (d) before June 30, 2005, to 
353.13  continue with a capacity of five or six adults if the license 
353.14  holder continues to comply with the requirements in paragraph 
353.15  (d). 
353.16     Sec. 11.  Minnesota Statutes 2002, section 245A.11, 
353.17  subdivision 2b, is amended to read: 
353.18     Subd. 2b.  [ADULT FOSTER CARE; FAMILY ADULT DAY CARE.] An 
353.19  adult foster care license holder licensed under the conditions 
353.20  in subdivision 2a may also provide family adult day care for 
353.21  adults age 55 or over if no persons in the adult foster or adult 
353.22  family day care program have a serious and persistent mental 
353.23  illness or a developmental disability.  The maximum combined 
353.24  capacity for adult foster care and family adult day care is five 
353.25  adults, except that the commissioner may grant a variance for a 
353.26  family adult day care provider to admit up to seven individuals 
353.27  for day care services and one individual for respite care 
353.28  services, if all of the following requirements are met:  (1) the 
353.29  variance complies with section 245A.04, subdivision 9; (2) a 
353.30  second caregiver is present whenever six or more clients are 
353.31  being served; and (3) the variance is recommended by the county 
353.32  social service agency in the county where the provider is 
353.33  located.  A separate license is not required to provide family 
353.34  adult day care under this subdivision.  Adult foster care homes 
353.35  providing services to five adults under this section shall not 
353.36  be subject to licensure by the commissioner of health under the 
354.1   provisions of chapter 144, 144A, 157, or any other law requiring 
354.2   facility licensure by the commissioner of health. 
354.3      Sec. 12.  Minnesota Statutes 2002, section 245A.11, is 
354.4   amended by adding a subdivision to read: 
354.5      Subd. 7.  [ADULT FOSTER CARE; VARIANCE FOR ALTERNATE 
354.6   OVERNIGHT SUPERVISION.] (a) The commissioner may grant a 
354.7   variance under section 245A.04, subdivision 9, to rule parts 
354.8   requiring a caregiver to be present in an adult foster care home 
354.9   during normal sleeping hours to allow for alternative methods of 
354.10  overnight supervision.  The commissioner may grant the variance 
354.11  if the local county licensing agency recommends the variance and 
354.12  the county recommendation includes documentation verifying that: 
354.13     (1) the county has approved the license holder's plan for 
354.14  alternative methods of providing overnight supervision and 
354.15  determined the plan protects the residents' health, safety, and 
354.16  rights; 
354.17     (2) the license holder has obtained written and signed 
354.18  informed consent from each resident or each resident's legal 
354.19  representative documenting the resident's or legal 
354.20  representative's agreement with the alternative method of 
354.21  overnight supervision; and 
354.22     (3) the alternative method of providing overnight 
354.23  supervision is specified for each resident in the resident's: 
354.24  (i) individualized plan of care; (ii) individual service plan 
354.25  under section 256B.092, subdivision 1b, if required; or (iii) 
354.26  individual resident placement agreement under Minnesota Rules, 
354.27  part 9555.5105, subpart 19, if required. 
354.28     (b) To be eligible for a variance under paragraph (a), the 
354.29  adult foster care license holder must not have had a licensing 
354.30  action under section 245A.06 or 245A.07 during the prior 24 
354.31  months based on failure to provide adequate supervision, health 
354.32  care services, or resident safety in the adult foster care home. 
354.33     Sec. 13.  Minnesota Statutes 2002, section 245B.03, 
354.34  subdivision 2, is amended to read: 
354.35     Subd. 2.  [RELATIONSHIP TO OTHER STANDARDS GOVERNING 
354.36  SERVICES FOR PERSONS WITH MENTAL RETARDATION OR RELATED 
355.1   CONDITIONS.] (a) ICFs/MR are exempt from: 
355.2      (1) section 245B.04; 
355.3      (2) section 245B.06, subdivisions 4 and 6; and 
355.4      (3) section 245B.07, subdivisions 4, paragraphs (b) and 
355.5   (c); 7; and 8, paragraphs (1), clause (iv), and (2). 
355.6      (b) License holders also licensed under chapter 144 as a 
355.7   supervised living facility are exempt from section 245B.04. 
355.8      (c) Residential service sites controlled by license holders 
355.9   licensed under chapter 245B for home and community-based 
355.10  waivered services for four or fewer adults are exempt from 
355.11  compliance with Minnesota Rules, parts 9543.0040, subpart 2, 
355.12  item C; 9555.5505; 9555.5515, items B and G; 9555.5605; 
355.13  9555.5705; 9555.6125, subparts 3, item C, subitem (2), and 4 to 
355.14  6; 9555.6185; 9555.6225, subpart 8; 9555.6245; 9555.6255; and 
355.15  9555.6265; and as provided under section 245B.06, subdivision 2, 
355.16  the license holder is exempt from the program abuse prevention 
355.17  plans and individual abuse prevention plans otherwise required 
355.18  under sections 245A.65, subdivision 2, and 626.557, subdivision 
355.19  14.  The commissioner may approve alternative methods of 
355.20  providing overnight supervision using the process and criteria 
355.21  for granting a variance in section 245A.04, subdivision 9.  This 
355.22  chapter does not apply to foster care homes that do not provide 
355.23  residential habilitation services funded under the home and 
355.24  community-based waiver programs defined in section 256B.092. 
355.25     (d) Residential service sites controlled by license holders 
355.26  licensed under this chapter for home and community-based 
355.27  waivered services for four or fewer children are exempt from 
355.28  compliance with Minnesota Rules, parts 9545.0130; 9545.0140; 
355.29  9545.0150; 9545.0170; 9545.0220, subparts 1, items C, F, and I, 
355.30  and 3; and 9545.0230. 
355.31     (e) The commissioner may exempt license holders from 
355.32  applicable standards of this chapter when the license holder 
355.33  meets the standards under section 245A.09, subdivision 7.  
355.34  License holders that are accredited by an independent 
355.35  accreditation body shall continue to be licensed under this 
355.36  chapter. 
356.1      ~~(e)~~ (f) License holders governed by sections 245B.02 to 
356.2   245B.07 must also meet the licensure requirements in chapter 
356.3   245A.  
356.4      ~~(f)~~ (g) Nothing in this chapter prohibits license holders 
356.5   from concurrently serving consumers with and without mental 
356.6   retardation or related conditions provided this chapter's 
356.7   standards are met as well as other relevant standards. 
356.8      ~~(g)~~ (h) The documentation that sections 245B.02 to 245B.07 
356.9   require of the license holder meets the individual program plan 
356.10  required in section 256B.092 or successor provisions.  
356.11     Sec. 14.  Minnesota Statutes 2002, section 245B.03, is 
356.12  amended by adding a subdivision to read: 
356.13     Subd. 3.  [CONTINUITY OF CARE.] (a) When a consumer changes 
356.14  service to the same type of service provided under a different 
356.15  license held by the same license holder and the policies and 
356.16  procedures under section 245B.07, subdivision 8, are 
356.17  substantially similar, the license holder is exempt from the 
356.18  requirements in sections 245B.06, subdivisions 2, paragraphs (e) 
356.19  and (f), and 4; and 245B.07, subdivision 9, clause (2). 
356.20     (b) When a direct service staff person begins providing 
356.21  direct service under one or more licenses other than the license 
356.22  for which the staff person initially received the staff 
356.23  orientation requirements under section 245B.07, subdivision 5, 
356.24  the license holder is exempt from all staff orientation 
356.25  requirements under section 245B.07, subdivision 5, except that: 
356.26     (1) if the service provision location changes, the staff 
356.27  person must receive orientation regarding any policies or 
356.28  procedures under section 245B.07, subdivision 8, that are 
356.29  specific to the service provision location; and 
356.30     (2) if the staff person provides direct service to one or 
356.31  more consumers for whom the staff person has not previously 
356.32  provided direct service, the staff person must review each 
356.33  consumer's:  (i) service plans and risk management plan in 
356.34  accordance with section 245B.07, subdivision 5, paragraph (b), 
356.35  clause (1); and (ii) medication administration in accordance 
356.36  with section 245B.07, subdivision 5, paragraph (b), clause (6). 
357.1      Sec. 15.  Minnesota Statutes 2002, section 245B.04, 
357.2   subdivision 2, is amended to read: 
357.3      Subd. 2.  [SERVICE-RELATED RIGHTS.] A consumer's 
357.4   service-related rights include the right to: 
357.5      (1) refuse or terminate services and be informed of the 
357.6   consequences of refusing or terminating services; 
357.7      (2) know, in advance, limits to the services available from 
357.8   the license holder; 
357.9      (3) know conditions and terms governing the provision of 
357.10  services, including those related to initiation and termination; 
357.11     (4) know what the charges are for services, regardless of 
357.12  who will be paying for the services, and be notified upon 
357.13  request of changes in those charges; 
357.14     (5) know, in advance, whether services are covered by 
357.15  insurance, government funding, or other sources, and be told of 
357.16  any charges the consumer or other private party may have to pay; 
357.17  and 
357.18     (6) receive licensed services from individuals who are 
357.19  competent and trained, who have professional certification or 
357.20  licensure, as required, and who meet additional qualifications 
357.21  identified in the individual service plan. 
357.22     Sec. 16.  Minnesota Statutes 2002, section 245B.06, 
357.23  subdivision 2, is amended to read: 
357.24     Subd. 2.  [RISK MANAGEMENT PLAN.] (a) The license holder 
357.25  must develop ~~and~~, document in writing, and implement a risk 
357.26  management plan that ~~incorporates the individual abuse~~ 
357.27  ~~prevention plan as required in section 245A.65~~ meets the 
357.28  requirements of this subdivision.  License holders licensed 
357.29  under this chapter are exempt from sections 245A.65, subdivision 
357.30  2, and 626.557, subdivision 14, if the requirements of this 
357.31  subdivision are met.  
357.32     (b) The risk management plan must identify areas in which 
357.33  the consumer is vulnerable, based on an assessment, at a 
357.34  minimum, of the following areas: 
357.35     (1) an adult consumer's susceptibility to physical, 
357.36  emotional, and sexual abuse as defined in section 626.5572, 
358.1   subdivision 2, and financial exploitation as defined in section 
358.2   626.5572, subdivision 9; a minor consumer's susceptibility to 
358.3   sexual and physical abuse as defined in section 626.556, 
358.4   subdivision 2; and a consumer's susceptibility to self-abuse, 
358.5   regardless of age; 
358.6      (2) the consumer's health needs, considering the consumer's 
358.7   physical disabilities; allergies; sensory impairments; seizures; 
358.8   diet; need for medications; and ability to obtain medical 
358.9   treatment; 
358.10     (3) the consumer's safety needs, considering the consumer's 
358.11  ability to take reasonable safety precautions; community 
358.12  survival skills; water survival skills; ability to seek 
358.13  assistance or provide medical care; and access to toxic 
358.14  substances or dangerous items; 
358.15     (4) environmental issues, considering the program's 
358.16  location in a particular neighborhood or community; the type of 
358.17  grounds and terrain surrounding the building; and the consumer's 
358.18  ability to respond to weather-related conditions, open locked 
358.19  doors, and remain alone in any environment; and 
358.20     (5) the consumer's behavior, including behaviors that may 
358.21  increase the likelihood of physical aggression between consumers 
358.22  or sexual activity between consumers involving force or 
358.23  coercion, as defined under section 245B.02, subdivision 10, 
358.24  clauses (6) and (7). 
358.25     (c) When assessing a consumer's vulnerability, the license 
358.26  holder must consider only the consumer's skills and abilities, 
358.27  independent of staffing patterns, supervision plans, the 
358.28  environment, or other situational elements.  
358.29     (d) License holders jointly providing services to a 
358.30  consumer shall coordinate and use the resulting assessment of 
358.31  risk areas for the development of ~~this~~ each license holder's 
358.32  risk management or the shared risk management plan.  ~~Upon~~ 
358.33  ~~initiation of services, the license holder will have in place an~~ 
358.34  ~~initial risk management plan that identifies areas in which the~~ 
358.35  ~~consumer is vulnerable, including health, safety, and~~ 
358.36  ~~environmental issues and the supports the provider will have in~~ 
359.1   ~~place to protect the consumer and to minimize these risks.  The~~ 
359.2   ~~plan must be changed based on the needs of the individual~~ 
359.3   ~~consumer and reviewed at least annually.~~  The license holder's 
359.4   plan must include the specific actions a staff person will take 
359.5   to protect the consumer and minimize risks for the identified 
359.6   vulnerability areas.  The specific actions must include the 
359.7   proactive measures being taken, training being provided, or a 
359.8   detailed description of actions a staff person will take when 
359.9   intervention is needed. 
359.10     (e) Prior to or upon initiating services, a license holder 
359.11  must develop an initial risk management plan that is, at a 
359.12  minimum, verbally approved by the consumer or consumer's legal 
359.13  representative and case manager.  The license holder must 
359.14  document the date the license holder receives the consumer's or 
359.15  consumer's legal representative's and case manager's verbal 
359.16  approval of the initial plan. 
359.17     (f) As part of the meeting held within 45 days of 
359.18  initiating service, as required under section 245B.06, 
359.19  subdivision 4, the license holder must review the initial risk 
359.20  management plan for accuracy and revise the plan if necessary.  
359.21  The license holder must give the consumer or consumer's legal 
359.22  representative and case manager an opportunity to participate in 
359.23  this plan review.  If the license holder revises the plan, or if 
359.24  the consumer or consumer's legal representative and case manager 
359.25  have not previously signed and dated the plan, the license 
359.26  holder must obtain dated signatures to document the plan's 
359.27  approval. 
359.28     (g) After plan approval, the license holder must review the 
359.29  plan at least annually and update the plan based on the 
359.30  individual consumer's needs and changes to the environment.  The 
359.31  license holder must give the consumer or consumer's legal 
359.32  representative and case manager an opportunity to participate in 
359.33  the ongoing plan development.  The license holder shall obtain 
359.34  dated signatures from the consumer or consumer's legal 
359.35  representative and case manager to document completion of the 
359.36  annual review and approval of plan changes. 
360.1      Sec. 17.  Minnesota Statutes 2002, section 245B.06, 
360.2   subdivision 5, is amended to read: 
360.3      Subd. 5.  [PROGRESS REVIEWS.] The license holder must 
360.4   participate in progress review meetings following stated time 
360.5   lines established in the consumer's individual service plan or 
360.6   as requested in writing by the consumer, the consumer's legal 
360.7   representative, or the case manager, at a minimum of once a 
360.8   year.  The license holder must summarize the progress toward 
360.9   achieving the desired outcomes and make recommendations in a 
360.10  written report sent to the consumer or the consumer's legal 
360.11  representative and case manager prior to the review meeting.  
360.12  ~~For consumers under public guardianship, the license holder is~~ 
360.13  ~~required to provide quarterly written progress review reports to~~ 
360.14  ~~the consumer, designated family member, and case manager.~~  
360.15     Sec. 18.  Minnesota Statutes 2002, section 245B.07, 
360.16  subdivision 6, is amended to read: 
360.17     Subd. 6.  [STAFF TRAINING.] (a) ~~The~~ A license holder 
360.18  providing semi-independent living services shall ensure that 
360.19  direct service staff annually complete hours of training equal 
360.20  to ~~two~~ one percent of the number of hours the staff person 
360.21  worked ~~or one percent for license holders providing~~ 
360.22  ~~semi-independent living services~~.  All other license holders 
360.23  shall ensure that direct service staff annually complete hours 
360.24  of training as follows: 
360.25     (1) if the direct services staff have been employed for one 
360.26  to 24 months and: 
360.27     (i) the average number of work hours scheduled per week is 
360.28  30 to 40 hours, the staff must annually complete 40 training 
360.29  hours; 
360.30     (ii) the average number of work hours scheduled per week is 
360.31  20 to 29 hours, the staff must annually complete 30 training 
360.32  hours; and 
360.33     (iii) the average number of work hours scheduled per week 
360.34  is one to 19 hours, the staff must annually complete 20 training 
360.35  hours; or 
360.36     (2) if the direct services staff have been employed for 
361.1   more than 24 months and: 
361.2      (i) the average number of work hours scheduled per week is 
361.3   30 to 40 hours, the staff must annually complete 20 training 
361.4   hours; 
361.5      (ii) the average number of work hours scheduled per week is 
361.6   20 to 29 hours, the staff must annually complete 15 training 
361.7   hours; and 
361.8      (iii) the average number of work hours scheduled per week 
361.9   is one to 19 hours, the staff must annually complete 12 training 
361.10  hours. 
361.11     If direct service staff has received training from a 
361.12  license holder licensed under a program rule identified in this 
361.13  chapter or completed course work regarding disability-related 
361.14  issues from a post-secondary educational institute, that 
361.15  training may also count toward training requirements for other 
361.16  services and for other license holders. 
361.17     (b) The license holder must document the training completed 
361.18  by each employee. 
361.19     (c) Training shall address staff competencies necessary to 
361.20  address the consumer needs as identified in the consumer's 
361.21  individual service plan and ensure consumer health, safety, and 
361.22  protection of rights.  Training may also include other areas 
361.23  identified by the license holder. 
361.24     (d) For consumers requiring a 24-hour plan of care, the 
361.25  license holder shall provide training in cardiopulmonary 
361.26  resuscitation, from a qualified source determined by the 
361.27  commissioner, if the consumer's health needs as determined by 
361.28  the consumer's physician indicate trained staff would be 
361.29  necessary to the consumer. 
361.30     Sec. 19.  Minnesota Statutes 2002, section 245B.07, 
361.31  subdivision 9, is amended to read: 
361.32     Subd. 9.  [AVAILABILITY OF CURRENT WRITTEN POLICIES AND 
361.33  PROCEDURES.] The license holder shall: 
361.34     (1) review and update, as needed, the written policies and 
361.35  procedures in this chapter ~~and inform all consumers or the~~ 
361.36  ~~consumer's legal representatives, case managers, and employees~~ 
362.1   ~~of the revised policies and procedures when they affect the~~ 
362.2   ~~service provision~~; 
362.3      (2) inform consumers or the consumer's legal 
362.4   representatives of the written policies and procedures in this 
362.5   chapter upon service initiation.  Copies must be available to 
362.6   consumers or the consumer's legal representatives, case 
362.7   managers, the county where services are located, and the 
362.8   commissioner upon request; ~~and~~ 
362.9      (3) provide all consumers or the consumers' legal 
362.10  representatives and case managers a copy and explanation of 
362.11  revisions to policies and procedures that affect consumers' 
362.12  service-related or protection-related rights under section 
362.13  245B.04.  Unless there is reasonable cause, the license holder 
362.14  must provide this notice at least 30 days before implementing 
362.15  the revised policy and procedure.  The license holder must 
362.16  document the reason for not providing the notice at least 30 
362.17  days before implementing the revisions; 
362.18     (4) annually notify all consumers or the consumers' legal 
362.19  representatives and case managers of any revised policies and 
362.20  procedures under this chapter, other than those in clause (3).  
362.21  Upon request, the license holder must provide the consumer or 
362.22  consumer's legal representative and case manager copies of the 
362.23  revised policies and procedures; 
362.24     (5) before implementing revisions to policies and 
362.25  procedures under this chapter, inform all employees of the 
362.26  revised policies and procedures; and 
362.27     (6) document and maintain relevant information related to 
362.28  the policies and procedures in this chapter. 
362.29     Sec. 20.  Minnesota Statutes 2002, section 245B.08, 
362.30  subdivision 1, is amended to read: 
362.31     Subdivision 1.  [ALTERNATIVE METHODS OF DETERMINING 
362.32  COMPLIANCE.] (a) In addition to methods specified in chapter 
362.33  245A, the commissioner may use alternative methods and new 
362.34  regulatory strategies to determine compliance with this 
362.35  section.  The commissioner may use sampling techniques to ensure 
362.36  compliance with this section.  Notwithstanding section 245A.09, 
363.1   subdivision 7, paragraph ~~(d)~~ (e), the commissioner may also 
363.2   extend periods of licensure, not to exceed five years, for 
363.3   license holders who have demonstrated substantial and consistent 
363.4   compliance with sections 245B.02 to 245B.07 and have 
363.5   consistently maintained the health and safety of consumers and 
363.6   have demonstrated by alternative methods in paragraph (b) that 
363.7   they meet or exceed the requirements of this section.  For 
363.8   purposes of this section, "substantial and consistent 
363.9   compliance" means that during the current licensing period: 
363.10     (1) the license holder's license has not been made 
363.11  conditional, suspended, or revoked; 
363.12     (2) there have been no substantiated allegations of 
363.13  maltreatment against the license holder; 
363.14     (3) there have been no program deficiencies that have been 
363.15  identified that would jeopardize the health or safety of 
363.16  consumers being served; and 
363.17     (4) the license holder is in substantial compliance with 
363.18  the other requirements of chapter 245A and other applicable laws 
363.19  and rules. 
363.20     (b) To determine the length of a license, the commissioner 
363.21  shall consider: 
363.22     (1) information from affected consumers, and the license 
363.23  holder's responsiveness to consumers' concerns and 
363.24  recommendations; 
363.25     (2) self assessments and peer reviews of the standards of 
363.26  this section, corrective actions taken by the license holder, 
363.27  and sharing the results of the inspections with consumers, the 
363.28  consumers' families, and others, as requested; 
363.29     (3) length of accreditation by an independent accreditation 
363.30  body, if applicable; 
363.31     (4) information from the county where the license holder is 
363.32  located; and 
363.33     (5) information from the license holder demonstrating 
363.34  performance that meets or exceeds the minimum standards of this 
363.35  chapter. 
363.36     (c) The commissioner may reduce the length of the license 
364.1   if the license holder fails to meet the criteria in paragraph 
364.2   (a) and the conditions specified in paragraph (b). 
364.3      Sec. 21.  Minnesota Statutes 2002, section 246.014, is 
364.4   amended to read: 
364.5      246.014 [SERVICES.] 
364.6      The measure of services established and prescribed by 
364.7   section 246.012, are: 
364.8      (a) The commissioner of human services shall develop and 
364.9   maintain state-operated services in a manner consistent with 
364.10  sections 245.461, 245.487, and 253.28, and chapters 252A, 254A, 
364.11  and 254B.  State-operated services shall be provided in 
364.12  coordination with counties and other vendors.  State-operated 
364.13  services shall include regional treatment centers, specialized 
364.14  inpatient or outpatient treatment programs, enterprise services, 
364.15  community-based services and programs, community preparation 
364.16  services, consultative services, and other services consistent 
364.17  with the mission of the department of human services.  These 
364.18  services shall include crisis beds, waivered homes, intermediate 
364.19  care facilities, and day training and habilitation facilities.  
364.20  The administrative structure of state-operated services must be 
364.21  statewide in character.  The state-operated services staff may 
364.22  deliver services at any location throughout the state. 
364.23     (b) The commissioner of human services shall create and 
364.24  maintain forensic services programs.  Forensic services shall be 
364.25  provided in coordination with counties and other vendors.  
364.26  Forensic services shall include specialized inpatient programs 
364.27  at secure treatment facilities as defined in section 253B.02, 
364.28  subdivision 18a, consultative services, aftercare services, 
364.29  community-based services and programs, transition services, or 
364.30  other services consistent with the mission of the department of 
364.31  human services. 
364.32     (c) Community preparation services as identified in 
364.33  paragraphs (a) and (b) are defined as specialized inpatient or 
364.34  outpatient services or programs operated outside of a secure 
364.35  environment but are administered by a secured treatment facility.
364.36     (d) The commissioner of human services may establish 
365.1   policies and procedures which govern the operation of the 
365.2   services and programs under the direct administrative authority 
365.3   of the commissioner. 
365.4      ~~(1) There shall be served in state hospitals a single~~ 
365.5   ~~standard of food for patients and employees alike, which is~~ 
365.6   ~~nutritious and palatable together with special diets as~~ 
365.7   ~~prescribed by the medical staff thereof.  There shall be a chief~~ 
365.8   ~~dietitian in the department of human services and at least one~~ 
365.9   ~~dietitian at each state hospital.  There shall be adequate staff~~ 
365.10  ~~and equipment for processing, preparation, distribution and~~ 
365.11  ~~serving of food.~~ 
365.12     ~~(2) There shall be a staff of persons, professional and~~ 
365.13  ~~lay, sufficient in number, trained in the diagnosis, care and~~ 
365.14  ~~treatment of persons with mental illness, physical illness, and~~ 
365.15  ~~including religious and spiritual counsel through qualified~~ 
365.16  ~~chaplains (who shall be in the unclassified service) adequate to~~ 
365.17  ~~take advantage of and put into practice modern methods of~~ 
365.18  ~~psychiatry, medicine and related field~~. 
365.19     ~~(3) There shall be a staff and facilities to provide~~ 
365.20  ~~occupational and recreational therapy, entertainment and other~~ 
365.21  ~~creative activities as are consistent with modern methods of~~ 
365.22  ~~treatment and well being.~~ 
365.23     ~~(4) There shall be in each state hospital for the care and~~ 
365.24  ~~treatment of persons with mental illness facilities for the~~ 
365.25  ~~segregation and treatment of patients and residents who have~~ 
365.26  ~~communicable disease.~~ 
365.27     ~~(5) The commissioner of human services shall provide modern~~ 
365.28  ~~and adequate psychiatric social case work service.~~ 
365.29     ~~(6) The commissioner of human services shall make every~~ 
365.30  ~~effort to improve the accommodations for patients and residents~~ 
365.31  ~~so that the same shall be comfortable and attractive with~~ 
365.32  ~~adequate furnishings, clothing, and supplies.~~ 
365.33     ~~(7) The commissioner of human services shall establish~~ 
365.34  ~~training programs for the training of personnel and may require~~ 
365.35  ~~the participation of personnel in such programs.  Within the~~ 
365.36  ~~limits of the appropriations available the commissioner may~~ 
366.1   ~~establish professional training programs in the forms of~~ 
366.2   ~~educational stipends for positions for which there is a scarcity~~ 
366.3   ~~of applicants.~~ 
366.4      ~~(8) The standards herein established shall be adapted and~~ 
366.5   ~~applied to the diagnosis, care and treatment of persons with~~ 
366.6   ~~chemical dependency or mental retardation who come within those~~ 
366.7   ~~terms as defined in the laws relating to the hospitalization and~~ 
366.8   ~~commitment of such persons, and of persons who have sexual~~ 
366.9   ~~psychopathic personalities or are sexually dangerous persons as~~ 
366.10  ~~defined in chapter 253B.~~  
366.11     ~~(9) The commissioner of human services shall establish a~~ 
366.12  ~~program of detection, diagnosis and treatment of persons with~~ 
366.13  ~~mental illness and persons described in clause (8), and within~~ 
366.14  ~~the limits of appropriations may establish clinics and staff the~~ 
366.15  ~~same with persons specially trained in psychiatry and related~~ 
366.16  ~~fields.~~ 
366.17     ~~(10) The commissioner of employee relations may reclassify~~ 
366.18  ~~employees of the state hospitals from time to time, and assign~~ 
366.19  ~~classifications to such salary brackets as will adequately~~ 
366.20  ~~compensate personnel and reasonably assure a continuity of~~ 
366.21  ~~adequate staff.~~ 
366.22     ~~(11) In addition to the chaplaincy services, provided in~~ 
366.23  ~~clause (2), the commissioner of human services shall open said~~ 
366.24  ~~state hospitals to members of the clergy and other spiritual~~ 
366.25  ~~leaders to the end that religious and spiritual counsel and~~ 
366.26  ~~services are made available to the patients and residents~~ 
366.27  ~~therein, and shall cooperate with all members of the clergy and~~ 
366.28  ~~other spiritual leaders in making said patients and residents~~ 
366.29  ~~available for religious and spiritual counsel, and shall provide~~ 
366.30  ~~such members of the clergy and other spiritual leaders with~~ 
366.31  ~~meals and accommodations.~~ 
366.32     ~~(12) Within the limits of the appropriations therefor, the~~ 
366.33  ~~commissioner of human services shall establish and provide~~ 
366.34  ~~facilities and equipment for research and study in the field of~~ 
366.35  ~~modern hospital management, the causes of mental and related~~ 
366.36  ~~illness and the treatment, diagnosis and care of persons with~~ 
367.1   ~~mental illness and funds provided therefor may be used to make~~ 
367.2   ~~available services, abilities and advice of leaders in these and~~ 
367.3   ~~related fields, and may provide them with meals and~~ 
367.4   ~~accommodations and compensate them for traveling expenses and~~ 
367.5   ~~services.~~ 
367.6      Sec. 22.  Minnesota Statutes 2002, section 246.015, 
367.7   subdivision 3, is amended to read: 
367.8      Subd. 3.  ~~Within the limits of the appropriations~~ 
367.9   ~~available,~~ The commissioner of human services may authorize 
367.10  state-operated services to provide consultative services for 
367.11  courts, ~~and~~ state welfare agencies, and supervise the placement 
367.12  and aftercare of patients, on a fee-for-service basis as defined 
367.13  in section 246.50, provisionally or otherwise discharged from 
367.14  a ~~state hospital or institution,~~ state-operated services 
367.15  facility.  State-operated services may also promote and conduct 
367.16  programs of education ~~for the people of the state~~ relating to 
367.17  ~~the problem of~~ mental health ~~and mental hygiene~~.  The 
367.18  commissioner shall administer, expend, and distribute federal 
367.19  funds which may be made available to the state and other funds 
367.20  ~~other than those~~ not appropriated by the legislature, which may 
367.21  be made available to the state for mental health ~~and mental~~ 
367.22  ~~hygiene~~ purposes. 
367.23     Sec. 23.  Minnesota Statutes 2002, section 246.018, 
367.24  subdivision 2, is amended to read: 
367.25     Subd. 2.  [MEDICAL DIRECTOR.] The commissioner of human 
367.26  services shall appoint ~~a medical director~~, and unless otherwise 
367.27  established by law, set the salary of a licensed physician to 
367.28  serve as medical director to assist in establishing and 
367.29  maintaining the medical policies of the department of human 
367.30  services.  The commissioner may place the medical director's 
367.31  position in the unclassified service if the position meets the 
367.32  criteria of section 43A.08, subdivision 1a.  The medical 
367.33  director must be a psychiatrist certified by the board of 
367.34  psychiatry. 
367.35     Sec. 24.  Minnesota Statutes 2002, section 246.018, 
367.36  subdivision 3, is amended to read: 
368.1      Subd. 3.  [DUTIES.] The medical director shall: 
368.2      (1) oversee the clinical provision of inpatient mental 
368.3   health services provided in the state's regional treatment 
368.4   centers; 
368.5      (2) recruit and retain psychiatrists to serve on the state 
368.6   medical staff established in subdivision 4; 
368.7      (3) consult with the commissioner of human services, ~~the~~ 
368.8   ~~assistant commissioner of mental health,~~ community mental health 
368.9   center directors, and the ~~regional treatment center governing~~ 
368.10  ~~bodies~~ state-operated services governing body to develop 
368.11  standards for treatment and care of patients in ~~regional~~ 
368.12  ~~treatment centers and outpatient~~ state-operated service 
368.13  programs; 
368.14     (4) develop and oversee a continuing education program for 
368.15  members of the ~~regional treatment center~~ medical staff; and 
368.16     (5) ~~consult with the commissioner on the appointment of the~~ 
368.17  ~~chief executive officers for regional treatment centers; and~~ 
368.18     ~~(6)~~ participate and cooperate in the development and 
368.19  maintenance of a quality assurance program for ~~regional~~ 
368.20  ~~treatment centers~~ state-operated services that assures that 
368.21  residents receive quality inpatient care and continuous quality 
368.22  care once they are discharged or transferred to an outpatient 
368.23  setting. 
368.24     Sec. 25.  Minnesota Statutes 2002, section 246.018, 
368.25  subdivision 4, is amended to read: 
368.26     Subd. 4.  [~~REGIONAL TREATMENT CENTER~~ STATE-OPERATED 
368.27  SERVICES MEDICAL STAFF.] (a) The ~~commissioner of human services~~ 
368.28  medical director shall establish a ~~regional treatment center~~ 
368.29  state-operated service medical staff which shall be under the 
368.30  clinical direction of the office of medical director. 
368.31     (b) The medical director, in conjunction with the ~~regional~~ 
368.32  ~~treatment center~~ medical staff, shall: 
368.33     (1) establish standards and define qualifications for 
368.34  physicians who care for residents in ~~regional treatment~~ 
368.35  ~~centers~~ state-operated services; 
368.36     (2) monitor the performance of physicians who care for 
369.1   residents in ~~regional treatment centers~~ state-operated services; 
369.2   and 
369.3      (3) recommend to the commissioner changes in procedures for 
369.4   operating ~~regional treatment centers~~ state-operated service 
369.5   facilities that are needed to improve the provision of medical 
369.6   care in those facilities. 
369.7      Sec. 26.  Minnesota Statutes 2002, section 246.13, is 
369.8   amended to read: 
369.9      246.13 [RECORD OF PATIENTS AND RESIDENTS~~; DEPARTMENT OF~~ 
369.10  ~~HUMAN~~ IN STATE-OPERATED SERVICES.] 
369.11     The commissioner of human services' office shall have, 
369.12  accessible only by consent of the commissioner or on the order 
369.13  of a judge or court of record, a record showing the residence, 
369.14  sex, age, nativity, occupation, civil condition, and date of 
369.15  entrance or commitment of every person, in the ~~state hospitals~~ 
369.16  state-operated services facilities as defined under section 
369.17  246.014 under exclusive control of the commissioner~~,~~; the date 
369.18  of discharge and whether such discharge was final~~,~~; the 
369.19  condition of ~~such~~ the person when the person left the ~~state~~ 
369.20  ~~hospital,~~ state-operated services facility; and the date and 
369.21  cause of all deaths.  The record shall state every transfer from 
369.22  one ~~state hospital~~ state-operated services facility to another, 
369.23  naming each state-operated services facility.  This information 
369.24  shall be furnished to the commissioner of human services by each 
369.25  public ~~and private~~ agency, along with ~~such~~ other obtainable 
369.26  facts as the commissioner may ~~from time to time~~ require.  ~~The~~ 
369.27  ~~chief executive officer of each such state hospital, within ten~~ 
369.28  ~~days after the commitment or entrance thereto of a patient or~~ 
369.29  ~~resident, shall cause a true copy of an entrance record to be~~ 
369.30  ~~forwarded to the commissioner of human services.~~  When a patient 
369.31  or resident ~~leaves,~~ in a state-operated services facility is 
369.32  discharged ~~or~~, transferred, or dies ~~in any state hospital~~, 
369.33  the ~~chief executive officer, or other person in charge~~ head of 
369.34  the state-operated services facility or designee shall inform 
369.35  the commissioner of human services of these events within ten 
369.36  days ~~thereafter~~ on forms furnished by the commissioner.  
370.1      ~~The commissioner of human services may authorize the chief~~ 
370.2   ~~executive officer of any state hospital for persons with mental~~ 
370.3   ~~illness or mental retardation, to release to public or private~~ 
370.4   ~~medical personnel, hospitals, clinics, local social services~~ 
370.5   ~~agencies or other specifically designated interested persons or~~ 
370.6   ~~agencies any information regarding any patient or resident~~ 
370.7   ~~thereat, if, in the opinion of the commissioner, it will be for~~ 
370.8   ~~the benefit of the patient or resident.~~  
370.9      Sec. 27.  Minnesota Statutes 2002, section 246.15, is 
370.10  amended to read: 
370.11     246.15 [MONEY OF ~~INMATES OF PUBLIC WELFARE INSTITUTIONS~~ 
370.12  PATIENTS OR RESIDENTS.] 
370.13     Subdivision 1.  [RECORD KEEPING OF MONEY.] The ~~chief~~ 
370.14  ~~executive officer of each institution~~ head of the state-operated 
370.15  services facility or designee under the jurisdiction of the 
370.16  commissioner of human services ~~shall~~ may have the care and 
370.17  custody of all money belonging to ~~inmates thereof~~ patients or 
370.18  residents which may come into the ~~chief executive officer's~~ head 
370.19  of the state-operated services facility or designee's hands~~,~~.  
370.20  The head of the state-operated services facility or designee 
370.21  shall keep accurate accounts ~~thereof~~ of the money, and pay them 
370.22  out under rules prescribed by law or by the commissioner of 
370.23  human services, taking vouchers ~~therefor~~ for the money.  
370.24  All ~~such~~ money received by any officer or employee shall be paid 
370.25  to the ~~chief executive officer forthwith~~ head of the 
370.26  state-operated services facility or designee immediately.  Every 
370.27  ~~such executive officer~~ head of the state-operated services 
370.28  facility or designee, at the close of each month, or ~~oftener~~ 
370.29  earlier if required by the commissioner, shall forward to the 
370.30  commissioner a statement of the amount of all money ~~so~~ received 
370.31  and the names of the ~~inmates~~ patients or residents from whom 
370.32  received, accompanied by a check for the amount, payable to the 
370.33  state treasurer.  On receipt of ~~such~~ the statement, the 
370.34  commissioner shall transmit the ~~same~~ statement along with a 
370.35  check to the commissioner of finance~~, together with such check~~, 
370.36  who shall deliver the ~~same~~ statement and check to the state 
371.1   treasurer.  Upon the payment of ~~such~~ the check, the amount shall 
371.2   be credited to a fund to be known as "~~Inmates~~ Client Fund," for 
371.3   the institution from which the ~~same~~ check was received.  All 
371.4   ~~such~~ funds shall be paid out by the state treasurer upon 
371.5   vouchers duly approved by the commissioner of human services ~~as~~ 
371.6   ~~in other cases~~.  The commissioner may permit a contingent fund 
371.7   to remain in the hands of the ~~executive officer~~ head of the 
371.8   state-operated services facility or designee of ~~any such~~ the 
371.9   institution from which necessary ~~expenditure~~ expenditures may 
371.10  ~~from time to time~~ be made.  
371.11     Subd. 2.  [CORRECTIONAL INMATES FUND.] Any money in the 
371.12  inmates fund provided for in this section, belonging to inmates 
371.13  of state institutions under the jurisdiction of the commissioner 
371.14  of corrections shall ~~forthwith~~ be immediately transferred by the 
371.15  commissioner of human services to the correctional ~~inmates~~ 
371.16  inmates' fund created by section 241.08.  
371.17     Sec. 28.  Minnesota Statutes 2002, section 246.16, is 
371.18  amended to read: 
371.19     246.16 [UNCLAIMED MONEY OR PERSONAL PROPERTY OF 
371.20  ~~INMATES~~ PATIENTS OR RESIDENTS.] 
371.21     Subdivision 1.  [UNCLAIMED MONEY.] When ~~there~~ money has 
371.22  ~~heretofore~~ accumulated ~~or shall hereafter accumulate~~ in the 
371.23  hands of the ~~superintendent of any state institution~~ head of the 
371.24  state-operated services facility or designee under the 
371.25  jurisdiction of the commissioner of human services money 
371.26  belonging to ~~inmates~~ patients or residents of ~~such~~ the 
371.27  institution who have died ~~therein~~ there, or 
371.28  disappeared ~~therefrom~~ from there, and for which ~~money~~ there is 
371.29  no claimant or person entitled ~~thereto~~ to the money known to the 
371.30  ~~superintendent, such~~ head of the state-operated services 
371.31  facility or designee the money may, at the discretion of ~~such~~ 
371.32  ~~superintendent~~ the head of the state-operated services facility 
371.33  or designee, ~~to~~ be expended under the direction of the 
371.34  ~~superintendent~~ head of the state-operated services facility or 
371.35  designee for the ~~amusement, entertainment, and general~~ benefit 
371.36  of the ~~inmates~~ patients or residents of ~~such~~ the institution.  
372.1   No money shall be ~~so~~ used until it ~~shall have~~ has remained 
372.2   unclaimed for at least five years.  If, at any time after the 
372.3   expiration of the five years, the legal heirs of the ~~inmate~~ 
372.4   ~~shall~~ patients or residents appear and make proper proof of ~~such~~ 
372.5   heirship, they shall be entitled to receive from the state 
372.6   ~~treasurer such~~ the sum of money ~~as shall have been~~ expended by 
372.7   the ~~superintendent~~ head of the state-operated services facility 
372.8   or designee belonging to the ~~inmate~~ patient or resident. 
372.9      Subd. 2.  [UNCLAIMED PERSONAL PROPERTY.] When any 
372.10  ~~inmate~~ patient or resident of a ~~state institution~~ state-operated 
372.11  services facility under the jurisdiction of the commissioner of 
372.12  human services ~~has died or disappeared therefrom, or hereafter~~ 
372.13  ~~shall die or disappear therefrom~~ dies or disappears from the 
372.14  state-operated services facility, leaving personal property 
372.15  exclusive of money in the custody of the ~~superintendent thereof~~ 
372.16  ~~personal property, exclusive of money, which~~ head of the 
372.17  state-operated services facility or designee and the property 
372.18  remains unclaimed for a period of two years, ~~and there is~~ with 
372.19  no person entitled ~~thereto~~ to the property known to the 
372.20  ~~superintendent~~ head of the state-operated services or designee, 
372.21  the ~~superintendent or an agent~~ head of the state-operated 
372.22  services facility or designee may sell ~~such~~ the property at 
372.23  public auction.  Notice of ~~such~~ the sale shall be published for 
372.24  two consecutive weeks in a legal newspaper in the county ~~wherein~~ 
372.25  where the ~~institution~~ state-operated services facility is 
372.26  located and shall state the time and place of ~~such~~ the sale.  
372.27  The proceeds of the sale, after deduction of the costs of 
372.28  publication and auction, may be expended, at the discretion of 
372.29  the ~~superintendent~~ head of the state-operated services facility 
372.30  or designee, for the ~~entertainment and~~ benefit of the ~~inmates~~ 
372.31  patients or residents of ~~such institution~~ the state-operated 
372.32  services facility.  Any ~~inmate~~ patient or resident, or heir or 
372.33  representative of the ~~inmate~~ patient or resident, may file with, 
372.34  and make proof of ownership to, the ~~superintendent~~ head of the 
372.35  state-operated services facility or designee of the ~~institution~~ 
372.36  state-operated services facility disposing of ~~such~~ the personal 
373.1   property within four years after ~~such~~ the sale, and, upon ~~proof~~ 
373.2   satisfactory proof to ~~such superintendent~~ the head of the 
373.3   state-operated services or designee, shall certify for payment 
373.4   to the state treasurer the amount received by the sale of ~~such~~ 
373.5   the property.  No suit shall be brought for damages consequent 
373.6   to the disposal of personal property or use of money in 
373.7   accordance with this section against the state or any official, 
373.8   employee, or agent thereof.  
373.9      Sec. 29.  Minnesota Statutes 2002, section 246.57, 
373.10  subdivision 1, is amended to read: 
373.11     Subdivision 1.  [AUTHORIZED.] The commissioner of human 
373.12  services may authorize any ~~state~~ state-operated services 
373.13  ~~facility operated under the authority of the commissioner~~ to 
373.14  enter into agreement with other governmental entities and both 
373.15  nonprofit and for-profit organizations for participation in 
373.16  shared service agreements that would be of mutual benefit to the 
373.17  state, other governmental entities and organizations involved, 
373.18  and the public.  ~~Notwithstanding section 16C.05, subdivision 2,~~ 
373.19  ~~the commissioner of human services may delegate the execution of~~ 
373.20  ~~shared services contracts to the chief executive officers of the~~ 
373.21  ~~regional centers or state operated nursing homes.  No additional~~ 
373.22  ~~employees shall be added to the legislatively approved~~ 
373.23  ~~complement for any regional center or state nursing home as a~~ 
373.24  ~~result of entering into any shared service agreement.  However,~~ 
373.25  Positions funded by a shared service agreement ~~may be~~ are 
373.26  authorized ~~by the commissioner of finance~~ for the duration of 
373.27  the shared service agreement.  The charges for the services 
373.28  shall be on an actual cost basis.  All receipts for shared 
373.29  services may be retained by the ~~regional treatment center or~~ 
373.30  state-operated ~~nursing home~~ service that provided the services~~,~~ 
373.31  ~~in addition to other funding the regional treatment center or~~ 
373.32  ~~state-operated nursing home receives~~. 
373.33     Sec. 30.  Minnesota Statutes 2002, section 246.57, 
373.34  subdivision 4, is amended to read: 
373.35     Subd. 4.  [SHARED STAFF OR SERVICES.] The commissioner of 
373.36  human services may authorize a ~~regional treatment center~~ 
374.1   state-operated services to provide staff or services to Camp 
374.2   Confidence in return for services to, or use of the camp's 
374.3   facilities by, residents of the ~~treatment center~~ facility who 
374.4   have mental retardation or a related condition. 
374.5      Sec. 31.  Minnesota Statutes 2002, section 246.57, 
374.6   subdivision 6, is amended to read: 
374.7      Subd. 6.  [DENTAL SERVICES.] The commissioner of human 
374.8   services shall authorize any ~~regional treatment center or~~ 
374.9   state-operated ~~nursing home~~ services facility under the 
374.10  commissioner's authority to provide dental services to disabled 
374.11  persons who are eligible for medical assistance and are not 
374.12  residing at the regional treatment center or state-operated 
374.13  nursing home, provided that the reimbursement received for these 
374.14  services is sufficient to cover actual costs.  To provide these 
374.15  services, regional treatment centers and state-operated nursing 
374.16  homes may participate under contract with health networks in 
374.17  their service area.  ~~Notwithstanding section 16C.05, subdivision~~ 
374.18  ~~2, the commissioner of human services may delegate the execution~~ 
374.19  ~~of these dental services contracts to the chief executive~~ 
374.20  ~~officers of the regional centers or state-operated nursing~~ 
374.21  ~~homes.~~  All receipts for these dental services shall be retained 
374.22  by the regional treatment center or state-operated nursing home 
374.23  that provides the services and shall be in addition to other 
374.24  funding the regional treatment center or state-operated nursing 
374.25  home receives. 
374.26     Sec. 32.  Minnesota Statutes 2002, section 246.71, 
374.27  subdivision 4, is amended to read: 
374.28     Subd. 4.  [EMPLOYEE OF A SECURE TREATMENT FACILITY OR 
374.29  EMPLOYEE.] "Employee of a secure treatment facility" or 
374.30  "employee" means an employee of the Minnesota security hospital 
374.31  or a secure treatment facility operated by the Minnesota ~~sexual~~ 
374.32  ~~psychopathic personality treatment center~~ sex offender program. 
374.33     Sec. 33.  Minnesota Statutes 2002, section 246.71, 
374.34  subdivision 5, is amended to read: 
374.35     Subd. 5.  [SECURE TREATMENT FACILITY.] "Secure treatment 
374.36  facility" means the Minnesota security hospital ~~or the Minnesota~~ 
375.1   ~~sexual psychopathic personality treatment center~~ and the 
375.2   Minnesota sex offender program facility in Moose Lake and any 
375.3   portion of the Minnesota sex offender program operated by the 
375.4   Minnesota sex offender program at the Minnesota security 
375.5   hospital.  
375.6      Sec. 34.  Minnesota Statutes 2002, section 246B.02, is 
375.7   amended to read: 
375.8      246B.02 [ESTABLISHMENT OF MINNESOTA ~~SEXUAL PSYCHOPATHIC~~ 
375.9   ~~PERSONALITY TREATMENT CENTER~~ SEX OFFENDER PROGRAM.] 
375.10     The commissioner of human services shall establish and 
375.11  maintain a secure facility located in Moose Lake.  The facility 
375.12  ~~shall be known as~~ shall be operated by the Minnesota ~~Sexual~~ 
375.13  ~~Psychopathic Personality Treatment Center~~ sex offender program.  
375.14  The ~~facility~~ program shall provide care and treatment in secure 
375.15  treatment facilities to ~~100~~ persons committed by the courts as 
375.16  sexual psychopathic personalities or sexually dangerous persons, 
375.17  or persons admitted there with the consent of the commissioner 
375.18  of human services. 
375.19     Sec. 35.  Minnesota Statutes 2002, section 246B.03, is 
375.20  amended to read: 
375.21     246B.03 [LICENSURE.] 
375.22     The commissioner of human services shall apply to the 
375.23  commissioner of health to license the secure treatment 
375.24  facilities operated by the Minnesota ~~Sexual Psychopathic~~ 
375.25  ~~Personality Treatment Center~~ sex offender program as ~~a~~ 
375.26  supervised living ~~facility~~ facilities with applicable program 
375.27  licensing standards. 
375.28     Sec. 36.  Minnesota Statutes 2002, section 246B.04, is 
375.29  amended to read: 
375.30     246B.04 [RULES; EVALUATION.] 
375.31     The commissioner of human services shall adopt rules to 
375.32  govern the operation, maintenance, and licensure of ~~the~~ secure 
375.33  treatment facilities operated by the Minnesota sex offender 
375.34  program ~~established at the Minnesota Sexual Psychopathic~~ 
375.35  ~~Personality Treatment Center,~~ or at any other facility operated 
375.36  by the commissioner, for persons committed as a sexual 
376.1   psychopathic personality or sexually dangerous person.  The 
376.2   commissioner shall establish an evaluation process to measure 
376.3   outcomes and behavioral changes as a result of treatment 
376.4   compared with incarceration without treatment, to determine the 
376.5   value, if any, of treatment in protecting the public. 
376.6      Sec. 37.  Minnesota Statutes 2002, section 252.025, 
376.7   subdivision 7, is amended to read: 
376.8      Subd. 7.  [MINNESOTA EXTENDED TREATMENT OPTIONS.] The 
376.9   commissioner shall develop by July 1, 1997, the Minnesota 
376.10  extended treatment options to serve Minnesotans who have mental 
376.11  retardation and exhibit severe behaviors which present a risk to 
376.12  public safety.  This program must provide specialized 
376.13  residential services ~~on the Cambridge campus~~ in Cambridge and an 
376.14  array of community support services statewide. 
376.15     Sec. 38.  Minnesota Statutes 2002, section 252.06, is 
376.16  amended to read: 
376.17     252.06 [SHERIFF TO TRANSPORT PERSONS ~~WITH MENTAL~~ 
376.18  ~~RETARDATION~~.] 
376.19     It shall be the duty of the sheriff of any county, upon the 
376.20  request of the commissioner of human services, to take charge of 
376.21  ~~and~~, transport, and deliver any person ~~with mental retardation~~ 
376.22  who has been committed by the district court of any county to 
376.23  the care and custody of the commissioner of human services 
376.24  to ~~such state hospital~~ a state-operated services facility as may 
376.25  be designated by the commissioner of human services ~~and there~~ 
376.26  ~~deliver such person to the chief executive officer of the state~~ 
376.27  ~~hospital~~. 
376.28     Sec. 39.  Minnesota Statutes 2002, section 252.27, 
376.29  subdivision 2a, is amended to read: 
376.30     Subd. 2a.  [CONTRIBUTION AMOUNT.] (a) The natural or 
376.31  adoptive parents of a minor child, including a child determined 
376.32  eligible for medical assistance without consideration of 
376.33  parental income, must contribute monthly to the cost of 
376.34  services, unless the child is married or has been married, 
376.35  parental rights have been terminated, or the child's adoption is 
376.36  subsidized according to section 259.67 or through title IV-E of 
377.1   the Social Security Act. 
377.2      (b) For households with adjusted gross income equal to or 
377.3   greater than 100 percent of federal poverty guidelines, the 
377.4   parental contribution shall be ~~the greater of a minimum monthly~~ 
377.5   ~~fee of $25 for households with adjusted gross income of $30,000~~ 
377.6   ~~and over, or an amount to be~~ computed by applying the following 
377.7   schedule of rates to the adjusted gross income of the natural or 
377.8   adoptive parents ~~that exceeds 150 percent of the federal poverty~~ 
377.9   ~~guidelines for the applicable household size, the following~~ 
377.10  ~~schedule of rates~~: 
377.11     (1) ~~on the amount of adjusted gross income over 150 percent~~ 
377.12  ~~of poverty, but not over $50,000, ten percent~~ if the adjusted 
377.13  gross income is equal to or greater than 100 percent of federal 
377.14  poverty guidelines and less than 175 percent of federal poverty 
377.15  guidelines, the parental contribution is $4 per month; 
377.16     (2) ~~on~~ if the ~~amount of~~ adjusted gross income ~~over 150~~ 
377.17  ~~percent of poverty and over $50,000 but not over $60,000, 12~~ 
377.18  ~~percent~~ is equal to or greater than 175 percent of federal 
377.19  poverty guidelines and less than or equal to 375 percent of 
377.20  federal poverty guidelines, the parental contribution shall be 
377.21  determined using a sliding fee scale established by the 
377.22  commissioner of human services which begins at one percent of 
377.23  adjusted gross income at 175 percent of federal poverty 
377.24  guidelines and increases to 7.5 percent of adjusted gross income 
377.25  for those with adjusted gross income up to 375 percent of 
377.26  federal poverty guidelines; 
377.27     (3) ~~on~~ if the ~~amount of~~ adjusted gross income ~~over 150~~ is 
377.28  greater than 375 percent of federal poverty~~, and over $60,000~~ 
377.29  ~~but not over $75,000, 14 percent~~ guidelines and less than 675 
377.30  percent of federal poverty guidelines, the parental contribution 
377.31  shall be 7.5 percent of adjusted gross income; ~~and~~ 
377.32     (4) ~~on all~~ if the adjusted gross income ~~amounts over 150~~ is 
377.33  equal to or greater than 675 percent of federal poverty~~, and~~ 
377.34  ~~over $75,000, 15 percent~~ guidelines and less than 975 percent of 
377.35  federal poverty guidelines, the parental contribution shall be 
377.36  ten percent of adjusted gross income; and 
378.1      (5) if the adjusted gross income is equal to or greater 
378.2   than 975 percent of federal poverty guidelines, the parental 
378.3   contribution shall be 12.5 percent of adjusted gross income. 
378.4      If the child lives with the parent, the ~~parental~~ 
378.5   ~~contribution~~ annual adjusted gross income is reduced by ~~$200,~~ 
378.6   ~~except that the parent must pay the minimum monthly $25 fee~~ 
378.7   ~~under this paragraph~~ $2,400 prior to calculating the parental 
378.8   contribution.  If the child resides in an institution specified 
378.9   in section 256B.35, the parent is responsible for the personal 
378.10  needs allowance specified under that section in addition to the 
378.11  parental contribution determined under this section.  The 
378.12  parental contribution is reduced by any amount required to be 
378.13  paid directly to the child pursuant to a court order, but only 
378.14  if actually paid. 
378.15     (c) The household size to be used in determining the amount 
378.16  of contribution under paragraph (b) includes natural and 
378.17  adoptive parents and their dependents under age 21, including 
378.18  the child receiving services.  Adjustments in the contribution 
378.19  amount due to annual changes in the federal poverty guidelines 
378.20  shall be implemented on the first day of July following 
378.21  publication of the changes. 
378.22     (d) For purposes of paragraph (b), "income" means the 
378.23  adjusted gross income of the natural or adoptive parents 
378.24  determined according to the previous year's federal tax form. 
378.25     (e) The contribution shall be explained in writing to the 
378.26  parents at the time eligibility for services is being 
378.27  determined.  The contribution shall be made on a monthly basis 
378.28  effective with the first month in which the child receives 
378.29  services.  Annually upon redetermination or at termination of 
378.30  eligibility, if the contribution exceeded the cost of services 
378.31  provided, the local agency or the state shall reimburse that 
378.32  excess amount to the parents, either by direct reimbursement if 
378.33  the parent is no longer required to pay a contribution, or by a 
378.34  reduction in or waiver of parental fees until the excess amount 
378.35  is exhausted. 
378.36     (f) The monthly contribution amount must be reviewed at 
379.1   least every 12 months; when there is a change in household size; 
379.2   and when there is a loss of or gain in income from one month to 
379.3   another in excess of ten percent.  The local agency shall mail a 
379.4   written notice 30 days in advance of the effective date of a 
379.5   change in the contribution amount.  A decrease in the 
379.6   contribution amount is effective in the month that the parent 
379.7   verifies a reduction in income or change in household size. 
379.8      (g) Parents of a minor child who do not live with each 
379.9   other shall each pay the contribution required under paragraph 
379.10  (a)~~, except that a~~.  An amount equal to the annual court-ordered 
379.11  child support payment actually paid on behalf of the child 
379.12  receiving services shall be deducted from the ~~contribution~~ 
379.13  adjusted gross income of the parent making the payment prior to 
379.14  calculating the parental contribution under paragraph (b). 
379.15     (h) The contribution under paragraph (b) shall be increased 
379.16  by an additional five percent if the local agency determines 
379.17  that insurance coverage is available but not obtained for the 
379.18  child.  For purposes of this section, "available" means the 
379.19  insurance is a benefit of employment for a family member at an 
379.20  annual cost of no more than five percent of the family's annual 
379.21  income.  For purposes of this section, "insurance" means health 
379.22  and accident insurance coverage, enrollment in a nonprofit 
379.23  health service plan, health maintenance organization, 
379.24  self-insured plan, or preferred provider organization. 
379.25     Parents who have more than one child receiving services 
379.26  shall not be required to pay more than the amount for the child 
379.27  with the highest expenditures.  There shall be no resource 
379.28  contribution from the parents.  The parent shall not be required 
379.29  to pay a contribution in excess of the cost of the services 
379.30  provided to the child, not counting payments made to school 
379.31  districts for education-related services.  Notice of an increase 
379.32  in fee payment must be given at least 30 days before the 
379.33  increased fee is due.  
379.34     (i) The contribution under paragraph (b) shall be reduced 
379.35  by $300 per fiscal year if, in the 12 months prior to July 1: 
379.36     (1) the parent applied for insurance for the child; 
380.1      (2) the insurer denied insurance; 
380.2      (3) the parents submitted a complaint or appeal, in writing 
380.3   to the insurer, submitted a complaint or appeal, in writing, to 
380.4   the commissioner of health or the commissioner of commerce, or 
380.5   litigated the complaint or appeal; and 
380.6      (4) as a result of the dispute, the insurer reversed its 
380.7   decision and granted insurance. 
380.8      For purposes of this section, "insurance" has the meaning 
380.9   given in paragraph (h). 
380.10     A parent who has requested a reduction in the contribution 
380.11  amount under this paragraph shall submit proof in the form and 
380.12  manner prescribed by the commissioner or county agency, 
380.13  including, but not limited to, the insurer's denial of 
380.14  insurance, the written letter or complaint of the parents, court 
380.15  documents, and the written response of the insurer approving 
380.16  insurance.  The determinations of the commissioner or county 
380.17  agency under this paragraph are not rules subject to chapter 14. 
380.18     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
380.19     Sec. 40.  Minnesota Statutes 2002, section 253.015, 
380.20  subdivision 1, is amended to read: 
380.21     Subdivision 1.  [~~STATE HOSPITALS~~ STATE-OPERATED SERVICES 
380.22  FOR PERSONS WITH MENTAL ILLNESS.] The ~~state hospitals~~ 
380.23  state-operated services facilities located at Anoka, Brainerd, 
380.24  Fergus Falls, St. Peter, and Willmar~~, and Moose Lake until June~~ 
380.25  ~~30, 1995,~~ shall constitute the ~~state hospitals~~ state-operated 
380.26  services facilities for persons with mental illness, and shall 
380.27  be maintained under the general management of the commissioner 
380.28  of human services.  The commissioner of human services shall 
380.29  determine to what ~~state hospital~~ state-operated services 
380.30  facility persons with mental illness shall be committed from 
380.31  each county and notify the judge exercising probate jurisdiction 
380.32  thereof, and of changes made from time to time.  ~~The chief~~ 
380.33  ~~executive officer of each hospital for persons with mental~~ 
380.34  ~~illness shall be known as the chief executive officer.~~  
380.35     Sec. 41.  Minnesota Statutes 2002, section 253.017, is 
380.36  amended to read: 
381.1      253.017 [TREATMENT PROVIDED BY ~~REGIONAL TREATMENT CENTERS~~ 
381.2   STATE-OPERATED SERVICES.] 
381.3      Subdivision 1.  [ACTIVE PSYCHIATRIC TREATMENT.] The 
381.4   ~~regional treatment centers~~ state-operated services shall provide 
381.5   active psychiatric treatment according to contemporary 
381.6   professional standards.  Treatment must be designed to: 
381.7      (1) stabilize the individual and the symptoms that required 
381.8   hospital admission; 
381.9      (2) restore individual functioning to a level permitting 
381.10  return to the community; 
381.11     (3) strengthen family and community support; and 
381.12     (4) facilitate discharge, after care, and follow-up as 
381.13  patients return to the community. 
381.14     Subd. 2.  [NEED FOR SERVICES.] The commissioner shall 
381.15  determine the need for the psychiatric services provided by the 
381.16  department based upon individual needs assessments of persons in 
381.17  the ~~regional treatment centers~~ state-operated services as 
381.18  required by section 245.474, subdivision 2, and an evaluation 
381.19  of:  (1) ~~regional treatment center~~ state-operated service 
381.20  programs, (2) programs needed in the region for persons who 
381.21  require hospitalization, and (3) available epidemiologic data.  
381.22  Throughout its planning and implementation, the assessment 
381.23  process must be discussed with the state advisory council on 
381.24  mental health in accordance with its duties under section 
381.25  245.697.  Continuing assessment of this information must be 
381.26  considered in planning for and implementing changes in 
381.27  state-operated programs and facilities for persons with mental 
381.28  illness.  ~~By January 31, 1990, the commissioner shall submit a~~ 
381.29  ~~proposal for renovation or new construction of the facilities at~~ 
381.30  ~~Anoka, Brainerd, Moose Lake, and Fergus Falls.~~  Expansion may be 
381.31  considered only after a thorough analysis of need and in 
381.32  conjunction with a comprehensive mental health plan. 
381.33     Subd. 3.  [DISSEMINATION OF ADMISSION AND STAY CRITERIA.] 
381.34  The commissioner shall periodically disseminate criteria for 
381.35  admission and continued stay in a ~~regional treatment center and~~ 
381.36  ~~security hospital~~ state-operated services facility.  The 
382.1   commissioner shall disseminate the criteria to the courts of the 
382.2   state and counties. 
382.3      Sec. 42.  Minnesota Statutes 2002, section 253.20, is 
382.4   amended to read: 
382.5      253.20 [MINNESOTA SECURITY HOSPITAL.] 
382.6      The commissioner of human services ~~is hereby authorized and~~ 
382.7   ~~directed to~~ shall erect, equip, and maintain in ~~connection with~~ 
382.8   ~~a state hospital at~~ St. Peter a suitable building to be known as 
382.9   the Minnesota Security Hospital, for the purpose of ~~holding in~~ 
382.10  ~~custody and caring for such persons with mental illness or~~ 
382.11  ~~mental retardation as~~ providing a secure treatment facility as 
382.12  defined in section 253B.02, subdivision 18a, for persons who may 
382.13  be committed ~~thereto~~ there by courts ~~of criminal jurisdiction~~, 
382.14  or otherwise, or transferred ~~thereto~~ there by the commissioner 
382.15  of human services, and for ~~such~~ persons ~~as may be declared~~ 
382.16  ~~insane~~ who are found to be mentally ill while confined in any 
382.17  ~~penal institution~~ correctional facility, or who may be found to 
382.18  be mentally ill and dangerous, and the commissioner shall 
382.19  supervise and manage the same as in the case of other state 
382.20  hospitals. 
382.21     Sec. 43.  Minnesota Statutes 2002, section 253.26, is 
382.22  amended to read: 
382.23     253.26 [TRANSFERS OF PATIENTS OR RESIDENTS.] 
382.24     ~~When any person of the state hospital for patients with~~ 
382.25  ~~mental illness or residents with mental retardation is found by~~ 
382.26  ~~the commissioner of human services to have homicidal tendencies~~ 
382.27  ~~or to be under sentence or indictment or information the person~~ 
382.28  ~~may be transferred by the commissioner to the Minnesota Security~~ 
382.29  ~~Hospital for safekeeping and treatment~~ The commissioner of human 
382.30  services may transfer a committed patient to the Minnesota 
382.31  Security Hospital following a determination that the patient's 
382.32  behavior presents a danger to others and treatment in a secure 
382.33  treatment facility is necessary.  The commissioner shall 
382.34  establish a written policy creating the transfer criteria. 
382.35     Sec. 44.  Minnesota Statutes 2002, section 253B.02, 
382.36  subdivision 18a, is amended to read: 
383.1      Subd. 18a.  [SECURE TREATMENT FACILITY.] "Secure treatment 
383.2   facility" means the Minnesota security hospital ~~or the Minnesota~~ 
383.3   ~~sexual psychopathic personality treatment center~~ and the 
383.4   Minnesota sex offender program facility in Moose Lake and any 
383.5   portion of the Minnesota sex offender program operated by the 
383.6   Minnesota sex offender program at the Minnesota security 
383.7   hospital, but does not include services or programs administered 
383.8   by the secure treatment facility outside a secure environment. 
383.9      Sec. 45.  Minnesota Statutes 2002, section 253B.04, 
383.10  subdivision 1, is amended to read: 
383.11     Subdivision 1.  [VOLUNTARY ADMISSION AND TREATMENT.] (a) 
383.12  Voluntary admission is preferred over involuntary commitment and 
383.13  treatment.  Any person 16 years of age or older may request to 
383.14  be admitted to a treatment facility as a voluntary patient for 
383.15  observation, evaluation, diagnosis, care and treatment without 
383.16  making formal written application.  Any person under the age of 
383.17  16 years may be admitted as a patient with the consent of a 
383.18  parent or legal guardian if it is determined by independent 
383.19  examination that there is reasonable evidence that (1) the 
383.20  proposed patient has a mental illness, or is mentally retarded 
383.21  or chemically dependent; and (2) the proposed patient is 
383.22  suitable for treatment.  The head of the treatment facility 
383.23  shall not arbitrarily refuse any person seeking admission as a 
383.24  voluntary patient.  In making decisions regarding admissions, 
383.25  the facility shall use clinical admission criteria consistent 
383.26  with the current applicable inpatient admission standards 
383.27  established by the American Psychiatric Association or the 
383.28  American Academy of Child and Adolescent Psychiatry.  These 
383.29  criteria must be no more restrictive than, and must be 
383.30  consistent with, the requirements of section 62Q.53.  The 
383.31  facility may not refuse to admit a person voluntarily solely 
383.32  because the person does not meet the criteria for involuntary 
383.33  holds under section 253B.05 or the definition of mental illness 
383.34  under section 253B.02, subdivision 13.  
383.35     (b) In addition to the consent provisions of paragraph (a), 
383.36  a person who is 16 or 17 years of age who refuses to consent 
384.1   personally to admission may be admitted as a patient for mental 
384.2   illness or chemical dependency treatment with the consent of a 
384.3   parent or legal guardian if it is determined by an independent 
384.4   examination that there is reasonable evidence that the proposed 
384.5   patient is chemically dependent or has a mental illness and is 
384.6   suitable for treatment.  The person conducting the examination 
384.7   shall notify the proposed patient and the parent or legal 
384.8   guardian of this determination. 
384.9      (c) A person who is voluntarily participating in treatment 
384.10  for a mental illness is not subject to civil commitment under 
384.11  this chapter if the person: 
384.12     (1) has given informed consent or, if lacking capacity, is 
384.13  a person for whom legally valid substitute consent has been 
384.14  given; and 
384.15     (2) is participating in a medically appropriate course of 
384.16  treatment, including clinically appropriate and lawful use of 
384.17  neuroleptic medication and electroconvulsive therapy.  The 
384.18  limitation on commitment in this paragraph does not apply if, 
384.19  based on clinical assessment, the court finds that it is 
384.20  unlikely that the person will remain in and cooperate with a 
384.21  medically appropriate course of treatment absent commitment and 
384.22  the standards for commitment are otherwise met.  This paragraph 
384.23  does not apply to a person for whom commitment proceedings are 
384.24  initiated pursuant to rule 20.01 or 20.02 of the Rules of 
384.25  Criminal Procedure, or a person found by the court to meet the 
384.26  requirements under section 253B.02, subdivision 17. 
384.27     Legally valid substitute consent may be provided by a proxy 
384.28  under a health care directive, a guardian or conservator with 
384.29  authority to consent to mental health treatment, or consent to 
384.30  admission under subdivision 1a or 1b.  
384.31     Sec. 46.  Minnesota Statutes 2002, section 253B.05, 
384.32  subdivision 3, is amended to read: 
384.33     Subd. 3.  [DURATION OF HOLD.] (a) Any person held pursuant 
384.34  to this section may be held up to 72 hours, exclusive of 
384.35  Saturdays, Sundays, and legal holidays after admission.  If a 
384.36  petition for the commitment of the person is filed in the 
385.1   district court in the county of the person's residence or of the 
385.2   county in which the treatment facility is located, the court may 
385.3   issue a judicial hold order pursuant to section 253B.07, 
385.4   subdivision 2b. 
385.5      (b) During the 72-hour hold period, a court may not release 
385.6   a person held under this section unless the court has received a 
385.7   written petition for release and held a summary hearing 
385.8   regarding the release.  The petition must include the name of 
385.9   the person being held, the basis for and location of the hold, 
385.10  and a statement as to why the hold is improper.  The petition 
385.11  also must include copies of any written documentation under 
385.12  subdivision 1 or 2 in support of the hold, unless the person 
385.13  holding the petitioner refuses to supply the documentation.  The 
385.14  hearing must be held as soon as practicable and may be conducted 
385.15  by means of a telephone conference call or similar method by 
385.16  which the participants are able to simultaneously hear each 
385.17  other.  If the court decides to release the person, the court 
385.18  shall direct the release and shall issue written findings 
385.19  supporting the decision.  The release may not be delayed pending 
385.20  the written order.  Before deciding to release the person, the 
385.21  court shall make every reasonable effort to provide notice of 
385.22  the proposed release to: 
385.23     (1) any specific individuals identified in a statement 
385.24  under subdivision 1 or 2 or individuals identified in the record 
385.25  who might be endangered if the person was not held; 
385.26     (2) the examiner whose written statement was a basis for a 
385.27  hold under subdivision 1; and 
385.28     (3) the peace or health officer who applied for a hold 
385.29  under subdivision 2. 
385.30     (c) If a person is intoxicated in public and held under 
385.31  this section for detoxification, a treatment facility may 
385.32  release the person without providing notice under paragraph (d) 
385.33  as soon as the treatment facility determines the person is no 
385.34  longer a danger to themselves or others.  Notice must be 
385.35  provided to the peace officer or health officer who transported 
385.36  the person, or the appropriate law enforcement agency, if the 
386.1   officer or agency requests notification. 
386.2      ~~(c)~~ (d) If a treatment facility releases a person during 
386.3   the 72-hour hold period, the head of the treatment facility 
386.4   shall immediately notify the agency which employs the peace or 
386.5   health officer who transported the person to the treatment 
386.6   facility under this section. 
386.7      (e) A person held under a 72-hour emergency hold must be 
386.8   released by the facility within 72 hours unless a court order to 
386.9   hold the person is obtained.  A consecutive emergency hold order 
386.10  under this section may not be issued. 
386.11     Sec. 47.  Minnesota Statutes 2002, section 253B.09, 
386.12  subdivision 1, is amended to read: 
386.13     Subdivision 1.  [STANDARD OF PROOF.] (a) If the court finds 
386.14  by clear and convincing evidence that the proposed patient is a 
386.15  person who is mentally ill, mentally retarded, or chemically 
386.16  dependent and after careful consideration of reasonable 
386.17  alternative dispositions, including but not limited to, 
386.18  dismissal of petition, voluntary outpatient care, voluntary 
386.19  admission to a treatment facility, appointment of a guardian or 
386.20  conservator, or release before commitment as provided for in 
386.21  subdivision 4, it finds that there is no suitable alternative to 
386.22  judicial commitment, the court shall commit the patient to the 
386.23  least restrictive treatment program or alternative programs 
386.24  which can meet the patient's treatment needs consistent with 
386.25  section 253B.03, subdivision 7.  
386.26     (b) In deciding on the least restrictive program, the court 
386.27  shall consider a range of treatment alternatives including, but 
386.28  not limited to, community-based nonresidential treatment, 
386.29  community residential treatment, partial hospitalization, acute 
386.30  care hospital, and regional treatment center services.  The 
386.31  court shall also consider the proposed patient's treatment 
386.32  preferences and willingness to participate voluntarily in the 
386.33  treatment ordered.  The court may not commit a patient to a 
386.34  facility or program that is not capable of meeting the patient's 
386.35  needs.  
386.36     (c) If the commitment as mentally ill, chemically 
387.1   dependent, or mentally retarded is to a service facility 
387.2   provided by the commissioner of human services, the court shall 
387.3   order the commitment to the commissioner.  The commissioner 
387.4   shall designate the placement of the person to the court. 
387.5      (d) If the court finds a proposed patient to be a person 
387.6   who is mentally ill under section 253B.02, subdivision 13, 
387.7   paragraph (a), clause (2) or (4), the court shall commit to a 
387.8   community-based program that meets the proposed patient's 
387.9   needs.  For purposes of this paragraph, a community-based 
387.10  program may include inpatient mental health services at a 
387.11  community hospital. 
387.12     Sec. 48.  Minnesota Statutes 2002, section 256.012, is 
387.13  amended to read: 
387.14     256.012 [MINNESOTA MERIT SYSTEM.] 
387.15     Subdivision 1.  [MINNESOTA MERIT SYSTEM.] The commissioner 
387.16  of human services shall promulgate by rule personnel standards 
387.17  on a merit basis in accordance with federal standards for a 
387.18  merit system of personnel administration for all employees of 
387.19  county boards engaged in the administration of community social 
387.20  services or income maintenance programs, all employees of human 
387.21  services boards that have adopted the rules of the Minnesota 
387.22  merit system, and all employees of local social services 
387.23  agencies.  
387.24     Excluded from the rules are employees of institutions and 
387.25  hospitals under the jurisdiction of the aforementioned boards 
387.26  and agencies; employees of county personnel systems otherwise 
387.27  provided for by law that meet federal merit system requirements; 
387.28  duly appointed or elected members of the aforementioned boards 
387.29  and agencies; and the director of community social services and 
387.30  employees in positions that, upon the request of the appointing 
387.31  authority, the commissioner chooses to exempt, provided the 
387.32  exemption accords with the federal standards for a merit system 
387.33  of personnel administration.  
387.34     Subd. 2.  [PAYMENT FOR SERVICES PROVIDED.] (a) The cost of 
387.35  merit system operations shall be paid by counties and other 
387.36  entities that utilize merit system services.  Total costs shall 
388.1   be determined by the commissioner annually and must be set at a 
388.2   level that neither significantly overrecovers nor underrecovers 
388.3   the costs of providing the service.  The costs of merit system 
388.4   services shall be prorated among participating counties in 
388.5   accordance with an agreement between the commissioner and these 
388.6   counties.  Participating counties will be billed quarterly in 
388.7   advance and shall pay their share of the costs upon receipt of 
388.8   the billing. 
388.9      (b) This subdivision does not apply to counties with 
388.10  personnel systems otherwise provided by law that meet federal 
388.11  merit system requirements.  A county that applies to withdraw 
388.12  from the merit system must notify the commissioner of the 
388.13  county's intent to develop its own personnel system.  This 
388.14  notice must be provided in writing by December 31 of the year 
388.15  preceding the year of final participation in the merit system.  
388.16  The county may withdraw after the commissioner has certified 
388.17  that its personnel system meets federal merit system 
388.18  requirements. 
388.19     (c) A county merit system operations account is established 
388.20  in the special revenue fund.  Payments received by the 
388.21  commissioner for merit system costs must be deposited in the 
388.22  merit system operations account and must be used for the purpose 
388.23  of providing the services and administering the merit system. 
388.24     (d) County payment of merit system costs is effective July 
388.25  1, 2003, however payment for the period from July 1, 2003 
388.26  through December 31, 2003, shall be made no later than January 
388.27  31, 2004. 
388.28     Subd. 3.  [PARTICIPATING COUNTY CONSULTATION.] The 
388.29  commissioner shall ensure that participating counties are 
388.30  consulted regularly and offered the opportunity to provide input 
388.31  on the management of the merit system to ensure effective use of 
388.32  resources and to monitor system performance. 
388.33     Sec. 49.  [256.0451] [HEARING PROCEDURES.] 
388.34     Subdivision 1.  [SCOPE.] The requirements in this section 
388.35  apply to all fair hearings and appeals under section 256.045, 
388.36  subdivision 3, paragraph (a), clauses (1), (2), (3), (5), (6), 
389.1   and (7).  Except as provided in subdivisions 3 and 19, the 
389.2   requirements under this section apply to fair hearings and 
389.3   appeals under section 256.045, subdivision 3, paragraph (a), 
389.4   clauses (4), (8), and (9). 
389.5      The term "person" is used in this section to mean an 
389.6   individual who, on behalf of themselves or their household, is 
389.7   appealing or disputing or challenging an action, a decision, or 
389.8   a failure to act, by an agency in the human services system.  
389.9   When a person involved in a proceeding under this section is 
389.10  represented by an attorney or by an authorized representative, 
389.11  the term "person" also refers to the person's attorney or 
389.12  authorized representative.  Any notice sent to the person 
389.13  involved in the hearing must also be sent to the person's 
389.14  attorney or authorized representative. 
389.15     The term "agency" includes the county human services 
389.16  agency, the state human services agency, and, where applicable, 
389.17  any entity involved under a contract, subcontract, grant, or 
389.18  subgrant with the state agency or with a county agency, that 
389.19  provides or operates programs or services in which appeals are 
389.20  governed by section 256.045. 
389.21     Subd. 2.  [ACCESS TO FILES.] A person involved in a fair 
389.22  hearing appeal has the right of access to the person's complete 
389.23  case files and to examine all private welfare data on the person 
389.24  which has been generated, collected, stored, or disseminated by 
389.25  the agency.  A person involved in a fair hearing appeal has the 
389.26  right to a free copy of all documents in the case file involved 
389.27  in a fair hearing appeal.  "Case file" means the information, 
389.28  documents, and data, in whatever form, which have been 
389.29  generated, collected, stored, or disseminated by the agency in 
389.30  connection with the person and the program or service involved. 
389.31     Subd. 3.  [AGENCY APPEAL SUMMARY.] (a) Except in fair 
389.32  hearings and appeals under section 256.045, subdivision 3, 
389.33  paragraph (a), clauses (4), (8), and (9), the agency involved in 
389.34  an appeal must prepare a state agency appeal summary for each 
389.35  fair hearing appeal.  The state agency appeal summary shall be 
389.36  mailed or otherwise delivered to the person who is involved in 
390.1   the appeal at least three working days before the date of the 
390.2   hearing.  The state agency appeal summary must also be mailed or 
390.3   otherwise delivered to the department's appeals office at least 
390.4   three working days before the date of the fair hearing appeal. 
390.5      (b) In addition, the appeals referee shall confirm that the 
390.6   state agency appeal summary is mailed or otherwise delivered to 
390.7   the person involved in the appeal as required under paragraph 
390.8   (a).  The person involved in the fair hearing should be 
390.9   provided, through the state agency appeal summary or other 
390.10  reasonable methods, appropriate information about the procedures 
390.11  for the fair hearing and an adequate opportunity to prepare.  
390.12  These requirements apply equally to the state agency or an 
390.13  entity under contract when involved in the appeal. 
390.14     (c) The contents of the state agency appeal summary must be 
390.15  adequate to inform the person involved in the appeal of the 
390.16  evidence on which the agency relies and the legal basis for the 
390.17  agency's action or determination. 
390.18     Subd. 4.  [ENFORCING ACCESS TO FILES.] A person involved in 
390.19  a fair hearing appeal may enforce the right of access to data 
390.20  and copies of the case file by making a request to the appeals 
390.21  referee.  The appeals referee will make an appropriate order 
390.22  enforcing the person's rights under the Minnesota Government 
390.23  Data Practices Act, including but not limited to, ordering 
390.24  access to files, data, and documents; continuing a hearing to 
390.25  allow adequate time for access to data; or prohibiting use by 
390.26  the agency of files, data, or documents which have been 
390.27  generated, collected, stored, or disseminated without compliance 
390.28  with the Minnesota Government Data Practices Act and which have 
390.29  not been provided to the person involved in the appeal. 
390.30     Subd. 5.  [PREHEARING CONFERENCES.] (a) The appeals referee 
390.31  prior to a fair hearing appeal may hold a prehearing conference 
390.32  to further the interests of justice or efficiency and must 
390.33  include the person involved in the appeal.  A person involved in 
390.34  a fair hearing appeal or the agency may request a prehearing 
390.35  conference.  The prehearing conference may be conducted by 
390.36  telephone, in person, or in writing.  The prehearing conference 
391.1   may address the following: 
391.2      (1) disputes regarding access to files, evidence, 
391.3   subpoenas, or testimony; 
391.4      (2) the time required for the hearing or any need for 
391.5   expedited procedures or decision; 
391.6      (3) identification or clarification of legal or other 
391.7   issues that may arise at the hearing; 
391.8      (4) identification of and possible agreement to factual 
391.9   issues; and 
391.10     (5) scheduling and any other matter which will aid in the 
391.11  proper and fair functioning of the hearing. 
391.12     (b) The appeals referee shall make a record or otherwise 
391.13  contemporaneously summarize the prehearing conference in 
391.14  writing, which shall be sent to both the person involved in the 
391.15  hearing, the person's attorney or authorized representative, and 
391.16  the agency. 
391.17     Subd. 6.  [APPEAL REQUEST FOR EMERGENCY ASSISTANCE OR 
391.18  URGENT MATTER.] (a) When an appeal involves an application for 
391.19  emergency assistance, the agency involved shall mail or 
391.20  otherwise deliver the state agency appeal summary to the 
391.21  department's appeals office within two working days of receiving 
391.22  the request for an appeal.  A person may also request that a 
391.23  fair hearing be held on an emergency basis when the issue 
391.24  requires an immediate resolution.  The appeals referee shall 
391.25  schedule the fair hearing on the earliest available date 
391.26  according to the urgency of the issue involved.  Issuance of the 
391.27  recommended decision after an emergency hearing shall be 
391.28  expedited. 
391.29     (b) The commissioner shall issue a written decision within 
391.30  five working days of receiving the recommended decision, shall 
391.31  immediately inform the parties of the outcome by telephone, and 
391.32  shall mail the decision no later than two working days following 
391.33  the date of the decision. 
391.34     Subd. 7.  [CONTINUANCE, RESCHEDULING, OR ADJOURNING A 
391.35  HEARING.] (a) A person involved in a fair hearing, or the 
391.36  agency, may request a continuance, a rescheduling, or an 
392.1   adjournment of a hearing for a reasonable period of time.  The 
392.2   grounds for granting a request for a continuance, a 
392.3   rescheduling, or adjournment of a hearing include, but are not 
392.4   limited to, the following: 
392.5      (1) to reasonably accommodate the appearance of a witness; 
392.6      (2) to ensure that the person has adequate opportunity for 
392.7   preparation and for presentation of evidence and argument; 
392.8      (3) to ensure that the person or the agency has adequate 
392.9   opportunity to review, evaluate, and respond to new evidence, or 
392.10  where appropriate, to require that the person or agency review, 
392.11  evaluate, and respond to new evidence; 
392.12     (4) to permit the person involved and the agency to 
392.13  negotiate toward resolution of some or all of the issues where 
392.14  both agree that additional time is needed; 
392.15     (5) to permit the agency to reconsider a previous action or 
392.16  determination; 
392.17     (6) to permit or to require the performance of actions not 
392.18  previously taken; and 
392.19     (7) to provide additional time or to permit or require 
392.20  additional activity by the person or agency as the interests of 
392.21  fairness may require. 
392.22     (b) Requests for continuances or for rescheduling may be 
392.23  made orally or in writing.  The person or agency requesting the 
392.24  continuance or rescheduling must first make reasonable efforts 
392.25  to contact the other participants in the hearing or their 
392.26  representatives, and seek to obtain an agreement on the 
392.27  request.  Requests for continuance or rescheduling should be 
392.28  made no later than three working days before the scheduled date 
392.29  of the hearing, unless there is a good cause as specified in 
392.30  subdivision 13.  Granting a continuance or rescheduling may be 
392.31  conditioned upon a waiver by the requester of applicable time 
392.32  limits, but should not cause unreasonable delay. 
392.33     Subd. 8.  [SUBPOENAS.] A person involved in a fair hearing 
392.34  or the agency may request a subpoena for a witness, for 
392.35  evidence, or for both.  A reasonable number of subpoenas shall 
392.36  be issued to require the attendance and the testimony of 
393.1   witnesses, and the production of evidence relating to any issue 
393.2   of fact in the appeal hearing.  The request for a subpoena must 
393.3   show a need for the subpoena and the general relevance to the 
393.4   issues involved.  The subpoena shall be issued in the name of 
393.5   the department and shall be served and enforced as provided in 
393.6   section 357.22 and the Minnesota Rules of Civil Procedure. 
393.7      An individual or entity served with a subpoena may petition 
393.8   the appeals referee in writing to vacate or modify a subpoena.  
393.9   The appeals referee shall resolve such a petition in a 
393.10  prehearing conference involving all parties and shall make a 
393.11  written decision.  A subpoena may be vacated or modified if the 
393.12  appeals referee determines that the testimony or evidence sought 
393.13  does not relate with reasonable directness to the issues of the 
393.14  fair hearing appeal; that the subpoena is unreasonable, over 
393.15  broad, or oppressive; that the evidence sought is repetitious or 
393.16  cumulative; or that the subpoena has not been served reasonably 
393.17  in advance of the time when the appeal hearing will be held. 
393.18     Subd. 9.  [NO EX PARTE CONTACT.] The appeals referee shall 
393.19  not have ex parte contact on substantive issues with the agency 
393.20  or with any person or witness in a fair hearing appeal.  No 
393.21  employee of the department or agency shall review, interfere 
393.22  with, change, or attempt to influence the recommended decision 
393.23  of the appeals referee in any fair hearing appeal, except 
393.24  through the procedure allowed in subdivision 18.  The 
393.25  limitations in this subdivision do not affect the commissioner's 
393.26  authority to review or reconsider decisions or make final 
393.27  decisions. 
393.28     Subd. 10.  [TELEPHONE OR FACE-TO-FACE HEARING.] A fair 
393.29  hearing appeal may be conducted by telephone, by other 
393.30  electronic media, or by an in-person, face-to-face hearing.  At 
393.31  the request of the person involved in a fair hearing appeal or 
393.32  their representative, a face-to-face hearing shall be conducted 
393.33  with all participants personally present before the appeals 
393.34  referee. 
393.35     Subd. 11.  [HEARING FACILITIES AND EQUIPMENT.] The appeals 
393.36  referee shall conduct the hearing in the county where the person 
394.1   involved resides, unless an alternate location is mutually 
394.2   agreed upon before the hearing, or unless the person has agreed 
394.3   to a hearing by telephone.  Hearings under section 256.045, 
394.4   subdivision 3, paragraph (a), clauses (4), (8), and (9), must be 
394.5   conducted in the county where the determination was made, unless 
394.6   an alternate location is mutually agreed upon before the 
394.7   hearing.  The hearing room shall be of sufficient size and 
394.8   layout to adequately accommodate both the number of individuals 
394.9   participating in the hearing and any identified special needs of 
394.10  any individual participating in the hearing.  The appeals 
394.11  referee shall ensure that all communication and recording 
394.12  equipment that is necessary to conduct the hearing and to create 
394.13  an adequate record is present and functioning properly.  If any 
394.14  necessary communication or recording equipment fails or ceases 
394.15  to operate effectively, the appeals referee shall take any steps 
394.16  necessary, including stopping or adjourning the hearing, until 
394.17  the necessary equipment is present and functioning properly.  
394.18  All reasonable efforts shall be undertaken to prevent and avoid 
394.19  any delay in the hearing process caused by defective 
394.20  communication or recording equipment. 
394.21     Subd. 12.  [INTERPRETER AND TRANSLATION SERVICES.] The 
394.22  appeals referee has a duty to inquire and to determine whether 
394.23  any participant in the hearing needs the services of an 
394.24  interpreter or translator in order to participate in or to 
394.25  understand the hearing process.  Necessary interpreter or 
394.26  translation services must be provided at no charge to the person 
394.27  involved in the hearing.  If it appears that interpreter or 
394.28  translation services are needed but are not available for the 
394.29  scheduled hearing, the appeals referee shall continue or 
394.30  postpone the hearing until appropriate services can be provided. 
394.31     Subd. 13.  [FAILURE TO APPEAR; GOOD CAUSE.] If a person 
394.32  involved in a fair hearing appeal fails to appear at the 
394.33  hearing, the appeals referee may dismiss the appeal.  The person 
394.34  may reopen the appeal if within ten working days the person 
394.35  submits information to the appeals referee to show good cause 
394.36  for not appearing.  Good cause can be shown when there is: 
395.1      (1) a death or serious illness in the person's family; 
395.2      (2) a personal injury or illness which reasonably prevents 
395.3   the person from attending the hearing; 
395.4      (3) an emergency, crisis, or unforeseen event which 
395.5   reasonably prevents the person from attending the hearing; 
395.6      (4) an obligation or responsibility of the person which a 
395.7   reasonable person, in the conduct of one's affairs, could 
395.8   reasonably determine takes precedence over attending the 
395.9   hearing; 
395.10     (5) lack of or failure to receive timely notice of the 
395.11  hearing in the preferred language of the person involved in the 
395.12  hearing; and 
395.13     (6) excusable neglect, excusable inadvertence, excusable 
395.14  mistake, or other good cause as determined by the appeals 
395.15  referee. 
395.16     Subd. 14.  [COMMENCEMENT OF HEARING.] The appeals referee 
395.17  shall begin each hearing by describing the process to be 
395.18  followed in the hearing, including the swearing-in of witnesses, 
395.19  how testimony and evidence are presented, the order of examining 
395.20  and cross-examining witnesses, and the opportunity for an 
395.21  opening statement and a closing statement.  The appeals referee 
395.22  shall identify for the participants the issues to be addressed 
395.23  at the hearing and shall explain to the participants the burden 
395.24  of proof which applies to the person involved and the agency.  
395.25  The appeals referee shall confirm, prior to proceeding with the 
395.26  hearing, that the state agency appeal summary, if required under 
395.27  subdivision 3, has been properly completed and provided to the 
395.28  person involved in the hearing, and that the person has been 
395.29  provided documents and an opportunity to review the case file, 
395.30  as provided in this section. 
395.31     Subd. 15.  [CONDUCT OF THE HEARING.] The appeals referee 
395.32  shall act in a fair and impartial manner at all times.  At the 
395.33  beginning of the hearing the agency must designate one person as 
395.34  their representative who shall be responsible for presenting the 
395.35  agency's evidence and questioning any witnesses.  The appeals 
395.36  referee shall make sure that the person and the agency are 
396.1   provided sufficient time to present testimony and evidence, to 
396.2   confront and cross-examine all adverse witnesses, and to make 
396.3   any relevant statement at the hearing.  The appeals referee 
396.4   shall make reasonable efforts to explain the hearing process to 
396.5   persons who are not represented, and shall ensure that the 
396.6   hearing is conducted fairly and efficiently.  Upon the 
396.7   reasonable request of the person or the agency involved, the 
396.8   appeals referee may direct witnesses to remain outside the 
396.9   hearing room, except during their individual testimony.  The 
396.10  appeals referee shall not terminate the hearing before affording 
396.11  the person and the agency a complete opportunity to submit all 
396.12  admissible evidence, and reasonable opportunity for oral or 
396.13  written statement.  When a hearing extends beyond the time which 
396.14  was anticipated, the hearing shall be rescheduled or continued 
396.15  from day-to-day until completion.  Hearings that have been 
396.16  continued shall be timely scheduled to minimize delay in the 
396.17  disposition of the appeal. 
396.18     Subd. 16.  [SCOPE OF ISSUES ADDRESSED AT THE HEARING.] The 
396.19  hearing shall address the correctness and legality of the 
396.20  agency's action and shall not be limited simply to a review of 
396.21  the propriety of the agency's action.  The person involved may 
396.22  raise and present evidence on all legal claims or defenses 
396.23  arising under state or federal law as a basis for appealing or 
396.24  disputing an agency action, but not constitutional claims beyond 
396.25  the jurisdiction of the fair hearing.  The appeals referee may 
396.26  take official notice of adjudicative facts. 
396.27     Subd. 17.  [BURDEN OF PERSUASION.] The burden of persuasion 
396.28  is governed by specific state or federal law and regulations 
396.29  that apply to the subject of the hearing.  If there is no 
396.30  specific law, then the participant in the hearing who asserts 
396.31  the truth of a claim is under the burden to persuade the appeals 
396.32  referee that the claim is true. 
396.33     Subd. 18.  [INVITING COMMENT BY DEPARTMENT.] The appeals 
396.34  referee or the commissioner may determine that a written comment 
396.35  by the department about the policy implications of a specific 
396.36  legal issue could help resolve a pending appeal.  Such a written 
397.1   policy comment from the department shall be obtained only by a 
397.2   written request that is also sent to the person involved and to 
397.3   the agency or its representative.  When such a written comment 
397.4   is received, both the person involved in the hearing and the 
397.5   agency shall have adequate opportunity to review, evaluate, and 
397.6   respond to the written comment, including submission of 
397.7   additional testimony or evidence, and cross-examination 
397.8   concerning the written comment. 
397.9      Subd. 19.  [DEVELOPING THE RECORD.] The appeals referee 
397.10  shall accept all evidence, except evidence privileged by law, 
397.11  that is commonly accepted by reasonable people in the conduct of 
397.12  their affairs as having probative value on the issues to be 
397.13  addressed at the hearing.  Except in fair hearings and appeals 
397.14  under section 256.045, subdivision 3, paragraph (a), clauses 
397.15  (4), (8), and (9), in cases involving medical issues such as a 
397.16  diagnosis, a physician's report, or a review team's decision, 
397.17  the appeals referee shall consider whether it is necessary to 
397.18  have a medical assessment other than that of the individual 
397.19  making the original decision.  When necessary, the appeals 
397.20  referee shall require an additional assessment be obtained at 
397.21  agency expense and made part of the hearing record.  The appeals 
397.22  referee shall ensure for all cases that the record is 
397.23  sufficiently complete to make a fair and accurate decision.  
397.24     Subd. 20.  [UNREPRESENTED PERSONS.] In cases involving 
397.25  unrepresented persons, the appeals referee shall take 
397.26  appropriate steps to identify and develop in the hearing 
397.27  relevant facts necessary for making an informed and fair 
397.28  decision.  These steps may include, but are not limited to, 
397.29  asking questions of witnesses, and referring the person to a 
397.30  legal services office.  An unrepresented person shall be 
397.31  provided an adequate opportunity to respond to testimony or 
397.32  other evidence presented by the agency at the hearing.  The 
397.33  appeals referee shall ensure that an unrepresented person has a 
397.34  full and reasonable opportunity at the hearing to establish a 
397.35  record for appeal. 
397.36     Subd. 21.  [CLOSING OF THE RECORD.] The agency must present 
398.1   its evidence prior to or at the hearing.  The agency shall not 
398.2   be permitted to submit evidence after the hearing except by 
398.3   agreement at the hearing between the person involved, the 
398.4   agency, and the appeals referee.  If evidence is submitted after 
398.5   the hearing, based on such an agreement, the person involved and 
398.6   the agency must be allowed sufficient opportunity to respond to 
398.7   the evidence.  When necessary, the record shall remain open to 
398.8   permit a person to submit additional evidence on the issues 
398.9   presented at the hearing. 
398.10     Subd. 22.  [DECISIONS.] A timely, written decision must be 
398.11  issued in every appeal.  Each decision must contain a clear 
398.12  ruling on the issues presented in the appeal hearing, and should 
398.13  contain a ruling only on questions directly presented by the 
398.14  appeal and the arguments raised in the appeal. 
398.15     (a) [TIMELINESS.] A written decision must be issued within 
398.16  90 days of the date the person involved requested the appeal 
398.17  unless a shorter time is required by law.  An additional 30 days 
398.18  is provided in those cases where the commissioner refuses to 
398.19  accept the recommended decision. 
398.20     (b) [CONTENTS OF HEARING DECISION.] The decision must 
398.21  contain both findings of fact and conclusions of law, clearly 
398.22  separated and identified.  The findings of fact must be based on 
398.23  the entire record.  Each finding of fact made by the appeals 
398.24  referee shall be supported by a preponderance of the evidence 
398.25  unless a different standard is required under the regulations of 
398.26  a particular program.  The "preponderance of the evidence" 
398.27  means, in light of the record as a whole, the evidence leads the 
398.28  appeals referee to believe that the finding of fact is more 
398.29  likely to be true than not true.  The legal claims or arguments 
398.30  of a participant do not constitute either a finding of fact or a 
398.31  conclusion of law, except to the extent the appeals referee 
398.32  adopts an argument as a finding of fact or conclusion of law. 
398.33     The decision shall contain at least the following: 
398.34     (1) a listing of the date and place of the hearing and the 
398.35  participants at the hearing; 
398.36     (2) a clear and precise statement of the issues, including 
399.1   the dispute under consideration and the specific points which 
399.2   must be resolved in order to decide the case; 
399.3      (3) a listing of the material, including exhibits, records, 
399.4   reports, placed into evidence at the hearing, and upon which the 
399.5   hearing decision is based; 
399.6      (4) the findings of fact based upon the entire hearing 
399.7   record.  The findings of fact must be adequate to inform the 
399.8   participants and any interested person in the public of the 
399.9   basis of the decision.  If the evidence is in conflict on an 
399.10  issue which must be resolved, the findings of fact must state 
399.11  the reasoning used in resolving the conflict; 
399.12     (5) conclusions of law that address the legal authority for 
399.13  the hearing and the ruling, and which give appropriate attention 
399.14  to the claims of the participants to the hearing; 
399.15     (6) a clear and precise statement of the decision made 
399.16  resolving the dispute under consideration in the hearing; and 
399.17     (7) written notice of the right to appeal to district court 
399.18  or to request reconsideration, and of the actions required and 
399.19  the time limits for taking appropriate action to appeal to 
399.20  district court or to request a reconsideration. 
399.21     (c) [NO INDEPENDENT INVESTIGATION.] The appeals referee 
399.22  shall not independently investigate facts or otherwise rely on 
399.23  information not presented at the hearing.  The appeals referee 
399.24  may not contact other agency personnel, except as provided in 
399.25  subdivision 18.  The appeals referee's recommended decision must 
399.26  be based exclusively on the testimony and evidence presented at 
399.27  the hearing, and legal arguments presented, and the appeals 
399.28  referee's research and knowledge of the law. 
399.29     (d) [RECOMMENDED DECISION.] The commissioner will review 
399.30  the recommended decision and accept or refuse to accept the 
399.31  decision according to section 256.045, subdivision 5. 
399.32     Subd. 23.  [REFUSAL TO ACCEPT RECOMMENDED ORDERS.] (a) If 
399.33  the commissioner refuses to accept the recommended order from 
399.34  the appeals referee, the person involved, the person's attorney 
399.35  or authorized representative, and the agency shall be sent a 
399.36  copy of the recommended order, a detailed explanation of the 
400.1   basis for refusing to accept the recommended order, and the 
400.2   proposed modified order. 
400.3      (b) The person involved and the agency shall have at least 
400.4   ten business days to respond to the proposed modification of the 
400.5   recommended order.  The person involved and the agency may 
400.6   submit a legal argument concerning the proposed modification, 
400.7   and may propose to submit additional evidence that relates to 
400.8   the proposed modified order. 
400.9      Subd. 24.  [RECONSIDERATION.] Reconsideration may be 
400.10  requested within 30 days of the date of the commissioner's final 
400.11  order.  If reconsideration is requested, the other participants 
400.12  in the appeal shall be informed of the request.  The person 
400.13  seeking reconsideration has the burden to demonstrate why the 
400.14  matter should be reconsidered.  The request for reconsideration 
400.15  may include legal argument and may include proposed additional 
400.16  evidence supporting the request.  The other participants shall 
400.17  be sent a copy of all material submitted in support of the 
400.18  request for reconsideration and must be given ten days to 
400.19  respond. 
400.20     (a) [FINDINGS OF FACT.] When the requesting party raises a 
400.21  question as to the appropriateness of the findings of fact, the 
400.22  commissioner shall review the entire record. 
400.23     (b) [CONCLUSIONS OF LAW.] When the requesting party 
400.24  questions the appropriateness of a conclusion of law, the 
400.25  commissioner shall consider the recommended decision, the 
400.26  decision under reconsideration, and the material submitted in 
400.27  connection with the reconsideration.  The commissioner shall 
400.28  review the remaining record as necessary to issue a reconsidered 
400.29  decision. 
400.30     (c) [WRITTEN DECISION.] The commissioner shall issue a 
400.31  written decision on reconsideration in a timely fashion.  The 
400.32  decision must clearly inform the parties that this constitutes 
400.33  the final administrative decision, advise the participants of 
400.34  the right to seek judicial review, and the deadline for doing so.
400.35     Subd. 25.  [ACCESS TO APPEAL DECISIONS.] Appeal decisions 
400.36  must be maintained in a manner so that the public has ready 
401.1   access to previous decisions on particular topics, subject to 
401.2   appropriate procedures for safeguarding names, personal 
401.3   identifying information, and other private data on the 
401.4   individual persons involved in the appeal. 
401.5      Sec. 50.  Minnesota Statutes 2002, section 256B.092, 
401.6   subdivision 5, is amended to read: 
401.7      Subd. 5.  [FEDERAL WAIVERS.] (a) The commissioner shall 
401.8   apply for any federal waivers necessary to secure, to the extent 
401.9   allowed by law, federal financial participation under United 
401.10  States Code, title 42, sections 1396 et seq., as amended, for 
401.11  the provision of services to persons who, in the absence of the 
401.12  services, would need the level of care provided in a regional 
401.13  treatment center or a community intermediate care facility for 
401.14  persons with mental retardation or related conditions.  The 
401.15  commissioner may seek amendments to the waivers or apply for 
401.16  additional waivers under United States Code, title 42, sections 
401.17  1396 et seq., as amended, to contain costs.  The commissioner 
401.18  shall ensure that payment for the cost of providing home and 
401.19  community-based alternative services under the federal waiver 
401.20  plan shall not exceed the cost of intermediate care services 
401.21  including day training and habilitation services that would have 
401.22  been provided without the waivered services.  
401.23     The commissioner shall seek an amendment to the 1915c home 
401.24  and community-based waiver to allow properly licensed adult 
401.25  foster care homes to provide residential services to up to five 
401.26  individuals with mental retardation or a related condition.  If 
401.27  the amendment to the waiver is approved, adult foster care 
401.28  providers that can accommodate five individuals shall increase 
401.29  their capacity to five beds, provided the providers continue to 
401.30  meet all applicable licensing requirements. 
401.31     (b) The commissioner, in administering home and 
401.32  community-based waivers for persons with mental retardation and 
401.33  related conditions, shall ensure that day services for eligible 
401.34  persons are not provided by the person's residential service 
401.35  provider, unless the person or the person's legal representative 
401.36  is offered a choice of providers and agrees in writing to 
402.1   provision of day services by the residential service provider.  
402.2   The individual service plan for individuals who choose to have 
402.3   their residential service provider provide their day services 
402.4   must describe how health, safety, and protection needs will be 
402.5   met by frequent and regular contact with persons other than the 
402.6   residential service provider. 
402.7      Sec. 51.  Minnesota Statutes 2002, section 256B.092, is 
402.8   amended by adding a subdivision to read: 
402.9      Subd. 5a.  [INCREASING ADULT FOSTER CARE CAPACITY TO SERVE 
402.10  FIVE PERSONS.] (a) When an adult foster care provider increases 
402.11  the capacity of an existing home licensed to serve four persons 
402.12  to serve a fifth person under this section, the county agency 
402.13  shall reduce the contracted per diem cost for room and board and 
402.14  the mental retardation or a related condition waiver services of 
402.15  the existing foster care home by an average of 14 percent for 
402.16  all individuals living in that home.  A county agency may 
402.17  average the required per diem rate reductions across several 
402.18  adult foster care homes that expand capacity under this section, 
402.19  to achieve the necessary overall per diem reduction. 
402.20     (b) Following the contract changes in paragraph (a), the 
402.21  commissioner shall adjust: 
402.22     (1) individual county allocations for mental retardation or 
402.23  a related condition waivered services by the amount of savings 
402.24  that results from the changes made for mental retardation or a 
402.25  related condition waiver recipients for whom the county is 
402.26  financially responsible; and 
402.27     (2) group residential housing rate payments to the adult 
402.28  foster home by the amount of savings that results from the 
402.29  changes made. 
402.30     (c) Effective July 1, 2003, when a new five-person adult 
402.31  foster care home is licensed under this section, county agencies 
402.32  shall not establish group residential housing room and board 
402.33  rates and mental retardation or a related condition waiver 
402.34  service rates for the new home that exceed 86 percent of the 
402.35  average per diem room and board and mental retardation or a 
402.36  related condition waiver services costs of four-person homes 
403.1   serving persons with comparable needs and in the same geographic 
403.2   area.  A county agency developing more than one new five-person 
403.3   adult foster care home may average the required per diem rates 
403.4   across the homes to achieve the necessary overall per diem 
403.5   reductions. 
403.6      (d) The commissioner shall reduce the individual county 
403.7   allocations for mental retardation or a related condition 
403.8   waivered services by the savings resulting from the per diem 
403.9   limits on adult foster care recipients for whom the county is 
403.10  financially responsible, and shall limit the group residential 
403.11  housing rate for a new five-person adult foster care home. 
403.12     Sec. 52.  Minnesota Statutes 2002, section 257.0769, is 
403.13  amended to read: 
403.14     257.0769 [FUNDING FOR THE OMBUDSPERSON PROGRAM.] 
403.15     Subdivision 1.  [APPROPRIATIONS.] (a) Money is appropriated 
403.16  from the special fund authorized by section 256.01, subdivision 
403.17  2, clause (15), to the Indian affairs council for the purposes 
403.18  of sections 257.0755 to 257.0768. 
403.19     (b) Money is appropriated from the special fund authorized 
403.20  by section 256.01, subdivision 2, clause (15), to the council on 
403.21  affairs of Chicano/Latino people for the purposes of sections 
403.22  257.0755 to 257.0768. 
403.23     (c) Money is appropriated from the special fund authorized 
403.24  by section 256.01, subdivision 2, clause (15), to the Council of 
403.25  Black Minnesotans for the purposes of sections 257.0755 to 
403.26  257.0768. 
403.27     (d) Money is appropriated from the special fund authorized 
403.28  by section 256.01, subdivision 2, clause (15), to the Council on 
403.29  Asian-Pacific Minnesotans for the purposes of sections 257.0755 
403.30  to 257.0768. 
403.31     Subd. 2.  [TITLE IV-E REIMBURSEMENT.] The commissioner 
403.32  shall obtain federal title IV-E financial participation for 
403.33  eligible activity by the ombudsperson for families under section 
403.34  257.0755.  The ombudsperson for families shall maintain and 
403.35  transmit to the department of human services documentation that 
403.36  is necessary in order to obtain federal funds. 
404.1      Sec. 53.  Minnesota Statutes 2002, section 259.21, 
404.2   subdivision 6, is amended to read: 
404.3      Subd. 6.  [AGENCY.] "Agency" means an organization or 
404.4   department of government designated or authorized by law to 
404.5   place children for adoption or any person, group of persons, 
404.6   organization, association or society licensed or certified by 
404.7   the commissioner of human services to place children for 
404.8   adoption, including a Minnesota federally recognized tribe.  
404.9      Sec. 54.  Minnesota Statutes 2002, section 259.67, 
404.10  subdivision 7, is amended to read: 
404.11     Subd. 7.  [REIMBURSEMENT OF COSTS.] (a) Subject to rules of 
404.12  the commissioner, and the provisions of this subdivision a 
404.13  child-placing agency licensed in Minnesota or any other state, 
404.14  or local or tribal social services agency shall receive a 
404.15  reimbursement from the commissioner equal to 100 percent of the 
404.16  reasonable and appropriate cost of providing adoption services 
404.17  for a child certified as eligible for adoption assistance under 
404.18  subdivision 4.  Such assistance may include adoptive family 
404.19  recruitment, counseling, and special training when needed.  A 
404.20  child-placing agency licensed in Minnesota or any other state 
404.21  shall receive reimbursement for adoption services it purchases 
404.22  for or directly provides to an eligible child.  A local or 
404.23  tribal social services agency shall receive such reimbursement 
404.24  only for adoption services it purchases for an eligible child. 
404.25     (b) A child-placing agency licensed in Minnesota or any 
404.26  other state or local or tribal social services agency seeking 
404.27  reimbursement under this subdivision shall enter into a 
404.28  reimbursement agreement with the commissioner before providing 
404.29  adoption services for which reimbursement is sought.  No 
404.30  reimbursement under this subdivision shall be made to an agency 
404.31  for services provided prior to entering a reimbursement 
404.32  agreement.  Separate reimbursement agreements shall be made for 
404.33  each child and separate records shall be kept on each child for 
404.34  whom a reimbursement agreement is made.  Funds encumbered and 
404.35  obligated under such an agreement for the child remain available 
404.36  until the terms of the agreement are fulfilled or the agreement 
405.1   is terminated. 
405.2      (c) When a local or tribal social services agency uses a 
405.3   purchase of service agreement to provide services reimbursable 
405.4   under a reimbursement agreement, the commissioner may make 
405.5   reimbursement payments directly to the agency providing the 
405.6   service if direct reimbursement is specified by the purchase of 
405.7   service agreement, and if the request for reimbursement is 
405.8   submitted by the local or tribal social services agency along 
405.9   with a verification that the service was provided.  
405.10     Sec. 55.  Minnesota Statutes 2002, section 393.07, 
405.11  subdivision 1, is amended to read: 
405.12     Subdivision 1.  [PUBLIC CHILD WELFARE PROGRAM.] (a) To 
405.13  assist in carrying out the child protection, delinquency 
405.14  prevention and family assistance responsibilities of the state, 
405.15  the local social services agency shall administer a program of 
405.16  social services and financial assistance to be known as the 
405.17  public child welfare program.  The public child welfare program 
405.18  shall be supervised by the commissioner of human services and 
405.19  administered by the local social services agency in accordance 
405.20  with law and with rules of the commissioner. 
405.21     (b) The purpose of the public child welfare program is to 
405.22  assure protection for and financial assistance to children who 
405.23  are confronted with social, physical, or emotional problems 
405.24  requiring protection and assistance.  These problems include, 
405.25  but are not limited to the following: 
405.26     (1) mental, emotional, or physical handicap; 
405.27     (2) birth of a child to a mother who was not married to the 
405.28  child's father when the child was conceived nor when the child 
405.29  was born, including but not limited to costs of prenatal care, 
405.30  confinement and other care necessary for the protection of a 
405.31  child born to a mother who was not married to the child's father 
405.32  at the time of the child's conception nor at the birth; 
405.33     (3) dependency, neglect; 
405.34     (4) delinquency; 
405.35     (5) abuse or rejection of a child by its parents; 
405.36     (6) absence of a parent or guardian able and willing to 
406.1   provide needed care and supervision; 
406.2      (7) need of parents for assistance with child rearing 
406.3   problems, or in placing the child in foster care. 
406.4      (c) A local social services agency shall make the services 
406.5   of its public child welfare program available as required by 
406.6   law, by the commissioner, or by the courts and shall cooperate 
406.7   with other agencies, public or private, dealing with the 
406.8   problems of children and their parents as provided in this 
406.9   subdivision. 
406.10     ~~The public child welfare program shall be available in~~ 
406.11  ~~divorce cases for investigations of children and home conditions~~ 
406.12  ~~and for supervision of children when directed by the court~~ 
406.13  ~~hearing the divorce.~~ 
406.14     (d) A local social services agency may rent, lease, or 
406.15  purchase property, or in any other way approved by the 
406.16  commissioner, contract with individuals or agencies to provide 
406.17  needed facilities for foster care of children.  It may purchase 
406.18  services or child care from duly authorized individuals, 
406.19  agencies or institutions when in its judgment the needs of a 
406.20  child or the child's family can best be met in this way. 
406.21     Sec. 56.  Minnesota Statutes 2002, section 393.07, 
406.22  subdivision 5, is amended to read: 
406.23     Subd. 5.  [COMPLIANCE WITH FEDERAL SOCIAL SECURITY ACT; 
406.24  MERIT SYSTEM.] The commissioner of human services shall have 
406.25  authority to require such methods of administration as are 
406.26  necessary for compliance with requirements of the federal Social 
406.27  Security Act, as amended, and for the proper and efficient 
406.28  operation of all welfare programs.  This authority to require 
406.29  methods of administration includes methods relating to the 
406.30  establishment and maintenance of personnel standards on a merit 
406.31  basis as concerns all employees of local social services 
406.32  agencies except those employed in an institution, sanitarium, or 
406.33  hospital.  The commissioner of human services shall exercise no 
406.34  authority with respect to the selection, tenure of office, and 
406.35  compensation of any individual employed in accordance with such 
406.36  methods.  The adoption of methods relating to the establishment 
407.1   and maintenance of personnel standards on a merit basis of all 
407.2   such employees of the local social services agencies and the 
407.3   examination thereof, and the administration thereof shall be 
407.4   directed and controlled exclusively by the commissioner of human 
407.5   services. 
407.6      Notwithstanding the provisions of any other law to the 
407.7   contrary, every employee of every local social services agency 
407.8   who occupies a position which requires as prerequisite to 
407.9   eligibility therefor graduation from an accredited four year 
407.10  college or a certificate of registration as a registered nurse 
407.11  under section 148.231, must be employed in such position under 
407.12  the merit system established under authority of this 
407.13  subdivision.  Every such employee now employed by a local social 
407.14  services agency and who is not under said merit system is 
407.15  transferred, as of January 1, 1962, to a position of comparable 
407.16  classification in the merit system with the same status therein 
407.17  as the employee had in the county of employment prior thereto 
407.18  and every such employee shall be subject to and have the benefit 
407.19  of the merit system, including seniority within the local social 
407.20  services agency, as though the employee had served thereunder 
407.21  from the date of entry into the service of the local social 
407.22  services agency. 
407.23     ~~By March 1, 1996, the commissioner of human services shall~~ 
407.24  ~~report to the chair of the senate health care and family~~ 
407.25  ~~services finance division and the chair of the house health and~~ 
407.26  ~~human services finance division on options for the delivery of~~ 
407.27  ~~merit-based employment services by entities other than the~~ 
407.28  ~~department of human services in order to reduce the~~ 
407.29  ~~administrative costs to the state while maintaining compliance~~ 
407.30  ~~with applicable federal regulations.~~ 
407.31     Sec. 57.  Minnesota Statutes 2002, section 518.167, 
407.32  subdivision 1, is amended to read: 
407.33     Subdivision 1.  [COURT ORDER.] In contested custody 
407.34  proceedings, and in other custody proceedings if a parent or the 
407.35  child's custodian requests, the court may order an investigation 
407.36  and report concerning custodial arrangements for the child.  If 
408.1   the county elects to conduct an investigation, the county may 
408.2   charge a fee.  The investigation and report may be made by the 
408.3   county welfare agency or department of court services. 
408.4      Sec. 58.  Minnesota Statutes 2002, section 518.551, 
408.5   subdivision 7, is amended to read: 
408.6      Subd. 7.  [~~SERVICE FEE~~ FEES AND COST RECOVERY FEES FOR IV-D 
408.7   SERVICES.] ~~When the public agency responsible for child support~~ 
408.8   ~~enforcement provides child support collection services either to~~ 
408.9   ~~a public assistance recipient or to a party who does not receive~~ 
408.10  ~~public assistance, the public agency may upon written notice to~~ 
408.11  ~~the obligor charge a monthly collection fee equivalent to the~~ 
408.12  ~~full monthly cost to the county of providing collection~~ 
408.13  ~~services, in addition to the amount of the child support which~~ 
408.14  ~~was ordered by the court.  The fee shall be deposited in the~~ 
408.15  ~~county general fund.  The service fee assessed is limited to ten~~ 
408.16  ~~percent of the monthly court ordered child support and shall not~~ 
408.17  ~~be assessed to obligors who are current in payment of the~~ 
408.18  ~~monthly court ordered child support.~~ (a) When a recipient of 
408.19  IV-D services is no longer receiving assistance under the 
408.20  state's title IV-A, IV-E foster care, medical assistance, or 
408.21  MinnesotaCare programs, the public authority responsible for 
408.22  child support enforcement must notify the recipient, within five 
408.23  working days of the notification of ineligibility, that IV-D 
408.24  services will be continued unless the public authority is 
408.25  notified to the contrary by the recipient.  The notice must 
408.26  include the implications of continuing to receive IV-D services, 
408.27  including the available services and fees, cost recovery fees, 
408.28  and distribution policies relating to fees. 
408.29     (b) An application fee of $25 shall be paid by the person 
408.30  who applies for child support and maintenance collection 
408.31  services, except persons who are receiving public assistance as 
408.32  defined in section 256.741 and, if enacted, the diversionary 
408.33  work program under section 256J.95, persons who transfer from 
408.34  public assistance to nonpublic assistance status, and minor 
408.35  parents and parents enrolled in a public secondary school, area 
408.36  learning center, or alternative learning program approved by the 
409.1   commissioner of children, families, and learning.  
409.2      (c) When the public authority provides full IV-D services 
409.3   to an obligee who has applied for those services, upon written 
409.4   notice to the obligee, the public authority must charge a cost 
409.5   recovery fee of one percent of the amount collected.  This fee 
409.6   must be deducted from the amount of the child support and 
409.7   maintenance collected and not assigned under section 256.741, 
409.8   before disbursement to the obligee.  This fee does not apply to 
409.9   an obligee who: 
409.10     (1) is currently receiving assistance under the state's 
409.11  title IV-A, IV-E foster care, medical assistance, or 
409.12  MinnesotaCare programs; or 
409.13     (2) has received assistance under the state's title IV-A or 
409.14  IV-E foster care programs, until the person has not received 
409.15  this assistance for 24 consecutive months.  
409.16     (d) When the public authority provides full IV-D services 
409.17  to an obligor who has applied for such services, upon written 
409.18  notice to the obligor, the public authority must charge a cost 
409.19  recovery fee of one percent of the monthly court ordered child 
409.20  support and maintenance obligation.  The fee may be collected 
409.21  through income withholding, as well as by any other enforcement 
409.22  remedy available to the public authority responsible for child 
409.23  support enforcement. 
409.24     (e) Fees assessed by state and federal tax agencies for 
409.25  collection of overdue support owed to or on behalf of a person 
409.26  not receiving public assistance must be imposed on the person 
409.27  for whom these services are provided.  The public authority upon 
409.28  written notice to the obligee shall assess a fee of $25 to the 
409.29  person not receiving public assistance for each successful 
409.30  federal tax interception.  The fee must be withheld prior to the 
409.31  release of the funds received from each interception and 
409.32  deposited in the general fund. 
409.33     (f) Cost recovery fees collected under paragraphs (c) and 
409.34  (d) shall be considered child support program income according 
409.35  to Code of Federal Regulations, title 45, section 304.50, and 
409.36  shall be deposited in the cost recovery fee account established 
410.1   under paragraph (h).  The commissioner of human services must 
410.2   elect to recover costs based on either actual or standardized 
410.3   costs. 
410.4      ~~However,~~ (g) The limitations of this subdivision on the 
410.5   assessment of fees shall not apply to the extent inconsistent 
410.6   with the requirements of federal law for receiving funds for the 
410.7   programs under Title IV-A and Title IV-D of the Social Security 
410.8   Act, United States Code, title 42, sections 601 to 613 and 
410.9   United States Code, title 42, sections 651 to 662.  
410.10     (h) The commissioner of human services is authorized to 
410.11  establish a special revenue fund account to receive child 
410.12  support cost recovery fees.  A portion of the nonfederal share 
410.13  of these fees may be retained for expenditures necessary to 
410.14  administer the fee, and must be transferred to the child support 
410.15  system special revenue account.  The remaining nonfederal share 
410.16  of the cost recovery fee must be retained by the commissioner 
410.17  and dedicated to the child support general fund county 
410.18  performance based grant account authorized under sections 
410.19  256.979 and 256.9791. 
410.20     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004, 
410.21  except paragraph (d) is effective July 1, 2005. 
410.22     Sec. 59.  Minnesota Statutes 2002, section 518.6111, 
410.23  subdivision 2, is amended to read: 
410.24     Subd. 2.  [APPLICATION.] This section applies to all 
410.25  support orders issued by a court or an administrative tribunal 
410.26  and orders for or notices of withholding issued by the public 
410.27  authority ~~according to section 518.5513, subdivision 5,~~ 
410.28  ~~paragraph (a), clause (5)~~. 
410.29     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
410.30     Sec. 60.  Minnesota Statutes 2002, section 518.6111, 
410.31  subdivision 3, is amended to read: 
410.32     Subd. 3.  [ORDER.] Every support order must address income 
410.33  withholding.  Whenever a support order is initially entered or 
410.34  modified, the full amount of the support order must be 
410.35  ~~withheld~~ subject to income withholding from the income of the 
410.36  obligor.  If the obligee or obligor applies for either full IV-D 
411.1   services or for income withholding only services from the public 
411.2   authority responsible for child support enforcement, the full 
411.3   amount of the support order must be withheld from the income of 
411.4   the obligor and forwarded to the public authority.  Every order 
411.5   for support or maintenance shall provide for a conspicuous 
411.6   notice of the provisions of this section that complies with 
411.7   section 518.68, subdivision 2.  An order without this notice 
411.8   remains subject to this section.  This section applies 
411.9   regardless of the source of income of the person obligated to 
411.10  pay the support or maintenance. 
411.11     A payor of funds shall implement income withholding 
411.12  according to this section upon receipt of an order for or notice 
411.13  of withholding.  The notice of withholding shall be on a form 
411.14  provided by the commissioner of human services. 
411.15     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
411.16     Sec. 61.  Minnesota Statutes 2002, section 518.6111, 
411.17  subdivision 4, is amended to read: 
411.18     Subd. 4.  [COLLECTION SERVICES.] (a) The commissioner of 
411.19  human services shall prepare and make available to the courts a 
411.20  notice of services that explains child support and maintenance 
411.21  collection services available through the public authority, 
411.22  including income withholding, and the fees for such services.  
411.23  Upon receiving a petition for dissolution of marriage or legal 
411.24  separation, the court administrator shall promptly send the 
411.25  notice of services to the petitioner and respondent at the 
411.26  addresses stated in the petition. 
411.27     (b) Either the obligee or obligor may at any time apply to 
411.28  the public authority for either full IV-D services or for income 
411.29  withholding only services. 
411.30     ~~Upon receipt of a support order requiring income~~ 
411.31  ~~withholding, a petitioner or respondent, who is not a recipient~~ 
411.32  ~~of public assistance and does not receive child support services~~ 
411.33  ~~from the public authority, shall apply to the public authority~~ 
411.34  ~~for either full child support collection services or for income~~ 
411.35  ~~withholding only services.~~ 
411.36     (c) For those persons applying for income withholding only 
412.1   services, a monthly service fee of $15 must be charged to the 
412.2   obligor.  This fee is in addition to the amount of the support 
412.3   order and shall be withheld through income withholding.  The 
412.4   public authority shall explain the service options in this 
412.5   section to the affected parties and encourage the application 
412.6   for full child support collection services. 
412.7      (d) If the obligee is not a current recipient of public 
412.8   assistance as defined in section 256.741, the person who applied 
412.9   for services may at any time choose to terminate either full 
412.10  IV-D services or income withholding only services regardless of 
412.11  whether income withholding is currently in place.  The obligee 
412.12  or obligor may reapply for either full IV-D services or income 
412.13  withholding only services at any time.  Unless the applicant is 
412.14  a recipient of public assistance as defined in section 256.741, 
412.15  a $25 application fee shall be charged at the time of each 
412.16  application.  
412.17     (e) When a person terminates IV-D services, if an arrearage 
412.18  for public assistance as defined in section 256.741 exists, the 
412.19  public authority may continue income withholding, as well as use 
412.20  any other enforcement remedy for the collection of child 
412.21  support, until all public assistance arrears are paid in full.  
412.22  Income withholding shall be in an amount equal to 20 percent of 
412.23  the support order in effect at the time the services terminated. 
412.24     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
412.25     Sec. 62.  Minnesota Statutes 2002, section 518.6111, 
412.26  subdivision 16, is amended to read: 
412.27     Subd. 16.  [WAIVER.] (a) If the public authority is 
412.28  providing child support and maintenance enforcement services and 
412.29  child support or maintenance is not assigned under section 
412.30  256.741, the court may waive the requirements of this section if 
412.31  ~~the court finds there is no arrearage in child support and~~ 
412.32  ~~maintenance as of the date of the hearing and~~: 
412.33     (1) one party demonstrates and the court ~~finds~~ determines 
412.34  there is good cause to waive the requirements of this section or 
412.35  to terminate an order for or notice of income withholding 
412.36  previously entered under this section.  The court must make 
413.1   written findings to include the reasons income withholding would 
413.2   not be in the best interests of the child.  In cases involving a 
413.3   modification of support, the court must also make a finding that 
413.4   support payments have been timely made; or 
413.5      (2) ~~all parties reach an~~ the obligee and obligor sign a 
413.6   written agreement ~~and the agreement~~ providing for an alternative 
413.7   payment arrangement which is ~~approved~~ reviewed and entered in 
413.8   the record by the court ~~after a finding that the agreement is~~ 
413.9   ~~likely to result in regular and timely payments.  The court's~~ 
413.10  ~~findings waiving the requirements of this paragraph shall~~ 
413.11  ~~include a written explanation of the reasons why income~~ 
413.12  ~~withholding would not be in the best interests of the child~~. 
413.13     ~~In addition to the other requirements in this subdivision,~~ 
413.14  ~~if the case involves a modification of support, the court shall~~ 
413.15  ~~make a finding that support has been timely made.~~ 
413.16     (b) If the public authority is not providing child support 
413.17  and maintenance enforcement services and child support or 
413.18  maintenance is not assigned under section 256.741, the court may 
413.19  waive the requirements of this section if the parties sign a 
413.20  written agreement.  
413.21     (c) If the court waives income withholding, the obligee or 
413.22  obligor may at any time request income withholding under 
413.23  subdivision 7. 
413.24     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
413.25     Sec. 63.  [STATE-OPERATED SERVICES STUDY.] 
413.26     The commissioner of human services shall study the services 
413.27  provided to persons with developmental disabilities who have 
413.28  complex care needs.  The commissioner shall analyze: 
413.29     (1) the needs of the target population; 
413.30     (2) the methods of providing services to the target 
413.31  population; 
413.32     (3) the costs and cost-effectiveness of providing services 
413.33  to the target population; 
413.34     (4) factors that encourage and inhibit vendors, including 
413.35  state-operated community services (SOCS), to provide services to 
413.36  the target population; 
414.1      (5) alternative populations that could be served by 
414.2   state-operated residential facilities; and 
414.3      (6) the population served by Minnesota extended treatment 
414.4   options and the cost-effectiveness of these services.  
414.5      The commissioner shall report on the results of the study 
414.6   under this section to the chairs of the house and senate 
414.7   committees with jurisdiction over state-operated services by 
414.8   January 15, 2004. 
414.9      Sec. 64.  [STATE-OPERATED SERVICES REFINANCING STRATEGY.] 
414.10     Subdivision 1.  [REDESIGN OF MENTAL HEALTH SAFETY NET.] (a) 
414.11  Pursuant to Minnesota Statutes, sections 246.0135, 251.011, and 
414.12  251.013, the commissioner of human services must seek specific 
414.13  legislative authorization to close any regional treatment center 
414.14  or state-operated nursing home or any program at a regional 
414.15  treatment center or state-operated nursing home. 
414.16     (b) In developing and seeking legislative authorization for 
414.17  any proposals to restructure state-operated services under this 
414.18  subdivision, the commissioner must consider: 
414.19     (1) the needs and preferences of the individuals served by 
414.20  affected state-operated services programs and their families; 
414.21     (2) the location of necessary support services, as 
414.22  identified in the service or treatment plans of individuals 
414.23  served by affected state-operated services programs; 
414.24     (3) the appropriate grouping of individuals served by a 
414.25  community-based state-operated services program; 
414.26     (4) the availability of qualified staff to provide services 
414.27  in community-based state-operated services programs; 
414.28     (5) the need for state-operated services programs in 
414.29  certain geographical regions in the state; and 
414.30     (6) whether commuting distance to the program for staff and 
414.31  families is reasonable. 
414.32     (c) The commissioner's proposals to close a regional 
414.33  treatment center, state-operated nursing home or program 
414.34  operated by a regional treatment center or state-operated 
414.35  nursing home under this subdivision must not result in a net 
414.36  reduction in the total number of services in any catchment area 
415.1   in the state and must ensure that any new community-based 
415.2   programs are located in areas that are convenient to the 
415.3   individuals receiving services and their families. 
415.4      (d) Legislative authorization as required by Minnesota 
415.5   Statutes, sections 246.0135, 251.011, and 251.013, shall mean 
415.6   language specifically authorizing the commissioner's proposals, 
415.7   the authorization to transfer land on which a regional treatment 
415.8   center is located to a nonstate entity, or the authorization to 
415.9   demolish buildings in which programs are or were housed. 
415.10     Subd. 2.  [REDEVELOPMENT PLAN.] (a) In closing any regional 
415.11  treatment center or state-operated nursing home, the 
415.12  commissioner shall develop or aid in the development of a 
415.13  comprehensive redevelopment plan for any facilities or land 
415.14  vacated as a result of the proposal in consultation with the 
415.15  local governmental entity in the jurisdiction in which the 
415.16  facility is located.  If a local government entity cannot be 
415.17  secured for facility redevelopment, then the commissioner shall 
415.18  develop the plan in collaboration with affected communities.  
415.19  The plan must include specific information on the redevelopment 
415.20  of the affected facilities or land, specific information about 
415.21  the implementation schedule for the plan, proposed legislation, 
415.22  and letters of commitment regarding the reuse and redevelopment 
415.23  of the facilities or land vacated as a result of the proposal. 
415.24     (b) The commissioner shall not implement a redevelopment 
415.25  plan under this subdivision until a local governmental entity in 
415.26  which any regional treatment center is located that is affected 
415.27  by the commissioner's redevelopment plan approves the plan. 
415.28     Subd. 3.  [STAFFING.] When closing or restructuring a 
415.29  regional treatment center or state-operated nursing home or a 
415.30  program at a regional treatment center or state-operated nursing 
415.31  home, the commissioner shall comply with the provisions of the 
415.32  applicable collective bargaining agreements or future negotiated 
415.33  agreements, and the agreement authorized under Minnesota 
415.34  Statutes, section 252.50, subdivision 11. 
415.35     Subd. 4.  [STATE-OPERATED SERVICES COSTS.] (a) Programs 
415.36  that remain at a regional treatment center campus during and 
416.1   after the restructuring of state-operated services shall not be 
416.2   assessed any disproportional increase in fees, charges, or other 
416.3   costs associated with operating and maintaining the campus.  
416.4   Increased costs associated with inflation are permissible. 
416.5      (b) There shall be no increase in the county share of the 
416.6   cost of care provided in state-operated services without 
416.7   legislative authority. 
416.8      Subd. 5.  [REQUEST FOR FEDERAL WAIVER.] By January 1, 2004, 
416.9   the commissioner of human services shall apply to the federal 
416.10  government for a waiver from Medicaid requirements to permit 
416.11  medical assistance coverage for: 
416.12     (1) mental health treatment services provided by an 
416.13  existing program located at a regional treatment center with a 
416.14  capacity of more than 15 beds; and 
416.15     (2) mental health treatment services provided by a new 
416.16  program at a facility with a capacity of more than 15 beds. 
416.17     Sec. 65.  [FEDERAL GRANTS TO MAINTAIN INDEPENDENCE AND 
416.18  EMPLOYMENT.] 
416.19     (a) The commissioner of human services shall seek federal 
416.20  funding to participate in grant activities authorized under 
416.21  Public Law 106-170, the Ticket to Work and Work Incentives 
416.22  Improvement Act of 1999.  The purpose of the federal grant funds 
416.23  are to establish: 
416.24     (1) a demonstration project to improve the availability of 
416.25  health care services and benefits to workers with potentially 
416.26  severe physical or mental impairments that are likely to lead to 
416.27  disability without access to Medicaid services; and 
416.28     (2) a comprehensive initiative to remove employment 
416.29  barriers that includes linkages with non-Medicaid programs, 
416.30  including those administered by the Social Security 
416.31  Administration and the Department of Labor. 
416.32     (b) The state's proposal for a demonstration project in 
416.33  paragraph (a), clause (1), shall focus on assisting workers with:
416.34     (1) a serious mental illness as defined by the federal 
416.35  Center for Mental Health Services; 
416.36     (2) concurrent mental health and chemical dependency 
417.1   conditions; and 
417.2      (3) young adults up to the age of 24 who have a physical or 
417.3   mental impairment that is severe and will potentially lead to a 
417.4   determination of disability by the Social Security 
417.5   Administration or state medical review team. 
417.6      (c) The commissioner is authorized to take the actions 
417.7   necessary to design and implement the demonstration project in 
417.8   paragraph (a), clause (1), that include: 
417.9      (1) establishing work-related requirements for 
417.10  participation in the demonstration project; 
417.11     (2) working with stakeholders to establish methods that 
417.12  identify the population that will be served in the demonstration 
417.13  project; 
417.14     (3) seeking funding for activities to design, implement, 
417.15  and evaluate the demonstration project; 
417.16     (4) taking necessary administrative actions to implement 
417.17  the demonstration project by July 1, 2004, or within 180 days of 
417.18  receiving formal notice from the Centers for Medicare and 
417.19  Medicaid Services that a grant has been awarded; 
417.20     (5) establishing limits on income and resources; 
417.21     (6) establishing a method to coordinate health care 
417.22  benefits and payments with other coverage that is available to 
417.23  the participants; 
417.24     (7) establishing premiums based on guidelines that are 
417.25  consistent with those found in Minnesota Statutes, section 
417.26  256B.057, subdivision 9, for employed persons with disabilities; 
417.27     (8) notifying local agencies of potentially eligible 
417.28  individuals in accordance with Minnesota Statutes, section 
417.29  256B.19, subdivision 2c; and 
417.30     (9) limiting the caseload of qualifying individuals 
417.31  participating in the demonstration project. 
417.32     (d) The state's proposal for the comprehensive employment 
417.33  initiative in paragraph (a), clause (2), shall focus on: 
417.34     (1) infrastructure development that creates incentives for 
417.35  greater work effort and participation by people with 
417.36  disabilities or workers with severe physical or mental 
418.1   impairments; 
418.2      (2) consumer access to information and benefit assistance 
418.3   that enables the person to maximize employment and career 
418.4   advancement potential; 
418.5      (3) improved consumer access to essential assistance and 
418.6   support; 
418.7      (4) enhanced linkages between state and federal agencies to 
418.8   decrease the barriers to employment experienced by persons with 
418.9   disabilities or workers with severe physical or mental 
418.10  impairments; and 
418.11     (5) research efforts to provide useful information to guide 
418.12  future policy development on both the state and federal levels. 
418.13     (e) Funds awarded by the federal government for the 
418.14  purposes of this section are appropriated to the commissioner of 
418.15  human services. 
418.16     (f) The commissioner shall report to the chairs of the 
418.17  senate and house of representatives finance divisions having 
418.18  jurisdiction over health care issues on the federal approval of 
418.19  the waiver under this section and the projected savings in the 
418.20  November and February forecasts. 
418.21     The commissioner must consider using the savings to 
418.22  increase GAMC hospital rates to the July 1, 2003, levels as a 
418.23  supplemental budget proposal in the 2004 legislative session. 
418.24     Sec. 66.  [CONVEYANCE OF SURPLUS STATE LAND; CASS COUNTY.] 
418.25     (a) Notwithstanding Minnesota Statutes, chapter 94, or 
418.26  other law, administrative rule, or commissioner's order to the 
418.27  contrary, the commissioner of administration may convey to Cass 
418.28  county or a regional jail authority for no consideration all the 
418.29  buildings and land that are described in paragraph (c), except 
418.30  the land described in paragraph (d). 
418.31     (b) The conveyance shall be in a form approved by the 
418.32  attorney general and subject to Minnesota Statutes, section 
418.33  16A.695.  The commissioner of administration shall have a 
418.34  registered land surveyor prepare a legal description of the 
418.35  property to be conveyed.  The attorney general may make 
418.36  necessary changes in the legal description to correct errors and 
419.1   ensure accuracy. 
419.2      (c) The land and buildings of the Ah-Gwah-Ching property 
419.3   that may be conveyed to Cass county or a regional jail authority 
419.4   are located in that part of the South Half, Section 35, Township 
419.5   142 North, Range 31 West and that part of Government Lot 6, 
419.6   Section 2, Township 141 North, Range 31 West, in Cass county, 
419.7   depicted on the certificate of survey prepared by Landecker and 
419.8   Associates, Inc. dated April 25, 2002.  The land described in 
419.9   paragraph (d) is excepted from the conveyance. 
419.10     (d) That portion of the Ah-Gwah-Ching property to be 
419.11  excepted from the conveyance to Cass county or a regional jail 
419.12  authority is the land located between the shoreline and the top 
419.13  of the bluff line and is approximately described as follows: 
419.14     (1) all that part of the Southeast Quarter of Southwest 
419.15  Quarter, Section 35, Township 142 North, Range 31 West, lying 
419.16  southeasterly of a line that lies 450 feet southeasterly of and 
419.17  parallel with Minnesota Highway No. 290; 
419.18     (2) Government Lot 4, Section 35, Township 142 North, Range 
419.19  31 West; 
419.20     (3) that part of Government Lot 3, Section 35, Township 142 
419.21  North, Range 31 West, lying southerly of Minnesota Highway No. 
419.22  290 and westerly of Minnesota Highway No. 371; and 
419.23     (4) that part of Government Lot 6, Section 2, Township 141 
419.24  North, Range 31 West, lying southeasterly of the 1,410 foot 
419.25  contour. 
419.26  The commissioner of administration shall determine the exact 
419.27  legal description upon further site analysis and the preparation 
419.28  of the surveyor's legal description described in paragraph (b). 
419.29     (e) Notwithstanding anything herein to the contrary, a 
419.30  conveyance under this section to Cass county or a regional jail 
419.31  authority may include a conveyance by a bill of sale of the 
419.32  water treatment facilities located within the land described in 
419.33  paragraph (d) and a nonexclusive appurtenant easement for such 
419.34  facilities over the land upon which such facilities are located, 
419.35  including ingress and egress as determined by the commissioner.  
419.36  The easement shall be in a form approved by the attorney general.
420.1      (f) At the option of the state, Cass county or the regional 
420.2   jail authority must, for a period of at least two years, allow 
420.3   the state to lease the space necessary to operate its programs 
420.4   for the cost of utilities for the leased space.  During the term 
420.5   of the lease, the state shall be responsible for any and all 
420.6   maintenance and repairs the state determines are necessary for 
420.7   its use of the leased space. 
420.8      Sec. 67.  [REVISOR'S INSTRUCTION.] 
420.9      For sections in Minnesota Statutes and Minnesota Rules 
420.10  affected by the repealed sections in this article, the revisor 
420.11  shall delete internal cross-references where appropriate and 
420.12  make changes necessary to correct the punctuation, grammar, or 
420.13  structure of the remaining text and preserve its meaning. 
420.14     Sec. 68.  [REPEALER.] 
420.15     (a) Minnesota Statutes 2002, sections 246.017, subdivision 
420.16  2; 246.022; 246.06; 246.07; 246.08; 246.11; 246.19; 246.42; 
420.17  252.025, subdivisions 1, 2, 4, 5, and 6; 252.032; 252.10; 
420.18  253.015, subdivisions 2 and 3; 253.10; 253.19; 253.201; 253.202; 
420.19  253.25; 253.27; 256.05; 256.06; 256.08; 256.09; 256.10; and 
420.20  268A.08, are repealed. 
420.21     (b) Minnesota Rules, parts 9545.2000; 9545.2010; 9545.2020; 
420.22  9545.2030; and 9545.2040, are repealed. 
420.23                             ARTICLE 7 
420.24                        HEALTH MISCELLANEOUS 
420.25     Section 1.  Minnesota Statutes 2002, section 41A.09, 
420.26  subdivision 2a, is amended to read: 
420.27     Subd. 2a.  [DEFINITIONS.] For the purposes of this section, 
420.28  the terms defined in this subdivision have the meanings given 
420.29  them. 
420.30     (a) "Ethanol" means fermentation ethyl alcohol derived from 
420.31  agricultural products, including potatoes, cereal, grains, 
420.32  cheese whey, and sugar beets; forest products; or other 
420.33  renewable resources, including residue and waste generated from 
420.34  the production, processing, and marketing of agricultural 
420.35  products, forest products, and other renewable resources, that: 
420.36     (1) meets all of the specifications in ASTM specification ~~D~~ 
421.1   ~~4806-88~~ D4806-01; and 
421.2      (2) is denatured as specified in Code of Federal 
421.3   Regulations, title 27, parts 20 and 21. 
421.4      (b) "Wet alcohol" means agriculturally derived fermentation 
421.5   ethyl alcohol having a purity of at least 50 percent but less 
421.6   than 99 percent. 
421.7      (c) "Anhydrous alcohol" means fermentation ethyl alcohol 
421.8   derived from agricultural products as described in paragraph 
421.9   (a), but that does not meet ASTM specifications or is not 
421.10  denatured and is shipped in bond for further processing. 
421.11     (d) "Ethanol plant" means a plant at which ethanol, 
421.12  anhydrous alcohol, or wet alcohol is produced. 
421.13     Sec. 2.  Minnesota Statutes 2002, section 62A.31, 
421.14  subdivision 1f, is amended to read: 
421.15     Subd. 1f.  [SUSPENSION BASED ON ENTITLEMENT TO MEDICAL 
421.16  ASSISTANCE.] (a) The policy or certificate must provide that 
421.17  benefits and premiums under the policy or certificate shall be 
421.18  suspended for any period that may be provided by federal 
421.19  regulation at the request of the policyholder or certificate 
421.20  holder for the period, not to exceed 24 months, in which the 
421.21  policyholder or certificate holder has applied for and is 
421.22  determined to be entitled to medical assistance under title XIX 
421.23  of the Social Security Act, but only if the policyholder or 
421.24  certificate holder notifies the issuer of the policy or 
421.25  certificate within 90 days after the date the individual becomes 
421.26  entitled to this assistance. 
421.27     (b) If suspension occurs and if the policyholder or 
421.28  certificate holder loses entitlement to this medical assistance, 
421.29  the policy or certificate shall be automatically reinstated, 
421.30  effective as of the date of termination of this entitlement, if 
421.31  the policyholder or certificate holder provides notice of loss 
421.32  of the entitlement within 90 days after the date of the loss and 
421.33  pays the premium attributable to the period, effective as of the 
421.34  date of termination of entitlement. 
421.35     (c) The policy must provide that upon reinstatement (1) 
421.36  there is no additional waiting period with respect to treatment 
422.1   of preexisting conditions, (2) coverage is provided which is 
422.2   substantially equivalent to coverage in effect before the date 
422.3   of the suspension, and (3) premiums are classified on terms that 
422.4   are at least as favorable to the policyholder or certificate 
422.5   holder as the premium classification terms that would have 
422.6   applied to the policyholder or certificate holder had coverage 
422.7   not been suspended. 
422.8      Sec. 3.  Minnesota Statutes 2002, section 62A.31, 
422.9   subdivision 1u, is amended to read: 
422.10     Subd. 1u.  [GUARANTEED ISSUE FOR ELIGIBLE PERSONS.] (a)(1) 
422.11  Eligible persons are those individuals described in paragraph 
422.12  (b) who ~~apply to enroll under the Medicare supplement policy not~~ 
422.13  ~~later than 63 days after the date of the termination of~~ 
422.14  ~~enrollment described in paragraph (b),~~ seek to enroll under the 
422.15  policy during the period specified in paragraph (c), and who 
422.16  submit evidence of the date of termination or disenrollment with 
422.17  the application for a Medicare supplement policy. 
422.18     (2) With respect to eligible persons, an issuer shall not:  
422.19  deny or condition the issuance or effectiveness of a Medicare 
422.20  supplement policy described in paragraph (c) that is offered and 
422.21  is available for issuance to new enrollees by the issuer; 
422.22  discriminate in the pricing of such a Medicare supplement policy 
422.23  because of health status, claims experience, receipt of health 
422.24  care, medical condition, or age; or impose an exclusion of 
422.25  benefits based upon a preexisting condition under such a 
422.26  Medicare supplement policy. 
422.27     (b) An eligible person is an individual described in any of 
422.28  the following: 
422.29     (1) the individual is enrolled under an employee welfare 
422.30  benefit plan that provides health benefits that supplement the 
422.31  benefits under Medicare; and the plan terminates, or the plan 
422.32  ceases to provide all such supplemental health benefits to the 
422.33  individual; 
422.34     (2) the individual is enrolled with a Medicare+Choice 
422.35  organization under a Medicare+Choice plan under Medicare part C, 
422.36  and any of the following circumstances apply, or the individual 
423.1   is 65 years of age or older and is enrolled with a Program of 
423.2   All-Inclusive Care for the Elderly (PACE) provider under section 
423.3   1894 of the federal Social Security Act, and there are 
423.4   circumstances similar to those described in this clause that 
423.5   would permit discontinuance of the individual's enrollment with 
423.6   the provider if the individual were enrolled in a 
423.7   Medicare+Choice plan: 
423.8      (i) the organization's or plan's certification under 
423.9   Medicare part C has been terminated or the organization has 
423.10  terminated or otherwise discontinued providing the plan in the 
423.11  area in which the individual resides; 
423.12     (ii) the individual is no longer eligible to elect the plan 
423.13  because of a change in the individual's place of residence or 
423.14  other change in circumstances specified by the secretary, but 
423.15  not including termination of the individual's enrollment on the 
423.16  basis described in section 1851(g)(3)(B) of the federal Social 
423.17  Security Act, United States Code, title 42, section 
423.18  1395w-21(g)(3)(b) (where the individual has not paid premiums on 
423.19  a timely basis or has engaged in disruptive behavior as 
423.20  specified in standards under section 1856 of the federal Social 
423.21  Security Act, United States Code, title 42, section 1395w-26), 
423.22  or the plan is terminated for all individuals within a residence 
423.23  area; 
423.24     (iii) the individual demonstrates, in accordance with 
423.25  guidelines established by the Secretary, that: 
423.26     (A) the organization offering the plan substantially 
423.27  violated a material provision of the organization's contract in 
423.28  relation to the individual, including the failure to provide an 
423.29  enrollee on a timely basis medically necessary care for which 
423.30  benefits are available under the plan or the failure to provide 
423.31  such covered care in accordance with applicable quality 
423.32  standards; or 
423.33     (B) the organization, or agent or other entity acting on 
423.34  the organization's behalf, materially misrepresented the plan's 
423.35  provisions in marketing the plan to the individual; or 
423.36     (iv) the individual meets such other exceptional conditions 
424.1   as the secretary may provide; 
424.2      (3)(i) the individual is enrolled with: 
424.3      (A) an eligible organization under a contract under section 
424.4   1876 of the federal Social Security Act, United States Code, 
424.5   title 42, section 1395mm (Medicare ~~risk or~~ cost); 
424.6      (B) a similar organization operating under demonstration 
424.7   project authority, effective for periods before April 1, 1999; 
424.8      (C) an organization under an agreement under section 
424.9   1833(a)(1)(A) of the federal Social Security Act, United States 
424.10  Code, title 42, section 1395l(a)(1)(A) (health care prepayment 
424.11  plan); or 
424.12     (D) an organization under a Medicare Select policy under 
424.13  section 62A.318 or the similar law of another state; and 
424.14     (ii) the enrollment ceases under the same circumstances 
424.15  that would permit discontinuance of an individual's election of 
424.16  coverage under clause (2); 
424.17     (4) the individual is enrolled under a Medicare supplement 
424.18  policy, and the enrollment ceases because: 
424.19     (i)(A) of the insolvency of the issuer or bankruptcy of the 
424.20  nonissuer organization; or 
424.21     (B) of other involuntary termination of coverage or 
424.22  enrollment under the policy; 
424.23     (ii) the issuer of the policy substantially violated a 
424.24  material provision of the policy; or 
424.25     (iii) the issuer, or an agent or other entity acting on the 
424.26  issuer's behalf, materially misrepresented the policy's 
424.27  provisions in marketing the policy to the individual; 
424.28     (5)(i) the individual was enrolled under a Medicare 
424.29  supplement policy and terminates that enrollment and 
424.30  subsequently enrolls, for the first time, with any 
424.31  Medicare+Choice organization under a Medicare+Choice plan under 
424.32  Medicare part C; any eligible organization under a contract 
424.33  under section 1876 of the federal Social Security Act, United 
424.34  States Code, title 42, section 1395mm (Medicare ~~risk or~~ cost); 
424.35  any similar organization operating under demonstration project 
424.36  authority; ~~an organization under an agreement under section~~ 
425.1   ~~1833(a)(1)(A) of the federal Social Security Act, United States~~ 
425.2   ~~Code, title 42, section 1395l(a)(1)(A) (health care prepayment~~ 
425.3   ~~plan);~~ any PACE provider under section 1894 of the federal 
425.4   Social Security Act, or a Medicare Select policy under section 
425.5   62A.318 or the similar law of another state; and 
425.6      (ii) the subsequent enrollment under ~~paragraph (a)~~ item (i) 
425.7   is terminated by the enrollee during any period within the first 
425.8   12 months of ~~such~~ the subsequent enrollment during which the 
425.9   enrollee is permitted to terminate the subsequent enrollment 
425.10  under section 1851(e) of the federal Social Security Act; or 
425.11     (6) the individual, upon first enrolling for benefits under 
425.12  Medicare part B, enrolls in a Medicare+Choice plan under 
425.13  Medicare part C, or with a PACE provider under section 1894 of 
425.14  the federal Social Security Act, and disenrolls from the plan by 
425.15  not later than 12 months after the effective date of enrollment. 
425.16     (c)(1) In the case of an individual described in paragraph 
425.17  (b), clause (1), the guaranteed issue period begins on the date 
425.18  the individual receives a notice of termination or cessation of 
425.19  all supplemental health benefits or, if a notice is not 
425.20  received, notice that a claim has been denied because of a 
425.21  termination or cessation, and ends 63 days after the date of the 
425.22  applicable notice. 
425.23     (2) In the case of an individual described in paragraph 
425.24  (b), clause (2), (3), (5), or (6), whose enrollment is 
425.25  terminated involuntarily, the guaranteed issue period begins on 
425.26  the date that the individual receives a notice of termination 
425.27  and ends 63 days after the date the applicable coverage is 
425.28  terminated. 
425.29     (3) In the case of an individual described in paragraph 
425.30  (b), clause (4), item (i), the guaranteed issue period begins on 
425.31  the earlier of:  (i) the date that the individual receives a 
425.32  notice of termination, a notice of the issuer's bankruptcy or 
425.33  insolvency, or other such similar notice if any; and (ii) the 
425.34  date that the applicable coverage is terminated, and ends on the 
425.35  date that is 63 days after the date the coverage is terminated. 
425.36     (4) In the case of an individual described in paragraph 
426.1   (b), clause (2), (4), (5), or (6), who disenrolls voluntarily, 
426.2   the guaranteed issue period begins on the date that is 60 days 
426.3   before the effective date of the disenrollment and ends on the 
426.4   date that is 63 days after the effective date. 
426.5      (5) In the case of an individual described in paragraph (b) 
426.6   but not described in this paragraph, the guaranteed issue period 
426.7   begins on the effective date of disenrollment and ends on the 
426.8   date that is 63 days after the effective date. 
426.9      (d)(1) In the case of an individual described in paragraph 
426.10  (b), clause (5), or deemed to be so described, pursuant to this 
426.11  paragraph, whose enrollment with an organization or provider 
426.12  described in paragraph (b), clause (5), item (i), is 
426.13  involuntarily terminated within the first 12 months of 
426.14  enrollment, and who, without an intervening enrollment, enrolls 
426.15  with another such organization or provider, the subsequent 
426.16  enrollment is deemed to be an initial enrollment described in 
426.17  paragraph (b), clause (5). 
426.18     (2) In the case of an individual described in paragraph 
426.19  (b), clause (6), or deemed to be so described, pursuant to this 
426.20  paragraph, whose enrollment with a plan or in a program 
426.21  described in paragraph (b), clause (6), is involuntarily 
426.22  terminated within the first 12 months of enrollment, and who, 
426.23  without an intervening enrollment, enrolls in another such plan 
426.24  or program, the subsequent enrollment is deemed to be an initial 
426.25  enrollment described in paragraph (b), clause (6). 
426.26     (3) For purposes of paragraph (b), clauses (5) and (6), no 
426.27  enrollment of an individual with an organization or provider 
426.28  described in paragraph (b), clause (5), item (i), or with a plan 
426.29  or in a program described in paragraph (b), clause (6), may be 
426.30  deemed to be an initial enrollment under this paragraph after 
426.31  the two-year period beginning on the date on which the 
426.32  individual first enrolled with the organization, provider, plan, 
426.33  or program. 
426.34     (e) The Medicare supplement policy to which eligible 
426.35  persons are entitled under: 
426.36     (1) paragraph (b), clauses (1) to (4), is any Medicare 
427.1   supplement policy that has a benefit package consisting of the 
427.2   basic Medicare supplement plan described in section 62A.316, 
427.3   paragraph (a), plus any combination of the three optional riders 
427.4   described in section 62A.316, paragraph (b), clauses (1) to (3), 
427.5   offered by any issuer; 
427.6      (2) paragraph (b), clause (5), is the same Medicare 
427.7   supplement policy in which the individual was most recently 
427.8   previously enrolled, if available from the same issuer, or, if 
427.9   not so available, any policy described in clause (1) offered by 
427.10  any issuer; 
427.11     (3) paragraph (b), clause (6), shall include any Medicare 
427.12  supplement policy offered by any issuer. 
427.13     ~~(d)~~ (f)(1) At the time of an event described in paragraph 
427.14  (b), because of which an individual loses coverage or benefits 
427.15  due to the termination of a contract or agreement, policy, or 
427.16  plan, the organization that terminates the contract or 
427.17  agreement, the issuer terminating the policy, or the 
427.18  administrator of the plan being terminated, respectively, shall 
427.19  notify the individual of the individual's rights under this 
427.20  subdivision, and of the obligations of issuers of Medicare 
427.21  supplement policies under paragraph (a).  The notice must be 
427.22  communicated contemporaneously with the notification of 
427.23  termination. 
427.24     (2) At the time of an event described in paragraph (b), 
427.25  because of which an individual ceases enrollment under a 
427.26  contract or agreement, policy, or plan, the organization that 
427.27  offers the contract or agreement, regardless of the basis for 
427.28  the cessation of enrollment, the issuer offering the policy, or 
427.29  the administrator of the plan, respectively, shall notify the 
427.30  individual of the individual's rights under this subdivision, 
427.31  and of the obligations of issuers of Medicare supplement 
427.32  policies under paragraph (a).  The notice must be communicated 
427.33  within ten working days of the issuer receiving notification of 
427.34  disenrollment.  
427.35     ~~(e)~~ (g) Reference in this subdivision to a situation in 
427.36  which, or to a basis upon which, an individual's coverage has 
428.1   been terminated does not provide authority under the laws of 
428.2   this state for the termination in that situation or upon that 
428.3   basis. 
428.4      ~~(f)~~ (h) An individual's rights under this subdivision are 
428.5   in addition to, and do not modify or limit, the individual's 
428.6   rights under subdivision 1h. 
428.7      Sec. 4.  Minnesota Statutes 2002, section 62A.31, is 
428.8   amended by adding a subdivision to read: 
428.9      Subd. 7.  [MEDICARE PRESCRIPTION DRUG BENEFIT.] If Congress 
428.10  enacts legislation creating a prescription drug benefit in the 
428.11  Medicare program, nothing in this section or any other section 
428.12  shall prohibit an issuer of a Medicare supplement policy from 
428.13  offering this prescription drug benefit consistent with the 
428.14  applicable federal law or regulations.  If an issuer offers the 
428.15  federal benefit, such an offer shall be deemed to meet the 
428.16  issuer's mandatory offer obligations under this section and may, 
428.17  at the discretion of the issuer, constitute replacement coverage 
428.18  as defined in subdivision 1i for any existing policy containing 
428.19  a prescription drug benefit. 
428.20     Sec. 5.  Minnesota Statutes 2002, section 62A.315, is 
428.21  amended to read: 
428.22     62A.315 [EXTENDED BASIC MEDICARE SUPPLEMENT PLAN; 
428.23  COVERAGE.] 
428.24     The extended basic Medicare supplement plan must have a 
428.25  level of coverage so that it will be certified as a qualified 
428.26  plan pursuant to section 62E.07, and will provide: 
428.27     (1) coverage for all of the Medicare part A inpatient 
428.28  hospital deductible and coinsurance amounts, and 100 percent of 
428.29  all Medicare part A eligible expenses for hospitalization not 
428.30  covered by Medicare; 
428.31     (2) coverage for the daily copayment amount of Medicare 
428.32  part A eligible expenses for the calendar year incurred for 
428.33  skilled nursing facility care; 
428.34     (3) coverage for the ~~copayment~~ coinsurance amount or in the 
428.35  case of hospital outpatient department services paid under a 
428.36  prospective payment system, the co-payment amount, of Medicare 
429.1   eligible expenses under Medicare part B regardless of hospital 
429.2   confinement, and the Medicare part B deductible amount; 
429.3      (4) 80 percent of the usual and customary hospital and 
429.4   medical expenses and supplies described in section 62E.06, 
429.5   subdivision 1, not to exceed any charge limitation established 
429.6   by the Medicare program or state law, the usual and customary 
429.7   hospital and medical expenses and supplies, described in section 
429.8   62E.06, subdivision 1, while in a foreign country, and 
429.9   prescription drug expenses, not covered by Medicare; 
429.10     (5) coverage for the reasonable cost of the first three 
429.11  pints of blood, or equivalent quantities of packed red blood 
429.12  cells as defined under federal regulations under Medicare parts 
429.13  A and B, unless replaced in accordance with federal regulations; 
429.14     (6) 100 percent of the cost of immunizations and routine 
429.15  screening procedures for cancer, including mammograms and pap 
429.16  smears; 
429.17     (7) preventive medical care benefit:  coverage for the 
429.18  following preventive health services: 
429.19     (i) an annual clinical preventive medical history and 
429.20  physical examination that may include tests and services from 
429.21  clause (ii) and patient education to address preventive health 
429.22  care measures; 
429.23     (ii) any one or a combination of the following preventive 
429.24  screening tests or preventive services, the frequency of which 
429.25  is considered medically appropriate: 
429.26     (A) fecal occult blood test and/or digital rectal 
429.27  examination; 
429.28     (B) dipstick urinalysis for hematuria, bacteriuria, and 
429.29  proteinuria; 
429.30     (C) pure tone (air only) hearing screening test 
429.31  administered or ordered by a physician; 
429.32     (D) serum cholesterol screening every five years; 
429.33     (E) thyroid function test; 
429.34     (F) diabetes screening; 
429.35     (iii) any other tests or preventive measures determined 
429.36  appropriate by the attending physician.  
430.1      Reimbursement shall be for the actual charges up to 100 
430.2   percent of the Medicare-approved amount for each service as if 
430.3   Medicare were to cover the service as identified in American 
430.4   Medical Association current procedural terminology (AMA CPT) 
430.5   codes to a maximum of $120 annually under this benefit.  This 
430.6   benefit shall not include payment for any procedure covered by 
430.7   Medicare; 
430.8      (8) at-home recovery benefit:  coverage for services to 
430.9   provide short-term at-home assistance with activities of daily 
430.10  living for those recovering from an illness, injury, or surgery: 
430.11     (i) for purposes of this benefit, the following definitions 
430.12  shall apply: 
430.13     (A) "activities of daily living" include, but are not 
430.14  limited to, bathing, dressing, personal hygiene, transferring, 
430.15  eating, ambulating, assistance with drugs that are normally 
430.16  self-administered, and changing bandages or other dressings; 
430.17     (B) "care provider" means a duly qualified or licensed home 
430.18  health aide/homemaker, personal care aide, or nurse provided 
430.19  through a licensed home health care agency or referred by a 
430.20  licensed referral agency or licensed nurses registry; 
430.21     (C) "home" means a place used by the insured as a place of 
430.22  residence, provided that the place would qualify as a residence 
430.23  for home health care services covered by Medicare.  A hospital 
430.24  or skilled nursing facility shall not be considered the 
430.25  insured's place of residence; 
430.26     (D) "at-home recovery visit" means the period of a visit 
430.27  required to provide at-home recovery care, without limit on the 
430.28  duration of the visit, except each consecutive four hours in a 
430.29  24-hour period of services provided by a care provider is one 
430.30  visit; 
430.31     (ii) coverage requirements and limitations: 
430.32     (A) at-home recovery services provided must be primarily 
430.33  services that assist in activities of daily living; 
430.34     (B) the insured's attending physician must certify that the 
430.35  specific type and frequency of at-home recovery services are 
430.36  necessary because of a condition for which a home care plan of 
431.1   treatment was approved by Medicare; 
431.2      (C) coverage is limited to: 
431.3      (I) no more than the number and type of at-home recovery 
431.4   visits certified as medically necessary by the insured's 
431.5   attending physician.  The total number of at-home recovery 
431.6   visits shall not exceed the number of Medicare-approved home 
431.7   health care visits under a Medicare-approved home care plan of 
431.8   treatment; 
431.9      (II) the actual charges for each visit up to a maximum 
431.10  reimbursement of $40 per visit; 
431.11     (III) $1,600 per calendar year; 
431.12     (IV) seven visits in any one week; 
431.13     (V) care furnished on a visiting basis in the insured's 
431.14  home; 
431.15     (VI) services provided by a care provider as defined in 
431.16  this section; 
431.17     (VII) at-home recovery visits while the insured is covered 
431.18  under the policy or certificate and not otherwise excluded; 
431.19     (VIII) at-home recovery visits received during the period 
431.20  the insured is receiving Medicare-approved home care services or 
431.21  no more than eight weeks after the service date of the last 
431.22  Medicare-approved home health care visit; 
431.23     (iii) coverage is excluded for: 
431.24     (A) home care visits paid for by Medicare or other 
431.25  government programs; and 
431.26     (B) care provided by family members, unpaid volunteers, or 
431.27  providers who are not care providers. 
431.28     Sec. 6.  Minnesota Statutes 2002, section 62A.316, is 
431.29  amended to read: 
431.30     62A.316 [BASIC MEDICARE SUPPLEMENT PLAN; COVERAGE.] 
431.31     (a) The basic Medicare supplement plan must have a level of 
431.32  coverage that will provide: 
431.33     (1) coverage for all of the Medicare part A inpatient 
431.34  hospital coinsurance amounts, and 100 percent of all Medicare 
431.35  part A eligible expenses for hospitalization not covered by 
431.36  Medicare, after satisfying the Medicare part A deductible; 
432.1      (2) coverage for the daily copayment amount of Medicare 
432.2   part A eligible expenses for the calendar year incurred for 
432.3   skilled nursing facility care; 
432.4      (3) coverage for the ~~copayment~~ coinsurance amount, or in 
432.5   the case of outpatient department services paid under a 
432.6   prospective payment system, the co-payment amount, of Medicare 
432.7   eligible expenses under Medicare part B regardless of hospital 
432.8   confinement, subject to the Medicare part B deductible amount; 
432.9      (4) 80 percent of the hospital and medical expenses and 
432.10  supplies incurred during travel outside the United States as a 
432.11  result of a medical emergency; 
432.12     (5) coverage for the reasonable cost of the first three 
432.13  pints of blood, or equivalent quantities of packed red blood 
432.14  cells as defined under federal regulations under Medicare parts 
432.15  A and B, unless replaced in accordance with federal regulations; 
432.16     (6) 100 percent of the cost of immunizations and routine 
432.17  screening procedures for cancer screening including mammograms 
432.18  and pap smears; and 
432.19     (7) 80 percent of coverage for all physician prescribed 
432.20  medically appropriate and necessary equipment and supplies used 
432.21  in the management and treatment of diabetes.  Coverage must 
432.22  include persons with gestational, type I, or type II diabetes. 
432.23     (b) Only the following optional benefit riders may be added 
432.24  to this plan: 
432.25     (1) coverage for all of the Medicare part A inpatient 
432.26  hospital deductible amount; 
432.27     (2) a minimum of 80 percent of eligible medical expenses 
432.28  and supplies not covered by Medicare part B, not to exceed any 
432.29  charge limitation established by the Medicare program or state 
432.30  law; 
432.31     (3) coverage for all of the Medicare part B annual 
432.32  deductible; 
432.33     (4) coverage for at least 50 percent, or the equivalent of 
432.34  50 percent, of usual and customary prescription drug expenses; 
432.35     (5) coverage for the following preventive health services: 
432.36     (i) an annual clinical preventive medical history and 
433.1   physical examination that may include tests and services from 
433.2   clause (ii) and patient education to address preventive health 
433.3   care measures; 
433.4      (ii) any one or a combination of the following preventive 
433.5   screening tests or preventive services, the frequency of which 
433.6   is considered medically appropriate: 
433.7      (A) fecal occult blood test and/or digital rectal 
433.8   examination; 
433.9      (B) dipstick urinalysis for hematuria, bacteriuria, and 
433.10  proteinuria; 
433.11     (C) pure tone (air only) hearing screening test, 
433.12  administered or ordered by a physician; 
433.13     (D) serum cholesterol screening every five years; 
433.14     (E) thyroid function test; 
433.15     (F) diabetes screening; 
433.16     (iii) any other tests or preventive measures determined 
433.17  appropriate by the attending physician. 
433.18     Reimbursement shall be for the actual charges up to 100 
433.19  percent of the Medicare-approved amount for each service, as if 
433.20  Medicare were to cover the service as identified in American 
433.21  Medical Association current procedural terminology (AMA CPT) 
433.22  codes, to a maximum of $120 annually under this benefit.  This 
433.23  benefit shall not include payment for a procedure covered by 
433.24  Medicare; 
433.25     (6) coverage for services to provide short-term at-home 
433.26  assistance with activities of daily living for those recovering 
433.27  from an illness, injury, or surgery: 
433.28     (i) For purposes of this benefit, the following definitions 
433.29  apply: 
433.30     (A) "activities of daily living" include, but are not 
433.31  limited to, bathing, dressing, personal hygiene, transferring, 
433.32  eating, ambulating, assistance with drugs that are normally 
433.33  self-administered, and changing bandages or other dressings; 
433.34     (B) "care provider" means a duly qualified or licensed home 
433.35  health aide/homemaker, personal care aid, or nurse provided 
433.36  through a licensed home health care agency or referred by a 
434.1   licensed referral agency or licensed nurses registry; 
434.2      (C) "home" means a place used by the insured as a place of 
434.3   residence, provided that the place would qualify as a residence 
434.4   for home health care services covered by Medicare.  A hospital 
434.5   or skilled nursing facility shall not be considered the 
434.6   insured's place of residence; 
434.7      (D) "at-home recovery visit" means the period of a visit 
434.8   required to provide at-home recovery care, without limit on the 
434.9   duration of the visit, except each consecutive four hours in a 
434.10  24-hour period of services provided by a care provider is one 
434.11  visit; 
434.12     (ii) Coverage requirements and limitations: 
434.13     (A) at-home recovery services provided must be primarily 
434.14  services that assist in activities of daily living; 
434.15     (B) the insured's attending physician must certify that the 
434.16  specific type and frequency of at-home recovery services are 
434.17  necessary because of a condition for which a home care plan of 
434.18  treatment was approved by Medicare; 
434.19     (C) coverage is limited to: 
434.20     (I) no more than the number and type of at-home recovery 
434.21  visits certified as necessary by the insured's attending 
434.22  physician.  The total number of at-home recovery visits shall 
434.23  not exceed the number of Medicare-approved home care visits 
434.24  under a Medicare-approved home care plan of treatment; 
434.25     (II) the actual charges for each visit up to a maximum 
434.26  reimbursement of $40 per visit; 
434.27     (III) $1,600 per calendar year; 
434.28     (IV) seven visits in any one week; 
434.29     (V) care furnished on a visiting basis in the insured's 
434.30  home; 
434.31     (VI) services provided by a care provider as defined in 
434.32  this section; 
434.33     (VII) at-home recovery visits while the insured is covered 
434.34  under the policy or certificate and not otherwise excluded; 
434.35     (VIII) at-home recovery visits received during the period 
434.36  the insured is receiving Medicare-approved home care services or 
435.1   no more than eight weeks after the service date of the last 
435.2   Medicare-approved home health care visit; 
435.3      (iii) Coverage is excluded for: 
435.4      (A) home care visits paid for by Medicare or other 
435.5   government programs; and 
435.6      (B) care provided by family members, unpaid volunteers, or 
435.7   providers who are not care providers; 
435.8      (7) coverage for at least 50 percent, or the equivalent of 
435.9   50 percent, of usual and customary prescription drug expenses to 
435.10  a maximum of $1,200 paid by the issuer annually under this 
435.11  benefit.  An issuer of Medicare supplement insurance policies 
435.12  that elects to offer this benefit rider shall also make 
435.13  available coverage that contains the rider specified in clause 
435.14  (4). 
435.15     Sec. 7.  Minnesota Statutes 2002, section 62A.65, 
435.16  subdivision 7, is amended to read: 
435.17     Subd. 7.  [SHORT-TERM COVERAGE.] (a) For purposes of this 
435.18  section, "short-term coverage" means an individual health plan 
435.19  that: 
435.20     (1) is issued to provide coverage for a period of 185 days 
435.21  or less, except that the health plan may permit coverage to 
435.22  continue until the end of a period of hospitalization for a 
435.23  condition for which the covered person was hospitalized on the 
435.24  day that coverage would otherwise have ended; 
435.25     (2) is nonrenewable, provided that the health carrier may 
435.26  provide coverage for one or more subsequent periods that satisfy 
435.27  clause (1), if the total of the periods of coverage do not 
435.28  exceed a total of ~~185~~ 365 days out of any ~~365-day~~ 555-day 
435.29  period, plus any additional days covered as a result of 
435.30  hospitalization on the day that a period of coverage would 
435.31  otherwise have ended; 
435.32     (3) does not cover any preexisting conditions, including 
435.33  ones that originated during a previous identical policy or 
435.34  contract with the same health carrier where coverage was 
435.35  continuous between the previous and the current policy or 
435.36  contract; and 
436.1      (4) is available with an immediate effective date without 
436.2   underwriting upon receipt of a completed application indicating 
436.3   eligibility under the health carrier's eligibility requirements, 
436.4   provided that coverage that includes optional benefits may be 
436.5   offered on a basis that does not meet this requirement. 
436.6      (b) Short-term coverage is not subject to subdivisions 2 
436.7   and 5.  Short-term coverage may exclude as a preexisting 
436.8   condition any injury, illness, or condition for which the 
436.9   covered person had medical treatment, symptoms, or any 
436.10  manifestations before the effective date of the coverage, but 
436.11  dependent children born or placed for adoption during the policy 
436.12  period must not be subject to this provision.  
436.13     (c) Notwithstanding subdivision 3, and section 62A.021, a 
436.14  health carrier may combine short-term coverage with its most 
436.15  commonly sold individual qualified plan, as defined in section 
436.16  62E.02, other than short-term coverage, for purposes of 
436.17  complying with the loss ratio requirement. 
436.18     (d) The ~~185~~ 365 day coverage limitation provided in 
436.19  paragraph (a) applies to the total number of days of short-term 
436.20  coverage that covers a person, regardless of the number of 
436.21  policies, contracts, or health carriers that provide the 
436.22  coverage.  A written application for short-term coverage must 
436.23  ask the applicant whether the applicant has been covered by 
436.24  short-term coverage by any health carrier within the ~~365~~ 555 
436.25  days immediately preceding the effective date of the coverage 
436.26  being applied for.  Short-term coverage issued in violation of 
436.27  the ~~185-day~~ 365-day limitation is valid until the end of its 
436.28  term and does not lose its status as short-term coverage, in 
436.29  spite of the violation.  A health carrier that knowingly issues 
436.30  short-term coverage in violation of the ~~185-day~~ 365-day 
436.31  limitation is subject to the administrative penalties otherwise 
436.32  available to the commissioner of commerce or the commissioner of 
436.33  health, as appropriate. 
436.34     (e) Time spent under short-term coverage counts as time 
436.35  spent under a preexisting condition limitation for purposes of 
436.36  group or individual health plans, other than short-term 
437.1   coverage, subsequently issued to that person, or to cover that 
437.2   person, by any health carrier, if the person maintains 
437.3   continuous coverage as defined in section 62L.02.  Short-term 
437.4   coverage is a health plan and is qualifying coverage as defined 
437.5   in section 62L.02.  Notwithstanding any other law to the 
437.6   contrary, a health carrier is not required under any 
437.7   circumstances to provide a person covered by short-term coverage 
437.8   the right to obtain coverage on a guaranteed issue basis under 
437.9   another health plan offered by the health carrier, as a result 
437.10  of the person's enrollment in short-term coverage. 
437.11     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
437.12  following final enactment and applies to policies issued on or 
437.13  after that date. 
437.14     Sec. 8.  Minnesota Statutes 2002, section 62D.095, 
437.15  subdivision 2, is amended to read: 
437.16     Subd. 2.  [CO-PAYMENTS.] (a) A health maintenance contract 
437.17  may impose a co-payment as authorized under Minnesota Rules, 
437.18  part 4685.0801, or under this section.  
437.19     (b) A health maintenance organization may impose a flat fee 
437.20  co-payment on outpatient office visits not to exceed 40 percent 
437.21  of the median provider's charges for similar services or goods 
437.22  received by the enrollees as calculated under Minnesota Rules, 
437.23  part 4685.0801.  A health maintenance organization may impose a 
437.24  flat fee co-payment on outpatient prescription drugs not to 
437.25  exceed 50 percent of the median provider's charges for similar 
437.26  services or goods received by the enrollees as calculated under 
437.27  Minnesota Rules, part 4685.0801.  
437.28     (c) If a health maintenance contract is permitted to impose 
437.29  a co-payment for preexisting health status under sections 62D.01 
437.30  to 62D.30, these provisions may vary with respect to length of 
437.31  enrollment in the health plan.  
437.32     Sec. 9.  Minnesota Statutes 2002, section 62D.095, is 
437.33  amended by adding a subdivision to read: 
437.34     Subd. 6.  [PUBLIC PROGRAMS.] This section does not apply to 
437.35  the prepaid medical assistance program, the MinnesotaCare 
437.36  program, the prepaid general assistance program, the federal 
438.1   Medicare program, or the health plans provided through any of 
438.2   those programs. 
438.3      Sec. 10.  Minnesota Statutes 2002, section 62E.06, 
438.4   subdivision 1, is amended to read: 
438.5      Subdivision 1.  [NUMBER THREE PLAN.] A plan of health 
438.6   coverage shall be certified as a number three qualified plan if 
438.7   it otherwise meets the requirements established by chapters 62A, 
438.8   62C, and 62Q, and the other laws of this state, whether or not 
438.9   the policy is issued in Minnesota, and meets or exceeds the 
438.10  following minimum standards: 
438.11     (a) The minimum benefits for a covered individual shall, 
438.12  subject to the other provisions of this subdivision, be equal to 
438.13  at least 80 percent of the cost of covered services in excess of 
438.14  an annual deductible which does not exceed $150 per person.  The 
438.15  coverage shall include a limitation of $3,000 per person on 
438.16  total annual out-of-pocket expenses for services covered under 
438.17  this subdivision.  The coverage shall be subject to a maximum 
438.18  lifetime benefit of not less than $1,000,000. 
438.19     The $3,000 limitation on total annual out-of-pocket 
438.20  expenses and the $1,000,000 maximum lifetime benefit shall not 
438.21  be subject to change or substitution by use of an actuarially 
438.22  equivalent benefit. 
438.23     (b) Covered expenses shall be the usual and customary 
438.24  charges for the following services and articles when prescribed 
438.25  by a physician: 
438.26     (1) hospital services; 
438.27     (2) professional services for the diagnosis or treatment of 
438.28  injuries, illnesses, or conditions, other than dental, which are 
438.29  rendered by a physician or at the physician's direction; 
438.30     (3) drugs requiring a physician's prescription; 
438.31     (4) services of a nursing home for not more than 120 days 
438.32  in a year if the services would qualify as reimbursable services 
438.33  under Medicare; 
438.34     (5) services of a home health agency if the services would 
438.35  qualify as reimbursable services under Medicare; 
438.36     (6) use of radium or other radioactive materials; 
439.1      (7) oxygen; 
439.2      (8) anesthetics; 
439.3      (9) prostheses other than dental but including scalp hair 
439.4   prostheses worn for hair loss suffered as a result of alopecia 
439.5   areata; 
439.6      (10) rental or purchase, as appropriate, of durable medical 
439.7   equipment other than eyeglasses and hearing aids, unless 
439.8   coverage is required under section 62Q.675; 
439.9      (11) diagnostic x-rays and laboratory tests; 
439.10     (12) oral surgery for partially or completely unerupted 
439.11  impacted teeth, a tooth root without the extraction of the 
439.12  entire tooth, or the gums and tissues of the mouth when not 
439.13  performed in connection with the extraction or repair of teeth; 
439.14     (13) services of a physical therapist; 
439.15     (14) transportation provided by licensed ambulance service 
439.16  to the nearest facility qualified to treat the condition; or a 
439.17  reasonable mileage rate for transportation to a kidney dialysis 
439.18  center for treatment; and 
439.19     (15) services of an occupational therapist. 
439.20     (c) Covered expenses for the services and articles 
439.21  specified in this subdivision do not include the following: 
439.22     (1) any charge for care for injury or disease either (i) 
439.23  arising out of an injury in the course of employment and subject 
439.24  to a workers' compensation or similar law, (ii) for which 
439.25  benefits are payable without regard to fault under coverage 
439.26  statutorily required to be contained in any motor vehicle, or 
439.27  other liability insurance policy or equivalent self-insurance, 
439.28  or (iii) for which benefits are payable under another policy of 
439.29  accident and health insurance, Medicare, or any other 
439.30  governmental program except as otherwise provided by section 
439.31  62A.04, subdivision 3, clause (4); 
439.32     (2) any charge for treatment for cosmetic purposes other 
439.33  than for reconstructive surgery when such service is incidental 
439.34  to or follows surgery resulting from injury, sickness, or other 
439.35  diseases of the involved part or when such service is performed 
439.36  on a covered dependent child because of congenital disease or 
440.1   anomaly which has resulted in a functional defect as determined 
440.2   by the attending physician; 
440.3      (3) care which is primarily for custodial or domiciliary 
440.4   purposes which would not qualify as eligible services under 
440.5   Medicare; 
440.6      (4) any charge for confinement in a private room to the 
440.7   extent it is in excess of the institution's charge for its most 
440.8   common semiprivate room, unless a private room is prescribed as 
440.9   medically necessary by a physician, provided, however, that if 
440.10  the institution does not have semiprivate rooms, its most common 
440.11  semiprivate room charge shall be considered to be 90 percent of 
440.12  its lowest private room charge; 
440.13     (5) that part of any charge for services or articles 
440.14  rendered or prescribed by a physician, dentist, or other health 
440.15  care personnel which exceeds the prevailing charge in the 
440.16  locality where the service is provided; and 
440.17     (6) any charge for services or articles the provision of 
440.18  which is not within the scope of authorized practice of the 
440.19  institution or individual rendering the services or articles. 
440.20     (d) The minimum benefits for a qualified plan shall 
440.21  include, in addition to those benefits specified in clauses (a) 
440.22  and (e), benefits for well baby care, effective July 1, 1980, 
440.23  subject to applicable deductibles, coinsurance provisions, and 
440.24  maximum lifetime benefit limitations. 
440.25     (e) Effective July 1, 1979, the minimum benefits of a 
440.26  qualified plan shall include, in addition to those benefits 
440.27  specified in clause (a), a second opinion from a physician on 
440.28  all surgical procedures expected to cost a total of $500 or more 
440.29  in physician, laboratory, and hospital fees, provided that the 
440.30  coverage need not include the repetition of any diagnostic tests.
440.31     (f) Effective August 1, 1985, the minimum benefits of a 
440.32  qualified plan must include, in addition to the benefits 
440.33  specified in clauses (a), (d), and (e), coverage for special 
440.34  dietary treatment for phenylketonuria when recommended by a 
440.35  physician. 
440.36     (g) Outpatient mental health coverage is subject to section 
441.1   62A.152, subdivision 2.  
441.2      <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
441.3   and applies to policies, contracts, and certificates issued or 
441.4   renewed on or after that date. 
441.5      Sec. 11.  Minnesota Statutes 2002, section 62J.17, 
441.6   subdivision 2, is amended to read: 
441.7      Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
441.8   terms defined in this subdivision have the meanings given. 
441.9      (a) "Access" means the financial, temporal, and geographic 
441.10  availability of health care to individuals who need it. 
441.11     (b) "Capital expenditure" means an expenditure which, under 
441.12  generally accepted accounting principles, is not properly 
441.13  chargeable as an expense of operation and maintenance. 
441.14     (c) "Cost" means the amount paid by consumers or third 
441.15  party payers for health care services or products. 
441.16     (d) "Date of the major spending commitment" means the date 
441.17  the provider formally obligated itself to the major spending 
441.18  commitment.  The obligation may be incurred by entering into a 
441.19  contract, making a down payment, issuing bonds or entering a 
441.20  loan agreement to provide financing for the major spending 
441.21  commitment, or taking some other formal, tangible action 
441.22  evidencing the provider's intention to make the major spending 
441.23  commitment.  
441.24     (e) "Health care service" means: 
441.25     (1) a service or item that would be covered by the medical 
441.26  assistance program under chapter 256B if provided in accordance 
441.27  with medical assistance requirements to an eligible medical 
441.28  assistance recipient; and 
441.29     (2) a service or item that would be covered by medical 
441.30  assistance except that it is characterized as experimental, 
441.31  cosmetic, or voluntary. 
441.32     "Health care service" does not include retail, 
441.33  over-the-counter sales of nonprescription drugs and other retail 
441.34  sales of health-related products that are not generally paid for 
441.35  by medical assistance and other third-party coverage. 
441.36     (f) "Major spending commitment" means an expenditure in 
442.1   excess of ~~$500,000~~ $1,000,000 for: 
442.2      (1) acquisition of a unit of medical equipment; 
442.3      (2) a capital expenditure for a single project for the 
442.4   purposes of providing health care services, other than for the 
442.5   acquisition of medical equipment; 
442.6      (3) offering a new specialized service not offered before; 
442.7      (4) planning for an activity that would qualify as a major 
442.8   spending commitment under this paragraph; or 
442.9      (5) a project involving a combination of two or more of the 
442.10  activities in clauses (1) to (4). 
442.11     The cost of acquisition of medical equipment, and the 
442.12  amount of a capital expenditure, is the total cost to the 
442.13  provider regardless of whether the cost is distributed over time 
442.14  through a lease arrangement or other financing or payment 
442.15  mechanism.  
442.16     (g) "Medical equipment" means fixed and movable equipment 
442.17  that is used by a provider in the provision of a health care 
442.18  service.  "Medical equipment" includes, but is not limited to, 
442.19  the following: 
442.20     (1) an extracorporeal shock wave lithotripter; 
442.21     (2) a computerized axial tomography (CAT) scanner; 
442.22     (3) a magnetic resonance imaging (MRI) unit; 
442.23     (4) a positron emission tomography (PET) scanner; and 
442.24     (5) emergency and nonemergency medical transportation 
442.25  equipment and vehicles. 
442.26     (h) "New specialized service" means a specialized health 
442.27  care procedure or treatment regimen offered by a provider that 
442.28  was not previously offered by the provider, including, but not 
442.29  limited to:  
442.30     (1) cardiac catheterization services involving high-risk 
442.31  patients as defined in the Guidelines for Coronary Angiography 
442.32  established by the American Heart Association and the American 
442.33  College of Cardiology; 
442.34     (2) heart, heart-lung, liver, kidney, bowel, or pancreas 
442.35  transplantation service, or any other service for 
442.36  transplantation of any other organ; 
443.1      (3) megavoltage radiation therapy; 
443.2      (4) open heart surgery; 
443.3      (5) neonatal intensive care services; and 
443.4      (6) any new medical technology for which premarket approval 
443.5   has been granted by the United States Food and Drug 
443.6   Administration, excluding implantable and wearable devices. 
443.7      Sec. 12.  Minnesota Statutes 2002, section 62J.23, is 
443.8   amended by adding a subdivision to read: 
443.9      Subd. 5.  [AUDITS OF EXEMPT PROVIDERS.] The commissioner 
443.10  may audit the referral patterns of providers that qualify for 
443.11  exceptions under the federal Stark Law, United States Code, 
443.12  title 42, section 1395nn.  The commissioner has access to 
443.13  provider records according to section 144.99, subdivision 2.  
443.14  The commissioner shall report to the legislature any audit 
443.15  results that reveal a pattern of referrals by a provider for the 
443.16  furnishing of health services to an entity with which the 
443.17  provider has a direct or indirect financial relationship. 
443.18     Sec. 13.  [62J.26] [EVALUATION OF PROPOSED HEALTH COVERAGE 
443.19  MANDATES.] 
443.20     Subdivision 1.  [DEFINITIONS.] For purposes of this 
443.21  section, the following terms have the meanings given unless the 
443.22  context otherwise requires:  
443.23     (1) "commissioner" means the commissioner of commerce; 
443.24     (2) "health plan" means a health plan as defined in section 
443.25  62A.011, subdivision 3, but includes coverage listed in clauses 
443.26  (7) and (10) of that definition; 
443.27     (3) "mandated health benefit proposal" means a proposal 
443.28  that would statutorily require a health plan to do the following:
443.29     (i) provide coverage or increase the amount of coverage for 
443.30  the treatment of a particular disease, condition, or other 
443.31  health care need; 
443.32     (ii) provide coverage or increase the amount of coverage of 
443.33  a particular type of health care treatment or service or of 
443.34  equipment, supplies, or drugs used in connection with a health 
443.35  care treatment or service; or 
443.36     (iii) provide coverage for care delivered by a specific 
444.1   type of provider. 
444.2      "Mandated health benefit proposal" does not include health 
444.3   benefit proposals amending the scope of practice of a licensed 
444.4   health care professional. 
444.5      Subd. 2.  [EVALUATION PROCESS AND CONTENT.] (a) The 
444.6   commissioner, in consultation with the commissioners of health 
444.7   and employee relations, must evaluate mandated health benefit 
444.8   proposals as provided under subdivision 3.  
444.9      (b) The purpose of the evaluation is to provide the 
444.10  legislature with a complete and timely analysis of all 
444.11  ramifications of any mandated health benefit proposal.  The 
444.12  evaluation must include, in addition to other relevant 
444.13  information, the following: 
444.14     (1) scientific and medical information on the proposed 
444.15  health benefit, on the potential for harm or benefit to the 
444.16  patient, and on the comparative benefit or harm from alternative 
444.17  forms of treatment; 
444.18     (2) public health, economic, and fiscal impacts of the 
444.19  proposed mandate on persons receiving health services in 
444.20  Minnesota, on the relative cost-effectiveness of the benefit, 
444.21  and on the health care system in general; 
444.22     (3) the extent to which the service is generally utilized 
444.23  by a significant portion of the population; 
444.24     (4) the extent to which insurance coverage for the proposed 
444.25  mandated benefit is already generally available; 
444.26     (5) the extent to which the mandated coverage will increase 
444.27  or decrease the cost of the service; and 
444.28     (6) the commissioner may consider actuarial analysis done 
444.29  by health insurers in determining the cost of the proposed 
444.30  mandated benefit. 
444.31     (c) The commissioner must summarize the nature and quality 
444.32  of available information on these issues, and, if possible, must 
444.33  provide preliminary information to the public.  The commissioner 
444.34  may conduct research on these issues or may determine that 
444.35  existing research is sufficient to meet the informational needs 
444.36  of the legislature.  The commissioner may seek the assistance 
445.1   and advice of researchers, community leaders, or other persons 
445.2   or organizations with relevant expertise.  
445.3      Subd. 3.  [REQUESTS FOR EVALUATION.] (a) Whenever a 
445.4   legislative measure containing a mandated health benefit 
445.5   proposal is introduced as a bill or offered as an amendment to a 
445.6   bill, or is likely to be introduced as a bill or offered as an 
445.7   amendment, a chair of any standing legislative committee that 
445.8   has jurisdiction over the subject matter of the proposal may 
445.9   request that the commissioner complete an evaluation of the 
445.10  proposal under this section, to inform any committee of floor 
445.11  action by either house of the legislature.  
445.12     (b) The commissioner must conduct an evaluation described 
445.13  in subdivision 2 of each mandated health benefit proposal for 
445.14  which an evaluation is requested under paragraph (a), unless the 
445.15  commissioner determines under paragraph (c) or subdivision 4 
445.16  that priorities and resources do not permit its evaluation. 
445.17     (c) If requests for evaluation of multiple proposals are 
445.18  received, the commissioner must consult with the chairs of the 
445.19  standing legislative committees having jurisdiction over the 
445.20  subject matter of the mandated health benefit proposals to 
445.21  prioritize the requests and establish a reporting date for each 
445.22  proposal to be evaluated.  The commissioner is not required to 
445.23  direct an unreasonable quantity of the commissioner's resources 
445.24  to these evaluations.  
445.25     Subd. 4.  [SOURCES OF FUNDING.] (a) The commissioner need 
445.26  not use any funds for purposes of this section other than as 
445.27  provided in this subdivision or as specified in an appropriation.
445.28     (b) The commissioner may seek and accept funding from 
445.29  sources other than the state to pay for evaluations under this 
445.30  section to supplement or replace state appropriations.  Any 
445.31  money received under this paragraph must be deposited in the 
445.32  state treasury, credited to a separate account for this purpose 
445.33  in the special revenue fund, and is appropriated to the 
445.34  commissioner for purposes of this section. 
445.35     (c) If a request for an evaluation under this section has 
445.36  been made, the commissioner may use for purposes of the 
446.1   evaluation: 
446.2      (1) any funds appropriated to the commissioner specifically 
446.3   for purposes of this section; or 
446.4      (2) funds available under paragraph (b), if use of the 
446.5   funds for evaluation of that mandated health benefit proposal is 
446.6   consistent with any restrictions imposed by the source of the 
446.7   funds. 
446.8      (d) The commissioner must ensure that the source of the 
446.9   funding has no influence on the process or outcome of the 
446.10  evaluation. 
446.11     Subd. 5.  [REPORT TO LEGISLATURE.] The commissioner must 
446.12  submit a written report on the evaluation to the legislature no 
446.13  later than 180 days after the request.  The report must be 
446.14  submitted in compliance with sections 3.195 and 3.197. 
446.15     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2004.
446.16     Sec. 14.  Minnesota Statutes 2002, section 62J.52, 
446.17  subdivision 1, is amended to read: 
446.18     Subdivision 1.  [UNIFORM BILLING FORM HCFA 1450.] (a) On 
446.19  and after January 1, 1996, all institutional inpatient hospital 
446.20  services, ancillary services, institutionally owned or operated 
446.21  outpatient services rendered by providers in Minnesota, and 
446.22  institutional or noninstitutional home health services that are 
446.23  not being billed using an equivalent electronic billing format, 
446.24  must be billed using the uniform billing form HCFA 1450, except 
446.25  as provided in subdivision 5. 
446.26     (b) The instructions and definitions for the use of the 
446.27  uniform billing form HCFA 1450 shall be in accordance with the 
446.28  uniform billing form manual specified by the commissioner.  In 
446.29  promulgating these instructions, the commissioner may utilize 
446.30  the manual developed by the National Uniform Billing Committee, 
446.31  as adopted and finalized by the Minnesota uniform billing 
446.32  committee.  
446.33     (c) Services to be billed using the uniform billing form 
446.34  HCFA 1450 include:  institutional inpatient hospital services 
446.35  and distinct units in the hospital such as psychiatric unit 
446.36  services, physical therapy unit services, swing bed (SNF)  
447.1   services, inpatient state psychiatric hospital services, 
447.2   inpatient skilled nursing facility services, home health 
447.3   services (Medicare part A), and hospice services; ancillary 
447.4   services, where benefits are exhausted or patient has no 
447.5   Medicare part A, from hospitals, state psychiatric hospitals, 
447.6   skilled nursing facilities, and home health (Medicare part B); 
447.7   institutional owned or operated outpatient services such as 
447.8   waivered services, hospital outpatient services, including 
447.9   ambulatory surgical center services, hospital referred 
447.10  laboratory services, hospital-based ambulance services, and 
447.11  other hospital outpatient services, skilled nursing facilities, 
447.12  home health, ~~including infusion therapy,~~ freestanding renal 
447.13  dialysis centers, comprehensive outpatient rehabilitation 
447.14  facilities (CORF), outpatient rehabilitation facilities (ORF), 
447.15  rural health clinics, and community mental health centers; home 
447.16  health services such as home health intravenous therapy 
447.17  providers, waivered services, personal care attendants, and 
447.18  hospice; and any other health care provider certified by the 
447.19  Medicare program to use this form. 
447.20     (d) On and after January 1, 1996, a mother and newborn 
447.21  child must be billed separately, and must not be combined on one 
447.22  claim form. 
447.23     Sec. 15.  Minnesota Statutes 2002, section 62J.52, 
447.24  subdivision 2, is amended to read: 
447.25     Subd. 2.  [UNIFORM BILLING FORM HCFA 1500.] (a) On and 
447.26  after January 1, 1996, all noninstitutional health care services 
447.27  rendered by providers in Minnesota except dental or pharmacy 
447.28  providers, that are not currently being billed using an 
447.29  equivalent electronic billing format, must be billed using the 
447.30  health insurance claim form HCFA 1500, except as provided in 
447.31  subdivision 5. 
447.32     (b) The instructions and definitions for the use of the 
447.33  uniform billing form HCFA 1500 shall be in accordance with the 
447.34  manual developed by the administrative uniformity committee 
447.35  entitled standards for the use of the HCFA 1500 form, dated 
447.36  February 1994, as further defined by the commissioner. 
448.1      (c) Services to be billed using the uniform billing form 
448.2   HCFA 1500 include physician services and supplies, durable 
448.3   medical equipment, noninstitutional ambulance services, 
448.4   independent ancillary services including occupational therapy, 
448.5   physical therapy, speech therapy and audiology, home infusion 
448.6   therapy, podiatry services, optometry services, mental health 
448.7   licensed professional services, substance abuse licensed 
448.8   professional services, nursing practitioner professional 
448.9   services, certified registered nurse anesthetists, 
448.10  chiropractors, physician assistants, laboratories, medical 
448.11  suppliers, and other health care providers such as day activity 
448.12  centers and freestanding ambulatory surgical centers. 
448.13     Sec. 16.  Minnesota Statutes 2002, section 62J.692, 
448.14  subdivision 3, is amended to read: 
448.15     Subd. 3.  [APPLICATION PROCESS.] (a) A clinical medical 
448.16  education program conducted in Minnesota by a teaching 
448.17  institution to train physicians, doctor of pharmacy 
448.18  practitioners, dentists, chiropractors, or physician assistants 
448.19  is eligible for funds under subdivision 4 if the program: 
448.20     (1) is funded, in part, by patient care revenues; 
448.21     (2) occurs in patient care settings that face increased 
448.22  financial pressure as a result of competition with nonteaching 
448.23  patient care entities; and 
448.24     (3) emphasizes primary care or specialties that are in 
448.25  undersupply in Minnesota. 
448.26     (b) A clinical medical education program for advanced 
448.27  practice nursing is eligible for funds under subdivision 4 if 
448.28  the program meets the eligibility requirements in paragraph (a), 
448.29  clauses (1) to (3), and is sponsored by the University of 
448.30  Minnesota Academic Health Center, the Mayo Foundation, or 
448.31  institutions that are part of the Minnesota state colleges and 
448.32  universities system or members of the Minnesota private college 
448.33  council.  
448.34     (c) Applications must be submitted to the commissioner by a 
448.35  sponsoring institution on behalf of an eligible clinical medical 
448.36  education program and must be received by October 31 of each 
449.1   year for distribution in the following year.  An application for 
449.2   funds must contain the following information: 
449.3      (1) the official name and address of the sponsoring 
449.4   institution and the official name and site address of the 
449.5   clinical medical education programs on whose behalf the 
449.6   sponsoring institution is applying; 
449.7      (2) the name, title, and business address of those persons 
449.8   responsible for administering the funds; 
449.9      (3) for each clinical medical education program for which 
449.10  funds are being sought; the type and specialty orientation of 
449.11  trainees in the program; the name, site address, and medical 
449.12  assistance provider number of each training site used in the 
449.13  program; the total number of trainees at each training site; and 
449.14  the total number of eligible trainee FTEs at each site.  Only 
449.15  those training sites that host 0.5 FTE or more eligible trainees 
449.16  for a program may be included in the program's application; and 
449.17     (4) other supporting information the commissioner deems 
449.18  necessary to determine program eligibility based on the criteria 
449.19  in ~~paragraph~~ paragraphs (a) and (b) and to ensure the equitable 
449.20  distribution of funds.  
449.21     ~~(c)~~ (d) An application must include the information 
449.22  specified in clauses (1) to (3) for each clinical medical 
449.23  education program on an annual basis for three consecutive 
449.24  years.  After that time, an application must include the 
449.25  information specified in clauses (1) to (3) in the first year of 
449.26  each biennium:  
449.27     (1) audited clinical training costs per trainee for each 
449.28  clinical medical education program when available or estimates 
449.29  of clinical training costs based on audited financial data; 
449.30     (2) a description of current sources of funding for 
449.31  clinical medical education costs, including a description and 
449.32  dollar amount of all state and federal financial support, 
449.33  including Medicare direct and indirect payments; and 
449.34     (3) other revenue received for the purposes of clinical 
449.35  training.  
449.36     ~~(d)~~ (e) An applicant that does not provide information 
450.1   requested by the commissioner shall not be eligible for funds 
450.2   for the current funding cycle. 
450.3      Sec. 17.  Minnesota Statutes 2002, section 62J.692, 
450.4   subdivision 4, is amended to read: 
450.5      Subd. 4.  [DISTRIBUTION OF FUNDS.] (a) The commissioner 
450.6   shall annually distribute 90 percent of available medical 
450.7   education funds to all qualifying applicants based on ~~the~~ 
450.8   ~~following criteria~~ a distribution formula that reflects a 
450.9   summation of two factors:  
450.10     (1) ~~total medical education funds available for~~ 
450.11  ~~distribution;~~ an education factor, which is determined by the 
450.12  total number of eligible trainee FTEs and the total statewide 
450.13  average costs per trainee, by type of trainee, in each clinical 
450.14  medical education program; and 
450.15     (2) ~~total number of eligible trainee FTEs in each clinical~~ 
450.16  ~~medical education program; and~~ 
450.17     ~~(3) the statewide average cost per trainee as determined by~~ 
450.18  ~~the application information provided in the first year of the~~ 
450.19  ~~biennium, by type of trainee, in each clinical medical education~~ 
450.20  ~~program.~~ a public program volume factor, which is determined by 
450.21  the total volume of public program revenue received by each 
450.22  training site as a percentage of all public program revenue 
450.23  received by all training sites in the fund pool.  
450.24     In this formula, the education factor is weighted at 67 
450.25  percent and the public program volume factor is weighted at 33 
450.26  percent. 
450.27     Public program revenue for the distribution formula 
450.28  includes revenue from medical assistance, prepaid medical 
450.29  assistance, general assistance medical care, and prepaid general 
450.30  assistance medical care.  Training sites that receive no public 
450.31  program revenue are ineligible for funds available under this 
450.32  paragraph.  Total statewide average costs per trainee for 
450.33  medical residents is based on audited clinical training costs 
450.34  per trainee in primary care clinical medical education programs 
450.35  for medical residents.  Total statewide average costs per 
450.36  trainee for dental residents is based on audited clinical 
451.1   training costs per trainee in clinical medical education 
451.2   programs for dental students.  Total statewide average costs per 
451.3   trainee for pharmacy residents is based on audited clinical 
451.4   training costs per trainee in clinical medical education 
451.5   programs for pharmacy students. 
451.6      (b) The commissioner shall annually distribute ten percent 
451.7   of total available medical education funds to all qualifying 
451.8   applicants based on the percentage received by each applicant 
451.9   under paragraph (a).  These funds are to be used to offset 
451.10  clinical education costs at eligible clinical training sites 
451.11  based on criteria developed by the clinical medical education 
451.12  program.  Applicants may choose to distribute funds allocated 
451.13  under this paragraph based on the distribution formula described 
451.14  in paragraph (a).  Applicants may also choose to distribute 
451.15  funds to clinical training sites with a valid Minnesota medical 
451.16  assistance identification number that host fewer than 0.5 
451.17  eligible trainee FTE's for a clinical medical education program. 
451.18     (c) Funds distributed shall not be used to displace current 
451.19  funding appropriations from federal or state sources.  
451.20     ~~(c)~~ (d) Funds shall be distributed to the sponsoring 
451.21  institutions indicating the amount to be distributed to each of 
451.22  the sponsor's clinical medical education programs based on the 
451.23  criteria in this subdivision and in accordance with the 
451.24  commissioner's approval letter.  Each clinical medical education 
451.25  program must distribute funds allocated under paragraph (a) to 
451.26  the training sites as specified in the commissioner's approval 
451.27  letter.  Sponsoring institutions, which are accredited through 
451.28  an organization recognized by the department of education or the 
451.29  Centers for Medicare and Medicaid Services, may contract 
451.30  directly with training sites to provide clinical training.  To 
451.31  ensure the quality of clinical training, those accredited 
451.32  sponsoring institutions must: 
451.33     (1) develop contracts specifying the terms, expectations, 
451.34  and outcomes of the clinical training conducted at sites; and 
451.35     (2) take necessary action if the contract requirements are 
451.36  not met.  Action may include the withholding of payments under 
452.1   this section or the removal of students from the site.  
452.2      ~~(d)~~ (e) Any funds not distributed in accordance with the 
452.3   commissioner's approval letter must be returned to the medical 
452.4   education and research fund within 30 days of receiving notice 
452.5   from the commissioner.  The commissioner shall distribute 
452.6   returned funds to the appropriate training sites in accordance 
452.7   with the commissioner's approval letter. 
452.8      ~~(e) The commissioner shall distribute by June 30 of each~~ 
452.9   ~~year an amount equal to the funds transferred under section~~ 
452.10  ~~62J.694, subdivision 2a, paragraph (b), plus five percent~~ 
452.11  ~~interest to the University of Minnesota board of regents for the~~ 
452.12  ~~costs of the academic health center as specified under section~~ 
452.13  ~~62J.694, subdivision 2a, paragraph (a).~~ 
452.14     Sec. 18.  Minnesota Statutes 2002, section 62J.692, 
452.15  subdivision 5, is amended to read: 
452.16     Subd. 5.  [REPORT.] (a) Sponsoring institutions receiving 
452.17  funds under this section must sign and submit a medical 
452.18  education grant verification report (GVR) to verify that the 
452.19  correct grant amount was forwarded to each eligible training 
452.20  site.  If the sponsoring institution fails to submit the GVR by 
452.21  the stated deadline, or to request and meet the deadline for an 
452.22  extension, the sponsoring institution is required to return the 
452.23  full amount of funds received to the commissioner within 30 days 
452.24  of receiving notice from the commissioner.  The commissioner 
452.25  shall distribute returned funds to the appropriate training 
452.26  sites in accordance with the commissioner's approval letter.  
452.27     (b) The reports must provide verification of the 
452.28  distribution of the funds and must include:  
452.29     (1) the total number of eligible trainee FTEs in each 
452.30  clinical medical education program; 
452.31     (2) the name of each funded program and, for each program, 
452.32  the dollar amount distributed to each training site; 
452.33     (3) documentation of any discrepancies between the initial 
452.34  grant distribution notice included in the commissioner's 
452.35  approval letter and the actual distribution; 
452.36     (4) a statement by the sponsoring institution describing 
453.1   the distribution of funds allocated under subdivision 4, 
453.2   paragraph (b), including information on which clinical training 
453.3   sites received funding and the rationale used for determining 
453.4   funding priorities; 
453.5      (5) a statement by the sponsoring institution stating that 
453.6   the completed grant verification report is valid and accurate; 
453.7   and 
453.8      ~~(5)~~ (6) other information the commissioner, with advice 
453.9   from the advisory committee, deems appropriate to evaluate the 
453.10  effectiveness of the use of funds for medical education.  
453.11     (c) By February 15 of each year, the commissioner, with 
453.12  advice from the advisory committee, shall provide an annual 
453.13  summary report to the legislature on the implementation of this 
453.14  section. 
453.15     Sec. 19.  Minnesota Statutes 2002, section 62J.692, 
453.16  subdivision 7, is amended to read: 
453.17     Subd. 7.  [TRANSFERS FROM THE COMMISSIONER OF HUMAN 
453.18  SERVICES.] (a) The amount transferred according to section 
453.19  256B.69, subdivision 5c, paragraph (a), clause (1), shall be 
453.20  distributed by the commissioner annually to clinical medical 
453.21  education programs that meet the qualifications of subdivision 3 
453.22  based on ~~a distribution formula that reflects a summation of two~~ 
453.23  ~~factors:~~ the formula in subdivision 4, paragraph (a). 
453.24     ~~(1) an education factor, which is determined by the total~~ 
453.25  ~~number of eligible trainee FTEs and the total statewide average~~ 
453.26  ~~costs per trainee, by type of trainee, in each clinical medical~~ 
453.27  ~~education program; and~~ 
453.28     ~~(2) a public program volume factor, which is determined by~~ 
453.29  ~~the total volume of public program revenue received by each~~ 
453.30  ~~training site as a percentage of all public program revenue~~ 
453.31  ~~received by all training sites in the fund pool created under~~ 
453.32  ~~this subdivision.~~  
453.33     ~~In this formula, the education factor shall be weighted at~~ 
453.34  ~~50 percent and the public program volume factor shall be~~ 
453.35  ~~weighted at 50 percent.~~ 
453.36     ~~Public program revenue for the distribution formula shall~~ 
454.1   ~~include revenue from medical assistance, prepaid medical~~ 
454.2   ~~assistance, general assistance medical care, and prepaid general~~ 
454.3   ~~assistance medical care.  Training sites that receive no public~~ 
454.4   ~~program revenue shall be ineligible for funds available under~~ 
454.5   ~~this paragraph.~~ 
454.6      (b) Fifty percent of the amount transferred according to 
454.7   section 256B.69, subdivision 5c, paragraph (a), clause (2), 
454.8   shall be distributed by the commissioner to the University of 
454.9   Minnesota board of regents for the purposes described in 
454.10  sections 137.38 to 137.40.  Of the remaining amount transferred 
454.11  according to section 256B.69, subdivision 5c, paragraph (a), 
454.12  clause (2), 24 percent of the amount shall be distributed by the 
454.13  commissioner to the Hennepin County Medical Center for clinical 
454.14  medical education.  The remaining 26 percent of the amount 
454.15  transferred shall be distributed by the commissioner in 
454.16  accordance with subdivision 7a.  If the federal approval is not 
454.17  obtained for the matching funds under section 256B.69, 
454.18  subdivision 5c, paragraph (a), clause (2), 100 percent of the 
454.19  amount transferred under this paragraph shall be distributed by 
454.20  the commissioner to the University of Minnesota board of regents 
454.21  for the purposes described in sections 137.38 to 137.40.  
454.22     (c) The amount transferred according to section 256B.69, 
454.23  subdivision 5c, paragraph (a), clause (3), shall be distributed 
454.24  by the commissioner upon receipt to the University of Minnesota 
454.25  board of regents for the purposes of clinical graduate medical 
454.26  education. 
454.27     Sec. 20.  Minnesota Statutes 2002, section 62J.694, is 
454.28  amended by adding a subdivision to read: 
454.29     Subd. 5.  [EFFECTIVE DATE.] This section is only in effect 
454.30  if there are funds available in the medical education endowment 
454.31  fund.  
454.32     Sec. 21.  Minnesota Statutes 2002, section 62L.05, 
454.33  subdivision 4, is amended to read: 
454.34     Subd. 4.  [BENEFITS.] The medical services and supplies 
454.35  listed in this subdivision are the benefits that must be covered 
454.36  by the small employer plans described in subdivisions 2 and 3.  
455.1   Benefits under this subdivision may be provided through the 
455.2   managed care procedures practiced by health carriers:  
455.3      (1) inpatient and outpatient hospital services, excluding 
455.4   services provided for the diagnosis, care, or treatment of 
455.5   chemical dependency or a mental illness or condition, other than 
455.6   those conditions specified in clauses (10), (11), and (12).  The 
455.7   health care services required to be covered under this clause 
455.8   must also be covered if rendered in a nonhospital environment, 
455.9   on the same basis as coverage provided for those same treatments 
455.10  or services if rendered in a hospital, provided, however, that 
455.11  this sentence must not be interpreted as expanding the types or 
455.12  extent of services covered; 
455.13     (2) physician, chiropractor, and nurse practitioner 
455.14  services for the diagnosis or treatment of illnesses, injuries, 
455.15  or conditions; 
455.16     (3) diagnostic x-rays and laboratory tests; 
455.17     (4) ground transportation provided by a licensed ambulance 
455.18  service to the nearest facility qualified to treat the 
455.19  condition, or as otherwise required by the health carrier; 
455.20     (5) services of a home health agency if the services 
455.21  qualify as reimbursable services under Medicare; 
455.22     (6) services of a private duty registered nurse if 
455.23  medically necessary, as determined by the health carrier; 
455.24     (7) the rental or purchase, as appropriate, of durable 
455.25  medical equipment, other than eyeglasses and hearing aids, 
455.26  unless coverage is required under section 62Q.675; 
455.27     (8) child health supervision services up to age 18, as 
455.28  defined in section 62A.047; 
455.29     (9) maternity and prenatal care services, as defined in 
455.30  sections 62A.041 and 62A.047; 
455.31     (10) inpatient hospital and outpatient services for the 
455.32  diagnosis and treatment of certain mental illnesses or 
455.33  conditions, as defined by the International Classification of 
455.34  Diseases-Clinical Modification (ICD-9-CM), seventh edition 
455.35  (1990) and as classified as ICD-9 codes 295 to 299; 
455.36     (11) ten hours per year of outpatient mental health 
456.1   diagnosis or treatment for illnesses or conditions not described 
456.2   in clause (10); 
456.3      (12) 60 hours per year of outpatient treatment of chemical 
456.4   dependency; and 
456.5      (13) 50 percent of eligible charges for prescription drugs, 
456.6   up to a separate annual maximum out-of-pocket expense of $1,000 
456.7   per individual for prescription drugs, and 100 percent of 
456.8   eligible charges thereafter.  
456.9      <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
456.10  and applies to policies, contracts, and certificates issued or 
456.11  renewed on or after that date. 
456.12     Sec. 22.  Minnesota Statutes 2002, section 62Q.19, 
456.13  subdivision 1, is amended to read: 
456.14     Subdivision 1.  [DESIGNATION.] (a) The commissioner shall 
456.15  designate essential community providers.  The criteria for 
456.16  essential community provider designation shall be the following: 
456.17     (1) a demonstrated ability to integrate applicable 
456.18  supportive and stabilizing services with medical care for 
456.19  uninsured persons and high-risk and special needs populations, 
456.20  underserved, and other special needs populations; and 
456.21     (2) a commitment to serve low-income and underserved 
456.22  populations by meeting the following requirements: 
456.23     (i) has nonprofit status in accordance with chapter 317A; 
456.24     (ii) has tax exempt status in accordance with the Internal 
456.25  Revenue Service Code, section 501(c)(3); 
456.26     (iii) charges for services on a sliding fee schedule based 
456.27  on current poverty income guidelines; and 
456.28     (iv) does not restrict access or services because of a 
456.29  client's financial limitation; 
456.30     (3) status as a local government unit as defined in section 
456.31  62D.02, subdivision 11, a hospital district created or 
456.32  reorganized under sections 447.31 to 447.37, an Indian tribal 
456.33  government, an Indian health service unit, or a community health 
456.34  board as defined in chapter 145A; 
456.35     (4) a former state hospital that specializes in the 
456.36  treatment of cerebral palsy, spina bifida, epilepsy, closed head 
457.1   injuries, specialized orthopedic problems, and other disabling 
457.2   conditions; or 
457.3      (5) ~~a rural hospital that has qualified for~~ a sole 
457.4   community hospital ~~financial assistance grant in the past three~~ 
457.5   ~~years under section 144.1484, subdivision 1~~.  For these rural 
457.6   hospitals, the essential community provider designation applies 
457.7   to all health services provided, including both inpatient and 
457.8   outpatient services.  For purposes of this section, "sole 
457.9   community hospital" means a rural hospital that: 
457.10     (i) is eligible to be classified as a sole community 
457.11  hospital according to Code of Federal Regulations, title 42, 
457.12  section 412.92, or is located in a community with a population 
457.13  of less than 5,000 and located more than 25 miles from a like 
457.14  hospital currently providing acute short-term services; 
457.15     (ii) has experienced net operating income losses in two of 
457.16  the previous three most recent consecutive hospital fiscal years 
457.17  for which audited financial information is available; and 
457.18     (iii) consists of 40 or fewer licensed beds. 
457.19     (b) Prior to designation, the commissioner shall publish 
457.20  the names of all applicants in the State Register.  The public 
457.21  shall have 30 days from the date of publication to submit 
457.22  written comments to the commissioner on the application.  No 
457.23  designation shall be made by the commissioner until the 30-day 
457.24  period has expired. 
457.25     (c) The commissioner may designate an eligible provider as 
457.26  an essential community provider for all the services offered by 
457.27  that provider or for specific services designated by the 
457.28  commissioner. 
457.29     (d) For the purpose of this subdivision, supportive and 
457.30  stabilizing services include at a minimum, transportation, child 
457.31  care, cultural, and linguistic services where appropriate. 
457.32     Sec. 23.  Minnesota Statutes 2002, section 62Q.19, 
457.33  subdivision 2, is amended to read: 
457.34     Subd. 2.  [APPLICATION.] (a) Any provider may apply to the 
457.35  commissioner for designation as an essential community provider 
457.36  by submitting an application form developed by the 
458.1   commissioner.  Except as provided in ~~paragraph~~ 
458.2   paragraphs (d) and (e), applications must be accepted within two 
458.3   years after the effective date of the rules adopted by the 
458.4   commissioner to implement this section. 
458.5      (b) Each application submitted must be accompanied by an 
458.6   application fee in an amount determined by the commissioner.  
458.7   The fee shall be no more than what is needed to cover the 
458.8   administrative costs of processing the application. 
458.9      (c) The name, address, contact person, and the date by 
458.10  which the commissioner's decision is expected to be made shall 
458.11  be classified as public data under section 13.41.  All other 
458.12  information contained in the application form shall be 
458.13  classified as private data under section 13.41 until the 
458.14  application has been approved, approved as modified, or denied 
458.15  by the commissioner.  Once the decision has been made, all 
458.16  information shall be classified as public data unless the 
458.17  applicant designates and the commissioner determines that the 
458.18  information contains trade secret information. 
458.19     (d) The commissioner shall accept an application for 
458.20  designation as an essential community provider until June 30, 
458.21  2001, from: 
458.22     (1) one applicant that is a nonprofit community health care 
458.23  facility, certified as a medical assistance provider effective 
458.24  April 1, 1998, that provides culturally competent health care to 
458.25  an underserved Southeast Asian immigrant and refugee population 
458.26  residing in the immediate neighborhood of the facility; 
458.27     (2) one applicant that is a nonprofit home health care 
458.28  provider, certified as a Medicare and a medical assistance 
458.29  provider that provides culturally competent home health care 
458.30  services to a low-income culturally diverse population; 
458.31     (3) up to five applicants that are nonprofit community 
458.32  mental health centers certified as medical assistance providers 
458.33  that provide mental health services to children with serious 
458.34  emotional disturbance and their families or to adults with 
458.35  serious and persistent mental illness; and 
458.36     (4) one applicant that is a nonprofit provider certified as 
459.1   a medical assistance provider that provides mental health, child 
459.2   development, and family services to children with physical and 
459.3   mental health disorders and their families. 
459.4      (e) The commissioner shall accept an application for 
459.5   designation as an essential community provider until June 30, 
459.6   2003, from one applicant that is a nonprofit community clinic 
459.7   located in Hennepin county that provides health care to an 
459.8   underserved American Indian population and that is collaborating 
459.9   with other neighboring organizations on a community diabetes 
459.10  project and an immunization project. 
459.11     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
459.12  following final enactment. 
459.13     Sec. 24.  [62Q.675] [HEARING AIDS; PERSONS 18 OR YOUNGER.] 
459.14     A health plan must cover hearing aids for individuals 18 
459.15  years of age or younger for hearing loss due to functional 
459.16  congenital malformation of the ears that is not correctable by 
459.17  other covered procedures.  Coverage required under this section 
459.18  is limited to one hearing aid in each ear every three years.  No 
459.19  special deductible, coinsurance, co-payment, or other limitation 
459.20  on the coverage under this section that is not generally 
459.21  applicable to other coverages under the plan may be imposed. 
459.22     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
459.23  and applies to policies, contracts, and certificates issued or 
459.24  renewed on or after that date. 
459.25     Sec. 25.  Minnesota Statutes 2002, section 144.1222, is 
459.26  amended by adding a subdivision to read: 
459.27     Subd. 1a.  [FEES.] All plans and specifications for public 
459.28  swimming pool and spa construction, installation, or alteration 
459.29  or requests for a variance that are submitted to the 
459.30  commissioner according to Minnesota Rules, part 4717.3975, shall 
459.31  be accompanied by the appropriate fees.  If the commissioner 
459.32  determines, upon review of the plans, that inadequate fees were 
459.33  paid, the necessary additional fees shall be paid before plan 
459.34  approval.  For purposes of determining fees, a project is 
459.35  defined as a proposal to construct or install a public pool, 
459.36  spa, special purpose pool, or wading pool and all associated 
460.1   water treatment equipment and drains, gutters, decks, water 
460.2   recreation features, spray pads, and those design and safety 
460.3   features that are within five feet of any pool or spa.  The 
460.4   commissioner shall charge the following fees for plan review and 
460.5   inspection of public pools and spas and for requests for 
460.6   variance from the public pool and spa rules:  
460.7      (1) each spa pool, $500; 
460.8      (2) projects valued at $250,000 or less, a minimum of $800 
460.9   per pool plus:  
460.10     (i) for each slide, an additional $400; and 
460.11     (ii) for each spa pool, an additional $500; 
460.12     (3) projects valued at $250,000 or more, 0.5 percent of 
460.13  documented estimated project cost to a maximum fee of $10,000; 
460.14     (4) alterations to an existing pool without changing the 
460.15  size or configuration of the pool, $400; 
460.16     (5) removal or replacement of pool disinfection equipment 
460.17  only, $75; and 
460.18     (6) request for variance from the public pool and spa 
460.19  rules, $500. 
460.20     Sec. 26.  Minnesota Statutes 2002, section 144.125, is 
460.21  amended to read: 
460.22     144.125 [TESTS OF INFANTS FOR ~~INBORN METABOLIC ERRORS~~ 
460.23  HERITABLE AND CONGENITAL DISORDERS.] 
460.24     Subdivision 1.  [DUTY TO PERFORM TESTING.] It is the duty 
460.25  of (1) the administrative officer or other person in charge of 
460.26  each institution caring for infants 28 days or less of age, (2) 
460.27  the person required in pursuance of the provisions of section 
460.28  144.215, to register the birth of a child, or (3) the nurse 
460.29  midwife or midwife in attendance at the birth, to arrange to 
460.30  have administered to every infant or child in its care tests for 
460.31  ~~inborn errors of metabolism in accordance with~~ heritable and 
460.32  congenital disorders according to subdivision 2 and rules 
460.33  prescribed by the state commissioner of health.  ~~In determining~~ 
460.34  ~~which tests must be administered, the commissioner shall take~~ 
460.35  ~~into consideration the adequacy of laboratory methods to detect~~ 
460.36  ~~the inborn metabolic error, the ability to treat or prevent~~ 
461.1   ~~medical conditions caused by the inborn metabolic error, and the~~ 
461.2   ~~severity of the medical conditions caused by the inborn~~ 
461.3   ~~metabolic error.~~  Testing and the recording and reporting of 
461.4   test results shall be performed at the times and in the manner 
461.5   prescribed by the commissioner of health.  The commissioner 
461.6   shall charge laboratory service fees so that the total of fees 
461.7   collected will approximate the costs of conducting the tests and 
461.8   implementing and maintaining a system to follow-up infants with 
461.9   ~~inborn metabolic errors~~ heritable or congenital disorders.  The 
461.10  laboratory service fee is $61 per specimen.  Costs associated 
461.11  with capital expenditures and the development of new procedures 
461.12  may be prorated over a three-year period when calculating the 
461.13  amount of the fees. 
461.14     Subd. 2.  [DETERMINATION OF TESTS TO BE ADMINISTERED.] The 
461.15  commissioner shall periodically revise the list of tests to be 
461.16  administered for determining the presence of a heritable or 
461.17  congenital disorder.  Revisions to the list shall reflect 
461.18  advances in medical science, new and improved testing methods, 
461.19  or other factors that will improve the public health.  In 
461.20  determining whether a test must be administered, the 
461.21  commissioner shall take into consideration the adequacy of 
461.22  laboratory methods to detect the heritable or congenital 
461.23  disorder, the ability to treat or prevent medical conditions 
461.24  caused by the heritable or congenital disorder, and the severity 
461.25  of the medical conditions caused by the heritable or congenital 
461.26  disorder.  The list of tests to be performed may be revised if 
461.27  the changes are recommended by the advisory committee 
461.28  established under section 144.1255, approved by the 
461.29  commissioner, and published in the State Register.  The revision 
461.30  is exempt from the rulemaking requirements in chapter 14 and 
461.31  sections 14.385 and 14.386 do not apply.  
461.32     Subd. 3.  [OBJECTION OF PARENTS TO TEST.] Persons with a 
461.33  duty to perform testing under subdivision 1 shall advise parents 
461.34  of infants (1) that the blood or tissue samples used to perform 
461.35  testing thereunder as well as the results of such testing may be 
461.36  retained by the department of health, (2) the benefit of 
462.1   retaining the blood or tissue sample, and (3) that the following 
462.2   options are available to them with respect to the testing: 
462.3      (i) to decline to have the tests, or 
462.4      (ii) to elect to have the tests but to require that all 
462.5   blood samples and records of test results be destroyed within 24 
462.6   months of the testing.  If the parents of an infant object in 
462.7   writing to testing for heritable and congenital disorders or 
462.8   elect to require that blood samples and test results be 
462.9   destroyed, the objection or election shall be recorded on a form 
462.10  that is signed by a parent or legal guardian and made part of 
462.11  the infant's medical record.  A written objection exempts an 
462.12  infant from the requirements of this section and section 144.128.
462.13     Sec. 27.  [144.1255] [ADVISORY COMMITTEE ON HERITABLE AND 
462.14  CONGENITAL DISORDERS.] 
462.15     Subdivision 1.  [CREATION AND MEMBERSHIP.] (a) By July 1, 
462.16  2003, the commissioner of health shall appoint an advisory 
462.17  committee to provide advice and recommendations to the 
462.18  commissioner concerning tests and treatments for heritable and 
462.19  congenital disorders found in newborn children.  Membership of 
462.20  the committee shall include, but not be limited to, at least one 
462.21  member from each of the following representative groups:  
462.22     (1) parents and other consumers; 
462.23     (2) primary care providers; 
462.24     (3) clinicians and researchers specializing in newborn 
462.25  diseases and disorders; 
462.26     (4) genetic counselors; 
462.27     (5) birth hospital representatives; 
462.28     (6) newborn screening laboratory professionals; 
462.29     (7) nutritionists; and 
462.30     (8) other experts as needed representing related fields 
462.31  such as emerging technologies and health insurance. 
462.32     (b) The terms and removal of members are governed by 
462.33  section 15.059.  Members shall not receive per diems but shall 
462.34  be compensated for expenses.  Notwithstanding section 15.059, 
462.35  subdivision 5, the advisory committee does not expire. 
462.36     Subd. 2.  [FUNCTION AND OBJECTIVES.] The committee's 
463.1   activities include, but are not limited to:  
463.2      (1) collection of information on the efficacy and 
463.3   reliability of various tests for heritable and congenital 
463.4   disorders; 
463.5      (2) collection of information on the availability and 
463.6   efficacy of treatments for heritable and congenital disorders; 
463.7      (3) collection of information on the severity of medical 
463.8   conditions caused by heritable and congenital disorders; 
463.9      (4) discussion and assessment of the benefits of performing 
463.10  tests for heritable or congenital disorders as compared to the 
463.11  costs, treatment limitations, or other potential disadvantages 
463.12  of requiring the tests; 
463.13     (5) discussion and assessment of ethical considerations 
463.14  surrounding the testing, treatment, and handling of data and 
463.15  specimens generated by the testing requirements of sections 
463.16  144.125 to 144.128; and 
463.17     (6) providing advice and recommendations to the 
463.18  commissioner concerning tests and treatments for heritable and 
463.19  congenital disorders found in newborn children. 
463.20     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
463.21  following final enactment. 
463.22     Sec. 28.  Minnesota Statutes 2002, section 144.128, is 
463.23  amended to read: 
463.24     144.128 [~~TREATMENT FOR POSITIVE DIAGNOSIS, REGISTRY OF~~ 
463.25  ~~CASES~~ COMMISSIONER'S DUTIES.] 
463.26     The commissioner shall: 
463.27     (1) notify the physicians of newborns tested of the results 
463.28  of the tests performed; 
463.29     ~~(1)~~ (2) make ~~arrangements~~ referrals for the necessary 
463.30  treatment of diagnosed cases of ~~hemoglobinopathy,~~ 
463.31  ~~phenylketonuria, and other inborn errors of metabolism~~ heritable 
463.32  or congenital disorders when treatment is indicated ~~and the~~ 
463.33  ~~family is uninsured and, because of a lack of available income,~~ 
463.34  ~~is unable to pay the cost of the treatment~~; 
463.35     ~~(2)~~ (3) maintain a registry of the cases of 
463.36  ~~hemoglobinopathy, phenylketonuria, and other inborn errors of~~ 
464.1   ~~metabolism~~ heritable and congenital disorders detected by the 
464.2   screening program for the purpose of follow-up services; and 
464.3      ~~(3)~~ (4) adopt rules to carry out ~~section 144.126 and this~~ 
464.4   ~~section~~ sections 144.125 to 144.128. 
464.5      Sec. 29.  Minnesota Statutes 2002, section 144.1481, 
464.6   subdivision 1, is amended to read: 
464.7      Subdivision 1.  [ESTABLISHMENT; MEMBERSHIP.] The 
464.8   commissioner of health shall establish a 15-member rural health 
464.9   advisory committee.  The committee shall consist of the 
464.10  following members, all of whom must reside outside the 
464.11  seven-county metropolitan area, as defined in section 473.121, 
464.12  subdivision 2: 
464.13     (1) two members from the house of representatives of the 
464.14  state of Minnesota, one from the majority party and one from the 
464.15  minority party; 
464.16     (2) two members from the senate of the state of Minnesota, 
464.17  one from the majority party and one from the minority party; 
464.18     (3) a volunteer member of an ambulance service based 
464.19  outside the seven-county metropolitan area; 
464.20     (4) a representative of a hospital located outside the 
464.21  seven-county metropolitan area; 
464.22     (5) a representative of a nursing home located outside the 
464.23  seven-county metropolitan area; 
464.24     (6) a medical doctor or doctor of osteopathy licensed under 
464.25  chapter 147; 
464.26     (7) a midlevel practitioner; 
464.27     (8) a registered nurse or licensed practical nurse; 
464.28     (9) a licensed health care professional from an occupation 
464.29  not otherwise represented on the committee; 
464.30     (10) a representative of an institution of higher education 
464.31  located outside the seven-county metropolitan area that provides 
464.32  training for rural health care providers; and 
464.33     (11) three consumers, at least one of whom must be an 
464.34  advocate for persons who are mentally ill or developmentally 
464.35  disabled. 
464.36     The commissioner will make recommendations for committee 
465.1   membership.  Committee members will be appointed by the 
465.2   governor.  In making appointments, the governor shall ensure 
465.3   that appointments provide geographic balance among those areas 
465.4   of the state outside the seven-county metropolitan area.  The 
465.5   chair of the committee shall be elected by the members.  The 
465.6   advisory committee is governed by section 15.059, except that 
465.7   the members do not receive per diem 
465.8   compensation.  Notwithstanding section 15.059, the advisory 
465.9   committee does not expire. 
465.10     Sec. 30.  Minnesota Statutes 2002, section 144.1483, is 
465.11  amended to read: 
465.12     144.1483 [RURAL HEALTH INITIATIVES.] 
465.13     The commissioner of health, through the office of rural 
465.14  health, and consulting as necessary with the commissioner of 
465.15  human services, the commissioner of commerce, the higher 
465.16  education services office, and other state agencies, shall: 
465.17     (1) develop a detailed plan regarding the feasibility of 
465.18  coordinating rural health care services by organizing individual 
465.19  medical providers and smaller hospitals and clinics into 
465.20  referral networks with larger rural hospitals and clinics that 
465.21  provide a broader array of services; 
465.22     (2) develop and implement a program to assist rural 
465.23  communities in establishing community health centers, as 
465.24  required by section 144.1486; 
465.25     (3) ~~administer the program of financial assistance~~ 
465.26  ~~established under section 144.1484 for rural hospitals in~~ 
465.27  ~~isolated areas of the state that are in danger of closing~~ 
465.28  ~~without financial assistance, and that have exhausted local~~ 
465.29  ~~sources of support;~~ 
465.30     ~~(4)~~ develop recommendations regarding health education and 
465.31  training programs in rural areas, including but not limited to a 
465.32  physician assistants' training program, continuing education 
465.33  programs for rural health care providers, and rural outreach 
465.34  programs for nurse practitioners within existing training 
465.35  programs; 
465.36     ~~(5)~~ (4) develop a statewide, coordinated recruitment 
466.1   strategy for health care personnel and maintain a database on 
466.2   health care personnel as required under section 144.1485; 
466.3      ~~(6)~~ (5) develop and administer technical assistance 
466.4   programs to assist rural communities in:  (i) planning and 
466.5   coordinating the delivery of local health care services; and 
466.6   (ii) hiring physicians, nurse practitioners, public health 
466.7   nurses, physician assistants, and other health personnel; 
466.8      ~~(7)~~ (6) study and recommend changes in the regulation of 
466.9   health care personnel, such as nurse practitioners and physician 
466.10  assistants, related to scope of practice, the amount of on-site 
466.11  physician supervision, and dispensing of medication, to address 
466.12  rural health personnel shortages; 
466.13     ~~(8)~~ (7) support efforts to ensure continued funding for 
466.14  medical and nursing education programs that will increase the 
466.15  number of health professionals serving in rural areas; 
466.16     ~~(9)~~ (8) support efforts to secure higher reimbursement for 
466.17  rural health care providers from the Medicare and medical 
466.18  assistance programs; 
466.19     ~~(10)~~ (9) coordinate the development of a statewide plan for 
466.20  emergency medical services, in cooperation with the emergency 
466.21  medical services advisory council; 
466.22     ~~(11)~~ (10) establish a Medicare rural hospital flexibility 
466.23  program pursuant to section 1820 of the federal Social Security 
466.24  Act, United States Code, title 42, section 1395i-4, by 
466.25  developing a state rural health plan and designating, consistent 
466.26  with the rural health plan, rural nonprofit or public hospitals 
466.27  in the state as critical access hospitals.  Critical access 
466.28  hospitals shall include facilities that are certified by the 
466.29  state as necessary providers of health care services to 
466.30  residents in the area.  Necessary providers of health care 
466.31  services are designated as critical access hospitals on the 
466.32  basis of being more than 20 miles, defined as official mileage 
466.33  as reported by the Minnesota department of transportation, from 
466.34  the next nearest hospital, being the sole hospital in the 
466.35  county, being a hospital located in a county with a designated 
466.36  medically underserved area or health professional shortage area, 
467.1   or being a hospital located in a county contiguous to a county 
467.2   with a medically underserved area or health professional 
467.3   shortage area.  A critical access hospital located in a county 
467.4   with a designated medically underserved area or a health 
467.5   professional shortage area or in a county contiguous to a county 
467.6   with a medically underserved area or health professional 
467.7   shortage area shall continue to be recognized as a critical 
467.8   access hospital in the event the medically underserved area or 
467.9   health professional shortage area designation is subsequently 
467.10  withdrawn; and 
467.11     ~~(12)~~ (11) carry out other activities necessary to address 
467.12  rural health problems. 
467.13     Sec. 31.  Minnesota Statutes 2002, section 144.1488, 
467.14  subdivision 4, is amended to read: 
467.15     Subd. 4.  [ELIGIBLE HEALTH PROFESSIONALS.] (a) To be 
467.16  eligible to apply to the commissioner for the loan repayment 
467.17  program, health professionals must be citizens or nationals of 
467.18  the United States, must not have any unserved obligations for 
467.19  service to a federal, state, or local government, or other 
467.20  entity, must have a current and unrestricted Minnesota license 
467.21  to practice, and must be ready to begin full-time clinical 
467.22  practice upon signing a contract for obligated service. 
467.23     (b) Eligible providers are those specified by the federal 
467.24  Bureau of ~~Primary Health Care~~ Health Professions in the policy 
467.25  information notice for the state's current federal grant 
467.26  application.  A health professional selected for participation 
467.27  is not eligible for loan repayment until the health professional 
467.28  has an employment agreement or contract with an eligible loan 
467.29  repayment site and has signed a contract for obligated service 
467.30  with the commissioner. 
467.31     Sec. 32.  Minnesota Statutes 2002, section 144.1491, 
467.32  subdivision 1, is amended to read: 
467.33     Subdivision 1.  [PENALTIES FOR BREACH OF CONTRACT.] A 
467.34  program participant who fails to complete ~~two~~ the required years 
467.35  of obligated service shall repay the amount paid, as well as a 
467.36  financial penalty ~~based upon the length of the service~~ 
468.1   ~~obligation not fulfilled.  If the participant has served at~~ 
468.2   ~~least one year, the financial penalty is the number of unserved~~ 
468.3   ~~months multiplied by $1,000.  If the participant has served less~~ 
468.4   ~~than one year, the financial penalty is the total number of~~ 
468.5   ~~obligated months multiplied by $1,000~~ specified by the federal 
468.6   Bureau of Health Professions in the policy information notice 
468.7   for the state's current federal grant application.  The 
468.8   commissioner shall report to the appropriate health-related 
468.9   licensing board a participant who fails to complete the service 
468.10  obligation and fails to repay the amount paid or fails to pay 
468.11  any financial penalty owed under this subdivision. 
468.12     Sec. 33.  [144.1501] [HEALTH PROFESSIONAL EDUCATION LOAN 
468.13  FORGIVENESS PROGRAM.] 
468.14     Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
468.15  section, the following definitions apply.  
468.16     (b) "Designated rural area" means:  
468.17     (1) an area in Minnesota outside the counties of Anoka, 
468.18  Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 
468.19  excluding the cities of Duluth, Mankato, Moorhead, Rochester, 
468.20  and St. Cloud; or 
468.21     (2) a municipal corporation, as defined under section 
468.22  471.634, that is physically located, in whole or in part, in an 
468.23  area defined as a designated rural area under clause (1).  
468.24     (c) "Emergency circumstances" means those conditions that 
468.25  make it impossible for the participant to fulfill the service 
468.26  commitment, including death, total and permanent disability, or 
468.27  temporary disability lasting more than two years. 
468.28     (d) "Medical resident" means an individual participating in 
468.29  a medical residency in family practice, internal medicine, 
468.30  obstetrics and gynecology, pediatrics, or psychiatry.  
468.31     (e) "Midlevel practitioner" means a nurse practitioner, 
468.32  nurse-midwife, nurse anesthetist, advanced clinical nurse 
468.33  specialist, or physician assistant.  
468.34     (f) "Nurse" means an individual who has completed training 
468.35  and received all licensing or certification necessary to perform 
468.36  duties as a licensed practical nurse or registered nurse.  
469.1      (g) "Nurse-midwife" means a registered nurse who has 
469.2   graduated from a program of study designed to prepare registered 
469.3   nurses for advanced practice as nurse-midwives.  
469.4      (h) "Nurse practitioner" means a registered nurse who has 
469.5   graduated from a program of study designed to prepare registered 
469.6   nurses for advanced practice as nurse practitioners.  
469.7      (i) "Physician" means an individual who is licensed to 
469.8   practice medicine in the areas of family practice, internal 
469.9   medicine, obstetrics and gynecology, pediatrics, or psychiatry.  
469.10     (j) "Physician assistant" means a person registered under 
469.11  chapter 147A.  
469.12     (k) "Qualified educational loan" means a government, 
469.13  commercial, or foundation loan for actual costs paid for 
469.14  tuition, reasonable education expenses, and reasonable living 
469.15  expenses related to the graduate or undergraduate education of a 
469.16  health care professional.  
469.17     (l) "Underserved urban community" means a Minnesota urban 
469.18  area or population included in the list of designated primary 
469.19  medical care health professional shortage areas (HPSAs), 
469.20  medically underserved areas (MUAs), or medically underserved 
469.21  populations (MUPs) maintained and updated by the United States 
469.22  Department of Health and Human Services.  
469.23     Subd. 2.  [CREATION OF ACCOUNT.] A health professional 
469.24  education loan forgiveness program account is established.  The 
469.25  commissioner of health shall use money from the account to 
469.26  establish a loan forgiveness program for medical residents 
469.27  agreeing to practice in designated rural areas or underserved 
469.28  urban communities, for midlevel practitioners agreeing to 
469.29  practice in designated rural areas, and for nurses who agree to 
469.30  practice in a Minnesota nursing home or intermediate care 
469.31  facility for persons with mental retardation or related 
469.32  conditions.  Appropriations made to the account do not cancel 
469.33  and are available until expended, except that at the end of each 
469.34  biennium, any remaining balance in the account that is not 
469.35  committed by contract and not needed to fulfill existing 
469.36  commitments shall cancel to the fund. 
470.1      Subd. 3.  [ELIGIBILITY.] (a) To be eligible to participate 
470.2   in the loan forgiveness program, an individual must: 
470.3      (1) be a medical resident or be enrolled in a midlevel 
470.4   practitioner, registered nurse, or a licensed practical nurse 
470.5   training program; and 
470.6      (2) submit an application to the commissioner of health.  
470.7      (b) An applicant selected to participate must sign a 
470.8   contract to agree to serve a minimum three-year full-time 
470.9   service obligation according to subdivision 2, which shall begin 
470.10  no later than March 31 following completion of required training.
470.11     Subd. 4.  [LOAN FORGIVENESS.] The commissioner of health 
470.12  may select applicants each year for participation in the loan 
470.13  forgiveness program, within the limits of available funding.  
470.14  The commissioner shall distribute available funds for loan 
470.15  forgiveness proportionally among the eligible professions 
470.16  according to the vacancy rate for each profession in the 
470.17  required geographic area or facility type specified in 
470.18  subdivision 2.  The commissioner shall allocate funds for 
470.19  physician loan forgiveness so that 75 percent of the funds 
470.20  available are used for rural physician loan forgiveness and 25 
470.21  percent of the funds available are used for underserved urban 
470.22  communities loan forgiveness.  If the commissioner does not 
470.23  receive enough qualified applicants each year to use the entire 
470.24  allocation of funds for urban underserved communities, the 
470.25  remaining funds may be allocated for rural physician loan 
470.26  forgiveness.  Applicants are responsible for securing their own 
470.27  qualified educational loans.  The commissioner shall select 
470.28  participants based on their suitability for practice serving the 
470.29  required geographic area or facility type specified in 
470.30  subdivision 2, as indicated by experience or training.  The 
470.31  commissioner shall give preference to applicants closest to 
470.32  completing their training.  For each year that a participant 
470.33  meets the service obligation required under subdivision 3, up to 
470.34  a maximum of four years, the commissioner shall make annual 
470.35  disbursements directly to the participant equivalent to 15 
470.36  percent of the average educational debt for indebted graduates 
471.1   in their profession in the year closest to the applicant's 
471.2   selection for which information is available, not to exceed the 
471.3   balance of the participant's qualifying educational loans.  
471.4   Before receiving loan repayment disbursements and as requested, 
471.5   the participant must complete and return to the commissioner an 
471.6   affidavit of practice form provided by the commissioner 
471.7   verifying that the participant is practicing as required under 
471.8   subdivisions 2 and 3.  The participant must provide the 
471.9   commissioner with verification that the full amount of loan 
471.10  repayment disbursement received by the participant has been 
471.11  applied toward the designated loans.  After each disbursement, 
471.12  verification must be received by the commissioner and approved 
471.13  before the next loan repayment disbursement is made.  
471.14  Participants who move their practice remain eligible for loan 
471.15  repayment as long as they practice as required under subdivision 
471.16  2.  
471.17     Subd. 5.  [PENALTY FOR NONFULFILLMENT.] If a participant 
471.18  does not fulfill the required minimum commitment of service 
471.19  according to subdivision 3, the commissioner of health shall 
471.20  collect from the participant the total amount paid to the 
471.21  participant under the loan forgiveness program plus interest at 
471.22  a rate established according to section 270.75.  The 
471.23  commissioner shall deposit the money collected in the health 
471.24  care access fund to be credited to the health professional 
471.25  education loan forgiveness program account established in 
471.26  subdivision 2.  The commissioner shall allow waivers of all or 
471.27  part of the money owed the commissioner as a result of a 
471.28  nonfulfillment penalty if emergency circumstances prevented 
471.29  fulfillment of the minimum service commitment.  
471.30     Subd. 6.  [RULES.] The commissioner may adopt rules to 
471.31  implement this section.  
471.32     Sec. 34.  Minnesota Statutes 2002, section 144.1502, 
471.33  subdivision 4, is amended to read: 
471.34     Subd. 4.  [LOAN FORGIVENESS.] The commissioner of health 
471.35  may accept ~~up to 14~~ applicants ~~per~~ each year for participation 
471.36  in the loan forgiveness program, within the limits of available 
472.1   funding.  Applicants are responsible for securing their own 
472.2   loans.  The commissioner shall select participants based on 
472.3   their suitability for practice serving public program patients, 
472.4   as indicated by experience or training.  The commissioner shall 
472.5   give preference to applicants who have attended a Minnesota 
472.6   dentistry educational institution and to applicants closest to 
472.7   completing their training.  For each year that a participant 
472.8   meets the service obligation required under subdivision 3, up to 
472.9   a maximum of four years, the commissioner shall make annual 
472.10  disbursements directly to the participant equivalent to ~~$10,000~~ 
472.11  ~~per year of service, not to exceed $40,000~~ 15 percent of the 
472.12  average educational debt for indebted dental school graduates in 
472.13  the year closest to the applicant's selection for which 
472.14  information is available or the balance of the qualifying 
472.15  educational loans, whichever is less.  Before receiving loan 
472.16  repayment disbursements and as requested, the participant must 
472.17  complete and return to the commissioner an affidavit of practice 
472.18  form provided by the commissioner verifying that the participant 
472.19  is practicing as required under subdivision 3.  The participant 
472.20  must provide the commissioner with verification that the full 
472.21  amount of loan repayment disbursement received by the 
472.22  participant has been applied toward the designated loans.  After 
472.23  each disbursement, verification must be received by the 
472.24  commissioner and approved before the next loan repayment 
472.25  disbursement is made.  Participants who move their practice 
472.26  remain eligible for loan repayment as long as they practice as 
472.27  required under subdivision 3. 
472.28     Sec. 35.  Minnesota Statutes 2002, section 144.396, 
472.29  subdivision 1, is amended to read: 
472.30     Subdivision 1.  [PURPOSE.] The legislature finds that it is 
472.31  important to reduce the prevalence of tobacco use among the 
472.32  youth of this state.  It is a goal of the state to reduce 
472.33  tobacco use among youth by ~~30~~ 25 percent by the year 2005, and 
472.34  to promote statewide and local tobacco use prevention activities 
472.35  to achieve this goal.  
472.36     Sec. 36.  Minnesota Statutes 2002, section 144.396, 
473.1   subdivision 5, is amended to read: 
473.2      Subd. 5.  [STATEWIDE TOBACCO PREVENTION GRANTS.] (a) To the 
473.3   extent funds are appropriated for the purposes of this 
473.4   subdivision, the commissioner of health shall award competitive 
473.5   grants to eligible applicants for projects and initiatives 
473.6   directed at the prevention of tobacco use.  The project areas 
473.7   for grants include: 
473.8      (1) statewide public education and information campaigns 
473.9   which include implementation at the local level; and 
473.10     (2) coordinated special projects, including training and 
473.11  technical assistance, a resource clearinghouse, and contracts 
473.12  with ethnic and minority communities. 
473.13     (b) Eligible applicants may include, but are not limited 
473.14  to, nonprofit organizations, colleges and universities, 
473.15  professional health associations, community health boards, and 
473.16  other health care organizations.  Applicants must submit 
473.17  proposals to the commissioner.  The proposals must specify the 
473.18  strategies to be implemented to target tobacco use among youth, 
473.19  and must take into account the need for a coordinated statewide 
473.20  tobacco prevention effort. 
473.21     (c) The commissioner must give priority to applicants who 
473.22  demonstrate that the proposed project: 
473.23     (1) is research based or based on proven effective 
473.24  strategies; 
473.25     (2) is designed to coordinate with other activities and 
473.26  education messages related to other health initiatives; 
473.27     (3) utilizes and enhances existing prevention activities 
473.28  and resources; or 
473.29     (4) involves innovative approaches preventing tobacco use 
473.30  among youth.  
473.31     Sec. 37.  Minnesota Statutes 2002, section 144.396, 
473.32  subdivision 7, is amended to read: 
473.33     Subd. 7.  [LOCAL PUBLIC HEALTH PROMOTION AND PROTECTION.] 
473.34  The commissioner shall distribute ~~the~~ funds ~~available under~~ 
473.35  ~~section 144.395, subdivision 2, paragraph (c), clause~~ 
473.36  ~~(3)~~ appropriated for the purpose of local health promotion and 
474.1   protection activities to community health boards ~~for local~~ 
474.2   ~~health promotion and protection activities~~ for local health 
474.3   initiatives other than tobacco prevention aimed at high risk 
474.4   health behaviors among youth.  The commissioner shall distribute 
474.5   these funds to the community health boards based on demographics 
474.6   and other need-based factors relating to health. 
474.7      Sec. 38.  Minnesota Statutes 2002, section 144.396, 
474.8   subdivision 10, is amended to read: 
474.9      Subd. 10.  [REPORT.] The commissioner of health shall 
474.10  submit ~~an annual~~ a biennial report to the chairs and members of 
474.11  the house health and human services finance committee and the 
474.12  senate health and family security budget division on the 
474.13  statewide and local projects and community health board 
474.14  prevention activities funded under this section.  These reports 
474.15  must include information on grant recipients, activities that 
474.16  were conducted using grant funds, and evaluation data and 
474.17  outcome measures, if available.  These reports are due by 
474.18  January 15 of ~~each year~~ the odd-numbered years, beginning in 
474.19  2001. 
474.20     Sec. 39.  Minnesota Statutes 2002, section 144.396, 
474.21  subdivision 11, is amended to read: 
474.22     Subd. 11.  [AUDITS.] The legislative auditor ~~shall~~ may 
474.23  audit tobacco use prevention and local public health ~~endowment~~ 
474.24  ~~fund~~ expenditures to ensure that the money is spent for tobacco 
474.25  use prevention measures and public health initiatives.  
474.26     Sec. 40.  Minnesota Statutes 2002, section 144.396, 
474.27  subdivision 12, is amended to read: 
474.28     Subd. 12.  [~~ENDOWMENT FUND~~ FUNDS NOT TO SUPPLANT EXISTING 
474.29  FUNDING.] ~~Appropriations from the tobacco use prevention and~~ 
474.30  ~~local public health endowment fund~~ Funds appropriated to the 
474.31  statewide tobacco prevention grants, local tobacco prevention 
474.32  grants, or the local public health promotion and prevention must 
474.33  not be used as a substitute for traditional sources of funding 
474.34  tobacco use prevention activities or public health initiatives.  
474.35  Any local unit of government receiving money under this section 
474.36  must ensure that existing local financial efforts remain in 
475.1   place. 
475.2      Sec. 41.  Minnesota Statutes 2002, section 144.414, 
475.3   subdivision 3, is amended to read: 
475.4      Subd. 3.  [HEALTH CARE FACILITIES AND CLINICS.] (a) Smoking 
475.5   is prohibited in any area of a hospital, health care clinic, 
475.6   doctor's office, or other health care-related facility, other 
475.7   than a nursing home, boarding care facility, or licensed 
475.8   residential facility, except as allowed in this subdivision.  
475.9      (b) ~~Smoking by patients in a chemical dependency treatment~~ 
475.10  ~~program or mental health program may be allowed in a separated~~ 
475.11  ~~well-ventilated area pursuant to a policy established by the~~ 
475.12  ~~administrator of the program that identifies circumstances in~~ 
475.13  ~~which prohibiting smoking would interfere with the treatment of~~ 
475.14  ~~persons recovering from chemical dependency or mental illness.~~  
475.15     ~~(c)~~ Smoking by participants in peer reviewed scientific 
475.16  studies related to the health effects of smoking may be allowed 
475.17  in a separated room ventilated at a rate of 60 cubic feet per 
475.18  minute per person pursuant to a policy that is approved by the 
475.19  commissioner and is established by the administrator of the 
475.20  program to minimize exposure of nonsmokers to smoke.  
475.21     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2004.
475.22     Sec. 42.  [144.5509] [RADIATION THERAPY FACILITY 
475.23  CONSTRUCTION.] 
475.24     (a) A radiation therapy facility may be constructed only by 
475.25  an entity owned, operated, or controlled by a hospital licensed 
475.26  according to sections 144.50 to 144.56 either alone or in 
475.27  cooperation with another entity. 
475.28     (b) This section expires August 1, 2008. 
475.29     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
475.30  following final enactment and applies to construction commenced 
475.31  on or after that date. 
475.32     Sec. 43.  Minnesota Statutes 2002, section 144.551, 
475.33  subdivision 1, is amended to read: 
475.34     Subdivision 1.  [RESTRICTED CONSTRUCTION OR MODIFICATION.] 
475.35  (a) The following construction or modification may not be 
475.36  commenced:  
476.1      (1) any erection, building, alteration, reconstruction, 
476.2   modernization, improvement, extension, lease, or other 
476.3   acquisition by or on behalf of a hospital that increases the bed 
476.4   capacity of a hospital, relocates hospital beds from one 
476.5   physical facility, complex, or site to another, or otherwise 
476.6   results in an increase or redistribution of hospital beds within 
476.7   the state; and 
476.8      (2) the establishment of a new hospital.  
476.9      (b) This section does not apply to:  
476.10     (1) construction or relocation within a county by a 
476.11  hospital, clinic, or other health care facility that is a 
476.12  national referral center engaged in substantial programs of 
476.13  patient care, medical research, and medical education meeting 
476.14  state and national needs that receives more than 40 percent of 
476.15  its patients from outside the state of Minnesota; 
476.16     (2) a project for construction or modification for which a 
476.17  health care facility held an approved certificate of need on May 
476.18  1, 1984, regardless of the date of expiration of the 
476.19  certificate; 
476.20     (3) a project for which a certificate of need was denied 
476.21  before July 1, 1990, if a timely appeal results in an order 
476.22  reversing the denial; 
476.23     (4) a project exempted from certificate of need 
476.24  requirements by Laws 1981, chapter 200, section 2; 
476.25     (5) a project involving consolidation of pediatric 
476.26  specialty hospital services within the Minneapolis-St. Paul 
476.27  metropolitan area that would not result in a net increase in the 
476.28  number of pediatric specialty hospital beds among the hospitals 
476.29  being consolidated; 
476.30     (6) a project involving the temporary relocation of 
476.31  pediatric-orthopedic hospital beds to an existing licensed 
476.32  hospital that will allow for the reconstruction of a new 
476.33  philanthropic, pediatric-orthopedic hospital on an existing site 
476.34  and that will not result in a net increase in the number of 
476.35  hospital beds.  Upon completion of the reconstruction, the 
476.36  licenses of both hospitals must be reinstated at the capacity 
477.1   that existed on each site before the relocation; 
477.2      (7) the relocation or redistribution of hospital beds 
477.3   within a hospital building or identifiable complex of buildings 
477.4   provided the relocation or redistribution does not result in: 
477.5   (i) an increase in the overall bed capacity at that site; (ii) 
477.6   relocation of hospital beds from one physical site or complex to 
477.7   another; or (iii) redistribution of hospital beds within the 
477.8   state or a region of the state; 
477.9      (8) relocation or redistribution of hospital beds within a 
477.10  hospital corporate system that involves the transfer of beds 
477.11  from a closed facility site or complex to an existing site or 
477.12  complex provided that:  (i) no more than 50 percent of the 
477.13  capacity of the closed facility is transferred; (ii) the 
477.14  capacity of the site or complex to which the beds are 
477.15  transferred does not increase by more than 50 percent; (iii) the 
477.16  beds are not transferred outside of a federal health systems 
477.17  agency boundary in place on July 1, 1983; and (iv) the 
477.18  relocation or redistribution does not involve the construction 
477.19  of a new hospital building; 
477.20     (9) a construction project involving up to 35 new beds in a 
477.21  psychiatric hospital in Rice county that primarily serves 
477.22  adolescents and that receives more than 70 percent of its 
477.23  patients from outside the state of Minnesota; 
477.24     (10) a project to replace a hospital or hospitals with a 
477.25  combined licensed capacity of 130 beds or less if:  (i) the new 
477.26  hospital site is located within five miles of the current site; 
477.27  and (ii) the total licensed capacity of the replacement 
477.28  hospital, either at the time of construction of the initial 
477.29  building or as the result of future expansion, will not exceed 
477.30  70 licensed hospital beds, or the combined licensed capacity of 
477.31  the hospitals, whichever is less; 
477.32     (11) the relocation of licensed hospital beds from an 
477.33  existing state facility operated by the commissioner of human 
477.34  services to a new or existing facility, building, or complex 
477.35  operated by the commissioner of human services; from one 
477.36  regional treatment center site to another; or from one building 
478.1   or site to a new or existing building or site on the same 
478.2   campus; 
478.3      (12) the construction or relocation of hospital beds 
478.4   operated by a hospital having a statutory obligation to provide 
478.5   hospital and medical services for the indigent that does not 
478.6   result in a net increase in the number of hospital beds; 
478.7      (13) a construction project involving the addition of up to 
478.8   31 new beds in an existing nonfederal hospital in Beltrami 
478.9   county; ~~or~~ 
478.10     (14) a construction project involving the addition of up to 
478.11  eight new beds in an existing nonfederal hospital in Otter Tail 
478.12  county with 100 licensed acute care beds; 
478.13     (15) a construction project involving the addition of 20 
478.14  new hospital beds used for rehabilitation services in an 
478.15  existing hospital in Carver county serving the southwest 
478.16  suburban metropolitan area.  Beds constructed under this clause 
478.17  shall not be eligible for reimbursement under medical 
478.18  assistance, general assistance medical care, or MinnesotaCare; 
478.19  or 
478.20     (16) a project for the construction or relocation of up to 
478.21  20 hospital beds for the operation of up to two psychiatric 
478.22  facilities or units for children provided that the operation of 
478.23  the facilities or units have received the approval of the 
478.24  commissioner of human services. 
478.25     Sec. 44.  Minnesota Statutes 2002, section 144E.50, 
478.26  subdivision 5, is amended to read: 
478.27     Subd. 5.  [DISTRIBUTION.] Money from the fund shall be 
478.28  distributed according to this subdivision.  ~~Ninety-three and~~ 
478.29  ~~one-third~~ Ninety-five percent of the fund shall be distributed 
478.30  annually on a contract for services basis with each of the eight 
478.31  regional emergency medical services systems designated by the 
478.32  board.  The systems shall be governed by a body consisting of 
478.33  appointed representatives from each of the counties in that 
478.34  region and shall also include representatives from emergency 
478.35  medical services organizations.  The board shall contract with a 
478.36  regional entity only if the contract proposal satisfactorily 
479.1   addresses proposed emergency medical services activities in the 
479.2   following areas:  personnel training, transportation 
479.3   coordination, public safety agency cooperation, communications 
479.4   systems maintenance and development, public involvement, health 
479.5   care facilities involvement, and system management.  If each of 
479.6   the regional emergency medical services systems submits a 
479.7   satisfactory contract proposal, then this part of the fund shall 
479.8   be distributed evenly among the regions.  If one or more of the 
479.9   regions does not contract for the full amount of its even share 
479.10  or if its proposal is unsatisfactory, then the board may 
479.11  reallocate the unused funds to the remaining regions on a pro 
479.12  rata basis.  ~~Six and two-thirds~~ Five percent of the fund shall 
479.13  be used by the board to support regionwide reporting systems and 
479.14  to provide other regional administration and technical 
479.15  assistance. 
479.16     Sec. 45.  Minnesota Statutes 2002, section 145.881, 
479.17  subdivision 1, is amended to read: 
479.18     Subdivision 1.  [COMPOSITION OF TASK FORCE.] The 
479.19  commissioner shall establish and appoint a maternal and child 
479.20  health advisory task force consisting of 15 members who will 
479.21  provide equal representation from: 
479.22     (1) professionals with expertise in maternal and child 
479.23  health services; 
479.24     (2) representatives of community health boards as defined 
479.25  in section 145A.02, subdivision 5; and 
479.26     (3) consumer representatives interested in the health of 
479.27  mothers and children. 
479.28     No members shall be employees of the state department of 
479.29  health.  Section 15.059 governs the maternal and child health 
479.30  advisory task force.  Notwithstanding section 15.059, the 
479.31  maternal and child health advisory task force expires June 30, 
479.32  2007. 
479.33     Sec. 46.  Minnesota Statutes 2002, section 145A.10, 
479.34  subdivision 10, is amended to read: 
479.35     Subd. 10.  [STATE AND LOCAL ADVISORY COMMITTEES.] (a) A 
479.36  state community health advisory committee is established to 
480.1   advise, consult with, and make recommendations to the 
480.2   commissioner on the development, maintenance, funding, and 
480.3   evaluation of community health services.  Each community health 
480.4   board may appoint a member to serve on the committee.  The 
480.5   committee must meet at least quarterly, and special meetings may 
480.6   be called by the committee chair or a majority of the members.  
480.7   Members or their alternates may receive a per diem and must be 
480.8   reimbursed for travel and other necessary expenses while engaged 
480.9   in their official duties.  Notwithstanding section 15.059, the 
480.10  state community health advisory committee does not expire. 
480.11     (b) The city councils or county boards that have 
480.12  established or are members of a community health board must 
480.13  appoint a community health advisory committee to advise, consult 
480.14  with, and make recommendations to the community health board on 
480.15  matters relating to the development, maintenance, funding, and 
480.16  evaluation of community health services.  The committee must 
480.17  consist of at least five members and must be generally 
480.18  representative of the population and health care providers of 
480.19  the community health service area.  The committee must meet at 
480.20  least three times a year and at the call of the chair or a 
480.21  majority of the members.  Members may receive a per diem and 
480.22  reimbursement for travel and other necessary expenses while 
480.23  engaged in their official duties. 
480.24     (c) State and local advisory committees must adopt bylaws 
480.25  or operating procedures that specify the length of terms of 
480.26  membership, procedures for assuring that no more than half of 
480.27  these terms expire during the same year, and other matters 
480.28  relating to the conduct of committee business.  Bylaws or 
480.29  operating procedures may allow one alternate to be appointed for 
480.30  each member of a state or local advisory committee.  Alternates 
480.31  may be given full or partial powers and duties of members. 
480.32     Sec. 47.  Minnesota Statutes 2002, section 147A.08, is 
480.33  amended to read: 
480.34     147A.08 [EXEMPTIONS.] 
480.35     (a) This chapter does not apply to, control, prevent, or 
480.36  restrict the practice, service, or activities of persons listed 
481.1   in section 147.09, clauses (1) to (6) and (8) to (13), persons 
481.2   regulated under section 214.01, subdivision 2, or persons 
481.3   defined in section ~~144.1495~~ 144.1501, subdivision 1, 
481.4   paragraphs ~~(a) to (d)~~ (e), (g), and (h). 
481.5      (b) Nothing in this chapter shall be construed to require 
481.6   registration of: 
481.7      (1) a physician assistant student enrolled in a physician 
481.8   assistant or surgeon assistant educational program accredited by 
481.9   the Committee on Allied Health Education and Accreditation or by 
481.10  its successor agency approved by the board; 
481.11     (2) a physician assistant employed in the service of the 
481.12  federal government while performing duties incident to that 
481.13  employment; or 
481.14     (3) technicians, other assistants, or employees of 
481.15  physicians who perform delegated tasks in the office of a 
481.16  physician but who do not identify themselves as a physician 
481.17  assistant. 
481.18     Sec. 48.  Minnesota Statutes 2002, section 148.5194, 
481.19  subdivision 1, is amended to read: 
481.20     Subdivision 1.  [FEE PRORATION.] The commissioner shall 
481.21  prorate the registration fee for clinical fellowship, temporary, 
481.22  and first time registrants according to the number of months 
481.23  that have elapsed between the date registration is issued and 
481.24  the date registration expires or must be renewed under section 
481.25  148.5191, subdivision 4.  
481.26     Sec. 49.  Minnesota Statutes 2002, section 148.5194, 
481.27  subdivision 2, is amended to read: 
481.28     Subd. 2.  [BIENNIAL REGISTRATION FEE.] The fee for initial 
481.29  registration and biennial registration, clinical fellowship 
481.30  registration, temporary registration, or renewal is $200.  
481.31     Sec. 50.  Minnesota Statutes 2002, section 148.5194, 
481.32  subdivision 3, is amended to read: 
481.33     Subd. 3.  [BIENNIAL REGISTRATION FEE FOR DUAL 
481.34  REGISTRATION.] The fee for initial registration and biennial 
481.35  registration, clinical fellowship registration, temporary 
481.36  registration, or renewal is $200.  
482.1      Sec. 51.  Minnesota Statutes 2002, section 148.5194, is 
482.2   amended by adding a subdivision to read: 
482.3      Subd. 6.  [VERIFICATION OF CREDENTIAL.] The fee for written 
482.4   verification of credentialed status is $25. 
482.5      Sec. 52.  Minnesota Statutes 2002, section 148.6445, 
482.6   subdivision 7, is amended to read: 
482.7      Subd. 7.  [~~CERTIFICATION~~ VERIFICATION TO OTHER STATES.] The 
482.8   fee for ~~certification~~ verification of licensure to other states 
482.9   is $25. 
482.10     Sec. 53.  [148C.12] [FEES.] 
482.11     Subdivision 1.  [APPLICATION FEE.] The application fee is 
482.12  $295.  
482.13     Subd. 2.  [BIENNIAL RENEWAL FEE.] The license renewal fee 
482.14  is $295.  If the commissioner changes the renewal schedule and 
482.15  the expiration date is less than two years, the fee must be 
482.16  prorated.  
482.17     Subd. 3.  [TEMPORARY PERMIT FEE.] The initial fee for 
482.18  applicants under section 148C.04, subdivision 6, paragraph (a), 
482.19  is $100.  The fee for annual renewal of a temporary permit is 
482.20  $100.  
482.21     Subd. 4.  [EXAMINATION FEE.] The examination fee for the 
482.22  written examination is $95 and for the oral examination is $200. 
482.23     Subd. 5.  [INACTIVE RENEWAL FEE.] The inactive renewal fee 
482.24  is $150.  
482.25     Subd. 6.  [LATE FEE.] The late fee is 25 percent of the 
482.26  biennial renewal fee, the inactive renewal fee, or the annual 
482.27  fee for renewal of temporary practice status.  
482.28     Subd. 7.  [FEE TO RENEW AFTER EXPIRATION OF LICENSE.] The 
482.29  fee for renewal of a license that has expired for less than two 
482.30  years is the total of the biennial renewal fee, the late fee, 
482.31  and a fee of $100 for review and approval of the continuing 
482.32  education report.  
482.33     Subd. 8.  [FEE FOR LICENSE VERIFICATIONS.] The fee for 
482.34  license verification to institutions and other jurisdictions is 
482.35  $25.  
482.36     Subd. 9.  [SURCHARGE FEE.] Notwithstanding section 
483.1   16A.1285, subdivision 2, a surcharge of $99 shall be paid at the 
483.2   time of initial application for or renewal of an alcohol and 
483.3   drug counselor license until June 30, 2013.  
483.4      Subd. 10.  [NONREFUNDABLE FEES.] All fees are nonrefundable.
483.5      Sec. 54.  Minnesota Statutes 2002, section 153A.17, is 
483.6   amended to read: 
483.7      153A.17 [EXPENSES; FEES.] 
483.8      The expenses for administering the certification 
483.9   requirements including the complaint handling system for hearing 
483.10  aid dispensers in sections 153A.14 and 153A.15 and the consumer 
483.11  information center under section 153A.18 must be paid from 
483.12  initial application and examination fees, renewal fees, 
483.13  penalties, and fines.  All fees are nonrefundable.  The 
483.14  certificate application fee is ~~$165 for audiologists registered~~ 
483.15  ~~under section 148.511 and $490 for all others~~ $350, the 
483.16  examination fee is ~~$200~~ $250 for the written portion and 
483.17  ~~$200~~ $250 for the practical portion each time one or the other 
483.18  is taken, and the trainee application fee 
483.19  is ~~$100~~ $200.  ~~Notwithstanding the policy set forth in section~~ 
483.20  ~~16A.1285, subdivision 2, a surcharge of $165 for audiologists~~ 
483.21  ~~registered under section 148.511 and $330 for all others shall~~ 
483.22  ~~be paid at the time of application or renewal until June 30,~~ 
483.23  ~~2003, to recover the commissioner's accumulated direct~~ 
483.24  ~~expenditures for administering the requirements of this~~ 
483.25  ~~chapter.~~  The penalty fee for late submission of a renewal 
483.26  application is $200.  The fee for verification of certification 
483.27  to other jurisdictions or entities is $25.  All fees, penalties, 
483.28  and fines received must be deposited in the state government 
483.29  special revenue fund.  The commissioner may prorate the 
483.30  certification fee for new applicants based on the number of 
483.31  quarters remaining in the annual certification period. 
483.32     Sec. 55.  Minnesota Statutes 2002, section 239.761, 
483.33  subdivision 3, is amended to read: 
483.34     Subd. 3.  [GASOLINE.] (a) Gasoline that is not blended with 
483.35  ethanol must not be contaminated with water or other impurities 
483.36  and must comply with ASTM specification ~~D 4814-96~~ D4814-01.  
484.1   Gasoline that is not blended with ethanol must also comply with 
484.2   the volatility requirements in Code of Federal Regulations, 
484.3   title 40, part 80.  
484.4      (b) After gasoline is sold, transferred, or otherwise 
484.5   removed from a refinery or terminal, a person responsible for 
484.6   the product: 
484.7      (1) may blend the gasoline with agriculturally derived 
484.8   ethanol as provided in subdivision 4; 
484.9      (2) shall not blend the gasoline with any oxygenate other 
484.10  than denatured, agriculturally derived ethanol; 
484.11     (3) shall not blend the gasoline with other petroleum 
484.12  products that are not gasoline or denatured, agriculturally 
484.13  derived ethanol; 
484.14     (4) shall not blend the gasoline with products commonly and 
484.15  commercially known as casinghead gasoline, absorption gasoline, 
484.16  condensation gasoline, drip gasoline, or natural gasoline; and 
484.17     (5) may blend the gasoline with a detergent additive, an 
484.18  antiknock additive, or an additive designed to replace 
484.19  tetra-ethyl lead, that is registered by the EPA. 
484.20     Sec. 56.  Minnesota Statutes 2002, section 239.761, 
484.21  subdivision 4, is amended to read: 
484.22     Subd. 4.  [GASOLINE BLENDED WITH ETHANOL.] (a) Gasoline may 
484.23  be blended with up to ten percent, by volume, agriculturally 
484.24  derived, denatured ethanol that complies with the requirements 
484.25  of subdivision 5.  
484.26     (b) A gasoline-ethanol blend must: 
484.27     (1) comply with the volatility requirements in Code of 
484.28  Federal Regulations, title 40, part 80; 
484.29     (2) comply with ASTM specification ~~D 4814-96~~ D4814-01, or 
484.30  the gasoline base stock from which a gasoline-ethanol blend was 
484.31  produced must comply with ASTM specification ~~D 4814-96~~ D4814-01; 
484.32  and 
484.33     (3) not be blended with casinghead gasoline, absorption 
484.34  gasoline, condensation gasoline, drip gasoline, or natural 
484.35  gasoline after the gasoline-ethanol blend has been sold, 
484.36  transferred, or otherwise removed from a refinery or terminal. 
485.1      Sec. 57.  Minnesota Statutes 2002, section 239.761, 
485.2   subdivision 5, is amended to read: 
485.3      Subd. 5.  [DENATURED ETHANOL.] Denatured ethanol that is to 
485.4   be blended with gasoline must be agriculturally derived and must 
485.5   comply with ASTM specification ~~D 4806-95b~~ D4806-01.  This 
485.6   includes the requirement that ethanol may be denatured only as 
485.7   specified in Code of Federal Regulations, title 27, parts 20 and 
485.8   21. 
485.9      Sec. 58.  Minnesota Statutes 2002, section 239.761, 
485.10  subdivision 6, is amended to read: 
485.11     Subd. 6.  [GASOLINE BLENDED WITH NONETHANOL OXYGENATE.] (a) 
485.12  A person responsible for the product shall comply with the 
485.13  following requirements: 
485.14     (1) after July 1, 2000, gasoline containing in excess of 
485.15  one-third of one percent, in total, of ~~the~~ nonethanol oxygenates 
485.16  listed in paragraph (b) ~~may~~ must not be sold or offered for sale 
485.17  at any time in this state; and 
485.18     (2) after July 1, 2005, gasoline containing any of the 
485.19  nonethanol oxygenates listed in paragraph (b) ~~may~~ must not be 
485.20  sold or offered for sale in this state. 
485.21     (b) The oxygenates prohibited under paragraph (a) are: 
485.22     (1) methyl tertiary butyl ether, as defined in section 
485.23  296A.01, subdivision 34; 
485.24     (2) ethyl tertiary butyl ether, as defined in section 
485.25  296A.01, subdivision 18; or 
485.26     (3) tertiary amyl methyl ether. 
485.27     (c) Gasoline that is blended with ~~an~~ a nonethanol oxygenate 
485.28  ~~, other than denatured ethanol,~~ must comply with ASTM 
485.29  specification ~~D 4814-96~~ D4814-01.  Nonethanol oxygenates~~, other~~ 
485.30  ~~than denatured ethanol,~~ must not be blended into gasoline after 
485.31  the gasoline has been sold, transferred, or otherwise removed 
485.32  from a refinery or terminal. 
485.33     Sec. 59.  Minnesota Statutes 2002, section 239.761, 
485.34  subdivision 7, is amended to read: 
485.35     Subd. 7.  [HEATING FUEL OIL.] Heating fuel oil must comply 
485.36  with ASTM specification ~~D 396-96~~ D396-01. 
486.1      Sec. 60.  Minnesota Statutes 2002, section 239.761, 
486.2   subdivision 8, is amended to read: 
486.3      Subd. 8.  [DIESEL FUEL OIL.] Diesel fuel oil must comply 
486.4   with ASTM specification ~~D 975-96a~~ D975-01a. 
486.5      Sec. 61.  Minnesota Statutes 2002, section 239.761, 
486.6   subdivision 9, is amended to read: 
486.7      Subd. 9.  [KEROSENE.] Kerosene must comply with ASTM 
486.8   specification ~~D 3699-96a~~ D3699-01. 
486.9      Sec. 62.  Minnesota Statutes 2002, section 239.761, 
486.10  subdivision 10, is amended to read: 
486.11     Subd. 10.  [AVIATION GASOLINE.] Aviation gasoline must 
486.12  comply with ASTM specification ~~D 910-96~~ D910-00. 
486.13     Sec. 63.  Minnesota Statutes 2002, section 239.761, 
486.14  subdivision 11, is amended to read: 
486.15     Subd. 11.  [AVIATION TURBINE FUEL, JET FUEL.] Aviation 
486.16  turbine fuel and jet fuel must comply with ASTM specification ~~D~~ 
486.17  ~~1655-96c~~ D1655-01. 
486.18     Sec. 64.  Minnesota Statutes 2002, section 239.761, 
486.19  subdivision 12, is amended to read: 
486.20     Subd. 12.  [GAS TURBINE FUEL OIL.] Fuel oil for use in 
486.21  nonaviation gas turbine engines must comply with ASTM 
486.22  specification ~~D 2880-96a~~ D2880-00. 
486.23     Sec. 65.  Minnesota Statutes 2002, section 239.761, 
486.24  subdivision 13, is amended to read: 
486.25     Subd. 13.  [E85.] A blend of ethanol and gasoline, 
486.26  containing at least 60 percent ethanol and not more than 85 
486.27  percent ethanol, produced for use as a motor fuel in alternative 
486.28  fuel vehicles as defined in section 296A.01, subdivision 5, must 
486.29  comply with ASTM specification ~~D 5798-96~~ D5798-99. 
486.30     Sec. 66.  Minnesota Statutes 2002, section 239.792, is 
486.31  amended to read: 
486.32     239.792 [GASOLINE OCTANE.] 
486.33     Subdivision 1.  [DISCLOSURE.] A manufacturer, hauler, 
486.34  blender, agent, jobber, consignment agent, importer, or 
486.35  distributor who sells, delivers, or distributes gasoline or 
486.36  gasoline-oxygenate blends, shall provide, at the time of 
487.1   delivery, a bill of lading or shipping manifest to the person 
487.2   who receives the gasoline.  The bill or manifest must state the 
487.3   minimum octane of the gasoline delivered.  The stated octane 
487.4   number must be the average of the "motor method" octane number 
487.5   and the "research method" octane number as determined by the 
487.6   test methods in ASTM specification ~~D 4814-96~~ D4814-01, or by a 
487.7   test method adopted by department rule. 
487.8      Subd. 2.  [DISPENSER LABELING.] A person responsible for 
487.9   the product shall clearly, conspicuously, and permanently label 
487.10  each gasoline dispenser that is used to sell gasoline or 
487.11  gasoline-oxygenate blends at retail or to dispense gasoline or 
487.12  gasoline-oxygenate blends into the fuel supply tanks of motor 
487.13  vehicles, with the minimum octane of the gasoline dispensed.  
487.14  The label must meet the following requirements: 
487.15     (a) The octane number displayed on the label must represent 
487.16  the average of the "motor method" octane number and the 
487.17  "research method" octane number as determined by the test 
487.18  methods in ASTM specification ~~D 4814-96~~ D4814-01, or by a test 
487.19  method adopted by department rule. 
487.20     (b) The label must be at least 2-1/2 inches high and three 
487.21  inches wide, with a yellow background, black border, and black 
487.22  figures and letters. 
487.23     (c) The number representing the octane of the gasoline must 
487.24  be at least one inch high. 
487.25     (d) The label must include the words "minimum octane" and 
487.26  the term "(R+M)/2" or "(RON+MON)/2." 
487.27     Sec. 67.  [246.0141] [TOBACCO USE PROHIBITED.] 
487.28     No patient, staff, guest, or visitor on the grounds or in a 
487.29  state regional treatment center, the Minnesota security 
487.30  hospital, the Minnesota sex offender program, or the Minnesota 
487.31  extended treatment options program may possess or use tobacco or 
487.32  a tobacco related device.  For the purposes of this section, 
487.33  "tobacco" and "tobacco related device" have the meanings given 
487.34  in section 609.685, subdivision 1.  This section does not 
487.35  prohibit the possession or use of tobacco or a tobacco related 
487.36  device by an adult as part of a traditional Indian spiritual or 
488.1   cultural ceremony.  For purposes of this section, an Indian is a 
488.2   person who is a member of an Indian tribe as defined in section 
488.3   260.755, subdivision 12.  
488.4      <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2004.
488.5      Sec. 68.  Minnesota Statutes 2002, section 295.55, 
488.6   subdivision 2, is amended to read: 
488.7      Subd. 2.  [ESTIMATED TAX; HOSPITALS; SURGICAL CENTERS.] (a) 
488.8   Each hospital or surgical center must make estimated payments of 
488.9   the taxes for the calendar year in monthly installments to the 
488.10  commissioner within 15 days after the end of the month. 
488.11     (b) Estimated tax payments are not required of hospitals or 
488.12  surgical centers if:  (1) the tax for the current calendar year 
488.13  is less than $500; or (2) the tax for the previous calendar year 
488.14  is less than $500, if the taxpayer had a tax liability and was 
488.15  doing business the entire year~~; or (3) if a hospital has been~~ 
488.16  ~~allowed a grant under section 144.1484, subdivision 2, for the~~ 
488.17  ~~year~~. 
488.18     (c) Underpayment of estimated installments bear interest at 
488.19  the rate specified in section 270.75, from the due date of the 
488.20  payment until paid or until the due date of the annual return 
488.21  whichever comes first.  An underpayment of an estimated 
488.22  installment is the difference between the amount paid and the 
488.23  lesser of (1) 90 percent of one-twelfth of the tax for the 
488.24  calendar year or (2) one-twelfth of the total tax for the 
488.25  previous calendar year if the taxpayer had a tax liability and 
488.26  was doing business the entire year. 
488.27     Sec. 69.  Minnesota Statutes 2002, section 296A.01, 
488.28  subdivision 2, is amended to read: 
488.29     Subd. 2.  [AGRICULTURAL ALCOHOL GASOLINE.] "Agricultural 
488.30  alcohol gasoline" means a gasoline-ethanol blend of up to ten 
488.31  percent agriculturally derived fermentation ethanol derived from 
488.32  agricultural products, such as potatoes, cereal, grains, cheese 
488.33  whey, sugar beets, forest products, or other renewable 
488.34  resources, that: 
488.35     (1) meets the specifications in ASTM specification ~~D~~ 
488.36  ~~4806-95b~~ D4806-01; and 
489.1      (2) is denatured as specified in Code of Federal 
489.2   Regulations, title 27, parts 20 and 21. 
489.3      Sec. 70.  Minnesota Statutes 2002, section 296A.01, 
489.4   subdivision 7, is amended to read:  
489.5      Subd. 7.  [AVIATION GASOLINE.] "Aviation gasoline" means 
489.6   any gasoline that is capable of use for the purpose of producing 
489.7   or generating power for propelling internal combustion engine 
489.8   aircraft, that meets the specifications in ASTM specification ~~D~~ 
489.9   ~~910-96~~ D910-00, and that either: 
489.10     (1) is invoiced and billed by a producer, manufacturer, 
489.11  refiner, or blender to a distributor or dealer, by a distributor 
489.12  to a dealer or consumer, or by a dealer to consumer, as 
489.13  "aviation gasoline"; or 
489.14     (2) whether or not invoiced and billed as provided in 
489.15  clause (1), is received, sold, stored, or withdrawn from storage 
489.16  by any person, to be used for the purpose of producing or 
489.17  generating power for propelling internal combustion engine 
489.18  aircraft. 
489.19     Sec. 71.  Minnesota Statutes 2002, section 296A.01, 
489.20  subdivision 8, is amended to read: 
489.21     Subd. 8.  [AVIATION TURBINE FUEL AND JET FUEL.] "Aviation 
489.22  turbine fuel" and "jet fuel" mean blends of hydrocarbons derived 
489.23  from crude petroleum, natural gasoline, and synthetic 
489.24  hydrocarbons, intended for use in aviation turbine engines, and 
489.25  that meet the specifications in ASTM specification ~~D~~ 
489.26  ~~1655-96c~~ D1655-01. 
489.27     Sec. 72.  Minnesota Statutes 2002, section 296A.01, 
489.28  subdivision 14, is amended to read: 
489.29     Subd. 14.  [DIESEL FUEL OIL.] "Diesel fuel oil" means a 
489.30  petroleum distillate or blend of petroleum distillate and 
489.31  residual fuels, intended for use as a motor fuel in internal 
489.32  combustion diesel engines, that meets the specifications in ASTM 
489.33  specification ~~D 975-96a~~ D975-01A.  Diesel fuel includes number 1 
489.34  and number 2 fuel oils.  K-1 kerosene is not diesel fuel unless 
489.35  it is blended with diesel fuel for use in motor vehicles.  
489.36     Sec. 73.  Minnesota Statutes 2002, section 296A.01, 
490.1   subdivision 19, is amended to read: 
490.2      Subd. 19.  [E85.] "E85" means a petroleum product that is a 
490.3   blend of agriculturally derived denatured ethanol and gasoline 
490.4   or natural gasoline that typically contains 85 percent ethanol 
490.5   by volume, but at a minimum must contain 60 percent ethanol by 
490.6   volume.  For the purposes of this chapter, the energy content of 
490.7   E85 will be considered to be 82,000 BTUs per gallon.  E85 
490.8   produced for use as a motor fuel in alternative fuel vehicles as 
490.9   defined in subdivision 5 must comply with ASTM specification ~~D~~ 
490.10  ~~5798-96~~ D5798-99. 
490.11     Sec. 74.  Minnesota Statutes 2002, section 296A.01, 
490.12  subdivision 20, is amended to read:  
490.13     Subd. 20.  [ETHANOL, DENATURED.] "Ethanol, denatured" means 
490.14  ethanol that is to be blended with gasoline, has been 
490.15  agriculturally derived, and complies with ASTM specification ~~D~~ 
490.16  ~~4806-95b~~ D4806-01.  This includes the requirement that ethanol 
490.17  may be denatured only as specified in Code of Federal 
490.18  Regulations, title 27, parts 20 and 21. 
490.19     Sec. 75.  Minnesota Statutes 2002, section 296A.01, 
490.20  subdivision 22, is amended to read:  
490.21     Subd. 22.  [GAS TURBINE FUEL OIL.] "Gas turbine fuel oil" 
490.22  means fuel that contains mixtures of hydrocarbon oils free of 
490.23  inorganic acid and excessive amounts of solid or fibrous foreign 
490.24  matter, intended for use in nonaviation gas turbine engines, and 
490.25  that meets the specifications in ASTM specification ~~D 2880-96a~~ 
490.26  D2880-00. 
490.27     Sec. 76.  Minnesota Statutes 2002, section 296A.01, 
490.28  subdivision 23, is amended to read: 
490.29     Subd. 23.  [GASOLINE.] (a) "Gasoline" means: 
490.30     (1) all products commonly or commercially known or sold as 
490.31  gasoline regardless of their classification or uses, except 
490.32  casinghead gasoline, absorption gasoline, condensation gasoline, 
490.33  drip gasoline, or natural gasoline that under the requirements 
490.34  of section 239.761, subdivision 3, must not be blended with 
490.35  gasoline that has been sold, transferred, or otherwise removed 
490.36  from a refinery or terminal; and 
491.1      (2) any liquid prepared, advertised, offered for sale or 
491.2   sold for use as, or commonly and commercially used as, a fuel in 
491.3   spark-ignition, internal combustion engines, and that when 
491.4   tested by the weights and measures division meets the 
491.5   specifications in ASTM specification ~~D 4814-96~~ D4814-01. 
491.6      (b) Gasoline that is not blended with ethanol must not be 
491.7   contaminated with water or other impurities and must comply with 
491.8   both ASTM specification ~~D 4814-96~~ D4814-01 and the volatility 
491.9   requirements in Code of Federal Regulations, title 40, part 80. 
491.10     (c) After gasoline is sold, transferred, or otherwise 
491.11  removed from a refinery or terminal, a person responsible for 
491.12  the product: 
491.13     (1) may blend the gasoline with agriculturally derived 
491.14  ethanol, as provided in subdivision 24; 
491.15     (2) must not blend the gasoline with any oxygenate other 
491.16  than denatured, agriculturally derived ethanol; 
491.17     (3) must not blend the gasoline with other petroleum 
491.18  products that are not gasoline or denatured, agriculturally 
491.19  derived ethanol; 
491.20     (4) must not blend the gasoline with products commonly and 
491.21  commercially known as casinghead gasoline, absorption gasoline, 
491.22  condensation gasoline, drip gasoline, or natural gasoline; and 
491.23     (5) may blend the gasoline with a detergent additive, an 
491.24  antiknock additive, or an additive designed to replace 
491.25  tetra-ethyl lead, that is registered by the EPA. 
491.26     Sec. 77.  Minnesota Statutes 2002, section 296A.01, 
491.27  subdivision 24, is amended to read:  
491.28     Subd. 24.  [GASOLINE BLENDED WITH NONETHANOL OXYGENATE.] 
491.29  "Gasoline blended with nonethanol oxygenate" means gasoline 
491.30  blended with ETBE, MTBE, or other alcohol or ether, except 
491.31  denatured ethanol, that is approved as an oxygenate by the EPA, 
491.32  and that complies with ASTM specification ~~D 4814-96~~ D4814-01.  
491.33  Oxygenates, other than denatured ethanol, must not be blended 
491.34  into gasoline after the gasoline has been sold, transferred, or 
491.35  otherwise removed from a refinery or terminal. 
491.36     Sec. 78.  Minnesota Statutes 2002, section 296A.01, 
492.1   subdivision 25, is amended to read:  
492.2      Subd. 25.  [GASOLINE BLENDED WITH ETHANOL.] "Gasoline 
492.3   blended with ethanol" means gasoline blended with up to ten 
492.4   percent, by volume, agriculturally derived, denatured ethanol.  
492.5   The blend must comply with the volatility requirements in Code 
492.6   of Federal Regulations, title 40, part 80.  The blend must also 
492.7   comply with ASTM specification ~~D 4814-96~~ D4814-01, or the 
492.8   gasoline base stock from which a gasoline-ethanol blend was 
492.9   produced must comply with ASTM specification ~~D 4814-96~~ D4814-01; 
492.10  and the gasoline-ethanol blend must not be blended with 
492.11  casinghead gasoline, absorption gasoline, condensation gasoline, 
492.12  drip gasoline, or natural gasoline after the gasoline-ethanol 
492.13  blend has been sold, transferred, or otherwise removed from a 
492.14  refinery or terminal.  The blend need not comply with ASTM 
492.15  specification ~~D 4814-96~~ D4814-01 if it is subjected to a 
492.16  standard distillation test.  For a distillation test, a 
492.17  gasoline-ethanol blend is not required to comply with the 
492.18  temperature specification at the 50 percent liquid recovery 
492.19  point, if the gasoline from which the gasoline-ethanol blend was 
492.20  produced complies with all of the distillation specifications. 
492.21     Sec. 79.  Minnesota Statutes 2002, section 296A.01, 
492.22  subdivision 26, is amended to read: 
492.23     Subd. 26.  [HEATING FUEL OIL.] "Heating fuel oil" means a 
492.24  petroleum distillate, blend of petroleum distillates and 
492.25  residuals, or petroleum residual heating fuel that meets the 
492.26  specifications in ASTM specification ~~D 396-96~~ D396-01. 
492.27     Sec. 80.  Minnesota Statutes 2002, section 296A.01, 
492.28  subdivision 28, is amended to read: 
492.29     Subd. 28.  [KEROSENE.] "Kerosene" means a refined petroleum 
492.30  distillate consisting of a homogeneous mixture of hydrocarbons 
492.31  essentially free of water, inorganic acidic and basic compounds, 
492.32  and excessive amounts of particulate contaminants and that meets 
492.33  the specifications in ASTM specification ~~D 3699-96a~~ D3699-01. 
492.34     Sec. 81.  Minnesota Statutes 2002, section 296A.01, is 
492.35  amended by adding a subdivision to read:  
492.36     Subd. 38a.  [NONETHANOL OXYGENATE.] "Nonethanol oxygenate" 
493.1   means ETBE or MTBE, as defined in this section, or other alcohol 
493.2   or ether, except denatured ethanol, that is approved as an 
493.3   oxygenate by the EPA. 
493.4      Sec. 82.  Minnesota Statutes 2002, section 326.42, is 
493.5   amended to read: 
493.6      326.42 [APPLICATIONS, FEES.] 
493.7      Subdivision 1.  [APPLICATION.] Applications for plumber's 
493.8   license shall be made to the state commissioner of health, with 
493.9   fee.  Unless the applicant is entitled to a renewal, the 
493.10  applicant shall be licensed by the state commissioner of health 
493.11  only after passing a satisfactory examination by the examiners 
493.12  showing fitness.  Examination fees for both journeyman and 
493.13  master plumbers shall be in an amount prescribed by the state 
493.14  commissioner of health pursuant to section 144.122.  Upon being 
493.15  notified that of having successfully passed the examination for 
493.16  original license the applicant shall submit an application, with 
493.17  the license fee herein provided.  License fees shall be in an 
493.18  amount prescribed by the state commissioner of health pursuant 
493.19  to section 144.122.  Licenses shall expire and be renewed as 
493.20  prescribed by the commissioner pursuant to section 144.122. 
493.21     Subd. 2.  [FEES.] Plumbing system plans and specifications 
493.22  that are submitted to the commissioner for review shall be 
493.23  accompanied by the appropriate plan examination fees.  If the 
493.24  commissioner determines, upon review of the plans, that 
493.25  inadequate fees were paid, the necessary additional fees shall 
493.26  be paid prior to plan approval.  The commissioner shall charge 
493.27  the following fees for plan reviews and audits of plumbing 
493.28  installations for public, commercial, and industrial buildings:  
493.29     (1) systems with both water distribution and drain, waste, 
493.30  and vent systems and having:  
493.31     (i) 25 or fewer drainage fixture units, $150; 
493.32     (ii) 26 to 50 drainage fixture units, $250; 
493.33     (iii) 51 to 150 drainage fixture units, $350; 
493.34     (iv) 151 to 249 drainage fixture units, $500; 
493.35     (v) 250 or more drainage fixture units, $3 per drainage 
493.36  fixture unit to a maximum of $4,000; and 
494.1      (vi) interceptors, separators, or catch basins, $70 per 
494.2   interceptor, separator, or catch basin; 
494.3      (2) building sewer service only, $150; 
494.4      (3) building water service only, $150; 
494.5      (4) building water distribution system only, no drainage 
494.6   system, $5 per supply fixture unit or $150, whichever is 
494.7   greater; 
494.8      (5) storm drainage system, a minimum fee of $150 or: 
494.9      (i) $50 per drain opening, up to a maximum of $500; and 
494.10     (ii) $70 per interceptor, separator, or catch basin; 
494.11     (6) manufactured home park or campground, 1 to 25 sites, 
494.12  $300; 
494.13     (7) manufactured home park or campground, 26 to 50 sites, 
494.14  $350; 
494.15     (8) manufactured home park or campground, 51 to 125 sites, 
494.16  $400; 
494.17     (9) manufactured home park or campground, more than 125 
494.18  sites, $500; 
494.19     (10) accelerated review, double the regular fee, one-half 
494.20  to be refunded if no response from the commissioner within 15 
494.21  business days; and 
494.22     (11) revision to previously reviewed or incomplete plans: 
494.23     (i) review of plans for which commissioner has issued two 
494.24  or more requests for additional information, per review, $100 or 
494.25  ten percent of the original fee, whichever is greater; 
494.26     (ii) proposer-requested revision with no increase in 
494.27  project scope, $50 or ten percent of original fee, whichever is 
494.28  greater; and 
494.29     (iii) proposer-requested revision with an increase in 
494.30  project scope, $50 plus the difference between the original 
494.31  project fee and the revised project fee. 
494.32     Sec. 83.  Minnesota Statutes 2002, section 471.59, 
494.33  subdivision 1, is amended to read: 
494.34     Subdivision 1.  [AGREEMENT.] Two or more governmental 
494.35  units, by agreement entered into through action of their 
494.36  governing bodies, may jointly or cooperatively exercise any 
495.1   power common to the contracting parties or any similar powers, 
495.2   including those which are the same except for the territorial 
495.3   limits within which they may be exercised.  The agreement may 
495.4   provide for the exercise of such powers by one or more of the 
495.5   participating governmental units on behalf of the other 
495.6   participating units.  The term "governmental unit" as used in 
495.7   this section includes every city, county, town, school district, 
495.8   other political subdivision of this or another state, another 
495.9   state, the University of Minnesota, nonprofit hospitals licensed 
495.10  under sections 144.50 to 144.56, and any agency of the state of 
495.11  Minnesota or the United States, and includes any instrumentality 
495.12  of a governmental unit.  For the purpose of this section, an 
495.13  instrumentality of a governmental unit means an instrumentality 
495.14  having independent policy making and appropriating authority. 
495.15     Sec. 84.  2003 S.F. No. 1019, section 2, if enacted, is 
495.16  amended to read: 
495.17     Sec. 2.  [144.7063] [DEFINITIONS.] 
495.18     Subdivision 1.  [SCOPE.] Unless the context clearly 
495.19  indicates otherwise, for the purposes of sections 144.706 to 
495.20  144.7069, the terms defined in this section have the meanings 
495.21  given them. 
495.22     Subd. 2.  [COMMISSIONER.] "Commissioner" means the 
495.23  commissioner of health. 
495.24     Subd. 3.  [FACILITY.] "Facility" means a hospital licensed 
495.25  under sections 144.50 to 144.58. 
495.26     Subd. 4.  [SERIOUS DISABILITY.] "Serious disability" means 
495.27  (1) a physical or mental impairment that substantially limits 
495.28  one or more of the major life activities of an individual~~,~~ 
495.29  ~~(2)~~ or a loss of bodily function, if the impairment or loss 
495.30  lasts more than seven days or is still present at the time of 
495.31  discharge from an inpatient health care facility, or ~~(3)~~ (2) 
495.32  loss of a body part. 
495.33     Subd. 5.  [SURGERY.] "Surgery" means the treatment of 
495.34  disease, injury, or deformity by manual or operative methods.  
495.35  Surgery includes endoscopies and other invasive procedures. 
495.36     Sec. 85.  2003 S.F. No. 1019, section 3, if enacted, is 
496.1   amended to read: 
496.2      Sec. 3.  [144.7065] [FACILITY REQUIREMENTS TO REPORT, 
496.3   ANALYZE, AND CORRECT.] 
496.4      Subdivision 1.  [REPORTS OF ADVERSE HEALTH CARE EVENTS 
496.5   REQUIRED.] Each facility shall report to the commissioner the 
496.6   occurrence of any of the adverse health care events described in 
496.7   subdivisions 2 to 7 as soon as is reasonably and practically 
496.8   possible, but no later than 15 working days after discovery of 
496.9   the event.  The report shall be filed in a format specified by 
496.10  the commissioner and shall identify the facility but shall not 
496.11  include any identifying information for any of the health care 
496.12  professionals, facility employees, or patients involved.  The 
496.13  commissioner may consult with experts and organizations familiar 
496.14  with patient safety when developing the format for reporting and 
496.15  in further defining events in order to be consistent with 
496.16  industry standards. 
496.17     Subd. 2.  [SURGICAL EVENTS.] Events reportable under this 
496.18  subdivision are: 
496.19     (1) surgery performed on a wrong body part that is not 
496.20  consistent with the documented informed consent for that 
496.21  patient.  Reportable events under this clause do not include 
496.22  situations requiring prompt action that occur in the course of 
496.23  surgery or situations whose urgency precludes obtaining informed 
496.24  consent; 
496.25     (2) surgery performed on the wrong patient; 
496.26     (3) the wrong surgical procedure performed on a patient 
496.27  that is not consistent with the documented informed consent for 
496.28  that patient.  Reportable events under this clause do not 
496.29  include situations requiring prompt action that occur in the 
496.30  course of surgery or situations whose urgency precludes 
496.31  obtaining informed consent; 
496.32     (4) retention of a foreign object in a patient after 
496.33  surgery or other procedure, excluding objects intentionally 
496.34  implanted as part of a planned intervention and objects present 
496.35  prior to surgery that are intentionally retained; and 
496.36     (5) death during or immediately after surgery of a normal, 
497.1   healthy patient who has no organic, physiologic, biochemical, or 
497.2   psychiatric disturbance and for whom the pathologic processes 
497.3   for which the operation is to be performed are localized and do 
497.4   not entail a systemic disturbance. 
497.5      Subd. 3.  [PRODUCT OR DEVICE EVENTS.] Events reportable 
497.6   under this subdivision are: 
497.7      (1) patient death or serious disability associated with the 
497.8   use of contaminated drugs, devices, or biologics provided by the 
497.9   facility when the contamination is the result of generally 
497.10  detectable contaminants in drugs, devices, or biologics 
497.11  regardless of the source of the contamination or the product; 
497.12     (2) patient death or serious disability associated with the 
497.13  use or function of a device in patient care in which the device 
497.14  is used or functions other than as intended.  "Device" includes, 
497.15  but is not limited to, catheters, drains, and other specialized 
497.16  tubes, infusion pumps, and ventilators; and 
497.17     (3) patient death or serious disability associated with 
497.18  intravascular air embolism that occurs while being cared for in 
497.19  a facility, excluding deaths associated with neurosurgical 
497.20  procedures known to present a high risk of intravascular air 
497.21  embolism. 
497.22     Subd. 4.  [PATIENT PROTECTION EVENTS.] Events reportable 
497.23  under this subdivision are: 
497.24     (1) an infant discharged to the wrong person; 
497.25     (2) patient death or serious disability associated with 
497.26  patient disappearance for more than four hours, excluding events 
497.27  involving adults who have decision-making capacity; and 
497.28     (3) patient suicide or attempted suicide resulting in 
497.29  serious disability while being cared for in a facility due to 
497.30  patient actions after admission to the facility, excluding 
497.31  deaths resulting from self-inflicted injuries that were the 
497.32  reason for admission to the facility. 
497.33     Subd. 5.  [CARE MANAGEMENT EVENTS.] Events reportable under 
497.34  this subdivision are: 
497.35     (1) patient death or serious disability associated with a 
497.36  medication error, including, but not limited to, errors 
498.1   involving the wrong drug, the wrong dose, the wrong patient, the 
498.2   wrong time, the wrong rate, the wrong preparation, or the wrong 
498.3   route of administration, excluding reasonable differences in 
498.4   clinical judgment on drug selection and dose; 
498.5      (2) patient death or serious disability associated with a 
498.6   hemolytic reaction due to the administration of ABO-incompatible 
498.7   blood or blood products; 
498.8      (3) maternal death or serious disability associated with 
498.9   labor or delivery in a low-risk pregnancy while being cared for 
498.10  in a facility, including events that occur within 42 days 
498.11  postdelivery and excluding deaths from pulmonary or amniotic 
498.12  fluid embolism, acute fatty liver of pregnancy, or 
498.13  cardiomyopathy; 
498.14     (4) patient death or serious disability directly related to 
498.15  hypoglycemia, the onset of which occurs while the patient is 
498.16  being cared for in a facility; 
498.17     (5) death or serious disability, including kernicterus, 
498.18  associated with failure to identify and treat hyperbilirubinemia 
498.19  in neonates during the first 28 days of life.  
498.20  "Hyperbilirubinemia" means bilirubin levels greater than 30 
498.21  milligrams per deciliter; 
498.22     (6) stage 3 or 4 ulcers acquired after admission to a 
498.23  facility, excluding progression from stage 2 to stage 3 if stage 
498.24  2 was recognized upon admission; and 
498.25     (7) patient death or serious disability due to spinal 
498.26  manipulative therapy. 
498.27     Subd. 6.  [ENVIRONMENTAL EVENTS.] Events reportable under 
498.28  this subdivision are: 
498.29     (1) patient death or serious disability associated with an 
498.30  electric shock while being cared for in a facility, excluding 
498.31  events involving planned treatments such as electric 
498.32  countershock; 
498.33     (2) any incident in which a line designated for oxygen or 
498.34  other gas to be delivered to a patient contains the wrong gas or 
498.35  is contaminated by toxic substances; 
498.36     (3) patient death or serious disability associated with a 
499.1   burn incurred from any source while being cared for in a 
499.2   facility; 
499.3      (4) patient death associated with a fall while being cared 
499.4   for in a facility; and 
499.5      (5) patient death or serious disability associated with the 
499.6   use or lack of restraints or bedrails while being cared for in a 
499.7   facility. 
499.8      Subd. 7.  [CRIMINAL EVENTS.] Events reportable under this 
499.9   subdivision are: 
499.10     (1) any instance of care ordered by or provided by someone 
499.11  impersonating a physician, nurse, pharmacist, or other licensed 
499.12  health care provider; 
499.13     (2) abduction of a patient of any age; 
499.14     (3) sexual assault on a patient within or on the grounds of 
499.15  a facility; and 
499.16     (4) death or significant injury of a patient or staff 
499.17  member resulting from a physical assault that occurs within or 
499.18  on the grounds of a facility. 
499.19     Subd. 8.  [ROOT CAUSE ANALYSIS; CORRECTIVE ACTION PLAN.] 
499.20  Following the occurrence of an adverse health care event, the 
499.21  facility must conduct a root cause analysis of the event.  
499.22  Following the analysis, the facility must:  (1) implement a 
499.23  corrective action plan to implement the findings of the analysis 
499.24  or (2) report to the commissioner any reasons for not taking 
499.25  corrective action.  If the root cause analysis and the 
499.26  implementation of a corrective action plan are complete at the 
499.27  time an event must be reported, the findings of the analysis and 
499.28  the corrective action plan must be included in the report of the 
499.29  event.  The findings of the root cause analysis and a copy of 
499.30  the corrective action plan must otherwise be filed with the 
499.31  commissioner within 60 days of the event. 
499.32     Subd. 9.  [ELECTRONIC REPORTING.] The commissioner must 
499.33  design the reporting system so that a facility may file by 
499.34  electronic means the reports required under this section.  The 
499.35  commissioner shall encourage a facility to use the electronic 
499.36  filing option when that option is feasible for the facility. 
500.1      Subd. 10.  [RELATION TO OTHER LAW.] (a) Adverse health 
500.2   events described in subdivisions 2 to 6 do not constitute 
500.3   "maltreatment" or "a physical injury that is not reasonably 
500.4   explained" under section 626.557 and are excluded from the 
500.5   reporting requirements of section 626.557, provided the facility 
500.6   makes a determination within 24 hours of the discovery of the 
500.7   event that this section is applicable and the facility files the 
500.8   reports required under this section in a timely fashion. 
500.9      (b) A facility that has determined that an event described 
500.10  in subdivisions 2 to 6 has occurred must inform persons who are 
500.11  mandated reporters under section 626.5572, subdivision 16, of 
500.12  that determination.  A mandated reporter otherwise required to 
500.13  report under section 626.557, subdivision 3, paragraph (e), is 
500.14  relieved of the duty to report an event that the facility 
500.15  determines under paragraph (a) to be reportable under 
500.16  subdivisions 2 to 6. 
500.17     (c) The protections and immunities applicable to voluntary 
500.18  reports under section 626.557 are not affected by this section. 
500.19     (d) Notwithstanding section 626.557, a lead agency under 
500.20  section 626.5572, subdivision 13, is not required to conduct an 
500.21  investigation of an event described in subdivisions 2 to 6. 
500.22     Sec. 86.  2003 S.F. No. 1019, section 7, if enacted, is 
500.23  amended to read: 
500.24     Sec. 7.  [ADVERSE HEALTH CARE EVENTS REPORTING SYSTEM 
500.25  TRANSITION PERIOD.] 
500.26     (a) Effective July 1, 2003, limited implementation of the 
500.27  Adverse Health Care Events Reporting Act shall begin, provided 
500.28  the commissioner of health has secured sufficient nonstate funds 
500.29  for this purpose.  During this period, the commissioner must: 
500.30     (1) solicit additional nonstate funds to support full 
500.31  implementation of the system; 
500.32     (2) work with organizations and experts familiar with 
500.33  patient safety to review reporting categories in Minnesota 
500.34  Statutes, section 144.7065, make necessary clarifications, and 
500.35  develop educational materials; and 
500.36     (3) monitor activities of the National Quality Forum and 
501.1   other patient safety organizations, other states, and the 
501.2   federal government in the area of patient safety. 
501.3      (b) Effective July 1, 2003, facilities defined in Minnesota 
501.4   Statutes, section 144.7063, subdivision 3, shall report any 
501.5   adverse health care events, as defined in Minnesota Statutes, 
501.6   section 144.7065, to the incident reporting system maintained by 
501.7   the Minnesota Hospital Association.  The association shall 
501.8   provide a summary report to the commissioner that identifies the 
501.9   types of events by category.  The association shall consult with 
501.10  the commissioner regarding the data to be reported to the 
501.11  commissioner, storage of data received by the association but 
501.12  not reported to the commissioner, and eventual retrieval by the 
501.13  commissioner of stored data. 
501.14     (c) The commissioner shall report to the legislature by 
501.15  January 15 of 2004 and 2005, with a list of the number of 
501.16  reported events by type and recommendations, if any, for 
501.17  reporting system modifications, including additional categories 
501.18  of events that should be reported. 
501.19     (d) From July 1, 2003, until full implementation of the 
501.20  reporting system, the commissioner of health shall not make a 
501.21  final disposition as defined in Minnesota Statutes, section 
501.22  626.5572, subdivision 8, for investigations conducted in 
501.23  licensed hospitals under the provisions of Minnesota Statutes, 
501.24  section 626.557.  The commissioner's findings in these cases 
501.25  shall identify noncompliance with federal certification or state 
501.26  licensure rules or laws. 
501.27     (e) Effective July 1, 2004, the reporting system shall be 
501.28  fully implemented, provided (1) the commissioner has secured 
501.29  sufficient funds from nonstate sources to operate the system 
501.30  during fiscal year 2005, and (2) the commissioner has notified 
501.31  facilities by April 1, 2004, of their duty to report. 
501.32     ~~(f) Effective July 1, 2005, the reporting system shall be~~ 
501.33  ~~operated with state appropriations.~~ 
501.34     Sec. 87.  [AUTHORITY TO COLLECT CERTAIN FEES SUSPENDED.] 
501.35     (a) The commissioner's authority to collect the certificate 
501.36  application fee from hearing instrument dispensers under 
502.1   Minnesota Statutes, section 153A.17, is suspended for certified 
502.2   hearing instrument dispensers renewing certification in fiscal 
502.3   year 2004. 
502.4      (b) The commissioner's authority to collect the license 
502.5   renewal fee from occupational therapy practitioners under 
502.6   Minnesota Statutes, section 148.6445, subdivision 2, is 
502.7   suspended for fiscal years 2004 and 2005. 
502.8      Sec. 88.  [REVISOR'S INSTRUCTION.] 
502.9      (a) The revisor of statutes shall delete the reference to 
502.10  "144.1495" in Minnesota Statutes, section 62Q.145, and insert 
502.11  "144.1501." 
502.12     (b) For sections in Minnesota Statutes and Minnesota Rules 
502.13  affected by the repealed sections in this article, the revisor 
502.14  shall delete internal cross-references where appropriate and 
502.15  make changes necessary to correct the punctuation, grammar, or 
502.16  structure of the remaining text and preserve its meaning. 
502.17     Sec. 89.  [REPEALER.] 
502.18     (a) Minnesota Statutes 2002, sections 62J.15; 62J.152; 
502.19  62J.451; 62J.452; 144.126; 144.1484; 144.1494; 144.1495; 
502.20  144.1496; 144.1497; 144A.36; 144A.38; 148.5194, subdivision 3a; 
502.21  and 148.6445, subdivision 9, are repealed.  
502.22     (b) Minnesota Rules, parts 4763.0100; 4763.0110; 4763.0125; 
502.23  4763.0135; 4763.0140; 4763.0150; 4763.0160; 4763.0170; 
502.24  4763.0180; 4763.0190; 4763.0205; 4763.0215; 4763.0220; 
502.25  4763.0230; 4763.0240; 4763.0250; 4763.0260; 4763.0270; 
502.26  4763.0285; 4763.0295; and 4763.0300, are repealed. 
502.27                             ARTICLE 8 
502.28                     LOCAL PUBLIC HEALTH GRANTS
502.29     Section 1.  Minnesota Statutes 2002, section 144E.11, 
502.30  subdivision 6, is amended to read: 
502.31     Subd. 6.  [REVIEW CRITERIA.] When reviewing an application 
502.32  for licensure, the board and administrative law judge shall 
502.33  consider the following factors: 
502.34     (1) ~~the relationship of the proposed service or expansion~~ 
502.35  ~~in primary service area to the current community health plan as~~ 
502.36  ~~approved by the commissioner of health under section 145A.12,~~ 
503.1   ~~subdivision 4;~~ 
503.2      ~~(2)~~ the recommendations or comments of the governing bodies 
503.3   of the counties, municipalities, community health boards as 
503.4   defined under section 145A.09, subdivision 2, and regional 
503.5   emergency medical services system designated under section 
503.6   144E.50 in which the service would be provided; 
503.7      ~~(3)~~ (2) the deleterious effects on the public health from 
503.8   duplication, if any, of ambulance services that would result 
503.9   from granting the license; 
503.10     ~~(4)~~ (3) the estimated effect of the proposed service or 
503.11  expansion in primary service area on the public health; and 
503.12     ~~(5)~~ (4) whether any benefit accruing to the public health 
503.13  would outweigh the costs associated with the proposed service or 
503.14  expansion in primary service area.  The administrative law judge 
503.15  shall recommend that the board either grant or deny a license or 
503.16  recommend that a modified license be granted.  The reasons for 
503.17  the recommendation shall be set forth in detail.  The 
503.18  administrative law judge shall make the recommendations and 
503.19  reasons available to any individual requesting them.  
503.20     Sec. 2.  Minnesota Statutes 2002, section 145.88, is 
503.21  amended to read: 
503.22     145.88 [PURPOSE.] 
503.23     ~~The legislature finds that it is in the public interest to~~ 
503.24  ~~assure:~~  
503.25     ~~(a) statewide planning and coordination of maternal and~~ 
503.26  ~~child health services through the acquisition and analysis of~~ 
503.27  ~~population-based health data, provision of technical support and~~ 
503.28  ~~training, and coordination of the various public and private~~ 
503.29  ~~maternal and child health efforts; and~~ 
503.30     ~~(b) support for targeted maternal and child health services~~ 
503.31  ~~in communities with significant populations of high risk, low~~ 
503.32  ~~income families through a grants process.~~  
503.33     Federal money received by the Minnesota department of 
503.34  health, pursuant to United States Code, title 42, sections 701 
503.35  to 709, shall be expended to:  
503.36     (1) assure access to quality maternal and child health 
504.1   services for mothers and children, especially those of low 
504.2   income and with limited availability to health services and 
504.3   those children at risk of physical, neurological, emotional, and 
504.4   developmental problems arising from chemical abuse by a mother 
504.5   during pregnancy; 
504.6      (2) reduce infant mortality and the incidence of 
504.7   preventable diseases and handicapping conditions among children; 
504.8      (3) reduce the need for inpatient and long-term care 
504.9   services and to otherwise promote the health of mothers and 
504.10  children, especially by providing preventive and primary care 
504.11  services for low-income mothers and children and prenatal, 
504.12  delivery and postpartum care for low-income mothers; 
504.13     (4) provide rehabilitative services for blind and disabled 
504.14  children under age 16 receiving benefits under title XVI of the 
504.15  Social Security Act; and 
504.16     (5) provide and locate medical, surgical, corrective and 
504.17  other service for children who are crippled or who are suffering 
504.18  from conditions that lead to crippling.  
504.19     Sec. 3.  Minnesota Statutes 2002, section 145.881, 
504.20  subdivision 2, is amended to read: 
504.21     Subd. 2.  [DUTIES.] The advisory task force shall meet on a 
504.22  regular basis to perform the following duties:  
504.23     (a) review and report on the health care needs of mothers 
504.24  and children throughout the state of Minnesota; 
504.25     (b) review and report on the type, frequency and impact of 
504.26  maternal and child health care services provided to mothers and 
504.27  children under existing maternal and child health care programs, 
504.28  including programs administered by the commissioner of health; 
504.29     (c) establish, review, and report to the commissioner a 
504.30  list of program guidelines and criteria which the advisory task 
504.31  force considers essential to providing an effective maternal and 
504.32  child health care program to low income populations and high 
504.33  risk persons and fulfilling the purposes defined in section 
504.34  145.88; 
504.35     (d) ~~review staff recommendations of the department of~~ 
504.36  ~~health regarding maternal and child health grant awards before~~ 
505.1   ~~the awards are made;~~ 
505.2      ~~(e)~~ make recommendations to the commissioner for the use of 
505.3   other federal and state funds available to meet maternal and 
505.4   child health needs; 
505.5      ~~(f)~~ (e) make recommendations to the commissioner of health 
505.6   on priorities for funding the following maternal and child 
505.7   health services:  (1) prenatal, delivery and postpartum care, (2)
505.8   comprehensive health care for children, especially from birth 
505.9   through five years of age, (3) adolescent health services, (4) 
505.10  family planning services, (5) preventive dental care, (6) 
505.11  special services for chronically ill and handicapped children 
505.12  and (7) any other services which promote the health of mothers 
505.13  and children; and 
505.14     ~~(g) make recommendations to the commissioner of health on~~ 
505.15  ~~the process to distribute, award and administer the maternal and~~ 
505.16  ~~child health block grant funds; and~~ 
505.17     ~~(h) review the measures that are used to define the~~ 
505.18  ~~variables of the funding distribution formula in section~~ 
505.19  ~~145.882, subdivision 4, every two years and make recommendations~~ 
505.20  ~~to the commissioner of health for changes based upon principles~~ 
505.21  ~~established by the advisory task force for this purpose.~~  
505.22     (f) establish, in consultation with the commissioner and 
505.23  the state community health advisory committee established under 
505.24  section 145A.10, subdivision 10, paragraph (a), statewide 
505.25  outcomes that will improve the health status of mothers and 
505.26  children as required in section 145A.12, subdivision 7. 
505.27     Sec. 4.  Minnesota Statutes 2002, section 145.882, 
505.28  subdivision 1, is amended to read: 
505.29     Subdivision 1.  [FUNDING ~~LEVELS AND ADVISORY TASK FORCE~~ 
505.30  ~~REVIEW~~.] Any decrease in the amount of federal funding to the 
505.31  state for the maternal and child health block grant must be 
505.32  apportioned to reflect a proportional decrease for each 
505.33  recipient.  Any increase in the amount of federal funding to the 
505.34  state must be distributed under subdivisions 2~~,~~ and 3~~, and 4~~. 
505.35     ~~The advisory task force shall review and recommend the~~ 
505.36  ~~proportion of maternal and child health block grant funds to be~~ 
506.1   ~~expended for indirect costs, direct services and special~~ 
506.2   ~~projects.~~  
506.3      Sec. 5.  Minnesota Statutes 2002, section 145.882, 
506.4   subdivision 2, is amended to read: 
506.5      Subd. 2.  [ALLOCATION TO THE COMMISSIONER OF HEALTH.] 
506.6   Beginning January 1, 1986, up to one-third of the total maternal 
506.7   and child health block grant money may be retained by the 
506.8   commissioner of health ~~for administrative and technical~~ 
506.9   ~~assistance services, projects of regional or statewide~~ 
506.10  ~~significance, direct services to children with handicaps, and~~ 
506.11  ~~other activities of the commissioner.~~ to: 
506.12     (1) meet federal maternal and child block grant 
506.13  requirements of a statewide needs assessment every five years 
506.14  and prepare the annual federal block grant application and 
506.15  report; 
506.16     (2) collect and disseminate statewide data on the health 
506.17  status of mothers and children within one year of the end of the 
506.18  year; 
506.19     (3) provide technical assistance to community health boards 
506.20  in meeting statewide outcomes under section 145A.12, subdivision 
506.21  7; 
506.22     (4) evaluate the impact of maternal and child health 
506.23  activities on the health status of mothers and children; 
506.24     (5) provide services to children under age 16 receiving 
506.25  benefits under title XVI of the Social Security Act; and 
506.26     (6) perform other maternal and child health activities 
506.27  listed in section 145.88 and as deemed necessary by the 
506.28  commissioner. 
506.29     Sec. 6.  Minnesota Statutes 2002, section 145.882, 
506.30  subdivision 3, is amended to read: 
506.31     Subd. 3.  [ALLOCATION TO COMMUNITY HEALTH ~~SERVICES~~ 
506.32  ~~AREAS~~ BOARDS.] (a) The maternal and child health block grant 
506.33  money remaining after distributions made under subdivision 2 
506.34  must be allocated according to the formula in ~~subdivision 4 to~~ 
506.35  ~~community health services areas~~ section 145A.131, subdivision 2, 
506.36  for distribution ~~by~~ to community health boards. ~~as defined in~~ 
507.1   ~~section 145A.02, subdivision 5, to qualified programs that~~ 
507.2   ~~provide essential services within the community health services~~ 
507.3   ~~area as long as:~~  
507.4      ~~(1) the Minneapolis community health service area is~~ 
507.5   ~~allocated at least $1,626,215 per year;~~ 
507.6      ~~(2) the St. Paul community health service area is allocated~~ 
507.7   ~~at least $822,931 per year; and~~ 
507.8      ~~(3) all other community health service areas are allocated~~ 
507.9   ~~at least $30,000 per county per year or their 1988-1989 funding~~ 
507.10  ~~cycle award, whichever is less.~~ 
507.11     (b) ~~Notwithstanding paragraph (a), if the total amount of~~ 
507.12  ~~maternal and child health block grant funding decreases, the~~ 
507.13  ~~decrease must be apportioned to reflect a proportional decrease~~ 
507.14  ~~for each recipient, including recipients who would otherwise~~ 
507.15  ~~receive a guaranteed minimum allocation under paragraph (a).~~  A 
507.16  community health board that receives funding under this section 
507.17  shall provide at least a 50 percent match for funds received 
507.18  under United States Code, title 42, sections 701 to 709.  
507.19  Eligible funds must be used to meet match requirements.  
507.20  Eligible funds include funds from local property taxes, 
507.21  reimbursements from third parties, fees, other funds, donations, 
507.22  nonfederal grants, or state funds received under the local 
507.23  public health grant defined in section 145A.131, that are used 
507.24  for maternal and child health activities as described in section 
507.25  145.882, subdivision 7. 
507.26     Sec. 7.  Minnesota Statutes 2002, section 145.882, is 
507.27  amended by adding a subdivision to read:  
507.28     Subd. 5a.  [NONPARTICIPATING COMMUNITY HEALTH BOARDS.] If a 
507.29  community health board decides not to participate in maternal 
507.30  and child health block grant activities under subdivision 3 or 
507.31  the commissioner determines under section 145A.131, subdivision 
507.32  7, not to fund the community health board, the commissioner is 
507.33  responsible for directing maternal and child health block grant 
507.34  activities in that community health board's geographic area.  
507.35  The commissioner may elect to directly provide public health 
507.36  activities to meet the statewide outcomes or to contract with 
508.1   other governmental units or nonprofit organizations. 
508.2      Sec. 8.  Minnesota Statutes 2002, section 145.882, 
508.3   subdivision 7, is amended to read: 
508.4      Subd. 7.  [USE OF BLOCK GRANT MONEY.] ~~(a)~~ Maternal and 
508.5   child health block grant money allocated to a community health 
508.6   board ~~or community health services area~~ under this section must 
508.7   be used for qualified programs for high risk and low-income 
508.8   individuals.  Block grant money must be used for programs that: 
508.9      (1) specifically address the highest risk populations, 
508.10  particularly low-income and minority groups with a high rate of 
508.11  infant mortality and children with low birth weight, by 
508.12  providing services, including prepregnancy family planning 
508.13  services, calculated to produce measurable decreases in infant 
508.14  mortality rates, instances of children with low birth weight, 
508.15  and medical complications associated with pregnancy and 
508.16  childbirth, including infant mortality, low birth rates, and 
508.17  medical complications arising from chemical abuse by a mother 
508.18  during pregnancy; 
508.19     (2) specifically target pregnant women whose age, medical 
508.20  condition, maternal history, or chemical abuse substantially 
508.21  increases the likelihood of complications associated with 
508.22  pregnancy and childbirth or the birth of a child with an 
508.23  illness, disability, or special medical needs; 
508.24     (3) specifically address the health needs of young children 
508.25  who have or are likely to have a chronic disease or disability 
508.26  or special medical needs, including physical, neurological, 
508.27  emotional, and developmental problems that arise from chemical 
508.28  abuse by a mother during pregnancy; 
508.29     (4) provide family planning and preventive medical care for 
508.30  specifically identified target populations, such as minority and 
508.31  low-income teenagers, in a manner calculated to decrease the 
508.32  occurrence of inappropriate pregnancy and minimize the risk of 
508.33  complications associated with pregnancy and childbirth; ~~or~~ 
508.34     (5) specifically address the frequency and severity of 
508.35  childhood and adolescent health issues, including injuries in 
508.36  high risk target populations by providing services calculated to 
509.1   produce measurable decreases in mortality and morbidity~~.~~; 
509.2   ~~However, money may be used for this purpose only if the~~ 
509.3   ~~community health board's application includes program components~~ 
509.4   ~~for the purposes in clauses (1) to (4) in the proposed~~ 
509.5   ~~geographic service area and the total expenditure for~~ 
509.6   ~~injury-related programs under this clause does not exceed ten~~ 
509.7   ~~percent of the total allocation under subdivision 3.~~ 
509.8      ~~(b) Maternal and child health block grant money may be used~~ 
509.9   ~~for purposes other than the purposes listed in this subdivision~~ 
509.10  ~~only under the following conditions:~~  
509.11     ~~(1) the community health board or community health services~~ 
509.12  ~~area can demonstrate that existing programs fully address the~~ 
509.13  ~~needs of the highest risk target populations described in this~~ 
509.14  ~~subdivision; or~~ 
509.15     ~~(2) the money is used to continue projects that received~~ 
509.16  ~~funding before creation of the maternal and child health block~~ 
509.17  ~~grant in 1981.~~ 
509.18     ~~(c) Projects that received funding before creation of the~~ 
509.19  ~~maternal and child health block grant in 1981, must be allocated~~ 
509.20  ~~at least the amount of maternal and child health special project~~ 
509.21  ~~grant funds received in 1989, unless (1) the local board of~~ 
509.22  ~~health provides equivalent alternative funding for the project~~ 
509.23  ~~from another source; or (2) the local board of health~~ 
509.24  ~~demonstrates that the need for the specific services provided by~~ 
509.25  ~~the project has significantly decreased as a result of changes~~ 
509.26  ~~in the demographic characteristics of the population, or other~~ 
509.27  ~~factors that have a major impact on the demand for services.  If~~ 
509.28  ~~the amount of federal funding to the state for the maternal and~~ 
509.29  ~~child health block grant is decreased, these projects must~~ 
509.30  ~~receive a proportional decrease as required in subdivision 1.~~  
509.31  ~~Increases in allocation amounts to local boards of health under~~ 
509.32  ~~subdivision 4 may be used to increase funding levels for these~~ 
509.33  ~~projects.~~ 
509.34     (6) specifically address preventing child abuse and 
509.35  neglect, reducing juvenile delinquency, promoting positive 
509.36  parenting and resiliency in children, and promoting family 
510.1   health and economic sufficiency through public health nurse home 
510.2   visits under section 145A.17; or 
510.3      (7) specifically address nutritional issues of women, 
510.4   infants, and young children through WIC clinic services. 
510.5      Sec. 9.  [145.8821] [ACCOUNTABILITY.] 
510.6      (a) Coordinating with the statewide outcomes established 
510.7   under section 145A.12, subdivision 7, and with accountability 
510.8   measures outlined in section 145A.131, subdivision 7, each 
510.9   community health board that receives money under section 
510.10  145.882, subdivision 3, shall select by February 1, 2005, and 
510.11  every five years thereafter, up to two statewide maternal and 
510.12  child health outcomes. 
510.13     (b) For the period January 1, 2004, to December 31, 2005, 
510.14  each community health board must work toward the Healthy People 
510.15  2010 goal to reduce the state's percentage of low birth weight 
510.16  infants.  
510.17     (c) The commissioner shall monitor and evaluate whether 
510.18  each community health board has made sufficient progress toward 
510.19  the selected outcomes established in paragraph (b) and under 
510.20  section 145A.12, subdivision 7. 
510.21     (d) Community health boards shall provide the commissioner 
510.22  with annual information necessary to evaluate progress toward 
510.23  selected statewide outcomes and to meet federal reporting 
510.24  requirements. 
510.25     Sec. 10.  Minnesota Statutes 2002, section 145.883, 
510.26  subdivision 1, is amended to read: 
510.27     Subdivision 1.  [SCOPE.] For purposes of sections 145.881 
510.28  to ~~145.888~~ 145.883, the terms defined in this section shall have 
510.29  the meanings given them.  
510.30     Sec. 11.  Minnesota Statutes 2002, section 145.883, 
510.31  subdivision 9, is amended to read: 
510.32     Subd. 9.  [COMMUNITY HEALTH ~~SERVICES AREA~~ BOARD.] 
510.33  "Community health ~~services area~~ board" means ~~a city, county, or~~ 
510.34  ~~multicounty area that is organized as a community health board~~ 
510.35  ~~under section 145A.09 and for which a state subsidy is received~~ 
510.36  ~~under sections 145A.09 to 145A.13~~ a board of health established, 
511.1   operating, and eligible for a local public health grant under 
511.2   sections 145A.09 to 145A.131. 
511.3      Sec. 12.  Minnesota Statutes 2002, section 145A.02, 
511.4   subdivision 5, is amended to read: 
511.5      Subd. 5.  [COMMUNITY HEALTH BOARD.] "Community health 
511.6   board" means a board of health established, operating, and 
511.7   eligible for a ~~subsidy~~ local public health grant under sections 
511.8   145A.09 to ~~145A.13~~ 145A.131. 
511.9      Sec. 13.  Minnesota Statutes 2002, section 145A.02, 
511.10  subdivision 6, is amended to read: 
511.11     Subd. 6.  [COMMUNITY HEALTH SERVICES.] "Community health 
511.12  services" means activities designed to protect and promote the 
511.13  health of the general population within a community health 
511.14  service area by emphasizing the prevention of disease, injury, 
511.15  disability, and preventable death through the promotion of 
511.16  effective coordination and use of community resources, and by 
511.17  extending health services into the community.  ~~Program~~ 
511.18  ~~categories of community health services include disease~~ 
511.19  ~~prevention and control, emergency medical care, environmental~~ 
511.20  ~~health, family health, health promotion, and home health care.~~ 
511.21     Sec. 14.  Minnesota Statutes 2002, section 145A.02, 
511.22  subdivision 7, is amended to read: 
511.23     Subd. 7.  [COMMUNITY HEALTH SERVICE AREA.] "Community 
511.24  health service area" means a city, county, or multicounty area 
511.25  that is organized as a community health board under section 
511.26  145A.09 and for which a ~~subsidy~~ local public health grant is 
511.27  received under sections 145A.09 to ~~145A.13~~ 145A.131. 
511.28     Sec. 15.  Minnesota Statutes 2002, section 145A.06, 
511.29  subdivision 1, is amended to read: 
511.30     Subdivision 1.  [GENERALLY.] In addition to other powers 
511.31  and duties provided by law, the commissioner has the powers 
511.32  listed in subdivisions 2 to ~~4~~ 5. 
511.33     Sec. 16.  Minnesota Statutes 2002, section 145A.09, 
511.34  subdivision 2, is amended to read: 
511.35     Subd. 2.  [COMMUNITY HEALTH BOARD; ELIGIBILITY.] A board of 
511.36  health that meets the requirements of sections 145A.09 
512.1   to ~~145A.13~~ 145A.131 is a community health board and is eligible 
512.2   for a ~~community health subsidy~~ local public health grant under 
512.3   section ~~145A.13~~ 145A.131. 
512.4      Sec. 17.  Minnesota Statutes 2002, section 145A.09, 
512.5   subdivision 4, is amended to read: 
512.6      Subd. 4.  [CITIES.] A city that received a subsidy under 
512.7   section 145A.13 and that meets the requirements of sections 
512.8   145A.09 to ~~145A.13~~ 145A.131 is eligible for a ~~community health~~ 
512.9   ~~subsidy~~ local public health grant under section 
512.10  ~~145A.13~~ 145A.131. 
512.11     Sec. 18.  Minnesota Statutes 2002, section 145A.09, 
512.12  subdivision 7, is amended to read: 
512.13     Subd. 7.  [WITHDRAWAL.] (a) A county or city that has 
512.14  established or joined a community health board may withdraw from 
512.15  the ~~subsidy~~ local public health grant program authorized by 
512.16  sections 145A.09 to ~~145A.13~~ 145A.131 by resolution of its 
512.17  governing body in accordance with section 145A.03, subdivision 
512.18  3, and this subdivision. 
512.19     (b) A county or city may not withdraw from a joint powers 
512.20  community health board during the first two calendar years 
512.21  following that county's or city's initial adoption of the joint 
512.22  powers agreement.  
512.23     (c) The withdrawal of a county or city from a community 
512.24  health board does not affect the eligibility for the ~~community~~ 
512.25  ~~health subsidy~~ local public health grant of any remaining county 
512.26  or city for one calendar year following the effective date of 
512.27  withdrawal. 
512.28     (d) ~~The amount of additional annual payment for calendar~~ 
512.29  ~~year 1985 made pursuant to Minnesota Statutes 1984, section~~ 
512.30  ~~145.921, subdivision 4, must be subtracted from the subsidy for~~ 
512.31  ~~a county that, due to withdrawal from a community health board,~~ 
512.32  ~~ceases to meet the terms and conditions under which that~~ 
512.33  ~~additional annual payment was made~~ The local public health grant 
512.34  for a county that chooses to withdraw from a multicounty 
512.35  community health board shall be reduced by the amount of the 
512.36  local partnership incentive under section 145A.131, subdivision 
513.1   2, paragraph (c). 
513.2      Sec. 19.  Minnesota Statutes 2002, section 145A.10, 
513.3   subdivision 2, is amended to read: 
513.4      Subd. 2.  [PREEMPTION.] (a) Not later than 365 days after 
513.5   the ~~approval of a community health plan by the~~ 
513.6   ~~commissioner~~ formation of a community health board, any other 
513.7   board of health within the community health service area for 
513.8   which the plan has been prepared must cease operation, except as 
513.9   authorized in a joint powers agreement under section 145A.03, 
513.10  subdivision 2, or delegation agreement under section 145A.07, 
513.11  subdivision 2, or as otherwise allowed by this subdivision. 
513.12     (b) This subdivision does not preempt or otherwise change 
513.13  the powers and duties of any city or county eligible for ~~subsidy~~ 
513.14  a local public health grant under section 145A.09. 
513.15     (c) This subdivision does not preempt the authority to 
513.16  operate a community health services program of any city of the 
513.17  first or second class operating an existing program of community 
513.18  health services located within a county with a population of 
513.19  300,000 or more persons until the city council takes action to 
513.20  allow the county to preempt the city's powers and duties. 
513.21     Sec. 20.  Minnesota Statutes 2002, section 145A.10, is 
513.22  amended by adding a subdivision to read: 
513.23     Subd. 5a.  [DUTIES.] (a) Consistent with the guidelines and 
513.24  standards established under section 145A.12, and with input from 
513.25  the community, the community health board shall: 
513.26     (1) establish local public health priorities based on an 
513.27  assessment of community health needs and assets; and 
513.28     (2) determine the mechanisms by which the community health 
513.29  board will address the local public health priorities 
513.30  established under clause (1) and achieve the statewide outcomes 
513.31  established under sections 145.8821 and 145A.12, subdivision 7, 
513.32  within the limits of available funding.  In determining the 
513.33  mechanisms to address local public health priorities and achieve 
513.34  statewide outcomes, the community health board shall seek public 
513.35  input or consider the recommendations of the community health 
513.36  advisory committee and the following essential public health 
514.1   services: 
514.2      (i) monitor health status to identify community health 
514.3   problems; 
514.4      (ii) diagnose and investigate problems and health hazards 
514.5   in the community; 
514.6      (iii) inform, educate, and empower people about health 
514.7   issues; 
514.8      (iv) mobilize community partnerships to identify and solve 
514.9   health problems; 
514.10     (v) develop policies and plans that support individual and 
514.11  community health efforts; 
514.12     (vi) enforce laws and regulations that protect health and 
514.13  ensure safety; 
514.14     (vii) link people to needed personal health care services; 
514.15     (viii) ensure a competent public health and personal health 
514.16  care workforce; 
514.17     (ix) evaluate effectiveness, accessibility, and quality of 
514.18  personal and population-based health services; and 
514.19     (x) research for new insights and innovative solutions to 
514.20  health problems. 
514.21     (b) By February 1, 2005, and every five years thereafter, 
514.22  each community health board that receives a local public health 
514.23  grant under section 145A.131 shall notify the commissioner in 
514.24  writing of the statewide outcomes established under sections 
514.25  145.8821 and 145A.12, subdivision 7, that the board will address 
514.26  and the local priorities established under paragraph (a) that 
514.27  the board will address. 
514.28     (c) Each community health board receiving a local public 
514.29  health grant under section 145A.131 must submit an annual report 
514.30  to the commissioner documenting progress toward the achievement 
514.31  of statewide outcomes established under sections 145.8821 and 
514.32  145A.12, subdivision 7, and the local public health priorities 
514.33  established under paragraph (a), using reporting standards and 
514.34  procedures established by the commissioner and in compliance 
514.35  with all applicable federal requirements.  If a community health 
514.36  board has identified additional local priorities for use of the 
515.1   local public health grant since the last notification of 
515.2   outcomes and priorities under paragraph (b), the community 
515.3   health board shall notify the commissioner of the additional 
515.4   local public health priorities in the annual report. 
515.5      Sec. 21.  Minnesota Statutes 2002, section 145A.10, 
515.6   subdivision 10, is amended to read: 
515.7      Subd. 10.  [STATE AND LOCAL ADVISORY COMMITTEES.] (a) A 
515.8   state community health advisory committee is established to 
515.9   advise, consult with, and make recommendations to the 
515.10  commissioner on the development, maintenance, funding, and 
515.11  evaluation of community health services.  Each community health 
515.12  board may appoint a member to serve on the committee.  The 
515.13  committee must meet at least quarterly, and special meetings may 
515.14  be called by the committee chair or a majority of the members.  
515.15  Members or their alternates may ~~receive a per diem and must~~ be 
515.16  reimbursed for travel and other necessary expenses while engaged 
515.17  in their official duties.  
515.18     (b) The city councils or county boards that have 
515.19  established or are members of a community health board ~~must~~ may 
515.20  appoint a community health advisory committee to advise, consult 
515.21  with, and make recommendations to the community health board on 
515.22  ~~matters relating to the development, maintenance, funding, and~~ 
515.23  ~~evaluation of community health services.  The committee must~~ 
515.24  ~~consist of at least five members and must be generally~~ 
515.25  ~~representative of the population and health care providers of~~ 
515.26  ~~the community health service area.  The committee must meet at~~ 
515.27  ~~least three times a year and at the call of the chair or a~~ 
515.28  ~~majority of the members.  Members may receive a per diem and~~ 
515.29  ~~reimbursement for travel and other necessary expenses while~~ 
515.30  ~~engaged in their official duties.~~ 
515.31     ~~(c) State and local advisory committees must adopt bylaws~~ 
515.32  ~~or operating procedures that specify the length of terms of~~ 
515.33  ~~membership, procedures for assuring that no more than half of~~ 
515.34  ~~these terms expire during the same year, and other matters~~ 
515.35  ~~relating to the conduct of committee business.  Bylaws or~~ 
515.36  ~~operating procedures may allow one alternate to be appointed for~~ 
516.1   ~~each member of a state or local advisory committee.  Alternates~~ 
516.2   ~~may be given full or partial powers and duties of members~~ the 
516.3   duties under subdivision 5a. 
516.4      Sec. 22.  Minnesota Statutes 2002, section 145A.11, 
516.5   subdivision 2, is amended to read: 
516.6      Subd. 2.  [CONSIDERATION OF ~~COMMUNITY HEALTH PLAN~~ LOCAL 
516.7   PUBLIC HEALTH PRIORITIES AND STATEWIDE OUTCOMES IN TAX LEVY.] In 
516.8   levying taxes authorized under section 145A.08, subdivision 3, a 
516.9   city council or county board that has formed or is a member of a 
516.10  community health board must consider the income and expenditures 
516.11  required to meet ~~the objectives of the community health plan for~~ 
516.12  ~~its area~~ local public health priorities established under 
516.13  section 145A.10, subdivision 5a, and statewide outcomes 
516.14  established under section 145A.12, subdivision 7. 
516.15     Sec. 23.  Minnesota Statutes 2002, section 145A.11, 
516.16  subdivision 4, is amended to read: 
516.17     Subd. 4.  [ORDINANCES RELATING TO COMMUNITY HEALTH 
516.18  SERVICES.] A city council or county board that has established 
516.19  or is a member of a community health board may by ordinance 
516.20  adopt and enforce minimum standards for services provided 
516.21  according to sections 145A.02 and 145A.10~~, subdivision 5~~.  An 
516.22  ordinance must not conflict with state law or with more 
516.23  stringent standards established either by rule of an agency of 
516.24  state government or by the provisions of the charter or 
516.25  ordinances of any city organized under section 145A.09, 
516.26  subdivision 4. 
516.27     Sec. 24.  Minnesota Statutes 2002, section 145A.12, 
516.28  subdivision 1, is amended to read: 
516.29     Subdivision 1.  [ADMINISTRATIVE AND PROGRAM SUPPORT.] The 
516.30  commissioner must assist community health boards in the 
516.31  development, administration, and implementation of community 
516.32  health services.  This assistance may consist of but is not 
516.33  limited to: 
516.34     (1) informational resources, consultation, and training to 
516.35  help community health boards plan, develop, integrate, provide 
516.36  and evaluate community health services; and 
517.1      (2) administrative and program guidelines and standards, 
517.2   developed with the advice of the state community health advisory 
517.3   committee.  ~~Adoption of these guidelines by a community health~~ 
517.4   ~~board is not a prerequisite for plan approval as prescribed in~~ 
517.5   ~~subdivision 4.~~ 
517.6      Sec. 25.  Minnesota Statutes 2002, section 145A.12, 
517.7   subdivision 2, is amended to read: 
517.8      Subd. 2.  [PERSONNEL STANDARDS.] In accordance with chapter 
517.9   14, and in consultation with the state community health advisory 
517.10  committee, the commissioner may adopt rules to set standards for 
517.11  administrative and program personnel to ensure competence in 
517.12  administration and planning ~~and in each program area defined in~~ 
517.13  ~~section 145A.02~~. 
517.14     Sec. 26.  Minnesota Statutes 2002, section 145A.12, is 
517.15  amended by adding a subdivision to read:  
517.16     Subd. 7.  [STATEWIDE OUTCOMES.] (a) The commissioner, in 
517.17  consultation with the state community health advisory committee 
517.18  established under section 145A.10, subdivision 10, paragraph 
517.19  (a), shall establish statewide outcomes for local public health 
517.20  grant funds allocated to community health boards between January 
517.21  1, 2004, and December 31, 2005. 
517.22     (b) At least one statewide outcome must be established in 
517.23  each of the following public health areas: 
517.24     (1) preventing diseases; 
517.25     (2) protecting against environmental hazards; 
517.26     (3) preventing injuries; 
517.27     (4) promoting healthy behavior; 
517.28     (5) responding to disasters; and 
517.29     (6) ensuring access to health services. 
517.30     (c) The commissioner shall use Minnesota's public health 
517.31  goals established under section 62J.212 and the essential public 
517.32  health services under section 145A.10, subdivision 5a, as a 
517.33  basis for the development of statewide outcomes. 
517.34     (d) The statewide maternal and child health outcomes 
517.35  established under section 145.8821 shall be included as 
517.36  statewide outcomes under this section. 
518.1      (e) By December 31, 2004, and every five years thereafter, 
518.2   the commissioner, in consultation with the state community 
518.3   health advisory committee established under section 145A.10, 
518.4   subdivision 10, paragraph (a), and the maternal and child health 
518.5   advisory task force established under section 145.881, shall 
518.6   develop statewide outcomes for the local public health grant 
518.7   established under section 145A.131, based on state and local 
518.8   assessment data regarding the health of Minnesota residents, the 
518.9   essential public health services under section 145A.10, and 
518.10  current Minnesota public health goals established under section 
518.11  62J.212. 
518.12     Sec. 27.  Minnesota Statutes 2002, section 145A.13, is 
518.13  amended by adding a subdivision to read: 
518.14     Subd. 4.  [EXPIRATION.] This section expires January 1, 
518.15  2004. 
518.16     Sec. 28.  [145A.131] [LOCAL PUBLIC HEALTH GRANT.] 
518.17     Subdivision 1.  [FUNDING FORMULA FOR COMMUNITY HEALTH 
518.18  BOARDS.] (a) Base funding for each community health board 
518.19  eligible for a local public health grant under section 145A.09, 
518.20  subdivision 2, shall be determined by each community health 
518.21  board's fiscal year 2003 allocations, prior to unallotment, for 
518.22  the following grant programs:  community health services 
518.23  subsidy; state and federal maternal and child health special 
518.24  projects grants; family home visiting grants, TANF MN ENABL 
518.25  grants, TANF youth risk behavior grants, and available women, 
518.26  infants, and children grant funds in fiscal year 2003, prior to 
518.27  unallotment, distributed based on the proportion of WIC 
518.28  participants served in fiscal year 2003 within the CHS service 
518.29  area. 
518.30     (b) Base funding for a community health board eligible for 
518.31  a local public health grant under section 145A.09, subdivision 
518.32  2, as determined in paragraph (a), shall be adjusted by the 
518.33  percentage difference between the base, as calculated in 
518.34  paragraph (a), and the funding available for the local public 
518.35  health grant. 
518.36     (c) Multicounty community health boards shall receive a 
519.1   local partnership base of up to $5,000 per year for each county 
519.2   included in the community health board. 
519.3      (d) The state community health advisory committee may 
519.4   recommend a formula to the commissioner to use in distributing 
519.5   state and federal funds to community health boards organized and 
519.6   operating under sections 145A.09 to 145A.131 to achieve locally 
519.7   identified priorities under section 145A.12, subdivision 7, by 
519.8   July 1, 2004, for use in distributing funds to community health 
519.9   boards beginning January 1, 2006, and thereafter. 
519.10     Subd. 2.  [LOCAL MATCH.] (a) A community health board that 
519.11  receives a local public health grant shall provide at least a 75 
519.12  percent match for the state funds received through the local 
519.13  public health grant described in subdivision 1, and subject to 
519.14  paragraphs (b) to (d). 
519.15     (b) Eligible funds must be used to meet match requirements. 
519.16  Eligible funds include funds from local property taxes, 
519.17  reimbursements from third parties, fees, other local funds, and 
519.18  donations or nonfederal grants that are used for community 
519.19  health services described in section 145A.02, subdivision 6. 
519.20     (c) When the amount of local matching funds for a community 
519.21  health board is less than the amount required under paragraph 
519.22  (a), the local public health grant provided for that community 
519.23  health board under this section shall be reduced proportionally. 
519.24     (d) A city organized under the provision of sections 
519.25  145A.09 to 145A.131 that levies a tax for provision of community 
519.26  health services is exempt from any county levy for the same 
519.27  services to the extent of the levy imposed by the city.  
519.28     Subd. 3.  [ACCOUNTABILITY.] (a) Community health boards 
519.29  accepting local public health grants must document progress 
519.30  toward the statewide outcomes established in section 145A.12, 
519.31  subdivision 7, to maintain eligibility to receive the local 
519.32  public health grant. 
519.33     (b) In determining whether or not the community health 
519.34  board is documenting progress toward statewide outcomes, the 
519.35  commissioner shall consider the following factors: 
519.36     (1) whether the community health board has documented 
520.1   progress to meeting essential local activities related to the 
520.2   statewide outcomes, as specified in the grant agreement; 
520.3      (2) the effort put forth by the community health board 
520.4   toward the selected statewide outcomes; 
520.5      (3) whether the community health board has previously 
520.6   failed to document progress toward selected statewide outcomes 
520.7   under this section; 
520.8      (4) the amount of funding received by the community health 
520.9   board to address the statewide outcomes; and 
520.10     (5) other factors as the commissioner may require, if the 
520.11  commissioner specifically identifies the additional factors in 
520.12  the commissioner's written notice of determination. 
520.13     (c) If the commissioner determines that a community health 
520.14  board has not by the applicable deadline documented progress 
520.15  toward the selected statewide outcomes established under section 
520.16  145.8821 or 145A.12, subdivision 7, the commissioner shall 
520.17  notify the community health board in writing and recommend 
520.18  specific actions that the community health board should take 
520.19  over the following 12 months to maintain eligibility for the 
520.20  local public health grant. 
520.21     (d) During the 12 months following the written 
520.22  notification, the commissioner shall provide administrative and 
520.23  program support to assist the community health board in taking 
520.24  the actions recommended in the written notification. 
520.25     (e) If the community health board has not taken the 
520.26  specific actions recommended by the commissioner within 12 
520.27  months following written notification, the commissioner may 
520.28  determine not to distribute funds to the community health board 
520.29  under section 145A.12, subdivision 2, for the next fiscal year. 
520.30     (f) If the commissioner determines not to distribute funds 
520.31  for the next fiscal year, the commissioner must give the 
520.32  community health board written notice of this determination and 
520.33  allow the community health board to appeal the determination in 
520.34  writing. 
520.35     (g) If the commissioner determines not to distribute funds 
520.36  for the next fiscal year to a community health board that has 
521.1   not documented progress toward the statewide outcomes and not 
521.2   taken the actions recommended by the commissioner, the 
521.3   commissioner may retain local public health grant funds that the 
521.4   community health board would have otherwise received and 
521.5   directly carry out essential local activities to meet the 
521.6   statewide outcomes, or contract with other units of government 
521.7   or community-based organizations to carry out essential local 
521.8   activities related to the statewide outcomes. 
521.9      (h) If the community health board that does not document 
521.10  progress toward the statewide outcomes is a city, the 
521.11  commissioner shall distribute the local public health funds that 
521.12  would have been allocated to that city to the county in which 
521.13  the city is located, if that county is part of a community 
521.14  health board. 
521.15     (i) The commissioner shall establish a reporting system by 
521.16  which community health boards will document their progress 
521.17  toward statewide outcomes.  This system will be developed in 
521.18  consultation with the state community health services advisory 
521.19  committee established in section 145A.10, subdivision 10, 
521.20  paragraph (a), and the maternal and the child health advisory 
521.21  committee established in section 145.881.  
521.22     Subd. 4.  [RESPONSIBILITY OF COMMISSIONER TO ENSURE A 
521.23  STATEWIDE PUBLIC HEALTH SYSTEM.] If a county withdraws from a 
521.24  community health board and operates as a board of health or if a 
521.25  community health board elects not to accept the local public 
521.26  health grant, the commissioner may retain the amount of funding 
521.27  that would have been allocated to the community health board 
521.28  using the formula described in subdivision 1 and assume 
521.29  responsibility for public health activities to meet the 
521.30  statewide outcomes in the geographic area served by the board of 
521.31  health or community health board.  The commissioner may elect to 
521.32  directly provide public health activities to meet the statewide 
521.33  outcomes or contract with other units of government or with 
521.34  community-based organizations.  If a city that is currently a 
521.35  community health board withdraws from a community health board 
521.36  or elects not to accept the local public health grant, the local 
522.1   public health grant funds that would have been allocated to that 
522.2   city shall be distributed to the county in which the city is 
522.3   located, if the county is part of a community health board.  
522.4      Subd. 5.  [LOCAL PUBLIC HEALTH PRIORITIES.] Community 
522.5   health boards may use their local public health grant to address 
522.6   local public health priorities identified under section 145A.10, 
522.7   subdivision 5a. 
522.8      Sec. 29.  Minnesota Statutes 2002, section 145A.14, 
522.9   subdivision 2, is amended to read: 
522.10     Subd. 2.  [INDIAN HEALTH GRANTS.] (a) The commissioner may 
522.11  make special grants to ~~community health boards to~~ establish, 
522.12  operate, or subsidize clinic facilities and services to furnish 
522.13  health services for American Indians who reside off reservations.
522.14     (b) ~~To qualify for a grant under this subdivision the~~ 
522.15  ~~community health plan submitted by the community health board~~ 
522.16  ~~must contain a proposal for the delivery of the services and~~ 
522.17  ~~documentation that representatives of the Indian community~~ 
522.18  ~~affected by the plan were involved in its development.~~ 
522.19     ~~(c)~~ Applicants must submit for approval a plan and budget 
522.20  for the use of the funds in the form and detail specified by the 
522.21  commissioner. 
522.22     ~~(d)~~ (c) Applicants must keep records, including records of 
522.23  expenditures to be audited, as the commissioner specifies. 
522.24     Sec. 30.  Minnesota Statutes 2002, section 145A.14, is 
522.25  amended by adding a subdivision to read: 
522.26     Subd. 2a.  [TRIBAL GOVERNMENTS.] (a) Of the funding 
522.27  available for local public health grants, $1,500,000 per year is 
522.28  available to tribal governments for: 
522.29     (1) maternal and child health activities under section 
522.30  145.882, subdivision 7; 
522.31     (2) activities to reduce health disparities under section 
522.32  145.928, subdivision 10; and 
522.33     (3) emergency preparedness. 
522.34     (b) The commissioner, in consultation with tribal 
522.35  governments, shall establish a formula for distributing the 
522.36  funds and developing the outcomes to be measured. 
523.1      Sec. 31.  [REVISOR'S INSTRUCTION.] 
523.2      (a) The revisor of statutes shall delete "145A.13" and 
523.3   insert "145A.131" in Minnesota Statutes, sections 145A.03, 
523.4   subdivision 1; 145A.04, subdivision 4; 145A.10, subdivision 1; 
523.5   256E.03, subdivision 2; 383B.221, subdivision 2; and 402.02, 
523.6   subdivision 2. 
523.7      (b) For sections in Minnesota Statutes and Minnesota Rules 
523.8   affected by the repealed sections in this article, the revisor 
523.9   shall delete internal cross-references where appropriate and 
523.10  make changes necessary to correct the punctuation, grammar, or 
523.11  structure of the remaining text and preserve its meaning. 
523.12     Sec. 32.  [REPEALER.] 
523.13     (a) Minnesota Statutes 2002, sections 144.401; 145.882, 
523.14  subdivisions 4, 5, 6, and 8; 145.883, subdivisions 4 and 7; 
523.15  145.884; 145.885; 145.886; 145.888; 145.889; 145.890; 145A.02, 
523.16  subdivisions 9, 10, 11, 12, 13, and 14; 145A.09, subdivision 6; 
523.17  145A.10, subdivisions 5, 6, and 8; 145A.11, subdivision 3; 
523.18  145A.12, subdivisions 3, 4, and 5; 145A.14, subdivisions 3 and 
523.19  4; and 145A.17, subdivision 2, are repealed. 
523.20     (b) Minnesota Rules, parts 4736.0010; 4736.0020; 4736.0030; 
523.21  4736.0040; 4736.0050; 4736.0060; 4736.0070; 4736.0080; 
523.22  4736.0090; 4736.0120; and 4736.0130, are repealed effective 
523.23  January 1, 2004. 
523.24     (c) Minnesota Rules, parts 4705.0100; 4705.0200; 4705.0300; 
523.25  4705.0400; 4705.0500; 4705.0600; 4705.0700; 4705.0800; 
523.26  4705.0900; 4705.1000; 4705.1100; 4705.1200; 4705.1300; 
523.27  4705.1400; 4705.1500; and 4705.1600, are repealed effective June 
523.28  30, 2004. 
523.29                             ARTICLE 9 
523.30              CHILD CARE AND MISCELLANEOUS PROVISIONS 
523.31     Section 1.  Minnesota Statutes 2002, section 119B.011, 
523.32  subdivision 5, is amended to read: 
523.33     Subd. 5.  [CHILD CARE.] "Child care" means the care of a 
523.34  child by someone other than a parent ~~or~~, stepparent, legal 
523.35  guardian, eligible relative caregiver, or the spouses of any of 
523.36  the foregoing in or outside the child's own home for gain or 
524.1   otherwise, on a regular basis, for any part of a 24-hour day. 
524.2      Sec. 2.  Minnesota Statutes 2002, section 119B.011, 
524.3   subdivision 6, is amended to read: 
524.4      Subd. 6.  [CHILD CARE FUND.] "Child care fund" means a 
524.5   program under this chapter providing:  
524.6      (1) financial assistance for child care to parents engaged 
524.7   in employment, job search, or education and training leading to 
524.8   employment~~, or an at-home infant care subsidy~~; and 
524.9      (2) grants to develop, expand, and improve the access and 
524.10  availability of child care services statewide. 
524.11     Sec. 3.  Minnesota Statutes 2002, section 119B.011, 
524.12  subdivision 15, is amended to read: 
524.13     Subd. 15.  [INCOME.] "Income" means earned or unearned 
524.14  income received by all family members, including public 
524.15  assistance cash benefits ~~and at-home infant care subsidy~~ 
524.16  ~~payments~~, unless specifically excluded and child support and 
524.17  maintenance distributed to the family under section 256.741, 
524.18  subdivision 15.  The following are excluded from income:  funds 
524.19  used to pay for health insurance premiums for family members, 
524.20  Supplemental Security Income, scholarships, work-study income, 
524.21  and grants that cover costs or reimbursement for tuition, fees, 
524.22  books, and educational supplies; student loans for tuition, 
524.23  fees, books, supplies, and living expenses; state and federal 
524.24  earned income tax credits; assistance specifically excluded as 
524.25  income by law; in-kind income such as food stamps, energy 
524.26  assistance, foster care assistance, medical assistance, child 
524.27  care assistance, and housing subsidies; earned income of 
524.28  full-time or part-time students up to the age of 19, who have 
524.29  not earned a high school diploma or GED high school equivalency 
524.30  diploma including earnings from summer employment; grant awards 
524.31  under the family subsidy program; nonrecurring lump sum income 
524.32  only to the extent that it is earmarked and used for the purpose 
524.33  for which it is paid; and any income assigned to the public 
524.34  authority according to section 256.741. 
524.35     Sec. 4.  Minnesota Statutes 2002, section 119B.011, 
524.36  subdivision 19, is amended to read: 
525.1      Subd. 19.  [PROVIDER.] "Provider" means:  (1) an individual 
525.2   or child care center or facility, either licensed or unlicensed, 
525.3   providing legal child care services as defined under section 
525.4   245A.03; or (2) an individual or child care center or facility 
525.5   holding a valid child care license issued by another state or a 
525.6   tribe and providing child care services in the licensing state 
525.7   or in the area under the licensing tribe's jurisdiction.  A 
525.8   legally unlicensed ~~registered~~ family child care provider must be 
525.9   at least 18 years of age, and not a member of the MFIP 
525.10  assistance unit or a member of the family receiving child care 
525.11  assistance to be authorized under this chapter.  
525.12     Sec. 5.  Minnesota Statutes 2002, section 119B.011, is 
525.13  amended by adding a subdivision to read: 
525.14     Subd. 19a.  [REGISTRATION.] "Registration" means the 
525.15  process used by a county to determine whether the provider 
525.16  selected by a family applying for or receiving child care 
525.17  assistance to care for that family's children meets the 
525.18  requirements necessary for payment of child care assistance for 
525.19  care provided by that provider. 
525.20     Sec. 6.  Minnesota Statutes 2002, section 119B.011, 
525.21  subdivision 20, is amended to read: 
525.22     Subd. 20.  [TRANSITION YEAR FAMILIES.] (a) "Transition year 
525.23  families" means families who have received MFIP assistance, or 
525.24  who were eligible to receive MFIP assistance after choosing to 
525.25  discontinue receipt of the cash portion of MFIP assistance under 
525.26  section 256J.31, subdivision 12, for at least three of the last 
525.27  six months before losing eligibility for MFIP or families 
525.28  participating in work first under chapter 256K who meet the 
525.29  requirements of section 256K.07.  Transition year child care may 
525.30  be used to support employment or job search.  Transition year 
525.31  child care is not available to families who have been 
525.32  disqualified from MFIP due to fraud.  
525.33     (b) "Transition year extension year families" means 
525.34  families who have completed their transition year of child care 
525.35  assistance under this subdivision and who are eligible for, but 
525.36  on a waiting list for, services under section 119B.03.  For 
526.1   purposes of sections 119B.03, subdivision 3, and 119B.05, 
526.2   subdivision 1, clause (2), families participating in extended 
526.3   transition year shall not be considered transition year 
526.4   families.  Transition year extension child care may be used to 
526.5   support employment or a job search that meets the requirements 
526.6   of section 119B.10 for the length of time necessary for families 
526.7   to be moved from the basic sliding fee waiting list into the 
526.8   basic sliding fee program.  
526.9      Sec. 7.  Minnesota Statutes 2002, section 119B.011, 
526.10  subdivision 21, is amended to read: 
526.11     Subd. 21.  [RECOUPMENT OF OVERPAYMENTS.] "Recoupment of 
526.12  overpayments" means the reduction of child care assistance 
526.13  payments to an eligible family or a child care provider in order 
526.14  to correct an overpayment ~~to the family even when the~~ 
526.15  ~~overpayment is due to agency error or other circumstances~~ 
526.16  ~~outside the responsibility or control of the family~~ of child 
526.17  care assistance. 
526.18     Sec. 8.  Minnesota Statutes 2002, section 119B.02, 
526.19  subdivision 1, is amended to read: 
526.20     Subdivision 1.  [CHILD CARE SERVICES.] The commissioner 
526.21  shall develop standards for county and human services boards to 
526.22  provide child care services to enable eligible families to 
526.23  participate in employment, training, or education programs.  
526.24  Within the limits of available appropriations, the commissioner 
526.25  shall distribute money to counties to reduce the costs of child 
526.26  care for eligible families.  The commissioner shall adopt rules 
526.27  to govern the program in accordance with this section.  The 
526.28  rules must establish a sliding schedule of fees for parents 
526.29  receiving child care services.  The rules shall provide that 
526.30  funds received as a lump sum payment of child support arrearages 
526.31  shall not be counted as income to a family in the month received 
526.32  but shall be prorated over the 12 months following receipt and 
526.33  added to the family income during those months.  ~~In the rules~~ 
526.34  ~~adopted under this section, county and human services boards~~ 
526.35  ~~shall be authorized to establish policies for payment of child~~ 
526.36  ~~care spaces for absent children, when the payment is required by~~ 
527.1   ~~the child's regular provider.  The rules shall not set a maximum~~ 
527.2   ~~number of days for which absence payments can be made, but~~ 
527.3   ~~instead shall direct the county agency to set limits and pay for~~ 
527.4   ~~absences according to the prevailing market practice in the~~ 
527.5   ~~county.  County policies for payment of absences shall be~~ 
527.6   ~~subject to the approval of the commissioner.~~  The commissioner 
527.7   shall maximize the use of federal money under title I and title 
527.8   IV of Public Law Number 104-193, the Personal Responsibility and 
527.9   Work Opportunity Reconciliation Act of 1996, and other programs 
527.10  that provide federal or state reimbursement for child care 
527.11  services for low-income families who are in education, training, 
527.12  job search, or other activities allowed under those programs.  
527.13  Money appropriated under this section must be coordinated with 
527.14  the programs that provide federal reimbursement for child care 
527.15  services to accomplish this purpose.  Federal reimbursement 
527.16  obtained must be allocated to the county that spent money for 
527.17  child care that is federally reimbursable under programs that 
527.18  provide federal reimbursement for child care services.  The 
527.19  counties shall use the federal money to expand child care 
527.20  services.  The commissioner may adopt rules under chapter 14 to 
527.21  implement and coordinate federal program requirements. 
527.22     Sec. 9.  [119B.025] [DUTIES OF COUNTIES.] 
527.23     Subdivision 1.  [FACTORS WHICH MUST BE VERIFIED.] (a) The 
527.24  county shall verify the following at all initial child care 
527.25  applications using the universal application: 
527.26     (1) identity of adults; 
527.27     (2) presence of the minor child in the home, if 
527.28  questionable; 
527.29     (3) relationship of minor child to the parent, stepparent, 
527.30  legal guardian, eligible relative caretaker, or the spouses of 
527.31  any of the foregoing; 
527.32     (4) age; 
527.33     (5) immigration status, if related to eligibility; 
527.34     (6) social security number, if given; 
527.35     (7) income; 
527.36     (8) spousal support and child support payments made to 
528.1   persons outside the household; 
528.2      (9) residence; and 
528.3      (10) inconsistent information, if related to eligibility. 
528.4      (b) If a family did not use the universal application to 
528.5   apply for child care assistance, the family must complete the 
528.6   universal application at its next eligibility redetermination 
528.7   and the county must verify the factors listed in paragraph (a) 
528.8   as part of that redetermination.  Once a family has completed a 
528.9   universal application, the county shall use the redetermination 
528.10  form described in paragraph (c) for that family's subsequent 
528.11  redeterminations.  
528.12     (c) The commissioner shall develop a recertification form 
528.13  to redetermine eligibility that minimizes paperwork for the 
528.14  county and the participant. 
528.15     Subd. 2.  [SOCIAL SECURITY NUMBERS.] The county must 
528.16  request social security numbers from all applicants for child 
528.17  care assistance under this chapter.  A county may not deny child 
528.18  care assistance solely on the basis of failure of an applicant 
528.19  to report a social security number. 
528.20     Sec. 10.  Minnesota Statutes 2002, section 119B.03, 
528.21  subdivision 4, is amended to read: 
528.22     Subd. 4.  [FUNDING PRIORITY.] (a) First priority for child 
528.23  care assistance under the basic sliding fee program must be 
528.24  given to eligible non-MFIP families who do not have a high 
528.25  school or general equivalency diploma or who need remedial and 
528.26  basic skill courses in order to pursue employment or to pursue 
528.27  education leading to employment and who need child care 
528.28  assistance to participate in the education program.  Within this 
528.29  priority, the following subpriorities must be used: 
528.30     (1) child care needs of minor parents; 
528.31     (2) child care needs of parents under 21 years of age; and 
528.32     (3) child care needs of other parents within the priority 
528.33  group described in this paragraph. 
528.34     (b) Second priority must be given to parents who have 
528.35  completed their MFIP or work first transition year. 
528.36     (c) Third priority must be given to families who are 
529.1   eligible for portable basic sliding fee assistance through the 
529.2   portability pool under subdivision 9. 
529.3      (d) Families under paragraph (b) must be added to the basic 
529.4   sliding fee waiting list on the date they begin transition year 
529.5   under section 119B.011, subdivision 20, and must be moved into 
529.6   basic sliding fee as soon as possible after they complete their 
529.7   transition year.  
529.8      Sec. 11.  Minnesota Statutes 2002, section 119B.03, 
529.9   subdivision 9, is amended to read: 
529.10     Subd. 9.  [PORTABILITY POOL.] (a) The commissioner shall 
529.11  establish a pool of up to five percent of the annual 
529.12  appropriation for the basic sliding fee program to provide 
529.13  continuous child care assistance for eligible families who move 
529.14  between Minnesota counties.  At the end of each allocation 
529.15  period, any unspent funds in the portability pool must be used 
529.16  for assistance under the basic sliding fee program.  If 
529.17  expenditures from the portability pool exceed the amount of 
529.18  money available, the reallocation pool must be reduced to cover 
529.19  these shortages. 
529.20     (b) To be eligible for portable basic sliding fee 
529.21  assistance, a family that has moved from a county in which it 
529.22  was receiving basic sliding fee assistance to a county with a 
529.23  waiting list for the basic sliding fee program must: 
529.24     (1) meet the income and eligibility guidelines for the 
529.25  basic sliding fee program; and 
529.26     (2) notify the new county of residence within ~~30~~ 60 days of 
529.27  moving and ~~apply for basic sliding fee assistance in~~ submit 
529.28  information to the new county of residence to verify eligibility 
529.29  for the basic sliding fee program. 
529.30     (c) The receiving county must: 
529.31     (1) accept administrative responsibility for applicants for 
529.32  portable basic sliding fee assistance at the end of the two 
529.33  months of assistance under the Unitary Residency Act; 
529.34     (2) continue basic sliding fee assistance for the lesser of 
529.35  six months or until the family is able to receive assistance 
529.36  under the county's regular basic sliding program; and 
530.1      (3) notify the commissioner through the quarterly reporting 
530.2   process of any family that meets the criteria of the portable 
530.3   basic sliding fee assistance pool. 
530.4      Sec. 12.  Minnesota Statutes 2002, section 119B.05, 
530.5   subdivision 1, is amended to read: 
530.6      Subdivision 1.  [ELIGIBLE PARTICIPANTS.] Families eligible 
530.7   for child care assistance under the MFIP child care program are: 
530.8      (1) MFIP participants who are employed or in job search and 
530.9   meet the requirements of section 119B.10; 
530.10     (2) persons who are members of transition year families 
530.11  under section 119B.011, subdivision 20, and meet the 
530.12  requirements of section 119B.10; 
530.13     (3) families who are participating in employment 
530.14  orientation or job search, or other employment or training 
530.15  activities that are included in an approved employability 
530.16  development plan under chapter 256K; 
530.17     (4) MFIP families who are participating in work job search, 
530.18  job support, employment, or training activities as required in 
530.19  their job search support or employment plan, or in appeals, 
530.20  hearings, assessments, or orientations according to chapter 
530.21  256J; 
530.22     (5) MFIP families who are participating in social services 
530.23  activities under chapter 256J or 256K as required in their 
530.24  employment plan approved according to chapter 256J or 256K; ~~and~~ 
530.25     (6) families who are participating in programs as required 
530.26  in tribal contracts under section 119B.02, subdivision 2, or 
530.27  256.01, subdivision 2; and 
530.28     (7) families who are participating in the transition year 
530.29  extension under section 119B.011, subdivsion 20, paragraph (a).  
530.30     Sec. 13.  Minnesota Statutes 2002, section 119B.08, 
530.31  subdivision 3, is amended to read: 
530.32     Subd. 3.  [CHILD CARE FUND PLAN.] The county and designated 
530.33  administering agency shall submit a biennial child care fund 
530.34  plan to the commissioner ~~an annual child care fund plan in its~~ 
530.35  ~~biennial community social services plan~~.  The commissioner shall 
530.36  establish the dates by which the county must submit the plans.  
531.1   The plan shall include: 
531.2      (1) ~~a narrative of the total program for child care~~ 
531.3   ~~services, including all policies and procedures that affect~~ 
531.4   ~~eligible families and are used to administer the child care~~ 
531.5   ~~funds;~~ 
531.6      ~~(2) the methods used by the county to inform eligible~~ 
531.7   ~~families of the availability of child care assistance and~~ 
531.8   ~~related services;~~ 
531.9      ~~(3) the provider rates paid for all children with special~~ 
531.10  ~~needs by provider type;~~ 
531.11     ~~(4) the county prioritization policy for all eligible~~ 
531.12  ~~families under the basic sliding fee program; and~~ 
531.13     ~~(5) other~~ a description of strategies to coordinate and 
531.14  maximize public and private community resources, including 
531.15  school districts, health care facilities, government agencies, 
531.16  neighborhood organizations, and other resources knowledgeable in 
531.17  early childhood development, in particular to coordinate child 
531.18  care assistance with existing community-based programs and 
531.19  service providers including child care resource and referral 
531.20  programs, early childhood family education, school readiness, 
531.21  Head Start, local interagency early intervention committees, 
531.22  special education services, early childhood screening, and other 
531.23  early childhood care and education services and programs to the 
531.24  extent possible, to foster collaboration among agencies and 
531.25  other community-based programs that provide flexible, 
531.26  family-focused services to families with young children and to 
531.27  facilitate transition into kindergarten.  The county must 
531.28  describe a method by which to share information, responsibility, 
531.29  and accountability among service and program providers; 
531.30     (2) a description of procedures and methods to be used to 
531.31  make copies of the proposed state plan reasonably available to 
531.32  the public, including members of the public particularly 
531.33  interested in child care policies such as parents, child care 
531.34  providers, culturally specific service organizations, child care 
531.35  resource and referral programs, interagency early intervention 
531.36  committees, potential collaborative partners and agencies 
532.1   involved in the provision of care and education to young 
532.2   children, and allowing sufficient time for public review and 
532.3   comment; and 
532.4      (3) information as requested by the department to ensure 
532.5   compliance with the child care fund statutes and rules 
532.6   promulgated by the commissioner. 
532.7      The commissioner shall notify counties within ~~60~~ 90 days of 
532.8   the date the plan is submitted whether the plan is approved or 
532.9   the corrections or information needed to approve the plan.  The 
532.10  commissioner shall withhold a county's allocation until it has 
532.11  an approved plan.  Plans not approved by the end of the second 
532.12  quarter after the plan is due may result in a 25 percent 
532.13  reduction in allocation.  Plans not approved by the end of the 
532.14  third quarter after the plan is due may result in a 100 percent 
532.15  reduction in the allocation to the county.  Counties are to 
532.16  maintain services despite any reduction in their allocation due 
532.17  to plans not being approved. 
532.18     Sec. 14.  Minnesota Statutes 2002, section 119B.09, 
532.19  subdivision 1, is amended to read: 
532.20     Subdivision 1.  [GENERAL ELIGIBILITY REQUIREMENTS FOR ALL 
532.21  APPLICANTS FOR CHILD CARE ASSISTANCE.] (a) Child care services 
532.22  must be available to families who need child care to find or 
532.23  keep employment or to obtain the training or education necessary 
532.24  to find employment and who: 
532.25     (1) meet the requirements of section 119B.05; receive MFIP 
532.26  assistance; and are participating in employment and training 
532.27  services under chapter 256J or 256K; 
532.28     (2) have household income below the eligibility levels for 
532.29  MFIP; or 
532.30     (3) have household income ~~within a range established by the~~ 
532.31  ~~commissioner~~ less than or equal to 175 percent of the federal 
532.32  poverty guidelines, adjusted for family size, at program entry 
532.33  and less than 250 percent of the federal poverty guidelines, 
532.34  adjusted for family size, at program exit. 
532.35     (b) Child care services must be made available as in-kind 
532.36  services.  
533.1      (c) All applicants for child care assistance and families 
533.2   currently receiving child care assistance must be assisted and 
533.3   required to cooperate in establishment of paternity and 
533.4   enforcement of child support obligations for all children in the 
533.5   family as a condition of program eligibility.  For purposes of 
533.6   this section, a family is considered to meet the requirement for 
533.7   cooperation when the family complies with the requirements of 
533.8   section 256.741. 
533.9      Sec. 15.  Minnesota Statutes 2002, section 119B.09, 
533.10  subdivision 2, is amended to read: 
533.11     Subd. 2.  [SLIDING FEE.] Child care services to 
533.12  families ~~with incomes in the commissioner's established range~~ 
533.13  must be made available on a sliding fee basis.  ~~The upper limit~~ 
533.14  ~~of the range must be neither less than 70 percent nor more than~~ 
533.15  ~~90 percent of the state median income for a family of four,~~ 
533.16  ~~adjusted for family size.~~  
533.17     Sec. 16.  Minnesota Statutes 2002, section 119B.09, 
533.18  subdivision 7, is amended to read: 
533.19     Subd. 7.  [DATE OF ELIGIBILITY FOR ASSISTANCE.] (a) The 
533.20  date of eligibility for child care assistance under this chapter 
533.21  is the later of the date the application was signed; the 
533.22  beginning date of employment, education, or training; or the 
533.23  date a determination has been made that the applicant is a 
533.24  participant in employment and training services under Minnesota 
533.25  Rules, part 3400.0080, subpart 2a, or chapter 256J or 256K.  ~~The~~ 
533.26  ~~date of eligibility for the basic sliding fee at-home infant~~ 
533.27  ~~child care program is the later of the date the infant is born~~ 
533.28  ~~or, in a county with a basic sliding fee waiting list, the date~~ 
533.29  ~~the family applies for at-home infant child care.~~  
533.30     (b) ~~Payment ceases for a family under the at-home infant~~ 
533.31  ~~child care program when a family has used a total of 12 months~~ 
533.32  ~~of assistance as specified under section 119B.061.~~  Payment of 
533.33  child care assistance for employed persons on MFIP is effective 
533.34  the date of employment or the date of MFIP eligibility, 
533.35  whichever is later.  Payment of child care assistance for MFIP 
533.36  or work first participants in employment and training services 
534.1   is effective the date of commencement of the services or the 
534.2   date of MFIP or work first eligibility, whichever is later.  
534.3   Payment of child care assistance for transition year child care 
534.4   must be made retroactive to the date of eligibility for 
534.5   transition year child care. 
534.6      Sec. 17.  Minnesota Statutes 2002, section 119B.09, is 
534.7   amended by adding a subdivision to read: 
534.8      Subd. 9.  [LICENSED AND LEGAL NONLICENSED FAMILY CHILD CARE 
534.9   PROVIDERS; ASSISTANCE.] Licensed and legal nonlicensed family 
534.10  child care providers are not eligible to receive child care 
534.11  assistance subsidies under this chapter for their own children 
534.12  or children in their custody. 
534.13     Sec. 18.  Minnesota Statutes 2002, section 119B.09, is 
534.14  amended by adding a subdivision to read: 
534.15     Subd. 10.  [PAYMENT OF FUNDS.] All federal, state, and 
534.16  local child care funds must be paid directly to the parent when 
534.17  a provider cares for children in the children's own home.  In 
534.18  all other cases, all federal, state, and local child care funds 
534.19  must be paid directly to the child care provider, either 
534.20  licensed or legal nonlicensed, on behalf of the eligible family. 
534.21     Sec. 19.  Minnesota Statutes 2002, section 119B.11, 
534.22  subdivision 2a, is amended to read: 
534.23     Subd. 2a.  [RECOVERY OF OVERPAYMENTS.] (a) An amount of 
534.24  child care assistance paid to a recipient in excess of the 
534.25  payment due is recoverable by the county agency under paragraphs 
534.26  (b) and (c), even when the overpayment was caused by agency 
534.27  error or circumstances outside the responsibility and control of 
534.28  the family or provider.  
534.29     (b) An overpayment must be recouped or recovered from the 
534.30  family if the overpayment benefited the family by causing the 
534.31  family to pay less for child care expenses than the family 
534.32  otherwise would have been required to pay under child care 
534.33  assistance program requirements.  If the family remains eligible 
534.34  for child care assistance, the overpayment must be recovered 
534.35  through recoupment as identified in Minnesota Rules, 
534.36  part ~~3400.0140, subpart 19~~ 3400.0187, except that the 
535.1   overpayments must be calculated and collected on a service 
535.2   period basis.  If the family no longer remains eligible for 
535.3   child care assistance, the county may choose to initiate efforts 
535.4   to recover overpayments from the family for overpayment less 
535.5   than $50.  If the overpayment is greater than or equal to $50, 
535.6   the county shall seek voluntary repayment of the overpayment 
535.7   from the family.  If the county is unable to recoup the 
535.8   overpayment through voluntary repayment, the county shall 
535.9   initiate civil court proceedings to recover the overpayment 
535.10  unless the county's costs to recover the overpayment will exceed 
535.11  the amount of the overpayment.  A family with an outstanding 
535.12  debt under this subdivision is not eligible for child care 
535.13  assistance until:  (1) the debt is paid in full; or (2) 
535.14  satisfactory arrangements are made with the county to retire the 
535.15  debt consistent with the requirements of this chapter and 
535.16  Minnesota Rules, chapter 3400, and the family is in compliance 
535.17  with the arrangements. 
535.18     (c) The county must recover an overpayment from a provider 
535.19  if the overpayment did not benefit the family by causing it to 
535.20  receive more child care assistance or to pay less for child care 
535.21  expenses than the family otherwise would have been eligible to 
535.22  receive or required to pay under child care assistance program 
535.23  requirements, and benefited the provider by causing the provider 
535.24  to receive more child care assistance than otherwise would have 
535.25  been paid on the family's behalf under child care assistance 
535.26  program requirements.  If the provider continues to care for 
535.27  children receiving child care assistance, the overpayment must 
535.28  be recovered through reductions in child care assistance 
535.29  payments for services as described in an agreement with the 
535.30  county.  The provider may not charge families using that 
535.31  provider more to cover the cost of recouping the overpayment.  
535.32  If the provider no longer cares for children receiving child 
535.33  care assistance, the county may choose to initiate efforts to 
535.34  recover overpayments of less than $50 from the provider.  If the 
535.35  overpayment is greater than or equal to $50, the county shall 
535.36  seek voluntary repayment of the overpayment from the provider.  
536.1   If the county is unable to recoup the overpayment through 
536.2   voluntary repayment, the county shall initiate civil court 
536.3   proceedings to recover the overpayment unless the county's costs 
536.4   to recover the overpayment will exceed the amount of the 
536.5   overpayment.  A provider with an outstanding debt under this 
536.6   subdivision is not eligible to care for children receiving child 
536.7   care assistance until:  (1) the debt is paid in full; or (2) 
536.8   satisfactory arrangements are made with the county to retire the 
536.9   debt consistent with the requirements of this chapter and 
536.10  Minnesota Rules, chapter 3400, and the provider is in compliance 
536.11  with the arrangements. 
536.12     (d) When both the family and the provider acted together to 
536.13  intentionally cause the overpayment, both the family and the 
536.14  provider are jointly liable for the overpayment regardless of 
536.15  who benefited from the overpayment.  The county must recover the 
536.16  overpayment as provided in paragraphs (b) and (c).  When the 
536.17  family or the provider is in compliance with a repayment 
536.18  agreement, the party in compliance is eligible to receive child 
536.19  care assistance or to care for children receiving child care 
536.20  assistance despite the other party's noncompliance with 
536.21  repayment arrangements. 
536.22     Sec. 20.  Minnesota Statutes 2002, section 119B.12, 
536.23  subdivision 2, is amended to read: 
536.24     Subd. 2.  [PARENT FEE.] A family must be assessed a parent 
536.25  fee for each service period.  A family's ~~monthly~~ parent fee must 
536.26  be a fixed percentage of its annual gross income.  Parent fees 
536.27  must apply to families eligible for child care assistance under 
536.28  sections 119B.03 and 119B.05.  Income must be as defined in 
536.29  section 119B.011, subdivision 15.  The fixed percent is based on 
536.30  the relationship of the family's annual gross income to 100 
536.31  percent of ~~state median income~~ the annual federal poverty 
536.32  guidelines.  ~~Beginning January 1, 1998, parent fees must begin~~ 
536.33  ~~at 75 percent of the poverty level.  The minimum parent fees for~~ 
536.34  ~~families between 75 percent and 100 percent of poverty level~~ 
536.35  ~~must be $5 per month.~~  Parent fees must ~~be established in rule~~ 
536.36  ~~and must~~ provide for graduated movement to full payment. 
537.1      Sec. 21.  [119B.125] [PROVIDER REQUIREMENTS.] 
537.2      Subdivision 1.  [AUTHORIZATION.] Except as provided in 
537.3   subdivision 5, a county must authorize the provider chosen by an 
537.4   applicant or a participant before the county can authorize 
537.5   payment for care provided by that provider.  The commissioner 
537.6   must establish the requirements necessary for authorization of 
537.7   providers. 
537.8      Subd. 2.  [PERSONS WHO CANNOT BE AUTHORIZED.] (a) A person 
537.9   who meets any of the conditions under paragraphs (b) to (n) must 
537.10  not be authorized as a legal nonlicensed family child care 
537.11  provider.  For purposes of this subdivision, a finding that a 
537.12  delinquency petition is proven in juvenile court must be 
537.13  considered a conviction in state district court. 
537.14     (b) The person has been convicted of one of the following 
537.15  offenses or has admitted to committing or a preponderance of the 
537.16  evidence indicates that the person has committed an act that 
537.17  meets the definition of one of the following offenses:  sections 
537.18  609.185 to 609.195, murder in the first, second, or third 
537.19  degree; 609.2661 to 609.2663, murder of an unborn child in the 
537.20  first, second, or third degree; 609.322, solicitation, 
537.21  inducement, or promotion of prostitution; 609.323, receiving 
537.22  profit from prostitution; 609.342 to 609.345, criminal sexual 
537.23  conduct in the first, second, third, or fourth degree; 609.352, 
537.24  solicitation of children to engage in sexual conduct; 609.365, 
537.25  incest; 609.377, felony malicious punishment of a child; 
537.26  617.246, use of minors in sexual performance; 617.247, 
537.27  possession of pictorial representation of a minor; 609.2242 to 
537.28  609.2243, felony domestic assault; a felony offense of spousal 
537.29  abuse; a felony offense of child abuse or neglect; a felony 
537.30  offense of a crime against children; or an attempt or conspiracy 
537.31  to commit any of these offenses as defined in Minnesota 
537.32  Statutes; or an offense in any other state or country where the 
537.33  elements are substantially similar to any of the offenses listed 
537.34  in this paragraph. 
537.35     (c) Less than 15 years have passed since the discharge of 
537.36  the sentence imposed for the offense and the person has received 
538.1   a felony conviction for one of the following offenses, or the 
538.2   person has admitted to committing or a preponderance of the 
538.3   evidence indicates that the person has committed an act that 
538.4   meets the definition of a felony conviction for one of the 
538.5   following offenses:  sections 609.20 to 609.205, manslaughter in 
538.6   the first or second degree; 609.21, criminal vehicular homicide; 
538.7   609.215, aiding suicide or aiding attempted suicide; 609.221 to 
538.8   609.2231, assault in the first, second, third, or fourth degree; 
538.9   609.224, repeat offenses of fifth degree assault; 609.228, great 
538.10  bodily harm caused by distribution of drugs; 609.2325, criminal 
538.11  abuse of a vulnerable adult; 609.2335, financial exploitation of 
538.12  a vulnerable adult; 609.235, use of drugs to injure or 
538.13  facilitate a crime; 609.24, simple robbery; 617.241, repeat 
538.14  offenses of obscene materials and performances; 609.245, 
538.15  aggravated robbery; 609.25, kidnapping; 609.255, false 
538.16  imprisonment; 609.2664 to 609.2665, manslaughter of an unborn 
538.17  child in the first or second degree; 609.267 to 609.2672, 
538.18  assault of an unborn child in the first, second, or third 
538.19  degree; 609.268, injury or death of an unborn child in the 
538.20  commission of a crime; 609.27, coercion; 609.275, attempt to 
538.21  coerce; 609.324, subdivision 1, other prohibited acts, minor 
538.22  engaged in prostitution; 609.3451, repeat offenses of criminal 
538.23  sexual conduct in the fifth degree; 609.378, neglect or 
538.24  endangerment of a child; 609.52, theft; 609.521, possession of 
538.25  shoplifting gear; 609.561 to 609.563, arson in the first, 
538.26  second, or third degree; 609.582, burglary in the first, second, 
538.27  third, or fourth degree; 609.625, aggravated forgery; 609.63, 
538.28  forgery; 609.631, check forgery, offering a forged check; 
538.29  609.635, obtaining signature by false pretenses; 609.66, 
538.30  dangerous weapon; 609.665, setting a spring gun; 609.67, 
538.31  unlawfully owning, possessing, or operating a machine gun; 
538.32  609.687, adulteration; 609.71, riot; 609.713, terrorist threats; 
538.33  609.749, harassment, stalking; 260.221, grounds for termination 
538.34  of parental rights; 152.021 to 152.022, controlled substance 
538.35  crime in the first or second degree; 152.023, subdivision 1, 
538.36  clause (3) or (4), or 152.023, subdivision 2, clause (4), 
539.1   controlled substance crime in third degree; 152.024, subdivision 
539.2   1, clause (2), (3), or (4), controlled substance crime in fourth 
539.3   degree; 617.23, repeat offenses of indecent exposure; an attempt 
539.4   or conspiracy to commit any of these offenses as defined in 
539.5   Minnesota Statutes; or an offense in any other state or country 
539.6   where the elements are substantially similar to any of the 
539.7   offenses listed in this paragraph. 
539.8      (d) Less than ten years have passed since the discharge of 
539.9   the sentence imposed for the offense and the person has received 
539.10  a gross misdemeanor conviction for one of the following offenses 
539.11  or the person has admitted to committing or a preponderance of 
539.12  the evidence indicates that the person has committed an act that 
539.13  meets the definition of a gross misdemeanor conviction for one 
539.14  of the following offenses:  sections 609.224, fifth degree 
539.15  assault; 609.2242 to 609.2243, domestic assault; 518B.01, 
539.16  subdivision 14, violation of an order for protection; 609.3451, 
539.17  fifth degree criminal sexual conduct; 609.746, repeat offenses 
539.18  of interference with privacy; 617.23, repeat offenses of 
539.19  indecent exposure; 617.241, obscene materials and performances; 
539.20  617.243, indecent literature, distribution; 617.293, 
539.21  disseminating or displaying harmful material to minors; 609.71, 
539.22  riot; 609.66, dangerous weapons; 609.749, harassment, stalking; 
539.23  609.224, subdivision 2, paragraph (c), fifth degree assault 
539.24  against a vulnerable adult by a caregiver; 609.23, mistreatment 
539.25  of persons confined; 609.231, mistreatment of residents or 
539.26  patients; 609.2325, criminal abuse of a vulnerable adult; 
539.27  609.2335, financial exploitation of a vulnerable adult; 609.233, 
539.28  criminal neglect of a vulnerable adult; 609.234, failure to 
539.29  report maltreatment of a vulnerable adult; 609.72, subdivision 
539.30  3, disorderly conduct against a vulnerable adult; 609.265, 
539.31  abduction; 609.378, neglect or endangerment of a child; 609.377, 
539.32  malicious punishment of a child; 609.324, subdivision 1a, other 
539.33  prohibited acts, minor engaged in prostitution; 609.33, 
539.34  disorderly house; 609.52, theft; 609.582, burglary in the first, 
539.35  second, third, or fourth degree; 609.631, check forgery, 
539.36  offering a forged check; 609.275, attempt to coerce; an attempt 
540.1   or conspiracy to commit any of these offenses as defined in 
540.2   Minnesota Statutes; or an offense in any other state or country 
540.3   where the elements are substantially similar to any of the 
540.4   offenses listed in this paragraph. 
540.5      (e) Less than seven years have passed since the discharge 
540.6   of the sentence imposed for the offense and the person has 
540.7   received a misdemeanor conviction for one of the following 
540.8   offenses or the person has admitted to committing or a 
540.9   preponderance of the evidence indicates that the person has 
540.10  committed an act that meets the definition of a misdemeanor 
540.11  conviction for one of the following offenses:  sections 609.224, 
540.12  fifth degree assault; 609.2242, domestic assault; 518B.01, 
540.13  violation of an order for protection; 609.3232, violation of an 
540.14  order for protection; 609.746, interference with privacy; 
540.15  609.79, obscene or harassing telephone calls; 609.795, letter, 
540.16  telegram, or package, opening, harassment; 617.23, indecent 
540.17  exposure; 609.2672, assault of an unborn child, third degree; 
540.18  617.293, dissemination and display of harmful materials to 
540.19  minors; 609.66, dangerous weapons; 609.665, spring guns; an 
540.20  attempt or conspiracy to commit any of these offenses as defined 
540.21  in Minnesota Statutes; or an offense in any other state or 
540.22  country where the elements are substantially similar to any of 
540.23  the offenses listed in this paragraph. 
540.24     (f) The person has been identified by the county's child 
540.25  protection agency or by the statewide child protection database 
540.26  as the person allegedly responsible for physical or sexual abuse 
540.27  of a child within the last seven years. 
540.28     (g) The person has been identified by the county's adult 
540.29  protection agency or by the statewide adult protection database 
540.30  as the person responsible for abuse or neglect of a vulnerable 
540.31  adult within the last seven years. 
540.32     (h) The person has refused to give written consent for 
540.33  disclosure of criminal history records. 
540.34     (i) The person has been denied a family child care license 
540.35  or has received a fine or a sanction as a licensed child care 
540.36  provider that has not been reversed on appeal. 
541.1      (j) The person has a family child care licensing 
541.2   disqualification that has not been set aside. 
541.3      (k) The person has admitted or a county has found that 
541.4   there is a preponderance of evidence that fraudulent information 
541.5   was given to the county for application purposes or was used in 
541.6   submitting bills for payment. 
541.7      (l) The person has been convicted or there is a 
541.8   preponderance of evidence of the crime of theft by wrongfully 
541.9   obtaining public assistance. 
541.10     (m) The person has a household member age 13 or older who 
541.11  has access to children during the hours that care is provided 
541.12  and who meets one of the conditions listed in paragraphs (b) to 
541.13  (l). 
541.14     (n) The person has a household member ages ten to 12 who 
541.15  has access to children during the hours that care is provided; 
541.16  information or circumstances exist which provide the county with 
541.17  articulable suspicion that further pertinent information may 
541.18  exist showing the household member meets one of the conditions 
541.19  listed in paragraphs (b) to (l); and the household member 
541.20  actually meets one of the conditions listed in paragraphs (b) to 
541.21  (l). 
541.22     Subd. 3.  [AUTHORIZATION EXCEPTION.] When a county denies a 
541.23  person authorization as a legal nonlicensed family child care 
541.24  provider under subdivision 2, the county later may authorize 
541.25  that person as a provider if the following conditions are met: 
541.26     (1) after receiving notice of the denial of the 
541.27  authorization, the person applies for and obtains a valid child 
541.28  care license issued under chapter 245A, issued by a tribe, or 
541.29  issued by another state; 
541.30     (2) the person maintains the valid child care license; and 
541.31     (3) the person is providing child care in the state of 
541.32  licensure or in the area under the jurisdiction of the licensing 
541.33  tribe. 
541.34     Subd. 4.  [UNSAFE CARE.] A county may deny authorization as 
541.35  a child care provider to any applicant or rescind authorization 
541.36  of any provider when the county knows or has reason to believe 
542.1   that the provider is unsafe or that the circumstances of the 
542.2   chosen child care arrangement are unsafe.  The county must 
542.3   include the conditions under which a provider or care 
542.4   arrangement will be determined to be unsafe in the county's 
542.5   child care fund plan under section 119B.08, subdivision 3. 
542.6      Subd. 5.  [PROVISIONAL PAYMENT.] After a county receives a 
542.7   completed application from a provider, the county may issue 
542.8   provisional authorization and payment to the provider during the 
542.9   time needed to determine whether to give final authorization to 
542.10  the provider. 
542.11     Subd. 6.  [RECORD KEEPING REQUIREMENT.] All providers must 
542.12  keep daily attendance records for children receiving child care 
542.13  assistance and must make those records available immediately to 
542.14  the county upon request.  The daily attendance records must be 
542.15  retained for six years after the date of service.  A county may 
542.16  deny authorization as a child care provider to any applicant or 
542.17  rescind authorization of any provider when the county knows or 
542.18  has reason to believe that the provider has not complied with 
542.19  the record keeping requirement in this subdivision. 
542.20     Sec. 22.  Minnesota Statutes 2002, section 119B.13, 
542.21  subdivision 1, is amended to read: 
542.22     Subdivision 1.  [SUBSIDY RESTRICTIONS.] The maximum rate 
542.23  paid for child care assistance under the child care fund may not 
542.24  exceed the 75th percentile rate for like-care arrangements in 
542.25  the county as surveyed by the commissioner.  A rate which 
542.26  includes a provider bonus paid under subdivision 2 or a special 
542.27  needs rate paid under subdivision 3 may be in excess of the 
542.28  maximum rate allowed under this subdivision.  The department 
542.29  shall monitor the effect of this paragraph on provider rates.  
542.30  The county shall pay the provider's full charges for every child 
542.31  in care up to the maximum established.  The commissioner shall 
542.32  determine the maximum rate for each type of care on an hourly, 
542.33  full-day, and weekly basis, including special needs and 
542.34  handicapped care.  Not less than once every two years, the 
542.35  commissioner shall evaluate market practices for payment of 
542.36  absences and shall establish policies for payment of absent days 
543.1   that reflect current market practice. 
543.2      When the provider charge is greater than the maximum 
543.3   provider rate allowed, the parent is responsible for payment of 
543.4   the difference in the rates in addition to any family copayment 
543.5   fee. 
543.6      Sec. 23.  Minnesota Statutes 2002, section 119B.13, is 
543.7   amended by adding a subdivision to read: 
543.8      Subd. 1b.  [LEGAL NONLICENSED FAMILY CHILD CARE PROVIDER 
543.9   RATES.] (a) Legal nonlicensed family child care providers 
543.10  receiving reimbursement under this chapter must be paid on an 
543.11  hourly basis for care provided to families receiving assistance. 
543.12     (b) The maximum rate paid to legal nonlicensed family child 
543.13  care providers must be 80 percent of the county maximum hourly 
543.14  rate for licensed family child care providers.  In counties 
543.15  where the maximum hourly rate for licensed family child care 
543.16  providers is higher than the maximum weekly rate for those 
543.17  providers divided by 50, the maximum hourly rate that may be 
543.18  paid to legal nonlicensed family child care providers is the 
543.19  rate equal to the maximum weekly rate for licensed family child 
543.20  care providers divided by 50 and then multiplied by 0.80. 
543.21     (c) A rate which includes a provider bonus paid under 
543.22  subdivision 2 or a special needs rate paid under subdivision 3 
543.23  may be in excess of the maximum rate allowed under this 
543.24  subdivision. 
543.25     (d) Legal nonlicensed family child care providers receiving 
543.26  reimbursement under this chapter may not be paid registration 
543.27  fees for families receiving assistance. 
543.28     Sec. 24.  Minnesota Statutes 2002, section 119B.13, 
543.29  subdivision 6, is amended to read: 
543.30     Subd. 6.  [PROVIDER PAYMENTS.] (a) Counties or the state 
543.31  shall make vendor payments to the child care provider or pay the 
543.32  parent directly for eligible child care expenses.  
543.33     (b) If payments for child care assistance are made to 
543.34  providers, the provider shall bill the county for services 
543.35  provided within ten days of the end of the ~~month of~~ service 
543.36  period.  If bills are submitted ~~in accordance with the~~ 
544.1   ~~provisions of this subdivision~~ within ten days of the end of the 
544.2   service period, a county or the state shall issue payment to the 
544.3   provider of child care under the child care fund within 30 days 
544.4   of receiving ~~an invoice~~ a bill from the provider.  Counties or 
544.5   the state may establish policies that make payments on a more 
544.6   frequent basis.  
544.7      (c) All bills must be submitted within 60 days of the last 
544.8   date of service on the bill.  A county may pay a bill submitted 
544.9   more than 60 days after the last date of service if the provider 
544.10  shows good cause why the bill was not submitted within 60 days.  
544.11  Good cause must be defined in the county's child care fund plan 
544.12  under section 119B.08, subdivision 3, and the definition of good 
544.13  cause must include county error.  A county may not pay any bill 
544.14  submitted more than a year after the last date of service on the 
544.15  bill. 
544.16     (d) A county may stop payment issued to a provider or may 
544.17  refuse to pay a bill submitted by a provider if: 
544.18     (1) the provider admits to intentionally giving the county 
544.19  materially false information on the provider's billing forms; or 
544.20     (2) a county finds by a preponderance of the evidence that 
544.21  the provider intentionally gave the county materially false 
544.22  information on the provider's billing forms. 
544.23     (e) A county's payment policies must be included in the 
544.24  county's child care plan under section 119B.08, subdivision 3.  
544.25  If payments are made by the state, in addition to being in 
544.26  compliance with this subdivision, the payments must be made in 
544.27  compliance with section 16A.124. 
544.28     Sec. 25.  Minnesota Statutes 2002, section 119B.16, is 
544.29  amended by adding a subdivision to read: 
544.30     Subd. 1a.  [FAIR HEARING ALLOWED FOR PROVIDERS.] (a) This 
544.31  subdivision applies to providers caring for children receiving 
544.32  child care assistance. 
544.33     (b) A provider to whom a county agency has assigned 
544.34  responsibility for an overpayment may request a fair hearing in 
544.35  accordance with section 256.045 for the limited purpose of 
544.36  challenging the assignment of responsibility for the overpayment 
545.1   and the amount of the overpayment.  The scope of the fair 
545.2   hearing does not include the issues of whether the provider 
545.3   wrongfully obtained public assistance in violation of section 
545.4   256.98 or was properly disqualified under section 256.98, 
545.5   subdivision 8, paragraph (c), unless the fair hearing has been 
545.6   combined with an administrative disqualification hearing brought 
545.7   against the provider under section 256.046. 
545.8      Sec. 26.  Minnesota Statutes 2002, section 119B.16, is 
545.9   amended by adding a subdivision to read: 
545.10     Subd. 1b.  [JOINT FAIR HEARINGS.] When a provider requests 
545.11  a fair hearing under subdivision 1a, the family in whose case 
545.12  the overpayment was created must be made a party to the fair 
545.13  hearing.  All other issues raised by the family must be resolved 
545.14  in the same proceeding.  When a family requests a fair hearing 
545.15  and claims that the county should have assigned responsibility 
545.16  for an overpayment to a provider, the provider must be made a 
545.17  party to the fair hearing.  The referee assigned to a fair 
545.18  hearing may join a family or a provider as a party to the fair 
545.19  hearing whenever joinder of that party is necessary to fully and 
545.20  fairly resolve overpayment issues raised in the appeal. 
545.21     Sec. 27.  Minnesota Statutes 2002, section 119B.16, 
545.22  subdivision 2, is amended to read: 
545.23     Subd. 2.  [INFORMAL CONFERENCE.] The county agency shall 
545.24  offer an informal conference to applicants and recipients 
545.25  adversely affected by an agency action to attempt to resolve the 
545.26  dispute.  The county agency shall offer an informal conference 
545.27  to providers to whom the county agency has assigned 
545.28  responsibility for an overpayment in an attempt to resolve the 
545.29  dispute.  The county agency or the provider may ask the family 
545.30  in whose case the overpayment arose to participate in the 
545.31  informal conference, but the family may refuse to do so.  The 
545.32  county agency shall advise adversely affected applicants ~~and~~, 
545.33  recipients, and providers that a request for a conference with 
545.34  the agency is optional and does not delay or replace the right 
545.35  to a fair hearing. 
545.36     Sec. 28.  Minnesota Statutes 2002, section 119B.19, 
546.1   subdivision 7, is amended to read: 
546.2      Subd. 7.  [CHILD CARE RESOURCE AND REFERRAL PROGRAMS.] 
546.3   Within each region, a child care resource and referral program 
546.4   must: 
546.5      (1) maintain one database of all existing child care 
546.6   resources and services and one database of family referrals; 
546.7      (2) provide a child care referral service for families; 
546.8      (3) develop resources to meet the child care service needs 
546.9   of families; 
546.10     (4) increase the capacity to provide culturally responsive 
546.11  child care services; 
546.12     (5) coordinate professional development opportunities for 
546.13  child care and school-age care providers; 
546.14     (6) administer and award child care services grants; 
546.15     (7) administer and provide loans for child development 
546.16  education and training; ~~and~~ 
546.17     (8) cooperate with the Minnesota Child Care Resource and 
546.18  Referral Network and its member programs to develop effective 
546.19  child care services and child care resources; and 
546.20     (9) assist in fostering coordination, collaboration, and 
546.21  planning among child care programs and community programs such 
546.22  as school readiness, Head Start, early childhood family 
546.23  education, local interagency early intervention committees, 
546.24  early childhood screening, special education services, and other 
546.25  early childhood care and education services and programs that 
546.26  provide flexible, family-focused services to families with young 
546.27  children to the extent possible. 
546.28     Sec. 29.  Minnesota Statutes 2002, section 119B.21, 
546.29  subdivision 11, is amended to read: 
546.30     Subd. 11.  [STATEWIDE ADVISORY TASK FORCE.] The 
546.31  commissioner may convene a statewide advisory task force to 
546.32  advise the commissioner on statewide grants or other child care 
546.33  issues.  The following groups must be represented:  family child 
546.34  care providers, child care center programs, school-age care 
546.35  providers, parents who use child care services, health services, 
546.36  social services, Head Start, public schools, school-based early 
547.1   childhood programs, special education programs, employers, and 
547.2   other citizens with demonstrated interest in child care issues.  
547.3   Additional members may be appointed by the commissioner.  The 
547.4   commissioner may compensate members for their travel, child 
547.5   care, and child care provider substitute expenses for attending 
547.6   task force meetings.  The commissioner may also pay a stipend to 
547.7   parent representatives for participating in task force meetings. 
547.8      Sec. 30.  Minnesota Statutes 2002, section 119B.23, 
547.9   subdivision 3, is amended to read: 
547.10     Subd. 3.  [BIENNIAL PLAN.] The county board shall 
547.11  biennially develop a plan for the distribution of money for 
547.12  child care services as part of the ~~community social services~~ 
547.13  ~~plan described in section 256E.09~~ child care fund plan under 
547.14  section 119B.08.  All licensed child care programs shall be 
547.15  given written notice concerning the availability of money and 
547.16  the application process. 
547.17     Sec. 31.  Minnesota Statutes 2002, section 256.046, 
547.18  subdivision 1, is amended to read: 
547.19     Subdivision 1.  [HEARING AUTHORITY.] A local agency must 
547.20  initiate an administrative fraud disqualification hearing for 
547.21  individuals, including child care providers caring for children 
547.22  receiving child care assistance, accused of wrongfully obtaining 
547.23  assistance or intentional program violations, in lieu of a 
547.24  criminal action when it has not been pursued, in the aid to 
547.25  families with dependent children program formerly codified in 
547.26  sections 256.72 to 256.87, MFIP, child care assistance programs, 
547.27  general assistance, family general assistance program formerly 
547.28  codified in section 256D.05, subdivision 1, clause (15), 
547.29  Minnesota supplemental aid, medical care, or food stamp 
547.30  programs.  The hearing is subject to the requirements of section 
547.31  256.045 and the requirements in Code of Federal Regulations, 
547.32  title 7, section 273.16, for the food stamp program and title 
547.33  45, section 235.112, as of September 30, 1995, for the cash 
547.34  grant ~~and~~, medical care programs, and child care assistance 
547.35  under chapter 119B. 
547.36     Sec. 32.  Minnesota Statutes 2002, section 256.0471, 
548.1   subdivision 1, is amended to read: 
548.2      Subdivision 1.  [QUALIFYING OVERPAYMENT.] Any overpayment 
548.3   for assistance granted under ~~section 119B.05~~ chapter 119B, the 
548.4   MFIP program formerly codified under sections 256.031 to 
548.5   256.0361, and the AFDC program formerly codified under sections 
548.6   256.72 to 256.871; chapters 256B, 256D, 256I, 256J, and 256K; 
548.7   and the food stamp program, except agency error claims, become a 
548.8   judgment by operation of law 90 days after the notice of 
548.9   overpayment is personally served upon the recipient in a manner 
548.10  that is sufficient under rule 4.03(a) of the Rules of Civil 
548.11  Procedure for district courts, or by certified mail, return 
548.12  receipt requested.  This judgment shall be entitled to full 
548.13  faith and credit in this and any other state. 
548.14     Sec. 33.  Minnesota Statutes 2002, section 256.98, 
548.15  subdivision 8, is amended to read: 
548.16     Subd. 8.  [DISQUALIFICATION FROM PROGRAM.] (a) Any person 
548.17  found to be guilty of wrongfully obtaining assistance by a 
548.18  federal or state court or by an administrative hearing 
548.19  determination, or waiver thereof, through a disqualification 
548.20  consent agreement, or as part of any approved diversion plan 
548.21  under section 401.065, or any court-ordered stay which carries 
548.22  with it any probationary or other conditions, in the Minnesota 
548.23  family investment program, the food stamp program, the general 
548.24  assistance program, the group residential housing program, or 
548.25  the Minnesota supplemental aid program shall be disqualified 
548.26  from that program.  In addition, any person disqualified from 
548.27  the Minnesota family investment program shall also be 
548.28  disqualified from the food stamp program.  The needs of that 
548.29  individual shall not be taken into consideration in determining 
548.30  the grant level for that assistance unit:  
548.31     (1) for one year after the first offense; 
548.32     (2) for two years after the second offense; and 
548.33     (3) permanently after the third or subsequent offense.  
548.34     The period of program disqualification shall begin on the 
548.35  date stipulated on the advance notice of disqualification 
548.36  without possibility of postponement for administrative stay or 
549.1   administrative hearing and shall continue through completion 
549.2   unless and until the findings upon which the sanctions were 
549.3   imposed are reversed by a court of competent jurisdiction.  The 
549.4   period for which sanctions are imposed is not subject to 
549.5   review.  The sanctions provided under this subdivision are in 
549.6   addition to, and not in substitution for, any other sanctions 
549.7   that may be provided for by law for the offense involved.  A 
549.8   disqualification established through hearing or waiver shall 
549.9   result in the disqualification period beginning immediately 
549.10  unless the person has become otherwise ineligible for 
549.11  assistance.  If the person is ineligible for assistance, the 
549.12  disqualification period begins when the person again meets the 
549.13  eligibility criteria of the program from which they were 
549.14  disqualified and makes application for that program. 
549.15     (b) A family receiving assistance through child care 
549.16  assistance programs under chapter 119B with a family member who 
549.17  is found to be guilty of wrongfully obtaining child care 
549.18  assistance by a federal court, state court, or an administrative 
549.19  hearing determination or waiver, through a disqualification 
549.20  consent agreement, as part of an approved diversion plan under 
549.21  section 401.065, or a court-ordered stay with probationary or 
549.22  other conditions, is disqualified from child care assistance 
549.23  programs.  The disqualifications must be for periods of three 
549.24  months, six months, and two years for the first, second, and 
549.25  third offenses respectively.  Subsequent violations must result 
549.26  in permanent disqualification.  During the disqualification 
549.27  period, disqualification from any child care program must extend 
549.28  to all child care programs and must be immediately applied. 
549.29     (c) A provider caring for children receiving assistance 
549.30  through child care assistance programs under chapter 119B is 
549.31  disqualified from receiving payment for child care services from 
549.32  the child care assistance program under chapter 119B when the 
549.33  provider is found to have wrongfully obtained child care 
549.34  assistance by a federal court, state court, or an administrative 
549.35  hearing determination or waiver under section 256.046, through a 
549.36  disqualification consent agreement, as part of an approved 
550.1   diversion plan under section 401.065, or a court-ordered stay 
550.2   with probationary or other conditions.  The disqualification 
550.3   must be for a period of one year for the first offense and two 
550.4   years for the second offense.  Any subsequent violation must 
550.5   result in permanent disqualification.  The disqualification 
550.6   period must be imposed immediately after a determination is made 
550.7   under this paragraph.  During the disqualification period, the 
550.8   provider is disqualified from receiving payment from any child 
550.9   care program under chapter 119B.  
550.10     Sec. 34.  [DIRECTION TO COMMISSIONER; PROVIDER RATES.] 
550.11     The provider rates determined under Minnesota Statutes, 
550.12  section 119B.13, for fiscal year 2003 and implemented on July 1, 
550.13  2002, are to be continued in effect through June 30, 2005.  The 
550.14  commissioner of human services is directed to evaluate the costs 
550.15  of child care in Minnesota, to examine the differences in the 
550.16  cost of child care in rural and metropolitan areas, and to make 
550.17  recommendations to the legislature for containing future cost 
550.18  increases in the child care program under Minnesota Statutes, 
550.19  chapter 119B, in a manner that complies with federal child care 
550.20  and development block grant requirements for promoting parental 
550.21  choice and permits the department to track the effect of rate 
550.22  changes on child care assistance program costs, the availability 
550.23  of different types of care throughout the state, the length of 
550.24  waiting lists, and the care options available to program 
550.25  participants.  The commissioner shall also examine the 
550.26  allocation formula under Minnesota Statutes, section 119B.03, 
550.27  and make recommendations to the legislature in order to create a 
550.28  more equitable formula.  The commissioner shall consider the 
550.29  impact any recommendations might have on work incentives for low 
550.30  and middle income families and possible changes to MFIP child 
550.31  care, basic sliding fee child care, and the dependent care tax 
550.32  credit.  The commissioner shall make recommendations to the 
550.33  legislature by January 15, 2005. 
550.34     The commissioner shall also study the relationship between 
550.35  child care assistance subsidies and tax credits or tax 
550.36  incentives related to child care expenses, and include this 
551.1   information in the January 15, 2005, report to the legislature 
551.2   under this section. 
551.3      Sec. 35.  [CHILD CARE WAITING LIST.] 
551.4      Notwithstanding Minnesota Statutes, section 119B.03, 
551.5   subdivision 6, the commissioner may manage the child care 
551.6   assistance waiting list under Minnesota Statutes, section 
551.7   119B.03, subdivision 2, on a regional or statewide basis in 
551.8   order to ensure that families listed under higher priority 
551.9   categories, as determined by Minnesota Statutes, section 
551.10  119B.03, subdivision 4, are served before families listed under 
551.11  lower priority categories. 
551.12     Sec. 36.  [CHILD CARE ASSISTANCE PARENT FEE SCHEDULE.] 
551.13     Notwithstanding Minnesota Rules, part 3400.0100, subpart 4, 
551.14  the parent fee schedule is as follows: 
551.15       Income Range                  Co-payment (as a percentage of
551.16       (as a percentage of the       adjusted gross income)
551.17       federal poverty guidelines)
551.18       0-74.99%                      $ 0/month
551.19       75.00-99.99%                  $10/month
551.20       100.00-104.99%                3.85%
551.21       105.00-109.99%                3.85%
551.22       110.00-114.99%                3.85%
551.23       115.00-119.99%                3.85%
551.24       120.00-124.99%                4.29%
551.25       125.00-139.99%                4.29%
551.26       140.00-144.99%                4.73%
551.27       145.00-149.99%                4.73%
551.28       150.00-154.99%                4.73%
551.29       155.00-159.99%                5.65%
551.30       160.00-164.99%                5.65%
551.31       165.00-169.99%                6.56%
551.32       170.00-174.99%                7.00%
551.33       175.00-179.99%                7.44%
551.34       180.00-184.99%                8.31%
551.35       185.00-189.99%                8.75%
551.36       190.00-194.99%                9.19%
552.1        195.00-199.99%                10.06%
552.2        200.00-209.99%                12.25%
552.3        210.00-224.99%                16.10%
552.4        225.00-229.99%                17.15%
552.5        230.00-234.99%                19.25%
552.6        235.00-239.99%                19.78%
552.7        240.00-244.99%                21.35%
552.8        245.00-249.99%                22.00%
552.9        250%                          ineligible
552.10     A family's monthly co-payment fee is the fixed percentage 
552.11  established for the income range multiplied by the highest 
552.12  possible income within that income range. 
552.13     Sec. 37.  [ELIGIBILITY FOR FAMILIES WITH HOUSEHOLD INCOME 
552.14  GREATER THAN 250 PERCENT OF THE FEDERAL POVERTY GUIDELINES.] 
552.15     Families receiving child care assistance on July 1, 2003, 
552.16  who have household income greater than 250 percent of the 
552.17  federal poverty guidelines, adjusted for family size, are 
552.18  eligible to continue receiving child care assistance until the 
552.19  family's next eligibility redetermination.  
552.20     Sec. 38.  [REPEALER.] 
552.21     (a) Minnesota Statutes 2002, sections 119B.061 and 119B.13, 
552.22  subdivision 2, are repealed. 
552.23     (b) Laws 2000, chapter 489, article 1, section 36, and Laws 
552.24  2001, First Special Session chapter 3, article 1, section 16, 
552.25  are repealed. 
552.26                             ARTICLE 10 
552.27                  CHILD SUPPORT FEDERAL COMPLIANCE 
552.28     Section 1.  Minnesota Statutes 2002, section 13.69, 
552.29  subdivision 1, is amended to read: 
552.30     Subdivision 1.  [CLASSIFICATIONS.] (a) The following 
552.31  government data of the department of public safety are private 
552.32  data:  
552.33     (1) medical data on driving instructors, licensed drivers, 
552.34  and applicants for parking certificates and special license 
552.35  plates issued to physically handicapped persons; 
552.36     (2) other data on holders of a disability certificate under 
553.1   section 169.345, except that data that are not medical data may 
553.2   be released to law enforcement agencies; 
553.3      (3) social security numbers in driver's license and motor 
553.4   vehicle registration records, except that social security 
553.5   numbers must be provided to the department of revenue for 
553.6   purposes of tax administration ~~and~~, the department of labor and 
553.7   industry for purposes of workers' compensation administration 
553.8   and enforcement, and the department of natural resources for 
553.9   purposes of license application administration; and 
553.10     (4) data on persons listed as standby or temporary 
553.11  custodians under section 171.07, subdivision 11, except that the 
553.12  data must be released to: 
553.13     (i) law enforcement agencies for the purpose of verifying 
553.14  that an individual is a designated caregiver; or 
553.15     (ii) law enforcement agencies who state that the license 
553.16  holder is unable to communicate at that time and that the 
553.17  information is necessary for notifying the designated caregiver 
553.18  of the need to care for a child of the license holder.  
553.19     The department may release the social security number only 
553.20  as provided in clause (3) and must not sell or otherwise provide 
553.21  individual social security numbers or lists of social security 
553.22  numbers for any other purpose.  
553.23     (b) The following government data of the department of 
553.24  public safety are confidential data:  data concerning an 
553.25  individual's driving ability when that data is received from a 
553.26  member of the individual's family. 
553.27     Sec. 2.  [97A.482] [LICENSE APPLICATIONS; COLLECTION OF 
553.28  SOCIAL SECURITY NUMBERS.] 
553.29     (a) All applicants for individual noncommercial game and 
553.30  fish licenses under this chapter and chapters 97B and 97C must 
553.31  include the applicant's social security number on the license 
553.32  application.  If an applicant does not have a social security 
553.33  number, the applicant must certify that the applicant does not 
553.34  have a social security number. 
553.35     (b) The social security numbers collected by the 
553.36  commissioner on game and fish license applications are private 
554.1   data under section 13.49, subdivision 1, and must be provided by 
554.2   the commissioner to the commissioner of human services for child 
554.3   support enforcement purposes.  Title IV-D of the Social Security 
554.4   Act, United States Code, title 42, section 666(a)(13), requires 
554.5   the collection of social security numbers on game and fish 
554.6   license applications for child support enforcement purposes. 
554.7      Sec. 3.  Minnesota Statutes 2002, section 171.06, 
554.8   subdivision 3, is amended to read: 
554.9      Subd. 3.  [CONTENTS OF APPLICATION; OTHER INFORMATION.] (a) 
554.10  An application must: 
554.11     (1) state the full name, date of birth, sex, and residence 
554.12  address of the applicant; 
554.13     (2) as may be required by the commissioner, contain a 
554.14  description of the applicant and any other facts pertaining to 
554.15  the applicant, the applicant's driving privileges, and the 
554.16  applicant's ability to operate a motor vehicle with safety; 
554.17     (3) ~~for a class C, class B, or class A driver's license,~~ 
554.18  state: 
554.19     (i) the applicant's social security number ~~or, for a class~~ 
554.20  ~~D driver's license, have a space for the applicant's social~~ 
554.21  ~~security number and state that providing the number is optional,~~ 
554.22  ~~or otherwise convey that the applicant is not required to enter~~ 
554.23  ~~the social security number~~; or 
554.24     (ii) if the applicant does not have a social security 
554.25  number and is applying for a Minnesota identification card, 
554.26  instruction permit, or class D provisional or driver's license, 
554.27  that the applicant certifies that the applicant does not have a 
554.28  social security number; 
554.29     (4) contain a space where the applicant may indicate a 
554.30  desire to make an anatomical gift according to paragraph (b); 
554.31  and 
554.32     (5) contain a notification to the applicant of the 
554.33  availability of a living will/health care directive designation 
554.34  on the license under section 171.07, subdivision 7.  
554.35     (b) If the applicant does not indicate a desire to make an 
554.36  anatomical gift when the application is made, the applicant must 
555.1   be offered a donor document in accordance with section 171.07, 
555.2   subdivision 5.  The application must contain statements 
555.3   sufficient to comply with the requirements of the Uniform 
555.4   Anatomical Gift Act (1987), sections 525.921 to 525.9224, so 
555.5   that execution of the application or donor document will make 
555.6   the anatomical gift as provided in section 171.07, subdivision 
555.7   5, for those indicating a desire to make an anatomical gift.  
555.8   The application must be accompanied by information describing 
555.9   Minnesota laws regarding anatomical gifts and the need for and 
555.10  benefits of anatomical gifts, and the legal implications of 
555.11  making an anatomical gift, including the law governing 
555.12  revocation of anatomical gifts.  The commissioner shall 
555.13  distribute a notice that must accompany all applications for and 
555.14  renewals of a driver's license or Minnesota identification 
555.15  card.  The notice must be prepared in conjunction with a 
555.16  Minnesota organ procurement organization that is certified by 
555.17  the federal Department of Health and Human Services and must 
555.18  include: 
555.19     (1) a statement that provides a fair and reasonable 
555.20  description of the organ donation process, the care of the donor 
555.21  body after death, and the importance of informing family members 
555.22  of the donation decision; and 
555.23     (2) a telephone number in a certified Minnesota organ 
555.24  procurement organization that may be called with respect to 
555.25  questions regarding anatomical gifts. 
555.26     (c) The application must be accompanied also by information 
555.27  containing relevant facts relating to:  
555.28     (1) the effect of alcohol on driving ability; 
555.29     (2) the effect of mixing alcohol with drugs; 
555.30     (3) the laws of Minnesota relating to operation of a motor 
555.31  vehicle while under the influence of alcohol or a controlled 
555.32  substance; and 
555.33     (4) the levels of alcohol-related fatalities and accidents 
555.34  in Minnesota and of arrests for alcohol-related violations. 
555.35     Sec. 4.  Minnesota Statutes 2002, section 171.07, is 
555.36  amended by adding a subdivision to read: 
556.1      Subd. 14.  [USE OF SOCIAL SECURITY NUMBER.] An applicant's 
556.2   social security number must not be displayed, encrypted, or 
556.3   encoded on the driver's license or Minnesota identification card 
556.4   or included in a magnetic strip or bar code used to store data 
556.5   on the license or Minnesota identification card.  The social 
556.6   security number must not be used as a Minnesota driver's license 
556.7   or identification number. 
556.8      Sec. 5.  Minnesota Statutes 2002, section 518.551, 
556.9   subdivision 12, is amended to read: 
556.10     Subd. 12.  [OCCUPATIONAL LICENSE SUSPENSION.] (a) Upon 
556.11  motion of an obligee, if the court finds that the obligor is or 
556.12  may be licensed by a licensing board listed in section 214.01 or 
556.13  other state, county, or municipal agency or board that issues an 
556.14  occupational license and the obligor is in arrears in 
556.15  court-ordered child support or maintenance payments or both in 
556.16  an amount equal to or greater than three times the obligor's 
556.17  total monthly support and maintenance payments and is not in 
556.18  compliance with a written payment agreement pursuant to section 
556.19  518.553 that is approved by the court, a child support 
556.20  magistrate, or the public authority, the court shall direct the 
556.21  licensing board or other licensing agency to suspend the license 
556.22  under section 214.101.  The court's order must be stayed for 90 
556.23  days in order to allow the obligor to execute a written payment 
556.24  agreement pursuant to section 518.553.  The payment agreement 
556.25  must be approved by either the court or the public authority 
556.26  responsible for child support enforcement.  If the obligor has 
556.27  not executed or is not in compliance with a written payment 
556.28  agreement pursuant to section 518.553 after the 90 days expires, 
556.29  the court's order becomes effective.  If the obligor is a 
556.30  licensed attorney, the court shall report the matter to the 
556.31  lawyers professional responsibility board for appropriate action 
556.32  in accordance with the rules of professional conduct.  The 
556.33  remedy under this subdivision is in addition to any other 
556.34  enforcement remedy available to the court. 
556.35     (b) If a public authority responsible for child support 
556.36  enforcement finds that the obligor is or may be licensed by a 
557.1   licensing board listed in section 214.01 or other state, county, 
557.2   or municipal agency or board that issues an occupational license 
557.3   and the obligor is in arrears in court-ordered child support or 
557.4   maintenance payments or both in an amount equal to or greater 
557.5   than three times the obligor's total monthly support and 
557.6   maintenance payments and is not in compliance with a written 
557.7   payment agreement pursuant to section 518.553 that is approved 
557.8   by the court, a child support magistrate, or the public 
557.9   authority, the court or the public authority shall direct the 
557.10  licensing board or other licensing agency to suspend the license 
557.11  under section 214.101.  If the obligor is a licensed attorney, 
557.12  the public authority may report the matter to the lawyers 
557.13  professional responsibility board for appropriate action in 
557.14  accordance with the rules of professional conduct.  The remedy 
557.15  under this subdivision is in addition to any other enforcement 
557.16  remedy available to the public authority. 
557.17     (c) At least 90 days before notifying a licensing authority 
557.18  or the lawyers professional responsibility board under paragraph 
557.19  (b), the public authority shall mail a written notice to the 
557.20  license holder addressed to the license holder's last known 
557.21  address that the public authority intends to seek license 
557.22  suspension under this subdivision and that the license holder 
557.23  must request a hearing within 30 days in order to contest the 
557.24  suspension.  If the license holder makes a written request for a 
557.25  hearing within 30 days of the date of the notice, a court 
557.26  hearing or a hearing under section 484.702 must be held.  
557.27  Notwithstanding any law to the contrary, the license holder must 
557.28  be served with 14 days' notice in writing specifying the time 
557.29  and place of the hearing and the allegations against the license 
557.30  holder.  The notice may be served personally or by mail.  If the 
557.31  public authority does not receive a request for a hearing within 
557.32  30 days of the date of the notice, and the obligor does not 
557.33  execute a written payment agreement pursuant to section 518.553 
557.34  that is approved by the public authority within 90 days of the 
557.35  date of the notice, the public authority shall direct the 
557.36  licensing board or other licensing agency to suspend the 
558.1   obligor's license under paragraph (b), or shall report the 
558.2   matter to the lawyers professional responsibility board. 
558.3      (d) The public authority or the court shall notify the 
558.4   lawyers professional responsibility board for appropriate action 
558.5   in accordance with the rules of professional responsibility 
558.6   conduct or order the licensing board or licensing agency to 
558.7   suspend the license if the judge finds that: 
558.8      (1) the person is licensed by a licensing board or other 
558.9   state agency that issues an occupational license; 
558.10     (2) the person has not made full payment of arrearages 
558.11  found to be due by the public authority; and 
558.12     (3) the person has not executed or is not in compliance 
558.13  with a payment plan approved by the court, a child support 
558.14  magistrate, or the public authority. 
558.15     (e) Within 15 days of the date on which the obligor either 
558.16  makes full payment of arrearages found to be due by the court or 
558.17  public authority or executes and initiates good faith compliance 
558.18  with a written payment plan approved by the court, a child 
558.19  support magistrate, or the public authority, the court, a child 
558.20  support magistrate, or the public authority responsible for 
558.21  child support enforcement shall notify the licensing board or 
558.22  licensing agency or the lawyers professional responsibility 
558.23  board that the obligor is no longer ineligible for license 
558.24  issuance, reinstatement, or renewal under this subdivision. 
558.25     (f) In addition to the criteria established under this 
558.26  section for the suspension of an obligor's occupational license, 
558.27  a court, a child support magistrate, or the public authority may 
558.28  direct the licensing board or other licensing agency to suspend 
558.29  the license of a party who has failed, after receiving notice, 
558.30  to comply with a subpoena relating to a paternity or child 
558.31  support proceeding.  Notice to an obligor of intent to suspend 
558.32  must be served by first class mail at the obligor's last known 
558.33  address.  The notice must inform the obligor of the right to 
558.34  request a hearing.  If the obligor makes a written request 
558.35  within ten days of the date of the hearing, a hearing must be 
558.36  held.  At the hearing, the only issues to be considered are 
559.1   mistake of fact and whether the obligor received the subpoena. 
559.2      (g) The license of an obligor who fails to remain in 
559.3   compliance with an approved written payment agreement may be 
559.4   suspended.  ~~Notice to the obligor of an intent to suspend under~~ 
559.5   ~~this paragraph must be served by first class mail at the~~ 
559.6   ~~obligor's last known address and must include a notice of~~ 
559.7   ~~hearing.  The notice must be served upon the obligor not less~~ 
559.8   ~~than ten days before the date of the hearing.~~  Prior to 
559.9   suspending a license for noncompliance with an approved written 
559.10  payment agreement, the public authority must mail to the 
559.11  obligor's last known address a written notice that (1) the 
559.12  public authority intends to seek suspension of the obligor's 
559.13  occupational license under this paragraph, and (2) the obligor 
559.14  must request a hearing, within 30 days of the date of the 
559.15  notice, to contest the suspension.  If, within 30 days of the 
559.16  date of the notice, the public authority does not receive a 
559.17  written request for a hearing and the obligor does not comply 
559.18  with an approved written payment agreement, the public authority 
559.19  must direct the licensing board or other licensing agency to 
559.20  suspend the obligor's license under paragraph (b), and, if the 
559.21  obligor is a licensed attorney, must report the matter to the 
559.22  lawyers professional responsibility board.  If the obligor makes 
559.23  a written request for a hearing within 30 days of the date of 
559.24  the notice, a court hearing must be held.  Notwithstanding any 
559.25  law to the contrary, the obligor must be served with 14 days' 
559.26  notice in writing specifying the time and place of the hearing 
559.27  and the allegations against the obligor.  The notice may be 
559.28  served personally or by mail to the obligor's last known 
559.29  address.  If the obligor appears at the hearing and the ~~judge~~ 
559.30  court determines that the obligor has failed to comply with an 
559.31  approved written payment agreement, the ~~judge shall~~ court or 
559.32  public authority must notify the occupational licensing board or 
559.33  other licensing agency to suspend the obligor's license under 
559.34  paragraph ~~(c)~~ (b) and, if the obligor is a licensed attorney, 
559.35  must report the matter to the lawyers professional 
559.36  responsibility board.  If the obligor fails to appear at the 
560.1   hearing, the ~~public authority may~~ court or public authority must 
560.2   notify the occupational ~~or~~ licensing board or other licensing 
560.3   agency to suspend the obligor's license under paragraph ~~(c)~~ (b), 
560.4   and if the obligor is a licensed attorney, must report the 
560.5   matter to the lawyers professional responsibility board. 
560.6      Sec. 6.  Minnesota Statutes 2002, section 518.551, 
560.7   subdivision 13, is amended to read: 
560.8      Subd. 13.  [DRIVER'S LICENSE SUSPENSION.] (a) Upon motion 
560.9   of an obligee, which has been properly served on the obligor and 
560.10  upon which there has been an opportunity for hearing, if a court 
560.11  finds that the obligor has been or may be issued a driver's 
560.12  license by the commissioner of public safety and the obligor is 
560.13  in arrears in court-ordered child support or maintenance 
560.14  payments, or both, in an amount equal to or greater than three 
560.15  times the obligor's total monthly support and maintenance 
560.16  payments and is not in compliance with a written payment 
560.17  agreement pursuant to section 518.553 that is approved by the 
560.18  court, a child support magistrate, or the public authority, the 
560.19  court shall order the commissioner of public safety to suspend 
560.20  the obligor's driver's license.  The court's order must be 
560.21  stayed for 90 days in order to allow the obligor to execute a 
560.22  written payment agreement pursuant to section 518.553.  The 
560.23  payment agreement must be approved by either the court or the 
560.24  public authority responsible for child support enforcement.  If 
560.25  the obligor has not executed or is not in compliance with a 
560.26  written payment agreement pursuant to section 518.553 after the 
560.27  90 days expires, the court's order becomes effective and the 
560.28  commissioner of public safety shall suspend the obligor's 
560.29  driver's license.  The remedy under this subdivision is in 
560.30  addition to any other enforcement remedy available to the 
560.31  court.  An obligee may not bring a motion under this paragraph 
560.32  within 12 months of a denial of a previous motion under this 
560.33  paragraph. 
560.34     (b) If a public authority responsible for child support 
560.35  enforcement determines that the obligor has been or may be 
560.36  issued a driver's license by the commissioner of public safety 
561.1   and the obligor is in arrears in court-ordered child support or 
561.2   maintenance payments or both in an amount equal to or greater 
561.3   than three times the obligor's total monthly support and 
561.4   maintenance payments and not in compliance with a written 
561.5   payment agreement pursuant to section 518.553 that is approved 
561.6   by the court, a child support magistrate, or the public 
561.7   authority, the public authority shall direct the commissioner of 
561.8   public safety to suspend the obligor's driver's license.  The 
561.9   remedy under this subdivision is in addition to any other 
561.10  enforcement remedy available to the public authority. 
561.11     (c) At least 90 days prior to notifying the commissioner of 
561.12  public safety according to paragraph (b), the public authority 
561.13  must mail a written notice to the obligor at the obligor's last 
561.14  known address, that it intends to seek suspension of the 
561.15  obligor's driver's license and that the obligor must request a 
561.16  hearing within 30 days in order to contest the suspension.  If 
561.17  the obligor makes a written request for a hearing within 30 days 
561.18  of the date of the notice, a court hearing must be held.  
561.19  Notwithstanding any law to the contrary, the obligor must be 
561.20  served with 14 days' notice in writing specifying the time and 
561.21  place of the hearing and the allegations against the obligor.  
561.22  The notice must include information that apprises the obligor of 
561.23  the requirement to develop a written payment agreement that is 
561.24  approved by a court, a child support magistrate, or the public 
561.25  authority responsible for child support enforcement regarding 
561.26  child support, maintenance, and any arrearages in order to avoid 
561.27  license suspension.  The notice may be served personally or by 
561.28  mail.  If the public authority does not receive a request for a 
561.29  hearing within 30 days of the date of the notice, and the 
561.30  obligor does not execute a written payment agreement pursuant to 
561.31  section 518.553 that is approved by the public authority within 
561.32  90 days of the date of the notice, the public authority shall 
561.33  direct the commissioner of public safety to suspend the 
561.34  obligor's driver's license under paragraph (b). 
561.35     (d) At a hearing requested by the obligor under paragraph 
561.36  (c), and on finding that the obligor is in arrears in 
562.1   court-ordered child support or maintenance payments or both in 
562.2   an amount equal to or greater than three times the obligor's 
562.3   total monthly support and maintenance payments, the district 
562.4   court or child support magistrate shall order the commissioner 
562.5   of public safety to suspend the obligor's driver's license or 
562.6   operating privileges unless the court or child support 
562.7   magistrate determines that the obligor has executed and is in 
562.8   compliance with a written payment agreement pursuant to section 
562.9   518.553 that is approved by the court, a child support 
562.10  magistrate, or the public authority. 
562.11     (e) An obligor whose driver's license or operating 
562.12  privileges are suspended may: 
562.13     (1) provide proof to the public authority responsible for 
562.14  child support enforcement that the obligor is in compliance with 
562.15  all written payment agreements pursuant to section 518.553; 
562.16     (2) bring a motion for reinstatement of the driver's 
562.17  license.  At the hearing, if the court or child support 
562.18  magistrate orders reinstatement of the driver's license, the 
562.19  court or child support magistrate must establish a written 
562.20  payment agreement pursuant to section 518.553; or 
562.21     (3) seek a limited license under section 171.30.  A limited 
562.22  license issued to an obligor under section 171.30 expires 90 
562.23  days after the date it is issued.  
562.24     Within 15 days of the receipt of that proof or a court 
562.25  order, the public authority shall inform the commissioner of 
562.26  public safety that the obligor's driver's license or operating 
562.27  privileges should no longer be suspended. 
562.28     (f) On January 15, 1997, and every two years after that, 
562.29  the commissioner of human services shall submit a report to the 
562.30  legislature that identifies the following information relevant 
562.31  to the implementation of this section: 
562.32     (1) the number of child support obligors notified of an 
562.33  intent to suspend a driver's license; 
562.34     (2) the amount collected in payments from the child support 
562.35  obligors notified of an intent to suspend a driver's license; 
562.36     (3) the number of cases paid in full and payment agreements 
563.1   executed in response to notification of an intent to suspend a 
563.2   driver's license; 
563.3      (4) the number of cases in which there has been 
563.4   notification and no payments or payment agreements; 
563.5      (5) the number of driver's licenses suspended; 
563.6      (6) the cost of implementation and operation of the 
563.7   requirements of this section; and 
563.8      (7) the number of limited licenses issued and number of 
563.9   cases in which payment agreements are executed and cases are 
563.10  paid in full following issuance of a limited license. 
563.11     (g) In addition to the criteria established under this 
563.12  section for the suspension of an obligor's driver's license, a 
563.13  court, a child support magistrate, or the public authority may 
563.14  direct the commissioner of public safety to suspend the license 
563.15  of a party who has failed, after receiving notice, to comply 
563.16  with a subpoena relating to a paternity or child support 
563.17  proceeding.  Notice to an obligor of intent to suspend must be 
563.18  served by first class mail at the obligor's last known address.  
563.19  The notice must inform the obligor of the right to request a 
563.20  hearing.  If the obligor makes a written request within ten days 
563.21  of the date of the hearing, a hearing must be held.  At the 
563.22  hearing, the only issues to be considered are mistake of fact 
563.23  and whether the obligor received the subpoena. 
563.24     (h) The license of an obligor who fails to remain in 
563.25  compliance with an approved written payment agreement may be 
563.26  suspended.  ~~Notice to the obligor of an intent to suspend under~~ 
563.27  ~~this paragraph must be served by first class mail at the~~ 
563.28  ~~obligor's last known address and must include a notice of~~ 
563.29  ~~hearing.  The notice must be served upon the obligor not less~~ 
563.30  ~~than ten days before the date of the hearing.~~  Prior to 
563.31  suspending a license for noncompliance with an approved written 
563.32  payment agreement, the public authority must mail to the 
563.33  obligor's last known address a written notice that (1) the 
563.34  public authority intends to seek suspension of the obligor's 
563.35  driver's license under this paragraph, and (2) the obligor must 
563.36  request a hearing, within 30 days of the date of the notice, to 
564.1   contest the suspension.  If, within 30 days of the date of the 
564.2   notice, the public authority does not receive a written request 
564.3   for a hearing and the obligor does not comply with an approved 
564.4   written payment agreement, the public authority must direct the 
564.5   department of public safety to suspend the obligor's license 
564.6   under paragraph (b).  If the obligor makes a written request for 
564.7   a hearing within 30 days of the date of the notice, a court 
564.8   hearing must be held.  Notwithstanding any law to the contrary, 
564.9   the obligor must be served with 14 days' notice in writing 
564.10  specifying the time and place of the hearing and the allegations 
564.11  against the obligor.  The notice may be served personally or by 
564.12  mail at the obligor's last known address.  If the obligor 
564.13  appears at the hearing and the ~~judge~~ court determines that the 
564.14  obligor has failed to comply with an approved written payment 
564.15  agreement, the ~~judge~~ court or public authority shall notify the 
564.16  department of public safety to suspend the obligor's license 
564.17  under paragraph ~~(c)~~ (b).  If the obligor fails to appear at the 
564.18  hearing, the ~~public authority may~~ court or public authority must 
564.19  notify the department of public safety to suspend the obligor's 
564.20  license under paragraph ~~(c)~~ (b). 
564.21     Sec. 7.  Laws 1997, chapter 245, article 2, section 11, is 
564.22  amended to read: 
564.23     Sec. 11.  [FEDERAL FUNDS FOR VISITATION AND ACCESS.] 
564.24     The commissioner of human services may accept on behalf of 
564.25  the state any federal funding received under Public Law Number 
564.26  104-193 for access and visitation programs, and ~~shall transfer~~ 
564.27  ~~these funds to the state court administrator for the cooperation~~ 
564.28  ~~for the children pilot project and the parent education program~~ 
564.29  ~~under Minnesota Statutes, section 518.571~~ must administer the 
564.30  funds for the activities allowed under federal law.  The 
564.31  commissioner may distribute the funds on a competitive basis and 
564.32  must monitor, evaluate, and report on the access and visitation 
564.33  programs in accordance with any applicable regulations. 
564.34     Sec. 8.  [EFFECTIVE DATE.] 
564.35     Sections 1 to 4 are effective August 1, 2003. 
564.36                             ARTICLE 11 
565.1                        COMMUNITY SERVICES ACT 
565.2      Section 1.  [256M.01] [CITATION.] 
565.3      Sections 256M.01 to 256M.80 may be cited as the "Children 
565.4   and Community Services Act."  This act establishes a fund to 
565.5   address the needs of children, adolescents, and adults within 
565.6   each county in accordance with a service plan entered into by 
565.7   the board of county commissioners of each county and the 
565.8   commissioner.  The service plan shall specify the outcomes to be 
565.9   achieved, the general strategies to be employed, and the 
565.10  respective state and county roles.  The service plan shall be 
565.11  reviewed and updated every two years, or sooner if both the 
565.12  state and the county deem it necessary.  
565.13     Sec. 2.  [256M.10] [DEFINITIONS.] 
565.14     Subdivision 1.  [SCOPE.] For the purposes of sections 
565.15  256M.01 to 256M.80, the terms defined in this section have the 
565.16  meanings given them. 
565.17     Subd. 2.  [CHILDREN AND COMMUNITY SERVICES.] (a) "Children 
565.18  and community services" means services provided or arranged for 
565.19  by county boards for children, adolescents and other individuals 
565.20  in transition from childhood to adulthood, and adults who 
565.21  experience dependency, abuse, neglect, poverty, disability, 
565.22  chronic health conditions, or other factors, including ethnicity 
565.23  and race, that may result in poor outcomes or disparities, as 
565.24  well as services for family members to support those individuals.
565.25  These services may be provided by professionals or 
565.26  nonprofessionals, including the person's natural supports in the 
565.27  community.  
565.28     (b) Children and community services do not include services 
565.29  under the public assistance programs known as the Minnesota 
565.30  family investment program, Minnesota supplemental aid, medical 
565.31  assistance, general assistance, general assistance medical care, 
565.32  MinnesotaCare, or community health services. 
565.33     Subd. 3.  [COMMISSIONER.] "Commissioner" means the 
565.34  commissioner of human services. 
565.35     Subd. 4.  [COUNTY BOARD.] "County board" means the board of 
565.36  county commissioners in each county. 
566.1      Subd. 5.  [FORMER CHILDREN'S SERVICES AND COMMUNITY SERVICE 
566.2   GRANTS.] "Former children's services and community service 
566.3   grants" means allocations for the following grants: 
566.4      (1) community social service grants under sections 252.24, 
566.5   256E.06, and 256E.14; 
566.6      (2) family preservation grants under section 256F.05, 
566.7   subdivision 3; 
566.8      (3) concurrent permanency planning grants under section 
566.9   260C.213, subdivision 5; 
566.10     (4) social service block grants (Title XX) under section 
566.11  256E.07; and 
566.12     (5) children's mental health grants under sections 245.4886 
566.13  and 260.152. 
566.14     Subd. 6.  [HUMAN SERVICES BOARD.] "Human services board" 
566.15  means a board established under section 402.02; Laws 1974, 
566.16  chapter 293; or Laws 1976, chapter 340.  
566.17     Sec. 3.  [256M.20] [DUTIES OF COMMISSIONER OF HUMAN 
566.18  SERVICES.] 
566.19     Subdivision 1.  [GENERAL SUPERVISION.] Each year the 
566.20  commissioner shall allocate funds to each county with an 
566.21  approved service plan according to section 256M.40 and service 
566.22  plans under section 256M.30.  The funds shall be used to address 
566.23  the needs of children, adolescents, and adults.  The 
566.24  commissioner, in consultation with counties, shall provide 
566.25  technical assistance and evaluate county performance in 
566.26  achieving outcomes. 
566.27     Subd. 2.  [ADDITIONAL DUTIES.] The commissioner shall: 
566.28     (1) provide necessary information and assistance to each 
566.29  county for establishing baselines and desired improvements on 
566.30  mental health, safety, permanency, and well-being for children 
566.31  and adolescents; 
566.32     (2) provide training, technical assistance, and other 
566.33  supports to each county board to assist in needs assessment, 
566.34  planning, implementation, and monitoring of outcomes and service 
566.35  quality; 
566.36     (3) use data collection, evaluation of service outcomes, 
567.1   and the review and approval of county service plans to supervise 
567.2   county performance in the delivery of children and community 
567.3   services; 
567.4      (4) specify requirements for reports, including fiscal 
567.5   reports to account for funds distributed; 
567.6      (5) request waivers from federal programs as necessary to 
567.7   implement this act; and 
567.8      (6) have authority under sections 14.055 and 14.056 to 
567.9   grant a variance to existing state rules as needed to eliminate 
567.10  barriers to achieving desired outcomes. 
567.11     Subd. 3.  [SANCTIONS.] The commissioner shall establish and 
567.12  maintain a monitoring program designed to reduce the possibility 
567.13  of noncompliance with federal laws and federal regulations that 
567.14  may result in federal fiscal sanctions.  If a county is not 
567.15  complying with federal law or federal regulation and the 
567.16  noncompliance may result in federal fiscal sanctions, the 
567.17  commissioner may withhold a portion of the county's share of 
567.18  state and federal funds for that program.  The amount withheld 
567.19  must be equal to the percentage difference between the level of 
567.20  compliance maintained by the county and the level of compliance 
567.21  required by the federal regulations, multiplied by the county's 
567.22  share of state and federal funds for the program.  The state and 
567.23  federal funds may be withheld until the county is found to be in 
567.24  compliance with all federal laws or federal regulations 
567.25  applicable to the program.  If a county remains out of 
567.26  compliance for more than six consecutive months, the 
567.27  commissioner may reallocate the withheld funds to counties that 
567.28  are in compliance with the federal regulations. 
567.29     Subd. 4.  [CORRECTIVE ACTION PROCEDURE.] The commissioner 
567.30  must comply with the following procedures when reducing county 
567.31  funds under subdivision 3. 
567.32     (a) The commissioner shall notify the county, by certified 
567.33  mail, of the statute, rule, federal law, or federal regulation 
567.34  with which the county has not complied. 
567.35     (b) The commissioner shall give the county 30 days to 
567.36  demonstrate to the commissioner that the county is in compliance 
568.1   with the statute, rule, federal law, or federal regulation cited 
568.2   in the notice or to develop a corrective action plan to address 
568.3   the problem.  Upon request from the county, the commissioner 
568.4   shall provide technical assistance to the county in developing a 
568.5   corrective action plan.  The county shall have 30 days from the 
568.6   date the technical assistance is provided to develop the 
568.7   corrective action plan. 
568.8      (c) The commissioner shall take no further action if the 
568.9   county demonstrates compliance with the statute, rule, federal 
568.10  law, or federal regulation cited in the notice. 
568.11     (d) The commissioner shall review and approve or disapprove 
568.12  the corrective action plan within 30 days after the commissioner 
568.13  receives the corrective action plan. 
568.14     (e) If the commissioner approves the corrective action plan 
568.15  submitted by the county, the county has 90 days after the date 
568.16  of approval to implement the corrective action plan. 
568.17     (f) If the county fails to demonstrate compliance or fails 
568.18  to implement the corrective action plan approved by the 
568.19  commissioner, the commissioner may reduce the county's share of 
568.20  state or federal funds according to subdivision 3. 
568.21     Sec. 4.  [256M.30] [SERVICE PLAN.] 
568.22     Subdivision 1.  [SERVICE PLAN SUBMITTED TO COMMISSIONER.] 
568.23  Effective January 1, 2004, and each two-year period thereafter, 
568.24  each county must have a biennial service plan approved by the 
568.25  commissioner in order to receive funds.  Counties may submit 
568.26  multicounty or regional service plans. 
568.27     Subd. 2.  [CONTENTS.] The service plan shall be completed 
568.28  in a form prescribed by the commissioner.  The plan must include:
568.29     (1) a statement of the needs of the children, adolescents, 
568.30  and adults who experience the conditions defined in section 
568.31  256M.10, subdivision 2, paragraph (a), and strengths and 
568.32  resources available in the community to address those needs; 
568.33     (2) strategies the county will pursue to achieve the 
568.34  performance targets.  Strategies must include specification of 
568.35  how funds under this section and other community resources will 
568.36  be used to achieve desired performance targets; 
569.1      (3) a description of the county's process to solicit public 
569.2   input and a summary of that input; 
569.3      (4) beginning with the service plans submitted for the 
569.4   period from January 1, 2006, through December 21, 2007, 
569.5   performance targets on statewide indicators for each county to 
569.6   measure outcomes of children's mental health, and child safety, 
569.7   permanency, and well-being.  The commissioner shall consult with 
569.8   counties and other stakeholders to develop these indicators and 
569.9   collect baseline data to inform the establishment of individual 
569.10  county performance targets for the 2006-2007 biennium and 
569.11  subsequent plans; and 
569.12     (5) a budget for services to be provided with funds under 
569.13  this section.  The county must budget at least 40 percent of 
569.14  funds appropriated under sections 256M.01 to 256M.80 for 
569.15  services to ensure the mental health, safety, permanency, and 
569.16  well-being of children from low-income families.  The 
569.17  commissioner may reduce the portion of child and community 
569.18  services funds that must be budgeted by a county for services to 
569.19  children in low-income families if: 
569.20     (i) the incidence of children in low-income families within 
569.21  the county's population is significantly below the statewide 
569.22  median; or 
569.23     (ii) the county has successfully achieved past performance 
569.24  targets for children's mental health, and child safety, 
569.25  permanency, and well-being and its proposed service plan is 
569.26  judged by the commissioner to provide an adequate level of 
569.27  service to the population with less funding. 
569.28     Subd. 3.  [CONTINUITY OF SERVICES.] In developing the plan 
569.29  required under this section, a county shall endeavor, within the 
569.30  limits of funds available, to consider the continuing need for 
569.31  services and programs for children and persons with disabilities 
569.32  that were funded by the former children's services and community 
569.33  service grants. 
569.34     Subd. 4.  [INFORMATION.] The commissioner shall provide 
569.35  each county with information and technical assistance needed to 
569.36  complete the service plan, including:  information on children's 
570.1   mental health, and child safety, permanency, and well-being in 
570.2   the county; comparisons with other counties; baseline 
570.3   performance on outcome measures; and promising program practices.
570.4      Subd. 5.  [TIMELINES.] The preliminary service plan must be 
570.5   submitted to the commissioner by October 15, 2003, and October 
570.6   15 of every two years thereafter.  
570.7      Subd. 6.  [PUBLIC COMMENT.] The county board must determine 
570.8   how citizens in the county will participate in the development 
570.9   of the service plan and provide opportunities for such 
570.10  participation.  The county must allow a period of no less than 
570.11  30 days prior to the submission of the plan to the commissioner 
570.12  to solicit comments from the public on the contents of the plan. 
570.13     Subd. 7.  [COMMISSIONER'S RESPONSIBILITIES.] The 
570.14  commissioner must, within 60 days of receiving each county 
570.15  service plan, inform the county if the service plan has been 
570.16  approved.  If the service plan is not approved, the commissioner 
570.17  must inform the county of any revisions needed for approval. 
570.18     Sec. 5.  [256M.40] [STATE CHILDREN AND COMMUNITY SERVICES 
570.19  GRANT ALLOCATION.] 
570.20     Subdivision 1.  [FORMULA.] The commissioner shall allocate 
570.21  state funds appropriated for children and community services 
570.22  grants to each county board on a calendar year basis in an 
570.23  amount determined according to the formula in paragraphs (a) to 
570.24  (c). 
570.25     (a) For July 1, 2003, through December 31, 2003, the 
570.26  commissioner shall allocate funds to each county equal to that 
570.27  county's allocation for the grants under section 256M.10, 
570.28  subdivision 5, for calendar year 2003 less payments made on or 
570.29  before June 30, 2003. 
570.30     (b) For calendar year 2004 and 2005, the commissioner shall 
570.31  allocate available funds to each county in proportion to that 
570.32  county's share of the calendar year 2003 allocations for the 
570.33  grants under section 256M.10, subdivision 5. 
570.34     (c) For calendar year 2006 and each calendar year 
570.35  thereafter, the commissioner shall allocate available funds to 
570.36  each county in proportion to that county's share in the 
571.1   preceding calendar year. 
571.2      Subd. 2.  [PROJECT OF REGIONAL SIGNIFICANCE; STUDY.] The 
571.3   commissioner shall study whether and how to dedicate a portion 
571.4   of the allocated funds for projects of regional significance.  
571.5   The study shall include an analysis of the amount of annual 
571.6   funding to be dedicated for projects of regional significance 
571.7   and what efforts these projects must support.  The commissioner 
571.8   shall submit a report to the chairs of the house and senate 
571.9   committees with jurisdiction over children and community 
571.10  services grants by January 15, 2005.  The commissioner of 
571.11  finance, in preparing the proposed biennial budget for fiscal 
571.12  years 2006 and 2007, is instructed to include $25 million each 
571.13  year in funding for projects of regional significance under this 
571.14  chapter. 
571.15     Subd. 3.  [PAYMENTS.] Calendar year allocations under 
571.16  subdivision 1 shall be paid to counties on or before July 10 of 
571.17  each year. 
571.18     Sec. 6.  [256M.50] [FEDERAL CHILDREN AND COMMUNITY SERVICES 
571.19  GRANT ALLOCATION.] 
571.20     In federal fiscal year 2004 and subsequent years, money for 
571.21  social services received from the federal government to 
571.22  reimburse counties for social service expenditures according to 
571.23  Title XX of the Social Security Act shall be allocated to each 
571.24  county according to section 256M.40, except for funds allocated 
571.25  for administrative purposes and migrant day care. 
571.26     Sec. 7.  [256M.60] [DUTIES OF COUNTY BOARDS.] 
571.27     Subdivision 1.  [RESPONSIBILITIES.] The county board of 
571.28  each county shall be responsible for administration and funding 
571.29  of children and community services as defined in section 
571.30  256M.10, subdivision 1.  Each county board shall singly or in 
571.31  combination with other county boards use funds available to the 
571.32  county under this act to carry out these responsibilities. The 
571.33  county board shall coordinate and facilitate the effective use 
571.34  of formal and informal helping systems to best support and 
571.35  nurture children, adolescents, and adults within the county who 
571.36  experience dependency, abuse, neglect, poverty, disability, 
572.1   chronic health conditions, or other factors, including ethnicity 
572.2   and race, that may result in poor outcomes or disparities, as 
572.3   well as services for family members to support such 
572.4   individuals.  This includes assisting individuals to function at 
572.5   the highest level of ability while maintaining family and 
572.6   community relationships to the greatest extent possible.  
572.7      Subd. 2.  [DAY TRAINING AND HABILITATION SERVICES; 
572.8   ALTERNATIVE HABILITATION SERVICES.] To the extent provided in 
572.9   the county service plan under section 256M.30, the county board 
572.10  of each county shall be responsible for providing day training 
572.11  and habilitation services or alternative habilitation services 
572.12  during the day for persons with developmental disabilities to 
572.13  the extent this is required by the person's individualized 
572.14  service plan. 
572.15     Subd. 3.  [REPORTS.] The county board shall provide 
572.16  necessary reports and data as required by the commissioner. 
572.17     Subd. 4.  [CONTRACTS FOR SERVICES.] The county board may 
572.18  contract with a human services board, a multicounty board 
572.19  established by a joint powers agreement, other political 
572.20  subdivisions, a children's mental health collaborative, a family 
572.21  services collaborative, or private organizations in discharging 
572.22  its duties. 
572.23     Subd. 5.  [EXEMPTION FROM LIABILITY.] The state of 
572.24  Minnesota, the county boards, or the agencies acting on behalf 
572.25  of the county boards in the implementation and administration of 
572.26  children and community services shall not be liable for damages, 
572.27  injuries, or liabilities sustained through the purchase of 
572.28  services by the individual, the individual's family, or the 
572.29  authorized representative under this section. 
572.30     Subd. 6.  [FEES FOR SERVICES.] The county board may 
572.31  establish a schedule of fees based upon clients' ability to pay 
572.32  to be charged to recipients of children and community services. 
572.33  Payment, in whole or in part, for services may be accepted from 
572.34  any person except that no fee may be charged to persons or 
572.35  families whose adjusted gross household income is below the 
572.36  federal poverty level.  When services are provided to any 
573.1   person, including a recipient of aids administered by the 
573.2   federal, state, or county government, payment of any charges due 
573.3   may be billed to and accepted from a public assistance agency or 
573.4   from any public or private corporation. 
573.5      Sec. 8.  [256M.70] [FISCAL LIMITATIONS.] 
573.6      Subdivision 1.  [DEMONSTRATION OF REASONABLE EFFORT.] The 
573.7   county shall make reasonable efforts to comply with all children 
573.8   and community services requirements.  For the purposes of this 
573.9   section, a county is making reasonable efforts if the county has 
573.10  made efforts to comply with requirements within the limits of 
573.11  available funding, including efforts to identify and apply for 
573.12  commonly available state and federal funding for services. 
573.13     Subd. 2.  [IDENTIFICATION OF SERVICES TO BE PROVIDED.] If a 
573.14  county has made reasonable efforts to provide services according 
573.15  to the service plan under section 256M.30, but funds 
573.16  appropriated for purposes of sections 256M.01 to 256M.80 are 
573.17  insufficient, then the county may limit services that do not 
573.18  meet the following criteria while giving the highest funding 
573.19  priority to clauses (1), (2), and (3):  
573.20     (1) services needed to protect individuals from 
573.21  maltreatment, abuse, and neglect; 
573.22     (2) emergency and crisis services needed to protect clients 
573.23  from physical, emotional, or psychological harm; 
573.24     (3) services that maintain a person in the person's home or 
573.25  least restrictive setting; 
573.26     (4) assessment of persons applying for services and 
573.27  referral to appropriate services when necessary; 
573.28     (5) public guardianship services; 
573.29     (6) case management for persons with developmental 
573.30  disabilities, children with serious emotional disturbances, and 
573.31  adults with serious and persistent mental illness; and 
573.32     (7) fulfilling licensing responsibilities delegated to the 
573.33  county by the commissioner under section 245A.16. 
573.34     Subd. 3.  [DENIAL, REDUCTION, OR TERMINATION OF SERVICES 
573.35  DUE TO FISCAL LIMITATIONS.] Before a county denies, reduces, or 
573.36  terminates services to an individual due to fiscal limitations, 
574.1   the county must meet the requirements in this section.  The 
574.2   county must notify the individual and the individual's guardian 
574.3   in writing of the reason for the denial, reduction, or 
574.4   termination of services and must inform the individual and the 
574.5   individual's guardian in writing that the county will, upon 
574.6   request, meet to discuss alternatives before services are 
574.7   terminated or reduced.  
574.8      Sec. 9.  [256M.80] [PROGRAM EVALUATION.] 
574.9      Subdivision 1.  [COUNTY EVALUATION.] Each county shall 
574.10  submit to the commissioner data from the past calendar year on 
574.11  the outcomes and performance indicators in the service plan.  
574.12  The commissioner shall prescribe standard methods to be used by 
574.13  the counties in providing the data.  The data shall be submitted 
574.14  no later than March 1 of each year, beginning with March 1, 2005.
574.15     Subd. 2.  [STATEWIDE EVALUATION.] Six months after the end 
574.16  of the first full calendar year and annually thereafter, the 
574.17  commissioner shall prepare a report on the counties' progress in 
574.18  improving the outcomes of children, adolescents, and adults 
574.19  related to mental health, safety, permanency, and well-being.  
574.20  This report shall be disseminated throughout the state.  
574.21     Sec. 10.  [256M.90] [GRANTS AND PURCHASE OF SERVICE 
574.22  CONTRACTS.] 
574.23     Subdivision 1.  [AUTHORITY.] The local agency may purchase 
574.24  community social services by grant or purchase of service 
574.25  contract from agencies or individuals approved as vendors. 
574.26     Subd. 2.  [DUTIES OF LOCAL AGENCY.] The local agency must: 
574.27     (1) use a written grant or purchase of service contract 
574.28  when purchasing community social services.  Every grant and 
574.29  purchase of service contract must be completed, signed, and 
574.30  approved by all parties to the agreement, including the county 
574.31  board, unless the county board has designated the local agency 
574.32  to sign on its behalf.  No service shall be provided before the 
574.33  effective date of the grant or purchase of service contract; 
574.34     (2) determine a client's eligibility for purchased 
574.35  services, or delegate the responsibility for making the 
574.36  preliminary determination to the approved vendor under the terms 
575.1   of the grant or purchase of service contract; 
575.2      (3) ensure the development of an individual social service 
575.3   plan based on the client's needs; 
575.4      (4) monitor purchased services and evaluate grants and 
575.5   contracts on the basis of client outcomes; and 
575.6      (5) purchase only from approved vendors. 
575.7      Subd. 3.  [LOCAL AGENCY CRITERIA.] When the local agency 
575.8   chooses to purchase community social services from a vendor that 
575.9   is not subject to state licensing laws or department rules, the 
575.10  local agency must establish written criteria for vendor approval 
575.11  to ensure the health, safety, and well being of clients. 
575.12     Subd. 4.  [CASE RECORDS AND REPORTING REQUIREMENTS.] Case 
575.13  records and data reporting requirements for grants and purchased 
575.14  services are the same as case record and data reporting 
575.15  requirements for direct services. 
575.16     Subd. 5.  [FILES.] The local agency must keep an 
575.17  administrative file for each grant and contract. 
575.18     Subd. 6.  [CONTRACTING WITHIN AND ACROSS COUNTY LINES; LEAD 
575.19  COUNTY CONTRACTS.] Paragraphs (a) to (e) govern contracting 
575.20  within and across county lines and lead county contracts. 
575.21     (a) Once a local agency and an approved vendor execute a 
575.22  contract that meets the requirements of this subdivision, the 
575.23  contract governs all other purchases of service from the vendor 
575.24  by all other local agencies for the term of the contract.  The 
575.25  local agency that negotiated and entered into the contract 
575.26  becomes the lead county for the contract. 
575.27     (b) When the local agency in the county where a vendor is 
575.28  located wants to purchase services from that vendor and the 
575.29  vendor has no contract with the local agency or any other 
575.30  county, the local agency must negotiate and execute a contract 
575.31  with the vendor. 
575.32     (c) When a local agency in one county wants to purchase 
575.33  services from a vendor located in another county, it must notify 
575.34  the local agency in the county where the vendor is located.  
575.35  Within 30 days of being notified, the local agency in the 
575.36  vendor's county must: 
576.1      (1) if it has a contract with the vendor, send a copy to 
576.2   the inquiring agency; 
576.3      (2) if there is a contract with the vendor for which 
576.4   another local agency is the lead county, identify the lead 
576.5   county to the inquiring agency; or 
576.6      (3) if no local agency has a contract with the vendor, 
576.7   inform the inquiring agency whether it will negotiate a contract 
576.8   and become the lead county.  If the agency where the vendor is 
576.9   located will not negotiate a contract with the vendor because of 
576.10  concerns related to clients' health and safety, the agency must 
576.11  share those concerns with the inquiring agency. 
576.12     (d) If the local agency in the county where the vendor is 
576.13  located declines to negotiate a contract with the vendor or 
576.14  fails to respond within 30 days of receiving the notification 
576.15  under paragraph (c), the inquiring agency is authorized to 
576.16  negotiate a contract and must notify the local agency that 
576.17  declined or failed to respond. 
576.18     (e) When the inquiring county under paragraph (d) becomes 
576.19  the lead county for a contract and the contract expires and 
576.20  needs to be renegotiated, that county must again follow the 
576.21  requirements under paragraph (c) and notify the local agency 
576.22  where the vendor is located.  The local agency where the vendor 
576.23  is located has the option of becoming the lead county for the 
576.24  new contract.  If the local agency does not exercise the option, 
576.25  paragraph (d) applies. 
576.26     (f) This subdivision does not affect the requirement to 
576.27  seek county concurrence under section 256B.092, subdivision 8a, 
576.28  when the services are to be purchased for a person with mental 
576.29  retardation or a related condition or under section 245.4711, 
576.30  subdivision 3, when the services to be purchased are for an 
576.31  adult with serious and persistent mental illness. 
576.32     Subd. 7.  [CONTRACTS WITH COMMUNITY MENTAL HEALTH 
576.33  BOARDS.] A local agency within the geographic area served by a 
576.34  community mental health board authorized by sections 245.61 to 
576.35  245.69, may contract directly with the community mental health 
576.36  board.  However, if a local agency outside of the geographic 
577.1   area served by a community mental health board wishes to 
577.2   purchase services from the board, the local agency must follow 
577.3   the requirements under subdivision 6. 
577.4      Subd. 8.  [PLACEMENT AGREEMENTS.] A placement agreement 
577.5   must be used for residential services.  Placement agreements are 
577.6   valid when signed by authorized representatives of the facility 
577.7   and the county of financial responsibility.  If the county of 
577.8   financial responsibility and the county where the approved 
577.9   vendor is located are not the same, the county of financial 
577.10  responsibility must, if requested, mail a copy of the placement 
577.11  agreement to the county where the approved vendor is providing 
577.12  the service and to the lead county within ten calendar days 
577.13  after the date on which the placement agreement is signed.  The 
577.14  placement agreement must specify that the service will be 
577.15  provided in accordance with the individual service plan as 
577.16  required and must specify the unit cost, the date of placement, 
577.17  and the date for the review of the placement.  A placement 
577.18  agreement may also be used for nonresidential services. 
577.19     Sec. 11.  [REVISOR'S INSTRUCTION.] 
577.20     For sections in Minnesota Statutes and Minnesota Rules 
577.21  affected by the repealed sections in this article, the revisor 
577.22  shall delete internal cross-references where appropriate and 
577.23  make changes necessary to correct the punctuation, grammar, or 
577.24  structure of the remaining text and preserve its meaning. 
577.25     Sec. 12.  [REPEALER.] 
577.26     (a) Minnesota Statutes 2002, sections 245.478; 245.4886; 
577.27  245.4888; 245.496; 254A.17; 256E.01; 256E.02; 256E.03; 256E.04; 
577.28  256E.05; 256E.06; 256E.07; 256E.08; 256E.081; 256E.09; 256E.10; 
577.29  256E.11; 256E.115; 256E.13; 256E.14; 256E.15; 256F.01; 256F.02; 
577.30  256F.03; 256F.04; 256F.05; 256F.06; 256F.07; 256F.08; 256F.11; 
577.31  256F.12; 256F.14; 257.075; 257.81; 260.152; and 626.562, are 
577.32  repealed. 
577.33     (b) Minnesota Rules, parts 9550.0010; 9550.0020; 9550.0030; 
577.34  9550.0040; 9550.0050; 9550.0060; 9550.0070; 9550.0080; 
577.35  9550.0090; 9550.0091; 9550.0092; and 9550.0093, are repealed. 
577.36                             ARTICLE 12 
578.1                             HEALTH CARE 
578.2      Section 1.  Minnesota Statutes 2002, section 62J.692, 
578.3   subdivision 8, is amended to read: 
578.4      Subd. 8.  [FEDERAL FINANCIAL PARTICIPATION.] (a) The 
578.5   commissioner of human services shall seek to maximize federal 
578.6   financial participation in payments for medical education and 
578.7   research costs.  If the commissioner of human services 
578.8   determines that federal financial participation is available for 
578.9   the medical education and research, the commissioner of health 
578.10  shall transfer to the commissioner of human services the amount 
578.11  of state funds necessary to maximize the federal funds 
578.12  available.  The amount transferred to the commissioner of human 
578.13  services, plus the amount of federal financial participation, 
578.14  shall be distributed to medical assistance providers in 
578.15  accordance with the distribution methodology described in 
578.16  subdivision 4. 
578.17     (b) For the purposes of paragraph (a), the commissioner 
578.18  shall use physician clinic rates where possible to maximize 
578.19  federal financial participation. 
578.20     Sec. 2.  Minnesota Statutes 2002, section 256.01, 
578.21  subdivision 2, is amended to read: 
578.22     Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
578.23  section 241.021, subdivision 2, the commissioner of human 
578.24  services shall: 
578.25     (1) Administer and supervise all forms of public assistance 
578.26  provided for by state law and other welfare activities or 
578.27  services as are vested in the commissioner.  Administration and 
578.28  supervision of human services activities or services includes, 
578.29  but is not limited to, assuring timely and accurate distribution 
578.30  of benefits, completeness of service, and quality program 
578.31  management.  In addition to administering and supervising human 
578.32  services activities vested by law in the department, the 
578.33  commissioner shall have the authority to: 
578.34     (a) require county agency participation in training and 
578.35  technical assistance programs to promote compliance with 
578.36  statutes, rules, federal laws, regulations, and policies 
579.1   governing human services; 
579.2      (b) monitor, on an ongoing basis, the performance of county 
579.3   agencies in the operation and administration of human services, 
579.4   enforce compliance with statutes, rules, federal laws, 
579.5   regulations, and policies governing welfare services and promote 
579.6   excellence of administration and program operation; 
579.7      (c) develop a quality control program or other monitoring 
579.8   program to review county performance and accuracy of benefit 
579.9   determinations; 
579.10     (d) require county agencies to make an adjustment to the 
579.11  public assistance benefits issued to any individual consistent 
579.12  with federal law and regulation and state law and rule and to 
579.13  issue or recover benefits as appropriate; 
579.14     (e) delay or deny payment of all or part of the state and 
579.15  federal share of benefits and administrative reimbursement 
579.16  according to the procedures set forth in section 256.017; 
579.17     (f) make contracts with and grants to public and private 
579.18  agencies and organizations, both profit and nonprofit, and 
579.19  individuals, using appropriated funds; and 
579.20     (g) enter into contractual agreements with federally 
579.21  recognized Indian tribes with a reservation in Minnesota to the 
579.22  extent necessary for the tribe to operate a federally approved 
579.23  family assistance program or any other program under the 
579.24  supervision of the commissioner.  The commissioner shall consult 
579.25  with the affected county or counties in the contractual 
579.26  agreement negotiations, if the county or counties wish to be 
579.27  included, in order to avoid the duplication of county and tribal 
579.28  assistance program services.  The commissioner may establish 
579.29  necessary accounts for the purposes of receiving and disbursing 
579.30  funds as necessary for the operation of the programs. 
579.31     (2) Inform county agencies, on a timely basis, of changes 
579.32  in statute, rule, federal law, regulation, and policy necessary 
579.33  to county agency administration of the programs. 
579.34     (3) Administer and supervise all child welfare activities; 
579.35  promote the enforcement of laws protecting handicapped, 
579.36  dependent, neglected and delinquent children, and children born 
580.1   to mothers who were not married to the children's fathers at the 
580.2   times of the conception nor at the births of the children; 
580.3   license and supervise child-caring and child-placing agencies 
580.4   and institutions; supervise the care of children in boarding and 
580.5   foster homes or in private institutions; and generally perform 
580.6   all functions relating to the field of child welfare now vested 
580.7   in the state board of control. 
580.8      (4) Administer and supervise all noninstitutional service 
580.9   to handicapped persons, including those who are visually 
580.10  impaired, hearing impaired, or physically impaired or otherwise 
580.11  handicapped.  The commissioner may provide and contract for the 
580.12  care and treatment of qualified indigent children in facilities 
580.13  other than those located and available at state hospitals when 
580.14  it is not feasible to provide the service in state hospitals. 
580.15     (5) Assist and actively cooperate with other departments, 
580.16  agencies and institutions, local, state, and federal, by 
580.17  performing services in conformity with the purposes of Laws 
580.18  1939, chapter 431. 
580.19     (6) Act as the agent of and cooperate with the federal 
580.20  government in matters of mutual concern relative to and in 
580.21  conformity with the provisions of Laws 1939, chapter 431, 
580.22  including the administration of any federal funds granted to the 
580.23  state to aid in the performance of any functions of the 
580.24  commissioner as specified in Laws 1939, chapter 431, and 
580.25  including the promulgation of rules making uniformly available 
580.26  medical care benefits to all recipients of public assistance, at 
580.27  such times as the federal government increases its participation 
580.28  in assistance expenditures for medical care to recipients of 
580.29  public assistance, the cost thereof to be borne in the same 
580.30  proportion as are grants of aid to said recipients. 
580.31     (7) Establish and maintain any administrative units 
580.32  reasonably necessary for the performance of administrative 
580.33  functions common to all divisions of the department. 
580.34     (8) Act as designated guardian of both the estate and the 
580.35  person of all the wards of the state of Minnesota, whether by 
580.36  operation of law or by an order of court, without any further 
581.1   act or proceeding whatever, except as to persons committed as 
581.2   mentally retarded.  For children under the guardianship of the 
581.3   commissioner whose interests would be best served by adoptive 
581.4   placement, the commissioner may contract with a licensed 
581.5   child-placing agency or a Minnesota tribal social services 
581.6   agency to provide adoption services.  A contract with a licensed 
581.7   child-placing agency must be designed to supplement existing 
581.8   county efforts and may not replace existing county programs, 
581.9   unless the replacement is agreed to by the county board and the 
581.10  appropriate exclusive bargaining representative or the 
581.11  commissioner has evidence that child placements of the county 
581.12  continue to be substantially below that of other counties.  
581.13  Funds encumbered and obligated under an agreement for a specific 
581.14  child shall remain available until the terms of the agreement 
581.15  are fulfilled or the agreement is terminated. 
581.16     (9) Act as coordinating referral and informational center 
581.17  on requests for service for newly arrived immigrants coming to 
581.18  Minnesota. 
581.19     (10) The specific enumeration of powers and duties as 
581.20  hereinabove set forth shall in no way be construed to be a 
581.21  limitation upon the general transfer of powers herein contained. 
581.22     (11) Establish county, regional, or statewide schedules of 
581.23  maximum fees and charges which may be paid by county agencies 
581.24  for medical, dental, surgical, hospital, nursing and nursing 
581.25  home care and medicine and medical supplies under all programs 
581.26  of medical care provided by the state and for congregate living 
581.27  care under the income maintenance programs. 
581.28     (12) Have the authority to conduct and administer 
581.29  experimental projects to test methods and procedures of 
581.30  administering assistance and services to recipients or potential 
581.31  recipients of public welfare.  To carry out such experimental 
581.32  projects, it is further provided that the commissioner of human 
581.33  services is authorized to waive the enforcement of existing 
581.34  specific statutory program requirements, rules, and standards in 
581.35  one or more counties.  The order establishing the waiver shall 
581.36  provide alternative methods and procedures of administration, 
582.1   shall not be in conflict with the basic purposes, coverage, or 
582.2   benefits provided by law, and in no event shall the duration of 
582.3   a project exceed four years.  It is further provided that no 
582.4   order establishing an experimental project as authorized by the 
582.5   provisions of this section shall become effective until the 
582.6   following conditions have been met: 
582.7      (a) The secretary of health and human services of the 
582.8   United States has agreed, for the same project, to waive state 
582.9   plan requirements relative to statewide uniformity. 
582.10     (b) A comprehensive plan, including estimated project 
582.11  costs, shall be approved by the legislative advisory commission 
582.12  and filed with the commissioner of administration.  
582.13     (13) According to federal requirements, establish 
582.14  procedures to be followed by local welfare boards in creating 
582.15  citizen advisory committees, including procedures for selection 
582.16  of committee members. 
582.17     (14) Allocate federal fiscal disallowances or sanctions 
582.18  which are based on quality control error rates for the aid to 
582.19  families with dependent children program formerly codified in 
582.20  sections 256.72 to 256.87, medical assistance, or food stamp 
582.21  program in the following manner:  
582.22     (a) One-half of the total amount of the disallowance shall 
582.23  be borne by the county boards responsible for administering the 
582.24  programs.  For the medical assistance and the AFDC program 
582.25  formerly codified in sections 256.72 to 256.87, disallowances 
582.26  shall be shared by each county board in the same proportion as 
582.27  that county's expenditures for the sanctioned program are to the 
582.28  total of all counties' expenditures for the AFDC program 
582.29  formerly codified in sections 256.72 to 256.87, and medical 
582.30  assistance programs.  For the food stamp program, sanctions 
582.31  shall be shared by each county board, with 50 percent of the 
582.32  sanction being distributed to each county in the same proportion 
582.33  as that county's administrative costs for food stamps are to the 
582.34  total of all food stamp administrative costs for all counties, 
582.35  and 50 percent of the sanctions being distributed to each county 
582.36  in the same proportion as that county's value of food stamp 
583.1   benefits issued are to the total of all benefits issued for all 
583.2   counties.  Each county shall pay its share of the disallowance 
583.3   to the state of Minnesota.  When a county fails to pay the 
583.4   amount due hereunder, the commissioner may deduct the amount 
583.5   from reimbursement otherwise due the county, or the attorney 
583.6   general, upon the request of the commissioner, may institute 
583.7   civil action to recover the amount due. 
583.8      (b) Notwithstanding the provisions of paragraph (a), if the 
583.9   disallowance results from knowing noncompliance by one or more 
583.10  counties with a specific program instruction, and that knowing 
583.11  noncompliance is a matter of official county board record, the 
583.12  commissioner may require payment or recover from the county or 
583.13  counties, in the manner prescribed in paragraph (a), an amount 
583.14  equal to the portion of the total disallowance which resulted 
583.15  from the noncompliance, and may distribute the balance of the 
583.16  disallowance according to paragraph (a).  
583.17     (15) Develop and implement special projects that maximize 
583.18  reimbursements and result in the recovery of money to the 
583.19  state.  For the purpose of recovering state money, the 
583.20  commissioner may enter into contracts with third parties.  Any 
583.21  recoveries that result from projects or contracts entered into 
583.22  under this paragraph shall be deposited in the state treasury 
583.23  and credited to a special account until the balance in the 
583.24  account reaches $1,000,000.  When the balance in the account 
583.25  exceeds $1,000,000, the excess shall be transferred and credited 
583.26  to the general fund.  All money in the account is appropriated 
583.27  to the commissioner for the purposes of this paragraph. 
583.28     (16) Have the authority to make direct payments to 
583.29  facilities providing shelter to women and their children 
583.30  according to section 256D.05, subdivision 3.  Upon the written 
583.31  request of a shelter facility that has been denied payments 
583.32  under section 256D.05, subdivision 3, the commissioner shall 
583.33  review all relevant evidence and make a determination within 30 
583.34  days of the request for review regarding issuance of direct 
583.35  payments to the shelter facility.  Failure to act within 30 days 
583.36  shall be considered a determination not to issue direct payments.
584.1      (17) Have the authority to establish and enforce the 
584.2   following county reporting requirements:  
584.3      (a) The commissioner shall establish fiscal and statistical 
584.4   reporting requirements necessary to account for the expenditure 
584.5   of funds allocated to counties for human services programs.  
584.6   When establishing financial and statistical reporting 
584.7   requirements, the commissioner shall evaluate all reports, in 
584.8   consultation with the counties, to determine if the reports can 
584.9   be simplified or the number of reports can be reduced. 
584.10     (b) The county board shall submit monthly or quarterly 
584.11  reports to the department as required by the commissioner.  
584.12  Monthly reports are due no later than 15 working days after the 
584.13  end of the month.  Quarterly reports are due no later than 30 
584.14  calendar days after the end of the quarter, unless the 
584.15  commissioner determines that the deadline must be shortened to 
584.16  20 calendar days to avoid jeopardizing compliance with federal 
584.17  deadlines or risking a loss of federal funding.  Only reports 
584.18  that are complete, legible, and in the required format shall be 
584.19  accepted by the commissioner.  
584.20     (c) If the required reports are not received by the 
584.21  deadlines established in clause (b), the commissioner may delay 
584.22  payments and withhold funds from the county board until the next 
584.23  reporting period.  When the report is needed to account for the 
584.24  use of federal funds and the late report results in a reduction 
584.25  in federal funding, the commissioner shall withhold from the 
584.26  county boards with late reports an amount equal to the reduction 
584.27  in federal funding until full federal funding is received.  
584.28     (d) A county board that submits reports that are late, 
584.29  illegible, incomplete, or not in the required format for two out 
584.30  of three consecutive reporting periods is considered 
584.31  noncompliant.  When a county board is found to be noncompliant, 
584.32  the commissioner shall notify the county board of the reason the 
584.33  county board is considered noncompliant and request that the 
584.34  county board develop a corrective action plan stating how the 
584.35  county board plans to correct the problem.  The corrective 
584.36  action plan must be submitted to the commissioner within 45 days 
585.1   after the date the county board received notice of noncompliance.
585.2      (e) The final deadline for fiscal reports or amendments to 
585.3   fiscal reports is one year after the date the report was 
585.4   originally due.  If the commissioner does not receive a report 
585.5   by the final deadline, the county board forfeits the funding 
585.6   associated with the report for that reporting period and the 
585.7   county board must repay any funds associated with the report 
585.8   received for that reporting period. 
585.9      (f) The commissioner may not delay payments, withhold 
585.10  funds, or require repayment under paragraph (c) or (e) if the 
585.11  county demonstrates that the commissioner failed to provide 
585.12  appropriate forms, guidelines, and technical assistance to 
585.13  enable the county to comply with the requirements.  If the 
585.14  county board disagrees with an action taken by the commissioner 
585.15  under paragraph (c) or (e), the county board may appeal the 
585.16  action according to sections 14.57 to 14.69. 
585.17     (g) Counties subject to withholding of funds under 
585.18  paragraph (c) or forfeiture or repayment of funds under 
585.19  paragraph (e) shall not reduce or withhold benefits or services 
585.20  to clients to cover costs incurred due to actions taken by the 
585.21  commissioner under paragraph (c) or (e). 
585.22     (18) Allocate federal fiscal disallowances or sanctions for 
585.23  audit exceptions when federal fiscal disallowances or sanctions 
585.24  are based on a statewide random sample for the foster care 
585.25  program under title IV-E of the Social Security Act, United 
585.26  States Code, title 42, in direct proportion to each county's 
585.27  title IV-E foster care maintenance claim for that period. 
585.28     (19) Be responsible for ensuring the detection, prevention, 
585.29  investigation, and resolution of fraudulent activities or 
585.30  behavior by applicants, recipients, and other participants in 
585.31  the human services programs administered by the department. 
585.32     (20) Require county agencies to identify overpayments, 
585.33  establish claims, and utilize all available and cost-beneficial 
585.34  methodologies to collect and recover these overpayments in the 
585.35  human services programs administered by the department. 
585.36     (21) Have the authority to administer a drug rebate program 
586.1   for drugs purchased pursuant to the prescription drug program 
586.2   established under section 256.955 after the beneficiary's 
586.3   satisfaction of any deductible established in the program.  The 
586.4   commissioner shall require a rebate agreement from all 
586.5   manufacturers of covered drugs as defined in section 256B.0625, 
586.6   subdivision 13.  Rebate agreements for prescription drugs 
586.7   delivered on or after July 1, 2002, must include rebates for 
586.8   individuals covered under the prescription drug program who are 
586.9   under 65 years of age.  For each drug, the amount of the rebate 
586.10  shall be equal to the ~~basic~~ rebate as defined for purposes of 
586.11  the federal rebate program in United States Code, title 42, 
586.12  section 1396r-8(c)(1).  ~~This basic rebate shall be applied to~~ 
586.13  ~~single-source and multiple-source drugs.~~  The manufacturers must 
586.14  provide full payment within 30 days of receipt of the state 
586.15  invoice for the rebate within the terms and conditions used for 
586.16  the federal rebate program established pursuant to section 1927 
586.17  of title XIX of the Social Security Act.  The manufacturers must 
586.18  provide the commissioner with any information necessary to 
586.19  verify the rebate determined per drug.  The rebate program shall 
586.20  utilize the terms and conditions used for the federal rebate 
586.21  program established pursuant to section 1927 of title XIX of the 
586.22  Social Security Act. 
586.23     (22) Have the authority to administer the federal drug 
586.24  rebate program for drugs purchased under the medical assistance 
586.25  program as allowed by section 1927 of title XIX of the Social 
586.26  Security Act and according to the terms and conditions of 
586.27  section 1927.  Rebates shall be collected for all drugs that 
586.28  have been dispensed or administered in an outpatient setting and 
586.29  that are from manufacturers who have signed a rebate agreement 
586.30  with the United States Department of Health and Human Services. 
586.31     (23) Have the authority to administer a supplemental drug 
586.32  rebate program for drugs purchased under the medical assistance 
586.33  program.  The commissioner may enter into supplemental rebate 
586.34  contracts with pharmaceutical manufacturers and may require 
586.35  prior authorization for drugs that are from manufacturers that 
586.36  have not signed a supplemental rebate contract.  Prior 
587.1   authorization of drugs shall be subject to the provisions of 
587.2   section 256B.0625, subdivision 13. 
587.3      (24) Operate the department's communication systems account 
587.4   established in Laws 1993, First Special Session chapter 1, 
587.5   article 1, section 2, subdivision 2, to manage shared 
587.6   communication costs necessary for the operation of the programs 
587.7   the commissioner supervises.  A communications account may also 
587.8   be established for each regional treatment center which operates 
587.9   communications systems.  Each account must be used to manage 
587.10  shared communication costs necessary for the operations of the 
587.11  programs the commissioner supervises.  The commissioner may 
587.12  distribute the costs of operating and maintaining communication 
587.13  systems to participants in a manner that reflects actual usage. 
587.14  Costs may include acquisition, licensing, insurance, 
587.15  maintenance, repair, staff time and other costs as determined by 
587.16  the commissioner.  Nonprofit organizations and state, county, 
587.17  and local government agencies involved in the operation of 
587.18  programs the commissioner supervises may participate in the use 
587.19  of the department's communications technology and share in the 
587.20  cost of operation.  The commissioner may accept on behalf of the 
587.21  state any gift, bequest, devise or personal property of any 
587.22  kind, or money tendered to the state for any lawful purpose 
587.23  pertaining to the communication activities of the department.  
587.24  Any money received for this purpose must be deposited in the 
587.25  department's communication systems accounts.  Money collected by 
587.26  the commissioner for the use of communication systems must be 
587.27  deposited in the state communication systems account and is 
587.28  appropriated to the commissioner for purposes of this section. 
587.29     (25) Receive any federal matching money that is made 
587.30  available through the medical assistance program for the 
587.31  consumer satisfaction survey.  Any federal money received for 
587.32  the survey is appropriated to the commissioner for this 
587.33  purpose.  The commissioner may expend the federal money received 
587.34  for the consumer satisfaction survey in either year of the 
587.35  biennium. 
587.36     (26) Incorporate cost reimbursement claims from First Call 
588.1   Minnesota and Greater Twin Cities United Way into the federal 
588.2   cost reimbursement claiming processes of the department 
588.3   according to federal law, rule, and regulations.  Any 
588.4   reimbursement received is appropriated to the commissioner and 
588.5   shall be disbursed to First Call Minnesota and Greater Twin 
588.6   Cities United Way according to normal department payment 
588.7   schedules. 
588.8      (27) Develop recommended standards for foster care homes 
588.9   that address the components of specialized therapeutic services 
588.10  to be provided by foster care homes with those services.  
588.11     Sec. 3.  Minnesota Statutes 2002, section 256.046, 
588.12  subdivision 1, is amended to read: 
588.13     Subdivision 1.  [HEARING AUTHORITY.] A local agency must 
588.14  initiate an administrative fraud disqualification hearing for 
588.15  individuals accused of wrongfully obtaining assistance or 
588.16  intentional program violations, in lieu of a criminal action 
588.17  when it has not been pursued, in the aid to families with 
588.18  dependent children program formerly codified in sections 256.72 
588.19  to 256.87, MFIP, child care assistance programs, general 
588.20  assistance, family general assistance program formerly codified 
588.21  in section 256D.05, subdivision 1, clause (15), Minnesota 
588.22  supplemental aid, ~~medical care, or~~ food stamp programs, general 
588.23  assistance medical care, MinnesotaCare for adults without 
588.24  children, and upon federal approval, all categories of medical 
588.25  assistance and remaining categories of MinnesotaCare except for 
588.26  children through age 18.  The hearing is subject to the 
588.27  requirements of section 256.045 and the requirements in Code of 
588.28  Federal Regulations, title 7, section 273.16, for the food stamp 
588.29  program and title 45, section 235.112, as of September 30, 1995, 
588.30  for the cash grant and medical care programs. 
588.31     Sec. 4.  [256.954] [PRESCRIPTION DRUG DISCOUNT PROGRAM.] 
588.32     Subdivision 1.  [ESTABLISHMENT; ADMINISTRATION.] The 
588.33  commissioner of human services shall establish and administer 
588.34  the prescription drug discount program, effective July 1, 2005.  
588.35     Subd. 2.  [COMMISSIONER'S AUTHORITY.] The commissioner 
588.36  shall administer a drug rebate program for drugs purchased 
589.1   according to the prescription drug discount program.  The 
589.2   commissioner shall require a rebate agreement from all 
589.3   manufacturers of covered drugs as defined in section 256B.0625, 
589.4   subdivision 13.  For each drug, the amount of the rebate shall 
589.5   be equal to the rebate as defined for purposes of the federal 
589.6   rebate program in United States Code, title 42, section 
589.7   1396r-8.  The rebate program shall utilize the terms and 
589.8   conditions used for the federal rebate program established 
589.9   according to section 1927 of title XIX of the federal Social 
589.10  Security Act. 
589.11     Subd. 3.  [DEFINITIONS.] For the purpose of this section, 
589.12  the following terms have the meanings given them: 
589.13     (a) "Commissioner" means the commissioner of human services.
589.14     (b) "Manufacturer" means a manufacturer as defined in 
589.15  section 151.44, paragraph (c). 
589.16     (c) "Covered prescription drug" means a prescription drug 
589.17  as defined in section 151.44, paragraph (d), that is covered 
589.18  under medical assistance as described in section 256B.0625, 
589.19  subdivision 13, and that is provided by a manufacturer that has 
589.20  a fully executed rebate agreement with the commissioner under 
589.21  this section and complies with that agreement.  
589.22     (d) "Health carrier" means an insurance company licensed 
589.23  under chapter 60A to offer, sell, or issue an individual or 
589.24  group policy of accident and sickness insurance as defined in 
589.25  section 62A.01; a nonprofit health service plan corporation 
589.26  operating under chapter 62C; a health maintenance organization 
589.27  operating under chapter 62D; a joint self-insurance employee 
589.28  health plan operating under chapter 62H; a community integrated 
589.29  systems network licensed under chapter 62N; a fraternal benefit 
589.30  society operating under chapter 64B; a city, county, school 
589.31  district, or other political subdivision providing self-insured 
589.32  health coverage under section 461.617 or sections 471.98 to 
589.33  471.982; and a self-funded health plan under the Employee 
589.34  Retirement Income Security Act of 1974, as amended. 
589.35     (e) "Participating pharmacy" means a pharmacy as defined in 
589.36  section 151.01, subdivision 2, that agrees to participate in the 
590.1   prescription drug discount program. 
590.2      (f) "Enrolled individual" means a person who is eligible 
590.3   for the program under subdivision 4 and has enrolled in the 
590.4   program according to subdivision 5. 
590.5      Subd. 4.  [ELIGIBLE PERSONS.] To be eligible for the 
590.6   program, an applicant must: 
590.7      (1) be a permanent resident of Minnesota as defined in 
590.8   section 256L.09, subdivision 4; 
590.9      (2) not be enrolled in medical assistance, general 
590.10  assistance medical care, MinnesotaCare, or the prescription drug 
590.11  program under section 256.955; 
590.12     (3) not be enrolled in and have currently available 
590.13  prescription drug coverage under a health plan offered by a 
590.14  health carrier or under a pharmacy benefit program offered by a 
590.15  pharmaceutical manufacturer; 
590.16     (4) not be enrolled in and have currently available 
590.17  prescription drug coverage under a Medicare supplement plan, as 
590.18  defined in sections 62A.31 to 62A.44, or policies, contracts, or 
590.19  certificates that supplement Medicare issued by health 
590.20  maintenance organizations or those policies, contracts, or 
590.21  certificates governed by section 1833 or 1876 of the federal 
590.22  Social Security Act, United States Code, title 42, section 1395, 
590.23  et. seq., as amended; and 
590.24     (5) have a gross household income that does not exceed 250 
590.25  percent of the federal poverty guidelines. 
590.26     Subd. 5.  [APPLICATION PROCEDURE.] (a) Applications and 
590.27  information on the program must be made available at county 
590.28  social services agencies, health care provider offices, and 
590.29  agencies and organizations serving senior citizens.  Individuals 
590.30  shall submit applications and any information specified by the 
590.31  commissioner as being necessary to verify eligibility directly 
590.32  to the commissioner.  The commissioner shall determine an 
590.33  applicant's eligibility for the program within 30 days from the 
590.34  date the application is received.  Eligibility begins the month 
590.35  after approval. 
590.36     (b) The commissioner shall develop an application form that 
591.1   does not exceed one page in length and requires information 
591.2   necessary to determine eligibility for the program. 
591.3      Subd. 6.  [PARTICIPATING PHARMACY.] According to a valid 
591.4   prescription, a participating pharmacy must sell a covered 
591.5   prescription drug to an enrolled individual at the pharmacy's 
591.6   usual and customary retail price, minus an amount that is equal 
591.7   to the rebate amount described in subdivision 8, plus the amount 
591.8   of any administrative fee and switch fee established by the 
591.9   commissioner under subdivision 10.  Each participating pharmacy 
591.10  shall provide the commissioner with all information necessary to 
591.11  administer the program, including, but not limited to, 
591.12  information on prescription drug sales to enrolled individuals 
591.13  and usual and customary retail prices. 
591.14     Subd. 7.  [NOTIFICATION OF REBATE AMOUNT.] The commissioner 
591.15  shall notify each drug manufacturer, each calendar quarter or 
591.16  according to a schedule to be established by the commissioner, 
591.17  of the amount of the rebate owed on the prescription drugs sold 
591.18  by participating pharmacies to enrolled individuals. 
591.19     Subd. 8.  [PROVISION OF REBATE.] To the extent that a 
591.20  manufacturer's prescription drugs are prescribed to a resident 
591.21  of this state, the manufacturer must provide a rebate equal to 
591.22  the rebate provided under the medical assistance program for any 
591.23  prescription drug distributed by the manufacturer that is 
591.24  purchased by an enrolled individual at a participating 
591.25  pharmacy.  The manufacturer must provide full payment within 30 
591.26  days of receipt of the state invoice for the rebate, or 
591.27  according to a schedule to be established by the commissioner.  
591.28  The commissioner shall deposit all rebates received into the 
591.29  Minnesota prescription drug dedicated fund established under 
591.30  subdivision 11.  The manufacturer must provide the commissioner 
591.31  with any information necessary to verify the rebate determined 
591.32  per drug. 
591.33     Subd. 9.  [PAYMENT TO PHARMACIES.] The commissioner shall 
591.34  distribute on a biweekly basis an amount that is equal to an 
591.35  amount collected under subdivision 8 to each participating 
591.36  pharmacy based on the prescription drugs sold by that pharmacy 
592.1   to enrolled individuals, minus the amount of the administrative 
592.2   fee established by the commissioner under subdivision 10. 
592.3      Subd. 10.  [ADMINISTRATIVE FEE; SWITCH FEE.] (a) The 
592.4   commissioner shall establish a reasonable administrative fee 
592.5   that covers the commissioner's expenses for enrollment, 
592.6   processing claims, and distributing rebates under this program. 
592.7      (b) The commissioner shall establish a reasonable switch 
592.8   fee that covers expenses incurred by pharmacies in formatting 
592.9   for electronic submission claims for prescription drugs sold to 
592.10  enrolled individuals. 
592.11     Subd. 11.  [DEDICATED FUND; CREATION; USE OF FUND.] (a) The 
592.12  Minnesota prescription drug dedicated fund is established as an 
592.13  account in the state treasury.  The commissioner of finance 
592.14  shall credit to the dedicated fund all rebates paid under 
592.15  subdivision 8, any federal funds received for the program, and 
592.16  any appropriations or allocations designated for the fund.  The 
592.17  commissioner of finance shall ensure that fund money is invested 
592.18  under section 11A.25.  All money earned by the fund must be 
592.19  credited to the fund.  The fund shall earn a proportionate share 
592.20  of the total state annual investment income. 
592.21     (b) Money in the fund is appropriated to the commissioner 
592.22  of human services to reimburse participating pharmacies for 
592.23  prescription drug discounts provided to enrolled individuals 
592.24  under this section, to reimburse the commissioner of human 
592.25  services for costs related to enrollment, processing claims, 
592.26  distributing rebates, and for other reasonable administrative 
592.27  costs related to administration of the prescription drug 
592.28  discount program, and to repay the appropriation provided for 
592.29  this section.  The commissioner must administer the program so 
592.30  that the costs total no more than funds appropriated plus the 
592.31  drug rebate proceeds. 
592.32     Subd. 12.  [EXPIRATION.] This section expires upon the 
592.33  effective date of an expanded prescription drug benefit under 
592.34  Medicare. 
592.35     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2005. 
592.36     Sec. 5.  Minnesota Statutes 2002, section 256.955, 
593.1   subdivision 2a, is amended to read: 
593.2      Subd. 2a.  [ELIGIBILITY.] An individual satisfying the 
593.3   following requirements and the requirements described in 
593.4   subdivision 2, paragraph (d), is eligible for the prescription 
593.5   drug program: 
593.6      (1) is at least 65 years of age or older; and 
593.7      (2) is eligible as a qualified Medicare beneficiary 
593.8   according to section 256B.057, subdivision 3~~,~~ or 3a, ~~or 3b,~~ 
593.9   ~~clause (1),~~ or is eligible under section 256B.057, subdivision 
593.10  3~~,~~ or 3a, ~~or 3b, clause (1),~~ and is also eligible for medical 
593.11  assistance or general assistance medical care with a spenddown 
593.12  as defined in section 256B.056, subdivision 5. 
593.13     Sec. 6.  Minnesota Statutes 2002, section 256.955, 
593.14  subdivision 3, is amended to read: 
593.15     Subd. 3.  [PRESCRIPTION DRUG COVERAGE.] Coverage under the 
593.16  program shall be limited to those prescription drugs that: 
593.17     (1) are covered under the medical assistance program as 
593.18  described in section 256B.0625, subdivision 13; ~~and~~ 
593.19     (2) are provided by manufacturers that have fully executed 
593.20  senior drug rebate agreements with the commissioner and comply 
593.21  with such agreements; and 
593.22     (3) for a specific enrollee, are not covered under an 
593.23  assistance program offered by a pharmaceutical manufacturer, as 
593.24  determined by the board on aging under section 256.975, 
593.25  subdivision 9, except that this shall not apply to qualified 
593.26  individuals under this section who are also eligible for medical 
593.27  assistance with a spenddown as described in subdivision 2a, 
593.28  clause (2), and subdivision 2b, clause (2). 
593.29     <b>[EFFECTIVE DATE.]</b> This section is effective 90 days after 
593.30  implementation by the board of aging of the prescription drug 
593.31  assistance program under section 256.975, subdivision 9. 
593.32     Sec. 7.  Minnesota Statutes 2002, section 256.955, is 
593.33  amended by adding a subdivision to read: 
593.34     Subd. 4a.  [REFERRALS TO PRESCRIPTION DRUG ASSISTANCE 
593.35  PROGRAM.] County social service agencies, in coordination with 
593.36  the commissioner and the Minnesota board on aging, shall refer 
594.1   individuals applying to the prescription drug program, or 
594.2   enrolled in the prescription drug program, to the prescription 
594.3   drug assistance program for all required prescription drugs that 
594.4   the board on aging determines, under section 256.975, 
594.5   subdivision 9, are covered under an assistance program offered 
594.6   by a pharmaceutical manufacturer.  Applicants and enrollees 
594.7   referred to the prescription drug assistance program remain 
594.8   eligible for coverage under the prescription drug program of all 
594.9   prescription drugs covered under subdivision 3.  The board on 
594.10  aging shall phase-in participation of enrollees, over a period 
594.11  of 90 days, after implementation of the program under section 
594.12  256.975, subdivision 9.  This subdivision does not apply to 
594.13  individuals who are also eligible for medical assistance with a 
594.14  spenddown as defined in section 256B.056, subdivision 5. 
594.15     <b>[EFFECTIVE DATE.]</b> This section is effective 90 days after 
594.16  implementation by the board of aging of the prescription drug 
594.17  assistance program under section 256.975, subdivision 9. 
594.18     Sec. 8.  Minnesota Statutes 2002, section 256.969, 
594.19  subdivision 2b, is amended to read: 
594.20     Subd. 2b.  [OPERATING PAYMENT RATES.] In determining 
594.21  operating payment rates for admissions occurring on or after the 
594.22  rate year beginning January 1, 1991, and every two years after, 
594.23  or more frequently as determined by the commissioner, the 
594.24  commissioner shall obtain operating data from an updated base 
594.25  year and establish operating payment rates per admission for 
594.26  each hospital based on the cost-finding methods and allowable 
594.27  costs of the Medicare program in effect during the base year.  
594.28  Rates under the general assistance medical care, medical 
594.29  assistance, and MinnesotaCare programs shall not be rebased to 
594.30  more current data on January 1, 1997, and January 1, 2005.  The 
594.31  base year operating payment rate per admission is standardized 
594.32  by the case mix index and adjusted by the hospital cost index, 
594.33  relative values, and disproportionate population adjustment.  
594.34  The cost and charge data used to establish operating rates shall 
594.35  only reflect inpatient services covered by medical assistance 
594.36  and shall not include property cost information and costs 
595.1   recognized in outlier payments. 
595.2      Sec. 9.  Minnesota Statutes 2002, section 256.969, 
595.3   subdivision 3a, is amended to read: 
595.4      Subd. 3a.  [PAYMENTS.] (a) Acute care hospital billings 
595.5   under the medical assistance program must not be submitted until 
595.6   the recipient is discharged.  However, the commissioner shall 
595.7   establish monthly interim payments for inpatient hospitals that 
595.8   have individual patient lengths of stay over 30 days regardless 
595.9   of diagnostic category.  Except as provided in section 256.9693, 
595.10  medical assistance reimbursement for treatment of mental illness 
595.11  shall be reimbursed based on diagnostic classifications.  
595.12  Individual hospital payments established under this section and 
595.13  sections 256.9685, 256.9686, and 256.9695, in addition to third 
595.14  party and recipient liability, for discharges occurring during 
595.15  the rate year shall not exceed, in aggregate, the charges for 
595.16  the medical assistance covered inpatient services paid for the 
595.17  same period of time to the hospital.  This payment limitation 
595.18  shall be calculated separately for medical assistance and 
595.19  general assistance medical care services.  The limitation on 
595.20  general assistance medical care shall be effective for 
595.21  admissions occurring on or after July 1, 1991.  Services that 
595.22  have rates established under subdivision 11 or 12, must be 
595.23  limited separately from other services.  After consulting with 
595.24  the affected hospitals, the commissioner may consider related 
595.25  hospitals one entity and may merge the payment rates while 
595.26  maintaining separate provider numbers.  The operating and 
595.27  property base rates per admission or per day shall be derived 
595.28  from the best Medicare and claims data available when rates are 
595.29  established.  The commissioner shall determine the best Medicare 
595.30  and claims data, taking into consideration variables of recency 
595.31  of the data, audit disposition, settlement status, and the 
595.32  ability to set rates in a timely manner.  The commissioner shall 
595.33  notify hospitals of payment rates by December 1 of the year 
595.34  preceding the rate year.  The rate setting data must reflect the 
595.35  admissions data used to establish relative values.  Base year 
595.36  changes from 1981 to the base year established for the rate year 
596.1   beginning January 1, 1991, and for subsequent rate years, shall 
596.2   not be limited to the limits ending June 30, 1987, on the 
596.3   maximum rate of increase under subdivision 1.  The commissioner 
596.4   may adjust base year cost, relative value, and case mix index 
596.5   data to exclude the costs of services that have been 
596.6   discontinued by the October 1 of the year preceding the rate 
596.7   year or that are paid separately from inpatient services.  
596.8   Inpatient stays that encompass portions of two or more rate 
596.9   years shall have payments established based on payment rates in 
596.10  effect at the time of admission unless the date of admission 
596.11  preceded the rate year in effect by six months or more.  In this 
596.12  case, operating payment rates for services rendered during the 
596.13  rate year in effect and established based on the date of 
596.14  admission shall be adjusted to the rate year in effect by the 
596.15  hospital cost index. 
596.16     (b) For fee-for-service admissions occurring on or after 
596.17  July 1, 2002, the total payment, before third-party liability 
596.18  and spenddown, made to hospitals for inpatient services is 
596.19  reduced by .5 percent from the current statutory rates.  
596.20     (c) In addition to the reduction in paragraph (b), the 
596.21  total payment for fee-for-service admissions occurring on or 
596.22  after July 1, 2003, made to hospitals for inpatient services 
596.23  before third-party liability and spenddown, is reduced five 
596.24  percent from the current statutory rates.  Mental health 
596.25  services within diagnosis related groups 424 to 432, and 
596.26  facilities defined under subdivision 16 are excluded from this 
596.27  paragraph. 
596.28     Sec. 10.  Minnesota Statutes 2002, section 256.969, is 
596.29  amended by adding a subdivision to read: 
596.30     Subd. 8b.  [ADMISSIONS FOR PERSONS WHO APPLY DURING 
596.31  HOSPITALIZATION.] For admissions for individuals under section 
596.32  256D.03, subdivision 3, paragraph (a), clause (2), that occur 
596.33  before the date of eligibility, payment for the days that the 
596.34  patient is eligible shall be established according to the 
596.35  methods of subdivision 14. 
596.36     <b>[EFFECTIVE DATE.]</b> This section is effective October 1, 2003.
597.1      Sec. 11.  Minnesota Statutes 2002, section 256.975, is 
597.2   amended by adding a subdivision to read: 
597.3      Subd. 9.  [PRESCRIPTION DRUG ASSISTANCE.] (a) The Minnesota 
597.4   board on aging shall establish and administer a prescription 
597.5   drug assistance program to assist individuals in accessing 
597.6   programs offered by pharmaceutical manufacturers that provide 
597.7   free or discounted prescription drugs or provide coverage for 
597.8   prescription drugs.  The board shall use computer software 
597.9   programs to: 
597.10     (1) list eligibility requirements for pharmaceutical 
597.11  assistance programs offered by manufacturers; 
597.12     (2) list drugs that are included in a supplemental rebate 
597.13  contract between the commissioner and a pharmaceutical 
597.14  manufacturer under section 256.01, subdivision 2, clause (23); 
597.15  and 
597.16     (3) link individuals with the pharmaceutical assistance 
597.17  programs most appropriate for the individual.  The board shall 
597.18  make information on the prescription drug assistance program 
597.19  available to interested individuals and health care providers 
597.20  and shall coordinate the program with the statewide information 
597.21  and assistance service provided through the Senior LinkAge Line 
597.22  under subdivision 7. 
597.23     (b) The board shall work with the commissioner and county 
597.24  social service agencies to coordinate the enrollment of 
597.25  individuals who are referred to the prescription drug assistance 
597.26  program from the prescription drug program, as required under 
597.27  section 256.955, subdivision 4a. 
597.28     Sec. 12.  Minnesota Statutes 2002, section 256.98, 
597.29  subdivision 3, is amended to read: 
597.30     Subd. 3.  [AMOUNT OF ASSISTANCE INCORRECTLY PAID.] The 
597.31  amount of the assistance incorrectly paid under this section is: 
597.32     (a) the difference between the amount of assistance 
597.33  actually received on the basis of misrepresented or concealed 
597.34  facts and the amount to which the recipient would have been 
597.35  entitled had the specific concealment or misrepresentation not 
597.36  occurred.  Unless required by law, rule, or regulation, earned 
598.1   income disregards shall not be applied to earnings not reported 
598.2   by the recipient; or 
598.3      (b) equal to all payments for health care services, 
598.4   including capitation payments made to a health plan, made on 
598.5   behalf of a person enrolled in MinnesotaCare, medical 
598.6   assistance, or general assistance medical care, for which the 
598.7   person was not entitled due to the concealment or 
598.8   misrepresentation of facts. 
598.9      Sec. 13.  Minnesota Statutes 2002, section 256.98, 
598.10  subdivision 4, is amended to read: 
598.11     Subd. 4.  [RECOVERY OF ASSISTANCE.] The amount of 
598.12  assistance determined to have been incorrectly paid is 
598.13  recoverable from: 
598.14     (1) the recipient or the recipient's estate by the county 
598.15  or the state as a debt due the county or the state or both; and 
598.16     (2) any person found to have taken independent action to 
598.17  establish eligibility for, conspired with, or aided and abetted, 
598.18  any recipient of public assistance found to have been 
598.19  incorrectly paid. 
598.20     The obligations established under this subdivision shall be 
598.21  joint and several and shall extend to all cases involving client 
598.22  error as well as cases involving wrongfully obtained assistance. 
598.23     MinnesotaCare participants who have been found to have 
598.24  wrongfully obtained assistance as described in subdivision 1, 
598.25  but who otherwise remain eligible for the program, may agree to 
598.26  have their MinnesotaCare premiums increased by an amount equal 
598.27  to ten percent of their premiums or $10 per month, whichever is 
598.28  greater, until the debt is satisfied. 
598.29     Sec. 14.  Minnesota Statutes 2002, section 256.98, 
598.30  subdivision 8, is amended to read: 
598.31     Subd. 8.  [DISQUALIFICATION FROM PROGRAM.] (a) Any person 
598.32  found to be guilty of wrongfully obtaining assistance by a 
598.33  federal or state court or by an administrative hearing 
598.34  determination, or waiver thereof, through a disqualification 
598.35  consent agreement, or as part of any approved diversion plan 
598.36  under section 401.065, or any court-ordered stay which carries 
599.1   with it any probationary or other conditions, in the Minnesota 
599.2   family investment program, the food stamp program, the general 
599.3   assistance program, the group residential housing program, or 
599.4   the Minnesota supplemental aid program shall be disqualified 
599.5   from that program.  In addition, any person disqualified from 
599.6   the Minnesota family investment program shall also be 
599.7   disqualified from the food stamp program.  The needs of that 
599.8   individual shall not be taken into consideration in determining 
599.9   the grant level for that assistance unit:  
599.10     (1) for one year after the first offense; 
599.11     (2) for two years after the second offense; and 
599.12     (3) permanently after the third or subsequent offense.  
599.13     The period of program disqualification shall begin on the 
599.14  date stipulated on the advance notice of disqualification 
599.15  without possibility of postponement for administrative stay or 
599.16  administrative hearing and shall continue through completion 
599.17  unless and until the findings upon which the sanctions were 
599.18  imposed are reversed by a court of competent jurisdiction.  The 
599.19  period for which sanctions are imposed is not subject to 
599.20  review.  The sanctions provided under this subdivision are in 
599.21  addition to, and not in substitution for, any other sanctions 
599.22  that may be provided for by law for the offense involved.  A 
599.23  disqualification established through hearing or waiver shall 
599.24  result in the disqualification period beginning immediately 
599.25  unless the person has become otherwise ineligible for 
599.26  assistance.  If the person is ineligible for assistance, the 
599.27  disqualification period begins when the person again meets the 
599.28  eligibility criteria of the program from which they were 
599.29  disqualified and makes application for that program. 
599.30     (b) A family receiving assistance through child care 
599.31  assistance programs under chapter 119B with a family member who 
599.32  is found to be guilty of wrongfully obtaining child care 
599.33  assistance by a federal court, state court, or an administrative 
599.34  hearing determination or waiver, through a disqualification 
599.35  consent agreement, as part of an approved diversion plan under 
599.36  section 401.065, or a court-ordered stay with probationary or 
600.1   other conditions, is disqualified from child care assistance 
600.2   programs.  The disqualifications must be for periods of three 
600.3   months, six months, and two years for the first, second, and 
600.4   third offenses respectively.  Subsequent violations must result 
600.5   in permanent disqualification.  During the disqualification 
600.6   period, disqualification from any child care program must extend 
600.7   to all child care programs and must be immediately applied. 
600.8      (c) Any person found to be guilty of wrongfully obtaining 
600.9   general assistance medical care, MinnesotaCare for adults 
600.10  without children, and upon federal approval, all categories of 
600.11  medical assistance and remaining categories of MinnesotaCare, 
600.12  except for children through age 18, by a federal or state court 
600.13  or by an administrative hearing determination, or waiver 
600.14  thereof, through a disqualification consent agreement, or as 
600.15  part of any approved diversion plan under section 401.065, or 
600.16  any court-ordered stay which carries with it any probationary or 
600.17  other conditions, is disqualified from that program.  The period 
600.18  of disqualification is one year after the first offense, two 
600.19  years after the second offense, and permanently after the third 
600.20  or subsequent offense.  The period of program disqualification 
600.21  shall begin on the date stipulated on the advance notice of 
600.22  disqualification without possibility of postponement for 
600.23  administrative stay or administrative hearing and shall continue 
600.24  through completion unless and until the findings upon which the 
600.25  sanctions were imposed are reversed by a court of competent 
600.26  jurisdiction.  The period for which sanctions are imposed is not 
600.27  subject to review.  The sanctions provided under this 
600.28  subdivision are in addition to, and not in substitution for, any 
600.29  other sanctions that may be provided for by law for the offense 
600.30  involved. 
600.31     Sec. 15.  Minnesota Statutes 2002, section 256B.055, is 
600.32  amended by adding a subdivision to read: 
600.33     Subd. 13.  [RESIDENTS OF INSTITUTIONS FOR MENTAL DISEASES.] 
600.34  Beginning October 1, 2003, persons who would be eligible for 
600.35  medical assistance under this chapter but for residing in a 
600.36  facility that is determined by the commissioner or the federal 
601.1   Centers for Medicare and Medicaid Services to be an institution 
601.2   for mental diseases are eligible for medical assistance without 
601.3   federal financial participation, except that coverage shall not 
601.4   include payment for a nursing facility determined to be an 
601.5   institution for mental diseases. 
601.6      Sec. 16.  Minnesota Statutes 2002, section 256B.056, 
601.7   subdivision 1a, is amended to read: 
601.8      Subd. 1a.  [INCOME AND ASSETS GENERALLY.] Unless 
601.9   specifically required by state law or rule or federal law or 
601.10  regulation, the methodologies used in counting income and assets 
601.11  to determine eligibility for medical assistance for persons 
601.12  whose eligibility category is based on blindness, disability, or 
601.13  age of 65 or more years, the methodologies for the supplemental 
601.14  security income program shall be used.  Increases in benefits 
601.15  under title II of the Social Security Act shall not be counted 
601.16  as income for purposes of this subdivision until July 1 of each 
601.17  year.  Effective upon federal approval, for children eligible 
601.18  under section 256B.055, subdivision 12, or for home and 
601.19  community-based waiver services whose eligibility for medical 
601.20  assistance is determined without regard to parental income, 
601.21  child support payments, including any payments made by an 
601.22  obligor in satisfaction of or in addition to a temporary or 
601.23  permanent order for child support, and social security payments 
601.24  are not counted as income.  For families and children, which 
601.25  includes all other eligibility categories, the methodologies 
601.26  under the state's AFDC plan in effect as of July 16, 1996, as 
601.27  required by the Personal Responsibility and Work Opportunity 
601.28  Reconciliation Act of 1996 (PRWORA), Public Law ~~Number~~ 104-193, 
601.29  shall be used, except that effective ~~July 1, 2002, the $90 and~~ 
601.30  ~~$30 and one-third earned income disregards shall not apply and~~ 
601.31  ~~the disregard specified in subdivision 1c shall apply~~ October 1, 
601.32  2003, the earned income disregards and deductions are limited to 
601.33  those in subdivision 1c.  For these purposes, a "methodology" 
601.34  does not include an asset or income standard, or accounting 
601.35  method, or method of determining effective dates. 
601.36     Sec. 17.  Minnesota Statutes 2002, section 256B.056, 
602.1   subdivision 1c, is amended to read: 
602.2      Subd. 1c.  [FAMILIES WITH CHILDREN INCOME METHODOLOGY.] 
602.3   (a)(1) For children ages one to five whose eligibility is 
602.4   determined under section 256B.057, subdivision 2, 21 percent of 
602.5   countable earned income shall be disregarded for up to four 
602.6   months.  This clause expires July 1, 2003. 
602.7      (2) For applications processed within one calendar month 
602.8   prior to the date clause (1) expires, eligibility shall be 
602.9   determined by applying the income standards and methodologies in 
602.10  effect prior to the date of the expiration for any months in the 
602.11  six-month budget period before the expiration date and the 
602.12  income standards and methodologies in effect on the expiration 
602.13  date for any months in the six-month budget period on or after 
602.14  that date.  The income standards for each month shall be added 
602.15  together and compared to the applicant's total countable income 
602.16  for the six-month budget period to determine eligibility. 
602.17     (3) For children ages one through 18 whose eligibility is 
602.18  determined under section 256B.057, subdivision 2, the following 
602.19  deductions shall be applied to income counted toward the child's 
602.20  eligibility as allowed under the state's AFDC plan in effect as 
602.21  of July 16, 1996:  $90 work expense, dependent care, and child 
602.22  support paid under court order.  This clause is effective 
602.23  October 1, 2003. 
602.24     (b) For families with children whose eligibility is 
602.25  determined using the standard specified in section 256B.056, 
602.26  subdivision 4, paragraph (c), 17 percent of countable earned 
602.27  income shall be disregarded for up to four months and the 
602.28  following deductions shall be applied to each individual's 
602.29  income counted toward eligibility as allowed under the state's 
602.30  AFDC plan in effect as of July 16, 1996:  dependent care and 
602.31  child support paid under court order. 
602.32     (c) If the four month disregard in paragraph (b) has been 
602.33  applied to the wage earner's income for four months, the 
602.34  disregard shall not be applied again until the wage earner's 
602.35  income has not been considered in determining medical assistance 
602.36  eligibility for 12 consecutive months.  
603.1      <b>[EFFECTIVE DATE.]</b> The amendments to paragraphs (b) and (c) 
603.2   are effective July 1, 2003. 
603.3      Sec. 18.  Minnesota Statutes 2002, section 256B.056, 
603.4   subdivision 3c, is amended to read: 
603.5      Subd. 3c.  [ASSET LIMITATIONS FOR FAMILIES AND CHILDREN.] A 
603.6   household of two or more persons must not own more than 
603.7   ~~$30,000~~ $20,000 in total net assets, and a household of one 
603.8   person must not own more than ~~$15,000~~ $10,000 in total net 
603.9   assets.  In addition to these maximum amounts, an eligible 
603.10  individual or family may accrue interest on these amounts, but 
603.11  they must be reduced to the maximum at the time of an 
603.12  eligibility redetermination.  The value of assets that are not 
603.13  considered in determining eligibility for medical assistance for 
603.14  families and children is the value of those assets excluded 
603.15  under the AFDC state plan as of July 16, 1996, as required by 
603.16  the Personal Responsibility and Work Opportunity Reconciliation 
603.17  Act of 1996 (PRWORA), Public Law ~~Number~~ 104-193, with the 
603.18  following exceptions: 
603.19     (1) household goods and personal effects are not 
603.20  considered; 
603.21     (2) capital and operating assets of a trade or business up 
603.22  to $200,000 are not considered; 
603.23     (3) one motor vehicle is excluded for each person of legal 
603.24  driving age who is employed or seeking employment; 
603.25     (4) one burial plot and all other burial expenses equal to 
603.26  the supplemental security income program asset limit are not 
603.27  considered for each individual; 
603.28     (5) court-ordered settlements up to $10,000 are not 
603.29  considered; 
603.30     (6) individual retirement accounts and funds are not 
603.31  considered; and 
603.32     (7) assets owned by children are not considered.  
603.33     Sec. 19.  Minnesota Statutes 2002, section 256B.057, 
603.34  subdivision 1, is amended to read: 
603.35     Subdivision 1.  [PREGNANT WOMEN AND INFANTS.] (a)(1) An 
603.36  infant less than one year of age ~~or a pregnant woman who has~~ 
604.1   ~~written verification of a positive pregnancy test from a~~ 
604.2   ~~physician or licensed registered nurse,~~ is eligible for medical 
604.3   assistance if countable family income is equal to or less than 
604.4   275 percent of the federal poverty guideline for the same family 
604.5   size.  A pregnant woman who has written verification of a 
604.6   positive pregnancy test from a physician or licensed registered 
604.7   nurse is eligible for medical assistance if countable family 
604.8   income is equal to or less than 200 percent of the federal 
604.9   poverty guideline for the same family size.  For purposes of 
604.10  this subdivision, "countable family income" means the amount of 
604.11  income considered available using the methodology of the AFDC 
604.12  program under the state's AFDC plan as of July 16, 1996, as 
604.13  required by the Personal Responsibility and Work Opportunity 
604.14  Reconciliation Act of 1996 (PRWORA), Public Law ~~Number~~ 104-193, 
604.15  except for the earned income disregard and employment deductions.
604.16     (2) For applications processed within one calendar month 
604.17  prior to the effective date, eligibility shall be determined by 
604.18  applying the income standards and methodologies in effect prior 
604.19  to the effective date for any months in the six-month budget 
604.20  period before that date and the income standards and 
604.21  methodologies in effect on the effective date for any months in 
604.22  the six-month budget period on or after that date.  The income 
604.23  standards for each month shall be added together and compared to 
604.24  the applicant's total countable income for the six-month budget 
604.25  period to determine eligibility. 
604.26     (b)(1) An amount equal to the amount of earned income 
604.27  exceeding 275 percent of the federal poverty guideline, up to a 
604.28  maximum of the amount by which the combined total of 185 percent 
604.29  of the federal poverty guideline plus the earned income 
604.30  disregards and deductions of the AFDC program under the state's 
604.31  AFDC plan as of July 16, 1996, as required by the Personal 
604.32  Responsibility and Work Opportunity Reconciliation Act of 1996 
604.33  (PRWORA), Public Law ~~Number~~ 104-193, exceeds 275 percent of the 
604.34  federal poverty guideline will be deducted for pregnant women 
604.35  and infants less than one year of age.  This clause expires July 
604.36  1, 2003. 
605.1      (2) For applications processed within one calendar month 
605.2   prior to the date clause (1) expires, eligibility shall be 
605.3   determined by applying the income standards and methodologies in 
605.4   effect prior to the date of the expiration for any months in the 
605.5   six-month budget period before the expiration date and the 
605.6   income standards and methodologies in effect on the expiration 
605.7   date for any months in the six-month budget period on or after 
605.8   that date.  The income standards for each month shall be added 
605.9   together and compared to the applicant's total countable income 
605.10  for the six-month budget period to determine eligibility. 
605.11     (c) Dependent care and child support paid under court order 
605.12  shall be deducted from the countable income of pregnant women. 
605.13     ~~(b)~~ (d) An infant born on or after January 1, 1991, to a 
605.14  woman who was eligible for and receiving medical assistance on 
605.15  the date of the child's birth shall continue to be eligible for 
605.16  medical assistance without redetermination until the child's 
605.17  first birthday, as long as the child remains in the woman's 
605.18  household. 
605.19     <b>[EFFECTIVE DATE.]</b> This section is effective February 1, 
605.20  2004, or upon federal approval, whichever is later, except where 
605.21  a different date is specified in the text. 
605.22     Sec. 20.  Minnesota Statutes 2002, section 256B.057, 
605.23  subdivision 2, is amended to read: 
605.24     Subd. 2.  [CHILDREN.] (a) Except as specified in 
605.25  subdivision 1b, effective ~~July 1, 2002~~ October 1, 2003, a child 
605.26  one through 18 years of age in a family whose countable income 
605.27  is no greater than ~~170~~ 150 percent of the federal poverty 
605.28  guidelines for the same family size, is eligible for medical 
605.29  assistance.  
605.30     (b) For applications processed within one calendar month 
605.31  prior to the effective date, eligibility shall be determined by 
605.32  applying the income standards and methodologies in effect prior 
605.33  to the effective date for any months in the six-month budget 
605.34  period before that date and the income standards and 
605.35  methodologies in effect on the effective date for any months in 
605.36  the six-month budget period on or after that date.  The income 
606.1   standards for each month shall be added together and compared to 
606.2   the applicant's total countable income for the six-month budget 
606.3   period to determine eligibility. 
606.4      Sec. 21.  Minnesota Statutes 2002, section 256B.057, 
606.5   subdivision 3b, is amended to read: 
606.6      Subd. 3b.  [QUALIFYING INDIVIDUALS.] Beginning July 1, 
606.7   1998, ~~to the extent of the federal allocation to Minnesota~~ 
606.8   contingent upon federal funding, a person who would otherwise be 
606.9   eligible as a qualified Medicare beneficiary under subdivision 
606.10  3, except that the person's income is in excess of the limit, is 
606.11  eligible as a qualifying individual according to the following 
606.12  criteria: 
606.13     (1) if the person's income is greater than 120 percent, but 
606.14  less than 135 percent of the official federal poverty guidelines 
606.15  for the applicable family size, the person is eligible for 
606.16  medical assistance reimbursement of Medicare Part B premiums; or 
606.17     (2) if the person's income is equal to or greater than 135 
606.18  percent but less than 175 percent of the official federal 
606.19  poverty guidelines for the applicable family size, the person is 
606.20  eligible for medical assistance reimbursement of that portion of 
606.21  the Medicare Part B premium attributable to an increase in Part 
606.22  B expenditures which resulted from the shift of home care 
606.23  services from Medicare Part A to Medicare Part B under Public 
606.24  Law ~~Number~~ 105-33, section 4732, the Balanced Budget Act of 1997.
606.25     The commissioner shall limit enrollment of qualifying 
606.26  individuals under this subdivision according to the requirements 
606.27  of Public Law ~~Number~~ 105-33, section 4732. 
606.28     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
606.29     Sec. 22.  Minnesota Statutes 2002, section 256B.057, 
606.30  subdivision 9, is amended to read: 
606.31     Subd. 9.  [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 
606.32  assistance may be paid for a person who is employed and who: 
606.33     (1) meets the definition of disabled under the supplemental 
606.34  security income program; 
606.35     (2) is at least 16 but less than 65 years of age; 
606.36     (3) meets the asset limits in paragraph (b); and 
607.1      (4) effective November 1, 2003, pays a premium~~, if~~ 
607.2   ~~required,~~ and other obligations under paragraph ~~(c)~~ (d).  
607.3   Any spousal income or assets shall be disregarded for purposes 
607.4   of eligibility and premium determinations. 
607.5      After the month of enrollment, a person enrolled in medical 
607.6   assistance under this subdivision who: 
607.7      (1) is temporarily unable to work and without receipt of 
607.8   earned income due to a medical condition, as verified by a 
607.9   physician, may retain eligibility for up to four calendar 
607.10  months; or 
607.11     (2) effective January 1, 2004, loses employment for reasons 
607.12  not attributable to the enrollee, may retain eligibility for up 
607.13  to four consecutive months after the month of job loss.  To 
607.14  receive a four-month extension, enrollees must verify the 
607.15  medical condition or provide notification of job loss.  All 
607.16  other eligibility requirements must be met and the enrollee must 
607.17  pay all calculated premium costs for continued eligibility. 
607.18     (b) For purposes of determining eligibility under this 
607.19  subdivision, a person's assets must not exceed $20,000, 
607.20  excluding: 
607.21     (1) all assets excluded under section 256B.056; 
607.22     (2) retirement accounts, including individual accounts, 
607.23  401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 
607.24     (3) medical expense accounts set up through the person's 
607.25  employer. 
607.26     (c)(1) Effective January 1, 2004, for purposes of 
607.27  eligibility, there will be a $65 earned income disregard.  To be 
607.28  eligible, a person applying for medical assistance under this 
607.29  subdivision must have earned income above the disregard level. 
607.30     (2) Effective January 1, 2004, to be considered earned 
607.31  income, Medicare, social security, and applicable state and 
607.32  federal income taxes must be withheld.  To be eligible, a person 
607.33  must document earned income tax withholding. 
607.34     (d)(1) A person whose earned and unearned income is equal 
607.35  to or greater than 100 percent of federal poverty guidelines for 
607.36  the applicable family size must pay a premium to be eligible for 
608.1   medical assistance under this subdivision.  The premium shall be 
608.2   based on the person's gross earned and unearned income and the 
608.3   applicable family size using a sliding fee scale established by 
608.4   the commissioner, which begins at one percent of income at 100 
608.5   percent of the federal poverty guidelines and increases to 7.5 
608.6   percent of income for those with incomes at or above 300 percent 
608.7   of the federal poverty guidelines.  Annual adjustments in the 
608.8   premium schedule based upon changes in the federal poverty 
608.9   guidelines shall be effective for premiums due in July of each 
608.10  year.  
608.11     (2) Effective January 1, 2004, all enrollees must pay a 
608.12  premium to be eligible for medical assistance under this 
608.13  subdivision.  An enrollee shall pay the greater of a $35 premium 
608.14  or the premium calculated in clause (1). 
608.15     (3) Effective November 1, 2003, all enrollees who receive 
608.16  unearned income must pay one-half of one percent of unearned 
608.17  income in addition to the premium amount. 
608.18     (4) Effective November 1, 2003, for enrollees whose income 
608.19  does not exceed 200 percent of the federal poverty guidelines 
608.20  and who are also enrolled in Medicare, the commissioner must 
608.21  reimburse the enrollee for Medicare Part B premiums under 
608.22  section 256B.0625, subdivision 15, paragraph (a). 
608.23     ~~(d)~~ (e) A person's eligibility and premium shall be 
608.24  determined by the local county agency.  Premiums must be paid to 
608.25  the commissioner.  All premiums are dedicated to the 
608.26  commissioner. 
608.27     ~~(e)~~ (f) Any required premium shall be determined at 
608.28  application and redetermined ~~annually at recertification~~ at the 
608.29  enrollee's six-month income review or when a change in income or 
608.30  ~~family~~ household size ~~occurs~~ is reported.  Enrollees must report 
608.31  any change in income or household size within ten days of when 
608.32  the change occurs.  A decreased premium resulting from a 
608.33  reported change in income or household size shall be effective 
608.34  the first day of the next available billing month after the 
608.35  change is reported.  Except for changes occurring from annual 
608.36  cost-of-living increases, a change resulting in an increased 
609.1   premium shall not affect the premium amount until the next 
609.2   six-month review. 
609.3      ~~(f)~~ (g) Premium payment is due upon notification from the 
609.4   commissioner of the premium amount required.  Premiums may be 
609.5   paid in installments at the discretion of the commissioner. 
609.6      ~~(g)~~ (h) Nonpayment of the premium shall result in denial or 
609.7   termination of medical assistance unless the person demonstrates 
609.8   good cause for nonpayment.  Good cause exists if the 
609.9   requirements specified in Minnesota Rules, part 9506.0040, 
609.10  subpart 7, items B to D, are met.  Except when an installment 
609.11  agreement is accepted by the commissioner, all persons 
609.12  disenrolled for nonpayment of a premium must pay any past due 
609.13  premiums as well as current premiums due prior to being 
609.14  reenrolled.  Nonpayment shall include payment with a returned, 
609.15  refused, or dishonored instrument.  The commissioner may require 
609.16  a guaranteed form of payment as the only means to replace a 
609.17  returned, refused, or dishonored instrument. 
609.18     <b>[EFFECTIVE DATE.]</b> This section is effective November 1, 
609.19  2003, except that the amendments to Minnesota Statutes 2002, 
609.20  section 256B.057, subdivision 9, paragraphs (f) and (h), are 
609.21  effective July 1, 2003. 
609.22     Sec. 23.  Minnesota Statutes 2002, section 256B.057, 
609.23  subdivision 10, is amended to read: 
609.24     Subd. 10.  [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR 
609.25  CERVICAL CANCER.] (a) Medical assistance may be paid for a 
609.26  person who: 
609.27     (1) has been screened for breast or cervical cancer by the 
609.28  Minnesota breast and cervical cancer control program, and 
609.29  program funds have been used to pay for the person's screening; 
609.30     (2) according to the person's treating health professional, 
609.31  needs treatment, including diagnostic services necessary to 
609.32  determine the extent and proper course of treatment, for breast 
609.33  or cervical cancer, including precancerous conditions and early 
609.34  stage cancer; 
609.35     (3) meets the income eligibility guidelines for the 
609.36  Minnesota breast and cervical cancer control program; 
610.1      (4) is under age 65; 
610.2      (5) is not otherwise eligible for medical assistance under 
610.3   United States Code, title 42, section 1396(a)(10)(A)(i); and 
610.4      (6) is not otherwise covered under creditable coverage, as 
610.5   defined under United States Code, title 42, section 
610.6   ~~300gg(c)~~ 1396a(aa). 
610.7      (b) Medical assistance provided for an eligible person 
610.8   under this subdivision shall be limited to services provided 
610.9   during the period that the person receives treatment for breast 
610.10  or cervical cancer. 
610.11     (c) A person meeting the criteria in paragraph (a) is 
610.12  eligible for medical assistance without meeting the eligibility 
610.13  criteria relating to income and assets in section 256B.056, 
610.14  subdivisions 1a to 5b. 
610.15     Sec. 24.  Minnesota Statutes 2002, section 256B.0595, 
610.16  subdivision 1, is amended to read: 
610.17     Subdivision 1.  [PROHIBITED TRANSFERS.] (a) For transfers 
610.18  of assets made on or before August 10, 1993, if a person or the 
610.19  person's spouse has given away, sold, or disposed of, for less 
610.20  than fair market value, any asset or interest therein, except 
610.21  assets other than the homestead that are excluded under the 
610.22  supplemental security program, within 30 months before or any 
610.23  time after the date of institutionalization if the person has 
610.24  been determined eligible for medical assistance, or within 30 
610.25  months before or any time after the date of the first approved 
610.26  application for medical assistance if the person has not yet 
610.27  been determined eligible for medical assistance, the person is 
610.28  ineligible for long-term care services for the period of time 
610.29  determined under subdivision 2.  
610.30     (b) Effective for transfers made after August 10, 1993, a 
610.31  person, a person's spouse, or any person, court, or 
610.32  administrative body with legal authority to act in place of, on 
610.33  behalf of, at the direction of, or upon the request of the 
610.34  person or person's spouse, may not give away, sell, or dispose 
610.35  of, for less than fair market value, any asset or interest 
610.36  therein, except assets other than the homestead that are 
611.1   excluded under the supplemental security income program, for the 
611.2   purpose of establishing or maintaining medical assistance 
611.3   eligibility.  This applies to all transfers, including those 
611.4   made by a community spouse after the month in which the 
611.5   institutionalized spouse is determined eligible for medical 
611.6   assistance.  For purposes of determining eligibility for 
611.7   long-term care services, any transfer of such assets within 36 
611.8   months before or any time after an institutionalized person 
611.9   applies for medical assistance, or 36 months before or any time 
611.10  after a medical assistance recipient becomes institutionalized, 
611.11  for less than fair market value may be considered.  Any such 
611.12  transfer is presumed to have been made for the purpose of 
611.13  establishing or maintaining medical assistance eligibility and 
611.14  the person is ineligible for long-term care services for the 
611.15  period of time determined under subdivision 2, unless the person 
611.16  furnishes convincing evidence to establish that the transaction 
611.17  was exclusively for another purpose, or unless the transfer is 
611.18  permitted under subdivision 3 or 4.  Notwithstanding the 
611.19  provisions of this paragraph, in the case of payments from a 
611.20  trust or portions of a trust that are considered transfers of 
611.21  assets under federal law, any transfers made within 60 months 
611.22  before or any time after an institutionalized person applies for 
611.23  medical assistance and within 60 months before or any time after 
611.24  a medical assistance recipient becomes institutionalized, may be 
611.25  considered. 
611.26     (c) This section applies to transfers, for less than fair 
611.27  market value, of income or assets, including assets that are 
611.28  considered income in the month received, such as inheritances, 
611.29  court settlements, and retroactive benefit payments or income to 
611.30  which the person or the person's spouse is entitled but does not 
611.31  receive due to action by the person, the person's spouse, or any 
611.32  person, court, or administrative body with legal authority to 
611.33  act in place of, on behalf of, at the direction of, or upon the 
611.34  request of the person or the person's spouse.  
611.35     (d) This section applies to payments for care or personal 
611.36  services provided by a relative, unless the compensation was 
612.1   stipulated in a notarized, written agreement which was in 
612.2   existence when the service was performed, the care or services 
612.3   directly benefited the person, and the payments made represented 
612.4   reasonable compensation for the care or services provided.  A 
612.5   notarized written agreement is not required if payment for the 
612.6   services was made within 60 days after the service was provided. 
612.7      (e) This section applies to the portion of any asset or 
612.8   interest that a person, a person's spouse, or any person, court, 
612.9   or administrative body with legal authority to act in place of, 
612.10  on behalf of, at the direction of, or upon the request of the 
612.11  person or the person's spouse, transfers to any annuity that 
612.12  exceeds the value of the benefit likely to be returned to the 
612.13  person or spouse while alive, based on estimated life expectancy 
612.14  using the life expectancy tables employed by the supplemental 
612.15  security income program to determine the value of an agreement 
612.16  for services for life.  The commissioner may adopt rules 
612.17  reducing life expectancies based on the need for long-term 
612.18  care.  This section applies to an annuity described in this 
612.19  paragraph purchased on or after March 1, 2002, that: 
612.20     (1) is not purchased from an insurance company or financial 
612.21  institution that is subject to licensing or regulation by the 
612.22  Minnesota department of commerce or a similar regulatory agency 
612.23  of another state; 
612.24     (2) does not pay out principal and interest in equal 
612.25  monthly installments; or 
612.26     (3) does not begin payment at the earliest possible date 
612.27  after annuitization.  
612.28     (f) For purposes of this section, long-term care services 
612.29  include services in a nursing facility, services that are 
612.30  eligible for payment according to section 256B.0625, subdivision 
612.31  2, because they are provided in a swing bed, intermediate care 
612.32  facility for persons with mental retardation, and home and 
612.33  community-based services provided pursuant to sections 
612.34  256B.0915, 256B.092, and 256B.49.  For purposes of this 
612.35  subdivision and subdivisions 2, 3, and 4, "institutionalized 
612.36  person" includes a person who is an inpatient in a nursing 
613.1   facility or in a swing bed, or intermediate care facility for 
613.2   persons with mental retardation or who is receiving home and 
613.3   community-based services under sections 256B.0915, 256B.092, and 
613.4   256B.49. 
613.5      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003.  
613.6      Sec. 25.  Minnesota Statutes 2002, section 256B.0595, is 
613.7   amended by adding a subdivision to read: 
613.8      Subd. 1b.  [PROHIBITED TRANSFERS.] (a) Notwithstanding any 
613.9   contrary provisions of this section, this subdivision applies to 
613.10  transfers involving recipients of medical assistance that are 
613.11  made on or after July 1, 2003, and to all transfers involving 
613.12  persons who apply for medical assistance on or after July 1, 
613.13  2003, if the transfer occurred within 72 months before the 
613.14  person applies for medical assistance, except that this 
613.15  subdivision does not apply to transfers made prior to July 1, 
613.16  2003.  A person, a person's spouse, or any person, court, or 
613.17  administrative body with legal authority to act in place of, on 
613.18  behalf of, at the direction of, or upon the request of the 
613.19  person or the person's spouse, may not give away, sell, dispose 
613.20  of, or reduce ownership or control of any income, asset, or 
613.21  interest therein for less than fair market value for the purpose 
613.22  of establishing or maintaining medical assistance eligibility.  
613.23  This applies to all transfers, including those made by a 
613.24  community spouse after the month in which the institutionalized 
613.25  spouse is determined eligible for medical assistance.  For 
613.26  purposes of determining eligibility for medical assistance 
613.27  services, any transfer of such income or assets for less than 
613.28  fair market value within 72 months before or any time after a 
613.29  person applies for medical assistance may be considered.  Any 
613.30  such transfer is presumed to have been made for the purpose of 
613.31  establishing or maintaining medical assistance eligibility, and 
613.32  the person is ineligible for medical assistance services for the 
613.33  period of time determined under subdivision 2b, unless the 
613.34  person furnishes convincing evidence to establish that the 
613.35  transaction was exclusively for another purpose or unless the 
613.36  transfer is permitted under subdivision 3b or 4b. 
614.1      (b) This section applies to transfers to trusts.  The 
614.2   commissioner shall determine valid trust purposes under this 
614.3   section.  Assets placed into a trust that is not for a valid 
614.4   purpose shall always be considered available for the purposes of 
614.5   medical assistance eligibility, regardless of when the trust is 
614.6   established. 
614.7      (c) This section applies to transfers of income or assets 
614.8   for less than fair market value, including assets that are 
614.9   considered income in the month received, such as inheritances, 
614.10  court settlements, and retroactive benefit payments or income to 
614.11  which the person or the person's spouse is entitled but does not 
614.12  receive due to action by the person, the person's spouse, or any 
614.13  person, court, or administrative body with legal authority to 
614.14  act in place of, on behalf of, at the direction of, or upon the 
614.15  request of the person or the person's spouse. 
614.16     (d) This section applies to payments for care or personal 
614.17  services provided by a relative, unless the compensation was 
614.18  stipulated in a notarized written agreement that was in 
614.19  existence when the service was performed, the care or services 
614.20  directly benefited the person, and the payments made represented 
614.21  reasonable compensation for the care or services provided.  A 
614.22  notarized written agreement is not required if payment for the 
614.23  services was made within 60 days after the service was provided. 
614.24     (e) This section applies to the portion of any income, 
614.25  asset, or interest therein that a person, a person's spouse, or 
614.26  any person, court, or administrative body with legal authority 
614.27  to act in place of, on behalf of, at the direction of, or upon 
614.28  the request of the person or the person's spouse, transfers to 
614.29  any annuity that exceeds the value of the benefit likely to be 
614.30  returned to the person or the person's spouse while alive, based 
614.31  on estimated life expectancy, using the life expectancy tables 
614.32  employed by the supplemental security income program, or based 
614.33  on a shorter life expectancy if the annuitant had a medical 
614.34  condition that would shorten the annuitant's life expectancy and 
614.35  that was diagnosed before funds were placed into the annuity.  
614.36  The agency may request and receive a physician's statement to 
615.1   determine if the annuitant had a diagnosed medical condition 
615.2   that would shorten the annuitant's life expectancy.  If so, the 
615.3   agency shall determine the expected value of the benefits based 
615.4   upon the physician's statement instead of using a life 
615.5   expectancy table.  This section applies to an annuity described 
615.6   in this paragraph purchased on or after March 1, 2002, that: 
615.7      (1) is not purchased from an insurance company or financial 
615.8   institution that is subject to licensing or regulation by the 
615.9   Minnesota department of commerce or a similar regulatory agency 
615.10  of another state; 
615.11     (2) does not pay out principal and interest in equal 
615.12  monthly installments; or 
615.13     (3) does not begin payment at the earliest possible date 
615.14  after annuitization. 
615.15     (f) Transfers under this section shall affect 
615.16  determinations of eligibility for all medical assistance 
615.17  services or long-term care services, whichever receives federal 
615.18  approval. 
615.19     <b>[EFFECTIVE DATE.]</b> (a) This section is effective July 1, 
615.20  2003, to the extent permitted by federal law.  If any provision 
615.21  of this section is prohibited by federal law, the provision 
615.22  shall become effective when federal law is changed to permit its 
615.23  application or a waiver is received.  The commissioner of human 
615.24  services shall notify the revisor of statutes when federal law 
615.25  is enacted or a waiver or other federal approval is received and 
615.26  publish a notice in the State Register.  The commissioner must 
615.27  include the notice in the first State Register published after 
615.28  the effective date of the federal changes. 
615.29     (b) If, by July 1, 2003, any provision of this section is 
615.30  not effective because of prohibitions in federal law, the 
615.31  commissioner of human services shall apply to the federal 
615.32  government by August 1, 2003, for a waiver of those prohibitions 
615.33  or other federal authority, and that provision shall become 
615.34  effective upon receipt of a federal waiver or other federal 
615.35  approval, notification to the revisor of statutes, and 
615.36  publication of a notice in the State Register to that effect.  
616.1   In applying for federal approval to extend the lookback period, 
616.2   the commissioner shall seek the longest lookback period the 
616.3   federal government will approve, not to exceed 72 months. 
616.4      Sec. 26.  Minnesota Statutes 2002, section 256B.0595, 
616.5   subdivision 2, is amended to read: 
616.6      Subd. 2.  [PERIOD OF INELIGIBILITY.] (a) For any 
616.7   uncompensated transfer occurring on or before August 10, 1993, 
616.8   the number of months of ineligibility for long-term care 
616.9   services shall be the lesser of 30 months, or the uncompensated 
616.10  transfer amount divided by the average medical assistance rate 
616.11  for nursing facility services in the state in effect on the date 
616.12  of application.  The amount used to calculate the average 
616.13  medical assistance payment rate shall be adjusted each July 1 to 
616.14  reflect payment rates for the previous calendar year.  The 
616.15  period of ineligibility begins with the month in which the 
616.16  assets were transferred.  If the transfer was not reported to 
616.17  the local agency at the time of application, and the applicant 
616.18  received long-term care services during what would have been the 
616.19  period of ineligibility if the transfer had been reported, a 
616.20  cause of action exists against the transferee for the cost of 
616.21  long-term care services provided during the period of 
616.22  ineligibility, or for the uncompensated amount of the transfer, 
616.23  whichever is less.  The action may be brought by the state or 
616.24  the local agency responsible for providing medical assistance 
616.25  under chapter 256G.  The uncompensated transfer amount is the 
616.26  fair market value of the asset at the time it was given away, 
616.27  sold, or disposed of, less the amount of compensation received.  
616.28     (b) For uncompensated transfers made after August 10, 1993, 
616.29  the number of months of ineligibility for long-term care 
616.30  services shall be the total uncompensated value of the resources 
616.31  transferred divided by the average medical assistance rate for 
616.32  nursing facility services in the state in effect on the date of 
616.33  application.  The amount used to calculate the average medical 
616.34  assistance payment rate shall be adjusted each July 1 to reflect 
616.35  payment rates for the previous calendar year.  The period of 
616.36  ineligibility begins with the first day of the month after the 
617.1   month in which the assets were transferred except that if one or 
617.2   more uncompensated transfers are made during a period of 
617.3   ineligibility, the total assets transferred during the 
617.4   ineligibility period shall be combined and a penalty period 
617.5   calculated to begin ~~in~~ on the first day of the month after the 
617.6   month in which the first uncompensated transfer was made.  If 
617.7   the transfer was not reported to the local agency ~~at the time of~~ 
617.8   ~~application~~, and the applicant received medical assistance 
617.9   services during what would have been the period of ineligibility 
617.10  if the transfer had been reported, a cause of action exists 
617.11  against the transferee for the cost of medical assistance 
617.12  services provided during the period of ineligibility, or for the 
617.13  uncompensated amount of the transfer, whichever is less.  The 
617.14  action may be brought by the state or the local agency 
617.15  responsible for providing medical assistance under chapter 
617.16  256G.  The uncompensated transfer amount is the fair market 
617.17  value of the asset at the time it was given away, sold, or 
617.18  disposed of, less the amount of compensation received.  
617.19  Effective for transfers made on or after March 1, 1996, 
617.20  involving persons who apply for medical assistance on or after 
617.21  April 13, 1996, no cause of action exists for a transfer unless: 
617.22     (1) the transferee knew or should have known that the 
617.23  transfer was being made by a person who was a resident of a 
617.24  long-term care facility or was receiving that level of care in 
617.25  the community at the time of the transfer; 
617.26     (2) the transferee knew or should have known that the 
617.27  transfer was being made to assist the person to qualify for or 
617.28  retain medical assistance eligibility; or 
617.29     (3) the transferee actively solicited the transfer with 
617.30  intent to assist the person to qualify for or retain eligibility 
617.31  for medical assistance.  
617.32     (c) If a calculation of a penalty period results in a 
617.33  partial month, payments for long-term care services shall be 
617.34  reduced in an amount equal to the fraction, except that in 
617.35  calculating the value of uncompensated transfers, if the total 
617.36  value of all uncompensated transfers made in a month not 
618.1   included in an existing penalty period does not exceed $200, 
618.2   then such transfers shall be disregarded for each month prior to 
618.3   the month of application for or during receipt of medical 
618.4   assistance. 
618.5      <b>[EFFECTIVE DATE.]</b> Paragraph (b) of this section is 
618.6   effective July 1, 2003. 
618.7      Sec. 27.  Minnesota Statutes 2002, section 256B.0595, is 
618.8   amended by adding a subdivision to read: 
618.9      Subd. 2b.  [PERIOD OF INELIGIBILITY.] (a) Notwithstanding 
618.10  any contrary provisions of this section, this subdivision 
618.11  applies to transfers, including transfers to trusts, involving 
618.12  recipients of medical assistance that are made on or after July 
618.13  1, 2003, and to all transfers involving persons who apply for 
618.14  medical assistance on or after July 1, 2003, regardless of when 
618.15  the transfer occurred, except that this subdivision does not 
618.16  apply to transfers made prior to July 1, 2003.  For any 
618.17  uncompensated transfer occurring within 72 months prior to the 
618.18  date of application, at any time after application, or while 
618.19  eligible, the number of months of cumulative ineligibility for 
618.20  medical assistance services shall be the total uncompensated 
618.21  value of the assets and income transferred divided by the 
618.22  statewide average per-person nursing facility payment made by 
618.23  the state in effect at the time a penalty for a transfer is 
618.24  determined.  The amount used to calculate the average per-person 
618.25  nursing facility payment shall be adjusted each July 1 to 
618.26  reflect average payments for the previous calendar year.  For 
618.27  applicants, the period of ineligibility begins with the month in 
618.28  which the person applied for medical assistance and satisfied 
618.29  all other requirements for eligibility, or the first month the 
618.30  local agency becomes aware of the transfer and can give proper 
618.31  notice, if later.  For recipients, the period of ineligibility 
618.32  begins in the first month after the month the agency becomes 
618.33  aware of the transfer and can give proper notice, except that 
618.34  penalty periods for transfers made during a period of 
618.35  ineligibility as determined under this section shall begin in 
618.36  the month following the existing period of ineligibility.  If 
619.1   the transfer was not reported to the local agency, and the 
619.2   applicant received medical assistance services during what would 
619.3   have been the period of ineligibility if the transfer had been 
619.4   reported, a cause of action exists against the transferee for 
619.5   the cost of medical assistance services provided during the 
619.6   period of ineligibility or for the uncompensated amount of the 
619.7   transfer that was not recovered from the transferor through the 
619.8   implementation of a penalty period under this subdivision, 
619.9   whichever is less.  Recovery shall include the costs incurred 
619.10  due to the action.  The action may be brought by the state or 
619.11  the local agency responsible for providing medical assistance 
619.12  under chapter 256B.  The total uncompensated value is the fair 
619.13  market value of the income or asset at the time it was given 
619.14  away, sold, or disposed of, less the amount of compensation 
619.15  received.  No cause of action exists for a transfer unless: 
619.16     (1) the transferee knew or should have known that the 
619.17  transfer was being made by a person who was a resident of a 
619.18  long-term care facility or was receiving that level of care in 
619.19  the community at the time of the transfer; 
619.20     (2) the transferee knew or should have known that the 
619.21  transfer was being made to assist the person to qualify for or 
619.22  retain medical assistance eligibility; or 
619.23     (3) the transferee actively solicited the transfer with 
619.24  intent to assist the person to qualify for or retain eligibility 
619.25  for medical assistance. 
619.26     (b) If a calculation of a penalty period results in a 
619.27  partial month, payments for medical assistance services shall be 
619.28  reduced in an amount equal to the fraction, except that in 
619.29  calculating the value of uncompensated transfers, if the total 
619.30  value of all uncompensated transfers made in a month not 
619.31  included in an existing penalty period does not exceed $200, 
619.32  then such transfers shall be disregarded for each month prior to 
619.33  the month of application for or during receipt of medical 
619.34  assistance. 
619.35     (c) Ineligibility under this section shall apply to medical 
619.36  assistance services or long-term care services, whichever 
620.1   receives federal approval. 
620.2      <b>[EFFECTIVE DATE.]</b> (a) This section is effective July 1, 
620.3   2003, to the extent permitted by federal law.  If any provision 
620.4   of this section is prohibited by federal law, the provision 
620.5   shall become effective when federal law is changed to permit its 
620.6   application or a waiver is received.  The commissioner of human 
620.7   services shall notify the revisor of statutes when federal law 
620.8   is enacted or a waiver or other federal approval is received and 
620.9   publish a notice in the State Register.  The commissioner must 
620.10  include the notice in the first State Register published after 
620.11  the effective date of the federal changes. 
620.12     (b) If, by July 1, 2003, any provision of this section is 
620.13  not effective because of prohibitions in federal law, the 
620.14  commissioner of human services shall apply to the federal 
620.15  government by August 1, 2003, for a waiver of those prohibitions 
620.16  or other federal authority, and that provision shall become 
620.17  effective upon receipt of a federal waiver or other federal 
620.18  approval, notification to the revisor of statutes, and 
620.19  publication of a notice in the State Register to that effect.  
620.20  In applying for federal approval to extend the lookback period, 
620.21  the commissioner shall seek the longest lookback period the 
620.22  federal government will approve, not to exceed 72 months. 
620.23     Sec. 28.  Minnesota Statutes 2002, section 256B.0595, is 
620.24  amended by adding a subdivision to read: 
620.25     Subd. 3b.  [HOMESTEAD EXCEPTION TO TRANSFER 
620.26  PROHIBITION.] (a) This subdivision applies to transfers 
620.27  involving recipients of medical assistance that are made on or 
620.28  after July 1, 2003, and to all transfers involving persons who 
620.29  apply for medical assistance on or after July 1, 2003, 
620.30  regardless of when the transfer occurred, except that this 
620.31  subdivision does not apply to transfers made prior to July 1, 
620.32  2003.  A person is not ineligible for medical assistance 
620.33  services due to a transfer of assets for less than fair market 
620.34  value as described in subdivision 1b, if the asset transferred 
620.35  was a homestead, and: 
620.36     (1) a satisfactory showing is made that the individual 
621.1   intended to dispose of the homestead at fair market value or for 
621.2   other valuable consideration; or 
621.3      (2) the local agency grants a waiver of a penalty resulting 
621.4   from a transfer for less than fair market value because denial 
621.5   of eligibility would cause undue hardship for the individual and 
621.6   there exists an imminent threat to the individual's health and 
621.7   well-being.  Whenever an applicant or recipient is denied 
621.8   eligibility because of a transfer for less than fair market 
621.9   value, the local agency shall notify the applicant or recipient 
621.10  that the applicant or recipient may request a waiver of the 
621.11  penalty if the denial of eligibility will cause undue hardship.  
621.12  In evaluating a waiver, the local agency shall take into account 
621.13  whether the individual was the victim of financial exploitation, 
621.14  whether the individual has made reasonable efforts to recover 
621.15  the transferred property or resource, and other factors relevant 
621.16  to a determination of hardship.  If the local agency does not 
621.17  approve a hardship waiver, the local agency shall issue a 
621.18  written notice to the individual stating the reasons for the 
621.19  denial and the process for appealing the local agency's decision.
621.20     (b) When a waiver is granted under paragraph (a), clause 
621.21  (2), a cause of action exists against the person to whom the 
621.22  homestead was transferred for that portion of medical assistance 
621.23  services granted within 72 months of the date the transferor 
621.24  applied for medical assistance and satisfied all other 
621.25  requirements for eligibility or the amount of the uncompensated 
621.26  transfer, whichever is less, together with the costs incurred 
621.27  due to the action.  The action shall be brought by the state 
621.28  unless the state delegates this responsibility to the local 
621.29  agency responsible for providing medical assistance under 
621.30  chapter 256B. 
621.31     <b>[EFFECTIVE DATE.]</b> (a) This section is effective July 1, 
621.32  2003, to the extent permitted by federal law.  If any provision 
621.33  of this section is prohibited by federal law, the provision 
621.34  shall become effective when federal law is changed to permit its 
621.35  application or a waiver is received.  The commissioner of human 
621.36  services shall notify the revisor of statutes when federal law 
622.1   is enacted or a waiver or other federal approval is received and 
622.2   publish a notice in the State Register.  The commissioner must 
622.3   include the notice in the first State Register published after 
622.4   the effective date of the federal changes. 
622.5      (b) If, by July 1, 2003, any provision of this section is 
622.6   not effective because of prohibitions in federal law, the 
622.7   commissioner of human services shall apply to the federal 
622.8   government by August 1, 2003, for a waiver of those prohibitions 
622.9   or other federal authority, and that provision shall become 
622.10  effective upon receipt of a federal waiver or other federal 
622.11  approval, notification to the revisor of statutes, and 
622.12  publication of a notice in the State Register to that effect.  
622.13  In applying for federal approval to extend the lookback period, 
622.14  the commissioner shall seek the longest lookback period the 
622.15  federal government will approve, not to exceed 72 months. 
622.16     Sec. 29.  Minnesota Statutes 2002, section 256B.0595, is 
622.17  amended by adding a subdivision to read: 
622.18     Subd. 4b.  [OTHER EXCEPTIONS TO TRANSFER PROHIBITION.] This 
622.19  subdivision applies to transfers involving recipients of medical 
622.20  assistance that are made on or after July 1, 2003, and to all 
622.21  transfers involving persons who apply for medical assistance on 
622.22  or after July 1, 2003, regardless of when the transfer occurred, 
622.23  except that this subdivision does not apply to transfers made 
622.24  prior to July 1, 2003.  A person or a person's spouse who made a 
622.25  transfer prohibited by subdivision 1b is not ineligible for 
622.26  medical assistance services if one of the following conditions 
622.27  applies: 
622.28     (1) the assets or income were transferred to the 
622.29  individual's spouse or to another for the sole benefit of the 
622.30  spouse, except that after eligibility is established and the 
622.31  assets have been divided between the spouses as part of the 
622.32  asset allowance under section 256B.059, no further transfers 
622.33  between spouses may be made; 
622.34     (2) the institutionalized spouse, prior to being 
622.35  institutionalized, transferred assets or income to a spouse, 
622.36  provided that the spouse to whom the assets or income were 
623.1   transferred does not then transfer those assets or income to 
623.2   another person for less than fair market value.  At the time 
623.3   when one spouse is institutionalized, assets must be allocated 
623.4   between the spouses as provided under section 256B.059; 
623.5      (3) the assets or income were transferred to a trust for 
623.6   the sole benefit of the individual's child who is blind or 
623.7   permanently and totally disabled as determined in the 
623.8   supplemental security income program and the trust reverts to 
623.9   the state upon the disabled child's death to the extent the 
623.10  medical assistance has paid for services for the grantor or 
623.11  beneficiary of the trust.  This clause applies to a trust 
623.12  established after the commissioner publishes a notice in the 
623.13  State Register that the commissioner has been authorized to 
623.14  implement this clause due to a change in federal law or the 
623.15  approval of a federal waiver; 
623.16     (4) a satisfactory showing is made that the individual 
623.17  intended to dispose of the assets or income either at fair 
623.18  market value or for other valuable consideration; or 
623.19     (5) the local agency determines that denial of eligibility 
623.20  for medical assistance services would cause undue hardship and 
623.21  grants a waiver of a penalty resulting from a transfer for less 
623.22  than fair market value because there exists an imminent threat 
623.23  to the individual's health and well-being.  Whenever an 
623.24  applicant or recipient is denied eligibility because of a 
623.25  transfer for less than fair market value, the local agency shall 
623.26  notify the applicant or recipient that the applicant or 
623.27  recipient may request a waiver of the penalty if the denial of 
623.28  eligibility will cause undue hardship.  In evaluating a waiver, 
623.29  the local agency shall take into account whether the individual 
623.30  was the victim of financial exploitation, whether the individual 
623.31  has made reasonable efforts to recover the transferred property 
623.32  or resource, and other factors relevant to a determination of 
623.33  hardship.  If the local agency does not approve a hardship 
623.34  waiver, the local agency shall issue a written notice to the 
623.35  individual stating the reasons for the denial and the process 
623.36  for appealing the local agency's decision.  When a waiver is 
624.1   granted, a cause of action exists against the person to whom the 
624.2   assets were transferred for that portion of medical assistance 
624.3   services granted within 72 months of the date the transferor 
624.4   applied for medical assistance and satisfied all other 
624.5   requirements for eligibility, or the amount of the uncompensated 
624.6   transfer, whichever is less, together with the costs incurred 
624.7   due to the action.  The action shall be brought by the state 
624.8   unless the state delegates this responsibility to the local 
624.9   agency responsible for providing medical assistance under this 
624.10  chapter. 
624.11     <b>[EFFECTIVE DATE.]</b> (a) This section is effective July 1, 
624.12  2003, to the extent permitted by federal law.  If any provision 
624.13  of this section is prohibited by federal law, the provision 
624.14  shall become effective when federal law is changed to permit its 
624.15  application or a waiver is received.  The commissioner of human 
624.16  services shall notify the revisor of statutes when federal law 
624.17  is enacted or a waiver or other federal approval is received and 
624.18  publish a notice in the State Register.  The commissioner must 
624.19  include the notice in the first State Register published after 
624.20  the effective date of the federal changes. 
624.21     (b) If, by July 1, 2003, any provision of this section is 
624.22  not effective because of prohibitions in federal law, the 
624.23  commissioner of human services shall apply to the federal 
624.24  government by August 1, 2003, for a waiver of those prohibitions 
624.25  or other federal authority, and that provision shall become 
624.26  effective upon receipt of a federal waiver or other federal 
624.27  approval, notification to the revisor of statutes, and 
624.28  publication of a notice in the State Register to that effect.  
624.29  In applying for federal approval to extend the lookback period, 
624.30  the commissioner shall seek the longest lookback period the 
624.31  federal government will approve, not to exceed 72 months. 
624.32     Sec. 30.  [256B.0596] [MENTAL HEALTH CASE MANAGEMENT.] 
624.33     Counties shall contract with eligible providers willing to 
624.34  provide mental health case management services under section 
624.35  256B.0625, subdivision 20.  In order to be eligible, in addition 
624.36  to general provider requirements under this chapter, the 
625.1   provider must: 
625.2      (1) be willing to provide the mental health case management 
625.3   services; and 
625.4      (2) have a minimum of at least one contact with the client 
625.5   per week. 
625.6      Sec. 31.  Minnesota Statutes 2002, section 256B.06, 
625.7   subdivision 4, is amended to read: 
625.8      Subd. 4.  [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 
625.9   medical assistance is limited to citizens of the United States, 
625.10  qualified noncitizens as defined in this subdivision, and other 
625.11  persons residing lawfully in the United States. 
625.12     (b) "Qualified noncitizen" means a person who meets one of 
625.13  the following immigration criteria: 
625.14     (1) admitted for lawful permanent residence according to 
625.15  United States Code, title 8; 
625.16     (2) admitted to the United States as a refugee according to 
625.17  United States Code, title 8, section 1157; 
625.18     (3) granted asylum according to United States Code, title 
625.19  8, section 1158; 
625.20     (4) granted withholding of deportation according to United 
625.21  States Code, title 8, section 1253(h); 
625.22     (5) paroled for a period of at least one year according to 
625.23  United States Code, title 8, section 1182(d)(5); 
625.24     (6) granted conditional entrant status according to United 
625.25  States Code, title 8, section 1153(a)(7); 
625.26     (7) determined to be a battered noncitizen by the United 
625.27  States Attorney General according to the Illegal Immigration 
625.28  Reform and Immigrant Responsibility Act of 1996, title V of the 
625.29  Omnibus Consolidated Appropriations Bill, Public Law ~~Number~~ 
625.30  104-200; 
625.31     (8) is a child of a noncitizen determined to be a battered 
625.32  noncitizen by the United States Attorney General according to 
625.33  the Illegal Immigration Reform and Immigrant Responsibility Act 
625.34  of 1996, title V, of the Omnibus Consolidated Appropriations 
625.35  Bill, Public Law ~~Number~~ 104-200; or 
625.36     (9) determined to be a Cuban or Haitian entrant as defined 
626.1   in section 501(e) of Public Law ~~Number~~ 96-422, the Refugee 
626.2   Education Assistance Act of 1980. 
626.3      (c) All qualified noncitizens who were residing in the 
626.4   United States before August 22, 1996, who otherwise meet the 
626.5   eligibility requirements of chapter 256B, are eligible for 
626.6   medical assistance with federal financial participation. 
626.7      (d) All qualified noncitizens who entered the United States 
626.8   on or after August 22, 1996, and who otherwise meet the 
626.9   eligibility requirements of chapter 256B, are eligible for 
626.10  medical assistance with federal financial participation through 
626.11  November 30, 1996. 
626.12     Beginning December 1, 1996, qualified noncitizens who 
626.13  entered the United States on or after August 22, 1996, and who 
626.14  otherwise meet the eligibility requirements of chapter 256B are 
626.15  eligible for medical assistance with federal participation for 
626.16  five years if they meet one of the following criteria: 
626.17     (i) refugees admitted to the United States according to 
626.18  United States Code, title 8, section 1157; 
626.19     (ii) persons granted asylum according to United States 
626.20  Code, title 8, section 1158; 
626.21     (iii) persons granted withholding of deportation according 
626.22  to United States Code, title 8, section 1253(h); 
626.23     (iv) veterans of the United States Armed Forces with an 
626.24  honorable discharge for a reason other than noncitizen status, 
626.25  their spouses and unmarried minor dependent children; or 
626.26     (v) persons on active duty in the United States Armed 
626.27  Forces, other than for training, their spouses and unmarried 
626.28  minor dependent children. 
626.29     Beginning December 1, 1996, qualified noncitizens who do 
626.30  not meet one of the criteria in items (i) to (v) are eligible 
626.31  for medical assistance without federal financial participation 
626.32  as described in paragraph (j). 
626.33     (e) Noncitizens who are not qualified noncitizens as 
626.34  defined in paragraph (b), who are lawfully residing in the 
626.35  United States and who otherwise meet the eligibility 
626.36  requirements of chapter 256B, are eligible for medical 
627.1   assistance under clauses (1) to (3).  These individuals must 
627.2   cooperate with the Immigration and Naturalization Service to 
627.3   pursue any applicable immigration status, including citizenship, 
627.4   that would qualify them for medical assistance with federal 
627.5   financial participation. 
627.6      (1) Persons who were medical assistance recipients on 
627.7   August 22, 1996, are eligible for medical assistance with 
627.8   federal financial participation through December 31, 1996. 
627.9      (2) Beginning January 1, 1997, persons described in clause 
627.10  (1) are eligible for medical assistance without federal 
627.11  financial participation as described in paragraph (j). 
627.12     (3) Beginning December 1, 1996, persons residing in the 
627.13  United States prior to August 22, 1996, who were not receiving 
627.14  medical assistance and persons who arrived on or after August 
627.15  22, 1996, are eligible for medical assistance without federal 
627.16  financial participation as described in paragraph (j). 
627.17     (f) Nonimmigrants who otherwise meet the eligibility 
627.18  requirements of chapter 256B are eligible for the benefits as 
627.19  provided in paragraphs (g) to (i).  For purposes of this 
627.20  subdivision, a "nonimmigrant" is a person in one of the classes 
627.21  listed in United States Code, title 8, section 1101(a)(15). 
627.22     (g) Payment shall also be made for care and services that 
627.23  are furnished to noncitizens, regardless of immigration status, 
627.24  who otherwise meet the eligibility requirements of chapter 256B, 
627.25  if such care and services are necessary for the treatment of an 
627.26  emergency medical condition, except for organ transplants and 
627.27  related care and services and routine prenatal care.  
627.28     (h) For purposes of this subdivision, the term "emergency 
627.29  medical condition" means a medical condition that meets the 
627.30  requirements of United States Code, title 42, section 1396b(v). 
627.31     (i) Pregnant noncitizens who are undocumented or 
627.32  nonimmigrants, who otherwise meet the eligibility requirements 
627.33  of chapter 256B, are eligible for medical assistance payment 
627.34  without federal financial participation for care and services 
627.35  through the period of pregnancy, and 60 days postpartum, except 
627.36  for labor and delivery.  
628.1      (j) Qualified noncitizens as described in paragraph (d), 
628.2   and all other noncitizens lawfully residing in the United States 
628.3   as described in paragraph (e), who are ineligible for medical 
628.4   assistance with federal financial participation and who 
628.5   otherwise meet the eligibility requirements of chapter 256B and 
628.6   of this paragraph, are eligible for medical assistance without 
628.7   federal financial participation.  Qualified noncitizens as 
628.8   described in paragraph (d) are only eligible for medical 
628.9   assistance without federal financial participation for five 
628.10  years from their date of entry into the United States.  
628.11     (k) ~~The commissioner shall submit to the legislature by~~ 
628.12  ~~December 31, 1998, a report on the number of recipients and cost~~ 
628.13  ~~of coverage of care and services made according to paragraphs~~ 
628.14  ~~(i) and (j).~~  Beginning October 1, 2003, persons who are 
628.15  receiving care and rehabilitation services from a nonprofit 
628.16  center established to serve victims of torture and are otherwise 
628.17  ineligible for medical assistance under chapter 256B or general 
628.18  assistance medical care under section 256D.03 are eligible for 
628.19  medical assistance without federal financial participation.  
628.20  These individuals are eligible only for the period during which 
628.21  they are receiving services from the center.  Individuals 
628.22  eligible under this clause shall not be required to participate 
628.23  in prepaid medical assistance. 
628.24     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
628.25  except where a different date is specified in the text. 
628.26     Sec. 32.  Minnesota Statutes 2002, section 256B.061, is 
628.27  amended to read: 
628.28     256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 
628.29     ~~(a)~~ If any individual has been determined to be eligible 
628.30  for medical assistance, it will be made available for care and 
628.31  services included under the plan and furnished in or after the 
628.32  third month before the month in which the individual made 
628.33  application for such assistance, if such individual was, or upon 
628.34  application would have been, eligible for medical assistance at 
628.35  the time the care and services were furnished.  The commissioner 
628.36  may limit, restrict, or suspend the eligibility of an individual 
629.1   for up to one year upon that individual's conviction of a 
629.2   criminal offense related to application for or receipt of 
629.3   medical assistance benefits. 
629.4      ~~(b) On the basis of information provided on the completed~~ 
629.5   ~~application, an applicant who meets the following criteria shall~~ 
629.6   ~~be determined eligible beginning in the month of application:~~ 
629.7      ~~(1) whose gross income is less than 90 percent of the~~ 
629.8   ~~applicable income standard;~~ 
629.9      ~~(2) whose total liquid assets are less than 90 percent of~~ 
629.10  ~~the asset limit;~~ 
629.11     ~~(3) does not reside in a long-term care facility; and~~ 
629.12     ~~(4) meets all other eligibility requirements.~~ 
629.13  ~~The applicant must provide all required verifications within 30~~ 
629.14  ~~days' notice of the eligibility determination or eligibility~~ 
629.15  ~~shall be terminated.~~ 
629.16     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
629.17  or upon federal approval, whichever is later. 
629.18     Sec. 33.  Minnesota Statutes 2002, section 256B.0625, 
629.19  subdivision 5a, is amended to read: 
629.20     Subd. 5a.  [INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY 
629.21  SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS.] ~~(a)~~  
629.22  [COVERAGE.] Medical assistance covers home-based intensive early 
629.23  intervention behavior therapy for children with autism spectrum 
629.24  disorders, effective July 1, 2007.  Children with autism 
629.25  spectrum disorder, and their custodial parents or foster 
629.26  parents, may access other covered services to treat autism 
629.27  spectrum disorder, and are not required to receive intensive 
629.28  early intervention behavior therapy services under this 
629.29  subdivision.  Intensive early intervention behavior therapy does 
629.30  not include coverage for services to treat developmental 
629.31  disorders of language, early onset psychosis, Rett's disorder, 
629.32  selective mutism, social anxiety disorder, stereotypic movement 
629.33  disorder, dementia, obsessive compulsive disorder, schizoid 
629.34  personality disorder, avoidant personality disorder, or reactive 
629.35  attachment disorder.  If a child with autism spectrum disorder 
629.36  is diagnosed to have one or more of these conditions, intensive 
630.1   early intervention behavior therapy includes coverage only for 
630.2   services necessary to treat the autism spectrum disorder. 
630.3      ~~(b)~~ Subd. 5b.  [PURPOSE OF INTENSIVE EARLY INTERVENTION 
630.4   BEHAVIOR THERAPY SERVICES (IEIBTS).] The purpose of IEIBTS is to 
630.5   improve the child's behavioral functioning, to prevent 
630.6   development of challenging behaviors, to eliminate autistic 
630.7   behaviors, to reduce the risk of out-of-home placement, and to 
630.8   establish independent typical functioning in language and social 
630.9   behavior.  The procedures used to accomplish these goals are 
630.10  based upon research in applied behavior analysis. 
630.11     ~~(c)~~ Subd. 5c.  [ELIGIBLE CHILDREN.] A child is eligible to 
630.12  initiate IEIBTS if, the child meets the additional eligibility 
630.13  criteria in paragraph (d) and in a diagnostic assessment by a 
630.14  mental health professional who is not under the employ of the 
630.15  service provider, the child: 
630.16     (1) is found to have an autism spectrum disorder; 
630.17     (2) has a current IQ of either untestable, or at least 30; 
630.18     (3) if nonverbal, initiated behavior therapy by 42 months 
630.19  of age; 
630.20     (4) if verbal, initiated behavior therapy by 48 months of 
630.21  age; or 
630.22     (5) if having an IQ of at least 50, initiated behavior 
630.23  therapy by 84 months of age. 
630.24  To continue after six-month individualized treatment plan (ITP) 
630.25  reviews, at least one of the child's custodial parents or foster 
630.26  parents must participate in an average of at least five hours of 
630.27  documented behavior therapy per week for six months, and 
630.28  consistently implement behavior therapy recommendations 24 hours 
630.29  a day.  To continue after six-month individualized treatment 
630.30  plan (ITP) reviews, the child must show documented progress 
630.31  toward mastery of six-month benchmark behavior objectives.  The 
630.32  maximum number of months during which services may be billed is 
630.33  54, or up to the month of August in the first year in which the 
630.34  child completes first grade, whichever comes last.  If 
630.35  significant progress towards treatment goals has not been 
630.36  achieved after 24 months of treatment, treatment must be 
631.1   discontinued. 
631.2      ~~(d)~~ Subd. 5d.  [ADDITIONAL ELIGIBILITY CRITERIA.] A child 
631.3   is eligible to initiate IEIBTS if: 
631.4      (1) in medical and diagnostic assessments by medical and 
631.5   mental health professionals, it is determined that the child 
631.6   does not have severe or profound mental retardation; 
631.7      (2) an accurate assessment of the child's hearing has been 
631.8   performed, including audiometry if the brain stem auditory 
631.9   evokes response; 
631.10     (3) a blood lead test has been performed prior to 
631.11  initiation of treatment; and 
631.12     (4) an EEG or neurologic evaluation is done, prior to 
631.13  initiation of treatment, if the child has a history of staring 
631.14  spells or developmental regression.  
631.15     ~~(e)~~ Subd. 5e.  [COVERED SERVICES.] The focus of IEIBTS must 
631.16  be to treat the principal diagnostic features of the autism 
631.17  spectrum disorder.  All IEIBTS must be delivered by a team of 
631.18  practitioners under the consistent supervision of a single 
631.19  clinical supervisor.  A mental health professional must develop 
631.20  the ITP for IEIBTS.  The ITP must include six-month benchmark 
631.21  behavior objectives.  All behavior therapy must be based upon 
631.22  research in applied behavior analysis, with an emphasis upon 
631.23  positive reinforcement of carefully task-analyzed skills for 
631.24  optimum rates of progress.  All behavior therapy must be 
631.25  consistently applied and generalized throughout the 24-hour day 
631.26  and seven-day week by all of the child's regular care 
631.27  providers.  When placing the child in school activities, a 
631.28  majority of the peers must have no mental health diagnosis, and 
631.29  the child must have sufficient social skills to succeed with 80 
631.30  percent of the school activities.  Reactive consequences, such 
631.31  as redirection, correction, positive practice, or time-out, must 
631.32  be used only when necessary to improve the child's success when 
631.33  proactive procedures alone have not been effective.  IEIBTS must 
631.34  be delivered by a team of behavior therapy practitioners who are 
631.35  employed under the direction of the same agency.  The team may 
631.36  deliver up to 200 billable hours per year of direct clinical 
632.1   supervisor services, up to 700 billable hours per year of senior 
632.2   behavior therapist services, and up to 1,800 billable hours per 
632.3   year of direct behavior therapist services.  A one-hour clinical 
632.4   review meeting for the child, parents, and staff must be 
632.5   scheduled 50 weeks a year, at which behavior therapy is reviewed 
632.6   and planned.  At least one-quarter of the annual clinical 
632.7   supervisor billable hours shall consist of on-site clinical 
632.8   meeting time.  At least one-half of the annual senior behavior 
632.9   therapist billable hours shall consist of direct services to the 
632.10  child or parents.  All of the behavioral therapist billable 
632.11  hours shall consist of direct on-site services to the child or 
632.12  parents.  None of the senior behavior therapist billable hours 
632.13  or behavior therapist billable hours shall consist of clinical 
632.14  meeting time.  If there is any regression of the autistic 
632.15  spectrum disorder after 12 months of therapy, a neurologic 
632.16  consultation must be performed. 
632.17     ~~(f)~~ Subd. 5f.  [PROVIDER QUALIFICATIONS.] The provider 
632.18  agency must be capable of delivering consistent applied behavior 
632.19  analysis (ABA) based behavior therapy in the home.  The site 
632.20  director of the agency must be a mental health professional and 
632.21  a board certified behavior analyst certified by the behavior 
632.22  analyst certification board.  Each clinical supervisor must be a 
632.23  certified associate behavior analyst certified by the behavior 
632.24  analyst certification board or have equivalent experience in 
632.25  applied behavior analysis. 
632.26     ~~(g)~~ Subd. 5g.  [SUPERVISION REQUIREMENTS.] (1) Each 
632.27  behavior therapist practitioner must be continuously supervised 
632.28  while in the home until the practitioner has mastered 
632.29  competencies for independent practice.  Each behavior therapist 
632.30  must have mastered three credits of academic content and 
632.31  practice in an applied behavior analysis sequence at an 
632.32  accredited university before providing more than 12 months of 
632.33  therapy.  A college degree or minimum hours of experience are 
632.34  not required.  Each behavior therapist must continue training 
632.35  through weekly direct observation by the senior behavior 
632.36  therapist, through demonstrated performance in clinical meetings 
633.1   with the clinical supervisor, and annual training in applied 
633.2   behavior analysis. 
633.3      (2) Each senior behavior therapist practitioner must have 
633.4   mastered the senior behavior therapy competencies, completed one 
633.5   year of practice as a behavior therapist, and six months of 
633.6   co-therapy training with another senior behavior therapist or 
633.7   have an equivalent amount of experience in applied behavior 
633.8   analysis.  Each senior behavior therapist must have mastered 12 
633.9   credits of academic content and practice in an applied behavior 
633.10  analysis sequence at an accredited university before providing 
633.11  more than 12 months of senior behavior therapy.  Each senior 
633.12  behavior therapist must continue training through demonstrated 
633.13  performance in clinical meetings with the clinical supervisor, 
633.14  and annual training in applied behavior analysis. 
633.15     (3) Each clinical supervisor practitioner must have 
633.16  mastered the clinical supervisor and family consultation 
633.17  competencies, completed two years of practice as a senior 
633.18  behavior therapist and one year of co-therapy training with 
633.19  another clinical supervisor, or equivalent experience in applied 
633.20  behavior analysis.  Each clinical supervisor must continue 
633.21  training through annual training in applied behavior analysis. 
633.22     ~~(h)~~ Subd. 5h.  [PLACE OF SERVICE.] IEIBTS are provided 
633.23  primarily in the child's home and community.  Services may be 
633.24  provided in the child's natural school or preschool classroom, 
633.25  home of a relative, natural recreational setting, or day care. 
633.26     ~~(i)~~ Subd. 5i.  [PRIOR AUTHORIZATION REQUIREMENTS.] Prior 
633.27  authorization shall be required for services provided after 200 
633.28  hours of clinical supervisor, 700 hours of senior behavior 
633.29  therapist, or 1,800 hours of behavior therapist services per 
633.30  year. 
633.31     ~~(j)~~ Subd. 5j.  [PAYMENT RATES.] The following payment rates 
633.32  apply: 
633.33     (1) for an IEIBTS clinical supervisor practitioner under 
633.34  supervision of a mental health professional, the lower of the 
633.35  submitted charge or $67 per hour unit; 
633.36     (2) for an IEIBTS senior behavior therapist practitioner 
634.1   under supervision of a mental health professional, the lower of 
634.2   the submitted charge or $37 per hour unit; or 
634.3      (3) for an IEIBTS behavior therapist practitioner under 
634.4   supervision of a mental health professional, the lower of the 
634.5   submitted charge or $27 per hour unit. 
634.6   An IEIBTS practitioner may receive payment for travel time which 
634.7   exceeds 50 minutes one-way.  The maximum payment allowed will be 
634.8   $0.51 per minute for up to a maximum of 300 hours per year. 
634.9      For any week during which the above charges are made to 
634.10  medical assistance, payments for the following services are 
634.11  excluded:  supervising mental health professional hours and 
634.12  personal care attendant, home-based mental health, 
634.13  family-community support, or mental health behavioral aide hours.
634.14     ~~(k)~~ Subd. 5k.  [REPORT.] The commissioner shall collect 
634.15  evidence of the effectiveness of intensive early intervention 
634.16  behavior therapy services and present a report to the 
634.17  legislature by July 1, ~~2006~~ 2010. 
634.18     Sec. 34.  Minnesota Statutes 2002, section 256B.0625, 
634.19  subdivision 9, is amended to read: 
634.20     Subd. 9.  [DENTAL SERVICES.] (a) Medical assistance covers 
634.21  dental services.  Dental services include, with prior 
634.22  authorization, fixed bridges that are cost-effective for persons 
634.23  who cannot use removable dentures because of their medical 
634.24  condition.  
634.25     (b) Coverage of dental services for adults age 21 and over 
634.26  who are not pregnant is subject to a $500 annual benefit limit 
634.27  and covered services are limited to:  
634.28     (1) diagnostic and preventative services; 
634.29     (2) basic restorative services; and 
634.30     (3) emergency services. 
634.31     Emergency services, dentures, and extractions related to 
634.32  dentures are not included in the $500 annual benefit limit. 
634.33     Sec. 35.  Minnesota Statutes 2002, section 256B.0625, 
634.34  subdivision 13, is amended to read: 
634.35     Subd. 13.  [DRUGS.] (a) Medical assistance covers drugs, 
634.36  except for fertility drugs when specifically used to enhance 
635.1   fertility, if prescribed by a licensed practitioner and 
635.2   dispensed by a licensed pharmacist, by a physician enrolled in 
635.3   the medical assistance program as a dispensing physician, or by 
635.4   a physician or a nurse practitioner employed by or under 
635.5   contract with a community health board as defined in section 
635.6   145A.02, subdivision 5, for the purposes of communicable disease 
635.7   control.  
635.8      (b) The dispensed quantity of a prescription drug must not 
635.9   exceed a 34-day supply, unless authorized by the commissioner.  
635.10     (c) Medical assistance covers the following 
635.11  over-the-counter drugs when prescribed by a licensed 
635.12  practitioner or by a licensed pharmacist who meets standards 
635.13  established by the commissioner, in consultation with the board 
635.14  of pharmacy:  antacids, acetaminophen, family planning products, 
635.15  aspirin, insulin, products for the treatment of lice, vitamins 
635.16  for adults with documented vitamin deficiencies, vitamins for 
635.17  children under the age of seven and pregnant or nursing women, 
635.18  and any other over-the-counter drug identified by the 
635.19  commissioner, in consultation with the formulary committee, as 
635.20  necessary, appropriate, and cost-effective for the treatment of 
635.21  certain specified chronic diseases, conditions, or disorders, 
635.22  and this determination shall not be subject to the requirements 
635.23  of chapter 14.  A pharmacist may prescribe over-the-counter 
635.24  medications as provided under this paragraph for purposes of 
635.25  receiving reimbursement under Medicaid.  When prescribing 
635.26  over-the-counter drugs under this paragraph, licensed 
635.27  pharmacists must consult with the recipient to determine 
635.28  necessity, provide drug counseling, review drug therapy for 
635.29  potential adverse interactions, and make referrals as needed to 
635.30  other health care professionals. 
635.31     Subd. 13c.  [FORMULARY COMMITTEE.] The commissioner, after 
635.32  receiving recommendations from professional medical associations 
635.33  and professional ~~pharmacist~~ pharmacy associations, and consumer 
635.34  groups shall designate a formulary committee to ~~advise the~~ 
635.35  ~~commissioner on the names of drugs for which payment is made,~~ 
635.36  ~~recommend a system for reimbursing providers on a set fee or~~ 
636.1   ~~charge basis rather than the present system, and develop methods~~ 
636.2   ~~encouraging use of generic drugs when they are less expensive~~ 
636.3   ~~and equally effective as trademark drugs.  The formulary~~ 
636.4   ~~committee shall consist of nine members, four of whom shall be~~ 
636.5   ~~physicians who are not employed by the department of human~~ 
636.6   ~~services, and a majority of whose practice is for persons paying~~ 
636.7   ~~privately or through health insurance, three of whom shall be~~ 
636.8   ~~pharmacists who are not employed by the department of human~~ 
636.9   ~~services, and a majority of whose practice is for persons paying~~ 
636.10  ~~privately or through health insurance, a consumer~~ 
636.11  ~~representative, and a nursing home representative~~ carry out 
636.12  duties as described in subdivisions 13 to 13g.  The formulary 
636.13  committee shall be comprised of four licensed physicians 
636.14  actively engaged in the practice of medicine in Minnesota one of 
636.15  whom must be actively engaged in the treatment of persons with 
636.16  mental illness; at least three licensed pharmacists actively 
636.17  engaged in the practice of pharmacy in Minnesota; and one 
636.18  consumer representative; the remainder to be made up of health 
636.19  care professionals who are licensed in their field and have 
636.20  recognized knowledge in the clinically appropriate prescribing, 
636.21  dispensing, and monitoring of covered outpatient drugs.  Members 
636.22  of the formulary committee shall not be employed by the 
636.23  department of human services.  Committee members shall serve 
636.24  three-year terms and ~~shall serve without compensation.  Members~~ 
636.25  may be reappointed ~~once~~ by the commissioner.  The formulary 
636.26  committee shall meet at least quarterly.  The commissioner may 
636.27  require more frequent formulary committee meetings as needed.  
636.28  An honorarium of $100 per meeting and reimbursement for mileage 
636.29  shall be paid to each committee member in attendance.  
636.30     Subd. 13d.  [DRUG FORMULARY.] ~~(b)~~ The commissioner shall 
636.31  establish a drug formulary.  Its establishment and publication 
636.32  shall not be subject to the requirements of the Administrative 
636.33  Procedure Act, but the formulary committee shall review and 
636.34  comment on the formulary contents.  
636.35     The formulary shall not include:  
636.36     ~~(i)~~ (1) drugs or products for which there is no federal 
637.1   funding; 
637.2      ~~(ii)~~ (2) over-the-counter drugs, except ~~for antacids,~~ 
637.3   ~~acetaminophen, family planning products, aspirin, insulin,~~ 
637.4   ~~products for the treatment of lice, vitamins for adults with~~ 
637.5   ~~documented vitamin deficiencies, vitamins for children under the~~ 
637.6   ~~age of seven and pregnant or nursing women, and any other~~ 
637.7   ~~over-the-counter drug identified by the commissioner, in~~ 
637.8   ~~consultation with the drug formulary committee, as necessary,~~ 
637.9   ~~appropriate, and cost-effective for the treatment of certain~~ 
637.10  ~~specified chronic diseases, conditions or disorders, and this~~ 
637.11  ~~determination shall not be subject to the requirements of~~ 
637.12  ~~chapter 14~~ as provided in subdivision 13; 
637.13     ~~(iii) anorectics, except that medically necessary~~ 
637.14  ~~anorectics shall be covered for a recipient previously diagnosed~~ 
637.15  ~~as having pickwickian syndrome and currently diagnosed as having~~ 
637.16  ~~diabetes and being morbidly obese~~ (3) drugs used for weight 
637.17  loss, except that medically necessary lipase inhibitors may be 
637.18  covered for a recipient with type II diabetes; 
637.19     ~~(iv)~~ (4) drugs for which medical value has not been 
637.20  established; and 
637.21     ~~(v)~~ (5) drugs from manufacturers who have not signed a 
637.22  rebate agreement with the Department of Health and Human 
637.23  Services pursuant to section 1927 of title XIX of the Social 
637.24  Security Act. 
637.25     ~~The commissioner shall publish conditions for prohibiting~~ 
637.26  ~~payment for specific drugs after considering the formulary~~ 
637.27  ~~committee's recommendations.  An honorarium of $100 per meeting~~ 
637.28  ~~and reimbursement for mileage shall be paid to each committee~~ 
637.29  ~~member in attendance.~~  
637.30     Subd. 13e.  [PAYMENT RATES.] ~~(c)~~ (a) The basis for 
637.31  determining the amount of payment shall be the lower of the 
637.32  actual acquisition costs of the drugs plus a fixed dispensing 
637.33  fee; the maximum allowable cost set by the federal government or 
637.34  by the commissioner plus the fixed dispensing fee; or the usual 
637.35  and customary price charged to the public.  The amount of 
637.36  payment basis must be reduced to reflect all discount amounts 
638.1   applied to the charge by any provider/insurer agreement or 
638.2   contract for submitted charges to medical assistance programs.  
638.3   The net submitted charge may not be greater than the patient 
638.4   liability for the service.  The pharmacy dispensing fee shall be 
638.5   $3.65, except that the dispensing fee for intravenous solutions 
638.6   which must be compounded by the pharmacist shall be $8 per bag, 
638.7   $14 per bag for cancer chemotherapy products, and $30 per bag 
638.8   for total parenteral nutritional products dispensed in one liter 
638.9   quantities, or $44 per bag for total parenteral nutritional 
638.10  products dispensed in quantities greater than one liter.  Actual 
638.11  acquisition cost includes quantity and other special discounts 
638.12  except time and cash discounts.  The actual acquisition cost of 
638.13  a drug shall be estimated by the commissioner, at average 
638.14  wholesale price minus ~~nine~~ 11.5 percent, except that where a 
638.15  drug has had its wholesale price reduced as a result of the 
638.16  actions of the National Association of Medicaid Fraud Control 
638.17  Units, the estimated actual acquisition cost shall be the 
638.18  reduced average wholesale price, without the ~~nine~~ 11.5 percent 
638.19  deduction.  The maximum allowable cost of a multisource drug may 
638.20  be set by the commissioner and it shall be comparable to, but no 
638.21  higher than, the maximum amount paid by other third-party payors 
638.22  in this state who have maximum allowable cost programs.  ~~The~~ 
638.23  ~~commissioner shall set maximum allowable costs for multisource~~ 
638.24  ~~drugs that are not on the federal upper limit list as described~~ 
638.25  ~~in United States Code, title 42, chapter 7, section 1396r-8(e),~~ 
638.26  ~~the Social Security Act, and Code of Federal Regulations, title~~ 
638.27  ~~42, part 447, section 447.332.~~  Establishment of the amount of 
638.28  payment for drugs shall not be subject to the requirements of 
638.29  the Administrative Procedure Act.  
638.30     (b) An additional dispensing fee of $.30 may be added to 
638.31  the dispensing fee paid to pharmacists for legend drug 
638.32  prescriptions dispensed to residents of long-term care 
638.33  facilities when a unit dose blister card system, approved by the 
638.34  department, is used.  Under this type of dispensing system, the 
638.35  pharmacist must dispense a 30-day supply of drug.  The National 
638.36  Drug Code (NDC) from the drug container used to fill the blister 
639.1   card must be identified on the claim to the department.  The 
639.2   unit dose blister card containing the drug must meet the 
639.3   packaging standards set forth in Minnesota Rules, part 
639.4   6800.2700, that govern the return of unused drugs to the 
639.5   pharmacy for reuse.  The pharmacy provider will be required to 
639.6   credit the department for the actual acquisition cost of all 
639.7   unused drugs that are eligible for reuse.  Over-the-counter 
639.8   medications must be dispensed in the manufacturer's unopened 
639.9   package.  The commissioner may permit the drug clozapine to be 
639.10  dispensed in a quantity that is less than a 30-day supply.  
639.11     (c) Whenever a generically equivalent product is available, 
639.12  payment shall be on the basis of the actual acquisition cost of 
639.13  the generic drug, ~~unless the prescriber specifically indicates~~ 
639.14  ~~"dispense as written - brand necessary" on the prescription as~~ 
639.15  ~~required by section 151.21, subdivision 2~~ or on the maximum 
639.16  allowable cost established by the commissioner. 
639.17     (d) ~~For purposes of this subdivision, "multisource drugs"~~ 
639.18  ~~means covered outpatient drugs, excluding innovator multisource~~ 
639.19  ~~drugs for which there are two or more drug products, which:~~ 
639.20     ~~(1) are related as therapeutically equivalent under the~~ 
639.21  ~~Food and Drug Administration's most recent publication of~~ 
639.22  ~~"Approved Drug Products with Therapeutic Equivalence~~ 
639.23  ~~Evaluations";~~ 
639.24     ~~(2) are pharmaceutically equivalent and bioequivalent as~~ 
639.25  ~~determined by the Food and Drug Administration; and~~ 
639.26     ~~(3) are sold or marketed in Minnesota.~~ 
639.27  ~~"Innovator multisource drug" means a multisource drug that was~~ 
639.28  ~~originally marketed under an original new drug application~~ 
639.29  ~~approved by the Food and Drug Administration.~~ 
639.30     ~~(e)~~ The basis for determining the amount of payment for 
639.31  drugs administered in an outpatient setting shall be the lower 
639.32  of the usual and customary cost submitted by the provider, the 
639.33  average wholesale price minus five percent, or the maximum 
639.34  allowable cost set by the federal government under United States 
639.35  Code, title 42, chapter 7, section 1396r-8(e), and Code of 
639.36  Federal Regulations, title 42, section 447.332, or by the 
640.1   commissioner under paragraphs (a) to (c). 
640.2      Subd. 13f.  [PRIOR AUTHORIZATION.] (a) The formulary 
640.3   committee shall review and recommend drugs which require prior 
640.4   authorization.  ~~The formulary committee may recommend drugs for~~ 
640.5   ~~prior authorization directly to the commissioner, as long as~~ 
640.6   ~~opportunity for public input is provided.  Prior authorization~~ 
640.7   ~~may be requested by the commissioner based on medical and~~ 
640.8   ~~clinical criteria and on cost before certain drugs are eligible~~ 
640.9   ~~for payment.  Before a drug may be considered for prior~~ 
640.10  ~~authorization at the request of the commissioner:~~ 
640.11     ~~(1) the drug formulary committee must develop criteria to~~ 
640.12  ~~be used for identifying drugs; the development of these criteria~~ 
640.13  ~~is not subject to the requirements of chapter 14, but the~~ 
640.14  ~~formulary committee shall provide opportunity for public input~~ 
640.15  ~~in developing criteria;~~ 
640.16     ~~(2) the drug formulary committee must hold a public forum~~ 
640.17  ~~and receive public comment for an additional 15 days;~~ 
640.18     ~~(3) the drug formulary committee must consider data from~~ 
640.19  ~~the state Medicaid program if such data is available; and~~ 
640.20     ~~(4) the commissioner must provide information to the~~ 
640.21  ~~formulary committee on the impact that placing the drug on prior~~ 
640.22  ~~authorization will have on the quality of patient care and on~~ 
640.23  ~~program costs, and information regarding whether the drug is~~ 
640.24  ~~subject to clinical abuse or misuse.~~  
640.25     ~~Prior authorization may be required by the commissioner~~ 
640.26  ~~before certain formulary drugs are eligible for payment.  If~~ 
640.27  ~~prior authorization of a drug is required by the commissioner,~~ 
640.28  ~~the commissioner must provide a 30-day notice period before~~ 
640.29  ~~implementing the prior authorization.  If a prior authorization~~ 
640.30  ~~request is denied by the department, the recipient may appeal~~ 
640.31  ~~the denial in accordance with section 256.045.  If an appeal is~~ 
640.32  ~~filed, the drug must be provided without prior authorization~~ 
640.33  ~~until a decision is made on the appeal.~~  
640.34     ~~(f) The basis for determining the amount of payment for~~ 
640.35  ~~drugs administered in an outpatient setting shall be the lower~~ 
640.36  ~~of the usual and customary cost submitted by the provider; the~~ 
641.1   ~~average wholesale price minus five percent; or the maximum~~ 
641.2   ~~allowable cost set by the federal government under United States~~ 
641.3   ~~Code, title 42, chapter 7, section 1396r-8(e), and Code of~~ 
641.4   ~~Federal Regulations, title 42, section 447.332, or by the~~ 
641.5   ~~commissioner under paragraph (c).~~ 
641.6      ~~(g) Prior authorization shall not be required or utilized~~ 
641.7   ~~for any antipsychotic drug prescribed for the treatment of~~ 
641.8   ~~mental illness where there is no generically equivalent drug~~ 
641.9   ~~available unless the commissioner determines that prior~~ 
641.10  ~~authorization is necessary for patient safety.  This paragraph~~ 
641.11  ~~applies to any supplemental drug rebate program established or~~ 
641.12  ~~administered by the commissioner.~~  The formulary committee shall 
641.13  establish general criteria to be used for the prior 
641.14  authorization of brand-name drugs for which generically 
641.15  equivalent drugs are available, but the committee is not 
641.16  required to review each brand-name drug for which a generically 
641.17  equivalent drug is available.  
641.18     (b) Prior authorization may be required by the commissioner 
641.19  before certain formulary drugs are eligible for payment.  The 
641.20  formulary committee may recommend drugs for prior authorization 
641.21  directly to the commissioner.  The commissioner may also request 
641.22  that the formulary committee review a drug for prior 
641.23  authorization.  Before the commissioner may require prior 
641.24  authorization for a drug: 
641.25     (1) the commissioner must provide information to the 
641.26  formulary committee on the impact that placing the drug on prior 
641.27  authorization may have on the quality of patient care and on 
641.28  program costs, information regarding whether the drug is subject 
641.29  to clinical abuse or misuse, and relevant data from the state 
641.30  Medicaid program if such data is available; 
641.31     (2) the formulary committee must review the drug, taking 
641.32  into account medical and clinical data and the information 
641.33  provided by the commissioner; and 
641.34     (3) the formulary committee must hold a public forum and 
641.35  receive public comment for an additional 15 days. 
641.36  The commissioner must provide a 15-day notice period before 
642.1   implementing the prior authorization.  
642.2      (c) Prior authorization shall not be required or utilized 
642.3   for any atypical antipsychotic drug prescribed for the treatment 
642.4   of mental illness if: 
642.5      (1) there is no generically equivalent drug available; and 
642.6      (2) the drug was initially prescribed for the recipient 
642.7   prior to July 1, 2003; or 
642.8      (3) the drug is part of the recipient's current course of 
642.9   treatment. 
642.10  This paragraph applies to any multistate preferred drug list or 
642.11  supplemental drug rebate program established or administered by 
642.12  the commissioner. 
642.13     ~~(h)~~ (d) Prior authorization shall not be required or 
642.14  utilized for any antihemophilic factor drug prescribed for the 
642.15  treatment of hemophilia and blood disorders where there is no 
642.16  generically equivalent drug available ~~unless the commissioner~~ 
642.17  ~~determines that prior authorization is necessary for patient~~ 
642.18  ~~safety.  This paragraph applies to~~ if the prior authorization is 
642.19  used in conjunction with any supplemental drug rebate program or 
642.20  multistate preferred drug list established or administered by 
642.21  the commissioner.  This paragraph expires July 1, ~~2003~~ 2005. 
642.22     (e) The commissioner may require prior authorization for 
642.23  brand name drugs whenever a generically equivalent product is 
642.24  available, even if the prescriber specifically indicates 
642.25  "dispense as written-brand necessary" on the prescription as 
642.26  required by section 151.21, subdivision 2. 
642.27     Subd. 13g.  [PREFERRED DRUG LIST.] (a) The commissioner 
642.28  shall adopt and implement a preferred drug list by January 1, 
642.29  2004.  The commissioner may enter into a contract with a vendor 
642.30  or one or more states for the purpose of participating in a 
642.31  multistate preferred drug list and supplemental rebate program.  
642.32  The commissioner shall ensure that any contract meets all 
642.33  federal requirements and maximizes federal financial 
642.34  participation.  The commissioner shall publish the preferred 
642.35  drug list annually in the State Register and shall maintain an 
642.36  accurate and up-to-date list on the agency Web site. 
643.1      (b) The commissioner may add to, delete from, and otherwise 
643.2   modify the preferred drug list, after consulting with the 
643.3   formulary committee and appropriate medical specialists and 
643.4   providing public notice and the opportunity for public comment. 
643.5      (c) The commissioner shall adopt and administer the 
643.6   preferred drug list as part of the administration of the 
643.7   supplemental drug rebate program.  Reimbursement for 
643.8   prescription drugs not on the preferred drug list may be subject 
643.9   to prior authorization, unless the drug manufacturer signs a 
643.10  supplemental rebate contract. 
643.11     (d) For purposes of this subdivision, "preferred drug list" 
643.12  means a list of prescription drugs within designated therapeutic 
643.13  classes selected by the commissioner, for which prior 
643.14  authorization based on the identity of the drug or class is not 
643.15  required. 
643.16     (e) The commissioner shall seek any federal waivers or 
643.17  approvals necessary to implement this subdivision. 
643.18     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
643.19     Sec. 36.  Minnesota Statutes 2002, section 256B.0625, 
643.20  subdivision 17, is amended to read: 
643.21     Subd. 17.  [TRANSPORTATION COSTS.] (a) Medical assistance 
643.22  covers transportation costs incurred solely for obtaining 
643.23  emergency medical care or transportation costs incurred by 
643.24  ~~nonambulatory~~ eligible persons in obtaining emergency or 
643.25  nonemergency medical care when paid directly to an ambulance 
643.26  company, common carrier, or other recognized providers of 
643.27  transportation services.  ~~For the purpose of this subdivision, a~~ 
643.28  ~~person who is incapable of transport by taxicab or bus shall be~~ 
643.29  ~~considered to be nonambulatory.~~ 
643.30     (b) Medical assistance covers special transportation, as 
643.31  defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 
643.32  if the ~~provider receives and maintains a current physician's~~ 
643.33  ~~order by the recipient's attending physician certifying that the~~ 
643.34  recipient has a physical or mental impairment that would 
643.35  prohibit the recipient from safely accessing and using a bus, 
643.36  taxi, other commercial transportation, or private automobile.  
644.1   The commissioner may use an order by the recipient's attending 
644.2   physician to certify that the recipient requires special 
644.3   transportation services.  Special transportation includes 
644.4   driver-assisted service to eligible individuals.  
644.5   Driver-assisted service includes passenger pickup at and return 
644.6   to the individual's residence or place of business, assistance 
644.7   with admittance of the individual to the medical facility, and 
644.8   assistance in passenger securement or in securing of wheelchairs 
644.9   or stretchers in the vehicle.  ~~The commissioner shall establish~~ 
644.10  ~~maximum medical assistance reimbursement rates for special~~ 
644.11  ~~transportation services for persons who need a~~ 
644.12  ~~wheelchair-accessible van or stretcher-accessible vehicle and~~ 
644.13  ~~for those who do not need a wheelchair-accessible van or~~ 
644.14  ~~stretcher-accessible vehicle.  The average of these two rates~~ 
644.15  ~~per trip must not exceed $15 for the base rate and $1.40 per~~ 
644.16  ~~mile.  Special transportation provided to nonambulatory persons~~ 
644.17  ~~who do not need a wheelchair-accessible van or~~ 
644.18  ~~stretcher-accessible vehicle, may be reimbursed at a lower rate~~ 
644.19  ~~than special transportation provided to persons who need a~~ 
644.20  ~~wheelchair-accessible van or stretcher-accessible~~ 
644.21  ~~vehicle.~~  Special transportation providers must obtain written 
644.22  documentation from the health care service provider who is 
644.23  serving the recipient being transported, identifying the time 
644.24  that the recipient arrived.  Special transportation providers 
644.25  may not bill for separate base rates for the continuation of a 
644.26  trip beyond the original destination.  Special transportation 
644.27  providers must take recipients to the nearest appropriate health 
644.28  care provider, using the most direct route available.  The 
644.29  maximum medical assistance reimbursement rates for special 
644.30  transportation services are: 
644.31     (1) $18 for the base rate and $1.40 per mile for services 
644.32  to eligible persons who need a wheelchair-accessible van; 
644.33     (2) $12 for the base rate and $1.35 per mile for services 
644.34  to eligible persons who do not need a wheelchair-accessible van; 
644.35  and 
644.36     (3) $36 for the base rate and $1.40 per mile, and an 
645.1   attendant rate of $9 per trip, for services to eligible persons 
645.2   who need a stretcher-accessible vehicle. 
645.3      Sec. 37.  [256B.0631] [MEDICAL ASSISTANCE CO-PAYMENTS.] 
645.4      Subdivision 1.  [CO-PAYMENTS.] (a) Except as provided in 
645.5   subdivision 2, the medical assistance benefit plan shall include 
645.6   the following co-payments for all recipients, effective for 
645.7   services provided on or after October 1, 2003: 
645.8      (1) $3 per nonpreventive visit.  For purposes of this 
645.9   subdivision, a visit means an episode of service which is 
645.10  required because of a recipient's symptoms, diagnosis, or 
645.11  established illness, and which is delivered in an ambulatory 
645.12  setting by a physician or physician ancillary, chiropractor, 
645.13  podiatrist, nurse midwife, advanced practice nurse, audiologist, 
645.14  optician, or optometrist; 
645.15     (2) $3 for eyeglasses; 
645.16     (3) $6 for nonemergency visits to a hospital-based 
645.17  emergency room; and 
645.18     (4) $3 per brand-name drug prescription and $1 per generic 
645.19  drug prescription, subject to a $20 per month maximum for 
645.20  prescription drug co-payments.  No co-payments shall apply to 
645.21  antipsychotic drugs when used for the treatment of mental 
645.22  illness. 
645.23     (b) Recipients of medical assistance are responsible for 
645.24  all co-payments in this subdivision. 
645.25     Subd. 2.  [EXCEPTIONS.] Co-payments shall be subject to the 
645.26  following exceptions: 
645.27     (1) children under the age of 21; 
645.28     (2) pregnant women for services that relate to the 
645.29  pregnancy or any other medical condition that may complicate the 
645.30  pregnancy; 
645.31     (3) recipients expected to reside for at least 30 days in a 
645.32  hospital, nursing home, or intermediate care facility for the 
645.33  mentally retarded; 
645.34     (4) recipients receiving hospice care; 
645.35     (5) 100 percent federally funded services provided by an 
645.36  Indian health service; 
646.1      (6) emergency services; 
646.2      (7) family planning services; 
646.3      (8) services that are paid by Medicare, resulting in the 
646.4   medical assistance program paying for the coinsurance and 
646.5   deductible; and 
646.6      (9) co-payments that exceed one per day per provider for 
646.7   nonpreventive visits, eyeglasses, and nonemergency visits to a 
646.8   hospital-based emergency room. 
646.9      Subd. 3.  [COLLECTION.] The medical assistance 
646.10  reimbursement to the provider shall be reduced by the amount of 
646.11  the co-payment, except that reimbursement for prescription drugs 
646.12  shall not be reduced once a recipient has reached the $20 per 
646.13  month maximum for prescription drug co-payments.  The provider 
646.14  collects the co-payment from the recipient.  Providers may not 
646.15  deny services to recipients who are unable to pay the 
646.16  co-payment, except as provided in subdivision 4. 
646.17     Subd. 4.  [UNCOLLECTED DEBT.] If it is the routine business 
646.18  practice of a provider to refuse service to an individual with 
646.19  uncollected debt, the provider may include uncollected 
646.20  co-payments under this section.  A provider must give advance 
646.21  notice to a recipient with uncollected debt before services can 
646.22  be denied. 
646.23     Sec. 38.  Minnesota Statutes 2002, section 256B.0635, 
646.24  subdivision 1, is amended to read: 
646.25     Subdivision 1.  [INCREASED EMPLOYMENT.] (a) Until June 30, 
646.26  2002, medical assistance may be paid for persons who received 
646.27  MFIP or medical assistance for families and children in at least 
646.28  three of six months preceding the month in which the person 
646.29  became ineligible for MFIP or medical assistance, if the 
646.30  ineligibility was due to an increase in hours of employment or 
646.31  employment income or due to the loss of an earned income 
646.32  disregard.  In addition, to receive continued assistance under 
646.33  this section, persons who received medical assistance for 
646.34  families and children but did not receive MFIP must have had 
646.35  income less than or equal to the assistance standard for their 
646.36  family size under the state's AFDC plan in effect as of July 16, 
647.1   1996, increased by three percent effective July 1, 2000, at the 
647.2   time medical assistance eligibility began.  A person who is 
647.3   eligible for extended medical assistance is entitled to six 
647.4   months of assistance without reapplication, unless the 
647.5   assistance unit ceases to include a dependent child.  For a 
647.6   person under 21 years of age, medical assistance may not be 
647.7   discontinued within the six-month period of extended eligibility 
647.8   until it has been determined that the person is not otherwise 
647.9   eligible for medical assistance.  Medical assistance may be 
647.10  continued for an additional six months if the person meets all 
647.11  requirements for the additional six months, according to title 
647.12  XIX of the Social Security Act, as amended by section 303 of the 
647.13  Family Support Act of 1988, Public Law ~~Number~~ 100-485. 
647.14     (b) Beginning July 1, 2002, contingent upon federal 
647.15  funding, medical assistance for families and children may be 
647.16  paid for persons who were eligible under section 256B.055, 
647.17  subdivision 3a, in at least three of six months preceding the 
647.18  month in which the person became ineligible under that section 
647.19  if the ineligibility was due to an increase in hours of 
647.20  employment or employment income or due to the loss of an earned 
647.21  income disregard.  A person who is eligible for extended medical 
647.22  assistance is entitled to six months of assistance without 
647.23  reapplication, unless the assistance unit ceases to include a 
647.24  dependent child, except medical assistance may not be 
647.25  discontinued for that dependent child under 21 years of age 
647.26  within the six-month period of extended eligibility until it has 
647.27  been determined that the person is not otherwise eligible for 
647.28  medical assistance.  Medical assistance may be continued for an 
647.29  additional six months if the person meets all requirements for 
647.30  the additional six months, according to title XIX of the Social 
647.31  Security Act, as amended by section 303 of the Family Support 
647.32  Act of 1988, Public Law ~~Number~~ 100-485. 
647.33     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
647.34     Sec. 39.  Minnesota Statutes 2002, section 256B.0635, 
647.35  subdivision 2, is amended to read: 
647.36     Subd. 2.  [INCREASED CHILD OR SPOUSAL SUPPORT.] (a) Until 
648.1   June 30, 2002, medical assistance may be paid for persons who 
648.2   received MFIP or medical assistance for families and children in 
648.3   at least three of the six months preceding the month in which 
648.4   the person became ineligible for MFIP or medical assistance, if 
648.5   the ineligibility was the result of the collection of child or 
648.6   spousal support under part D of title IV of the Social Security 
648.7   Act.  In addition, to receive continued assistance under this 
648.8   section, persons who received medical assistance for families 
648.9   and children but did not receive MFIP must have had income less 
648.10  than or equal to the assistance standard for their family size 
648.11  under the state's AFDC plan in effect as of July 16, 1996, 
648.12  increased by three percent effective July 1, 2000, at the time 
648.13  medical assistance eligibility began.  A person who is eligible 
648.14  for extended medical assistance under this subdivision is 
648.15  entitled to four months of assistance without reapplication, 
648.16  unless the assistance unit ceases to include a dependent child, 
648.17  except medical assistance may not be discontinued for that 
648.18  dependent child under 21 years of age within the four-month 
648.19  period of extended eligibility until it has been determined that 
648.20  the person is not otherwise eligible for medical assistance. 
648.21     (b) Beginning July 1, 2002, contingent upon federal 
648.22  funding, medical assistance for families and children may be 
648.23  paid for persons who were eligible under section 256B.055, 
648.24  subdivision 3a, in at least three of the six months preceding 
648.25  the month in which the person became ineligible under that 
648.26  section if the ineligibility was the result of the collection of 
648.27  child or spousal support under part D of title IV of the Social 
648.28  Security Act.  A person who is eligible for extended medical 
648.29  assistance under this subdivision is entitled to four months of 
648.30  assistance without reapplication, unless the assistance unit 
648.31  ceases to include a dependent child, except medical assistance 
648.32  may not be discontinued for that dependent child under 21 years 
648.33  of age within the four-month period of extended eligibility 
648.34  until it has been determined that the person is not otherwise 
648.35  eligible for medical assistance. 
648.36     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
649.1      Sec. 40.  Minnesota Statutes 2002, section 256B.15, 
649.2   subdivision 1, is amended to read: 
649.3      Subdivision 1.  [POLICY, APPLICABILITY, PURPOSE, AND 
649.4   CONSTRUCTION; DEFINITION.] (a) It is the policy of this state 
649.5   that individuals or couples, either or both of whom participate 
649.6   in the medical assistance program, use their own assets to pay 
649.7   their share of the total cost of their care during or after 
649.8   their enrollment in the program according to applicable federal 
649.9   law and the laws of this state.  The following provisions apply: 
649.10     (1) subdivisions 1c to 1k shall not apply to claims arising 
649.11  under this section which are presented under section 525.313; 
649.12     (2) the provisions of subdivisions 1c to 1k expanding the 
649.13  interests included in an estate for purposes of recovery under 
649.14  this section give effect to the provisions of United States 
649.15  Code, title 42, section 1396p, governing recoveries, but do not 
649.16  give rise to any express or implied liens in favor of any other 
649.17  parties not named in these provisions; 
649.18     (3) the continuation of a recipient's life estate or joint 
649.19  tenancy interest in real property after the recipient's death 
649.20  for the purpose of recovering medical assistance under this 
649.21  section modifies common law principles holding that these 
649.22  interests terminate on the death of the holder; 
649.23     (4) all laws, rules, and regulations governing or involved 
649.24  with a recovery of medical assistance shall be liberally 
649.25  construed to accomplish their intended purposes; 
649.26     (5) a deceased recipient's life estate and joint tenancy 
649.27  interests continued under this section shall be owned by the 
649.28  remaindermen or surviving joint tenants as their interests may 
649.29  appear on the date of the recipient's death.  They shall not be 
649.30  merged into the remainder interest or the interests of the 
649.31  surviving joint tenants by reason of ownership.  They shall be 
649.32  subject to the provisions of this section.  Any conveyance, 
649.33  transfer, sale, assignment, or encumbrance by a remainderman, a 
649.34  surviving joint tenant, or their heirs, successors, and assigns 
649.35  shall be deemed to include all of their interest in the deceased 
649.36  recipient's life estate or joint tenancy interest continued 
650.1   under this section; and 
650.2      (6) the provisions of subdivisions 1c to 1k continuing a 
650.3   recipient's joint tenancy interests in real property after the 
650.4   recipient's death do not apply to a homestead owned of record, 
650.5   on the date the recipient dies, by the recipient and the 
650.6   recipient's spouse as joint tenants with a right of 
650.7   survivorship.  Homestead means the real property occupied by the 
650.8   surviving joint tenant spouse as their sole residence on the 
650.9   date the recipient dies and classified and taxed to the 
650.10  recipient and surviving joint tenant spouse as homestead 
650.11  property for property tax purposes in the calendar year in which 
650.12  the recipient dies.  For purposes of this exemption, real 
650.13  property the recipient and their surviving joint tenant spouse 
650.14  purchase solely with the proceeds from the sale of their prior 
650.15  homestead, own of record as joint tenants, and qualify as 
650.16  homestead property under section 273.124 in the calendar year in 
650.17  which the recipient dies and prior to the recipient's death 
650.18  shall be deemed to be real property classified and taxed to the 
650.19  recipient and their surviving joint tenant spouse as homestead 
650.20  property in the calendar year in which the recipient dies.  The 
650.21  surviving spouse, or any person with personal knowledge of the 
650.22  facts, may provide an affidavit describing the homestead 
650.23  property affected by this clause and stating facts showing 
650.24  compliance with this clause.  The affidavit shall be prima facie 
650.25  evidence of the facts it states. 
650.26     (b) For purposes of this section, "medical assistance" 
650.27  includes the medical assistance program under this chapter and 
650.28  the general assistance medical care program under chapter 256D, 
650.29  but does not include the alternative care program for nonmedical 
650.30  assistance recipients under section 256B.0913, subdivision 4. 
650.31     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
650.32  and applies to estates of decedents who die on or after that 
650.33  date. 
650.34     Sec. 41.  Minnesota Statutes 2002, section 256B.15, 
650.35  subdivision 1a, is amended to read: 
650.36     Subd. 1a.  [ESTATES SUBJECT TO CLAIMS.] If a person 
651.1   receives any medical assistance hereunder, on the person's 
651.2   death, if single, or on the death of the survivor of a married 
651.3   couple, either or both of whom received medical assistance, or 
651.4   as otherwise provided for in this section, the total amount paid 
651.5   for medical assistance rendered for the person and spouse shall 
651.6   be filed as a claim against the estate of the person or the 
651.7   estate of the surviving spouse in the court having jurisdiction 
651.8   to probate the estate or to issue a decree of descent according 
651.9   to sections 525.31 to 525.313.  
651.10     A claim shall be filed if medical assistance was rendered 
651.11  for either or both persons under one of the following 
651.12  circumstances: 
651.13     (a) the person was over 55 years of age, and received 
651.14  services under this chapter~~, excluding alternative care~~; 
651.15     (b) the person resided in a medical institution for six 
651.16  months or longer, received services under this chapter ~~excluding~~ 
651.17  ~~alternative care~~, and, at the time of institutionalization or 
651.18  application for medical assistance, whichever is later, the 
651.19  person could not have reasonably been expected to be discharged 
651.20  and returned home, as certified in writing by the person's 
651.21  treating physician.  For purposes of this section only, a 
651.22  "medical institution" means a skilled nursing facility, 
651.23  intermediate care facility, intermediate care facility for 
651.24  persons with mental retardation, nursing facility, or inpatient 
651.25  hospital; or 
651.26     (c) the person received general assistance medical care 
651.27  services under chapter 256D.  
651.28     The claim shall be considered an expense of the last 
651.29  illness of the decedent for the purpose of section 524.3-805.  
651.30  Any statute of limitations that purports to limit any county 
651.31  agency or the state agency, or both, to recover for medical 
651.32  assistance granted hereunder shall not apply to any claim made 
651.33  hereunder for reimbursement for any medical assistance granted 
651.34  hereunder.  Notice of the claim shall be given to all heirs and 
651.35  devisees of the decedent whose identity can be ascertained with 
651.36  reasonable diligence.  The notice must include procedures and 
652.1   instructions for making an application for a hardship waiver 
652.2   under subdivision 5; time frames for submitting an application 
652.3   and determination; and information regarding appeal rights and 
652.4   procedures.  Counties are entitled to one-half of the nonfederal 
652.5   share of medical assistance collections from estates that are 
652.6   directly attributable to county effort.  Counties are entitled 
652.7   to ten percent of the collections for alternative care directly 
652.8   attributable to county effort. 
652.9      <b>[EFFECTIVE DATE.]</b> The amendments in this section relating 
652.10  to the alternative care program are effective July 1, 2003, and 
652.11  apply to the estates of decedents who die on or after that 
652.12  date.  The remaining amendments in this section are effective 
652.13  August 1, 2003, and apply to the estates of decedents who die on 
652.14  and after that date. 
652.15     Sec. 42.  Minnesota Statutes 2002, section 256B.15, is 
652.16  amended by adding a subdivision to read: 
652.17     Subd. 1c.  [NOTICE OF POTENTIAL CLAIM.] (a) A state agency 
652.18  with a claim or potential claim under this section may file a 
652.19  notice of potential claim under this subdivision anytime before 
652.20  or within one year after a medical assistance recipient dies.  
652.21  The claimant shall be the state agency.  A notice filed prior to 
652.22  the recipient's death shall not take effect and shall not be 
652.23  effective as notice until the recipient dies.  A notice filed 
652.24  after a recipient dies shall be effective from the time of 
652.25  filing.  
652.26     (b) The notice of claim shall be filed or recorded in the 
652.27  real estate records in the office of the county recorder or 
652.28  registrar of titles for each county in which any part of the 
652.29  property is located.  The recorder shall accept the notice for 
652.30  recording or filing.  The registrar of titles shall accept the 
652.31  notice for filing if the recipient has a recorded interest in 
652.32  the property.  The registrar of titles shall not carry forward 
652.33  to a new certificate of title any notice filed more than one 
652.34  year from the date of the recipient's death. 
652.35     (c) The notice must be dated, state the name of the 
652.36  claimant, the medical assistance recipient's name and social 
653.1   security number if filed before their death and their date of 
653.2   death if filed after they die, the name and date of death of any 
653.3   predeceased spouse of the medical assistance recipient for whom 
653.4   a claim may exist, a statement that the claimant may have a 
653.5   claim arising under this section, generally identify the 
653.6   recipient's interest in the property, contain a legal 
653.7   description for the property and whether it is abstract or 
653.8   registered property, a statement of when the notice becomes 
653.9   effective and the effect of the notice, be signed by an 
653.10  authorized representative of the state agency, and may include 
653.11  such other contents as the state agency may deem appropriate. 
653.12     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
653.13  and applies to the estates of decedents who die on or after that 
653.14  date. 
653.15     Sec. 43.  Minnesota Statutes 2002, section 256B.15, is 
653.16  amended by adding a subdivision to read: 
653.17     Subd. 1d.  [EFFECT OF NOTICE.] From the time it takes 
653.18  effect, the notice shall be notice to remaindermen, joint 
653.19  tenants, or to anyone else owning or acquiring an interest in or 
653.20  encumbrance against the property described in the notice that 
653.21  the medical assistance recipient's life estate, joint tenancy, 
653.22  or other interests in the real estate described in the notice: 
653.23     (1) shall, in the case of life estate and joint tenancy 
653.24  interests, continue to exist for purposes of this section, and 
653.25  be subject to liens and claims as provided in this section; 
653.26     (2) shall be subject to a lien in favor of the claimant 
653.27  effective upon the death of the recipient and dealt with as 
653.28  provided in this section; 
653.29     (3) may be included in the recipient's estate, as defined 
653.30  in this section; and 
653.31     (4) may be subject to administration and all other 
653.32  provisions of chapter 524 and may be sold, assigned, 
653.33  transferred, or encumbered free and clear of their interest or 
653.34  encumbrance to satisfy claims under this section. 
653.35     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
653.36  and applies to the estates of decedents who die on or after that 
654.1   date. 
654.2      Sec. 44.  Minnesota Statutes 2002, section 256B.15, is 
654.3   amended by adding a subdivision to read: 
654.4      Subd. 1e.  [FULL OR PARTIAL RELEASE OF NOTICE.] (a) The 
654.5   claimant may fully or partially release the notice and the lien 
654.6   arising out of the notice of record in the real estate records 
654.7   where the notice is filed or recorded at any time.  The claimant 
654.8   may give a full or partial release to extinguish any life 
654.9   estates or joint tenancy interests which are or may be continued 
654.10  under this section or whose existence or nonexistence may create 
654.11  a cloud on the title to real property at any time whether or not 
654.12  a notice has been filed.  The recorder or registrar of titles 
654.13  shall accept the release for recording or filing.  If the 
654.14  release is a partial release, it must include a legal 
654.15  description of the property being released. 
654.16     (b) At any time, the claimant may, at the claimant's 
654.17  discretion, wholly or partially release, subordinate, modify, or 
654.18  amend the recorded notice and the lien arising out of the notice.
654.19     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
654.20  and applies to the estates of decedents who die on or after that 
654.21  date. 
654.22     Sec. 45.  Minnesota Statutes 2002, section 256B.15, is 
654.23  amended by adding a subdivision to read: 
654.24     Subd. 1f.  [AGENCY LIEN.] (a) The notice shall constitute a 
654.25  lien in favor of the department of human services against the 
654.26  recipient's interests in the real estate it describes for a 
654.27  period of 20 years from the date of filing or the date of the 
654.28  recipient's death, whichever is later.  Notwithstanding any law 
654.29  or rule to the contrary, a recipient's life estate and joint 
654.30  tenancy interests shall not end upon the recipient's death but 
654.31  shall continue according to subdivisions 1h, 1i, and 1j.  The 
654.32  amount of the lien shall be equal to the total amount of the 
654.33  claims that could be presented in the recipient's estate under 
654.34  this section. 
654.35     (b) If no estate has been opened for the deceased 
654.36  recipient, any holder of an interest in the property may apply 
655.1   to the lien holder for a statement of the amount of the lien or 
655.2   for a full or partial release of the lien.  The application 
655.3   shall include the applicant's name, current mailing address, 
655.4   current home and work telephone numbers, and a description of 
655.5   their interest in the property, a legal description of the 
655.6   recipient's interest in the property, and the deceased 
655.7   recipient's name, date of birth, and social security number.  
655.8   The lien holder shall send the applicant by certified mail, 
655.9   return receipt requested, a written statement showing the amount 
655.10  of the lien, whether the lien holder is willing to release the 
655.11  lien and under what conditions, and inform them of the right to 
655.12  a hearing under section 256.045.  The lien holder shall have the 
655.13  discretion to compromise and settle the lien upon any terms and 
655.14  conditions the lien holder deems appropriate. 
655.15     (c) Any holder of an interest in property subject to the 
655.16  lien has a right to request a hearing under section 256.045 to 
655.17  determine the validity, extent, or amount of the lien.  The 
655.18  request must be in writing, and must include the names, current 
655.19  addresses, and home and business telephone numbers for all other 
655.20  parties holding an interest in the property.  A request for a 
655.21  hearing by any holder of an interest in the property shall be 
655.22  deemed to be a request for a hearing by all parties owning 
655.23  interests in the property.  Notice of the hearing shall be given 
655.24  to the lien holder, the party filing the appeal, and all of the 
655.25  other holders of interests in the property at the addresses 
655.26  listed in the appeal by certified mail, return receipt 
655.27  requested, or by ordinary mail.  Any owner of an interest in the 
655.28  property to whom notice of the hearing is mailed shall be deemed 
655.29  to have waived any and all claims or defenses in respect to the 
655.30  lien unless they appear and assert any claims or defenses at the 
655.31  hearing. 
655.32     (d) If the claim the lien secures could be filed under 
655.33  subdivision 1h, the lien holder may collect, compromise, settle, 
655.34  or release the lien upon any terms and conditions it deems 
655.35  appropriate.  If the claim the lien secures could be filed under 
655.36  subdivision 1i or 1j, the lien may be adjusted or enforced to 
656.1   the same extent had it been filed under subdivisions 1i and 1j, 
656.2   and the provisions of subdivisions 1i, clause (f), and lj, 
656.3   clause (d), shall apply to voluntary payment, settlement, or 
656.4   satisfaction of the lien. 
656.5      (e) If no probate proceedings have been commenced for the 
656.6   recipient as of the date the lien holder executes a release of 
656.7   the lien on a recipient's life estate or joint tenancy interest, 
656.8   created for purposes of this section, the release shall 
656.9   terminate the life estate or joint tenancy interest created 
656.10  under this section as of the date it is recorded or filed to the 
656.11  extent of the release.  If the claimant executes a release for 
656.12  purposes of extinguishing a life estate or a joint tenancy 
656.13  interest created under this section to remove a cloud on title 
656.14  to real property, the release shall have the effect of 
656.15  extinguishing any life estate or joint tenancy interests in the 
656.16  property it describes which may have been continued by reason of 
656.17  this section retroactive to the date of death of the deceased 
656.18  life tenant or joint tenant except as provided for in section 
656.19  514.981, subdivision 6. 
656.20     (f) If the deceased recipient's estate is probated, a claim 
656.21  shall be filed under this section.  The amount of the lien shall 
656.22  be limited to the amount of the claim as finally allowed.  If 
656.23  the claim the lien secures is filed under subdivision 1h, the 
656.24  lien may be released in full after any allowance of the claim 
656.25  becomes final or according to any agreement to settle and 
656.26  satisfy the claim.  The release shall release the lien but shall 
656.27  not extinguish or terminate the interest being released.  If the 
656.28  claim the lien secures is filed under subdivision 1i or 1j, the 
656.29  lien shall be released after the lien under subdivision 1i or 1j 
656.30  is filed or recorded, or settled according to any agreement to 
656.31  settle and satisfy the claim.  The release shall not extinguish 
656.32  or terminate the interest being released.  If the claim is 
656.33  finally disallowed in full, the claimant shall release the 
656.34  claimant's lien at the claimant's expense. 
656.35     <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
656.36  2003, and applies to the estates of decedents who die on or 
657.1   after that date. 
657.2      Sec. 46.  Minnesota Statutes 2002, section 256B.15, is 
657.3   amended by adding a subdivision to read: 
657.4      Subd. 1g.  [ESTATE PROPERTY.] Notwithstanding any law or 
657.5   rule to the contrary, if a claim is presented under this 
657.6   section, interests or the proceeds of interests in real property 
657.7   a decedent owned as a life tenant or a joint tenant with a right 
657.8   of survivorship shall be part of the decedent's estate, subject 
657.9   to administration, and shall be dealt with as provided in this 
657.10  section. 
657.11     <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
657.12  2003, and applies to the estates of decedents who die on or 
657.13  after that date. 
657.14     Sec. 47.  Minnesota Statutes 2002, section 256B.15, is 
657.15  amended by adding a subdivision to read: 
657.16     Subd. 1h.  [ESTATES OF SPECIFIC PERSONS RECEIVING MEDICAL 
657.17  ASSISTANCE.] (a) For purposes of this section, paragraphs (b) to 
657.18  (k) apply if a person received medical assistance for which a 
657.19  claim may be filed under this section and died single, or the 
657.20  surviving spouse of the couple and was not survived by any of 
657.21  the persons described in subdivisions 3 and 4. 
657.22     (b) For purposes of this section, the person's estate 
657.23  consists of:  (1) their probate estate; (2) all of the person's 
657.24  interests or proceeds of those interests in real property the 
657.25  person owned as a life tenant or as a joint tenant with a right 
657.26  of survivorship at the time of the person's death; (3) all of 
657.27  the person's interests or proceeds of those interests in 
657.28  securities the person owned in beneficiary form as provided 
657.29  under sections 524.6-301 to 524.6-311 at the time of the 
657.30  person's death, to the extent they become part of the probate 
657.31  estate under section 524.6-307; and (4) all of the person's 
657.32  interests in joint accounts, multiple party accounts, and pay on 
657.33  death accounts, or the proceeds of those accounts, as provided 
657.34  under sections 524.6-201 to 524.6-214 at the time of the 
657.35  person's death to the extent they become part of the probate 
657.36  estate under section 524.6-207.  Notwithstanding any law or rule 
658.1   to the contrary, a state or county agency with a claim under 
658.2   this section shall be a creditor under section 524.6-307. 
658.3      (c) Notwithstanding any law or rule to the contrary, the 
658.4   person's life estate or joint tenancy interest in real property 
658.5   not subject to a medical assistance lien under sections 514.980 
658.6   to 514.985 on the date of the person's death shall not end upon 
658.7   the person's death and shall continue as provided in this 
658.8   subdivision.  The life estate in the person's estate shall be 
658.9   that portion of the interest in the real property subject to the 
658.10  life estate that is equal to the life estate percentage factor 
658.11  for the life estate as listed in the Life Estate Mortality Table 
658.12  of the health care program's manual for a person who was the age 
658.13  of the medical assistance recipient on the date of the person's 
658.14  death.  The joint tenancy interest in real property in the 
658.15  estate shall be equal to the fractional interest the person 
658.16  would have owned in the jointly held interest in the property 
658.17  had they and the other owners held title to the property as 
658.18  tenants in common on the date the person died. 
658.19     (d) The court upon its own motion, or upon motion by the 
658.20  personal representative or any interested party, may enter an 
658.21  order directing the remaindermen or surviving joint tenants and 
658.22  their spouses, if any, to sign all documents, take all actions, 
658.23  and otherwise fully cooperate with the personal representative 
658.24  and the court to liquidate the decedent's life estate or joint 
658.25  tenancy interests in the estate and deliver the cash or the 
658.26  proceeds of those interests to the personal representative and 
658.27  provide for any legal and equitable sanctions as the court deems 
658.28  appropriate to enforce and carry out the order, including an 
658.29  award of reasonable attorney fees. 
658.30     (e) The personal representative may make, execute, and 
658.31  deliver any conveyances or other documents necessary to convey 
658.32  the decedent's life estate or joint tenancy interest in the 
658.33  estate that are necessary to liquidate and reduce to cash the 
658.34  decedent's interest or for any other purposes. 
658.35     (f) Subject to administration, all costs, including 
658.36  reasonable attorney fees, directly and immediately related to 
659.1   liquidating the decedent's life estate or joint tenancy interest 
659.2   in the decedent's estate, shall be paid from the gross proceeds 
659.3   of the liquidation allocable to the decedent's interest and the 
659.4   net proceeds shall be turned over to the personal representative 
659.5   and applied to payment of the claim presented under this section.
659.6      (g) The personal representative shall bring a motion in the 
659.7   district court in which the estate is being probated to compel 
659.8   the remaindermen or surviving joint tenants to account for and 
659.9   deliver to the personal representative all or any part of the 
659.10  proceeds of any sale, mortgage, transfer, conveyance, or any 
659.11  disposition of real property allocable to the decedent's life 
659.12  estate or joint tenancy interest in the decedent's estate, and 
659.13  do everything necessary to liquidate and reduce to cash the 
659.14  decedent's interest and turn the proceeds of the sale or other 
659.15  disposition over to the personal representative.  The court may 
659.16  grant any legal or equitable relief including, but not limited 
659.17  to, ordering a partition of real estate under chapter 558 
659.18  necessary to make the value of the decedent's life estate or 
659.19  joint tenancy interest available to the estate for payment of a 
659.20  claim under this section. 
659.21     (h) Subject to administration, the personal representative 
659.22  shall use all of the cash or proceeds of interests to pay an 
659.23  allowable claim under this section.  The remaindermen or 
659.24  surviving joint tenants and their spouses, if any, may enter 
659.25  into a written agreement with the personal representative or the 
659.26  claimant to settle and satisfy obligations imposed at any time 
659.27  before or after a claim is filed. 
659.28     (i) The personal representative may, at their discretion, 
659.29  provide any or all of the other owners, remaindermen, or 
659.30  surviving joint tenants with an affidavit terminating the 
659.31  decedent's estate's interest in real property the decedent owned 
659.32  as a life tenant or as a joint tenant with others, if the 
659.33  personal representative determines in good faith that neither 
659.34  the decedent nor any of the decedent's predeceased spouses 
659.35  received any medical assistance for which a claim could be filed 
659.36  under this section, or if the personal representative has filed 
660.1   an affidavit with the court that the estate has other assets 
660.2   sufficient to pay a claim, as presented, or if there is a 
660.3   written agreement under paragraph (h), or if the claim, as 
660.4   allowed, has been paid in full or to the full extent of the 
660.5   assets the estate has available to pay it.  The affidavit may be 
660.6   recorded in the office of the county recorder or filed in the 
660.7   office of the registrar of titles for the county in which the 
660.8   real property is located.  Except as provided in section 
660.9   514.981, subdivision 6, when recorded or filed, the affidavit 
660.10  shall terminate the decedent's interest in real estate the 
660.11  decedent owned as a life tenant or a joint tenant with others.  
660.12  The affidavit shall:  (1) be signed by the personal 
660.13  representative; (2) identify the decedent and the interest being 
660.14  terminated; (3) give recording information sufficient to 
660.15  identify the instrument that created the interest in real 
660.16  property being terminated; (4) legally describe the affected 
660.17  real property; (5) state that the personal representative has 
660.18  determined that neither the decedent nor any of the decedent's 
660.19  predeceased spouses received any medical assistance for which a 
660.20  claim could be filed under this section; (6) state that the 
660.21  decedent's estate has other assets sufficient to pay the claim, 
660.22  as presented, or that there is a written agreement between the 
660.23  personal representative and the claimant and the other owners or 
660.24  remaindermen or other joint tenants to satisfy the obligations 
660.25  imposed under this subdivision; and (7) state that the affidavit 
660.26  is being given to terminate the estate's interest under this 
660.27  subdivision, and any other contents as may be appropriate.  
660.28  The recorder or registrar of titles shall accept the affidavit 
660.29  for recording or filing.  The affidavit shall be effective as 
660.30  provided in this section and shall constitute notice even if it 
660.31  does not include recording information sufficient to identify 
660.32  the instrument creating the interest it terminates.  The 
660.33  affidavit shall be conclusive evidence of the stated facts. 
660.34     (j) The holder of a lien arising under subdivision 1c shall 
660.35  release the lien at the holder's expense against an interest 
660.36  terminated under paragraph (h) to the extent of the termination. 
661.1      (k) If a lien arising under subdivision 1c is not released 
661.2   under paragraph (j), prior to closing the estate, the personal 
661.3   representative shall deed the interest subject to the lien to 
661.4   the remaindermen or surviving joint tenants as their interests 
661.5   may appear.  Upon recording or filing, the deed shall work a 
661.6   merger of the recipient's life estate or joint tenancy interest, 
661.7   subject to the lien, into the remainder interest or interest the 
661.8   decedent and others owned jointly.  The lien shall attach to and 
661.9   run with the property to the extent of the decedent's interest 
661.10  at the time of the decedent's death. 
661.11     <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
661.12  2003, and applies to the estates of decedents who die on or 
661.13  after that date. 
661.14     Sec. 48.  Minnesota Statutes 2002, section 256B.15, is 
661.15  amended by adding a subdivision to read: 
661.16     Subd. 1i.  [ESTATES OF PERSONS RECEIVING MEDICAL ASSISTANCE 
661.17  AND SURVIVED BY OTHERS.] (a) For purposes of this subdivision, 
661.18  the person's estate consists of the person's probate estate and 
661.19  all of the person's interests in real property the person owned 
661.20  as a life tenant or a joint tenant at the time of the person's 
661.21  death. 
661.22     (b) Notwithstanding any law or rule to the contrary, this 
661.23  subdivision applies if a person received medical assistance for 
661.24  which a claim could be filed under this section but for the fact 
661.25  the person was survived by a spouse or by a person listed in 
661.26  subdivision 3, or if subdivision 4 applies to a claim arising 
661.27  under this section. 
661.28     (c) The person's life estate or joint tenancy interests in 
661.29  real property not subject to a medical assistance lien under 
661.30  sections 514.980 to 514.985 on the date of the person's death 
661.31  shall not end upon death and shall continue as provided in this 
661.32  subdivision.  The life estate in the estate shall be the portion 
661.33  of the interest in the property subject to the life estate that 
661.34  is equal to the life estate percentage factor for the life 
661.35  estate as listed in the Life Estate Mortality Table of the 
661.36  health care program's manual for a person who was the age of the 
662.1   medical assistance recipient on the date of the person's death.  
662.2   The joint tenancy interest in the estate shall be equal to the 
662.3   fractional interest the medical assistance recipient would have 
662.4   owned in the jointly held interest in the property had they and 
662.5   the other owners held title to the property as tenants in common 
662.6   on the date the medical assistance recipient died. 
662.7      (d) The county agency shall file a claim in the estate 
662.8   under this section on behalf of the claimant who shall be the 
662.9   commissioner of human services, notwithstanding that the 
662.10  decedent is survived by a spouse or a person listed in 
662.11  subdivision 3.  The claim, as allowed, shall not be paid by the 
662.12  estate and shall be disposed of as provided in this paragraph.  
662.13  The personal representative or the court shall make, execute, 
662.14  and deliver a lien in favor of the claimant on the decedent's 
662.15  interest in real property in the estate in the amount of the 
662.16  allowed claim on forms provided by the commissioner to the 
662.17  county agency filing the lien.  The lien shall bear interest as 
662.18  provided under section 524.3-806, shall attach to the property 
662.19  it describes upon filing or recording, and shall remain a lien 
662.20  on the real property it describes for a period of 20 years from 
662.21  the date it is filed or recorded.  The lien shall be a 
662.22  disposition of the claim sufficient to permit the estate to 
662.23  close. 
662.24     (e) The state or county agency shall file or record the 
662.25  lien in the office of the county recorder or registrar of titles 
662.26  for each county in which any of the real property is located.  
662.27  The recorder or registrar of titles shall accept the lien for 
662.28  filing or recording.  All recording or filing fees shall be paid 
662.29  by the department of human services.  The recorder or registrar 
662.30  of titles shall mail the recorded lien to the department of 
662.31  human services.  The lien need not be attested, certified, or 
662.32  acknowledged as a condition of recording or filing.  Upon 
662.33  recording or filing of a lien against a life estate or a joint 
662.34  tenancy interest, the interest subject to the lien shall merge 
662.35  into the remainder interest or the interest the recipient and 
662.36  others owned jointly.  The lien shall attach to and run with the 
663.1   property to the extent of the decedent's interest in the 
663.2   property at the time of the decedent's death as determined under 
663.3   this section.  
663.4      (f) The department shall make no adjustment or recovery 
663.5   under the lien until after the decedent's spouse, if any, has 
663.6   died, and only at a time when the decedent has no surviving 
663.7   child described in subdivision 3.  The estate, any owner of an 
663.8   interest in the property which is or may be subject to the lien, 
663.9   or any other interested party, may voluntarily pay off, settle, 
663.10  or otherwise satisfy the claim secured or to be secured by the 
663.11  lien at any time before or after the lien is filed or recorded.  
663.12  Such payoffs, settlements, and satisfactions shall be deemed to 
663.13  be voluntary repayments of past medical assistance payments for 
663.14  the benefit of the deceased recipient, and neither the process 
663.15  of settling the claim, the payment of the claim, or the 
663.16  acceptance of a payment shall constitute an adjustment or 
663.17  recovery that is prohibited under this subdivision. 
663.18     (g) The lien under this subdivision may be enforced or 
663.19  foreclosed in the manner provided by law for the enforcement of 
663.20  judgment liens against real estate or by a foreclosure by action 
663.21  under chapter 581.  When the lien is paid, satisfied, or 
663.22  otherwise discharged, the state or county agency shall prepare 
663.23  and file a release of lien at its own expense.  No action to 
663.24  foreclose the lien shall be commenced unless the lien holder has 
663.25  first given 30 days' prior written notice to pay the lien to the 
663.26  owners and parties in possession of the property subject to the 
663.27  lien.  The notice shall:  (1) include the name, address, and 
663.28  telephone number of the lien holder; (2) describe the lien; (3) 
663.29  give the amount of the lien; (4) inform the owner or party in 
663.30  possession that payment of the lien in full must be made to the 
663.31  lien holder within 30 days after service of the notice or the 
663.32  lien holder may begin proceedings to foreclose the lien; and (5) 
663.33  be served by personal service, certified mail, return receipt 
663.34  requested, ordinary first class mail, or by publishing it once 
663.35  in a newspaper of general circulation in the county in which any 
663.36  part of the property is located.  Service of the notice shall be 
664.1   complete upon mailing or publication. 
664.2      <b>[EFFECTIVE DATE.]</b> This section takes effect August 1, 2003, 
664.3   and applies to estates of decedents who die on or after that 
664.4   date. 
664.5      Sec. 49.  Minnesota Statutes 2002, section 256B.15, is 
664.6   amended by adding a subdivision to read: 
664.7      Subd. 1j.  [CLAIMS IN ESTATES OF DECEDENTS SURVIVED BY 
664.8   OTHER SURVIVORS.] For purposes of this subdivision, the 
664.9   provisions in subdivision 1i, paragraphs (a) to (c) apply. 
664.10     (a) If payment of a claim filed under this section is 
664.11  limited as provided in subdivision 4, and if the estate does not 
664.12  have other assets sufficient to pay the claim in full, as 
664.13  allowed, the personal representative or the court shall make, 
664.14  execute, and deliver a lien on the property in the estate that 
664.15  is exempt from the claim under subdivision 4 in favor of the 
664.16  commissioner of human services on forms provided by the 
664.17  commissioner to the county agency filing the claim.  If the 
664.18  estate pays a claim filed under this section in full from other 
664.19  assets of the estate, no lien shall be filed against the 
664.20  property described in subdivision 4. 
664.21     (b) The lien shall be in an amount equal to the unpaid 
664.22  balance of the allowed claim under this section remaining after 
664.23  the estate has applied all other available assets of the estate 
664.24  to pay the claim.  The property exempt under subdivision 4 shall 
664.25  not be sold, assigned, transferred, conveyed, encumbered, or 
664.26  distributed until after the personal representative has 
664.27  determined the estate has other assets sufficient to pay the 
664.28  allowed claim in full, or until after the lien has been filed or 
664.29  recorded.  The lien shall bear interest as provided under 
664.30  section 524.3-806, shall attach to the property it describes 
664.31  upon filing or recording, and shall remain a lien on the real 
664.32  property it describes for a period of 20 years from the date it 
664.33  is filed or recorded.  The lien shall be a disposition of the 
664.34  claim sufficient to permit the estate to close. 
664.35     (c) The state or county agency shall file or record the 
664.36  lien in the office of the county recorder or registrar of titles 
665.1   in each county in which any of the real property is located.  
665.2   The department shall pay the filing fees.  The lien need not be 
665.3   attested, certified, or acknowledged as a condition of recording 
665.4   or filing.  The recorder or registrar of titles shall accept the 
665.5   lien for filing or recording. 
665.6      (d) The commissioner shall make no adjustment or recovery 
665.7   under the lien until none of the persons listed in subdivision 4 
665.8   are residing on the property or until the property is sold or 
665.9   transferred.  The estate or any owner of an interest in the 
665.10  property that is or may be subject to the lien, or any other 
665.11  interested party, may voluntarily pay off, settle, or otherwise 
665.12  satisfy the claim secured or to be secured by the lien at any 
665.13  time before or after the lien is filed or recorded.  The 
665.14  payoffs, settlements, and satisfactions shall be deemed to be 
665.15  voluntary repayments of past medical assistance payments for the 
665.16  benefit of the deceased recipient and neither the process of 
665.17  settling the claim, the payment of the claim, or acceptance of a 
665.18  payment shall constitute an adjustment or recovery that is 
665.19  prohibited under this subdivision. 
665.20     (e) A lien under this subdivision may be enforced or 
665.21  foreclosed in the manner provided for by law for the enforcement 
665.22  of judgment liens against real estate or by a foreclosure by 
665.23  action under chapter 581.  When the lien has been paid, 
665.24  satisfied, or otherwise discharged, the claimant shall prepare 
665.25  and file a release of lien at the claimant's expense.  No action 
665.26  to foreclose the lien shall be commenced unless the lien holder 
665.27  has first given 30 days prior written notice to pay the lien to 
665.28  the record owners of the property and the parties in possession 
665.29  of the property subject to the lien.  The notice shall:  (1) 
665.30  include the name, address, and telephone number of the lien 
665.31  holder; (2) describe the lien; (3) give the amount of the lien; 
665.32  (4) inform the owner or party in possession that payment of the 
665.33  lien in full must be made to the lien holder within 30 days 
665.34  after service of the notice or the lien holder may begin 
665.35  proceedings to foreclose the lien; and (5) be served by personal 
665.36  service, certified mail, return receipt requested, ordinary 
666.1   first class mail, or by publishing it once in a newspaper of 
666.2   general circulation in the county in which any part of the 
666.3   property is located.  Service shall be complete upon mailing or 
666.4   publication. 
666.5      (f) Upon filing or recording of a lien against a life 
666.6   estate or joint tenancy interest under this subdivision, the 
666.7   interest subject to the lien shall merge into the remainder 
666.8   interest or the interest the decedent and others owned jointly, 
666.9   effective on the date of recording and filing.  The lien shall 
666.10  attach to and run with the property to the extent of the 
666.11  decedent's interest in the property at the time of the 
666.12  decedent's death as determined under this section. 
666.13     (g)(1) An affidavit may be provided by a personal 
666.14  representative, at their discretion, stating the personal 
666.15  representative has determined in good faith that a decedent 
666.16  survived by a spouse or a person listed in subdivision 3, or by 
666.17  a person listed in subdivision 4, or the decedent's predeceased 
666.18  spouse did not receive any medical assistance giving rise to a 
666.19  claim under this section, or that the real property described in 
666.20  subdivision 4 is not needed to pay in full a claim arising under 
666.21  this section. 
666.22     (2) The affidavit shall:  (i) describe the property and the 
666.23  interest being extinguished; (ii) name the decedent and give the 
666.24  date of death; (iii) state the facts listed in clause (1); (iv) 
666.25  state that the affidavit is being filed to terminate the life 
666.26  estate or joint tenancy interest created under this subdivision; 
666.27  (v) be signed by the personal representative; and (vi) contain 
666.28  any other information that the affiant deems appropriate. 
666.29     (3) Except as provided in section 514.981, subdivision 6, 
666.30  when the affidavit is filed or recorded, the life estate or 
666.31  joint tenancy interest in real property that the affidavit 
666.32  describes shall be terminated effective as of the date of filing 
666.33  or recording.  The termination shall be final and may not be set 
666.34  aside for any reason. 
666.35     <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
666.36  2003, and applies to the estates of decedents who die on or 
667.1   after that date. 
667.2      Sec. 50.  Minnesota Statutes 2002, section 256B.15, is 
667.3   amended by adding a subdivision to read: 
667.4      Subd. 1k.  [FILING.] Any notice, lien, release, or other 
667.5   document filed under subdivisions 1c to 1l, and any lien, 
667.6   release of lien, or other documents relating to a lien filed 
667.7   under subdivisions 1h, 1i, and 1j must be filed or recorded in 
667.8   the office of the county recorder or registrar of titles, as 
667.9   appropriate, in the county where the affected real property is 
667.10  located.  Notwithstanding section 386.77, the state or county 
667.11  agency shall pay any applicable filing fee.  An attestation, 
667.12  certification, or acknowledgment is not required as a condition 
667.13  of filing.  If the property described in the filing is 
667.14  registered property, the registrar of titles shall record the 
667.15  filing on the certificate of title for each parcel of property 
667.16  described in the filing.  If the property described in the 
667.17  filing is abstract property, the recorder shall file and index 
667.18  the property in the county's grantor-grantee indexes and any 
667.19  tract indexes the county maintains for each parcel of property 
667.20  described in the filing.  The recorder or registrar of titles 
667.21  shall return the filed document to the party filing it at no 
667.22  cost.  If the party making the filing provides a duplicate copy 
667.23  of the filing, the recorder or registrar of titles shall show 
667.24  the recording or filing data on the copy and return it to the 
667.25  party at no extra cost. 
667.26     <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
667.27  2003, and applies to the estates of decedents who die on or 
667.28  after that date. 
667.29     Sec. 51.  Minnesota Statutes 2002, section 256B.15, 
667.30  subdivision 3, is amended to read: 
667.31     Subd. 3.  [SURVIVING SPOUSE, MINOR, BLIND, OR DISABLED 
667.32  CHILDREN.] If a decedent ~~who~~ is survived by a spouse, or was 
667.33  single~~,~~ or ~~who was~~ the surviving spouse of a married couple~~,~~ and 
667.34  is survived by a child who is under age 21 or blind or 
667.35  permanently and totally disabled according to the supplemental 
667.36  security income program criteria, ~~no~~ a claim shall be filed 
668.1   against the estate according to this section. 
668.2      <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
668.3   and applies to decedents who die on or after that date. 
668.4      Sec. 52.  Minnesota Statutes 2002, section 256B.15, 
668.5   subdivision 4, is amended to read: 
668.6      Subd. 4.  [OTHER SURVIVORS.] If the decedent who was single 
668.7   or the surviving spouse of a married couple is survived by one 
668.8   of the following persons, a claim exists against the estate in 
668.9   an amount not to exceed the value of the nonhomestead property 
668.10  included in the estate and the personal representative shall 
668.11  make, execute, and deliver to the county agency a lien against 
668.12  the homestead property in the estate for any unpaid balance of 
668.13  the claim to the claimant as provided under this section: 
668.14     (a) a sibling who resided in the decedent medical 
668.15  assistance recipient's home at least one year before the 
668.16  decedent's institutionalization and continuously since the date 
668.17  of institutionalization; or 
668.18     (b) a son or daughter or a grandchild who resided in the 
668.19  decedent medical assistance recipient's home for at least two 
668.20  years immediately before the parent's or grandparent's 
668.21  institutionalization and continuously since the date of 
668.22  institutionalization, and who establishes by a preponderance of 
668.23  the evidence having provided care to the parent or grandparent 
668.24  who received medical assistance, that the care was provided 
668.25  before institutionalization, and that the care permitted the 
668.26  parent or grandparent to reside at home rather than in an 
668.27  institution. 
668.28     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
668.29  and applies to decedents who die on or after that date. 
668.30     Sec. 53.  Minnesota Statutes 2002, section 256B.195, 
668.31  subdivision 3, is amended to read: 
668.32     Subd. 3.  [PAYMENTS TO CERTAIN SAFETY NET PROVIDERS.] (a) 
668.33  Effective July 15, 2001, the commissioner shall make the 
668.34  following payments to the hospitals indicated after noon on the 
668.35  15th of each month: 
668.36     (1) to Hennepin County Medical Center, any federal matching 
669.1   funds available to match the payments received by the medical 
669.2   center under subdivision 2, to increase payments for medical 
669.3   assistance admissions and to recognize higher medical assistance 
669.4   costs in institutions that provide high levels of charity care; 
669.5   and 
669.6      (2) to Regions hospital, any federal matching funds 
669.7   available to match the payments received by the hospital under 
669.8   subdivision 2, to increase payments for medical assistance 
669.9   admissions and to recognize higher medical assistance costs in 
669.10  institutions that provide high levels of charity care.  
669.11     (b) Effective July 15, 2001, the following percentages of 
669.12  the transfers under subdivision 2 shall be retained by the 
669.13  commissioner for deposit each month into the general fund: 
669.14     (1) 18 percent, plus any federal matching funds, shall be 
669.15  allocated for the following purposes: 
669.16     (i) during the fiscal year beginning July 1, 2001, of the 
669.17  amount available under this clause, 39.7 percent shall be 
669.18  allocated to make increased hospital payments under section 
669.19  256.969, subdivision 26; 34.2 percent shall be allocated to fund 
669.20  the amounts due from small rural hospitals, as defined in 
669.21  section 144.148, for overpayments under section 256.969, 
669.22  subdivision 5a, resulting from a determination that medical 
669.23  assistance and general assistance payments exceeded the charge 
669.24  limit during the period from 1994 to 1997; and 26.1 percent 
669.25  shall be allocated to the commissioner of health for rural 
669.26  hospital capital improvement grants under section 144.148; and 
669.27     (ii) during fiscal years beginning on or after July 1, 
669.28  2002, of the amount available under this clause, 55 percent 
669.29  shall be allocated to make increased hospital payments under 
669.30  section 256.969, subdivision 26, and 45 percent shall be 
669.31  allocated to the commissioner of health for rural hospital 
669.32  capital improvement grants under section 144.148; and 
669.33     (2) 11 percent shall be allocated to the commissioner of 
669.34  health to fund community clinic grants under section 145.9268. 
669.35     (c) This subdivision shall apply to fee-for-service 
669.36  payments only and shall not increase capitation payments or 
670.1   payments made based on average rates. 
670.2      (d) Medical assistance rate or payment changes, including 
670.3   those required to obtain federal financial participation under 
670.4   section 62J.692, subdivision 8, shall precede the determination 
670.5   of intergovernmental transfer amounts determined in this 
670.6   subdivision.  Participation in the intergovernmental transfer 
670.7   program shall not result in the offset of any health care 
670.8   provider's receipt of medical assistance payment increases other 
670.9   than limits resulting from hospital-specific charge limits and 
670.10  limits on disproportionate share hospital payments. 
670.11     (e) Effective July 1, 2003, if the amount available for 
670.12  allocation under paragraph (b) is greater than the amounts 
670.13  available during March 2003, after any increase in 
670.14  intergovernmental transfers and payments that result from 
670.15  section 256.969, subdivision 3a, paragraph (c), are paid to the 
670.16  general fund, any additional amounts available under this 
670.17  subdivision after reimbursement of the transfers under 
670.18  subdivision 2 shall be allocated to increase medical assistance 
670.19  payments, subject to hospital-specific charge limits and limits 
670.20  on disproportionate share hospital payments, as follows: 
670.21     (1) if the payments under subdivision 5 are approved, the 
670.22  amount shall be paid to the largest ten percent of hospitals as 
670.23  measured by 2001 payments for medical assistance, general 
670.24  assistance medical care, and MinnesotaCare in the nonstate 
670.25  government hospital category.  Payments shall be allocated 
670.26  according to each hospital's proportionate share of the 2001 
670.27  payments; or 
670.28     (2) if the payments under subdivision 5 are not approved, 
670.29  the amount shall be paid to the largest ten percent of hospitals 
670.30  as measured by 2001 payments for medical assistance, general 
670.31  assistance medical care, and MinnesotaCare in the nonstate 
670.32  government category and to the largest ten percent of hospitals 
670.33  as measured by payments for medical assistance, general 
670.34  assistance medical care, and MinnesotaCare in the nongovernment 
670.35  hospital category.  Payments shall be allocated according to 
670.36  each hospital's proportionate share of the 2001 payments in 
671.1   their respective category of nonstate government and 
671.2   nongovernment.  The commissioner shall determine which hospitals 
671.3   are in the nonstate government and nongovernment hospital 
671.4   categories. 
671.5      Sec. 54.  Minnesota Statutes 2002, section 256B.195, 
671.6   subdivision 5, is amended to read: 
671.7      Subd. 5.  [INCLUSION OF FAIRVIEW UNIVERSITY MEDICAL 
671.8   CENTER.] (a) Upon federal approval of the ~~inclusion of Fairview~~ 
671.9   ~~University Medical Center in the nonstate government~~ 
671.10  ~~category~~ payments in paragraph (b), the commissioner shall 
671.11  establish an intergovernmental transfer with the University of 
671.12  Minnesota in an amount determined by the commissioner based on 
671.13  the ~~increase in the~~ amount of Medicare upper payment limit ~~due~~ 
671.14  ~~solely to the inclusion of Fairview University Medical Center as~~ 
671.15  ~~a nonstate government hospital and limited~~ available for 
671.16  nongovernment hospitals adjusted by hospital-specific charge 
671.17  limits and the amount available under the hospital-specific 
671.18  disproportionate share limit. 
671.19     (b) Effective July 1, 2003, the commissioner shall increase 
671.20  payments for medical assistance admissions at Fairview 
671.21  University Medical Center by 71 percent of the transfer plus any 
671.22  federal matching payments on that amount, to increase payments 
671.23  for medical assistance admissions and to recognize higher 
671.24  medical assistance costs in institutions that provide high 
671.25  levels of charity care.  ~~From this payment, Fairview University~~ 
671.26  ~~Medical Center shall pay to the University of Minnesota the cost~~ 
671.27  ~~of the transfer, on the same day the payment is received.~~  
671.28  ~~Eighteen percent of the transfer plus any federal matching~~ 
671.29  ~~payments shall be used as specified in subdivision 3, paragraph~~ 
671.30  ~~(b), clause (1).  Payments under section 256.969, subdivision~~ 
671.31  ~~26, may be increased above the 90 percent level specified in~~ 
671.32  ~~that subdivision within the limits of additional funding~~ 
671.33  ~~available under this subdivision.  Eleven percent of the~~ 
671.34  ~~transfer shall be used to increase the grants under section~~ 
671.35  ~~145.9268~~ Twenty-nine percent of the transfer plus federal 
671.36  matching funds available as a result of the transfers in 
672.1   subdivision 5 shall be paid to the largest ten percent of 
672.2   hospitals in the nongovernment hospital category as measured by 
672.3   2001 payments for medical assistance, general assistance medical 
672.4   care, and MinnesotaCare.  Payments shall be allocated according 
672.5   to each hospital's proportionate share of the 2001 payments.  
672.6   The commissioner shall determine which hospitals are in the 
672.7   nongovernment hospital category. 
672.8      Sec. 55.  Minnesota Statutes 2002, section 256B.32, 
672.9   subdivision 1, is amended to read: 
672.10     Subdivision 1.  [FACILITY FEE PAYMENT.] (a) The 
672.11  commissioner shall establish a facility fee payment mechanism 
672.12  that will pay a facility fee to all enrolled outpatient 
672.13  hospitals for each emergency room or outpatient clinic visit 
672.14  provided on or after July 1, 1989.  This payment mechanism may 
672.15  not result in an overall increase in outpatient payment rates.  
672.16  This section does not apply to federally mandated maximum 
672.17  payment limits, department approved program packages, or 
672.18  services billed using a nonoutpatient hospital provider number. 
672.19     (b) For fee-for-service services provided on or after July 
672.20  1, 2002, the total payment, before third-party liability and 
672.21  spenddown, made to hospitals for outpatient hospital facility 
672.22  services is reduced by .5 percent from the current statutory 
672.23  rates. 
672.24     (c) In addition to the reduction in paragraph (b), the 
672.25  total payment for fee-for-service services provided on or after 
672.26  July 1, 2003, made to hospitals for outpatient hospital facility 
672.27  services before third-party liability and spenddown, is reduced 
672.28  five percent from the current statutory rates.  Facilities 
672.29  defined under section 256.969, subdivision 16, are excluded from 
672.30  this paragraph. 
672.31     Sec. 56.  Minnesota Statutes 2002, section 256B.69, 
672.32  subdivision 2, is amended to read: 
672.33     Subd. 2.  [DEFINITIONS.] For the purposes of this section, 
672.34  the following terms have the meanings given.  
672.35     (a) "Commissioner" means the commissioner of human services.
672.36  For the remainder of this section, the commissioner's 
673.1   responsibilities for methods and policies for implementing the 
673.2   project will be proposed by the project advisory committees and 
673.3   approved by the commissioner.  
673.4      (b) "Demonstration provider" means a health maintenance 
673.5   organization, community integrated service network, or 
673.6   accountable provider network authorized and operating under 
673.7   chapter 62D, 62N, or 62T that participates in the demonstration 
673.8   project according to criteria, standards, methods, and other 
673.9   requirements established for the project and approved by the 
673.10  commissioner.  For purposes of this section, a county board, or 
673.11  group of county boards operating under a joint powers agreement, 
673.12  is considered a demonstration provider if the county or group of 
673.13  county boards meets the requirements of section 256B.692.  
673.14  Notwithstanding the above, Itasca county may continue to 
673.15  participate as a demonstration provider until July 1, 2004. 
673.16     (c) "Eligible individuals" means those persons eligible for 
673.17  medical assistance benefits as defined in sections 256B.055, 
673.18  256B.056, and 256B.06. 
673.19     (d) "Limitation of choice" means suspending freedom of 
673.20  choice while allowing eligible individuals to choose among the 
673.21  demonstration providers.  
673.22     ~~(e) This paragraph supersedes paragraph (c) as long as the~~ 
673.23  ~~Minnesota health care reform waiver remains in effect.  When the~~ 
673.24  ~~waiver expires, this paragraph expires and the commissioner of~~ 
673.25  ~~human services shall publish a notice in the State Register and~~ 
673.26  ~~notify the revisor of statutes.  "Eligible individuals" means~~ 
673.27  ~~those persons eligible for medical assistance benefits as~~ 
673.28  ~~defined in sections 256B.055, 256B.056, and 256B.06.~~  
673.29  ~~Notwithstanding sections 256B.055, 256B.056, and 256B.06, an~~ 
673.30  ~~individual who becomes ineligible for the program because of~~ 
673.31  ~~failure to submit income reports or recertification forms in a~~ 
673.32  ~~timely manner, shall remain enrolled in the prepaid health plan~~ 
673.33  ~~and shall remain eligible to receive medical assistance coverage~~ 
673.34  ~~through the last day of the month following the month in which~~ 
673.35  ~~the enrollee became ineligible for the medical assistance~~ 
673.36  ~~program.~~ 
674.1      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
674.2   or upon federal approval, whichever is later. 
674.3      Sec. 57.  Minnesota Statutes 2002, section 256B.69, 
674.4   subdivision 4, is amended to read: 
674.5      Subd. 4.  [LIMITATION OF CHOICE.] (a) The commissioner 
674.6   shall develop criteria to determine when limitation of choice 
674.7   may be implemented in the experimental counties.  The criteria 
674.8   shall ensure that all eligible individuals in the county have 
674.9   continuing access to the full range of medical assistance 
674.10  services as specified in subdivision 6.  
674.11     (b) The commissioner shall exempt the following persons 
674.12  from participation in the project, in addition to those who do 
674.13  not meet the criteria for limitation of choice:  
674.14     (1) persons eligible for medical assistance according to 
674.15  section 256B.055, subdivision 1; 
674.16     (2) persons eligible for medical assistance due to 
674.17  blindness or disability as determined by the social security 
674.18  administration or the state medical review team, unless:  
674.19     (i) they are 65 years of age or older; or 
674.20     (ii) they reside in Itasca county or they reside in a 
674.21  county in which the commissioner conducts a pilot project under 
674.22  a waiver granted pursuant to section 1115 of the Social Security 
674.23  Act; 
674.24     (3) recipients who currently have private coverage through 
674.25  a health maintenance organization; 
674.26     (4) recipients who are eligible for medical assistance by 
674.27  spending down excess income for medical expenses other than the 
674.28  nursing facility per diem expense; 
674.29     (5) recipients who receive benefits under the Refugee 
674.30  Assistance Program, established under United States Code, title 
674.31  8, section 1522(e); 
674.32     (6) children who are both determined to be severely 
674.33  emotionally disturbed and receiving case management services 
674.34  according to section 256B.0625, subdivision 20; 
674.35     (7) adults who are both determined to be seriously and 
674.36  persistently mentally ill and received case management services 
675.1   according to section 256B.0625, subdivision 20; ~~and~~ 
675.2      (8) persons eligible for medical assistance according to 
675.3   section 256B.057, subdivision 10; and 
675.4      (9) persons with access to cost-effective 
675.5   employer-sponsored private health insurance or persons enrolled 
675.6   in an individual health plan determined to be cost-effective 
675.7   according to section 256B.0625, subdivision 15.  
675.8   Children under age 21 who are in foster placement may enroll in 
675.9   the project on an elective basis.  Individuals excluded under 
675.10  clauses (6) and (7) may choose to enroll on an elective 
675.11  basis.  The commissioner may enroll recipients in the prepaid 
675.12  medical assistance program for seniors who are (1) age 65 and 
675.13  over, and (2) eligible for medical assistance by spending down 
675.14  excess income. 
675.15     (c) The commissioner may allow persons with a one-month 
675.16  spenddown who are otherwise eligible to enroll to voluntarily 
675.17  enroll or remain enrolled, if they elect to prepay their monthly 
675.18  spenddown to the state.  
675.19     (d) The commissioner may require those individuals to 
675.20  enroll in the prepaid medical assistance program who otherwise 
675.21  would have been excluded under paragraph (b), clauses (1), (3), 
675.22  and (8), and under Minnesota Rules, part 9500.1452, subpart 2, 
675.23  items H, K, and L.  
675.24     (e) Before limitation of choice is implemented, eligible 
675.25  individuals shall be notified and after notification, shall be 
675.26  allowed to choose only among demonstration providers.  The 
675.27  commissioner may assign an individual with private coverage 
675.28  through a health maintenance organization, to the same health 
675.29  maintenance organization for medical assistance coverage, if the 
675.30  health maintenance organization is under contract for medical 
675.31  assistance in the individual's county of residence.  After 
675.32  initially choosing a provider, the recipient is allowed to 
675.33  change that choice only at specified times as allowed by the 
675.34  commissioner.  If a demonstration provider ends participation in 
675.35  the project for any reason, a recipient enrolled with that 
675.36  provider must select a new provider but may change providers 
676.1   without cause once more within the first 60 days after 
676.2   enrollment with the second provider. 
676.3      Sec. 58.  Minnesota Statutes 2002, section 256B.69, 
676.4   subdivision 5, is amended to read: 
676.5      Subd. 5.  [PROSPECTIVE PER CAPITA PAYMENT.] The 
676.6   commissioner shall establish the method and amount of payments 
676.7   for services.  The commissioner shall annually contract with 
676.8   demonstration providers to provide services consistent with 
676.9   these established methods and amounts for payment.  
676.10     If allowed by the commissioner, a demonstration provider 
676.11  may contract with an insurer, health care provider, nonprofit 
676.12  health service plan corporation, or the commissioner, to provide 
676.13  insurance or similar protection against the cost of care 
676.14  provided by the demonstration provider or to provide coverage 
676.15  against the risks incurred by demonstration providers under this 
676.16  section.  The recipients enrolled with a demonstration provider 
676.17  are a permissible group under group insurance laws and chapter 
676.18  62C, the Nonprofit Health Service Plan Corporations Act.  Under 
676.19  this type of contract, the insurer or corporation may make 
676.20  benefit payments to a demonstration provider for services 
676.21  rendered or to be rendered to a recipient.  Any insurer or 
676.22  nonprofit health service plan corporation licensed to do 
676.23  business in this state is authorized to provide this insurance 
676.24  or similar protection.  
676.25     Payments to providers participating in the project are 
676.26  exempt from the requirements of sections 256.966 and 256B.03, 
676.27  subdivision 2.  The commissioner shall complete development of 
676.28  capitation rates for payments before delivery of services under 
676.29  this section is begun.  For payments made during calendar year 
676.30  1990 and later years, the commissioner shall contract with an 
676.31  independent actuary to establish prepayment rates. 
676.32     By January 15, 1996, the commissioner shall report to the 
676.33  legislature on the methodology used to allocate to participating 
676.34  counties available administrative reimbursement for advocacy and 
676.35  enrollment costs.  The report shall reflect the commissioner's 
676.36  judgment as to the adequacy of the funds made available and of 
677.1   the methodology for equitable distribution of the funds.  The 
677.2   commissioner must involve participating counties in the 
677.3   development of the report. 
677.4      Beginning July 1, 2004, the commissioner may include 
677.5   payments for elderly waiver services and 180 days of nursing 
677.6   home care in capitation payments for the prepaid medical 
677.7   assistance program for recipients age 65 and older.  Payments 
677.8   for elderly waiver services shall be made no earlier than the 
677.9   month following the month in which services were received.  
677.10     Sec. 59.  Minnesota Statutes 2002, section 256B.69, 
677.11  subdivision 5a, is amended to read: 
677.12     Subd. 5a.  [MANAGED CARE CONTRACTS.] (a) Managed care 
677.13  contracts under this section and sections 256L.12 and 256D.03, 
677.14  shall be entered into or renewed on a calendar year basis 
677.15  beginning January 1, 1996.  Managed care contracts which were in 
677.16  effect on June 30, 1995, and set to renew on July 1, 1995, shall 
677.17  be renewed for the period July 1, 1995 through December 31, 1995 
677.18  at the same terms that were in effect on June 30, 1995.  The 
677.19  commissioner may issue separate contracts with requirements 
677.20  specific to services to medical assistance recipients age 65 and 
677.21  older. 
677.22     (b) A prepaid health plan providing covered health services 
677.23  for eligible persons pursuant to chapters 256B, 256D, and 256L, 
677.24  is responsible for complying with the terms of its contract with 
677.25  the commissioner.  Requirements applicable to managed care 
677.26  programs under chapters 256B, 256D, and 256L, established after 
677.27  the effective date of a contract with the commissioner take 
677.28  effect when the contract is next issued or renewed. 
677.29     (c) Effective for services rendered on or after January 1, 
677.30  2003, the commissioner shall withhold five percent of managed 
677.31  care plan payments under this section for the prepaid medical 
677.32  assistance and general assistance medical care programs pending 
677.33  completion of performance targets.  Each performance target must 
677.34  be quantifiable, objective, measurable, and reasonably 
677.35  attainable, except in the case of a performance target based on 
677.36  a federal or state law or rule.  Criteria for assessment of each 
678.1   performance target must be outlined in writing prior to the 
678.2   contract effective date.  The withheld funds must be returned no 
678.3   sooner than July of the following year if performance targets in 
678.4   the contract are achieved.  The commissioner may exclude special 
678.5   demonstration projects under subdivision 23.  A managed care 
678.6   plan or a county-based purchasing plan under section 256B.692 
678.7   may include as admitted assets under section 62D.044 any amount 
678.8   withheld under this paragraph that is reasonably expected to be 
678.9   returned. 
678.10     <b>[EFFECTIVE DATE.]</b> This section is effective for services 
678.11  rendered on or after July 1, 2003, except that the amendment to 
678.12  paragraph (c) is effective for services rendered on or after 
678.13  January 1, 2004.  
678.14     Sec. 60.  Minnesota Statutes 2002, section 256B.69, 
678.15  subdivision 5c, is amended to read: 
678.16     Subd. 5c.  [MEDICAL EDUCATION AND RESEARCH FUND.] (a) 
678.17  Except as provided in paragraph (c), the commissioner of human 
678.18  services shall transfer each year to the medical education and 
678.19  research fund established under section 62J.692, the following: 
678.20     (1) an amount equal to the reduction in the prepaid medical 
678.21  assistance and prepaid general assistance medical care payments 
678.22  as specified in this clause.  Until January 1, 2002, the county 
678.23  medical assistance and general assistance medical care 
678.24  capitation base rate prior to plan specific adjustments and 
678.25  after the regional rate adjustments under section 256B.69, 
678.26  subdivision 5b, is reduced 6.3 percent for Hennepin county, two 
678.27  percent for the remaining metropolitan counties, and no 
678.28  reduction for nonmetropolitan Minnesota counties; and after 
678.29  January 1, 2002, the county medical assistance and general 
678.30  assistance medical care capitation base rate prior to plan 
678.31  specific adjustments is reduced 6.3 percent for Hennepin county, 
678.32  two percent for the remaining metropolitan counties, and 1.6 
678.33  percent for nonmetropolitan Minnesota counties.  Nursing 
678.34  facility and elderly waiver payments and demonstration project 
678.35  payments operating under subdivision 23 are excluded from this 
678.36  reduction.  The amount calculated under this clause shall not be 
679.1   adjusted for periods already paid due to subsequent changes to 
679.2   the capitation payments; 
679.3      (2) beginning July 1, ~~2001, $2,537,000~~ 2003, $2,157,000 
679.4   from the capitation rates paid under this section plus any 
679.5   federal matching funds on this amount; 
679.6      (3) beginning July 1, 2002, an additional $12,700,000 from 
679.7   the capitation rates paid under this section; and 
679.8      (4) beginning July 1, 2003, an additional $4,700,000 from 
679.9   the capitation rates paid under this section. 
679.10     (b) This subdivision shall be effective upon approval of a 
679.11  federal waiver which allows federal financial participation in 
679.12  the medical education and research fund. 
679.13     (c) Effective July 1, 2003, the amount reduced from the 
679.14  prepaid general assistance medical care payments under paragraph 
679.15  (a), clause (1), shall be transferred to the general fund. 
679.16     Sec. 61.  Minnesota Statutes 2002, section 256B.69, is 
679.17  amended by adding a subdivision to read: 
679.18     Subd. 5h.  [PAYMENT REDUCTION.] In addition to the 
679.19  reduction in subdivision 5g, the total payment made to managed 
679.20  care plans under the medical assistance program is reduced 1.0 
679.21  percent for services provided on or after October 1, 2003, and 
679.22  an additional 1.0 percent for services provided on or after 
679.23  January 1, 2004.  This provision excludes payments for nursing 
679.24  home services, home and community-based waivers, and payments to 
679.25  demonstration projects for persons with disabilities. 
679.26     Sec. 62.  Minnesota Statutes 2002, section 256B.69, 
679.27  subdivision 6a, is amended to read: 
679.28     Subd. 6a.  [NURSING HOME SERVICES.] (a) Notwithstanding 
679.29  Minnesota Rules, part 9500.1457, subpart 1, item B, up to ~~90~~ 180 
679.30  days of nursing facility services as defined in section 
679.31  256B.0625, subdivision 2, which are provided in a nursing 
679.32  facility certified by the Minnesota department of health for 
679.33  services provided and eligible for payment under Medicaid, shall 
679.34  be covered under the prepaid medical assistance program for 
679.35  individuals who are not residing in a nursing facility at the 
679.36  time of enrollment in the prepaid medical assistance 
680.1   program.  The commissioner may develop a schedule to phase in 
680.2   implementation of the 180-day provision. 
680.3      (b) For individuals enrolled in the Minnesota senior health 
680.4   options project authorized under subdivision 23, nursing 
680.5   facility services shall be covered according to the terms and 
680.6   conditions of the federal agreement governing that demonstration 
680.7   project. 
680.8      Sec. 63.  Minnesota Statutes 2002, section 256B.69, 
680.9   subdivision 6b, is amended to read: 
680.10     Subd. 6b.  [HOME AND COMMUNITY-BASED WAIVER SERVICES.] (a) 
680.11  For individuals enrolled in the Minnesota senior health options 
680.12  project authorized under subdivision 23, elderly waiver services 
680.13  shall be covered according to the terms and conditions of the 
680.14  federal agreement governing that demonstration project. 
680.15     (b) For individuals under age 65 enrolled in demonstrations 
680.16  authorized under subdivision 23, home and community-based waiver 
680.17  services shall be covered according to the terms and conditions 
680.18  of the federal agreement governing that demonstration project. 
680.19     (c) Notwithstanding Minnesota Rules, part 9500.1457, 
680.20  subpart 1, item C, elderly waiver services shall be covered 
680.21  under the prepaid medical assistance program for all individuals 
680.22  who are eligible according to section 256B.0915.  The 
680.23  commissioner may develop a schedule to phase in implementation 
680.24  of these waiver services.  
680.25     Sec. 64.  Minnesota Statutes 2002, section 256B.69, is 
680.26  amended by adding a subdivision to read: 
680.27     Subd. 6d.  [PRESCRIPTION DRUGS.] Effective January 1, 2004, 
680.28  the commissioner may exclude or modify coverage for prescription 
680.29  drugs from the prepaid managed care contracts entered into under 
680.30  this section in order to increase savings to the state by 
680.31  collecting additional prescription drug rebates.  The contracts 
680.32  must maintain incentives for the managed care plan to manage 
680.33  drug costs and utilization and may require that the managed care 
680.34  plans maintain an open drug formulary.  In order to manage drug 
680.35  costs and utilization, the contracts may authorize the managed 
680.36  care plans to use preferred drug lists and prior authorization.  
681.1   This subdivision is contingent on federal approval of the 
681.2   managed care contract changes and the collection of additional 
681.3   prescription drug rebates.  
681.4      Sec. 65.  Minnesota Statutes 2002, section 256B.69, 
681.5   subdivision 8, is amended to read: 
681.6      Subd. 8.  [PREADMISSION SCREENING WAIVER.] Except as 
681.7   applicable to the project's operation, the provisions of section 
681.8   256B.0911 are waived for the purposes of this section for 
681.9   recipients enrolled with demonstration providers or in the 
681.10  prepaid medical assistance program for seniors.  
681.11     Sec. 66.  Minnesota Statutes 2002, section 256B.75, is 
681.12  amended to read: 
681.13     256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 
681.14     (a) For outpatient hospital facility fee payments for 
681.15  services rendered on or after October 1, 1992, the commissioner 
681.16  of human services shall pay the lower of (1) submitted charge, 
681.17  or (2) 32 percent above the rate in effect on June 30, 1992, 
681.18  except for those services for which there is a federal maximum 
681.19  allowable payment.  Effective for services rendered on or after 
681.20  January 1, 2000, payment rates for nonsurgical outpatient 
681.21  hospital facility fees and emergency room facility fees shall be 
681.22  increased by eight percent over the rates in effect on December 
681.23  31, 1999, except for those services for which there is a federal 
681.24  maximum allowable payment.  Services for which there is a 
681.25  federal maximum allowable payment shall be paid at the lower of 
681.26  (1) submitted charge, or (2) the federal maximum allowable 
681.27  payment.  Total aggregate payment for outpatient hospital 
681.28  facility fee services shall not exceed the Medicare upper 
681.29  limit.  If it is determined that a provision of this section 
681.30  conflicts with existing or future requirements of the United 
681.31  States government with respect to federal financial 
681.32  participation in medical assistance, the federal requirements 
681.33  prevail.  The commissioner may, in the aggregate, prospectively 
681.34  reduce payment rates to avoid reduced federal financial 
681.35  participation resulting from rates that are in excess of the 
681.36  Medicare upper limitations. 
682.1      (b) Notwithstanding paragraph (a), payment for outpatient, 
682.2   emergency, and ambulatory surgery hospital facility fee services 
682.3   for critical access hospitals designated under section 144.1483, 
682.4   clause (11), shall be paid on a cost-based payment system that 
682.5   is based on the cost-finding methods and allowable costs of the 
682.6   Medicare program. 
682.7      (c) Effective for services provided on or after July 1, 
682.8   2003, rates that are based on the Medicare outpatient 
682.9   prospective payment system shall be replaced by a budget neutral 
682.10  prospective payment system that is derived using medical 
682.11  assistance data.  The commissioner shall provide a proposal to 
682.12  the 2003 legislature to define and implement this provision. 
682.13     (d) For fee-for-service services provided on or after July 
682.14  1, 2002, the total payment, before third-party liability and 
682.15  spenddown, made to hospitals for outpatient hospital facility 
682.16  services is reduced by .5 percent from the current statutory 
682.17  rate. 
682.18     (e) In addition to the reduction in paragraph (d), the 
682.19  total payment for fee-for-service services provided on or after 
682.20  July 1, 2003, made to hospitals for outpatient hospital facility 
682.21  services before third-party liability and spenddown, is reduced 
682.22  five percent from the current statutory rates.  Facilities 
682.23  defined under section 256.969, subdivision 16, are excluded from 
682.24  this paragraph. 
682.25     Sec. 67.  Minnesota Statutes 2002, section 256B.76, is 
682.26  amended to read: 
682.27     256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
682.28     (a) Effective for services rendered on or after October 1, 
682.29  1992, the commissioner shall make payments for physician 
682.30  services as follows: 
682.31     (1) payment for level one Centers for Medicare and Medicaid 
682.32  Services' common procedural coding system codes titled "office 
682.33  and other outpatient services," "preventive medicine new and 
682.34  established patient," "delivery, antepartum, and postpartum 
682.35  care," "critical care," cesarean delivery and pharmacologic 
682.36  management provided to psychiatric patients, and level three 
683.1   codes for enhanced services for prenatal high risk, shall be 
683.2   paid at the lower of (i) submitted charges, or (ii) 25 percent 
683.3   above the rate in effect on June 30, 1992.  If the rate on any 
683.4   procedure code within these categories is different than the 
683.5   rate that would have been paid under the methodology in section 
683.6   256B.74, subdivision 2, then the larger rate shall be paid; 
683.7      (2) payments for all other services shall be paid at the 
683.8   lower of (i) submitted charges, or (ii) 15.4 percent above the 
683.9   rate in effect on June 30, 1992; 
683.10     (3) all physician rates shall be converted from the 50th 
683.11  percentile of 1982 to the 50th percentile of 1989, less the 
683.12  percent in aggregate necessary to equal the above increases 
683.13  except that payment rates for home health agency services shall 
683.14  be the rates in effect on September 30, 1992; 
683.15     (4) effective for services rendered on or after January 1, 
683.16  2000, payment rates for physician and professional services 
683.17  shall be increased by three percent over the rates in effect on 
683.18  December 31, 1999, except for home health agency and family 
683.19  planning agency services; and 
683.20     (5) the increases in clause (4) shall be implemented 
683.21  January 1, 2000, for managed care. 
683.22     (b) Effective for services rendered on or after October 1, 
683.23  1992, the commissioner shall make payments for dental services 
683.24  as follows: 
683.25     (1) dental services shall be paid at the lower of (i) 
683.26  submitted charges, or (ii) 25 percent above the rate in effect 
683.27  on June 30, 1992; 
683.28     (2) dental rates shall be converted from the 50th 
683.29  percentile of 1982 to the 50th percentile of 1989, less the 
683.30  percent in aggregate necessary to equal the above increases; 
683.31     (3) effective for services rendered on or after January 1, 
683.32  2000, payment rates for dental services shall be increased by 
683.33  three percent over the rates in effect on December 31, 1999; 
683.34     (4) the commissioner shall award grants to community 
683.35  clinics or other nonprofit community organizations, political 
683.36  subdivisions, professional associations, or other organizations 
684.1   that demonstrate the ability to provide dental services 
684.2   effectively to public program recipients.  Grants may be used to 
684.3   fund the costs related to coordinating access for recipients, 
684.4   developing and implementing patient care criteria, upgrading or 
684.5   establishing new facilities, acquiring furnishings or equipment, 
684.6   recruiting new providers, or other development costs that will 
684.7   improve access to dental care in a region.  In awarding grants, 
684.8   the commissioner shall give priority to applicants that plan to 
684.9   serve areas of the state in which the number of dental providers 
684.10  is not currently sufficient to meet the needs of recipients of 
684.11  public programs or uninsured individuals.  The commissioner 
684.12  shall consider the following in awarding the grants: 
684.13     (i) potential to successfully increase access to an 
684.14  underserved population; 
684.15     (ii) the ability to raise matching funds; 
684.16     (iii) the long-term viability of the project to improve 
684.17  access beyond the period of initial funding; 
684.18     (iv) the efficiency in the use of the funding; and 
684.19     (v) the experience of the proposers in providing services 
684.20  to the target population. 
684.21     The commissioner shall monitor the grants and may terminate 
684.22  a grant if the grantee does not increase dental access for 
684.23  public program recipients.  The commissioner shall consider 
684.24  grants for the following: 
684.25     (i) implementation of new programs or continued expansion 
684.26  of current access programs that have demonstrated success in 
684.27  providing dental services in underserved areas; 
684.28     (ii) a pilot program for utilizing hygienists outside of a 
684.29  traditional dental office to provide dental hygiene services; 
684.30  and 
684.31     (iii) a program that organizes a network of volunteer 
684.32  dentists, establishes a system to refer eligible individuals to 
684.33  volunteer dentists, and through that network provides donated 
684.34  dental care services to public program recipients or uninsured 
684.35  individuals; 
684.36     (5) beginning October 1, 1999, the payment for tooth 
685.1   sealants and fluoride treatments shall be the lower of (i) 
685.2   submitted charge, or (ii) 80 percent of median 1997 charges; 
685.3      (6) the increases listed in clauses (3) and (5) shall be 
685.4   implemented January 1, 2000, for managed care; and 
685.5      (7) effective for services provided on or after January 1, 
685.6   2002, payment for diagnostic examinations and dental x-rays 
685.7   provided to children under age 21 shall be the lower of (i) the 
685.8   submitted charge, or (ii) 85 percent of median 1999 charges.  
685.9      (c) Effective for dental services rendered on or after 
685.10  January 1, 2002, the commissioner may, within the limits of 
685.11  available appropriation, increase reimbursements to dentists and 
685.12  dental clinics deemed by the commissioner to be critical access 
685.13  dental providers.  Reimbursement to a critical access dental 
685.14  provider may be increased by not more than 50 percent above the 
685.15  reimbursement rate that would otherwise be paid to the 
685.16  provider.  Payments to health plan companies shall be adjusted 
685.17  to reflect increased reimbursements to critical access dental 
685.18  providers as approved by the commissioner.  In determining which 
685.19  dentists and dental clinics shall be deemed critical access 
685.20  dental providers, the commissioner shall review: 
685.21     (1) the utilization rate in the service area in which the 
685.22  dentist or dental clinic operates for dental services to 
685.23  patients covered by medical assistance, general assistance 
685.24  medical care, or MinnesotaCare as their primary source of 
685.25  coverage; 
685.26     (2) the level of services provided by the dentist or dental 
685.27  clinic to patients covered by medical assistance, general 
685.28  assistance medical care, or MinnesotaCare as their primary 
685.29  source of coverage; and 
685.30     (3) whether the level of services provided by the dentist 
685.31  or dental clinic is critical to maintaining adequate levels of 
685.32  patient access within the service area. 
685.33  In the absence of a critical access dental provider in a service 
685.34  area, the commissioner may designate a dentist or dental clinic 
685.35  as a critical access dental provider if the dentist or dental 
685.36  clinic is willing to provide care to patients covered by medical 
686.1   assistance, general assistance medical care, or MinnesotaCare at 
686.2   a level which significantly increases access to dental care in 
686.3   the service area. 
686.4      (d) Effective July 1, 2001, the medical assistance rates 
686.5   for outpatient mental health services provided by an entity that 
686.6   operates: 
686.7      (1) a Medicare-certified comprehensive outpatient 
686.8   rehabilitation facility; and 
686.9      (2) a facility that was certified prior to January 1, 1993, 
686.10  with at least 33 percent of the clients receiving rehabilitation 
686.11  services in the most recent calendar year who are medical 
686.12  assistance recipients, will be increased by 38 percent, when 
686.13  those services are provided within the comprehensive outpatient 
686.14  rehabilitation facility and provided to residents of nursing 
686.15  facilities owned by the entity. 
686.16     (e) An entity that operates both a Medicare certified 
686.17  comprehensive outpatient rehabilitation facility and a facility 
686.18  which was certified prior to January 1, 1993, that is licensed 
686.19  under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
686.20  whom at least 33 percent of the clients receiving rehabilitation 
686.21  services in the most recent calendar year are medical assistance 
686.22  recipients, shall be reimbursed by the commissioner for 
686.23  rehabilitation services at rates that are 38 percent greater 
686.24  than the maximum reimbursement rate allowed under paragraph (a), 
686.25  clause (2), when those services are (1) provided within the 
686.26  comprehensive outpatient rehabilitation facility and (2) 
686.27  provided to residents of nursing facilities owned by the entity. 
686.28     (f) Effective for services rendered on or after January 1, 
686.29  2007, the commissioner shall make payments for physician and 
686.30  professional services based on the Medicare relative value units 
686.31  (RVUs).  This change shall be budget neutral and the cost of 
686.32  implementing RVUs will be incorporated in the established 
686.33  conversion factor. 
686.34     Sec. 68.  Minnesota Statutes 2002, section 256D.03, 
686.35  subdivision 3, is amended to read: 
686.36     Subd. 3.  [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 
687.1   (a) General assistance medical care may be paid for any person 
687.2   who is not eligible for medical assistance under chapter 256B, 
687.3   including eligibility for medical assistance based on a 
687.4   spenddown of excess income according to section 256B.056, 
687.5   subdivision 5, or MinnesotaCare as defined in paragraph (b), 
687.6   except as provided in paragraph (c)~~;~~, and: 
687.7      (1) who is receiving assistance under section 256D.05, 
687.8   except for families with children who are eligible under 
687.9   Minnesota family investment program (MFIP), or who is having a 
687.10  payment made on the person's behalf under sections 256I.01 to 
687.11  256I.06~~, or who resides in group residential housing as defined~~ 
687.12  ~~in chapter 256I and can meet a spenddown using the cost of~~ 
687.13  ~~remedial services received through group residential housing~~; or 
687.14     (2)~~(i)~~ who is a resident of Minnesota; and 
687.15     (i) who has gross countable income not in excess of 75 
687.16  percent of the federal poverty guidelines for the family size, 
687.17  using a six-month budget period and whose equity in assets is 
687.18  not in excess of $1,000 per assistance unit.  Exempt assets, the 
687.19  reduction of excess assets, and the waiver of excess assets must 
687.20  conform to the medical assistance program in ~~chapter~~ 
687.21  ~~256B~~ section 256B.056, subdivision 3, with the following 
687.22  exception:  the maximum amount of undistributed funds in a trust 
687.23  that could be distributed to or on behalf of the beneficiary by 
687.24  the trustee, assuming the full exercise of the trustee's 
687.25  discretion under the terms of the trust, must be applied toward 
687.26  the asset maximum; ~~and~~ or 
687.27     (ii) who has gross countable income ~~not in excess~~ above 75 
687.28  percent of ~~the assistance standards established in section~~ 
687.29  ~~256B.056, subdivision 5c, paragraph (b), or whose excess income~~ 
687.30  ~~is spent down to that standard using a six-month budget period.~~  
687.31  ~~The method for calculating earned income disregards and~~ 
687.32  ~~deductions for a person who resides with a dependent child under~~ 
687.33  ~~age 21 shall follow the AFDC income disregard and deductions in~~ 
687.34  ~~effect under the July 16, 1996, AFDC state plan.  The earned~~ 
687.35  ~~income and work expense deductions for a person who does not~~ 
687.36  ~~reside with a dependent child under age 21 shall be the same as~~ 
688.1   ~~the method used to determine eligibility for a person under~~ 
688.2   ~~section 256D.06, subdivision 1, except the disregard of the~~ 
688.3   ~~first $50 of earned income is not allowed;~~ 
688.4      ~~(3) who would be eligible for medical assistance except~~ 
688.5   ~~that the person resides in a facility that is determined by the~~ 
688.6   ~~commissioner or the federal Centers for Medicare and Medicaid~~ 
688.7   ~~Services to be an institution for mental diseases; or~~ 
688.8      ~~(4) who is ineligible for medical assistance under chapter~~ 
688.9   ~~256B or general assistance medical care under any other~~ 
688.10  ~~provision of this section, and is receiving care and~~ 
688.11  ~~rehabilitation services from a nonprofit center established to~~ 
688.12  ~~serve victims of torture.  These individuals are eligible for~~ 
688.13  ~~general assistance medical care only for the period during which~~ 
688.14  ~~they are receiving services from the center.  During this period~~ 
688.15  ~~of eligibility, individuals eligible under this clause shall not~~ 
688.16  ~~be required to participate in prepaid general assistance medical~~ 
688.17  ~~care~~ the federal poverty guidelines but not in excess of 175 
688.18  percent of the federal poverty guidelines for the family size, 
688.19  using a six-month budget period, whose equity in assets is not 
688.20  in excess of the limits in section 256B.056, subdivision 3c, and 
688.21  who applies during an inpatient hospitalization.  
688.22     (b) ~~Beginning January 1, 2000,~~ General assistance medical 
688.23  care may not be paid for applicants or recipients who meet all 
688.24  eligibility requirements of MinnesotaCare as defined in sections 
688.25  256L.01 to 256L.16, and are~~:~~  
688.26     ~~(i)~~ adults with dependent children under 21 whose gross 
688.27  family income is equal to or less than 275 percent of the 
688.28  federal poverty guidelines~~; or~~. 
688.29     ~~(ii) adults without children with earned income and whose~~ 
688.30  ~~family gross income is between 75 percent of the federal poverty~~ 
688.31  ~~guidelines and the amount set by section 256L.04, subdivision 7,~~ 
688.32  ~~shall be terminated from general assistance medical care upon~~ 
688.33  ~~enrollment in MinnesotaCare.  Earned income is deemed available~~ 
688.34  ~~to family members as defined in section 256D.02, subdivision 8.~~ 
688.35     (c) For ~~services rendered on or after July 1, 1997,~~ 
688.36  ~~eligibility is limited to one month prior to application if the~~ 
689.1   ~~person is determined eligible in the prior month~~ applications 
689.2   received on or after October 1, 2003, eligibility may begin no 
689.3   earlier than the date of application.  For individuals eligible 
689.4   under paragraph (a), clause (2), item (i), a redetermination of 
689.5   eligibility must occur every 12 months.  Individuals are 
689.6   eligible under paragraph (a), clause (2), item (ii), only during 
689.7   inpatient hospitalization but may reapply if there is a 
689.8   subsequent period of inpatient hospitalization.  Beginning 
689.9   January 1, 2000, Minnesota health care program applications 
689.10  completed by recipients and applicants who are persons described 
689.11  in paragraph (b), may be returned to the county agency to be 
689.12  forwarded to the department of human services or sent directly 
689.13  to the department of human services for enrollment in 
689.14  MinnesotaCare.  If all other eligibility requirements of this 
689.15  subdivision are met, eligibility for general assistance medical 
689.16  care shall be available in any month during which a 
689.17  MinnesotaCare eligibility determination and enrollment are 
689.18  pending.  Upon notification of eligibility for MinnesotaCare, 
689.19  notice of termination for eligibility for general assistance 
689.20  medical care shall be sent to an applicant or recipient.  If all 
689.21  other eligibility requirements of this subdivision are met, 
689.22  eligibility for general assistance medical care shall be 
689.23  available until enrollment in MinnesotaCare subject to the 
689.24  provisions of paragraph (e). 
689.25     (d) The date of an initial Minnesota health care program 
689.26  application necessary to begin a determination of eligibility 
689.27  shall be the date the applicant has provided a name, address, 
689.28  and social security number, signed and dated, to the county 
689.29  agency or the department of human services.  If the applicant is 
689.30  unable to provide ~~an initial application~~ a name, address, social 
689.31  security number, and signature when health care is delivered due 
689.32  to a medical condition or disability, a health care provider may 
689.33  act on ~~the person's~~ an applicant's behalf to ~~complete the~~ 
689.34  establish the date of an initial Minnesota health care program 
689.35  application by providing the county agency or department of 
689.36  human services with provider identification and a temporary 
690.1   unique identifier for the applicant.  The applicant must 
690.2   complete the remainder of the application and provide necessary 
690.3   verification before eligibility can be determined.  The county 
690.4   agency must assist the applicant in obtaining verification if 
690.5   necessary.  ~~On the basis of information provided on the~~ 
690.6   ~~completed application, an applicant who meets the following~~ 
690.7   ~~criteria shall be determined eligible beginning in the month of~~ 
690.8   ~~application:~~ 
690.9      ~~(1) has gross income less than 90 percent of the applicable~~ 
690.10  ~~income standard;~~ 
690.11     ~~(2) has liquid assets that total within $300 of the asset~~ 
690.12  ~~standard;~~ 
690.13     ~~(3) does not reside in a long-term care facility; and~~ 
690.14     ~~(4) meets all other eligibility requirements.~~ 
690.15  ~~The applicant must provide all required verifications within 30~~ 
690.16  ~~days' notice of the eligibility determination or eligibility~~ 
690.17  ~~shall be terminated.~~ 
690.18     (e) County agencies are authorized to use all automated 
690.19  databases containing information regarding recipients' or 
690.20  applicants' income in order to determine eligibility for general 
690.21  assistance medical care or MinnesotaCare.  Such use shall be 
690.22  considered sufficient in order to determine eligibility and 
690.23  premium payments by the county agency. 
690.24     (f) General assistance medical care is not available for a 
690.25  person in a correctional facility unless the person is detained 
690.26  by law for less than one year in a county correctional or 
690.27  detention facility as a person accused or convicted of a crime, 
690.28  or admitted as an inpatient to a hospital on a criminal hold 
690.29  order, and the person is a recipient of general assistance 
690.30  medical care at the time the person is detained by law or 
690.31  admitted on a criminal hold order and as long as the person 
690.32  continues to meet other eligibility requirements of this 
690.33  subdivision.  
690.34     (g) General assistance medical care is not available for 
690.35  applicants or recipients who do not cooperate with the county 
690.36  agency to meet the requirements of medical assistance.  ~~General~~ 
691.1   ~~assistance medical care is limited to payment of emergency~~ 
691.2   ~~services only for applicants or recipients as described in~~ 
691.3   ~~paragraph (b), whose MinnesotaCare coverage is denied or~~ 
691.4   ~~terminated for nonpayment of premiums as required by sections~~ 
691.5   ~~256L.06 and 256L.07.~~  
691.6      (h) In determining the amount of assets of an 
691.7   individual eligible under paragraph (a), clause (2), item (i), 
691.8   there shall be included any asset or interest in an asset, 
691.9   including an asset excluded under paragraph (a), that was given 
691.10  away, sold, or disposed of for less than fair market value 
691.11  within the 60 months preceding application for general 
691.12  assistance medical care or during the period of eligibility.  
691.13  Any transfer described in this paragraph shall be presumed to 
691.14  have been for the purpose of establishing eligibility for 
691.15  general assistance medical care, unless the individual furnishes 
691.16  convincing evidence to establish that the transaction was 
691.17  exclusively for another purpose.  For purposes of this 
691.18  paragraph, the value of the asset or interest shall be the fair 
691.19  market value at the time it was given away, sold, or disposed 
691.20  of, less the amount of compensation received.  For any 
691.21  uncompensated transfer, the number of months of ineligibility, 
691.22  including partial months, shall be calculated by dividing the 
691.23  uncompensated transfer amount by the average monthly per person 
691.24  payment made by the medical assistance program to skilled 
691.25  nursing facilities for the previous calendar year.  The 
691.26  individual shall remain ineligible until this fixed period has 
691.27  expired.  The period of ineligibility may exceed 30 months, and 
691.28  a reapplication for benefits after 30 months from the date of 
691.29  the transfer shall not result in eligibility unless and until 
691.30  the period of ineligibility has expired.  The period of 
691.31  ineligibility begins in the month the transfer was reported to 
691.32  the county agency, or if the transfer was not reported, the 
691.33  month in which the county agency discovered the transfer, 
691.34  whichever comes first.  For applicants, the period of 
691.35  ineligibility begins on the date of the first approved 
691.36  application. 
692.1      (i) When determining eligibility for any state benefits 
692.2   under this subdivision, the income and resources of all 
692.3   noncitizens shall be deemed to include their sponsor's income 
692.4   and resources as defined in the Personal Responsibility and Work 
692.5   Opportunity Reconciliation Act of 1996, title IV, Public Law 
692.6   Number 104-193, sections 421 and 422, and subsequently set out 
692.7   in federal rules. 
692.8      (j)~~(1) An~~ Undocumented ~~noncitizen or a nonimmigrant~~ 
692.9   ~~is~~ noncitizens and nonimmigrants are ineligible for general 
692.10  assistance medical care ~~other than emergency services~~, except an 
692.11  individual eligible under paragraph (a), clause (4), remains 
692.12  eligible through September 30, 2003.  For purposes of this 
692.13  subdivision, a nonimmigrant is an individual in one or more of 
692.14  the classes listed in United States Code, title 8, section 
692.15  1101(a)(15), and an undocumented noncitizen is an individual who 
692.16  resides in the United States without the approval or 
692.17  acquiescence of the Immigration and Naturalization Service. 
692.18     ~~(2) This paragraph does not apply to a child under age 18,~~ 
692.19  ~~to a Cuban or Haitian entrant as defined in Public Law Number~~ 
692.20  ~~96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is~~ 
692.21  ~~aged, blind, or disabled as defined in Code of Federal~~ 
692.22  ~~Regulations, title 42, sections 435.520, 435.530, 435.531,~~ 
692.23  ~~435.540, and 435.541, or effective October 1, 1998, to an~~ 
692.24  ~~individual eligible for general assistance medical care under~~ 
692.25  ~~paragraph (a), clause (4), who cooperates with the Immigration~~ 
692.26  ~~and Naturalization Service to pursue any applicable immigration~~ 
692.27  ~~status, including citizenship, that would qualify the individual~~ 
692.28  ~~for medical assistance with federal financial participation.~~ 
692.29     (k) ~~For purposes of paragraphs (g) and (j), "emergency~~ 
692.30  ~~services" has the meaning given in Code of Federal Regulations,~~ 
692.31  ~~title 42, section 440.255(b)(1), except that it also means~~ 
692.32  ~~services rendered because of suspected or actual pesticide~~ 
692.33  ~~poisoning.~~  
692.34     ~~(l)~~ Notwithstanding any other provision of law, a 
692.35  noncitizen who is ineligible for medical assistance due to the 
692.36  deeming of a sponsor's income and resources, is ineligible for 
693.1   general assistance medical care. 
693.2      (l) Effective July 1, 2003, general assistance medical care 
693.3   emergency services end.  
693.4      <b>[EFFECTIVE DATE.]</b> (a) The amendments to paragraph (a), 
693.5   clauses (1) to (4), and paragraphs (b), (c), and (h), are 
693.6   effective October 1, 2003.  For applications processed within 
693.7   one calendar month prior to the effective date, eligibility will 
693.8   be determined by applying the income standards and methodologies 
693.9   in effect prior to the effective date for any months in the 
693.10  six-month budget period before that date and the income 
693.11  standards and methodologies in effect on the effective date for 
693.12  any months in the six-month budget period on or after that 
693.13  date.  The income standards for each month will be added 
693.14  together and compared to the applicant's total countable income 
693.15  for the six-month budget period to determine eligibility. 
693.16     (b) The amendments to paragraphs (d), (g), (j), and (k), 
693.17  are effective July 1, 2003.  
693.18     Sec. 69.  Minnesota Statutes 2002, section 256D.03, 
693.19  subdivision 4, is amended to read: 
693.20     Subd. 4.  [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] 
693.21  (a)(i) For a person who is eligible under subdivision 3, 
693.22  paragraph (a), clause ~~(3)~~ (2), item (i), general assistance 
693.23  medical care covers, except as provided in paragraph (c): 
693.24     (1) inpatient hospital services; 
693.25     (2) outpatient hospital services; 
693.26     (3) services provided by Medicare certified rehabilitation 
693.27  agencies; 
693.28     (4) prescription drugs and other products recommended 
693.29  through the process established in section 256B.0625, 
693.30  subdivision 13; 
693.31     (5) equipment necessary to administer insulin and 
693.32  diagnostic supplies and equipment for diabetics to monitor blood 
693.33  sugar level; 
693.34     (6) eyeglasses and eye examinations provided by a physician 
693.35  or optometrist; 
693.36     (7) hearing aids; 
694.1      (8) prosthetic devices; 
694.2      (9) laboratory and X-ray services; 
694.3      (10) physician's services; 
694.4      (11) medical transportation except special transportation; 
694.5      (12) chiropractic services as covered under the medical 
694.6   assistance program; 
694.7      (13) podiatric services; 
694.8      (14) dental services and dentures, subject to the 
694.9   limitations specified in section 256B.0625, subdivision 9; 
694.10     (15) outpatient services provided by a mental health center 
694.11  or clinic that is under contract with the county board and is 
694.12  established under section 245.62; 
694.13     (16) day treatment services for mental illness provided 
694.14  under contract with the county board; 
694.15     (17) prescribed medications for persons who have been 
694.16  diagnosed as mentally ill as necessary to prevent more 
694.17  restrictive institutionalization; 
694.18     (18) psychological services, medical supplies and 
694.19  equipment, and Medicare premiums, coinsurance and deductible 
694.20  payments; 
694.21     (19) medical equipment not specifically listed in this 
694.22  paragraph when the use of the equipment will prevent the need 
694.23  for costlier services that are reimbursable under this 
694.24  subdivision; 
694.25     (20) services performed by a certified pediatric nurse 
694.26  practitioner, a certified family nurse practitioner, a certified 
694.27  adult nurse practitioner, a certified obstetric/gynecological 
694.28  nurse practitioner, a certified neonatal nurse practitioner, or 
694.29  a certified geriatric nurse practitioner in independent 
694.30  practice, if (1) the service is otherwise covered under this 
694.31  chapter as a physician service, (2) the service provided on an 
694.32  inpatient basis is not included as part of the cost for 
694.33  inpatient services included in the operating payment rate, and 
694.34  (3) the service is within the scope of practice of the nurse 
694.35  practitioner's license as a registered nurse, as defined in 
694.36  section 148.171; 
695.1      (21) services of a certified public health nurse or a 
695.2   registered nurse practicing in a public health nursing clinic 
695.3   that is a department of, or that operates under the direct 
695.4   authority of, a unit of government, if the service is within the 
695.5   scope of practice of the public health nurse's license as a 
695.6   registered nurse, as defined in section 148.171; and 
695.7      (22) telemedicine consultations, to the extent they are 
695.8   covered under section 256B.0625, subdivision 3b.  
695.9      (ii) Effective October 1, 2003, for a person who is 
695.10  eligible under subdivision 3, paragraph (a), clause (2), item 
695.11  (ii), general assistance medical care coverage is limited to 
695.12  inpatient hospital services, including physician services 
695.13  provided during the inpatient hospital stay.  A $1,000 
695.14  deductible is required for each inpatient hospitalization.  
695.15     (b) ~~Except as provided in paragraph (c), for a recipient~~ 
695.16  ~~who is eligible under subdivision 3, paragraph (a), clause (1)~~ 
695.17  ~~or (2), general assistance medical care covers the services~~ 
695.18  ~~listed in paragraph (a) with the exception of special~~ 
695.19  ~~transportation services.~~ 
695.20     ~~(c)~~ Gender reassignment surgery and related services are 
695.21  not covered services under this subdivision unless the 
695.22  individual began receiving gender reassignment services prior to 
695.23  July 1, 1995.  
695.24     ~~(d)~~ (c) In order to contain costs, the commissioner of 
695.25  human services shall select vendors of medical care who can 
695.26  provide the most economical care consistent with high medical 
695.27  standards and shall where possible contract with organizations 
695.28  on a prepaid capitation basis to provide these services.  The 
695.29  commissioner shall consider proposals by counties and vendors 
695.30  for prepaid health plans, competitive bidding programs, block 
695.31  grants, or other vendor payment mechanisms designed to provide 
695.32  services in an economical manner or to control utilization, with 
695.33  safeguards to ensure that necessary services are provided.  
695.34  Before implementing prepaid programs in counties with a county 
695.35  operated or affiliated public teaching hospital or a hospital or 
695.36  clinic operated by the University of Minnesota, the commissioner 
696.1   shall consider the risks the prepaid program creates for the 
696.2   hospital and allow the county or hospital the opportunity to 
696.3   participate in the program in a manner that reflects the risk of 
696.4   adverse selection and the nature of the patients served by the 
696.5   hospital, provided the terms of participation in the program are 
696.6   competitive with the terms of other participants considering the 
696.7   nature of the population served.  Payment for services provided 
696.8   pursuant to this subdivision shall be as provided to medical 
696.9   assistance vendors of these services under sections 256B.02, 
696.10  subdivision 8, and 256B.0625.  For payments made during fiscal 
696.11  year 1990 and later years, the commissioner shall consult with 
696.12  an independent actuary in establishing prepayment rates, but 
696.13  shall retain final control over the rate methodology.  
696.14  ~~Notwithstanding the provisions of subdivision 3, an individual~~ 
696.15  ~~who becomes ineligible for general assistance medical care~~ 
696.16  ~~because of failure to submit income reports or recertification~~ 
696.17  ~~forms in a timely manner, shall remain enrolled in the prepaid~~ 
696.18  ~~health plan and shall remain eligible for general assistance~~ 
696.19  ~~medical care coverage through the last day of the month in which~~ 
696.20  ~~the enrollee became ineligible for general assistance medical~~ 
696.21  ~~care.~~ 
696.22     ~~(e) There shall be no copayment required of any recipient~~ 
696.23  ~~of benefits for any services provided under this subdivision.~~ 
696.24  ~~A hospital receiving a reduced payment as a result of this~~ 
696.25  ~~section may apply the unpaid balance toward satisfaction of the~~ 
696.26  ~~hospital's bad debts.~~ 
696.27     (d) Recipients eligible under subdivision 3, paragraph (a), 
696.28  clause (2), item (i), shall pay the following co-payments for 
696.29  services provided on or after October 1, 2003: 
696.30     (1) $3 per nonpreventive visit.  For purposes of this 
696.31  subdivision, a visit means an episode of service which is 
696.32  required because of a recipient's symptoms, diagnosis, or 
696.33  established illness, and which is delivered in an ambulatory 
696.34  setting by a physician or physician ancillary, chiropractor, 
696.35  podiatrist, nurse midwife, mental health professional, advanced 
696.36  practice nurse, physical therapist, occupational therapist, 
697.1   speech therapist, audiologist, optician, or optometrist; 
697.2      (2) $25 for eyeglasses; 
697.3      (3) $25 for nonemergency visits to a hospital-based 
697.4   emergency room; 
697.5      (4) $3 per brand-name drug prescription and $1 per generic 
697.6   drug prescription, subject to a $20 per month maximum for 
697.7   prescription drug co-payments.  No co-payments shall apply to 
697.8   antipsychotic drugs when used for the treatment of mental 
697.9   illness; and 
697.10     (5) 50 percent coinsurance on basic restorative dental 
697.11  services. 
697.12     (e) Recipients of general assistance medical care are 
697.13  responsible for all co-payments in this subdivision.  The 
697.14  general assistance medical care reimbursement to the provider 
697.15  shall be reduced by the amount of the co-payment, except that 
697.16  reimbursement for prescription drugs shall not be reduced once a 
697.17  recipient has reached the $20 per month maximum for prescription 
697.18  drug co-payments.  The provider collects the co-payment from the 
697.19  recipient.  Providers may not deny services to recipients who 
697.20  are unable to pay the co-payment, except as provided in 
697.21  paragraph (f). 
697.22     (f) If it is the routine business practice of a provider to 
697.23  refuse service to an individual with uncollected debt, the 
697.24  provider may include uncollected co-payments under this 
697.25  section.  A provider must give advance notice to a recipient 
697.26  with uncollected debt before services can be denied. 
697.27     ~~(f)~~ (g) Any county may, from its own resources, provide 
697.28  medical payments for which state payments are not made. 
697.29     ~~(g)~~ (h) Chemical dependency services that are reimbursed 
697.30  under chapter 254B must not be reimbursed under general 
697.31  assistance medical care. 
697.32     ~~(h)~~ (i) The maximum payment for new vendors enrolled in the 
697.33  general assistance medical care program after the base year 
697.34  shall be determined from the average usual and customary charge 
697.35  of the same vendor type enrolled in the base year. 
697.36     ~~(i)~~ (j) The conditions of payment for services under this 
698.1   subdivision are the same as the conditions specified in rules 
698.2   adopted under chapter 256B governing the medical assistance 
698.3   program, unless otherwise provided by statute or rule. 
698.4      (k) Inpatient and outpatient payments shall be reduced by 
698.5   five percent, effective July 1, 2003.  This reduction is in 
698.6   addition to the five percent reduction effective July 1, 2003, 
698.7   and incorporated by reference in paragraph (i).  
698.8      (l) Payments for all other health services except 
698.9   inpatient, outpatient, and pharmacy services shall be reduced by 
698.10  five percent, effective July 1, 2003.  
698.11     (m) Payments to managed care plans shall be reduced by five 
698.12  percent for services provided on or after October 1, 2003. 
698.13     (n) A hospital receiving a reduced payment as a result of 
698.14  this section may apply the unpaid balance toward satisfaction of 
698.15  the hospital's bad debts. 
698.16     <b>[EFFECTIVE DATE.]</b> This section is effective October 1, 
698.17  2003, except that paragraph (c) is effective July 1, 2003. 
698.18     Sec. 70.  Minnesota Statutes 2002, section 256G.05, 
698.19  subdivision 2, is amended to read: 
698.20     Subd. 2.  [NON-MINNESOTA RESIDENTS.] State residence is not 
698.21  required for receiving emergency assistance in the Minnesota 
698.22  supplemental aid program.  The receipt of emergency assistance 
698.23  must not be used as a factor in determining county or state 
698.24  residence.  ~~Non-Minnesota residents are not eligible for~~ 
698.25  ~~emergency general assistance medical care, except emergency~~ 
698.26  ~~hospital services, and professional services incident to the~~ 
698.27  ~~hospital services, for the treatment of acute trauma resulting~~ 
698.28  ~~from an accident occurring in Minnesota.  To be eligible under~~ 
698.29  ~~this subdivision a non-Minnesota resident must verify that they~~ 
698.30  ~~are not eligible for coverage under any other health care~~ 
698.31  ~~program, including coverage from a program in their state of~~ 
698.32  ~~residence.~~ 
698.33     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
698.34     Sec. 71.  Minnesota Statutes 2002, section 256L.03, 
698.35  subdivision 1, is amended to read: 
698.36     Subdivision 1.  [COVERED HEALTH SERVICES.] For individuals 
699.1   under section 256L.04, subdivision 7, with income no greater 
699.2   than 75 percent of the federal poverty guidelines or for 
699.3   families with children under section 256L.04, subdivision 1, all 
699.4   subdivisions of this section apply.  "Covered health services" 
699.5   means the health services reimbursed under chapter 256B, with 
699.6   the exception of inpatient hospital services, special education 
699.7   services, private duty nursing services, adult dental care 
699.8   services other than ~~preventive services~~ services covered under 
699.9   section 256B.0625, subdivision 9, paragraph (b), orthodontic 
699.10  services, nonemergency medical transportation services, personal 
699.11  care assistant and case management services, nursing home or 
699.12  intermediate care facilities services, inpatient mental health 
699.13  services, and chemical dependency services.  ~~Effective July 1,~~ 
699.14  ~~1998, adult dental care for nonpreventive services with the~~ 
699.15  ~~exception of orthodontic services is available to persons who~~ 
699.16  ~~qualify under section 256L.04, subdivisions 1 to 7, with family~~ 
699.17  ~~gross income equal to or less than 175 percent of the federal~~ 
699.18  ~~poverty guidelines.~~  Outpatient mental health services covered 
699.19  under the MinnesotaCare program are limited to diagnostic 
699.20  assessments, psychological testing, explanation of findings, 
699.21  medication management by a physician, day treatment, partial 
699.22  hospitalization, and individual, family, and group psychotherapy.
699.23     No public funds shall be used for coverage of abortion 
699.24  under MinnesotaCare except where the life of the female would be 
699.25  endangered or substantial and irreversible impairment of a major 
699.26  bodily function would result if the fetus were carried to term; 
699.27  or where the pregnancy is the result of rape or incest. 
699.28     Covered health services shall be expanded as provided in 
699.29  this section. 
699.30     <b>[EFFECTIVE DATE.]</b> This section is effective October 1, 2003.
699.31     Sec. 72.  [256L.035] [LIMITED BENEFITS COVERAGE FOR CERTAIN 
699.32  SINGLE ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.] 
699.33     (a) "Covered health services" for individuals under section 
699.34  256L.04, subdivision 7, with income above 75 percent, but not 
699.35  exceeding 175 percent, of the federal poverty guideline means: 
699.36     (1) inpatient hospitalization benefits with a ten percent 
700.1   co-payment up to $1,000 and subject to an annual limitation of 
700.2   $10,000; 
700.3      (2) physician services provided during an inpatient stay; 
700.4   and 
700.5      (3) physician services not provided during an inpatient 
700.6   stay, outpatient hospital services, chiropractic services, lab 
700.7   and diagnostic services, and prescription drugs, subject to an 
700.8   aggregate cap of $2,000 per calendar year and the following 
700.9   co-payments: 
700.10     (i) $50 co-pay per emergency room visit; 
700.11     (ii) $3 co-pay per prescription drug; and 
700.12     (iii) $5 co-pay per nonpreventive physician visit. 
700.13     For purposes of this subdivision, "a visit" means an 
700.14  episode of service which is required because of a recipient's 
700.15  symptoms, diagnosis, or established illness, and which is 
700.16  delivered in an ambulatory setting by a physician or physician 
700.17  ancillary. 
700.18     Enrollees are responsible for all co-payments in this 
700.19  subdivision. 
700.20     (b) The November 2006 MinnesotaCare forecast for the 
700.21  biennium beginning July 1, 2007, shall assume an adjustment in 
700.22  the aggregate cap on the services identified in paragraph (a), 
700.23  clause (3), in $1,000 increments up to a maximum of $10,000, but 
700.24  not less than $2,000, to the extent that the balance in the 
700.25  health care access fund is sufficient in each year of the 
700.26  biennium to pay for this benefit level.  The aggregate cap shall 
700.27  be adjusted according to the forecast. 
700.28     (c) Reimbursement to the providers shall be reduced by the 
700.29  amount of the co-payment, except that reimbursement for 
700.30  prescription drugs shall not be reduced once a recipient has 
700.31  reached the $20 per month maximum for prescription drug 
700.32  co-payments.  The provider collects the co-payment from the 
700.33  recipient.  Providers may not deny services to recipients who 
700.34  are unable to pay the co-payment, except as provided in 
700.35  paragraph (d). 
700.36     (d) If it is the routine business practice of a provider to 
701.1   refuse service to an individual with uncollected debt, the 
701.2   provider may include uncollected co-payments under this 
701.3   section.  A provider must give advance notice to a recipient 
701.4   with uncollected debt before services can be denied. 
701.5      <b>[EFFECTIVE DATE.]</b> This section is effective October 1, 2003.
701.6      Sec. 73.  Minnesota Statutes 2002, section 256L.04, 
701.7   subdivision 1, is amended to read: 
701.8      Subdivision 1.  [FAMILIES WITH CHILDREN.] (a) Families with 
701.9   children with family income equal to or less than 275 percent of 
701.10  the federal poverty guidelines for the applicable family size 
701.11  shall be eligible for MinnesotaCare according to this section.  
701.12  All other provisions of sections 256L.01 to 256L.18, including 
701.13  the insurance-related barriers to enrollment under section 
701.14  256L.07, shall apply unless otherwise specified. 
701.15     (b) Parents who enroll in the MinnesotaCare program must 
701.16  also enroll their children ~~and dependent siblings~~, if the 
701.17  children ~~and their dependent siblings~~ are eligible.  Children 
701.18  ~~and dependent siblings~~ may be enrolled separately without 
701.19  enrollment by parents.  However, if one parent in the household 
701.20  enrolls, both parents must enroll, unless other insurance is 
701.21  available.  If one child from a family is enrolled, all children 
701.22  must be enrolled, unless other insurance is available.  If one 
701.23  spouse in a household enrolls, the other spouse in the household 
701.24  must also enroll, unless other insurance is available.  Families 
701.25  cannot choose to enroll only certain uninsured members.  
701.26     (c) Beginning October 1, 2003, the dependent sibling 
701.27  definition no longer applies to the MinnesotaCare program.  
701.28  These persons are no longer counted in the parental household 
701.29  and may apply as a separate household. 
701.30     (d) Beginning July 1, 2003, or upon federal approval, 
701.31  whichever is later, parents are not eligible for MinnesotaCare 
701.32  if their gross income exceeds $50,000. 
701.33     <b>[EFFECTIVE DATE.]</b> This section is effective October 1, 
701.34  2003, unless the statutory language specifies a different 
701.35  effective date. 
701.36     Sec. 74.  Minnesota Statutes 2002, section 256L.04, 
702.1   subdivision 10, is amended to read: 
702.2      Subd. 10.  [CITIZENSHIP REQUIREMENTS.] Eligibility for 
702.3   MinnesotaCare is limited to citizens of the United States, 
702.4   qualified noncitizens, and other persons residing lawfully in 
702.5   the United States as described in section 256B.06, subdivision 
702.6   4, paragraphs (a) to (e) and (j).  Undocumented noncitizens and 
702.7   nonimmigrants are ineligible for MinnesotaCare.  For purposes of 
702.8   this subdivision, a nonimmigrant is an individual in one or more 
702.9   of the classes listed in United States Code, title 8, section 
702.10  1101(a)(15), and an undocumented noncitizen is an individual who 
702.11  resides in the United States without the approval or 
702.12  acquiescence of the Immigration and Naturalization Service. 
702.13     Subd. 10a.  [SPONSOR'S INCOME AND RESOURCES DEEMED 
702.14  AVAILABLE; DOCUMENTATION.] When determining eligibility for any 
702.15  federal or state benefits under sections 256L.01 to 256L.18, the 
702.16  income and resources of all noncitizens whose sponsor signed an 
702.17  affidavit of support as defined under United States Code, title 
702.18  8, section 1183a, shall be deemed to include their sponsors' 
702.19  income and resources as defined in the Personal Responsibility 
702.20  and Work Opportunity Reconciliation Act of 1996, title IV, 
702.21  Public Law ~~Number~~ 104-193, sections 421 and 422, and 
702.22  subsequently set out in federal rules.  To be eligible for the 
702.23  program, noncitizens must provide documentation of their 
702.24  immigration status.  
702.25     Sec. 75.  Minnesota Statutes 2002, section 256L.05, 
702.26  subdivision 3a, is amended to read: 
702.27     Subd. 3a.  [RENEWAL OF ELIGIBILITY.] (a) Beginning January 
702.28  1, 1999, an enrollee's eligibility must be renewed every 12 
702.29  months.  The 12-month period begins in the month after the month 
702.30  the application is approved.  
702.31     (b) Beginning October 1, 2004, an enrollee's eligibility 
702.32  must be renewed every six months.  The first six-month period of 
702.33  eligibility begins in the month after the month the application 
702.34  is approved.  Each new period of eligibility must take into 
702.35  account any changes in circumstances that impact eligibility and 
702.36  premium amount.  An enrollee must provide all the information 
703.1   needed to redetermine eligibility by the first day of the month 
703.2   that ends the eligibility period.  The premium for the new 
703.3   period of eligibility must be received as provided in section 
703.4   256L.06 in order for eligibility to continue. 
703.5      Sec. 76.  Minnesota Statutes 2002, section 256L.05, 
703.6   subdivision 4, is amended to read: 
703.7      Subd. 4.  [APPLICATION PROCESSING.] The commissioner of 
703.8   human services shall determine an applicant's eligibility for 
703.9   MinnesotaCare no more than 30 days from the date that the 
703.10  application is received by the department of human services.  
703.11  Beginning January 1, 2000, this requirement also applies to 
703.12  local county human services agencies that determine eligibility 
703.13  for MinnesotaCare.  ~~Once annually at application or~~ 
703.14  ~~reenrollment, to prevent processing delays, applicants or~~ 
703.15  ~~enrollees who, from the information provided on the application,~~ 
703.16  ~~appear to meet eligibility requirements shall be enrolled upon~~ 
703.17  ~~timely payment of premiums.  The enrollee must provide all~~ 
703.18  ~~required verifications within 30 days of notification of the~~ 
703.19  ~~eligibility determination or coverage from the program shall be~~ 
703.20  ~~terminated.  Enrollees who are determined to be ineligible when~~ 
703.21  ~~verifications are provided shall be disenrolled from the program.~~
703.22     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
703.23  or upon federal approval, whichever is later. 
703.24     Sec. 77.  Minnesota Statutes 2002, section 256L.06, 
703.25  subdivision 3, is amended to read: 
703.26     Subd. 3.  [COMMISSIONER'S DUTIES AND PAYMENT.] (a) Premiums 
703.27  are dedicated to the commissioner for MinnesotaCare. 
703.28     (b) The commissioner shall develop and implement procedures 
703.29  to:  (1) require enrollees to report changes in income; (2) 
703.30  adjust sliding scale premium payments, based upon changes in 
703.31  enrollee income; and (3) disenroll enrollees from MinnesotaCare 
703.32  for failure to pay required premiums.  Failure to pay includes 
703.33  payment with a dishonored check, a returned automatic bank 
703.34  withdrawal, or a refused credit card or debit card payment.  The 
703.35  commissioner may demand a guaranteed form of payment, including 
703.36  a cashier's check or a money order, as the only means to replace 
704.1   a dishonored, returned, or refused payment. 
704.2      (c) Premiums are calculated on a calendar month basis and 
704.3   may be paid on a monthly, quarterly, or ~~annual~~ semiannual basis, 
704.4   with the first payment due upon notice from the commissioner of 
704.5   the premium amount required.  The commissioner shall inform 
704.6   applicants and enrollees of these premium payment options. 
704.7   Premium payment is required before enrollment is complete and to 
704.8   maintain eligibility in MinnesotaCare.  Premium payments 
704.9   received before noon are credited the same day.  Premium 
704.10  payments received after noon are credited on the next working 
704.11  day.  
704.12     (d) Nonpayment of the premium will result in disenrollment 
704.13  from the plan effective for the calendar month for which the 
704.14  premium was due.  Persons disenrolled for nonpayment or who 
704.15  voluntarily terminate coverage from the program may not reenroll 
704.16  until four calendar months have elapsed.  Persons disenrolled 
704.17  for nonpayment who pay all past due premiums as well as current 
704.18  premiums due, including premiums due for the period of 
704.19  disenrollment, within 20 days of disenrollment, shall be 
704.20  reenrolled retroactively to the first day of disenrollment.  
704.21  Persons disenrolled for nonpayment or who voluntarily terminate 
704.22  coverage from the program may not reenroll for four calendar 
704.23  months unless the person demonstrates good cause for 
704.24  nonpayment.  Good cause does not exist if a person chooses to 
704.25  pay other family expenses instead of the premium.  The 
704.26  commissioner shall define good cause in rule. 
704.27     <b>[EFFECTIVE DATE.]</b> This section is effective October 1, 2004.
704.28     Sec. 78.  Minnesota Statutes 2002, section 256L.07, 
704.29  subdivision 1, is amended to read: 
704.30     Subdivision 1.  [GENERAL REQUIREMENTS.] (a) Children 
704.31  enrolled in the original children's health plan as of September 
704.32  30, 1992, children who enrolled in the MinnesotaCare program 
704.33  after September 30, 1992, pursuant to Laws 1992, chapter 549, 
704.34  article 4, section 17, and children who have family gross 
704.35  incomes that are equal to or less than ~~175~~ 150 percent of the 
704.36  federal poverty guidelines are eligible without meeting the 
705.1   requirements of subdivision 2 and the four-month requirement in 
705.2   subdivision 3, as long as they maintain continuous coverage in 
705.3   the MinnesotaCare program or medical assistance.  Children who 
705.4   apply for MinnesotaCare on or after the implementation date of 
705.5   the employer-subsidized health coverage program as described in 
705.6   Laws 1998, chapter 407, article 5, section 45, who have family 
705.7   gross incomes that are equal to or less than ~~175~~ 150 percent of 
705.8   the federal poverty guidelines, must meet the requirements of 
705.9   subdivision 2 to be eligible for MinnesotaCare. 
705.10     (b) Families enrolled in MinnesotaCare under section 
705.11  256L.04, subdivision 1, whose income increases above 275 percent 
705.12  of the federal poverty guidelines, are no longer eligible for 
705.13  the program and shall be disenrolled by the commissioner.  
705.14  Individuals enrolled in MinnesotaCare under section 256L.04, 
705.15  subdivision 7, whose income increases above 175 percent of the 
705.16  federal poverty guidelines are no longer eligible for the 
705.17  program and shall be disenrolled by the commissioner.  For 
705.18  persons disenrolled under this subdivision, MinnesotaCare 
705.19  coverage terminates the last day of the calendar month following 
705.20  the month in which the commissioner determines that the income 
705.21  of a family or individual exceeds program income limits.  
705.22     (c)(1) Notwithstanding paragraph (b), ~~individuals and~~ 
705.23  families enrolled in MinnesotaCare under section 256L.04, 
705.24  subdivision 1, may remain enrolled in MinnesotaCare if ten 
705.25  percent of their annual income is less than the annual premium 
705.26  for a policy with a $500 deductible available through the 
705.27  Minnesota comprehensive health association.  ~~Individuals and~~ 
705.28  Families who are no longer eligible for MinnesotaCare under this 
705.29  subdivision shall be given an 18-month notice period from the 
705.30  date that ineligibility is determined before 
705.31  disenrollment.  This clause expires February 1, 2004. 
705.32     (2) Effective February 1, 2004, notwithstanding paragraph 
705.33  (b), children may remain enrolled in MinnesotaCare if ten 
705.34  percent of their annual family income is less than the annual 
705.35  premium for a policy with a $500 deductible available through 
705.36  the Minnesota comprehensive health association.  Children who 
706.1   are no longer eligible for MinnesotaCare under this clause shall 
706.2   be given a 12-month notice period from the date that 
706.3   ineligibility is determined before disenrollment.  The premium 
706.4   for children remaining eligible under this clause shall be the 
706.5   maximum premium determined under section 256L.15, subdivision 2, 
706.6   paragraph (b). 
706.7      (d) Effective July 1, 2003, notwithstanding paragraphs (b) 
706.8   and (c), parents are no longer eligible for MinnesotaCare if 
706.9   gross household income exceeds $50,000. 
706.10     <b>[EFFECTIVE DATE.]</b> The amendments to paragraph (a) are 
706.11  effective July 1, 2003.  The amendments to paragraph (c), clause 
706.12  (1), are effective October 1, 2003. 
706.13     Sec. 79.  Minnesota Statutes 2002, section 256L.07, 
706.14  subdivision 3, is amended to read: 
706.15     Subd. 3.  [OTHER HEALTH COVERAGE.] (a) Families and 
706.16  individuals enrolled in the MinnesotaCare program must have no 
706.17  health coverage while enrolled or for at least four months prior 
706.18  to application and renewal.  Children enrolled in the original 
706.19  children's health plan and children in families with income 
706.20  equal to or less than ~~175~~ 150 percent of the federal poverty 
706.21  guidelines, who have other health insurance, are eligible if the 
706.22  coverage: 
706.23     (1) lacks two or more of the following: 
706.24     (i) basic hospital insurance; 
706.25     (ii) medical-surgical insurance; 
706.26     (iii) prescription drug coverage; 
706.27     (iv) dental coverage; or 
706.28     (v) vision coverage; 
706.29     (2) requires a deductible of $100 or more per person per 
706.30  year; or 
706.31     (3) lacks coverage because the child has exceeded the 
706.32  maximum coverage for a particular diagnosis or the policy 
706.33  excludes a particular diagnosis. 
706.34     The commissioner may change this eligibility criterion for 
706.35  sliding scale premiums in order to remain within the limits of 
706.36  available appropriations.  The requirement of no health coverage 
707.1   does not apply to newborns.  
707.2      (b) Medical assistance, general assistance medical care, 
707.3   and the Civilian Health and Medical Program of the Uniformed 
707.4   Service, CHAMPUS, or other coverage provided under United States 
707.5   Code, title 10, subtitle A, part II, chapter 55, are not 
707.6   considered insurance or health coverage for purposes of the 
707.7   four-month requirement described in this subdivision. 
707.8      (c) For purposes of this subdivision, Medicare Part A or B 
707.9   coverage under title XVIII of the Social Security Act, United 
707.10  States Code, title 42, sections 1395c to 1395w-4, is considered 
707.11  health coverage.  An applicant or enrollee may not refuse 
707.12  Medicare coverage to establish eligibility for MinnesotaCare. 
707.13     (d) Applicants who were recipients of medical assistance or 
707.14  general assistance medical care within one month of application 
707.15  must meet the provisions of this subdivision and subdivision 2. 
707.16     (e) Effective October 1, 2003, applicants who were 
707.17  recipients of medical assistance and had cost-effective health 
707.18  insurance which was paid for by medical assistance are exempt 
707.19  from the four-month requirement under this section. 
707.20     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
707.21  except where a different effective date is specified in the text.
707.22     Sec. 80.  Minnesota Statutes 2002, section 256L.12, 
707.23  subdivision 6, is amended to read: 
707.24     Subd. 6.  [COPAYMENTS AND BENEFIT LIMITS.] Enrollees are 
707.25  responsible for all copayments in ~~section~~ sections 256L.03, 
707.26  subdivision ~~4~~ 5, and 256L.035, and shall pay copayments to the 
707.27  managed care plan or to its participating providers.  The 
707.28  enrollee is also responsible for payment of inpatient hospital 
707.29  charges which exceed the MinnesotaCare benefit limit. 
707.30     Sec. 81.  Minnesota Statutes 2002, section 256L.12, 
707.31  subdivision 9, is amended to read: 
707.32     Subd. 9.  [RATE SETTING; PERFORMANCE WITHHOLDS.] (a) Rates 
707.33  will be prospective, per capita, where possible.  The 
707.34  commissioner may allow health plans to arrange for inpatient 
707.35  hospital services on a risk or nonrisk basis.  The commissioner 
707.36  shall consult with an independent actuary to determine 
708.1   appropriate rates. 
708.2      (b) For services rendered on or after January 1, 2003, to 
708.3   December 31, 2003, the commissioner shall withhold .5 percent of 
708.4   managed care plan payments under this section pending completion 
708.5   of performance targets.  The withheld funds must be returned no 
708.6   sooner than July 1 and no later than July 31 of the following 
708.7   year if performance targets in the contract are achieved.  A 
708.8   managed care plan may include as admitted assets under section 
708.9   62D.044 any amount withheld under this paragraph that is 
708.10  reasonably expected to be returned.  
708.11     (c) For services rendered on or after January 1, 2004, the 
708.12  commissioner shall withhold five percent of managed care plan 
708.13  payments under this section pending completion of performance 
708.14  targets.  Each performance target must be quantifiable, 
708.15  objective, measurable, and reasonably attainable, except in the 
708.16  case of a performance target based on a federal or state law or 
708.17  rule.  Criteria for assessment of each performance target must 
708.18  be outlined in writing prior to the contract effective date.  
708.19  The withheld funds must be returned no sooner than July 1 and no 
708.20  later than July 31 of the following calendar year if performance 
708.21  targets in the contract are achieved.  A managed care plan or a 
708.22  county-based purchasing plan under section 256B.692 may include 
708.23  as admitted assets under section 62D.044 any amount withheld 
708.24  under this paragraph that is reasonably expected to be returned. 
708.25     <b>[EFFECTIVE DATE.]</b> This section is effective for services 
708.26  rendered on or after July 1, 2003, except as otherwise provided 
708.27  in the statutory language. 
708.28     Sec. 82.  Minnesota Statutes 2002, section 256L.12, is 
708.29  amending by adding a subdivision to read: 
708.30     Subd. 9a.  [RATE SETTING; RATABLE REDUCTION.] For services 
708.31  rendered on or after October 1, 2003, the total payment made to 
708.32  managed care plans under the MinnesotaCare program is reduced 
708.33  1.0 percent. 
708.34     Sec. 83.  Minnesota Statutes 2002, section 256L.15, 
708.35  subdivision 1, is amended to read: 
708.36     Subdivision 1.  [PREMIUM DETERMINATION.] (a) Families with 
709.1   children and individuals shall pay a premium determined 
709.2   according to ~~a sliding fee based on a percentage of the family's~~ 
709.3   ~~gross family income~~ subdivision 2.  
709.4      (b) Pregnant women and children under age two are exempt 
709.5   from the provisions of section 256L.06, subdivision 3, paragraph 
709.6   (b), clause (3), requiring disenrollment for failure to pay 
709.7   premiums.  For pregnant women, this exemption continues until 
709.8   the first day of the month following the 60th day postpartum.  
709.9   Women who remain enrolled during pregnancy or the postpartum 
709.10  period, despite nonpayment of premiums, shall be disenrolled on 
709.11  the first of the month following the 60th day postpartum for the 
709.12  penalty period that otherwise applies under section 256L.06, 
709.13  unless they begin paying premiums. 
709.14     Sec. 84.  Minnesota Statutes 2002, section 256L.15, 
709.15  subdivision 2, is amended to read: 
709.16     Subd. 2.  [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 
709.17  GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 
709.18  establish a sliding fee scale to determine the percentage of 
709.19  gross individual or family income that households at different 
709.20  income levels must pay to obtain coverage through the 
709.21  MinnesotaCare program.  The sliding fee scale must be based on 
709.22  the enrollee's gross individual or family income.  The sliding 
709.23  fee scale must contain separate tables based on enrollment of 
709.24  one, two, or three or more persons.  The sliding fee scale 
709.25  begins with a premium of 1.5 percent of gross individual or 
709.26  family income for individuals or families with incomes below the 
709.27  limits for the medical assistance program for families and 
709.28  children in effect on January 1, 1999, and proceeds through the 
709.29  following evenly spaced steps:  1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 
709.30  7.4, and 8.8 percent.  These percentages are matched to evenly 
709.31  spaced income steps ranging from the medical assistance income 
709.32  limit for families and children in effect on January 1, 1999, to 
709.33  275 percent of the federal poverty guidelines for the applicable 
709.34  family size, up to a family size of five.  The sliding fee scale 
709.35  for a family of five must be used for families of more than 
709.36  five.  Effective October 1, 2003, the commissioner shall 
710.1   increase each percentage by 0.5 percentage points for enrollees 
710.2   with income greater than 100 percent but not exceeding 200 
710.3   percent of the federal poverty guidelines and shall increase 
710.4   each percentage by 1.0 percentage points for families and 
710.5   children with incomes greater than 200 percent of the federal 
710.6   poverty guidelines.  The sliding fee scale and percentages are 
710.7   not subject to the provisions of chapter 14.  If a family or 
710.8   individual reports increased income after enrollment, premiums 
710.9   shall not be adjusted until eligibility renewal. 
710.10     (b)(1) Enrolled ~~individuals and~~ families whose gross annual 
710.11  income increases above 275 percent of the federal poverty 
710.12  guideline shall pay the maximum premium.  This clause expires 
710.13  effective February 1, 2004.  
710.14     (2) Effective February 1, 2004, children in families whose 
710.15  gross income is above 275 percent of the federal poverty 
710.16  guidelines shall pay the maximum premium.  
710.17     (3) The maximum premium is defined as a base charge for 
710.18  one, two, or three or more enrollees so that if all 
710.19  MinnesotaCare cases paid the maximum premium, the total revenue 
710.20  would equal the total cost of MinnesotaCare medical coverage and 
710.21  administration.  In this calculation, administrative costs shall 
710.22  be assumed to equal ten percent of the total.  The costs of 
710.23  medical coverage for pregnant women and children under age two 
710.24  and the enrollees in these groups shall be excluded from the 
710.25  total.  The maximum premium for two enrollees shall be twice the 
710.26  maximum premium for one, and the maximum premium for three or 
710.27  more enrollees shall be three times the maximum premium for one. 
710.28     <b>[EFFECTIVE DATE.]</b> The amendments to this section are 
710.29  effective October 1, 2003, unless specified otherwise in the 
710.30  statutory text.  
710.31     Sec. 85.  Minnesota Statutes 2002, section 256L.15, 
710.32  subdivision 3, is amended to read: 
710.33     Subd. 3.  [EXCEPTIONS TO SLIDING SCALE.] An annual premium 
710.34  of $48 is required for all children in families with income at 
710.35  or less than ~~175~~ 150 percent of federal poverty guidelines. 
710.36     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
711.1      Sec. 86.  Minnesota Statutes 2002, section 256L.17, 
711.2   subdivision 2, is amended to read: 
711.3      Subd. 2.  [LIMIT ON TOTAL ASSETS.] (a) Effective July 1, 
711.4   2002, or upon federal approval, whichever is later, in order to 
711.5   be eligible for the MinnesotaCare program, a household of two or 
711.6   more persons must not own more than ~~$30,000~~ $20,000 in total net 
711.7   assets, and a household of one person must not own more 
711.8   than ~~$15,000~~ $10,000 in total net assets. 
711.9      (b) For purposes of this subdivision, assets are determined 
711.10  according to section 256B.056, subdivision 3c.  
711.11     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
711.12     Sec. 87.  Minnesota Statutes 2002, section 295.53, 
711.13  subdivision 1, is amended to read: 
711.14     Subdivision 1.  [EXEMPTIONS.] (a) The following payments 
711.15  are excluded from the gross revenues subject to the hospital, 
711.16  surgical center, or health care provider taxes under sections 
711.17  295.50 to 295.57: 
711.18     (1) payments received for services provided under the 
711.19  Medicare program, including payments received from the 
711.20  government, and organizations governed by sections 1833 and 1876 
711.21  of title XVIII of the federal Social Security Act, United States 
711.22  Code, title 42, section 1395, and enrollee deductibles, 
711.23  coinsurance, and co-payments, whether paid by the Medicare 
711.24  enrollee or by a Medicare supplemental coverage as defined in 
711.25  section 62A.011, subdivision 3, clause (10).  Payments for 
711.26  services not covered by Medicare are taxable; 
711.27     (2) ~~medical assistance payments including payments received~~ 
711.28  ~~directly from the government or from a prepaid plan;~~ 
711.29     ~~(3)~~ payments received for home health care services; 
711.30     ~~(4)~~ (3) payments received from hospitals or surgical 
711.31  centers for goods and services on which liability for tax is 
711.32  imposed under section 295.52 or the source of funds for the 
711.33  payment is exempt under clause (1), ~~(2), (7), (8),~~ 
711.34  ~~(10)~~ (7), ~~(13)~~ (10), or ~~(20)~~ (17); 
711.35     ~~(5)~~ (4) payments received from health care providers for 
711.36  goods and services on which liability for tax is imposed under 
712.1   this chapter or the source of funds for the payment is exempt 
712.2   under clause (1), ~~(2), (7), (8), (10)~~ (7), ~~(13)~~ (10), 
712.3   or ~~(20)~~ (17); 
712.4      ~~(6)~~ (5) amounts paid for legend drugs, other than 
712.5   nutritional products, to a wholesale drug distributor who is 
712.6   subject to tax under section 295.52, subdivision 3, reduced by 
712.7   reimbursements received for legend drugs otherwise exempt under 
712.8   this chapter; 
712.9      ~~(7) payments received under the general assistance medical~~ 
712.10  ~~care program including payments received directly from the~~ 
712.11  ~~government or from a prepaid plan;~~ 
712.12     ~~(8) payments received for providing services under the~~ 
712.13  ~~MinnesotaCare program including payments received directly from~~ 
712.14  ~~the government or from a prepaid plan and enrollee deductibles,~~ 
712.15  ~~coinsurance, and copayments.  For purposes of this clause,~~ 
712.16  ~~coinsurance means the portion of payment that the enrollee is~~ 
712.17  ~~required to pay for the covered service;~~ 
712.18     ~~(9)~~ (6) payments received by a health care provider or the 
712.19  wholly owned subsidiary of a health care provider for care 
712.20  provided outside Minnesota; 
712.21     ~~(10)~~ (7) payments received from the chemical dependency 
712.22  fund under chapter 254B; 
712.23     ~~(11)~~ (8) payments received in the nature of charitable 
712.24  donations that are not designated for providing patient services 
712.25  to a specific individual or group; 
712.26     ~~(12)~~ (9) payments received for providing patient services 
712.27  incurred through a formal program of health care research 
712.28  conducted in conformity with federal regulations governing 
712.29  research on human subjects.  Payments received from patients or 
712.30  from other persons paying on behalf of the patients are subject 
712.31  to tax; 
712.32     ~~(13)~~ (10) payments received from any governmental agency 
712.33  for services benefiting the public, not including payments made 
712.34  by the government in its capacity as an employer or insurer or 
712.35  payments made by the government for services provided under 
712.36  medical assistance, general assistance medical care, or the 
713.1   MinnesotaCare program; 
713.2      ~~(14)~~ (11) payments received for services provided by 
713.3   community residential mental health facilities licensed under 
713.4   Minnesota Rules, parts 9520.0500 to 9520.0690, community support 
713.5   programs and family community support programs approved under 
713.6   Minnesota Rules, parts 9535.1700 to 9535.1760, and community 
713.7   mental health centers as defined in section 245.62, subdivision 
713.8   2; 
713.9      ~~(15)~~ (12) government payments received by a regional 
713.10  treatment center; 
713.11     ~~(16)~~ (13) payments received for hospice care services; 
713.12     ~~(17)~~ (14) payments received by a health care provider for 
713.13  hearing aids and related equipment or prescription eyewear 
713.14  delivered outside of Minnesota; 
713.15     ~~(18)~~ (15) payments received by an educational institution 
713.16  from student tuition, student activity fees, health care service 
713.17  fees, government appropriations, donations, or grants.  Fee for 
713.18  service payments and payments for extended coverage are taxable; 
713.19     ~~(19)~~ (16) payments received for services provided by:  
713.20  assisted living programs and congregate housing programs; and 
713.21     ~~(20)~~ (17) payments received under the federal Employees 
713.22  Health Benefits Act, United States Code, title 5, section 
713.23  8909(f), as amended by the Omnibus Reconciliation Act of 1990. 
713.24     (b) Payments received by wholesale drug distributors for 
713.25  legend drugs sold directly to veterinarians or veterinary bulk 
713.26  purchasing organizations are excluded from the gross revenues 
713.27  subject to the wholesale drug distributor tax under sections 
713.28  295.50 to 295.59. 
713.29     <b>[EFFECTIVE DATE.]</b> This section is effective for services 
713.30  rendered on or after January 1, 2004. 
713.31     Sec. 88.  Minnesota Statutes 2002, section 297I.15, 
713.32  subdivision 1, is amended to read: 
713.33     Subdivision 1.  [GOVERNMENT PAYMENTS.] Premiums under 
713.34  ~~medical assistance, general assistance medical care, the~~ 
713.35  ~~MinnesotaCare program, and~~ the Minnesota comprehensive health 
713.36  insurance plan and all payments, revenues, and reimbursements 
714.1   received from the federal government for Medicare-related 
714.2   coverage as defined in section 62A.31, subdivision 3, are not 
714.3   subject to tax under this chapter. 
714.4      <b>[EFFECTIVE DATE.]</b> This section is effective for premiums 
714.5   paid to health carriers on or after January 1, 2004. 
714.6      Sec. 89.  Minnesota Statutes 2002, section 297I.15, 
714.7   subdivision 4, is amended to read: 
714.8      Subd. 4.  [PREMIUMS PAID TO HEALTH CARRIERS BY STATE.] A 
714.9   health carrier as defined in section 62A.011 is exempt from the 
714.10  taxes imposed under this chapter on premiums paid to it by the 
714.11  state.  Premiums paid by the state under medical assistance, 
714.12  general assistance medical care, and the MinnesotaCare program 
714.13  are not exempt under this subdivision. 
714.14     <b>[EFFECTIVE DATE.]</b> This section is effective for premiums 
714.15  paid to health carriers on or after January 1, 2004. 
714.16     Sec. 90.  Minnesota Statutes 2002, section 514.981, 
714.17  subdivision 6, is amended to read: 
714.18     Subd. 6.  [TIME LIMITS; CLAIM LIMITS; LIENS ON LIFE ESTATES 
714.19  AND JOINT TENANCIES.] (a) A medical assistance lien is a lien on 
714.20  the real property it describes for a period of ten years from 
714.21  the date it attaches according to section 514.981, subdivision 
714.22  2, paragraph (a), except as otherwise provided for in sections 
714.23  514.980 to 514.985.  The agency may renew a medical assistance 
714.24  lien for an additional ten years from the date it would 
714.25  otherwise expire by recording or filing a certificate of renewal 
714.26  before the lien expires.  The certificate shall be recorded or 
714.27  filed in the office of the county recorder or registrar of 
714.28  titles for the county in which the lien is recorded or filed.  
714.29  The certificate must refer to the recording or filing data for 
714.30  the medical assistance lien it renews.  The certificate need not 
714.31  be attested, certified, or acknowledged as a condition for 
714.32  recording or filing.  The registrar of titles or the recorder 
714.33  shall file, record, index, and return the certificate of renewal 
714.34  in the same manner as provided for medical assistance liens in 
714.35  section 514.982, subdivision 2. 
714.36     (b) A medical assistance lien is not enforceable against 
715.1   the real property of an estate to the extent there is a 
715.2   determination by a court of competent jurisdiction, or by an 
715.3   officer of the court designated for that purpose, that there are 
715.4   insufficient assets in the estate to satisfy the agency's 
715.5   medical assistance lien in whole or in part because of the 
715.6   homestead exemption under section 256B.15, subdivision 4, the 
715.7   rights of the surviving spouse or minor children under section 
715.8   524.2-403, paragraphs (a) and (b), or claims with a priority 
715.9   under section 524.3-805, paragraph (a), clauses (1) to (4).  For 
715.10  purposes of this section, the rights of the decedent's adult 
715.11  children to exempt property under section 524.2-403, paragraph 
715.12  (b), shall not be considered costs of administration under 
715.13  section 524.3-805, paragraph (a), clause (1). 
715.14     (c) Notwithstanding any law or rule to the contrary, the 
715.15  provisions in clauses (1) to (7) apply if a life estate subject 
715.16  to a medical assistance lien ends according to its terms, or if 
715.17  a medical assistance recipient who owns a life estate or any 
715.18  interest in real property as a joint tenant that is subject to a 
715.19  medical assistance lien dies. 
715.20     (1) The medical assistance recipient's life estate or joint 
715.21  tenancy interest in the real property shall not end upon the 
715.22  recipient's death but shall merge into the remainder interest or 
715.23  other interest in real property the medical assistance recipient 
715.24  owned in joint tenancy with others.  The medical assistance lien 
715.25  shall attach to and run with the remainder or other interest in 
715.26  the real property to the extent of the medical assistance 
715.27  recipient's interest in the property at the time of the 
715.28  recipient's death as determined under this section. 
715.29     (2) If the medical assistance recipient's interest was a 
715.30  life estate in real property, the lien shall be a lien against 
715.31  the portion of the remainder equal to the percentage factor for 
715.32  the life estate of a person the medical assistance recipient's 
715.33  age on the date the life estate ended according to its terms or 
715.34  the date of the medical assistance recipient's death as listed 
715.35  in the Life Estate Mortality Table in the health care program's 
715.36  manual. 
716.1      (3) If the medical assistance recipient owned the interest 
716.2   in real property in joint tenancy with others, the lien shall be 
716.3   a lien against the portion of that interest equal to the 
716.4   fractional interest the medical assistance recipient would have 
716.5   owned in the jointly owned interest had the medical assistance 
716.6   recipient and the other owners held title to that interest as 
716.7   tenants in common on the date the medical assistance recipient 
716.8   died. 
716.9      (4) The medical assistance lien shall remain a lien against 
716.10  the remainder or other jointly owned interest for the length of 
716.11  time and be renewable as provided in paragraph (a). 
716.12     (5) Subdivision 5, paragraphs (a), clause (4), (b), clauses 
716.13  (1) and (2); and subdivision 6, paragraph (b), do not apply to 
716.14  medical assistance liens which attach to interests in real 
716.15  property as provided under this subdivision. 
716.16     (6) The continuation of a medical assistance recipient's 
716.17  life estate or joint tenancy interest in real property after the 
716.18  medical assistance recipient's death for the purpose of 
716.19  recovering medical assistance provided for in sections 514.980 
716.20  to 514.985 modifies common law principles holding that these 
716.21  interests terminate on the death of the holder. 
716.22     (7) Notwithstanding any law or rule to the contrary, no 
716.23  release, satisfaction, discharge, or affidavit under section 
716.24  256B.15 shall extinguish or terminate the life estate or joint 
716.25  tenancy interest of a medical assistance recipient subject to a 
716.26  lien under sections 514.980 to 514.985 on the date the recipient 
716.27  dies. 
716.28     (8) The provisions of clauses (1) to (7) do not apply to a 
716.29  homestead owned of record, on the date the recipient dies, by 
716.30  the recipient and the recipient's spouse as joint tenants with a 
716.31  right of survivorship.  Homestead means the real property 
716.32  occupied by the surviving joint tenant spouse as their sole 
716.33  residence on the date the recipient dies and classified and 
716.34  taxed to the recipient and surviving joint tenant spouse as 
716.35  homestead property for property tax purposes in the calendar 
716.36  year in which the recipient dies.  For purposes of this 
717.1   exemption, real property the recipient and their surviving joint 
717.2   tenant spouse purchase solely with the proceeds from the sale of 
717.3   their prior homestead, own of record as joint tenants, and 
717.4   qualify as homestead property under section 273.124 in the 
717.5   calendar year in which the recipient dies and prior to the 
717.6   recipient's death shall be deemed to be real property classified 
717.7   and taxed to the recipient and their surviving joint tenant 
717.8   spouse as homestead property in the calendar year in which the 
717.9   recipient dies.  The surviving spouse, or any person with 
717.10  personal knowledge of the facts, may provide an affidavit 
717.11  describing the homestead property affected by this clause and 
717.12  stating facts showing compliance with this clause.  The 
717.13  affidavit shall be prima facie evidence of the facts it states. 
717.14     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
717.15  and applies to all medical assistance liens recorded or filed on 
717.16  or after that date. 
717.17     Sec. 91.  Minnesota Statutes 2002, section 641.15, 
717.18  subdivision 2, is amended to read: 
717.19     Subd. 2.  [MEDICAL AID.] Except as provided in section 
717.20  466.101, the county board shall pay the costs of medical 
717.21  services provided to prisoners.  The amount paid by the Anoka 
717.22  county board for a medical service shall not exceed the maximum 
717.23  allowed medical assistance payment rate for the service, as 
717.24  determined by the commissioner of human services.  The county is 
717.25  entitled to reimbursement from the prisoner for payment of 
717.26  medical bills to the extent that the prisoner to whom the 
717.27  medical aid was provided has the ability to pay the bills.  The 
717.28  prisoner shall, at a minimum, incur copayment obligations for 
717.29  health care services provided by a county correctional 
717.30  facility.  The county board shall determine the copayment 
717.31  amount.  Notwithstanding any law to the contrary, the copayment 
717.32  shall be deducted from any of the prisoner's funds held by the 
717.33  county, to the extent possible.  If there is a disagreement 
717.34  between the county and a prisoner concerning the prisoner's 
717.35  ability to pay, the court with jurisdiction over the defendant 
717.36  shall determine the extent, if any, of the prisoner's ability to 
718.1   pay for the medical services.  If a prisoner is covered by 
718.2   health or medical insurance or other health plan when medical 
718.3   services are provided, the county providing the medical services 
718.4   has a right of subrogation to be reimbursed by the insurance 
718.5   carrier for all sums spent by it for medical services to the 
718.6   prisoner that are covered by the policy of insurance or health 
718.7   plan, in accordance with the benefits, limitations, exclusions, 
718.8   provider restrictions, and other provisions of the policy or 
718.9   health plan.  The county may maintain an action to enforce this 
718.10  subrogation right.  The county does not have a right of 
718.11  subrogation against the medical assistance program or the 
718.12  general assistance medical care program. 
718.13     Sec. 92.  [PHARMACY PLUS WAIVER.] 
718.14     (a) The commissioner of human services shall seek a 
718.15  pharmacy plus federal waiver for the prescription drug program 
718.16  in Minnesota Statutes, section 256.955, that uses the 
718.17  accumulated savings from all pharmacy and asset transfer 
718.18  provisions in this act and previously adopted pharmacy savings 
718.19  strategies as the factor to prove fiscal neutrality.  If the 
718.20  waiver is approved and federal funds are received for the 
718.21  prescription drug program, the commissioner shall expand 
718.22  eligibility for the program in the following order:  
718.23     (1) increase income eligibility up to 135 percent of the 
718.24  federal poverty guidelines for individuals eligible under 
718.25  Minnesota Statutes, section 256.955, subdivision 2a; and 
718.26     (2) increase income eligibility up to 135 percent of the 
718.27  federal poverty guidelines for individuals eligible under 
718.28  Minnesota Statutes, section 256.955, subdivision 2b. 
718.29     (b) If eligibility is increased, the commissioner shall 
718.30  publish the new income eligibility levels for the program in the 
718.31  State Register and shall inform the agencies and organizations 
718.32  serving senior citizens and persons with disabilities.  
718.33     Sec. 93.  [REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY 
718.34  CRITERIA AND POTENTIAL COST SAVINGS.] 
718.35     The commissioner of human services, in consultation with 
718.36  the commissioner of transportation and special transportation 
719.1   service providers, shall review eligibility criteria for medical 
719.2   assistance special transportation services and shall evaluate 
719.3   whether the level of special transportation services provided 
719.4   should be based on the degree of impairment of the client, as 
719.5   well as the medical diagnosis.  The commissioner shall also 
719.6   evaluate methods for reducing the cost of special transportation 
719.7   services, including, but not limited to: 
719.8      (1) requiring providers to maintain a daily log book 
719.9   confirming delivery of clients to medical facilities; 
719.10     (2) requiring providers to implement commercially available 
719.11  computer mapping programs to calculate mileage for purposes of 
719.12  reimbursement; 
719.13     (3) restricting special transportation service from being 
719.14  provided solely for trips to pharmacies; 
719.15     (4)modifying eligibility for special transportation; 
719.16     (5) expanding alternatives to the use of special 
719.17  transportation services; 
719.18     (6) improving the process of certifying persons as eligible 
719.19  for special transportation services; and 
719.20     (7) examining the feasibility and benefits of licensing 
719.21  special transportation providers. 
719.22     The commissioner shall present recommendations for changes 
719.23  in the eligibility criteria and potential cost-savings for 
719.24  special transportation services to the chairs and ranking 
719.25  minority members of the house and senate committees having 
719.26  jurisdiction over health and human services spending by January 
719.27  15, 2004.  The commissioner is prohibited from using a broker or 
719.28  coordinator to manage special transportation services until July 
719.29  1, 2005, except for the purposes of checking for recipient 
719.30  eligibility, authorizing recipients for appropriate level of 
719.31  transportation, and monitoring provider compliance with 
719.32  Minnesota Statutes, section 256B.0625, subdivision 17.  This 
719.33  prohibition does not apply to the purchase or management of 
719.34  common carrier transportation. 
719.35     Sec. 94.  [FEDERAL APPROVAL.] 
719.36     If the amendments to Minnesota Statutes, sections 256.046, 
720.1   subdivision 1, and 256.98, subdivision 8, are not effective 
720.2   because of prohibitions in federal law, the commissioner of 
720.3   human services shall seek the federal waivers and authority 
720.4   necessary to implement the provisions. 
720.5      Sec. 95.  [WITHHOLD EXEMPTION.] 
720.6      The commissioner of human services may exempt from the five 
720.7   percent withhold in Minnesota Statutes, section 256B.69, 
720.8   subdivision 5a, paragraph (c), and the five percent withhold in 
720.9   Minnesota Statutes, section 256L.12, subdivision 9, paragraph 
720.10  (b), a managed care plan that has entered into a managed care 
720.11  contract with the commissioner in accordance with Minnesota 
720.12  Statutes, section 256B.69 or 256L.12, if the contract was the 
720.13  initial contract between the managed care plan and the 
720.14  commissioner, and it was entered into after January 1, 2000.  
720.15     If an exemption is given, the exemption shall only apply 
720.16  for the first five years of operation of the managed care plan. 
720.17     Sec. 96.  [DRUG PURCHASING PROGRAM.] 
720.18     The commissioner of human services, in consultation with 
720.19  other state agencies, shall evaluate whether participation in a 
720.20  multistate or multiagency drug purchasing program can reduce 
720.21  costs or improve the operations of the drug benefit programs 
720.22  administered by the commissioner and other state agencies.  The 
720.23  commissioner shall also evaluate the possibility of contracting 
720.24  with a vendor or other states for purposes of participating in a 
720.25  multistate or multiagency drug purchasing program.  The 
720.26  commissioner shall submit the recommendations to the legislature 
720.27  by January 15, 2004. 
720.28     Sec. 97.  [MAIL ORDER DISPENSING OF PRESCRIPTION DRUGS.] 
720.29     The commissioner of human services shall assess the cost 
720.30  savings that could be generated by the mail order dispensing of 
720.31  prescription drugs to recipients of medical assistance, general 
720.32  assistance medical care, and the prescription drug program.  The 
720.33  report shall include the viability of contracting with mail 
720.34  order pharmacy vendors to provide mail order dispensing for 
720.35  state public programs.  The commissioner shall report to the 
720.36  chairs and ranking minority members of the health and human 
721.1   services finance committees by January 7, 2004. 
721.2      Sec. 98.  [NONPROFIT FOUNDATION GRANTS.] 
721.3      (a) The commissioner of human services may accept grants or 
721.4   donations from a nonprofit charitable foundation for the purpose 
721.5   of increasing dental access in the medical assistance program.  
721.6      (b) The commissioner may increase the critical access 
721.7   dental payments under Minnesota Statutes, section 256B.76, 
721.8   paragraph (c), and use any money received under paragraph (a) 
721.9   for the nonfederal state share of the medical assistance cost. 
721.10     Sec. 99.  [PHARMACEUTICAL CARE DEMONSTRATION PROJECT.] 
721.11     (a) The commissioner shall seek federal approval for a 
721.12  demonstration project to provide culturally specific 
721.13  pharmaceutical care to American Indian medical assistance 
721.14  recipients who are age 55 and older.  In developing the 
721.15  demonstration project, the commissioner shall consult with 
721.16  organizations and health care providers experienced in 
721.17  developing and implementing culturally competent intervention 
721.18  strategies to manage the use of prescription drugs, 
721.19  over-the-counter drugs, other drug products, and native 
721.20  therapies by American Indian elders.  
721.21     (b) For purposes of this section, "pharmaceutical care" 
721.22  means the provision of drug therapy and native therapy for the 
721.23  purpose of improving a patient's quality of life by:  (1) curing 
721.24  a disease; (2) eliminating or reducing a patient's symptoms; (3) 
721.25  arresting or slowing a disease process; or (4) preventing a 
721.26  disease or a symptom.  Pharmaceutical care involves the 
721.27  documented process through which a pharmacist cooperates with a 
721.28  patient and other professionals in designing, implementing, and 
721.29  monitoring a therapeutic plan that is expected to produce 
721.30  specific therapeutic outcomes, through the identification, 
721.31  resolution, and prevention of drug-related problems.  Nothing in 
721.32  this project shall be construed to expand or modify the scope of 
721.33  practice of the pharmacist as defined in Minnesota Statutes, 
721.34  section 151.01, subdivision 27. 
721.35     (c) Upon receipt of federal approval, the commissioner 
721.36  shall report to the legislature for legislative approval for 
722.1   implementation of the demonstration project. 
722.2      Sec. 100.  [HEALTH CARE PROGRAM REDUCTIONS.] 
722.3      The commissioner of human services may implement changes to 
722.4   the medical assistance, general assistance medical care, and 
722.5   MinnesotaCare programs, which will result in a reduction in 
722.6   state expenditures during the period of July 1, 2004, through 
722.7   June 30, 2005.  The commissioner may use the following options 
722.8   to achieve this savings:  
722.9      (1) require providers to use generally accepted clinical 
722.10  practice guidelines for specific services; 
722.11     (2) implement clinical care coordination programs, 
722.12  including chronic and acute care disease management programs; 
722.13  and 
722.14     (3) volume purchase health services as established in 
722.15  Minnesota Statutes, section 256B.04, subdivision 14, except that 
722.16  special transportation services shall be subject to the 
722.17  timelines established in Minnesota Statutes, section 256B.0625, 
722.18  subdivision 17.  
722.19     The commissioner shall notify the chairs of the house and 
722.20  senate health and human services policy and finance committees 
722.21  of any changes implemented as a result of this section. 
722.22     Sec. 101.  [REPEALER.] 
722.23     (a) Minnesota Statutes 2002, sections 256.955, subdivision 
722.24  8; and 256B.057, subdivision 1b, are repealed July 1, 2003.  
722.25     (b) Minnesota Statutes 2002, section 256B.055, subdivision 
722.26  10a, is repealed July 1, 2003, or upon federal approval, 
722.27  whichever is later. 
722.28                            ARTICLE 13A
722.29           HEALTH AND HUMAN SERVICES FORECAST ADJUSTMENTS 
722.30  Section 1.  [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 
722.31     The dollar amounts shown in the columns marked 
722.32  "APPROPRIATIONS" are added to or, if shown in parentheses, are 
722.33  subtracted from the appropriations in Laws 2001, First Special 
722.34  Session chapter 9, as amended by Laws 2002, chapter 220, and 
722.35  Laws 2002, chapter 374, and are appropriated from the general 
722.36  fund, or any other fund named, to the agencies and for the 
723.1   purposes specified in this article, to be available for the 
723.2   fiscal year indicated for each purpose.  The figure "2003" used 
723.3   in this article means that the appropriation or appropriations 
723.4   listed under it are available for the fiscal year ending June 
723.5   30, 2003. 
723.6                           SUMMARY BY FUND
723.7                                                          2003 
723.8   General                                            $103,756,000
723.9   Health Care Access                                   (1,492,000) 
723.10  Federal TANF                                         20,419,000 
723.11                                             APPROPRIATIONS 
723.12                                         Available for the Year 
723.13                                          Ending June 30, 2003
723.14  Sec. 2.  COMMISSIONER OF 
723.15  HUMAN SERVICES
723.16  Subdivision 1.  Total 
723.17  Appropriation                                      $128,203,000 
723.18                Summary by Fund
723.19  General                           109,276,000
723.20  Health Care Access                 (1,492,000)
723.21  Federal TANF                       20,419,000
723.22  Subd. 2.  Administrative 
723.23  Reimbursement/Pass-through                             1,180,000
723.24  Subd. 3.  Basic Health Care 
723.25  Grants 
723.26  General                                              59,364,000
723.27  Health Care Access                                   (1,492,000)
723.28  The amounts that may be spent from this 
723.29  appropriation for each purpose are as 
723.30  follows: 
723.31  (a) MinnesotaCare Grants 
723.32  Health Care Access                                   (1,492,000) 
723.33  (b) MA Basic Health Care Grants - 
723.34  Families and Children 
723.35  General                                              14,708,000 
723.36  (c) MA Basic Health Care Grants - 
723.37  Elderly and Disabled 
723.38  General                                              15,137,000 
723.39  (d) General Assistance Medical Care 
723.40  Grants 
723.41  General                                              29,519,000 
724.1   Subd. 4.  Continuing Care Grants 
724.2   General                                              56,615,000 
724.3   The amounts that may be spent from this 
724.4   appropriation for each purpose are as 
724.5   follows: 
724.6   (a) Medical Assistance Long-Term Care 
724.7   Waivers and Home Care Grants 
724.8   General                                              57,388,000 
724.9   (b) Medical Assistance Long-Term Care 
724.10  Facilities Grants 
724.11  General                                                 678,000 
724.12  (c) Group Residential Housing Grants 
724.13  General                                              (1,451,000) 
724.14  Subd. 5.  Economic Support Grants 
724.15  General                                              (6,703,000)
724.16  Federal TANF                                         19,239,000 
724.17  The amounts that may be spent from the 
724.18  appropriation for each purpose are as 
724.19  follows: 
724.20  (a) Assistance to Families Grants 
724.21  General                                              (9,306,000) 
724.22  Federal TANF                                         19,239,000 
724.23  (b) General Assistance Grants 
724.24  General                                               3,491,000 
724.25  (c) Minnesota Supplemental Aid Grants 
724.26  General                                                (888,000) 
724.27  Sec. 3.  COMMISSIONER OF HEALTH
724.28  Subdivision 1.  Total Appropriation                  (5,520,000)
724.29                Summary by Fund
724.30  General                                              (5,520,000) 
724.31  Subd. 2.  Access and Quality Improvement             (5,520,000)
724.32     Sec. 4.  [EFFECTIVE DATE.] 
724.33     Sections 1 to 3 are effective the day following final 
724.34  enactment. 
724.35                            ARTICLE 13B 
724.36           DEPARTMENT OF CHILDREN, FAMILIES, AND LEARNING
724.37                        FORECAST ADJUSTMENT 
724.38  Section 1.  [ADJUSTMENT.] 
724.39     The dollar amounts shown are added to or, if shown in 
725.1   parentheses, are subtracted from the appropriations in Laws 
725.2   2001, First Special Session chapter 6, as amended by Laws 2002, 
725.3   chapter 220, and Laws 2002, chapter 374, or other law, and are 
725.4   appropriated from the general fund to the department of 
725.5   children, families, and learning for the purposes specified in 
725.6   this article, to be available for the fiscal year indicated for 
725.7   each purpose.  The figure "2003" used in this article means that 
725.8   the appropriation or appropriations listed are available for the 
725.9   fiscal year ending June 30, 2003. 
725.10                                                         2003 
725.11                                             APPROPRIATION CHANGE
725.12  Sec. 2.  APPROPRIATIONS; EARLY CHILDHOOD
725.13  AND FAMILY EDUCATION 
725.14  MFIP Child Care                                       6,817,000 
725.15                            ARTICLE 13C 
725.16                           APPROPRIATIONS 
725.17  Section 1.  [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 
725.18     The sums shown in the columns marked "APPROPRIATIONS" are 
725.19  appropriated from the general fund, or any other fund named, to 
725.20  the agencies and for the purposes specified in the sections of 
725.21  this article, to be available for the fiscal years indicated for 
725.22  each purpose.  The figures "2004" and "2005" where used in this 
725.23  article, mean that the appropriation or appropriations listed 
725.24  under them are available for the fiscal year ending June 30, 
725.25  2004, or June 30, 2005, respectively.  Where a dollar amount 
725.26  appears in parentheses, it means a reduction of an appropriation.
725.27                          SUMMARY BY FUND
725.28                                                       BIENNIAL
725.29                             2004          2005           TOTAL
725.30  General            $3,765,212,000 $3,727,319,000 $7,492,531,000
725.31  State Government
725.32  Special Revenue        45,337,000     45,104,000     90,441,000
725.33  Health Care 
725.34  Access                294,090,000    308,525,000    602,615,000
725.35  Federal TANF          261,552,000    270,364,000    531,916,000
725.36  Lottery Prize 
725.37  Fund                    1,556,000      1,556,000      3,112,000
725.38  Special Revenue         3,340,000      3,340,000      6,680,000
726.1   TOTAL              $4,371,087,000 $4,356,208,000 $8,727,295,000
726.2                                              APPROPRIATIONS 
726.3                                          Available for the Year 
726.4                                              Ending June 30 
726.5                                             2004         2005 
726.6   Sec. 2.  COMMISSIONER OF
726.7   HUMAN SERVICES
726.8   Subdivision 1.  Total
726.9   Appropriation                     $4,111,558,000 $4,110,496,000
726.10                Summary by Fund
726.11  General           3,566,163,000 3,541,854,000
726.12  State Government 
726.13  Special Revenue         534,000       534,000
726.14  Health Care
726.15  Access              287,753,000   302,188,000
726.16  Federal TANF        255,552,000   264,364,000
726.17  Lottery Cash
726.18  Flow                  1,556,000     1,556,000
726.19  [FEDERAL CONTINGENCY APPROPRIATION.] 
726.20  (a) Any additional federal Medicaid 
726.21  funds made available under title IV of 
726.22  the federal Jobs and Growth Tax Relief 
726.23  Reconciliation Act of 2003 are 
726.24  appropriated to the commissioner of 
726.25  human services for use in the state's 
726.26  medical assistance and MinnesotaCare 
726.27  programs.  The commissioners of human 
726.28  services and finance shall report to 
726.29  the legislative advisory committee on 
726.30  the additional federal Medicaid 
726.31  matching funds that will be available 
726.32  to the state. 
726.33  (b) Contingent upon the availability of 
726.34  these funds, the following policies 
726.35  shall become effective and necessary 
726.36  funds are appropriated for those 
726.37  purposes: 
726.38  (1) medical assistance and 
726.39  MinnesotaCare eligibility and local 
726.40  financial participation changes 
726.41  provided for in this act may be 
726.42  implemented prior to September 2, 2003, 
726.43  or may be delayed as necessary to 
726.44  maximize the use of federal funds 
726.45  received under title IV of the Jobs and 
726.46  Growth Tax Relief Reconciliation Act of 
726.47  2003; 
726.48  (2) the aggregate cap on the services 
726.49  identified in Minnesota Statutes, 
726.50  section 256L.035, paragraph (a), clause 
726.51  (3), shall be increased from $2,000 to 
726.52  $5,000.  This increase shall expire at 
726.53  the end of fiscal year 2007.  Funds may 
726.54  be transferred from the general fund to 
726.55  the health care access fund as 
726.56  necessary to implement this provision; 
726.57  and 
727.1   (3) the following payment shifts shall 
727.2   not be implemented: 
727.3   (i) MFIP payment shift found in 
727.4   subdivision 11; 
727.5   (ii) the county payment shift found in 
727.6   subdivision 1; and 
727.7   (iii) the delay in medical assistance 
727.8   and general assistance medical care 
727.9   fee-for-service payments found in 
727.10  subdivision 6. 
727.11  (c) Notwithstanding section 14, 
727.12  paragraphs (a) and (b) shall expire 
727.13  June 30, 2007. 
727.14  [RECEIPTS FOR SYSTEMS PROJECTS.] 
727.15  Appropriations and federal receipts for 
727.16  information system projects for MAXIS, 
727.17  PRISM, MMIS, and SSIS must be deposited 
727.18  in the state system account authorized 
727.19  in Minnesota Statutes, section 
727.20  256.014.  Money appropriated for 
727.21  computer projects approved by the 
727.22  Minnesota office of technology, funded 
727.23  by the legislature, and approved by the 
727.24  commissioner of finance may be 
727.25  transferred from one project to another 
727.26  and from development to operations as 
727.27  the commissioner of human services 
727.28  considers necessary.  Any unexpended 
727.29  balance in the appropriation for these 
727.30  projects does not cancel but is 
727.31  available for ongoing development and 
727.32  operations. 
727.33  [GIFTS.] Notwithstanding Minnesota 
727.34  Statutes, chapter 7, the commissioner 
727.35  may accept on behalf of the state 
727.36  additional funding from sources other 
727.37  than state funds for the purpose of 
727.38  financing the cost of assistance 
727.39  program grants or nongrant 
727.40  administration.  All additional funding 
727.41  is appropriated to the commissioner for 
727.42  use as designated by the grantor of 
727.43  funding. 
727.44  [SYSTEMS CONTINUITY.] In the event of 
727.45  disruption of technical systems or 
727.46  computer operations, the commissioner 
727.47  may use available grant appropriations 
727.48  to ensure continuity of payments for 
727.49  maintaining the health, safety, and 
727.50  well-being of clients served by 
727.51  programs administered by the department 
727.52  of human services.  Grant funds must be 
727.53  used in a manner consistent with the 
727.54  original intent of the appropriation. 
727.55  [NONFEDERAL SHARE TRANSFERS.] The 
727.56  nonfederal share of activities for 
727.57  which federal administrative 
727.58  reimbursement is appropriated to the 
727.59  commissioner may be transferred to the 
727.60  special revenue fund. 
727.61  [TANF FUNDS APPROPRIATED TO OTHER 
727.62  ENTITIES.] Any expenditures from the 
728.1   TANF block grant shall be expended in 
728.2   accordance with the requirements and 
728.3   limitations of part A of title IV of 
728.4   the Social Security Act, as amended, 
728.5   and any other applicable federal 
728.6   requirement or limitation.  Prior to 
728.7   any expenditure of these funds, the 
728.8   commissioner shall assure that funds 
728.9   are expended in compliance with the 
728.10  requirements and limitations of federal 
728.11  law and that any reporting requirements 
728.12  of federal law are met.  It shall be 
728.13  the responsibility of any entity to 
728.14  which these funds are appropriated to 
728.15  implement a memorandum of understanding 
728.16  with the commissioner that provides the 
728.17  necessary assurance of compliance prior 
728.18  to any expenditure of funds.  The 
728.19  commissioner shall receipt TANF funds 
728.20  appropriated to other state agencies 
728.21  and coordinate all related interagency 
728.22  accounting transactions necessary to 
728.23  implement these appropriations.  
728.24  Unexpended TANF funds appropriated to 
728.25  any state, local, or nonprofit entity 
728.26  cancel at the end of the state fiscal 
728.27  year unless appropriating language 
728.28  permits otherwise. 
728.29  [TANF FUNDS TRANSFERRED TO OTHER 
728.30  FEDERAL GRANTS.] The commissioner must 
728.31  authorize transfers from TANF to other 
728.32  federal block grants so that funds are 
728.33  available to meet the annual 
728.34  expenditure needs as appropriated.  
728.35  Transfers may be authorized prior to 
728.36  the expenditure year with the agreement 
728.37  of the receiving entity.  Transferred 
728.38  funds must be expended in the year for 
728.39  which the funds were appropriated 
728.40  unless appropriation language permits 
728.41  otherwise.  In accelerating transfer 
728.42  authorizations, the commissioner must 
728.43  aim to preserve the future potential 
728.44  transfer capacity from TANF to other 
728.45  block grants. 
728.46  [TANF MAINTENANCE OF EFFORT.] (a) In 
728.47  order to meet the basic maintenance of 
728.48  effort (MOE) requirements of the TANF 
728.49  block grant specified under Code of 
728.50  Federal Regulations, title 45, section 
728.51  263.1, the commissioner may only report 
728.52  nonfederal money expended for allowable 
728.53  activities listed in the following 
728.54  clauses as TANF/MOE expenditures: 
728.55  (1) MFIP cash, diversionary work 
728.56  program, and food assistance benefits 
728.57  under Minnesota Statutes, chapter 256J; 
728.58  (2) the child care assistance programs 
728.59  under Minnesota Statutes, sections 
728.60  119B.03 and 119B.05, and county child 
728.61  care administrative costs under 
728.62  Minnesota Statutes, section 119B.15; 
728.63  (3) state and county MFIP 
728.64  administrative costs under Minnesota 
728.65  Statutes, chapters 256J and 256K; 
729.1   (4) state, county, and tribal MFIP 
729.2   employment services under Minnesota 
729.3   Statutes, chapters 256J and 256K; 
729.4   (5) expenditures made on behalf of 
729.5   noncitizen MFIP recipients who qualify 
729.6   for the medical assistance without 
729.7   federal financial participation program 
729.8   under Minnesota Statutes, section 
729.9   256B.06, subdivision 4, paragraphs (d), 
729.10  (e), and (j); and 
729.11  (6) qualifying working family credit 
729.12  expenditures under Minnesota Statutes, 
729.13  section 290.0671. 
729.14  (b) The commissioner shall ensure that 
729.15  sufficient qualified nonfederal 
729.16  expenditures are made each year to meet 
729.17  the state's TANF/MOE requirements.  For 
729.18  the activities listed in paragraph (a), 
729.19  clauses (2) to (6), the commissioner 
729.20  may only report expenditures that are 
729.21  excluded from the definition of 
729.22  assistance under Code of Federal 
729.23  Regulations, title 45, section 260.31. 
729.24  (c) By August 31 of each year, the 
729.25  commissioner shall make a preliminary 
729.26  calculation to determine the likelihood 
729.27  that the state will meet its annual 
729.28  federal work participation requirement 
729.29  under Code of Federal Regulations, 
729.30  title 45, sections 261.21 and 261.23, 
729.31  after adjustment for any caseload 
729.32  reduction credit under Code of Federal 
729.33  Regulations, title 45, section 261.41.  
729.34  If the commissioner determines that the 
729.35  state will meet its federal work 
729.36  participation rate for the federal 
729.37  fiscal year ending that September, the 
729.38  commissioner may reduce the expenditure 
729.39  under paragraph (a), clause (1), to the 
729.40  extent allowed under Code of Federal 
729.41  Regulations, title 45, section 
729.42  263.1(a)(2). 
729.43  (d) For fiscal years beginning with 
729.44  state fiscal year 2003, the 
729.45  commissioner shall assure that the 
729.46  maintenance of effort used by the 
729.47  commissioner of finance for the 
729.48  February and November forecasts 
729.49  required under Minnesota Statutes, 
729.50  section 16A.103, contains expenditures 
729.51  under paragraph (a), clause (1), equal 
729.52  to at least 25 percent of the total 
729.53  required under Code of Federal 
729.54  Regulations, title 45, section 263.1. 
729.55  (e) If nonfederal expenditures for the 
729.56  programs and purposes listed in 
729.57  paragraph (a) are insufficient to meet 
729.58  the state's TANF/MOE requirements, the 
729.59  commissioner shall recommend additional 
729.60  allowable sources of nonfederal 
729.61  expenditures to the legislature, if the 
729.62  legislature is or will be in session to 
729.63  take action to specify additional 
729.64  sources of nonfederal expenditures for 
729.65  TANF/MOE before a federal penalty is 
730.1   imposed.  The commissioner shall 
730.2   otherwise provide notice to the 
730.3   legislative commission on planning and 
730.4   fiscal policy under paragraph (g). 
730.5   (f) If the commissioner uses authority 
730.6   granted under section 11, or similar 
730.7   authority granted by a subsequent 
730.8   legislature, to meet the state's 
730.9   TANF/MOE requirement in a reporting 
730.10  period, the commissioner shall inform 
730.11  the chairs of the appropriate 
730.12  legislative committees about all 
730.13  transfers made under that authority for 
730.14  this purpose. 
730.15  (g) If the commissioner determines that 
730.16  nonfederal expenditures under paragraph 
730.17  (a) are insufficient to meet TANF/MOE 
730.18  expenditure requirements, and if the 
730.19  legislature is not or will not be in 
730.20  session to take timely action to avoid 
730.21  a federal penalty, the commissioner may 
730.22  report nonfederal expenditures from 
730.23  other allowable sources as TANF/MOE 
730.24  expenditures after the requirements of 
730.25  this paragraph are met.  The 
730.26  commissioner may report nonfederal 
730.27  expenditures in addition to those 
730.28  specified under paragraph (a) as 
730.29  nonfederal TANF/MOE expenditures, but 
730.30  only ten days after the commissioner of 
730.31  finance has first submitted the 
730.32  commissioner's recommendations for 
730.33  additional allowable sources of 
730.34  nonfederal TANF/MOE expenditures to the 
730.35  members of the legislative commission 
730.36  on planning and fiscal policy for their 
730.37  review. 
730.38  (h) The commissioner of finance shall 
730.39  not incorporate any changes in federal 
730.40  TANF expenditures or nonfederal 
730.41  expenditures for TANF/MOE that may 
730.42  result from reporting additional 
730.43  allowable sources of nonfederal 
730.44  TANF/MOE expenditures under the interim 
730.45  procedures in paragraph (g) into the 
730.46  February or November forecasts required 
730.47  under Minnesota Statutes, section 
730.48  16A.103, unless the commissioner of 
730.49  finance has approved the additional 
730.50  sources of expenditures under paragraph 
730.51  (g). 
730.52  (i) Minnesota Statutes, section 
730.53  256.011, subdivision 3, which requires 
730.54  that federal grants or aids secured or 
730.55  obtained under that subdivision be used 
730.56  to reduce any direct appropriations 
730.57  provided by law, do not apply if the 
730.58  grants or aids are federal TANF funds. 
730.59  (j) Notwithstanding section 14, 
730.60  paragraph (a), clauses (1) to (6), and 
730.61  paragraphs (b) to (j) expire June 30, 
730.62  2007. 
730.63  [WORKING FAMILY CREDIT EXPENDITURES AS 
730.64  TANF MOE.] The commissioner may claim 
730.65  as TANF maintenance of effort up to the 
731.1   following amounts of working family 
731.2   credit expenditures for the following 
731.3   fiscal years: 
731.4   (1) fiscal year 2004, $7,013,000; 
731.5   (2) fiscal year 2005, $25,133,000; 
731.6   (3) fiscal year 2006, $6,942,000; and 
731.7   (4) fiscal year 2007, $6,707,000. 
731.8   [FISCAL YEAR 2003 APPROPRIATIONS 
731.9   CARRYFORWARD.] Effective the day 
731.10  following final enactment, 
731.11  notwithstanding Minnesota Statutes, 
731.12  section 16A.28, or any other law to the 
731.13  contrary, state agencies and 
731.14  constitutional offices may carry 
731.15  forward unexpended and unencumbered 
731.16  nongrant operating balances from fiscal 
731.17  year 2003 general fund appropriations 
731.18  into fiscal year 2004 to offset general 
731.19  budget reductions. 
731.20  [TRANSFER OF GRANT BALANCES.] Effective 
731.21  the day following final enactment, the 
731.22  commissioner of human services, with 
731.23  the approval of the commissioner of 
731.24  finance and after notification of the 
731.25  chair of the senate health, human 
731.26  services and corrections budget 
731.27  division and the chair of the house of 
731.28  representatives health and human 
731.29  services finance committee, may 
731.30  transfer unencumbered appropriation 
731.31  balances for the biennium ending June 
731.32  30, 2003, in fiscal year 2003 among the 
731.33  MFIP, MFIP child care assistance under 
731.34  Minnesota Statutes, section 119B.05, 
731.35  general assistance, general assistance 
731.36  medical care, medical assistance, 
731.37  Minnesota supplemental aid, and group 
731.38  residential housing programs, and the 
731.39  entitlement portion of the chemical 
731.40  dependency consolidated treatment fund, 
731.41  and between fiscal years of the 
731.42  biennium. 
731.43  [TANF APPROPRIATION CANCELLATION.] 
731.44  Notwithstanding the provisions of Laws 
731.45  2000, chapter 488, article 1, section 
731.46  16, any prior appropriations of TANF 
731.47  funds to the department of trade and 
731.48  economic development or to the job 
731.49  skills partnership board or any 
731.50  transfers of TANF funds from another 
731.51  agency to the department of trade and 
731.52  economic development or to the job 
731.53  skills partnership board are not 
731.54  available until expended, and if 
731.55  unobligated as of June 30, 2003, these 
731.56  appropriations or transfers shall 
731.57  cancel to the TANF fund. 
731.58  [SHIFT COUNTY PAYMENT.] The 
731.59  commissioner shall make up to 100 
731.60  percent of the calendar year 2005 
731.61  payments to counties for developmental 
731.62  disabilities semi-independent living 
731.63  services grants, developmental 
732.1   disabilities family support grants, and 
732.2   adult mental health grants from fiscal 
732.3   year 2006 appropriations.  This is a 
732.4   onetime payment shift.  Calendar year 
732.5   2006 and future payments for these 
732.6   grants are not affected by this shift.  
732.7   This provision expires June 30, 2006. 
732.8   [CAPITATION RATE INCREASE.] Of the 
732.9   health care access fund appropriations 
732.10  to the University of Minnesota in the 
732.11  higher education omnibus appropriation 
732.12  bill, $2,157,000 in fiscal year 2004 
732.13  and $2,157,000 in fiscal year 2005 are 
732.14  to be used to increase the capitation 
732.15  payments under Minnesota Statutes, 
732.16  section 256B.69.  Notwithstanding the 
732.17  provisions of section 14, this 
732.18  provision shall not expire. 
732.19  Subd. 2.  Agency Management        
732.20                Summary by Fund
732.21  General              41,473,000    27,868,000
732.22  State Government                             
732.23  Special Revenue         415,000       415,000
732.24  Health Care Access    3,673,000     3,673,000
732.25  Federal TANF            320,000       320,000
732.26  The amounts that may be spent from the 
732.27  appropriation for each purpose are as 
732.28  follows: 
732.29  (a) Financial Operations 
732.30  General               8,751,000     9,056,000
732.31  Health Care Access      828,000       828,000
732.32  Federal TANF            220,000       220,000
732.33  [SPECIAL REVENUE FUND TRANSFER.] 
732.34  Notwithstanding any law to the 
732.35  contrary, excluding accounts authorized 
732.36  under Minnesota Statutes, section 
732.37  16A.1286, and chapter 254B, the 
732.38  commissioner shall transfer $1,400,000 
732.39  of uncommitted special revenue fund 
732.40  balances to the general fund upon final 
732.41  enactment.  The actual transfers shall 
732.42  be identified within the standard 
732.43  information provided to the chairs of 
732.44  the house health and human services 
732.45  finance committee and the senate 
732.46  health, human services, and corrections 
732.47  budget division in December 2003. 
732.48  (b) Legal and
732.49  Regulation Operations 
732.50  General               7,896,000     8,168,000
732.51  State Government                             
732.52  Special Revenue         415,000       415,000
732.53  Health Care Access      244,000       244,000
733.1   Federal TANF            100,000       100,000
733.2   (c) Management Operations 
733.3   General              17,373,000     3,076,000
733.4   Health Care Access    1,623,000     1,623,000
733.5   (d) Information Technology
733.6   Operations 
733.7   General               7,453,000     7,568,000
733.8   Health Care Access      978,000       978,000
733.9   Subd. 3.  Revenue and Pass-Through 
733.10  Federal TANF         55,855,000    53,315,000
733.11  [TANF TRANSFER TO SOCIAL SERVICES BLOCK 
733.12  GRANT.] $3,137,000 in fiscal year 2005 
733.13  is appropriated to the commissioner for 
733.14  the purposes of providing services for 
733.15  families with children whose incomes 
733.16  are at or below 200 percent of the 
733.17  federal poverty guidelines.  The 
733.18  commissioner shall authorize a 
733.19  sufficient transfer of funds from the 
733.20  state's federal TANF block grant to the 
733.21  state's federal social services block 
733.22  grant to meet this appropriation.  The 
733.23  funds shall be distributed to counties 
733.24  for the children and community services 
733.25  grant according to the formula for the 
733.26  state appropriations in Minnesota 
733.27  Statutes, chapter 256M. 
733.28  [TANF FUNDS FOR FISCAL YEAR 2006 AND 
733.29  FISCAL YEAR 2007 REFINANCING.] 
733.30  $12,692,000 in fiscal year 2006 and 
733.31  $9,192,000 in fiscal year 2007 in TANF 
733.32  funds are available to the commissioner 
733.33  to replace general funds in the amount 
733.34  of $12,692,000 in fiscal year 2006 and 
733.35  $9,192,000 in fiscal year 2007 in 
733.36  expenditures that may be counted toward 
733.37  TANF maintenance of effort requirements 
733.38  or as an allowable TANF expenditure. 
733.39  [ADJUSTMENTS IN TANF TRANSFER TO CHILD 
733.40  CARE AND DEVELOPMENT FUND.] Transfers 
733.41  of TANF to the child care development 
733.42  fund for the purposes of MFIP child 
733.43  care assistance shall be reduced by 
733.44  $116,000 in fiscal year 2004 and shall 
733.45  be increased by $1,976,000 in fiscal 
733.46  year 2005. 
733.47  Subd. 4.  Children's Services Grants 
733.48                Summary by Fund
733.49  General             111,264,000    94,020,000
733.50  Federal TANF            -0-         3,137,000
733.51  [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 
733.52  Federal funds available during fiscal 
733.53  year 2004 and fiscal year 2005, for 
733.54  adoption incentive grants are 
733.55  appropriated to the commissioner for 
734.1   these purposes. 
734.2   [ADOPTION ASSISTANCE AND RELATIVE 
734.3   CUSTODY ASSISTANCE.] The commissioner 
734.4   may transfer unencumbered appropriation 
734.5   balances for adoption assistance and 
734.6   relative custody assistance between 
734.7   fiscal years and between programs. 
734.8   [CHILDREN AND COMMUNITY SERVICES 
734.9   GRANTS.] Counties shall not reduce 
734.10  children and community service grant 
734.11  expenditures for services to adults 
734.12  with disabilities by more than the 
734.13  overall percentage of the reduction in 
734.14  the county's allocation of children and 
734.15  community service grant funds when 
734.16  compared to the county's calendar year 
734.17  2003 allocation of former children's 
734.18  services and community service grants 
734.19  defined under Minnesota Statutes, 
734.20  section 256M.10, subdivision 5. 
734.21  [OUT-OF-HOME PLACEMENT.] Minnesota 
734.22  youth who require out-of-home placement 
734.23  through a corrections order must be 
734.24  placed in a Minnesota program or 
734.25  facility unless a program in a border 
734.26  state is closer to the youth's home or 
734.27  there is no vacancy in an appropriate 
734.28  in-state program or facility.  If no 
734.29  appropriate, cost-effective regional or 
734.30  in-state program is available, this 
734.31  must be documented in the case plan 
734.32  prior to placement in an out-of-state 
734.33  facility.  Justification for 
734.34  out-of-state placement of Minnesota 
734.35  youth must be included in reports to 
734.36  the Minnesota department of corrections.
734.37  Subd. 5.  Children's Services Management 
734.38  General               5,221,000     5,283,000
734.39  Subd. 6.  Basic Health Care Grants 
734.40                Summary by Fund
734.41  General           1,499,941,000 1,533,016,000
734.42  Health Care Access  268,151,000   282,605,000
734.43  [UPDATING FEDERAL POVERTY GUIDELINES.] 
734.44  Annual updates to the federal poverty 
734.45  guidelines are effective each July 1, 
734.46  following publication by the United 
734.47  States Department of Health and Human 
734.48  Services for health care programs under 
734.49  Minnesota Statutes, chapters 256, 256B, 
734.50  256D, and 256L. 
734.51  The amounts that may be spent from this 
734.52  appropriation for each purpose are as 
734.53  follows: 
734.54  (a) MinnesotaCare Grants 
734.55  Health Care Access 267,401,000   281,855,000
734.56  [MINNESOTACARE FEDERAL RECEIPTS.] 
734.57  Receipts received as a result of 
735.1   federal participation pertaining to 
735.2   administrative costs of the Minnesota 
735.3   health care reform waiver shall be 
735.4   deposited as nondedicated revenue in 
735.5   the health care access fund.  Receipts 
735.6   received as a result of federal 
735.7   participation pertaining to grants 
735.8   shall be deposited in the federal fund 
735.9   and shall offset health care access 
735.10  funds for payments to providers. 
735.11  [MINNESOTACARE FUNDING.] The 
735.12  commissioner may expend money 
735.13  appropriated from the health care 
735.14  access fund for MinnesotaCare in either 
735.15  fiscal year of the biennium. 
735.16  (b) MA Basic Health Care Grants - 
735.17  Families and Children 
735.18  General             568,254,000   582,161,000
735.19  [SERVICES TO PREGNANT WOMEN.] The 
735.20  commissioner shall use available 
735.21  federal money for the State-Children's 
735.22  Health Insurance Program for medical 
735.23  assistance services provided to 
735.24  pregnant women who are not otherwise 
735.25  eligible for federal financial 
735.26  participation beginning in fiscal year 
735.27  2003.  This federal money shall be 
735.28  deposited in the federal fund and shall 
735.29  offset general funds for payments to 
735.30  providers.  Notwithstanding section 14, 
735.31  this paragraph shall not expire. 
735.32  [MANAGED CARE RATE INCREASE.] (a) 
735.33  Effective January 1, 2004, the 
735.34  commissioner of human services shall 
735.35  increase the total payments to managed 
735.36  care plans under Minnesota Statutes, 
735.37  section 256B.69, by an amount equal to 
735.38  the cost increases to the managed care 
735.39  plans from by the elimination of: (1) 
735.40  the exemption from the taxes imposed 
735.41  under Minnesota Statutes, section 
735.42  297I.05, subdivision 5, for premiums 
735.43  paid by the state for medical 
735.44  assistance, general assistance medical 
735.45  care, and the MinnesotaCare program; 
735.46  and (2) the exemption of gross revenues 
735.47  subject to the taxes imposed under 
735.48  Minnesota Statutes, sections 295.50 to 
735.49  295.57, for payments paid by the state 
735.50  for services provided under medical 
735.51  assistance, general assistance medical 
735.52  care, and the MinnesotaCare program.  
735.53  Any increase based on clause (2) must 
735.54  be reflected in provider rates paid by 
735.55  the managed care plan unless the 
735.56  managed care plan is a staff model 
735.57  health plan company. 
735.58  (b) The commissioner of human services 
735.59  shall increase by two percent the 
735.60  fee-for-service payments under medical 
735.61  assistance, general assistance medical 
735.62  care, and the MinnesotaCare program for 
735.63  services subject to the hospital, 
735.64  surgical center, or health care 
735.65  provider taxes under Minnesota 
736.1   Statutes, sections 295.50 to 295.57, 
736.2   effective for services rendered on or 
736.3   after January 1, 2004.  
736.4   (c) The commissioner of finance shall 
736.5   transfer from the health care access 
736.6   fund to the general fund the following 
736.7   amounts in the fiscal years indicated:  
736.8   2004, $16,587,000; 2005, $46,322,000; 
736.9   2006, $49,413,000; and 2007, 
736.10  $52,659,000. 
736.11  (d) For fiscal years after 2007, the 
736.12  commissioner of finance shall transfer 
736.13  from the health care access fund to the 
736.14  general fund an amount equal to the 
736.15  revenue collected by the commissioner 
736.16  of revenue on the following:  
736.17  (1) gross revenues received by 
736.18  hospitals, surgical centers, and health 
736.19  care providers as payments for services 
736.20  provided under medical assistance, 
736.21  general assistance medical care, and 
736.22  the MinnesotaCare program, including 
736.23  payments received directly from the 
736.24  state or from a prepaid plan, under 
736.25  Minnesota Statutes, sections 295.50 to 
736.26  295.57; and 
736.27  (2) premiums paid by the state under 
736.28  medical assistance, general assistance 
736.29  medical care, and the MinnesotaCare 
736.30  program under Minnesota Statutes, 
736.31  section 297I.05, subdivision 5.  
736.32  The commissioner of finance shall 
736.33  monitor and adjust if necessary the 
736.34  amount transferred each fiscal year 
736.35  from the health care access fund to the 
736.36  general fund to ensure that the amount 
736.37  transferred equals the tax revenue 
736.38  collected for the items described in 
736.39  clauses (1) and (2) for that fiscal 
736.40  year. 
736.41  (e) Notwithstanding section 14, these 
736.42  provisions shall not expire. 
736.43  (c) MA Basic Health Care Grants - Elderly 
736.44  and Disabled 
736.45  General             695,421,000   741,605,000
736.46  [DELAY MEDICAL ASSISTANCE 
736.47  FEE-FOR-SERVICE - ACUTE CARE.] The 
736.48  following payments in fiscal year 2005 
736.49  from the Medicaid Management 
736.50  Information System that would otherwise 
736.51  have been made to providers for medical 
736.52  assistance and general assistance 
736.53  medical care services shall be delayed 
736.54  and included in the first payment in 
736.55  fiscal year 2006: 
736.56  (1) for hospitals, the last two 
736.57  payments; and 
736.58  (2) for nonhospital providers, the last 
736.59  payment. 
737.1   This payment delay shall not include 
737.2   payments to skilled nursing facilities, 
737.3   intermediate care facilities for mental 
737.4   retardation, prepaid health plans, home 
737.5   health agencies, personal care nursing 
737.6   providers, and providers of only waiver 
737.7   services.  The provisions of Minnesota 
737.8   Statutes, section 16A.124, shall not 
737.9   apply to these delayed payments.  
737.10  Notwithstanding section 14, this 
737.11  provision shall not expire. 
737.12  [DEAF AND HARD-OF-HEARING SERVICES.] 
737.13  If, after making reasonable efforts, 
737.14  the service provider for mental health 
737.15  services to persons who are deaf or 
737.16  hearing impaired is not able to earn 
737.17  $227,000 through participation in 
737.18  medical assistance intensive 
737.19  rehabilitation services in fiscal year 
737.20  2005, the commissioner shall transfer 
737.21  $227,000 minus medical assistance 
737.22  earnings achieved by the grantee to 
737.23  deaf and hard-of-hearing grants to 
737.24  enable the provider to continue 
737.25  providing services to eligible persons. 
737.26  (d) General Assistance Medical Care 
737.27  Grants 
737.28  General             223,960,000   196,617,000
737.29  (e) Health Care Grants - Other 
737.30  Assistance 
737.31  General               3,067,000     3,407,000
737.32  Health Care Access      750,000       750,000
737.33  [MINNESOTA PRESCRIPTION DRUG DEDICATED 
737.34  FUND.] Of the general fund 
737.35  appropriation, $284,000 in fiscal year 
737.36  2005 is appropriated to the 
737.37  commissioner for the prescription drug 
737.38  dedicated fund established under the 
737.39  prescription drug discount program. 
737.40  [DENTAL ACCESS GRANTS CARRYOVER 
737.41  AUTHORITY.] Any unspent portion of the 
737.42  appropriation from the health care 
737.43  access fund in fiscal years 2002 and 
737.44  2003 for dental access grants under 
737.45  Minnesota Statutes, section 256B.53, 
737.46  shall not cancel but shall be allowed 
737.47  to carry forward to be spent in the 
737.48  biennium beginning July 1, 2003, for 
737.49  these purposes. 
737.50  [STOP-LOSS FUND ACCOUNT.] The 
737.51  appropriation to the purchasing 
737.52  alliance stop-loss fund account 
737.53  established under Minnesota Statutes, 
737.54  section 256.956, subdivision 2, for 
737.55  fiscal years 2004 and 2005 shall only 
737.56  be available for claim reimbursements 
737.57  for qualifying enrollees who are 
737.58  members of purchasing alliances that 
737.59  meet the requirements described under 
737.60  Minnesota Statutes, section 256.956, 
737.61  subdivision 1, paragraph (f), clauses 
737.62  (1), (2), and (3). 
738.1   (f) Prescription Drug Program 
738.2   General               9,239,000     9,226,000
738.3   [PRESCRIPTION DRUG ASSISTANCE PROGRAM.] 
738.4   Of the general fund appropriation, 
738.5   $702,000 in fiscal year 2004 and 
738.6   $887,000 in fiscal year 2005 are for 
738.7   the commissioner to establish and 
738.8   administer the prescription drug 
738.9   assistance program through the 
738.10  Minnesota board on aging. 
738.11  [REBATE REVENUE RECAPTURE.] Any funds 
738.12  received by the state from a drug 
738.13  manufacturer due to errors in the 
738.14  pharmaceutical pricing used by the 
738.15  manufacturer in determining the 
738.16  prescription drug rebate are 
738.17  appropriated to the commissioner to 
738.18  augment funding of the prescription 
738.19  drug program established in Minnesota 
738.20  Statutes, section 256.955. 
738.21  Subd. 7.  Health Care Management 
738.22                Summary by Fund
738.23  General              24,845,000    26,199,000
738.24  Health Care Access   14,522,000    14,533,000
738.25  The amounts that may be spent from this 
738.26  appropriation for each purpose are as 
738.27  follows: 
738.28  (a) Health Care Policy Administration 
738.29  General               5,523,000     7,223,000
738.30  Health Care Access    1,066,000     1,200,000
738.31  [PAYMENT CODE STUDY.] Of this 
738.32  appropriation, $345,000 each year is 
738.33  for a study to determine the 
738.34  appropriateness of eliminating 
738.35  reimbursement for certain payment codes 
738.36  under medical assistance, general 
738.37  assistance medical care, or 
738.38  MinnesotaCare.  As part of the study, 
738.39  the commissioner shall also examine 
738.40  covered services under the Minnesota 
738.41  health care programs and make 
738.42  recommendations on possible 
738.43  modification of the services covered 
738.44  under the program.  The commissioner 
738.45  shall report to the legislature by 
738.46  January 15, 2005, with an analysis of 
738.47  the feasibility of this approach, a 
738.48  list of codes, if any, to be eliminated 
738.49  from the payment system, and estimates 
738.50  of savings to be obtained from this 
738.51  approach. 
738.52  [TRANSFERS FROM HEALTH CARE ACCESS 
738.53  FUND.] (a) Notwithstanding Minnesota 
738.54  Statutes, section 295.581, to the 
738.55  extent available resources in the 
738.56  health care access fund exceed 
738.57  expenditures in that fund during fiscal 
738.58  years 2005 to 2007, the excess annual 
739.1   funds shall be transferred from the 
739.2   health care access fund to the general 
739.3   fund on June 30 of fiscal years 2005, 
739.4   2006, and 2007.  These transfers shall 
739.5   not be reduced to accommodate 
739.6   MinnesotaCare expansions.  The 
739.7   estimated amounts to be transferred are:
739.8   (1) in fiscal year 2005, $192,442,000; 
739.9   (2) in fiscal year 2006, $52,943,000; 
739.10  and 
739.11  (3) in fiscal year 2007, $59,105,000. 
739.12  These estimates shall be updated with 
739.13  each forecast, but in no case shall the 
739.14  transfers exceed the amounts listed in 
739.15  clauses (1) to (3). 
739.16  (b) The commissioner shall limit 
739.17  transfers under paragraph (a) in order 
739.18  to avoid implementation of Minnesota 
739.19  Statutes, section 256L.02, subdivision 
739.20  3, paragraph (b). 
739.21  (c) For fiscal years 2004 to 2007, 
739.22  MinnesotaCare shall be a forecasted 
739.23  program and, if necessary, the 
739.24  commissioner shall reduce transfers 
739.25  under paragraph (a) to meet forecasted 
739.26  expenditures. 
739.27  (d) The department of human services in 
739.28  recommending its 2007-2008 budget shall 
739.29  consider the repayment of the amount 
739.30  transferred in fiscal years 2006 and 
739.31  2007 from the health care access fund 
739.32  to the general fund to the health care 
739.33  access fund. 
739.34  (e) Notwithstanding section 14, this 
739.35  section is in effect until June 30, 
739.36  2007. 
739.37  [MINNESOTACARE OUTREACH REIMBURSEMENT.] 
739.38  Federal administrative reimbursement 
739.39  resulting from MinnesotaCare outreach 
739.40  is appropriated to the commissioner for 
739.41  this activity. 
739.42  [MINNESOTA SENIOR HEALTH OPTIONS 
739.43  REIMBURSEMENT.] Federal administrative 
739.44  reimbursement resulting from the 
739.45  Minnesota senior health options project 
739.46  is appropriated to the commissioner for 
739.47  this activity. 
739.48  [UTILIZATION REVIEW.] Federal 
739.49  administrative reimbursement resulting 
739.50  from prior authorization and inpatient 
739.51  admission certification by a 
739.52  professional review organization shall 
739.53  be dedicated to the commissioner for 
739.54  these purposes.  A portion of these 
739.55  funds must be used for activities to 
739.56  decrease unnecessary pharmaceutical 
739.57  costs in medical assistance. 
739.58  (b) Health Care Operations 
740.1   General              19,322,000    18,976,000
740.2   Health Care Access   13,456,000    13,333,000
740.3   [PREPAID MEDICAL PROGRAMS.] For all 
740.4   counties in which the PMAP program has 
740.5   been operating for 12 or more months, 
740.6   state funding for the nonfederal share 
740.7   of prepaid medical assistance program 
740.8   administration costs for county managed 
740.9   care advocacy and enrollment operations 
740.10  is eliminated.  State funding will 
740.11  continue for these activities for 
740.12  counties and tribes establishing new 
740.13  PMAP programs for a maximum of 16 
740.14  months (four months prior to beginning 
740.15  PMAP enrollment and through the first 
740.16  12 months of their PMAP program 
740.17  operation).  Those counties operating 
740.18  PMAP programs for less than 12 months 
740.19  can continue to receive state funding 
740.20  for advocacy and enrollment activities 
740.21  through their first year of operation. 
740.22  Subd. 8.  State-operated Services 
740.23  General             195,062,000   186,775,000
740.24  [MITIGATION RELATED TO STATE-OPERATED 
740.25  SERVICES RESTRUCTURING.] Money 
740.26  appropriated to finance mitigation 
740.27  expenses related to restructuring 
740.28  state-operated services programs and 
740.29  administrative services may be 
740.30  transferred between fiscal years within 
740.31  the biennium. 
740.32  [REPAIRS AND BETTERMENTS.] The 
740.33  commissioner may transfer unencumbered 
740.34  appropriation balances between fiscal 
740.35  years within the biennium for the state 
740.36  residential facilities repairs and 
740.37  betterments account and special 
740.38  equipment. 
740.39  [ONETIME REDUCTION TO DEDICATED 
740.40  REVENUES.] (a) For fiscal year 2003 
740.41  only, the commissioner shall transfer 
740.42  $4,700,000 of state-operated services 
740.43  fund balances from the accounts 
740.44  indicated to the general fund as 
740.45  follows: 
740.46  (1) $3,200,000 from traumatic brain 
740.47  injury enterprises; 
740.48  (2) $1,000,000 from lease income; and 
740.49  (3) $500,000 from ICF/MR depreciation. 
740.50  (b) Paragraph (a) is effective the day 
740.51  following final enactment. 
740.52  Subd. 9.  Continuing Care Grants 
740.53                Summary by Fund
740.54  General           1,504,933,000 1,490,958,000
740.55  Lottery Prize Fund    1,408,000     1,408,000
741.1   The amounts that may be spent from this 
741.2   appropriation for each purpose are as 
741.3   follows: 
741.4   (a) Community Social Services
741.5   General                 496,000       371,000
741.6   (b) Aging and Adult Service Grant 
741.7   General              12,998,000    13,951,000
741.8   [LONG-TERM CARE PROGRAM REDUCTIONS.] 
741.9   For the biennium ending June 30, 2005, 
741.10  state funding for the following state 
741.11  long-term care programs is reduced by 
741.12  15 percent from the level of state 
741.13  funding provided on June 30, 2003:  
741.14  SAIL project grants under Minnesota 
741.15  Statutes, section 256B.0917; senior 
741.16  nutrition programs under Minnesota 
741.17  Statutes, section 256.9752; foster 
741.18  grandparents program under Minnesota 
741.19  Statutes, section 256.976; retired 
741.20  senior volunteer program under 
741.21  Minnesota Statutes, section 256.9753; 
741.22  and the senior companion program under 
741.23  Minnesota Statutes, section 256.977. 
741.24  (c) Deaf and Hard-of-hearing 
741.25  Service Grants 
741.26  General               1,719,000     1,490,000
741.27  (d) Mental Health Grants 
741.28  General              53,479,000    34,690,000
741.29  Lottery Prize Fund    1,408,000     1,408,000
741.30  [RESTRUCTURING OF ADULT MENTAL HEALTH 
741.31  SERVICES.] The commissioner may make 
741.32  transfers that do not increase the 
741.33  state share of costs to effectively 
741.34  implement the restructuring of adult 
741.35  mental health services.  
741.36  [COMPULSIVE GAMBLING.] Of the 
741.37  appropriation from the lottery prize 
741.38  fund, $250,000 each year is for the 
741.39  following purposes: 
741.40  (1) $100,000 each year is for a grant 
741.41  to the Southeast Asian Problem Gambling 
741.42  Consortium.  The consortium must 
741.43  provide statewide compulsive gambling 
741.44  prevention and treatment services for 
741.45  Lao, Hmong, Vietnamese, and Cambodian 
741.46  families, adults, and adolescents.  The 
741.47  appropriation in this clause shall not 
741.48  become part of base level funding for 
741.49  the biennium beginning July 1, 2005.  
741.50  Any unencumbered balance of the 
741.51  appropriation in the first year does 
741.52  not cancel but is available for the 
741.53  second year; and 
741.54  (2) $150,000 each year is for a grant 
741.55  to a compulsive gambling council 
741.56  located in St. Louis county.  The 
741.57  gambling council must provide a 
742.1   statewide compulsive gambling 
742.2   prevention and education project for 
742.3   adolescents.  Any unencumbered balance 
742.4   of the appropriation in the first year 
742.5   of the biennium does not cancel but is 
742.6   available for the second year. 
742.7   (e) Community Support Grants 
742.8   General               12,523,000    9,093,000
742.9   [CENTERS FOR INDEPENDENT LIVING STUDY.] 
742.10  The commissioner of human services, in 
742.11  consultation with the commissioner of 
742.12  economic security, the centers for 
742.13  independent living, and consumer 
742.14  representatives, shall study the 
742.15  financing of the centers for 
742.16  independent living authorized under 
742.17  Minnesota Statutes, section 268A.11, 
742.18  and make recommendations on options to 
742.19  maximize federal financial 
742.20  participation.  Study components shall 
742.21  include: 
742.22  (1) the demographics of individuals 
742.23  served by the centers for independent 
742.24  living; 
742.25  (2) the range of services the centers 
742.26  for independent living provide to these 
742.27  individuals; 
742.28  (3) other publicly funded services 
742.29  received by individuals supported by 
742.30  the centers; and 
742.31  (4) strategies for maximizing federal 
742.32  financial participation for eligible 
742.33  activities carried out by centers for 
742.34  independent living. 
742.35  The commissioner shall report with 
742.36  fiscal and programmatic recommendations 
742.37  to the chairs of the appropriate house 
742.38  of representatives and senate finance 
742.39  and policy committees by January 15, 
742.40  2004. 
742.41  (f) Medical Assistance Long-Term 
742.42  Care Waivers and Home Care Grants 
742.43  General              659,211,000  718,665,000
742.44  [RATE AND ALLOCATION DECREASES FOR 
742.45  CONTINUING CARE PROGRAMS.] 
742.46  Notwithstanding any law or rule to the 
742.47  contrary, the commissioner of human 
742.48  services shall decrease reimbursement 
742.49  rates or reduce allocations to assure 
742.50  the necessary reductions in state 
742.51  spending for the providers or programs 
742.52  listed in paragraphs (a) to (d).  The 
742.53  decreases are effective for services 
742.54  rendered on or after July 1, 2003. 
742.55  (a) Effective July 1, 2003, the 
742.56  commissioner shall reduce payment rates 
742.57  for services and individual or service 
742.58  limits by one percent.  The rate 
742.59  decreases described in this section 
743.1   must be applied to: 
743.2   (1) home and community-based waivered 
743.3   services for the elderly under 
743.4   Minnesota Statutes, section 256B.0915; 
743.5   (2) day training and habilitation 
743.6   services for adults with mental 
743.7   retardation or related conditions under 
743.8   Minnesota Statutes, sections 252.40 to 
743.9   252.46; 
743.10  (3) the group residential housing 
743.11  supplementary service rate under 
743.12  Minnesota Statutes, section 256I.05, 
743.13  subdivision 1a; 
743.14  (4) chemical dependency residential and 
743.15  nonresidential service rates under 
743.16  Minnesota Statutes, section 245B.03; 
743.17  (5) consumer support grants under 
743.18  Minnesota Statutes, section 256.476; 
743.19  and 
743.20  (6) home and community-based services 
743.21  for alternative care services under 
743.22  Minnesota Statutes, section 256B.0913. 
743.23  (b) The commissioner shall reduce 
743.24  allocations made available to county 
743.25  agencies for home and community-based 
743.26  waivered services to assure a 
743.27  one-percent reduction in state spending 
743.28  for services rendered on or after July 
743.29  1, 2003.  The commissioner shall apply 
743.30  the allocation decreases described in 
743.31  this section to: 
743.32  (1) persons with mental retardation or 
743.33  related conditions under Minnesota 
743.34  Statutes, section 256B.501; 
743.35  (2) waivered services under community 
743.36  alternatives for disabled individuals 
743.37  under Minnesota Statutes, section 
743.38  256B.49; 
743.39  (3) community alternative care waivered 
743.40  services under Minnesota Statutes, 
743.41  section 256B.49; and 
743.42  (4) traumatic brain injury waivered 
743.43  services under Minnesota Statutes, 
743.44  section 256B.49. 
743.45  County agencies will be responsible for 
743.46  100 percent of any spending in excess 
743.47  of the allocation made by the 
743.48  commissioner.  Nothing in this section 
743.49  shall be construed as reducing the 
743.50  county's responsibility to offer and 
743.51  make available feasible home and 
743.52  community-based options to eligible 
743.53  waiver recipients within the resources 
743.54  allocated to them for that purpose. 
743.55  (c) The commissioner shall reduce deaf 
743.56  and hard-of-hearing grants by one 
743.57  percent on July 1, 2003. 
744.1   (d) Effective July 1, 2003, the 
744.2   commissioner shall reduce payment rates 
744.3   for each facility reimbursed under 
744.4   Minnesota Statutes, section 256B.5012, 
744.5   by decreasing the total operating 
744.6   payment rate for intermediate care 
744.7   facilities for the mentally retarded by 
744.8   one percent.  For each facility, the 
744.9   commissioner shall multiply the 
744.10  adjustment by the total payment rate, 
744.11  excluding the property-related payment 
744.12  rate, in effect on June 30, 2003.  A 
744.13  facility whose payment rates are 
744.14  governed by closure agreements, 
744.15  receivership agreements, or Minnesota 
744.16  Rules, part 9553.0075, is not subject 
744.17  to an adjustment otherwise taken under 
744.18  this subdivision. 
744.19  Notwithstanding section 14, these 
744.20  adjustments shall not expire. 
744.21  [REDUCE GROWTH IN MR/RC WAIVER.] The 
744.22  commissioner shall reduce the growth in 
744.23  the MR/RC waiver by not allocating the 
744.24  300 additional diversion allocations 
744.25  that are included in the February 2003 
744.26  forecast for the fiscal years that 
744.27  begin on July 1, 2003, and July 1, 2004.
744.28  [MANAGE THE GROWTH IN THE TBI WAIVER.] 
744.29  During the fiscal years beginning on 
744.30  July 1, 2003, and July 1, 2004, the 
744.31  commissioner shall allocate money for 
744.32  home and community-based programs 
744.33  covered under Minnesota Statutes, 
744.34  section 256B.49, to assure a reduction 
744.35  in state spending that is equivalent to 
744.36  limiting the caseload growth of the TBI 
744.37  waiver to 150 in each year of the 
744.38  biennium.  Priorities for the 
744.39  allocation of funds shall be for 
744.40  individuals anticipated to be 
744.41  discharged from institutional settings 
744.42  or who are at imminent risk of a 
744.43  placement in an institutional setting. 
744.44  [TARGETED CASE MANAGEMENT FOR HOME CARE 
744.45  RECIPIENTS.] Implementation of the 
744.46  targeted case management benefit for 
744.47  home care recipients, according to 
744.48  Minnesota Statutes, section 256B.0621, 
744.49  subdivisions 2, 3, 5, 6, 7, 9, and 10, 
744.50  will be delayed until July 1, 2005. 
744.51  [COMMON SERVICE MENU.] Implementation 
744.52  of the common service menu option 
744.53  within the home and community-based 
744.54  waivers, according to Minnesota 
744.55  Statutes, section 256B.49, subdivision 
744.56  16, will be delayed until July 1, 2005. 
744.57  [LIMITATION ON COMMUNITY ALTERNATIVES 
744.58  FOR DISABLED INDIVIDUALS CASELOAD 
744.59  GROWTH.] For the biennium ending June 
744.60  30, 2005, the commissioner shall limit 
744.61  the allocations made available in the 
744.62  community alternatives for disabled 
744.63  individuals waiver program in order not 
744.64  to exceed average caseload growth of 95 
744.65  per month from June 2003 program 
745.1   levels, plus any additional 
745.2   legislatively authorized program 
745.3   growth.  The commissioner shall 
745.4   allocate available resources to achieve 
745.5   the following outcomes: 
745.6   (1) the establishment of feasible and 
745.7   viable alternatives for persons in 
745.8   institutional or hospital settings to 
745.9   relocate to home and community-based 
745.10  settings; 
745.11  (2) the availability of timely 
745.12  assistance to persons at imminent risk 
745.13  of institutional or hospital placement 
745.14  or whose health and safety is at 
745.15  immediate risk; and 
745.16  (3) the maximum provision of essential 
745.17  community supports to eligible persons 
745.18  in need of and waiting for home and 
745.19  community-based service alternatives.  
745.20  The commissioner may reallocate 
745.21  resources from one county or region to 
745.22  another if available funding in that 
745.23  county or region is not likely to be 
745.24  spent and the reallocation is necessary 
745.25  to achieve the outcomes specified in 
745.26  this paragraph. 
745.27  (g) Medical Assistance Long-term 
745.28  Care Facilities Grants 
745.29  General             543,999,000   514,483,000
745.30  (h) Alternative Care Grants 
745.31  General              75,206,000    66,351,000
745.32  [ALTERNATIVE CARE TRANSFER.] Any money 
745.33  allocated to the alternative care 
745.34  program that is not spent for the 
745.35  purposes indicated does not cancel but 
745.36  shall be transferred to the medical 
745.37  assistance account. 
745.38  [ALTERNATIVE CARE APPROPRIATION.] The 
745.39  commissioner may expend the money 
745.40  appropriated for the alternative care 
745.41  program for that purpose in either year 
745.42  of the biennium. 
745.43  [ALTERNATIVE CARE IMPLEMENTATION OF 
745.44  CHANGES TO FEES AND ELIGIBILITY.] 
745.45  Changes to Minnesota Statutes, section 
745.46  256B.0913, subdivision 4, paragraph 
745.47  (d), and subdivision 12, are effective 
745.48  July 1, 2003, for all persons found 
745.49  eligible for the alternative care 
745.50  program on or after July 1, 2003.  All 
745.51  recipients of alternative care funding 
745.52  as of June 30, 2003, shall be subject 
745.53  to Minnesota Statutes, section 
745.54  256B.0913, subdivision 4, paragraph 
745.55  (d), and subdivision 12, on the annual 
745.56  reassessment and review of their 
745.57  eligibility after July 1, 2003, but no 
745.58  later than January 1, 2004. 
745.59  (i) Group Residential Housing Grants 
746.1   General              94,996,000    80,472,000
746.2   [GROUP RESIDENTIAL HOUSING COSTS 
746.3   REFINANCED.] (1) Effective July 1, 
746.4   2004, the commissioner shall increase 
746.5   the home and community-based service 
746.6   rates and county allocations provided 
746.7   to programs for persons with 
746.8   disabilities established under section 
746.9   1915(c) of the Social Security Act to 
746.10  the extent that these programs will be 
746.11  paying for the costs above the rate 
746.12  established in Minnesota Statutes, 
746.13  section 256I.05, subdivision 1. 
746.14  (2) For persons in receipt of services 
746.15  under Minnesota Statutes, section 
746.16  256B.0915, who reside in licensed adult 
746.17  foster care beds for which a 
746.18  supplemental room and board payment was 
746.19  being made under Minnesota Statutes, 
746.20  section 256I.05, subdivision 1, 
746.21  counties may request an exception to 
746.22  the individual caps specified in 
746.23  Minnesota Statutes, section 256B.0915, 
746.24  subdivision 3, paragraph (b), not to 
746.25  exceed the difference between the 
746.26  individual cap and the client's monthly 
746.27  service expenditures plus the amount of 
746.28  the supplemental room and board rate.  
746.29  The county must submit a request to 
746.30  exceed the individual cap to the 
746.31  commissioner for approval. 
746.32  (j) Chemical Dependency
746.33  Entitlement Grants 
746.34  General              49,251,000    50,337,000
746.35  (k) Chemical Dependency Nonentitlement 
746.36  Grants 
746.37  General               1,055,000     1,055,000
746.38  Subd. 10.  Continuing Care Management 
746.39                Summary by Fund
746.40  General              21,697,000    21,206,000
746.41  State Government 
746.42  Special Revenue         119,000       119,000
746.43  Lottery Prize Fund      148,000       148,000
746.44  [APPROPRIATION; REPORT ON LONG-TERM 
746.45  CARE FINANCING REFORM.] Money 
746.46  appropriated to the commissioner for 
746.47  fiscal year 2004 for the report on 
746.48  long-term care financing reform and 
746.49  long-term care insurance purchase 
746.50  incentives shall not cancel but shall 
746.51  be available to the commissioner for 
746.52  that purpose in fiscal year 2005. 
746.53  Subd. 11.  Economic Support Grants 
746.54                Summary by Fund
746.55  General             122,647,000   117,198,000
747.1   Federal TANF        199,009,000   207,224,000
747.2   The amounts that may be spent from this 
747.3   appropriation for each purpose are as 
747.4   follows: 
747.5   (a) Minnesota Family Investment Program 
747.6   General              59,922,000    39,375,000
747.7   Federal TANF        106,535,000   110,543,000
747.8   (b) Work Grants 
747.9   General                 666,000    14,678,000
747.10  Federal TANF         92,474,000    96,681,000
747.11  [MFIP SUPPORT SERVICES COUNTY AND 
747.12  TRIBAL ALLOCATION.] When determining 
747.13  the funds available for the 
747.14  consolidated MFIP support services 
747.15  grant in the 18-month period ending 
747.16  December 31, 2004, the commissioner 
747.17  shall apportion the funds appropriated 
747.18  for fiscal year 2005 in such manner as 
747.19  necessary to provide $14,000,000 more 
747.20  to counties and tribes for the period 
747.21  ending December 31, 2004, than would 
747.22  have been available had the funds been 
747.23  evenly divided within the fiscal year 
747.24  between the period before December 31, 
747.25  2004, and the period after December 31, 
747.26  2004. 
747.27  For allocations for the calendar years 
747.28  starting January 1, 2005, the 
747.29  commissioner shall apportion the funds 
747.30  appropriated for each fiscal year in 
747.31  such manner as necessary to provide 
747.32  $14,000,000 more to counties and tribes 
747.33  for the period ending December 31 of 
747.34  that year than would have been 
747.35  available had the funds been evenly 
747.36  divided within the fiscal year between 
747.37  the period before December 31 and the 
747.38  period after December 31. 
747.39  (c) Economic Support Grants - Other 
747.40  Assistance 
747.41  General               3,358,000     3,463,000
747.42  [SUPPORTIVE HOUSING.] Of the general 
747.43  fund appropriation, $500,000 each year 
747.44  is to provide services to families who 
747.45  are participating in the supportive 
747.46  housing and managed care pilot project 
747.47  under Minnesota Statutes, section 
747.48  256K.25.  This appropriation shall not 
747.49  become part of base level funding for 
747.50  the biennium beginning July 1, 2007. 
747.51  (d) Child Support Enforcement Grants 
747.52  General               3,571,000     3,503,000
747.53  (e) General Assistance Grants
747.54  General              24,901,000    24,732,000
748.1   [GENERAL ASSISTANCE STANDARD.] The 
748.2   commissioner shall set the monthly 
748.3   standard of assistance for general 
748.4   assistance units consisting of an adult 
748.5   recipient who is childless and 
748.6   unmarried or living apart from parents 
748.7   or a legal guardian at $203.  The 
748.8   commissioner may reduce this amount 
748.9   according to Laws 1997, chapter 85, 
748.10  article 3, section 54. 
748.11  [EMERGENCY GENERAL ASSISTANCE.] The 
748.12  amount appropriated for emergency 
748.13  general assistance funds is limited to 
748.14  no more than $7,889,812 in each fiscal 
748.15  year of 2004 and 2005.  Funds to 
748.16  counties shall be allocated by the 
748.17  commissioner using the allocation 
748.18  method specified in Minnesota Statutes, 
748.19  section 256D.06. 
748.20  (f) Minnesota Supplemental Aid Grants 
748.21  General              30,229,000    31,447,000
748.22  [EMERGENCY MINNESOTA SUPPLEMENTAL AID 
748.23  FUNDS.] The amount appropriated for 
748.24  emergency Minnesota supplemental aid 
748.25  funds is limited to no more than 
748.26  $1,138,707 in fiscal year 2004 and 
748.27  $1,017,000 in fiscal year 2005.  Funds 
748.28  to counties shall be allocated by the 
748.29  commissioner using the allocation 
748.30  method specified in Minnesota Statutes, 
748.31  section 256D.46. 
748.32  Subd. 12.  Economic Support
748.33  Management 
748.34                Summary by Fund
748.35  General              39,080,000    39,331,000
748.36  Health Care Access    1,407,000     1,377,000
748.37  Federal TANF            368,000       368,000
748.38  The amounts that may be spent from this 
748.39  appropriation for each purpose are as 
748.40  follows: 
748.41  (a) Economic Support 
748.42  Policy Administration
748.43  General               5,360,000     5,587,000
748.44  Federal TANF            368,000       368,000
748.45  (b) Economic Support 
748.46  Operations 
748.47  General              33,720,000    33,744,000
748.48  Health Care Access    1,407,000     1,377,000
748.49  [SPENDING AUTHORITY FOR FOOD STAMPS 
748.50  ENHANCED FUNDING.] In the event that 
748.51  Minnesota qualifies for the U.S. 
748.52  Department of Agriculture Food and 
748.53  Nutrition Services Food Stamp Program 
748.54  enhanced funding beginning in federal 
749.1   fiscal year 2002, the funding is 
749.2   appropriated to the commissioner.  The 
749.3   commissioner shall retain 25 percent of 
749.4   the funding, with the other 75 percent 
749.5   divided among the counties according to 
749.6   a formula that takes into account each 
749.7   county's impact on the statewide food 
749.8   stamp error rate. 
749.9   [CHILD SUPPORT PAYMENT CENTER.] 
749.10  Payments to the commissioner from other 
749.11  governmental units, private 
749.12  enterprises, and individuals for 
749.13  services performed by the child support 
749.14  payment center must be deposited in the 
749.15  state systems account authorized under 
749.16  Minnesota Statutes, section 256.014.  
749.17  These payments are appropriated to the 
749.18  commissioner for the operation of the 
749.19  child support payment center or system, 
749.20  according to Minnesota Statutes, 
749.21  section 256.014. 
749.22  [CHILD SUPPORT COST RECOVERY FEES.] The 
749.23  commissioner shall transfer $247,000 of 
749.24  child support cost recovery fees 
749.25  collected in fiscal year 2005 to the 
749.26  PRISM special revenue account to offset 
749.27  PRISM system costs of implementing the 
749.28  fee. 
749.29  [FINANCIAL INSTITUTION DATA MATCH AND 
749.30  PAYMENT OF FEES.] The commissioner is 
749.31  authorized to allocate up to $310,000 
749.32  each year in fiscal year 2004 and 
749.33  fiscal year 2005 from the PRISM special 
749.34  revenue account to make payments to 
749.35  financial institutions in exchange for 
749.36  performing data matches between account 
749.37  information held by financial 
749.38  institutions and the public authority's 
749.39  database of child support obligors as 
749.40  authorized by Minnesota Statutes, 
749.41  section 13B.06, subdivision 7. 
749.42  [CONSISTENT ACCOUNTING FOR PROGRAMS TO 
749.43  BE TRANSFERRED.] To ensure consistent 
749.44  accounting, including forecasting, 
749.45  budgeting, cost allocation, and 
749.46  financial reporting, the commissioner 
749.47  may establish accounts and processes in 
749.48  the state's accounting system so the 
749.49  programs being transferred from other 
749.50  state agencies are integrated into the 
749.51  department's standard accounting 
749.52  policies and procedures. 
749.53  Sec. 3.  COMMISSIONER OF HEALTH
749.54  Subdivision 1.  Total
749.55  Appropriation                        104,995,000    106,328,000
749.56                Summary by Fund
749.57  General              59,842,000    61,438,000
749.58  State Government
749.59  Special Revenue      32,880,000    32,617,000
749.60  Health Care Access    6,273,000     6,273,000
750.1   Federal TANF          6,000,000     6,000,000
750.2   Subd. 2.  Health Improvement 
750.3                 Summary by Fund
750.4   General              44,595,000    46,459,000
750.5   State Government
750.6   Special Revenue       1,987,000     1,987,000
750.7   Health Care Access    3,510,000     3,510,000
750.8   Federal TANF          6,000,000     6,000,000
750.9   [TOBACCO PREVENTION ENDOWMENT FUND 
750.10  TRANSFERS.] (a) On July 1, 2003, the 
750.11  commissioner of finance shall transfer 
750.12  $4,000,000 from the tobacco use 
750.13  prevention and local public health 
750.14  endowment expendable trust fund to the 
750.15  general fund. 
750.16  (b) Notwithstanding Minnesota Statutes, 
750.17  section 16A.62, any remaining 
750.18  unexpended balance in the fund after 
750.19  the transfer in paragraph (a) shall be 
750.20  transferred to the miscellaneous 
750.21  special revenue fund and dedicated to 
750.22  the commissioner of health for local 
750.23  tobacco prevention grants under 
750.24  Minnesota Statutes, section 144.396, 
750.25  subdivision 6.  Of this amount the 
750.26  commissioner may retain up to $150,000 
750.27  for administration and evaluation costs.
750.28  (c) Of the general fund appropriation 
750.29  for fiscal year 2005, $3,280,000 is to 
750.30  the commissioner for the grants 
750.31  specified in paragraph (b). 
750.32  [TANF APPROPRIATIONS.] TANF funds 
750.33  appropriated to the commissioner are 
750.34  available for home visiting and 
750.35  nutritional activities listed under 
750.36  Minnesota Statutes, section 145.882, 
750.37  subdivision 7, clauses (6) and (7), and 
750.38  eliminating health disparities 
750.39  activities under Minnesota Statutes, 
750.40  section 145.928, subdivision 10.  
750.41  Funding shall be distributed to 
750.42  community health boards and tribal 
750.43  governments based on the formula in 
750.44  Minnesota Statutes, section 145A.131, 
750.45  subdivisions 1 and 2. 
750.46  [TANF CARRYFORWARD.] Any unexpended 
750.47  balance of the TANF appropriation in 
750.48  the first year of the biennium does not 
750.49  cancel but is available for the second 
750.50  year. 
750.51  [MINNESOTA CHILDREN WITH SPECIAL HEALTH 
750.52  NEEDS CARRYFORWARD.] General fund 
750.53  appropriations for treatment services 
750.54  in the services for Minnesota children 
750.55  with special health needs program are 
750.56  available for either year of the 
750.57  biennium. 
750.58  [TRANSFER OF ENDOWMENT FUNDS.] On July 
751.1   1, 2003, the commissioner of finance 
751.2   shall transfer the tobacco use 
751.3   prevention and local public health 
751.4   endowment fund and the medical 
751.5   education endowment fund to the general 
751.6   fund. 
751.7   Subd. 3.  Health Quality and 
751.8   Access 
751.9                 Summary by Fund
751.10  General                 868,000       606,000
751.11  State Government
751.12  Special Revenue       8,888,000     8,888,000
751.13  Health Care Access    2,763,000     2,763,000
751.14  [STATE GOVERNMENT SPECIAL REVENUE FUND 
751.15  TRANSFERS.] On July 1, 2003, the 
751.16  commissioner of finance shall transfer 
751.17  $4,000,000 from the state government 
751.18  special revenue fund to the general 
751.19  fund. 
751.20  [NURSING HOME RECEIVERSHIP COSTS.] In 
751.21  the event that other funds are not 
751.22  available, the commissioner is 
751.23  authorized to expend up to $230,000 
751.24  from the fiscal year 2003 state 
751.25  government special revenue 
751.26  appropriation for nursing home 
751.27  regulation for those costs associated 
751.28  with nursing home receiverships 
751.29  necessary to protect the health and 
751.30  safety of residents.  The commissioner 
751.31  shall assert claims against any and all 
751.32  appropriate parties seeking 
751.33  reimbursement of any funds expended.  
751.34  This provision is effective the day 
751.35  following final enactment. 
751.36  [NURSING PROVIDERS WORK GROUP.] The 
751.37  commissioner shall establish a working 
751.38  group consisting of nursing home and 
751.39  boarding care home providers, 
751.40  representatives of nursing home 
751.41  residents, and other health care 
751.42  providers to review current licensure 
751.43  provisions and evaluate the continued 
751.44  appropriateness of these provisions.  
751.45  The commissioner shall present 
751.46  recommendations to the legislature by 
751.47  November 1, 2004. 
751.48  [MERC FUNDING.] Amounts in the medical 
751.49  education and research costs (MERC) 
751.50  special account not to exceed 
751.51  $8,660,000 in fiscal year 2004 and 
751.52  $8,616,000 in fiscal year 2005 are 
751.53  appropriated to the commissioner for 
751.54  medical education and research funding. 
751.55  Subd. 4.  Health Protection 
751.56                Summary by Fund
751.57  General               9,130,000     9,130,000
751.58  State Government
752.1   Special Revenue      22,005,000    21,742,000
752.2   Subd. 5.  Management and Support 
752.3   Services 
752.4   General               5,249,000     5,243,000
752.5   Sec. 4.  VETERANS NURSING HOMES BOARD 
752.6   General              30,030,000    30,030,000
752.7   [VETERANS HOMES SPECIAL REVENUE 
752.8   ACCOUNT.] The general fund 
752.9   appropriations made to the board may be 
752.10  transferred to a veterans homes special 
752.11  revenue account in the special revenue 
752.12  fund in the same manner as other 
752.13  receipts are deposited according to 
752.14  Minnesota Statutes, section 198.34, and 
752.15  are appropriated to the board for the 
752.16  operation of board facilities and 
752.17  programs. 
752.18  Sec. 5.  HEALTH-RELATED BOARDS 
752.19  Subdivision 1.  Total
752.20  Appropriation                         11,441,000     11,471,000 
752.21                Summary by Fund
752.22  State Government            
752.23  Special Revenue      11,377,000    11,407,000
752.24  Health Care Access       64,000        64,000
752.25  [STATE GOVERNMENT SPECIAL REVENUE 
752.26  FUND.] The appropriations in this 
752.27  section are from the state government 
752.28  special revenue fund, except where 
752.29  noted. 
752.30  [NO SPENDING IN EXCESS OF REVENUES.] 
752.31  The commissioner of finance shall not 
752.32  permit the allotment, encumbrance, or 
752.33  expenditure of money appropriated in 
752.34  this section in excess of the 
752.35  anticipated biennial revenues or 
752.36  accumulated surplus revenues from fees 
752.37  collected by the boards.  Neither this 
752.38  provision nor Minnesota Statutes, 
752.39  section 214.06, applies to transfers 
752.40  from the general contingent account. 
752.41  [STATE GOVERNMENT SPECIAL REVENUE FUND 
752.42  TRANSFERS.] On July 1, 2003, the 
752.43  commissioner of finance shall transfer 
752.44  $7,500,000 from the state government 
752.45  special revenue fund to the general 
752.46  fund.  Of this amount, $3,500,000 shall 
752.47  be transferred from the health-related 
752.48  boards and $4,000,000 shall be 
752.49  transferred as designated by the 
752.50  commissioner of finance. 
752.51  Subd. 2.  Board of Chiropractic
752.52  Examiners                                384,000        384,000 
752.53  [CONTESTED CASE EXPENSES.] In fiscal 
752.54  year 2003, $70,000 in state government 
752.55  special revenue funds is transferred 
752.56  from Laws 2001, First Special Session 
753.1   chapter 10, article 1, section 33, to 
753.2   the board of chiropractic examiners to 
753.3   pay for contested case activity.  These 
753.4   funds are available until September 30, 
753.5   2003. 
753.6   Subd. 3.  Board of Dentistry                                    
753.7   State Government Special    
753.8   Revenue Fund                             858,000        858,000 
753.9   Health Care                 
753.10  Access Fund                               64,000         64,000 
753.11  Subd. 4.  Board of Dietetic and 
753.12  Nutrition Practice                       101,000        101,000 
753.13  Subd. 5.  Board of Marriage and
753.14  Family Therapy                           118,000        118,000 
753.15  Subd. 6.  Board of Medical
753.16  Practice                               3,498,000      3,498,000 
753.17  Subd. 7.  Board of Nursing             2,405,000      2,405,000 
753.18  Subd. 8.  Board of Nursing
753.19  Home Administrators                      198,000        198,000 
753.20  Subd. 9.  Board of Optometry              96,000         96,000 
753.21  Subd. 10.  Board of Pharmacy           1,386,000      1,386,000 
753.22  [ADMINISTRATIVE SERVICES UNIT.] Of this 
753.23  appropriation, $359,000 the first year 
753.24  and $359,000 the second year are for 
753.25  the health boards administrative 
753.26  services unit.  The administrative 
753.27  services unit may receive and expend 
753.28  reimbursements for services performed 
753.29  for other agencies. 
753.30  Subd. 11.  Board of Physical
753.31  Therapy                                  197,000        197,000 
753.32  Subd. 12.  Board of Podiatry              45,000         45,000 
753.33  Subd. 13.  Board of Psychology           680,000        680,000 
753.34  Subd. 14.  Board of Social 
753.35  Work                                   1,073,000      1,073,000 
753.36  Subd. 15.  Board of Veterinary
753.37  Medicine                                 163,000        163,000 
753.38  Subd. 16.  Board of Behavioral
753.39  Health and Therapy                       175,000        205,000 
753.40  [ADDITIONAL FUNDING.] This amount is 
753.41  from the state government special 
753.42  revenue fund and is in addition to the 
753.43  appropriation in Laws 2003, chapter 
753.44  118, section 27.  Licensure fees will 
753.45  be increased accordingly to reimburse 
753.46  the fund balance. 
753.47  Sec. 6.  EMERGENCY MEDICAL SERVICES BOARD 
753.48  Subdivision 1.  Total
753.49  Appropriation                          3,027,000      3,027,000
753.50                Summary by Fund
754.1   General               2,481,000     2,481,000
754.2   State Government
754.3   Special Revenue         546,000       546,000
754.4   [HEALTH PROFESSIONAL SERVICES 
754.5   ACTIVITY.] $546,000 each year from the 
754.6   state government special revenue fund 
754.7   is for the health professional services 
754.8   activity. 
754.9   [COMPREHENSIVE ADVANCED LIFE SUPPORT 
754.10  ADMINISTRATIVE COSTS.] Of the 
754.11  appropriation for the comprehensive 
754.12  advanced life support program, not more 
754.13  than $5,000 each year may be retained 
754.14  by the board for administrative costs. 
754.15  [ROYALTY PAYMENTS DEDICATED TO BOARD.] 
754.16  Royalty payments from the sale of the 
754.17  Internet-based ambulance reporting 
754.18  program are appropriated to the board 
754.19  and shall remain available until 
754.20  expended.  Notwithstanding section 14, 
754.21  this provision shall not expire. 
754.22  [EMERGENCY MEDICAL SERVICES REGIONAL 
754.23  GRANTS.] Of this appropriation, 
754.24  $657,000 each year is for the purposes 
754.25  of Minnesota Statutes, section 144E.50. 
754.26  [AMBULANCE TRAINING GRANT CARRYFORWARD 
754.27  AND TRANSFER.] (a) Effective for fiscal 
754.28  year 2003 and succeeding fiscal years, 
754.29  any unspent portion of the 
754.30  appropriation for ambulance training 
754.31  grants shall not cancel but shall carry 
754.32  forward and be used in the following 
754.33  fiscal year for the purposes of 
754.34  Minnesota Statutes, section 144E.50.  
754.35  The board shall not retain any portion 
754.36  of the appropriation carried forward 
754.37  for administrative costs. 
754.38  (b) Notwithstanding section 14, this 
754.39  provision shall not expire. 
754.40  (c) This provision is effective the day 
754.41  following final enactment. 
754.42  Sec. 7.  COUNCIL ON DISABILITY 
754.43  General                                  500,000        500,000
754.44  Sec. 8.  OMBUDSMAN FOR MENTAL HEALTH 
754.45  AND MENTAL RETARDATION                                          
754.46  General                                1,462,000      1,462,000 
754.47  Sec. 9.  OMBUDSMAN FOR FAMILIES
754.48  General                                  245,000        245,000 
754.49  Sec. 10.  DEPARTMENT OF CHILDREN, 
754.50  FAMILIES, AND LEARNING 
754.51  Subdivision 1.  Total 
754.52  Appropriation                     $  107,829,000 $   92,649,000
754.53                Summary by Fund
755.1   General             104,489,000    89,309,000
755.2   State Special 
755.3   Revenue               3,340,000     3,340,000 
755.4   Subd. 2.  Child Care 
755.5   [BASIC SLIDING FEE CHILD CARE.] Of this 
755.6   appropriation, $27,628,000 in fiscal 
755.7   year 2004 and $18,771,000 in fiscal 
755.8   year 2005 are for child care assistance 
755.9   according to Minnesota Statutes, 
755.10  section 119B.03.  These appropriations 
755.11  are available to be spent either year.  
755.12  The fiscal years 2006 and 2007 general 
755.13  fund base for basic sliding fee child 
755.14  care is $30,312,000 each year. 
755.15  [MFIP CHILD CARE.] Of this 
755.16  appropriation, $69,543,000 in fiscal 
755.17  year 2004 and $63,720,000 in fiscal 
755.18  year 2005 are for MFIP child care. 
755.19  [CHILD CARE PROGRAM INTEGRITY.] Of this 
755.20  appropriation, $425,000 in fiscal year 
755.21  2004, and $376,000 in fiscal year 2005 
755.22  are for the administrative costs of 
755.23  program integrity and fraud prevention 
755.24  for child care assistance under 
755.25  Minnesota Statutes, chapter 119B. 
755.26  [CHILD CARE DEVELOPMENT.] Of this 
755.27  appropriation, $1,115,000 in fiscal 
755.28  year 2004, and $1,164,000 in fiscal 
755.29  year 2005 are for child care 
755.30  development grants according to 
755.31  Minnesota Statutes, section 119B.21. 
755.32  Subd. 3.  Child Care Assistance
755.33  Special Revenue Account                3,340,000      3,340,000
755.34  [CHILD SUPPORT SPECIAL REVENUE 
755.35  ACCOUNT.] Appropriations and transfers 
755.36  in this subdivision are from the child 
755.37  support collection payments in the 
755.38  special revenue fund, pursuant to 
755.39  Minnesota Statutes, section 119B.074.  
755.40  The sums indicated are appropriated to 
755.41  the department of children, families, 
755.42  and learning for the fiscal years 
755.43  designated. 
755.44  [CHILD CARE ASSISTANCE.] Of this 
755.45  appropriation, $3,340,000 in fiscal 
755.46  year 2004, and $3,340,000 in fiscal 
755.47  year 2005 are for child care assistance 
755.48  according to Minnesota Statutes, 
755.49  section 119B.03. 
755.50  [SPECIAL REVENUE ACCOUNT UNOBLIGATED 
755.51  FUND TRANSFER.] On July 1, 2003, the 
755.52  commissioner of finance shall transfer 
755.53  $1,800,000 from the special revenue 
755.54  fund to the general fund. 
755.55  Subd. 4.  Child Care
755.56  Assistance TANF Funds
755.57  [FEDERAL TANF TRANSFERS.] The sums 
755.58  indicated in this section are 
755.59  transferred from the federal TANF fund 
756.1   to the child care and development fund 
756.2   and are appropriated to the department 
756.3   of children, families, and learning for 
756.4   the fiscal years indicated.  The 
756.5   commissioner shall ensure that all 
756.6   transferred funds are expended 
756.7   according to the child care and 
756.8   development fund regulations and that 
756.9   maximum allowable transferred funds are 
756.10  used for the following programs: 
756.11  (a) For basic sliding fee child care, 
756.12  $17,686,000 in fiscal year 2004 and 
756.13  $17,700,000 in fiscal year 2005 are for 
756.14  child care assistance under Minnesota 
756.15  Statutes, section 119B.03. 
756.16  (b) For MFIP/TY, $7,312,000 in fiscal 
756.17  year 2004 and $4,919,000 in fiscal year 
756.18  2005 are for child care assistance 
756.19  under Minnesota Statutes, section 
756.20  119B.05. 
756.21  (c) For child care development grants 
756.22  under Minnesota Statutes, section 
756.23  119B.21, $14,000 is available in fiscal 
756.24  year 2004. 
756.25  Subd. 5.  Self-Sufficiency Programs
756.26  General        5,278,000     5,278,000 
756.27  [MINNESOTA ECONOMIC OPPORTUNITY 
756.28  GRANTS.] Of this appropriation, 
756.29  $4,000,000 in fiscal year 2004 and 
756.30  $4,000,000 in fiscal year 2005 are for 
756.31  Minnesota economic opportunity grants.  
756.32  Any balance in the first year does not 
756.33  cancel but is available in the second 
756.34  year. 
756.35  [FOOD SHELF PROGRAMS.] Of this 
756.36  appropriation, $1,278,000 in fiscal 
756.37  year 2004 and $1,278,000 in fiscal year 
756.38  2005 are for food shelf programs under 
756.39  Minnesota Statutes, section 119A.44.  
756.40  Any balance in the first year does not 
756.41  cancel but is available in the second 
756.42  year. 
756.43  Subd. 6.  Family Assets for Independence
756.44                   500,000         -0-   
756.45  Any balance in the first year does not 
756.46  cancel but is available in the second 
756.47  year. 
756.48     Sec. 11.  [TRANSFERS.] 
756.49     Subdivision 1.  [GRANTS.] The commissioner of human 
756.50  services, with the approval of the commissioner of finance, and 
756.51  after notification of the chair of the senate health, human 
756.52  services and corrections budget division and the chair of the 
756.53  house health and human services finance committee, may transfer 
756.54  unencumbered appropriation balances for the biennium ending June 
757.1   30, 2005, within fiscal years among the MFIP, general 
757.2   assistance, general assistance medical care, medical assistance, 
757.3   MFIP child care assistance under Minnesota Statutes, section 
757.4   119B.05, Minnesota supplemental aid, and group residential 
757.5   housing programs, and the entitlement portion of the chemical 
757.6   dependency consolidated treatment fund, and between fiscal years 
757.7   of the biennium. 
757.8      Subd. 2.  [ADMINISTRATION.] Positions, salary money, and 
757.9   nonsalary administrative money may be transferred within the 
757.10  departments of human services and health and within the programs 
757.11  operated by the veterans nursing homes board as the 
757.12  commissioners and the board consider necessary, with the advance 
757.13  approval of the commissioner of finance.  The commissioner or 
757.14  the board shall inform the chairs of the house health and human 
757.15  services finance committee and the senate health, human services 
757.16  and corrections budget division quarterly about transfers made 
757.17  under this provision. 
757.18     Subd. 3.  [PROHIBITED TRANSFERS.] Grant money shall not be 
757.19  transferred to operations within the departments of human 
757.20  services and health and within the programs operated by the 
757.21  veterans nursing homes board without the approval of the 
757.22  legislature. 
757.23     Sec. 12.  [INDIRECT COSTS NOT TO FUND PROGRAMS.] 
757.24     The commissioners of health and of human services shall not 
757.25  use indirect cost allocations to pay for the operational costs 
757.26  of any program for which they are responsible. 
757.27     Sec. 13.  [CARRYOVER LIMITATION.] 
757.28     The appropriations in this article which are allowed to be 
757.29  carried forward from fiscal year 2004 to fiscal year 2005 shall 
757.30  not become part of the base level funding for the 2006-2007 
757.31  biennial budget, unless specifically directed by the legislature.
757.32     Sec. 14.  [SUNSET OF UNCODIFIED LANGUAGE.] 
757.33     All uncodified language contained in this article expires 
757.34  on June 30, 2005, unless a different expiration date is explicit.
757.35     Sec. 15.  [REPEALER.] 
757.36     Laws 2002, chapter 374, article 9, section 8, is repealed 
758.1   effective upon final enactment. 
758.2      Sec. 16.  [EFFECTIVE DATE.] 
758.3      The provisions in this article are effective July 1, 2003, 
758.4   unless a different effective date is specified.