1.1                          A bill for an act 
  1.2             relating to human services; changing medical 
  1.3             assistance and general assistance medical care 
  1.4             eligibility requirements; amending Minnesota Statutes 
  1.5             1996, sections 256B.057, subdivisions 1, 1b, and 2; 
  1.6             and 256D.03, subdivision 3. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  Minnesota Statutes 1996, section 256B.057, 
  1.9   subdivision 1, is amended to read: 
  1.10     Subdivision 1.  [PREGNANT WOMEN AND INFANTS.] An infant 
  1.11  less than one year of age or a pregnant woman who has written 
  1.12  verification of a positive pregnancy test from a physician or 
  1.13  licensed registered nurse, is eligible for medical assistance if 
  1.14  countable family income is equal to or less than 275 percent of 
  1.15  the federal poverty guideline for the same family size.  For 
  1.16  purposes of this subdivision, "countable family income" means 
  1.17  the amount of income considered available using the methodology 
  1.18  of the AFDC program, except for the earned income disregard and 
  1.19  employment deductions.  An amount equal to the amount of earned 
  1.20  income exceeding 275 percent of the federal poverty guideline, 
  1.21  up to a maximum of the amount by which the combined total of 185 
  1.22  percent of the federal poverty guideline plus the earned income 
  1.23  disregards and deductions of the AFDC program exceeds 275 
  1.24  percent of the federal poverty guideline will be deducted for 
  1.25  pregnant women and infants less than one year of age.  
  1.26  Eligibility for a pregnant woman or infant less than one year of 
  2.1   age under this subdivision must be determined without regard to 
  2.2   asset standards established in section 256B.056, subdivision 3.  
  2.3      An infant born on or after January 1, 1991, to a woman who 
  2.4   was eligible for and receiving medical assistance on the date of 
  2.5   the child's birth shall continue to be eligible for medical 
  2.6   assistance without redetermination until the child's first 
  2.7   birthday, as long as the child remains in the woman's household. 
  2.8      Sec. 2.  Minnesota Statutes 1996, section 256B.057, 
  2.9   subdivision 1b, is amended to read: 
  2.10     Subd. 1b.  [PREGNANT WOMEN AND INFANTS; EXPANSION.] This 
  2.11  subdivision supersedes subdivision 1 as long as the Minnesota 
  2.12  health care reform waiver remains in effect.  When the waiver 
  2.13  expires, the commissioner of human services shall publish a 
  2.14  notice in the State Register and notify the revisor of 
  2.15  statutes.  An infant less than two years of age or a pregnant 
  2.16  woman who has written verification of a positive pregnancy test 
  2.17  from a physician or licensed registered nurse, is eligible for 
  2.18  medical assistance if countable family income is equal to or 
  2.19  less than 275 percent of the federal poverty guideline for the 
  2.20  same family size.  For purposes of this subdivision, "countable 
  2.21  family income" means the amount of income considered available 
  2.22  using the methodology of the AFDC program, except for the earned 
  2.23  income disregard and employment deductions.  An amount equal to 
  2.24  the amount of earned income exceeding 275 percent of the federal 
  2.25  poverty guideline, up to a maximum of the amount by which the 
  2.26  combined total of 185 percent of the federal poverty guideline 
  2.27  plus the earned income disregards and deductions of the AFDC 
  2.28  program exceeds 275 percent of the federal poverty guideline 
  2.29  will be deducted for pregnant women and infants less than two 
  2.30  years of age.  Eligibility for a pregnant woman or infant less 
  2.31  than two years of age under this subdivision must be determined 
  2.32  without regard to asset standards established in section 
  2.33  256B.056, subdivision 3.  
  2.34     An infant born on or after January 1, 1991, to a woman who 
  2.35  was eligible for and receiving medical assistance on the date of 
  2.36  the child's birth shall continue to be eligible for medical 
  3.1   assistance without redetermination until the child's second 
  3.2   birthday, as long as the child remains in the woman's household. 
  3.3      Sec. 3.  Minnesota Statutes 1996, section 256B.057, 
  3.4   subdivision 2, is amended to read: 
  3.5      Subd. 2.  [CHILDREN.] A child one through five years of age 
  3.6   in a family whose countable income is less than 133 percent of 
  3.7   the federal poverty guidelines for the same family size, is 
  3.8   eligible for medical assistance.  A child six through 18 years 
  3.9   of age, who was born after September 30, 1983, in a family whose 
  3.10  countable income is less than 100 percent of the federal poverty 
  3.11  guidelines for the same family size is eligible for medical 
  3.12  assistance.  Eligibility for children under this subdivision 
  3.13  must be determined without regard to asset standards established 
  3.14  in section 256B.056, subdivision 3.  
  3.15     Sec. 4.  Minnesota Statutes 1996, section 256D.03, 
  3.16  subdivision 3, is amended to read: 
  3.17     Subd. 3.  [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 
  3.18  (a) General assistance medical care may be paid for any person 
  3.19  who is not eligible for medical assistance under chapter 256B, 
  3.20  including eligibility for medical assistance based on a 
  3.21  spenddown of excess income according to section 256B.056, 
  3.22  subdivision 5, and: 
  3.23     (1) who is receiving assistance under section 256D.05, or 
  3.24  who is having a payment made on the person's behalf under 
  3.25  sections 256I.01 to 256I.06; or 
  3.26     (2)(i) who is a resident of Minnesota; and whose equity in 
  3.27  assets is not in excess of $1,000 per assistance unit.  No asset 
  3.28  test shall be applied to children and their parents living in 
  3.29  the same household.  Exempt assets, the reduction of excess 
  3.30  assets, and the waiver of excess assets must conform to the 
  3.31  medical assistance program in chapter 256B, with the following 
  3.32  exception:  the maximum amount of undistributed funds in a trust 
  3.33  that could be distributed to or on behalf of the beneficiary by 
  3.34  the trustee, assuming the full exercise of the trustee's 
  3.35  discretion under the terms of the trust, must be applied toward 
  3.36  the asset maximum; and 
  4.1      (ii) who has countable income not in excess of the 
  4.2   assistance standards established in section 256B.056, 
  4.3   subdivision 4, or whose excess income is spent down pursuant to 
  4.4   section 256B.056, subdivision 5, using a six-month budget 
  4.5   period, except that a one-month budget period must be used for 
  4.6   recipients residing in a long-term care facility.  The method 
  4.7   for calculating earned income disregards and deductions for a 
  4.8   person who resides with a dependent child under age 21 shall be 
  4.9   as specified in section 256.74, subdivision 1.  However, if a 
  4.10  disregard of $30 and one-third of the remainder described in 
  4.11  section 256.74, subdivision 1, clause (4), has been applied to 
  4.12  the wage earner's income, the disregard shall not be applied 
  4.13  again until the wage earner's income has not been considered in 
  4.14  an eligibility determination for general assistance, general 
  4.15  assistance medical care, medical assistance, or aid to families 
  4.16  with dependent children for 12 consecutive months.  The earned 
  4.17  income and work expense deductions for a person who does not 
  4.18  reside with a dependent child under age 21 shall be the same as 
  4.19  the method used to determine eligibility for a person under 
  4.20  section 256D.06, subdivision 1, except the disregard of the 
  4.21  first $50 of earned income is not allowed; or 
  4.22     (3) who would be eligible for medical assistance except 
  4.23  that the person resides in a facility that is determined by the 
  4.24  commissioner or the federal health care financing administration 
  4.25  to be an institution for mental diseases. 
  4.26     (b) Eligibility is available for the month of application, 
  4.27  and for three months prior to application if the person was 
  4.28  eligible in those prior months.  A redetermination of 
  4.29  eligibility must occur every 12 months. 
  4.30     (c) General assistance medical care is not available for a 
  4.31  person in a correctional facility unless the person is detained 
  4.32  by law for less than one year in a county correctional or 
  4.33  detention facility as a person accused or convicted of a crime, 
  4.34  or admitted as an inpatient to a hospital on a criminal hold 
  4.35  order, and the person is a recipient of general assistance 
  4.36  medical care at the time the person is detained by law or 
  5.1   admitted on a criminal hold order and as long as the person 
  5.2   continues to meet other eligibility requirements of this 
  5.3   subdivision.  
  5.4      (d) General assistance medical care is not available for 
  5.5   applicants or recipients who do not cooperate with the county 
  5.6   agency to meet the requirements of medical assistance. 
  5.7      (e) In determining the amount of assets of an individual, 
  5.8   there shall be included any asset or interest in an asset, 
  5.9   including an asset excluded under paragraph (a), that was given 
  5.10  away, sold, or disposed of for less than fair market value 
  5.11  within the 60 months preceding application for general 
  5.12  assistance medical care or during the period of eligibility.  
  5.13  Any transfer described in this paragraph shall be presumed to 
  5.14  have been for the purpose of establishing eligibility for 
  5.15  general assistance medical care, unless the individual furnishes 
  5.16  convincing evidence to establish that the transaction was 
  5.17  exclusively for another purpose.  For purposes of this 
  5.18  paragraph, the value of the asset or interest shall be the fair 
  5.19  market value at the time it was given away, sold, or disposed 
  5.20  of, less the amount of compensation received.  For any 
  5.21  uncompensated transfer, the number of months of ineligibility, 
  5.22  including partial months, shall be calculated by dividing the 
  5.23  uncompensated transfer amount by the average monthly per person 
  5.24  payment made by the medical assistance program to skilled 
  5.25  nursing facilities for the previous calendar year.  The 
  5.26  individual shall remain ineligible until this fixed period has 
  5.27  expired.  The period of ineligibility may exceed 30 months, and 
  5.28  a reapplication for benefits after 30 months from the date of 
  5.29  the transfer shall not result in eligibility unless and until 
  5.30  the period of ineligibility has expired.  The period of 
  5.31  ineligibility begins in the month the transfer was reported to 
  5.32  the county agency, or if the transfer was not reported, the 
  5.33  month in which the county agency discovered the transfer, 
  5.34  whichever comes first.  For applicants, the period of 
  5.35  ineligibility begins on the date of the first approved 
  5.36  application. 
  6.1      (f)(1) Beginning October 1, 1993, an undocumented alien or 
  6.2   a nonimmigrant is ineligible for general assistance medical care 
  6.3   other than emergency services.  For purposes of this 
  6.4   subdivision, a nonimmigrant is an individual in one or more of 
  6.5   the classes listed in United States Code, title 8, section 
  6.6   1101(a)(15), and an undocumented alien is an individual who 
  6.7   resides in the United States without the approval or 
  6.8   acquiescence of the Immigration and Naturalization Service. 
  6.9      (2) This subdivision does not apply to a child under age 
  6.10  18, to a Cuban or Haitian entrant as defined in Public Law 
  6.11  Number 96-422, section 501(e)(1) or (2)(a), or to an alien who 
  6.12  is aged, blind, or disabled as defined in United States Code, 
  6.13  title 42, section 1382c(a)(1). 
  6.14     (3) For purposes of paragraph (f), "emergency services" has 
  6.15  the meaning given in Code of Federal Regulations, title 42, 
  6.16  section 440.255(b)(1), except that it also means services 
  6.17  rendered because of suspected or actual pesticide poisoning.