1997 Minnesota Statutes

     252.27 Parental contribution for the cost of children's 
  services. 

    Subdivision 1.    County of financial responsibility.  
 Whenever any child who has mental retardation or a related 
 condition, or a physical disability or emotional disturbance is 
 in 24-hour care outside the home including respite care, in a 
 facility licensed by the commissioner of human services, the 
 cost of services shall be paid by the county of financial 
 responsibility determined pursuant to chapter 256G.  If the 
 child's parents or guardians do not reside in this state, the 
 cost shall be paid by the responsible governmental agency in the 
 state from which the child came, by the parents or guardians of 
 the child if they are financially able, or, if no other payment 
 source is available, by the commissioner of human services. 

    Subd. 1a.    Definitions.  A "related condition" is a 
 condition that is found to be closely related to mental 
 retardation, including, but not limited to, cerebral palsy, 
 epilepsy, autism, and Prader-Willi syndrome and that meets all 
 of the following criteria: 

    (a) is severe and chronic; 

    (b) results in impairment of general intellectual 
 functioning or adaptive behavior similar to that of persons with 
 mental retardation; 

    (c) requires treatment or services similar to those 
 required for persons with mental retardation; 

    (d) is manifested before the person reaches 22 years of 
 age; 

    (e) is likely to continue indefinitely; 

    (f) results in substantial functional limitations in three 
 or more of the following areas of major life activity:  (1) 
 self-care, (2) understanding and use of language, (3) learning, 
 (4) mobility, (5) self-direction, (6) capacity for independent 
 living; and 

    (g) is not attributable to mental illness as defined in 
 section 245.462, subdivision 20, or an emotional disturbance as 
 defined in section 245.4871, subdivision 15. 

 For purposes of paragraph (g), notwithstanding section 245.462, 
 subdivision 20, or 245.4871, subdivision 15, "mental illness" 
 does not include autism or other pervasive developmental 
 disorders. 

    Subd. 2.    Parental responsibility.  Responsibility of 
 the parents for the cost of services shall be based upon ability 
 to pay.  The state agency shall adopt rules to determine 
 responsibility of the parents for the cost of services when: 

    (a) Insurance or other health care benefits pay some but 
 not all of the cost of services; and 

    (b) No insurance or other health care benefits are 
 available.  

    Subd. 2a.    Contribution amount.  (a) The natural or 
 adoptive parents of a minor child, including a child determined 
 eligible for medical assistance without consideration of 
 parental income, must contribute monthly to the cost of 
 services, unless the child is married or has been married, 
 parental rights have been terminated, or the child's adoption is 
 subsidized according to section 259.67 or through title IV-E of 
 the Social Security Act. 

    (b) The parental contribution shall be the greater of a 
 minimum monthly fee of $25 for households with adjusted gross 
 income of $30,000 and over, or an amount to be computed by 
 applying to the adjusted gross income of the natural or adoptive 
 parents that exceeds 150 percent of the federal poverty 
 guidelines for the applicable household size, the following 
 schedule of rates: 

    (1) on the amount of adjusted gross income over 150 percent 
 of poverty, but not over $50,000, ten percent; 

    (2) on the amount of adjusted gross income over 150 percent 
 of poverty and over $50,000 but not over $60,000, 12 percent; 

    (3) on the amount of adjusted gross income over 150 percent 
 of poverty, and over $60,000 but not over $75,000, 14 percent; 
 and 

    (4) on all adjusted gross income amounts over 150 percent 
 of poverty, and over $75,000, 15 percent. 

    If the child lives with the parent, the parental 
 contribution is reduced by $200, except that the parent must pay 
 the minimum monthly $25 fee under this paragraph.  If the child 
 resides in an institution specified in section 256B.35, the 
 parent is responsible for the personal needs allowance specified 
 under that section in addition to the parental contribution 
 determined under this section.  The parental contribution is 
 reduced by any amount required to be paid directly to the child 
 pursuant to a court order, but only if actually paid. 

    (c) The household size to be used in determining the amount 
 of contribution under paragraph (b) includes natural and 
 adoptive parents and their dependents under age 21, including 
 the child receiving services.  Adjustments in the contribution 
 amount due to annual changes in the federal poverty guidelines 
 shall be implemented on the first day of July following 
 publication of the changes. 

    (d) For purposes of paragraph (b), "income" means the 
 adjusted gross income of the natural or adoptive parents 
 determined according to the previous year's federal tax form. 

    (e) The contribution shall be explained in writing to the 
 parents at the time eligibility for services is being 
 determined.  The contribution shall be made on a monthly basis 
 effective with the first month in which the child receives 
 services.  Annually upon redetermination or at termination of 
 eligibility, if the contribution exceeded the cost of services 
 provided, the local agency or the state shall reimburse that 
 excess amount to the parents, either by direct reimbursement if 
 the parent is no longer required to pay a contribution, or by a 
 reduction in or waiver of parental fees until the excess amount 
 is exhausted. 

    (f) The monthly contribution amount must be reviewed at 
 least every 12 months; when there is a change in household size; 
 and when there is a loss of or gain in income from one month to 
 another in excess of ten percent.  The local agency shall mail a 
 written notice 30 days in advance of the effective date of a 
 change in the contribution amount.  A decrease in the 
 contribution amount is effective in the month that the parent 
 verifies a reduction in income or change in household size. 

    (g) Parents of a minor child who do not live with each 
 other shall each pay the contribution required under paragraph 
 (a), except that a court-ordered child support payment actually 
 paid on behalf of the child receiving services shall be deducted 
 from the contribution of the parent making the payment. 

    (h) The contribution under paragraph (b) shall be increased 
 by an additional five percent if the local agency determines 
 that insurance coverage is available but not obtained for the 
 child.  For purposes of this section, "available" means the 
 insurance is a benefit of employment for a family member at an 
 annual cost of no more than five percent of the family's annual 
 income.  For purposes of this section, "insurance" means health 
 and accident insurance coverage, enrollment in a nonprofit 
 health service plan, health maintenance organization, 
 self-insured plan, or preferred provider organization. 

    Parents who have more than one child receiving services 
 shall not be required to pay more than the amount for the child 
 with the highest expenditures.  There shall be no resource 
 contribution from the parents.  The parent shall not be required 
 to pay a contribution in excess of the cost of the services 
 provided to the child, not counting payments made to school 
 districts for education-related services.  Notice of an increase 
 in fee payment must be given at least 30 days before the 
 increased fee is due.  

    (i) The contribution under paragraph (b) shall be reduced 
 by $300 per fiscal year if, in the 12 months prior to July 1: 

    (1) the parent applied for insurance for the child; 

    (2) the insurer denied insurance; 

    (3) the parents submitted a complaint or appeal, in writing 
 to the insurer, submitted a complaint or appeal, in writing, to 
 the commissioner of health or the commissioner of commerce, or 
 litigated the complaint or appeal; and 

    (4) as a result of the dispute, the insurer reversed its 
 decision and granted insurance. 

    For purposes of this section, "insurance" has the meaning 
 given in paragraph (h). 

    A parent who has requested a reduction in the contribution 
 amount under this paragraph shall submit proof in the form and 
 manner prescribed by the commissioner or county agency, 
 including, but not limited to, the insurer's denial of 
 insurance, the written letter or complaint of the parents, court 
 documents, and the written response of the insurer approving 
 insurance.  The determinations of the commissioner or county 
 agency under this paragraph are not rules subject to chapter 14. 

    Subd. 2b.    Child's responsibility.  Responsibility of 
 the child for the cost of care shall be up to the maximum amount 
 of the total income and resources attributed to the child except 
 for the clothing and personal needs allowance as provided in 
 section 256B.35, subdivision 1.  Reimbursement by the parents 
 and child shall be made to the county making any payments for 
 services.  The county board may require payment of the full cost 
 of caring for children whose parents or guardians do not reside 
 in this state. 

    To the extent that a child described in subdivision 1 is 
 eligible for benefits under chapter 62A, 62C, 62D, 62E, or 64B, 
 the county is not liable for the cost of services.  

    Subd. 2c. Repealed, 1995 c 207 art 6 s 124 

    Subd. 3.    Civil actions.  If the parent fails to make 
 appropriate reimbursement as required in subdivision 2a and 2b, 
 the attorney general, at the request of the commissioner, may 
 institute or direct the appropriate county attorney to institute 
 civil action to recover the required reimbursement. 

    Subd. 4. Repealed, 1986 c 414 s 5 

    Subd. 4.    Order of payment.  If the parental 
 contribution is for reimbursement for the cost of services to 
 both the local agency and the medical assistance program, the 
 local agency shall be reimbursed for its expenses first and the 
 remainder must be deposited in the medical assistance account. 

    Subd. 5.    Determination; redetermination; notice.  A 
 determination order and notice of parental fee shall be mailed 
 to the parent at least annually, or more frequently as provided 
 in Minnesota Rules, parts 9550.6220 to 9550.6229.  The 
 determination order and notice shall contain the following 
 information:  

    (1) the amount the parent is required to contribute; 

    (2) notice of the right to a redetermination and appeal; 
 and 

    (3) the telephone number of the division at the department 
 of human services that is responsible for redeterminations.  

    Subd. 6.    Appeals.  A parent may appeal the 
 determination or redetermination of an obligation to make a 
 contribution under this section, according to section 256.045.  
 The parent must make a request for a hearing in writing within 
 30 days of the date the determination or redetermination order 
 is mailed, or within 90 days of such written notice if the 
 parent shows good cause why the request was not submitted within 
 the 30-day time limit.  The commissioner must provide the parent 
 with a written notice that acknowledges receipt of the request 
 and notifies the parent of the date of the hearing.  While the 
 appeal is pending, the parent has the rights regarding making 
 payment that are provided in Minnesota Rules, part 9550.6235.  
 If the commissioner's determination or redetermination is 
 affirmed, the parent shall, within 90 calendar days after the 
 date an order is issued under section 256.045, subdivision 5, 
 pay the total amount due from the effective date of the notice 
 of determination or redetermination that was appealed by the 
 parent.  If the commissioner's order under this subdivision 
 results in a decrease in the parental fee amount, any payments 
 made by the parent that result in an overpayment shall be 
 credited to the parent as provided in Minnesota Rules, part 
 9550.6235, subpart 3. 

    HIST: 1969 c 582 s 1; 1971 c 648 s 1,2; 1973 c 696 s 1; 1974 c 
 406 s 45; 1975 c 293 s 1; 1976 c 163 s 53; 1977 c 331 s 2,3; 
 1978 c 560 s 3; 1981 c 355 s 28,29; 1982 c 607 s 12; 1984 c 530 
 s 2,3; 1984 c 654 art 5 s 58; 1985 c 21 s 33; 1985 c 49 s 41; 
 1986 c 444; 1989 c 282 art 2 s 92; 1990 c 568 art 2 s 56; 1990 c 
 612 s 11; 1991 c 292 art 6 s 32,33; 1993 c 339 s 6,7; 1994 c 631 
 s 31; 1995 c 207 art 6 s 4-8; 1996 c 451 art 2 s 3