2002 Minnesota Statutes

CHAPTER 252. Services for person with mental retardation

  252.01 Repealed, 1961 c 137 s 2 

  252.011 Repealed, 1961 c 137 s 2 

  252.015 Repealed, 1961 c 137 s 2 

  252.02 Repealed, 1961 c 137 s 2 

     252.021 Definition. 

    For the purposes of this chapter, the words "related 
 condition" have the meaning given them in section 252.27, 
 subdivision 1a. 

    HIST: 1985 c 21 s 21; 1992 c 464 art 1 s 55 

     252.025 State hospitals for persons with mental 
  retardation. 

    Subdivision 1.    Regional treatment centers.  State 
 hospitals for persons with mental retardation shall be 
 established and maintained at Faribault until June 30, 1998, 
 Cambridge and Brainerd, and notwithstanding any provision to the 
 contrary they shall be respectively known as the Faribault 
 regional center, the Cambridge regional human services center, 
 and the Brainerd regional human services center.  Each of the 
 foregoing state hospitals shall also be known by the name of 
 regional center at the discretion of the commissioner of human 
 services.  The terms "human services" or "treatment" may be 
 included in the designation. 

    Subd. 2.    Management and control of state hospitals.  
 They shall be under the general management and control of the 
 commissioner of human services. 

    Subd. 3.  Repealed, 1975 c 242 s 3 

    Subd. 4.    State-provided services.  (a) It is the 
 policy of the state to capitalize and recapitalize the regional 
 treatment centers as necessary to prevent depreciation and 
 obsolescence of physical facilities and to ensure they retain 
 the physical capability to provide residential programs.  
 Consistent with that policy and with section 252.50, and within 
 the limits of appropriations made available for this purpose, 
 the commissioner may establish, by June 30, 1991, the following 
 state-operated, community-based programs for the least 
 vulnerable regional treatment center residents:  at Brainerd 
 regional services center, two residential programs and two day 
 programs; at Cambridge regional treatment center, four 
 residential programs and two day programs; at Faribault regional 
 treatment center, ten residential programs and six day programs; 
 at Fergus Falls regional treatment center, two residential 
 programs and one day program; at Moose Lake regional treatment 
 center, four residential programs and two day programs; and at 
 Willmar regional treatment center, two residential programs and 
 one day program. 

    (b) By January 15, 1991, the commissioner shall report to 
 the legislature a plan to provide continued regional treatment 
 center capacity and state-operated, community-based residential 
 and day programs for persons with developmental disabilities at 
 Brainerd, Cambridge, Fergus Falls, St. Peter, and Willmar, as 
 follows: 

    (1) by July 1, 1998, continued regional treatment center 
 capacity to serve 350 persons with developmental disabilities as 
 follows:  at Brainerd, 80 persons; at Cambridge, 12 persons; at 
 Fergus Falls, 60 persons; at St. Peter, 35 persons; at Willmar, 
 25 persons; and up to 16 crisis beds in the Twin Cities 
 metropolitan area; and 

    (2) by July 1, 1999, continued regional treatment center 
 capacity to serve 254 persons with developmental disabilities as 
 follows:  at Brainerd, 57 persons; at Cambridge, 12 persons; at 
 Fergus Falls, 35 persons; at St. Peter, 30 persons; at Willmar, 
 12 persons, and up to 16 crisis beds in the Twin Cities 
 metropolitan area.  In addition, the plan shall provide for the 
 capacity to provide residential services to 570 persons with 
 developmental disabilities in 95 state-operated, community-based 
 residential programs. 

    The commissioner is subject to a mandamus action under 
 chapter 586 for any failure to comply with the provisions of 
 this subdivision. 

    Subd. 5.    Services for developmentally disabled persons: 
 Moose Lake regional treatment center catchment area.  
 Notwithstanding subdivision 4, the commissioner shall develop in 
 the Moose Lake regional treatment center catchment area for 
 persons with developmental disabilities at least 12 beds in 
 state-operated waivered homes, eight state-operated crisis beds, 
 one state-operated day training and habilitation facility, and 
 21 beds in other community settings.  These services must be 
 established by October 1, 1993, to serve persons relocated from 
 the Moose Lake regional treatment center. 

    These services shall be in addition to any state-operated, 
 community services and day treatment centers in operation in the 
 Moose Lake catchment area during state fiscal year 1993. 

    Subd. 6.    Development of state-operated services.  
 Notwithstanding subdivision 4, during the biennium ending June 
 30, 1995, the commissioner shall establish the following 
 services for persons with developmental disabilities: 

    (1) by June 30, 1994, eight state-operated, community-based 
 waivered homes located anywhere in the state for 32 persons and 
 two state-operated day training and habilitation facilities for 
 persons leaving regional treatment centers as a result of 
 downsizing; 

    (2) by June 30, 1994, 16 state-operated, community-based 
 waivered homes at Faribault for 64 persons, four state-operated 
 day training and habilitation facilities, and 38 beds in 
 community settings for persons leaving the Faribault regional 
 treatment center; 

    (3) by June 30, 1995, 78 beds in private community settings 
 for persons leaving the Faribault regional treatment center; 

    (4) by June 30, 1995, eight state-operated crisis beds in 
 the Faribault regional treatment center catchment area; 

    (5) by June 30, 1994, private community-based beds located 
 anywhere in the state to achieve a net reduction of 93 persons 
 leaving regional treatment centers as a result of downsizing; 
 and 

    (6) by June 30, 1995, nine state-operated waivered homes 
 for 36 persons and two state-operated day training and 
 habilitation facilities for persons leaving regional treatment 
 centers as a result of downsizing, and sufficient beds in 
 private community settings to achieve a net reduction of 84 beds 
 in regional treatment centers. 

    Subd. 7.    Minnesota extended treatment options.  The 
 commissioner shall develop by July 1, 1997, the Minnesota 
 extended treatment options to serve Minnesotans who have mental 
 retardation and exhibit severe behaviors which present a risk to 
 public safety.  This program must provide specialized 
 residential services on the Cambridge campus and an array of 
 community support services statewide. 

    HIST: 1961 c 137 s 1; 1967 c 6 s 1,2; 1976 c 289 s 1; 1983 c 
 10 s 1; 1984 c 654 art 5 s 58; 1985 c 21 s 22; 1Sp1985 c 9 art 2 
 s 27; 1987 c 384 art 1 s 49; 1989 c 282 art 6 s 14; 1992 c 513 
 art 9 s 20; 1Sp1993 c 1 art 7 s 31-33; 1997 c 203 art 7 s 7-9 

  252.03 Repealed, 1977 c 415 s 5 

     252.032 Administrative structure. 

    Subdivision 1.    Regional structure.  The 
 administrative structure of the state-operated system must be 
 regional in character. 

    Subd. 2.    Staff; location of facilities.  The 
 administrative and professional staffs of the regional treatment 
 centers must be based on campus.  Community-based facilities and 
 services must be located and operated so they facilitate the 
 delivery of professional and administrative staff services from 
 the regional treatment center campus.  The regional treatment 
 center professional staff and all other staff may deliver 
 services that they deliver on campus throughout the catchment 
 area. 

    HIST: 1989 c 282 art 6 s 15 

     252.035 Regional treatment center catchment areas. 

    The commissioner may administratively designate catchment 
 areas for regional treatment centers and state nursing homes.  
 Catchment areas may vary by client group served.  Catchment 
 areas in effect on January 1, 1989, may not be modified until 
 the commissioner has consulted with the regional planning 
 committees of the affected regional treatment centers. 

    HIST: 1989 c 282 art 6 s 16; 1997 c 7 art 2 s 37 

     252.038 Provision of residential services. 

    Subdivision 1.    Residential care.  The commissioner of 
 human services may continue to provide residential care in 
 regional treatment centers. 

    Subd. 2.    Technical assistance.  To the extent of 
 available money, the commissioner of human services may expand 
 the capacity to provide technical assistance to community 
 providers in handling the behavior problems of their patients.  
 Technical assistance may include site visits, consultation with 
 providers, or provider training. 

    Subd. 3.    Respite care.  Respite care may be provided 
 in a regional treatment center when space is available if (1) 
 payment for 20 percent of the prevailing facility per diem is 
 guaranteed by the person, the person's family or legal 
 representative, or a source other than a direct state 
 appropriation to the regional treatment center and (2) provision 
 of respite care to the individual meets the facility's admission 
 criteria and licensing standards.  The parent or guardian must 
 consent to admission and sign a waiver of liability.  Respite 
 care is limited to 30 days within a calendar year.  No 
 preadmission screening process is required for a respite care 
 stay under this subdivision. 

    HIST: 1989 c 282 art 6 s 17 

  252.04 Repealed, Ex1961 c 62 s 7 

  252.041 Repealed, 1971 c 637 s 7 

  252.042 Repealed, 1971 c 637 s 7 

  252.043 Repealed, 1971 c 637 s 7 

  252.044 Repealed, 1971 c 637 s 7 

  252.045 Repealed, 1971 c 637 s 7 

  252.046 Repealed, 1971 c 637 s 7 

  252.047 Repealed, 1969 c 204 s 4 

     252.05 Abduction or enticing away prohibited; penalty. 

    Every person who shall abduct, entice, or carry away from a 
 state hospital for persons with mental retardation any resident 
 thereof, who has not been legally discharged therefrom, shall be 
 guilty of a felony and punished by a fine of not to exceed 
 $3,000 or imprisonment in the Minnesota correctional 
 facility-Stillwater or the Minnesota correctional facility-St. 
 Cloud not to exceed three years, or both, in the discretion of 
 the court; any and every person who shall abduct, entice, or 
 carry away from any place other than a state hospital, a person 
 duly committed as mentally retarded to the guardianship of the 
 commissioner of human services with the intention of wrongfully 
 removing such person from the direct custody of the commissioner 
 of human services, such person known by the removing person to 
 be under the supervision of the commissioner of human services 
 or the commissioner's agents, shall be guilty of a gross 
 misdemeanor.  

    HIST: (4502) 1923 c 365 s 1; 1929 c 231 s 1; 1953 c 593 s 2; 
 1965 c 45 s 22; 1967 c 6 s 2; 1979 c 102 s 13; 1983 c 10 s 1; 
 1984 c 628 art 3 s 11; 1984 c 654 art 5 s 58; 1985 c 21 s 23; 
 1986 c 444 

     252.06 Sheriff to transport persons with mental 
  retardation. 

    It shall be the duty of the sheriff of any county, upon the 
 request of the commissioner of human services, to take charge of 
 and transport any person with mental retardation who has been 
 committed by the district court of any county to the care and 
 custody of the commissioner of human services to such state 
 hospital as may be designated by the commissioner of human 
 services and there deliver such person to the chief executive 
 officer of the state hospital.  

    HIST: (4503) 1921 c 76 s 1; Ex1936 c 57 s 1; 1947 c 212 s 1; 
 1953 c 593 s 2; 1965 c 45 s 23; 1983 c 10 s 1; 1984 c 654 art 5 
 s 58; 1985 c 21 s 24; 1995 c 189 s 8; 1996 c 277 s 1 

     252.07 Sheriff, expenses. 

    In any county where the sheriff receives a salary in full 
 compensation for official services performed for the county, the 
 sheriff shall receive no additional compensation for services 
 performed under the provisions of sections 252.06 to 252.08, but 
 shall be reimbursed by the county wherein such person with 
 mental retardation was committed for the necessary expenses 
 incurred by the sheriff in taking charge of and transporting 
 such person to a state hospital and the subsistence of the 
 sheriff and such person while enroute.  

    In any county where the sheriff does not receive a salary 
 the sheriff shall be paid $5 a day for the time necessarily 
 employed in performance of the service, together with expenses 
 incurred in taking charge of and transporting such person to 
 such state hospital and the subsistence of the sheriff and such 
 person while enroute.  

    When the person with mental retardation is not the same sex 
 as the sheriff, the sheriff shall appoint some suitable person 
 of the same sex as the person with mental retardation to act 
 instead.  The appointee shall exercise all the powers vested in 
 the sheriff and shall be paid $5 per day for the time 
 necessarily employed in the performance of such service, 
 together with expenses incurred in taking charge of and 
 transporting such person to such state hospital and the 
 subsistence of both while enroute.  

    HIST: (4504) 1921 c 76 s 2; Ex1936 c 57 s 2; 1947 c 212 s 2; 
 1951 c 339 s 1; 1965 c 45 s 24; 1983 c 10 s 1; 1985 c 21 s 25; 
 1986 c 444; 1987 c 49 s 6 

     252.08 District court to audit expense accounts.  

    The fees and expenses of any sheriff or other person 
 performing the service under the provisions of sections 252.06 
 to 252.08 shall be audited by a district court judge of the 
 county and paid by the county auditor and county treasurer upon 
 the written order of the judge without other or further 
 allowance.  

    HIST: (4505) 1921 c 76 s 3; 1995 c 189 s 8; 1996 c 277 s 1 

     252.09 Courses of instruction for teachers. 

    The commissioner of human services may establish and 
 maintain at the state hospital for persons with mental 
 retardation at Faribault courses of instruction for teachers and 
 others interested in the care and training of persons with 
 mental retardation and make all necessary rules for the 
 organization and conduct of such courses.  

    HIST: (4506) 1913 c 261 s 1; 1965 c 45 s 25; 1967 c 6 s 2; 
 1983 c 10 s 1; 1984 c 654 art 5 s 58; 1985 c 21 s 26; 1985 c 248 
 s 70 

     252.10 Fees and expenses. 

    The commissioner of human services shall charge and collect 
 from each person taking any such courses of instruction an 
 amount for board and tuition not exceeding $10 per week and the 
 money so collected shall be turned into the state treasury as 
 are other miscellaneous receipts from the state hospital.  The 
 expenses incident to the conduct of such courses of instruction 
 and for the board of those taking the same shall be paid as are 
 the other expenses for maintaining the state hospital for 
 persons with mental retardation.  The courses of instruction 
 herein referred to shall, within the limitation of charges as 
 stated, be made as near self-sustaining as possible.  

    HIST: (4507) 1913 c 261 s 2; 1965 c 45 s 26; 1967 c 6 s 2; 
 1983 c 10 s 1; 1984 c 654 art 5 s 58; 1985 c 21 s 27 

  252.11 Repealed, 1961 c 26 s 1 

  252.12 Repealed, 1961 c 26 s 1 

  252.13 Repealed, 1961 c 26 s 1 

  252.14 Repealed, 1961 c 26 s 1 

  252.15 Repealed, 1963 c 830 s 9 

  252.16 Repealed, 1963 c 830 s 9 

  252.17 Repealed, 1963 c 830 s 9 

  252.18 Repealed, 1963 c 830 s 9 

  252.19 Repealed, 1963 c 830 s 9 

  252.20 Repealed, 1963 c 830 s 9 

     252.21 County boards may make grants for developmental 
  achievement center services for children with mental retardation 
  or related conditions. 

    In order to assist county boards in carrying out 
 responsibilities for the provision of daytime developmental 
 achievement center services for eligible children, the county 
 board or boards are hereby authorized to make grants, within the 
 limits of the money appropriated, to developmental achievement 
 centers for services to children with mental retardation or 
 related conditions.  In order to fulfill its responsibilities to 
 children with mental retardation or related conditions as 
 required by sections 125A.03 to 125A.48, 125A.65, and 256E.08, 
 subdivision 1, a county board may, beginning January 1, 1983, 
 contract with developmental achievement centers or other 
 providers. 

    HIST: 1963 c 830 s 1; 1974 c 480 s 5; 1977 c 337 s 2; 1979 c 
 324 s 24; 1981 c 355 s 24; 1985 c 21 s 28; 1987 c 403 art 5 s 2; 
 1994 c 647 art 13 s 19; 1998 c 397 art 11 s 3 

     252.22 Applicants for assistance; tax levy. 

    Any city, town, governmental entity, nonprofit corporation, 
 or any combination thereof, may apply to the county board for 
 assistance in establishing and operating a developmental 
 achievement center and program for children with mental 
 retardation or related conditions.  Application for such 
 assistance shall be on forms supplied by the board.  Each 
 applicant shall annually submit to the board its plan and budget 
 for the next fiscal year.  No applicant shall be eligible for a 
 grant hereunder unless its plan and budget have been approved by 
 the board. 

    Any city, town, or county is authorized, at the discretion 
 of its governing body, to make grants from special tax revenues 
 or from its general revenue fund to any nonprofit organization, 
 governmental or corporate, within or outside its jurisdiction, 
 that has established a developmental achievement center for 
 children with mental retardation or related conditions.  Nothing 
 contained herein shall in any way preclude the use of funds 
 available for this purpose under any existing statute or charter 
 provision relating to cities, towns, and counties.  

    HIST: 1963 c 830 s 2; 1965 c 480 s 1; 1967 c 878 s 1; 1971 c 
 668 s 2; 1973 c 123 art 5 s 7; 1973 c 583 s 16; 1973 c 773 s 1; 
 1974 c 480 s 6; 1977 c 337 s 3; 1979 c 324 s 25; 1985 c 21 s 29; 
 1987 c 403 art 5 s 3 

     252.23 Eligibility requirements. 

    A developmental achievement center shall: 

    (1) provide developmental services to children with mental 
 retardation or related conditions who can benefit from the 
 program of services; and 

    (2)  comply with all rules duly adopted by the commissioner 
 of human services. 

    HIST: 1963 c 830 s 3; 1971 c 584 s 1; 1974 c 480 s 7; 1977 c 
 337 s 4; 1984 c 654 art 5 s 58; 1985 c 21 s 30; 1987 c 403 art 5 
 s 4 

     252.24 Duties of county boards. 

    Subdivision 1.    Selection of developmental achievement 
 centers.  The county board shall administer developmental 
 achievement services.  The county board shall ensure that 
 transportation is provided for children who fulfill the 
 eligibility requirements of section 252.23, clause (1), 
 utilizing the most efficient and reasonable means available.  
 The county board may contract for developmental achievement 
 services and transportation from a center which is licensed 
 under the provisions of sections 245A.01 to 245A.16, 252.28, and 
 257.175, and in the board's opinion, best provides daytime 
 developmental achievement services for children with mental 
 retardation or related conditions within the appropriation and 
 resources made available for this purpose.  Daytime 
 developmental achievement services administered by the county 
 board shall comply with standards established by the 
 commissioner pursuant to subdivision 2 and applicable federal 
 regulations.  

    Subd. 2.    Supervision of projects; promulgation of 
 rules.  The commissioner of human services shall closely 
 supervise any developmental achievement center receiving a grant 
 under sections 252.21 to 252.25.  The commissioner shall 
 promulgate rules in the manner provided by law as necessary to 
 carry out the purposes of sections 252.21 to 252.25, including 
 but not limited to rules pertaining to facilities for housing 
 developmental achievement centers, administration of centers, 
 and eligibility requirements for admission and participation in 
 activities of the center. 

    Subd. 3.    Payment procedure.  The board at the 
 beginning of each year, shall allocate available money for 
 developmental achievement services for disbursement during the 
 year to those centers that have been selected to receive grants 
 and whose plans and budgets have been approved.  The board 
 shall, from time to time during the fiscal year, review the 
 budgets, expenditures and programs of the various centers and if 
 it determines that any amount of funds are not needed for any 
 particular center to which they were allocated, it may, after 30 
 days' notice, withdraw such funds as are unencumbered and 
 reallocate them to other centers.  It may withdraw all funds 
 from any center upon 90 days' notice whose program is not being 
 administered in accordance with its approved plan and budget. 

    Subd. 4.    Fees.  The county board may, with the 
 approval of the commissioner, establish a schedule of fees for 
 daytime developmental achievement services as provided in 
 section 256E.08, subdivision 6.  No child, or family of a child, 
 with mental retardation or a related condition shall be denied 
 daytime developmental achievement services because of an 
 inability to pay such a fee. 

    Subd. 5.    Developmental achievement centers:  salary 
 adjustment per diem.  The commissioner shall approve a two 
 percent increase in the payment rates for day training and 
 habilitation services vendors effective July 1, 1991.  All 
 revenue generated shall be used by vendors to increase salaries, 
 fringe benefits, and payroll taxes by at least three percent for 
 personnel below top management.  County boards shall amend 
 contracts with vendors to require that all revenue generated by 
 this provision is expended on salary increases to staff below 
 top management.  County boards shall verify in writing to the 
 commissioner that each vendor has complied with this 
 requirement.  If a county board determines that a vendor has not 
 complied with this requirement for a specific contract period, 
 the county board shall reduce the vendor's payment rates for the 
 next contract period to reflect the amount of money not spent 
 appropriately.  The commissioner shall modify reporting 
 requirements for vendors and counties as necessary to monitor 
 compliance with this provision. 

    Each county agency shall report to the commissioner by July 
 30, 1991, its actual social service day training and 
 habilitation expenditures for calendar year 1990.  The 
 commissioner shall allocate the day habilitation service CSSA 
 appropriation made available for this purpose to county agencies 
 in proportion to these expenditures. 

    HIST: 1963 c 830 s 4; 1967 c 878 s 2,3; 1969 c 905 s 1; 1971 c 
 584 s 2; 1971 c 668 s 1; 1973 c 583 s 17; 1974 c 406 s 44; 1974 
 c 480 s 1,2; 1975 c 238 s 2; 1976 c 163 s 52; 1977 c 337 s 5; 
 1977 c 347 s 38; 1979 c 324 s 26-28; 1981 c 355 s 25-27; 1983 c 
 312 art 9 s 1; 1984 c 654 art 5 s 58; 1985 c 21 s 31; 1986 c 
 444; 1987 c 384 art 2 s 1; 1987 c 403 art 5 s 5,6; 1989 c 209 
 art 2 s 1; 1991 c 292 art 4 s 7 

     252.25 Board of directors. 

    Every city, town, governmental entity, nonprofit 
 corporation, or combination thereof, establishing a 
 developmental achievement center for children with mental 
 retardation or related conditions shall, before it comes under 
 the terms of sections 252.21 to 252.25, appoint a board of 
 directors for the center program.  When any city or town singly 
 establishes such a center, such board shall be appointed by the 
 chief executive officer of the city or the chair of the 
 governing board of the town.  When any combination of cities, 
 towns, or nonprofit corporations, establishes such a center, the 
 chief executive officers of the cities or nonprofit corporations 
 and the chair of the governing bodies of the towns shall appoint 
 the board of directors.  If a nonprofit corporation singly 
 establishes such a center, its chief executive officer shall 
 appoint the board of directors of the center.  Membership on a 
 board of directors while not mandatory, should be representative 
 of local health, education and welfare departments, medical 
 societies, mental health centers, associations concerned with 
 mental retardation and related conditions, civic groups, and the 
 general public.  Nothing in sections 252.21 to 252.25 shall be 
 construed to preclude the appointment of elected or appointed 
 public officials or members of the board of directors of the 
 sponsoring nonprofit corporation to such board of directors, or 
 public schools from administering programs under their present 
 administrative structure.  

    HIST: 1963 c 830 s 5; 1973 c 123 art 5 s 7; 1974 c 480 s 3; 
 1977 c 337 s 6; 1979 c 324 s 29; 1985 c 21 s 32; 1986 c 444; 
 1987 c 384 art 2 s 1; 1987 c 403 art 5 s 7 

  252.26 Repealed, 1981 c 355 s 34 

     252.261 Existence. 

    Any daytime activity center in existence on September 1, 
 1977, shall be deemed to be a developmental achievement center 
 for the purposes of sections 252.21 to 252.25.  

    HIST: 1977 c 337 s 8; 1979 c 324 s 31; 1991 c 199 art 2 s 1 

     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.  MS 1985 Supp Repealed, 1986 c 414 s 5 

    Subd. 4a.    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 

     252.275 Semi-independent living services for persons 
  with mental retardation or related conditions. 

    Subdivision 1.    Program.  The commissioner of human 
 services shall establish a statewide program to provide support 
 for persons with mental retardation or related conditions to 
 live as independently as possible in the community.  An 
 objective of the program is to reduce unnecessary use of 
 intermediate care facilities for persons with mental retardation 
 or related conditions and home and community-based services.  
 The commissioner shall reimburse county boards for 
 semi-independent living services provided by agencies or 
 individuals that meet the applicable standards of sections 
 245A.01 to 245A.16 and 252.28, and for the provision of onetime 
 living allowances to secure and furnish a home for a person who 
 will receive semi-independent living services under this 
 section, if other public funds are not available for the 
 allowance.  

    For the purposes of this section, "semi-independent living 
 services" means training and assistance in managing money, 
 preparing meals, shopping, maintaining personal appearance and 
 hygiene, and other activities which are needed to maintain and 
 improve an adult with mental retardation or a related 
 condition's capability to live in the community.  Eligible 
 persons: 

    (1) must be age 18 or older; 

    (2) must be unable to function independently without 
 semi-independent living services; and 

    (3) must not be at risk of placement in an intermediate 
 care facility for persons with mental retardation in the absence 
 of less restrictive services. 

    Semi-independent living services costs and onetime living 
 allowance costs may be paid directly by the county, or may be 
 paid by the recipient with a voucher or cash issued by the 
 county. 

    Subd. 1a.    Service requirements.  The methods, 
 materials, and settings used to provide semi-independent living 
 services to a person must be designed to: 

    (1) increase the person's independence in performing tasks 
 and activities by teaching skills that reduce dependence on 
 caregivers; 

    (2) provide training in an environment where the skill 
 being taught is typically used; 

    (3) increase the person's opportunities to interact with 
 nondisabled individuals who are not paid caregivers; 

    (4) increase the person's opportunities to use community 
 resources and participate in community activities, including 
 recreational, cultural, and educational resources, stores, 
 restaurants, religious services, and public transportation; 

    (5) increase the person's opportunities to develop 
 decision-making skills and to make informed choices in all 
 aspects of daily living, including: 

    (i) selection of service providers; 

    (ii) goals and methods; 

    (iii) location and decor of residence; 

    (iv) roommates; 

    (v) daily routines; 

    (vi) leisure activities; and 

    (vii) personal possessions; 

    (6) provide daily schedules, routines, environments and 
 interactions similar to those of nondisabled individuals of the 
 same chronological age; and 

    (7) comply with section 245.825, subdivision 1. 

    Subd. 2. Repealed, 1991 c 292 art 6 s 59 

    Subd. 3.    Reimbursement.  Counties shall be reimbursed 
 for all expenditures made pursuant to subdivision 1 at a rate of 
 70 percent, up to the allocation determined pursuant to 
 subdivisions 4 and 4b.  However, the commissioner shall not 
 reimburse costs of services for any person if the costs exceed 
 the state share of the average medical assistance costs for 
 services provided by intermediate care facilities for a person 
 with mental retardation or a related condition for the same 
 fiscal year, and shall not reimburse costs of a onetime living 
 allowance for any person if the costs exceed $1,500 in a state 
 fiscal year.  The commissioner may make payments to each county 
 in quarterly installments.  The commissioner may certify an 
 advance of up to 25 percent of the allocation.  Subsequent 
 payments shall be made on a reimbursement basis for reported 
 expenditures and may be adjusted for anticipated spending 
 patterns.  

    Subd. 4.    Formula.  The commissioner shall allocate 
 funds on a calendar year basis.  Beginning with the calendar 
 year in the 1996 grant period, funds shall be allocated first in 
 amounts equal to each county's guaranteed floor according to 
 subdivision 4b, with any remaining available funds allocated 
 based on each county's portion of the statewide expenditures 
 eligible for reimbursement under this section during the 12 
 months ending on June 30 of the preceding calendar year. 

    If the legislature appropriates funds for special purposes, 
 the commissioner may allocate the funds based on proposals 
 submitted by the counties to the commissioner in a format 
 prescribed by the commissioner.  Nothing in this section 
 prevents a county from using other funds to pay for additional 
 costs of semi-independent living services. 

    Subd. 4a. Repealed, 1995 c 207 art 3 s 23 

    Subd. 4b.    Guaranteed floor.  Each county shall have a 
 guaranteed floor equal to the lesser of clause (1) or (2): 

    (1) the county's original allocation for the preceding 
 year; or 

    (2) 70 percent of the county's reported expenditures 
 eligible for reimbursement during the 12 months ending on June 
 30 of the preceding calendar year. 

    Notwithstanding this subdivision, no county shall be 
 allocated a guaranteed floor of less than $1,000. 

    When the amount of funds available for allocation is less 
 than the amount available in the previous year, each county's 
 previous year allocation shall be reduced in proportion to the 
 reduction in the statewide funding, to establish each county's 
 guaranteed floor. 

    Subd. 4c.    Review of funds; reallocation.  After each 
 quarter, the commissioner shall review county program 
 expenditures.  The commissioner may reallocate unexpended money 
 at any time among those counties which have earned their full 
 allocation. 

    Subd. 5.    Displaced hospital workers.  Providers of 
 semi-independent living services shall make reasonable efforts 
 to hire qualified employees of regional treatment center mental 
 retardation units who have been displaced by reorganization, 
 closure, or consolidation of regional treatment center mental 
 retardation units.  

    Subd. 6.    Rules.  The commissioner may adopt rules in 
 accordance with chapter 14 to govern allocation, reimbursement, 
 and compliance.  

    Subd. 7.    Reports.  The commissioner shall specify 
 requirements for reports, including quarterly fiscal and annual 
 program reports, according to section 256.01, subdivision 2, 
 paragraph (17).  

    Subd. 8.    Use of federal funds and transfer of funds to 
 medical assistance.  (a) The commissioner shall make every 
 reasonable effort to maximize the use of federal funds for 
 semi-independent living services. 

    (b) The commissioner shall reduce the payments to be made 
 under this section to each county from January 1, 1994 to June 
 30, 1996, by the amount of the state share of medical assistance 
 reimbursement for services other than residential services 
 provided under the home and community-based waiver program under 
 section 256B.092 from January 1, 1994 to June 30, 1996, for 
 clients for whom the county is financially responsible and who 
 have been transferred by the county from the semi-independent 
 living services program to the home and community-based waiver 
 program.  Unless otherwise specified, all reduced amounts shall 
 be transferred to the medical assistance state account. 

    (c) For fiscal year 1997, the base appropriation available 
 under this section shall be reduced by the amount of the state 
 share of medical assistance reimbursement for services other 
 than residential services provided under the home and 
 community-based waiver program authorized in section 256B.092 
 from January 1, 1995 to December 31, 1995, for persons who have 
 been transferred from the semi-independent living services 
 program to the home and community-based waiver program.  The 
 base appropriation for the medical assistance state account 
 shall be increased by the same amount. 

    (d) For purposes of calculating the guaranteed floor under 
 subdivision 4b and to establish the calendar year 1996 
 allocations, each county's original allocation for calendar year 
 1995 shall be reduced by the amount transferred to the state 
 medical assistance account under paragraph (b) during the six 
 months ending on June 30, 1995.  For purposes of calculating the 
 guaranteed floor under subdivision 4b and to establish the 
 calendar year 1997 allocations, each county's original 
 allocation for calendar year 1996 shall be reduced by the amount 
 transferred to the state medical assistance account under 
 paragraph (b) during the six months ending on December 31, 1995. 

    Subd. 9.    Compliance.  If a county board or provider 
 under contract with a county board to provide semi-independent 
 living services does not comply with this section and the rules 
 adopted by the commissioner of human services under this 
 section, including the reporting requirements, the commissioner 
 may recover, suspend, or withhold payments. 

    Subd. 10. Repealed, 1995 c 207 art 3 s 23 

    HIST: 1983 c 310 s 1; 1984 c 640 s 32; 1984 c 654 art 5 s 58; 
 1985 c 21 s 34,35; 1986 c 444; 1987 c 403 art 2 s 56-59; 1989 c 
 89 s 4; 1989 c 209 art 2 s 1; 1991 c 292 art 4 s 8; art 6 s 34; 
 1Sp1993 c 1 art 4 s 1,2; 1995 c 207 art 3 s 2-4; 1997 c 7 art 5 
 s 26; 1Sp2001 c 9 art 3 s 3; 2002 c 379 art 1 s 113 

     252.28 Commissioner of human services; duties. 

    Subdivision 1.    Determinations; redeterminations.  In 
 conjunction with the appropriate county boards, the commissioner 
 of human services shall determine, and shall redetermine at 
 least every four years, the need, location, size, and program of 
 public and private day training and habilitation services for 
 persons with mental retardation or related conditions.  This 
 subdivision does not apply to semi-independent living services 
 and residential-based habilitation services provided to four or 
 fewer persons at a single site funded as home and 
 community-based services.  A determination of need shall not be 
 required for a change in ownership.  

    Subd. 2.    Rules; program standards; licenses.  The 
 commissioner of human services shall: 

    (1) Establish uniform rules and program standards for each 
 type of residential and day facility or service for persons with 
 mental retardation or related conditions, including state 
 hospitals under control of the commissioner and serving persons 
 with mental retardation or related conditions, and excluding 
 persons with mental retardation or related conditions residing 
 with their families. 

    (2) Grant licenses according to the provisions of Laws 
 1976, chapter 243, sections 2 to 13. 

    Subd. 3.    Licensing determinations.  (1) No new 
 license shall be granted pursuant to this section when the 
 issuance of the license would substantially contribute to an 
 excessive concentration of community residential facilities 
 within any town, municipality or county of the state. 

    (2) In determining whether a license shall be issued 
 pursuant to this subdivision, the commissioner of human services 
 shall specifically consider the population, size, land use plan, 
 availability of community services and the number and size of 
 existing public and private community residential facilities in 
 the town, municipality or county in which a licensee seeks to 
 operate a residence.  Under no circumstances may the 
 commissioner newly license any facility pursuant to this section 
 except as provided in section 245A.11.  The commissioner of 
 human services shall establish uniform rules to implement the 
 provisions of this subdivision. 

    (3) Licenses for community facilities and services shall be 
 issued pursuant to section 245.821. 

    (4) No new license shall be granted for a residential 
 program that provides home and community-based waivered services 
 to more than four individuals at a site, except as authorized by 
 the commissioner for emergency situations that would result in 
 the placement of individuals into regional treatment centers.  
 Such licenses shall not exceed 24 months.  

    (5) The commissioner shall not approve a determination of 
 need application that requests that an existing residential 
 program license under Minnesota Rules, parts 9525.0215 to 
 9525.0355 be modified in a manner that would result in the 
 issuance of two or more licenses for the same residential 
 program at the same location.  

    Subd. 3a.    Licensing exception.  (a) Notwithstanding 
 the provisions of subdivision 3, the commissioner may license 
 service sites, each accommodating up to six residents moving 
 from a 48-bed intermediate care facility for persons with mental 
 retardation or related conditions located in Dakota county that 
 is closing under section 252.292. 

    (b) Notwithstanding the provisions of any other state law 
 or administrative rule, the rate provisions of section 256I.05, 
 subdivision 1, apply to the exception in this subdivision. 

    (c) If a service site is licensed for six persons according 
 to this subdivision, the capacity of the license may remain at 
 six persons. 

    Subd. 3b.    Olmsted county licensing exemption.  (a) 
 Notwithstanding subdivision 3, the commissioner may license 
 service sites each accommodating up to five residents moving 
 from a 43-bed intermediate care facility for persons with mental 
 retardation or related conditions located in Olmsted county that 
 is closing under section 252.292. 

    (b) Notwithstanding the provisions of any other state law 
 or administrative rule, the rate provisions of section 256I.05, 
 subdivision 1, apply to the exception in this subdivision. 

    (c) If a service site is licensed for five persons 
 according to this subdivision, the capacity of the license may 
 remain at five persons. 

    Subd. 4.    Rules; decertification of beds.  The 
 commissioner shall promulgate in rule criteria for 
 decertification of beds in intermediate care facilities for 
 persons with mental retardation or related conditions, and shall 
 encourage providers in voluntary decertification efforts.  The 
 commissioner shall not recommend to the commissioner of health 
 the involuntary decertification of an intermediate care facility 
 for beds for persons with mental retardation or related 
 conditions prior to the availability of appropriate services for 
 those residents affected by the decertification.  The 
 commissioner of health shall decertify those intermediate care 
 beds determined to be not needed by the commissioner of human 
 services.  

    Subd. 5.    Appeals.  A county may appeal a 
 determination of need, size, location, or program according to 
 chapter 14.  Notice of appeals must be provided to the 
 commissioner within 30 days after the receipt of the 
 commissioner's determination.  

    HIST: 1971 c 229 s 1; 1975 c 60 s 1; 1976 c 149 s 50; 1976 c 
 243 s 14; 1980 c 612 s 2; 1983 c 312 art 9 s 2; 1984 c 654 art 5 
 s 58; 1985 c 21 s 36; 1985 c 248 s 70; 1Sp1985 c 9 art 2 s 28; 
 1989 c 209 art 2 s 1; 1991 c 292 art 6 s 35-37; 1992 c 513 art 9 
 s 21; 1997 c 203 art 3 s 5; 1999 c 159 s 31; 1999 c 245 art 3 s 
 9; 2000 c 474 s 5; 2000 c 488 art 9 s 5; 2001 c 203 s 3,4 

     252.282 ICF/MR local system needs planning. 

    Subdivision 1.    Host county responsibility.  (a) For 
 purposes of this section, "local system needs planning" means 
 the determination of need for ICF/MR services by program type, 
 location, demographics, and size of licensed services for 
 persons with developmental disabilities or related conditions. 

    (b) This section does not apply to semi-independent living 
 services and residential-based habilitation services funded as 
 home and community-based services. 

    (c) In collaboration with the commissioner and ICF/MR 
 providers, counties shall complete a local system needs planning 
 process for each ICF/MR facility.  Counties shall evaluate the 
 preferences and needs of persons with developmental disabilities 
 to determine resource demands through a systematic assessment 
 and planning process by May 15, 2000, and by July 1 every two 
 years thereafter beginning in 2001. 

    (d) A local system needs planning process shall be 
 undertaken more frequently when the needs or preferences of 
 consumers change significantly to require reformation of the 
 resources available to persons with developmental disabilities. 

    (e) A local system needs plan shall be amended anytime 
 recommendations for modifications to existing ICF/MR services 
 are made to the host county, including recommendations for: 

    (1) closure; 

    (2) relocation of services; 

    (3) downsizing; or 

    (4) modification of existing services for which a change in 
 the framework of service delivery is advocated. 

    Subd. 2.    Consumer needs and preferences.  In 
 conducting the local system needs planning process, the host 
 county must use information from the individual service plans of 
 persons for whom the county is financially responsible and of 
 persons from other counties for whom the county has agreed to be 
 the host county.  The determination of services and supports 
 offered within the county shall be based on the preferences and 
 needs of consumers.  The host county shall also consider the 
 community social services plan, waiting lists, and other sources 
 that identify unmet needs for services.  A review of ICF/MR 
 facility licensing and certification surveys, substantiated 
 maltreatment reports, and established service standards shall be 
 employed to assess the performance of providers and shall be 
 considered in the county's recommendations.  Consumer 
 satisfaction surveys may also be considered in this process. 

    Subd. 3.    Recommendations.  (a) Upon completion of the 
 local system needs planning assessment, the host county shall 
 make recommendations by May 15, 2000, and by July 1 every two 
 years thereafter beginning in 2001.  If no change is 
 recommended, a copy of the assessment along with corresponding 
 documentation shall be provided to the commissioner by July 1 
 prior to the contract year. 

    (b) Except as provided in section 252.292, subdivision 4, 
 recommendations regarding closures, relocations, or downsizings 
 that include a rate increase shall be submitted to the statewide 
 advisory committee for review, along with the assessment, plan, 
 and corresponding documentation that supports the payment rate 
 adjustment request. 

    (c) Recommendations for closures, relocations, and 
 downsizings that do not include a rate increase and for 
 modification of existing services for which a change in the 
 framework of service delivery is necessary shall be provided to 
 the commissioner by July 1 prior to the contract year or at 
 least 90 days prior to the anticipated change, along with the 
 assessment and corresponding documentation. 

    Subd. 4.    Statewide advisory committee.  (a) The 
 commissioner shall appoint a five-member statewide advisory 
 committee.  The advisory committee shall include representatives 
 of providers and counties and the commissioner or the 
 commissioner's designee. 

    (b) The criteria for ranking proposals, already developed 
 in 1997 by a task force authorized by the legislature, shall be 
 adopted and incorporated into the decision-making process.  
 Specific guidelines, including: 

    (1) time frame for submission of requests; 

    (2) the funds appropriated by the legislature for the 
 purposes outlined in section 256B.5013, subdivisions 2 to 4; and 

    (3) state policy directions for the provision of services 
 to persons with developmental disabilities, shall be established 
 and announced through the State Register, and all requests shall 
 be considered in comparison to each other and the ranking 
 criteria.  The advisory committee shall review and recommend 
 requests to the commissioner for approval of facility rate 
 adjustments to address closures, downsizings, or relocations.  
 The committee shall ensure that: 

    (1) applications are in compliance with applicable state 
 and federal law and with the state plan; 

    (2) cost projections for the proposed service are within 
 the fundings limits established by the legislative 
 appropriation; and 

    (3) their recommendations are submitted to the commissioner.

    Subd. 5.    Responsibilities of commissioner.  (a) In 
 collaboration with counties, providers, and the statewide 
 advisory committee, the commissioner shall ensure that services 
 recognize the preferences and needs of persons with 
 developmental disabilities and related conditions through a 
 recurring systemic review and assessment of ICF/MR facilities 
 within the state. 

    (b) The commissioner shall publish a notice in the State 
 Register no less than biannually to announce the opportunity for 
 counties or providers to submit requests for payment rate 
 adjustments associated with plans for downsizing, relocation, 
 and closure of ICF/MR facilities. 

    (c) The commissioner shall designate funding parameters to 
 counties and to the statewide advisory committee for the overall 
 implementation of system needs within the fiscal resources 
 allocated by the legislature. 

    (d) The commissioner shall contract with ICF/MR providers.  
 The initial contracts shall cover the period from October 1, 
 2000, to December 31, 2001.  Subsequent contracts shall be for 
 two-year periods beginning January 1, 2002. 

    HIST: 1999 c 245 art 3 s 10; 2002 c 220 art 14 s 1-4 

  252.29 Repealed, 1976 c 149 s 63 

     252.291 Limitation on determination of need. 

    Subdivision 1.    Moratorium.  Notwithstanding section 
 252.28, subdivision 1, or any other law or rule to the contrary, 
 the commissioner of human services shall deny any request for a 
 determination of need and refuse to grant a license pursuant to 
 section 245A.02 for any new intermediate care facility for 
 persons with mental retardation or related conditions or for an 
 increase in the licensed capacity of an existing facility except 
 as provided in this subdivision and subdivision 2.  The total 
 number of certified intermediate care beds for persons with 
 mental retardation or related conditions in community facilities 
 and state hospitals shall not exceed 7,000 beds except that, to 
 the extent that federal authorities disapprove any applications 
 of the commissioner for home and community-based waivers under 
 United States Code, title 42, section 1396n, as amended through 
 December 31, 1987, the commissioner may authorize new 
 intermediate care beds, as necessary, to serve persons with 
 mental retardation or related conditions who would otherwise 
 have been served under a proposed waiver.  "Certified bed" means 
 an intermediate care bed for persons with mental retardation or 
 related conditions certified by the commissioner of health for 
 the purposes of the medical assistance program under United 
 States Code, title 42, sections 1396 to 1396p, as amended 
 through December 31, 1987.  

    Subd. 2.    Exceptions.  (a) The commissioner of human 
 services in coordination with the commissioner of health may 
 approve a newly constructed or newly established publicly or 
 privately operated community intermediate care facility for six 
 or fewer persons with mental retardation or related conditions 
 only when:  

    (1) the facility is developed in accordance with a request 
 for proposal approved by the commissioner of human services; 

    (2) the facility is necessary to serve the needs of 
 identified persons with mental retardation or related conditions 
 who are seriously behaviorally disordered or who are seriously 
 physically or sensorily impaired.  No more than 40 percent of 
 the capacity specified in the proposal submitted to the 
 commissioner must be used for persons being discharged from 
 regional treatment centers; and 

    (3) the commissioner determines that the need for increased 
 service capacity cannot be met by the use of alternative 
 resources or the modification of existing facilities. 

    (b) The percentage limitation in paragraph (a), clause (2), 
 does not apply to state-operated, community-based facilities. 

    Subd. 2a.    Exception for Lake Owasso project.  (a) The 
 commissioner shall authorize and grant a license under chapter 
 245A to a new intermediate care facility for persons with mental 
 retardation effective January 1, 2000, under the following 
 circumstances: 

    (1) the new facility replaces an existing 64-bed 
 intermediate care facility for the mentally retarded located in 
 Ramsey county; 

    (2) the new facility is located upon a parcel of land 
 contiguous to the parcel upon which the existing 64-bed facility 
 is located; 

    (3) the new facility is comprised of no more than eight 
 twin home style buildings and an administration building; 

    (4) the total licensed bed capacity of the facility does 
 not exceed 64 beds; and 

    (5) the existing 64-bed facility is demolished. 

    (b) The medical assistance payment rate for the new 
 facility shall be the higher of the rate specified in paragraph 
 (c) or as otherwise provided by law. 

    (c) The new facility shall be considered a newly 
 established facility for rate setting purposes and shall be 
 eligible for the investment per bed limit specified in section 
 256B.501, subdivision 11, paragraph (c), and the interest 
 expense limitation specified in section 256B.501, subdivision 
 11, paragraph (d).  Notwithstanding section 256B.5011, the newly 
 established facility's initial payment rate shall be set 
 according to Minnesota Rules, part 9553.0075, and shall not be 
 subject to the provisions of section 256B.501, subdivision 5b. 

    (d) During the construction of the new facility, Ramsey 
 county shall work with residents, families, and service 
 providers to explore all service options open to current 
 residents of the facility. 

    Subd. 3.    Duties of commissioner of human services.  
 The commissioner shall:  

    (a) establish standard admission criteria for state 
 hospitals and county utilization targets to limit and reduce the 
 number of intermediate care beds in state hospitals and 
 community facilities in accordance with approved waivers under 
 United States Code, title 42, sections 1396 to 1396p, as amended 
 through December 31, 1987, to assure that appropriate services 
 are provided in the least restrictive setting; 

    (b) define services, including respite care, that may be 
 needed in meeting individual service plan objectives; 

    (c) provide technical assistance so that county boards may 
 establish a request for proposal system for meeting individual 
 service plan objectives through home and community-based 
 services; alternative community services; or, if no other 
 alternative will meet the needs of identifiable individuals for 
 whom the county is financially responsible, a new intermediate 
 care facility for persons with mental retardation or related 
 conditions; 

    (d) establish a client tracking and evaluation system as 
 required under applicable federal waiver regulations, Code of 
 Federal Regulations, title 42, sections 431, 435, 440, and 441, 
 as amended through December 31, 1987; and 

    (e) develop a state plan for the delivery and funding of 
 residential day and support services to persons with mental 
 retardation or related conditions in Minnesota.  The biennial 
 mental retardation plan shall include but not be limited to: 

    (1) county by county maximum intermediate care bed 
 utilization quotas; 

    (2) plans for the development of the number and types of 
 services alternative to intermediate care beds; 

    (3) procedures for the administration and management of the 
 plan; 

    (4) procedures for the evaluation of the implementation of 
 the plan; and 

    (5) the number, type, and location of intermediate care 
 beds targeted for decertification. 

    The commissioner shall modify the plan to ensure 
 conformance with the medical assistance home and community-based 
 services waiver. 

    Subd. 4.    Monitoring.  The commissioner of human 
 services, in coordination with the commissioner of health, shall 
 implement mechanisms to monitor and analyze the effect of the 
 bed moratorium in the different geographic areas of the state.  
 The commissioner of human services shall submit to the 
 legislature annually beginning January 15, 1984, an assessment 
 of the impact of the moratorium by geographic areas.  

    Subd. 5.    Rulemaking.  The commissioner of human 
 services shall promulgate rules pursuant to chapter 14, the 
 Administrative Procedure Act, to implement this section.  

    HIST: 1983 c 312 art 9 s 3; 1984 c 640 s 32; 1984 c 654 art 5 
 s 58; 1985 c 21 s 37; 1987 c 185 art 2 s 1; 1987 c 333 s 22; 
 1988 c 689 art 2 s 111-113; 1989 c 282 art 6 s 18; 1997 c 7 art 
 2 s 38; art 5 s 27; 1999 c 245 art 3 s 11 

     252.292 Community services conversion project. 

    Subdivision 1.    Commissioner's duties; report.  For 
 the purposes of section 252.291, subdivision 3, the commissioner 
 of human services shall ask counties to present proposals for 
 the voluntary conversion of services provided by community 
 intermediate care facilities for persons with mental retardation 
 or related conditions to services provided under home and 
 community-based services.  

    The commissioner shall report to the legislature by March 
 1, 1988, on the status of the community services conversion 
 project.  The report must include the project's cost, the number 
 of counties and facilities participating, the number and 
 location of decertified community intermediate care beds, and 
 the project's effect on residents, former residents, and 
 employees of community intermediate care facilities for persons 
 with mental retardation or related conditions.  

    Subd. 2.    County proposals.  (a) The commissioner may 
 approve county proposals within the limitations of this 
 section.  To be considered for approval, county proposals must 
 contain the following information:  

    (1) specific plans for the development and provision of 
 alternative services for residents moved from intermediate care 
 facilities for persons with mental retardation or related 
 conditions; 

    (2) time lines and expected beginning dates for resident 
 relocation and facility closure; and 

    (3) projected caseloads and expenditures for intermediate 
 care facilities for persons with mental retardation or related 
 conditions and for home and community-based services. 

    (b) Counties must ensure that residents discharged from 
 facilities participating in the project are moved to their home 
 communities whenever possible.  For the purposes of this 
 section, "home community" means the county of financial 
 responsibility or a county adjacent to the county of financial 
 responsibility.  The commissioner shall have the sole authority 
 to waive this requirement based on the choice of the person or 
 the person's legal representative, if any.  

    (c) County proposals must comply with the need 
 determination procedures in sections 252.28 and 252.291, the 
 responsibility for persons with mental retardation or related 
 conditions specified in section 256B.092, the requirements under 
 United States Code, title 42, sections 1396 et seq., and section 
 256B.501, and the rules adopted under these laws.  

    (d) The commissioner shall give first priority to proposals 
 that: 

    (1) respond to the emergency relocation of a facility's 
 residents; 

    (2) result in the closing of a facility; 

    (3) demonstrate that alternative placements will be 
 developed based on individual resident needs and applicable 
 federal and state rules; and 

    (4) demonstrate savings of medical assistance 
 expenditures.  The commissioner shall give second priority to 
 proposals that meet all of the above criteria except clause (1). 

    (e) The commissioner shall select proposals that best meet 
 the criteria established in this subdivision within the 
 appropriations made available for home and community-based 
 services.  The commissioner shall notify counties and facilities 
 of the selections made and approved by the commissioner. 

    (f) For each proposal approved by the commissioner, a 
 contract must be established between the commissioner, the 
 county where the facility is located, and the participating 
 facility.  The contract must address the items in this 
 subdivision and must be consistent with the requirements of this 
 section. 

    Subd. 3.    Home and community-based services.  Home and 
 community-based services shall be allocated to participating 
 counties to replace intermediate care facility services for 
 persons with mental retardation or related conditions that are 
 decertified through the project.  One additional home and 
 community-based services placement shall be provided for each 
 current resident of an intermediate care facility for persons 
 with mental retardation or related conditions who chooses and is 
 eligible for home and community-based services.  The placement 
 must meet applicable federal and state laws and rules.  
 Additional home and community-based services placements will not 
 be authorized for persons transferred to other intermediate care 
 facilities for persons with mental retardation or related 
 conditions, including state hospitals, or to nursing homes 
 licensed under chapter 144A, or for persons determined 
 ineligible for home and community-based services.  

    The county must provide quarterly reports to the 
 commissioner regarding the number of people moving out of 
 participating facilities each month and their alternative 
 placement.  County actions that result in a denial of services, 
 failure to act with reasonable promptness, suspension, 
 reduction, or termination of services may be appealed by 
 affected persons under section 256.045.  

    Subd. 4.    Facility rates.  For purposes of this 
 section, the commissioner shall establish payment rates under 
 section 256B.501 and Minnesota Rules, parts 9553.0010 to 
 9553.0080, except that, in order to facilitate an orderly 
 transition of residents from community intermediate care 
 facilities for persons with mental retardation or related 
 conditions to services provided under the home and 
 community-based services program, the commissioner may, in a 
 contract with the provider, modify the effect of provisions in 
 Minnesota Rules, parts 9553.0010 to 9553.0080, as stated in 
 clauses (a) to (i): 

    (a) extend the interim and settle-up rate provisions to 
 include facilities covered by this section; 

    (b) extend the length of the interim period but not to 
 exceed 12 months.  The commissioner may grant a variance to 
 exceed the 12-month interim period, as necessary, for facilities 
 which are licensed and certified to serve more than 99 persons.  
 In no case shall the commissioner approve an interim period 
 which exceeds 24 months; 

    (c) waive the investment per bed limitations for the 
 interim period and the settle-up rate; 

    (d) limit the amount of reimbursable expenses related to 
 the acquisition of new capital assets; 

    (e) prohibit the acquisition of additional capital debt or 
 refinancing of existing capital debt unless prior approval is 
 obtained from the commissioner; 

    (f) establish an administrative operating cost limitation 
 for the interim period and the settle-up rate; 

    (g) require the retention of financial and statistical 
 records until the commissioner has audited the interim period 
 and the settle-up rate; 

    (h) require that the interim period be audited by a 
 certified or licensed public accounting firm; or 

    (i) change any other provision to which all parties to the 
 contract agree. 

    HIST: 1987 c 305 s 1; 1995 c 207 art 3 s 5 

     252.293 Emergency relocations. 

    Subdivision 1.    Emergency transfers.  In emergency 
 situations, the commissioner of human services may order the 
 relocation of existing intermediate care facility for persons 
 with mental retardation or related conditions beds, transfer 
 residents, and establish an interim payment rate under the 
 procedures contained in Minnesota Rules, part 9553.0075, for up 
 to two years, as necessary to ensure the replacement of the 
 original services for the residents.  The payment rate must be 
 based on projected costs and is subject to settle up.  An 
 emergency situation exists when it appears to the commissioner 
 of human services that the health, safety, or welfare of 
 residents may be in jeopardy due to imminent or actual loss of 
 use of the physical plant or damage to the physical plant making 
 it temporarily or permanently uninhabitable.  The subsequent 
 rate for a facility providing services for the same resident 
 following the temporary emergency situation must be based upon 
 the costs incurred during the interim period if the residents 
 are permanently placed in the same facility.  If the residents 
 need to be relocated for permanent placements, the temporary 
 emergency location must close and the procedures for 
 establishing rates for newly constructed or newly established 
 facilities must be followed.  This provision regarding emergency 
 situations does not apply to facilities placed in receivership 
 by the commissioner of human services under section 245A.12 or 
 245A.13, or facilities that have rates set under section 
 252.292, subdivision 4, or to relocations of residents to 
 existing facilities. 

    Subd. 2.    Approval of temporary locations.  The 
 commissioner of human services shall notify the commissioner of 
 health of the existence of the emergency and the decision to 
 order the relocation of residents.  This notice shall also 
 identify the temporary location or locations selected by the 
 commissioner of human services for the relocation of the 
 residents.  Notwithstanding the provisions of section 252.291, 
 the commissioner of health may license and certify the temporary 
 location or locations as an intermediate care facility for 
 persons with mental retardation or related conditions if the 
 location complies with the applicable state rules and federal 
 regulations.  The facility from which the residents were 
 relocated shall not be used to house residents until the 
 commissioner of human services authorizes the return of 
 residents to the facility and the commissioner of health 
 verifies that the facility complies with the applicable state 
 and federal regulations.  If the temporary location closes under 
 the provisions of subdivision 1, the license and certification 
 of the temporary location is voided.  The voiding of the license 
 and certification shall not be considered as a suspension, 
 revocation, or nonrenewal of the license or as an involuntary 
 decertification of the facility. 

    HIST: 1991 c 292 art 6 s 38 

     252.294 Criteria for downsizing of facilities. 

    The commissioner of human services shall develop a process 
 to evaluate and rank proposals for the voluntary downsizing or 
 closure of intermediate care facilities for persons with mental 
 retardation or related conditions using the following guidelines:

    (1) the extent to which the option matches overall policy 
 direction of the department; 

    (2) the extent to which the option demonstrates respect for 
 individual needs and allows implementation of individual choice; 

    (3) the extent to which the option addresses safety, 
 privacy, and other programmatic issues; 

    (4) the extent to which the option appropriately redesigns 
 the overall community capacity; and 

    (5) the cost of each option. 

    The process shall, to the extent feasible, be modeled on 
 the nursing home moratorium exception process, including 
 procedures for administrative evaluation and approval of 
 projects within the limit of appropriations made available by 
 the legislature. 

    HIST: 1997 c 203 art 9 s 4 

     252.30 Authorization to make grants for community 
  residential facilities. 

    The commissioner of human services may make grants to 
 nonprofit organizations, municipalities or local units of 
 government to provide up to 25 percent of the cost of 
 constructing, purchasing or remodeling small community 
 residential facilities for persons with mental retardation or 
 related conditions allowing such persons to live in a homelike 
 atmosphere near their families.  Operating capital grants may 
 also be made for up to three months of reimbursable operating 
 costs after the facility begins processing applications for 
 admission and prior to reimbursement for services.  Repayment of 
 the operating grants shall be made to the commissioner of human 
 services at the end of the provider's first fiscal year, or at 
 the conclusion of the interim rate period, whichever occurs 
 first.  No aid under this section shall be granted to a facility 
 providing for more than 16 residents in a living unit and with 
 more than two living units.  The advisory council established by 
 section 252.31 shall recommend to the commissioner appropriate 
 disbursement of the funds appropriated by Laws 1973, chapter 
 673, section 3.  Prior to any disbursement of funds the 
 commissioner shall review the plans and location of any proposed 
 facility to determine whether such a facility is needed.  The 
 commissioner shall promulgate such rules for the making of 
 grants and for the administration of this section as the 
 commissioner deems proper.  The remaining portion of the cost of 
 constructing, purchasing, remodeling facilities, or of operating 
 capital shall be borne by nonstate sources including federal 
 grants, local government funds, funds from charitable sources, 
 gifts and mortgages. 

    HIST: 1973 c 673 s 2; 1980 c 367 s 1; 1984 c 654 art 5 s 58; 
 1985 c 21 s 38; 1985 c 248 s 70; 1986 c 444 

     252.31 Advisory task force. 

    The commissioner of human services may appoint an advisory 
 task force for services to persons with mental retardation, 
 related conditions, or physical handicaps.  The task force shall 
 advise the commissioner relative to those laws which the 
 commissioner is responsible to administer and enforce relating 
 to mental retardation or related conditions and physical 
 disabilities.  The commissioner also may request the task force 
 for advice on implementing a comprehensive plan of services 
 necessary to provide for the transition of persons with mental 
 retardation or related conditions from regional treatment 
 centers services to community-based programs.  The task force 
 shall consist of persons who are providers or consumers of 
 service for persons with mental retardation, related conditions, 
 or physical handicaps, or who are interested citizens.  The task 
 force shall expire and the terms, compensation and removal of 
 members shall be as provided in section 15.059. 

    HIST: 1976 c 149 s 51; 1983 c 260 s 54; 1984 c 654 art 5 s 58; 
 1985 c 21 s 39; 1989 c 282 art 6 s 19 

     252.32 Family support program. 

    Subdivision 1.    Program established.  In accordance 
 with state policy established in section 256F.01 that all 
 children are entitled to live in families that offer safe, 
 nurturing, permanent relationships, and that public services be 
 directed toward preventing the unnecessary separation of 
 children from their families, and because many families who have 
 children with mental retardation or related conditions have 
 special needs and expenses that other families do not have, the 
 commissioner of human services shall establish a program to 
 assist families who have dependents with mental retardation or 
 related conditions living in their home.  The program shall make 
 support grants available to the families. 

    Subd. 1a.    Support grants.  (a) Provision of support 
 grants must be limited to families who require support and whose 
 dependents are under the age of 22 and who have mental 
 retardation or who have a related condition and who have been 
 determined by a screening team established under section 
 256B.092 to be at risk of institutionalization.  Families who 
 are receiving home and community-based waivered services for 
 persons with mental retardation or related conditions are not 
 eligible for support grants.  

    Families receiving grants who will be receiving home and 
 community-based waiver services for persons with mental 
 retardation or a related condition for their family member 
 within the grant year, and who have ongoing payments for 
 environmental or vehicle modifications which have been approved 
 by the county as a grant expense and would have qualified for 
 payment under this waiver may receive a onetime grant payment 
 from the commissioner to reduce or eliminate the principal of 
 the remaining debt for the modifications, not to exceed the 
 maximum amount allowable for the remaining years of eligibility 
 for a family support grant.  The commissioner is authorized to 
 use up to $20,000 annually from the grant appropriation for this 
 purpose.  Any amount unexpended at the end of the grant year 
 shall be allocated by the commissioner in accordance with 
 subdivision 3a, paragraph (b), clause (2).  Families whose 
 annual adjusted gross income is $60,000 or more are not eligible 
 for support grants except in cases where extreme hardship is 
 demonstrated.  Beginning in state fiscal year 1994, the 
 commissioner shall adjust the income ceiling annually to reflect 
 the projected change in the average value in the United States 
 Department of Labor Bureau of Labor Statistics consumer price 
 index (all urban) for that year. 

    (b) Support grants may be made available as monthly subsidy 
 grants and lump sum grants. 

    (c) Support grants may be issued in the form of cash, 
 voucher, and direct county payment to a vendor.  

    (d) Applications for the support grant shall be made by the 
 legal guardian to the county social service agency.  The 
 application shall specify the needs of the families, the form of 
 the grant requested by the families, and that the families have 
 agreed to use the support grant for items and services within 
 the designated reimbursable expense categories and 
 recommendations of the county.  

    (e) Families who were receiving subsidies on the date of 
 implementation of the $60,000 income limit in paragraph (a) 
 continue to be eligible for a family support grant until 
 December 31, 1991, if all other eligibility criteria are met.  
 After December 31, 1991, these families are eligible for a grant 
 in the amount of one-half the grant they would otherwise 
 receive, for as long as they remain eligible under other 
 eligibility criteria. 

    Subd. 2.    Individual service plan.  Before a support 
 grant is issued, an individual service plan for the dependent as 
 required by section 256E.08 and the rules adopted thereunder, or 
 an individual service plan as requested by the family and 
 defined in 256B.092, shall be developed by the county social 
 service agency and agreed upon by the parents.  A transitional 
 plan shall be developed for the dependent when the dependent 
 turns age 17 in order to assure an orderly transition to other 
 services when the family terminates services from this program 
 and to assure that an application is made for supplemental 
 security income and other benefits.  

    Subd. 3.    Amount of support grant; use.  Support grant 
 amounts shall be determined by the county social service 
 agency.  Each service and item purchased with a support grant 
 must: 

    (1) be over and above the normal costs of caring for the 
 dependent if the dependent did not have a disability; 

    (2) be directly attributable to the dependent's disabling 
 condition; and 

    (3) enable the family to delay or prevent the out-of-home 
 placement of the dependent. 

    The design and delivery of services and items purchased 
 under this section must suit the dependent's chronological age 
 and be provided in the least restrictive environment possible, 
 consistent with the needs identified in the individual service 
 plan. 

    Items and services purchased with support grants must be 
 those for which there are no other public or private funds 
 available to the family.  Fees assessed to parents for health or 
 human services that are funded by federal, state, or county 
 dollars are not reimbursable through this program. 

    The maximum monthly grant amount shall be $250 per eligible 
 dependent, or $3,000 per eligible dependent per state fiscal 
 year, within the limits of available funds.  The county social 
 service agency may consider the dependent's supplemental 
 security income in determining the amount of the support grant.  
 The county social service agency may exceed $3,000 per state 
 fiscal year per eligible dependent for emergency circumstances 
 in cases where exceptional resources of the family are required 
 to meet the health, welfare-safety needs of the child.  

    County social service agencies shall continue to provide 
 funds to families receiving state grants on June 30, 1997, if 
 eligibility criteria continue to be met.  Any adjustments to 
 their monthly grant amount must be based on the needs of the 
 family and funding availability. 

    Subd. 3a.    Reports and allocations.  (a) The 
 commissioner shall specify requirements for quarterly fiscal and 
 annual program reports according to section 256.01, subdivision 
 2, paragraph (17).  Program reports shall include data which 
 will enable the commissioner to evaluate program effectiveness 
 and to audit compliance.  The commissioner shall reimburse 
 county costs on a quarterly basis. 

    (b) The commissioner shall allocate state funds made 
 available under this section to county social service agencies 
 on a calendar year basis.  The commissioner shall allocate to 
 each county first in amounts equal to each county's guaranteed 
 floor as described in clause (1), and second, any remaining 
 funds will be allocated to county agencies to support children 
 in their family homes.  

    (1) Each county's guaranteed floor shall be calculated as 
 follows:  

    (i) 95 percent of the county's allocation received in the 
 preceding calendar year; 

    (ii) when the amount of funds available for allocation is 
 less than the amount available in the preceding year, each 
 county's previous year allocation shall be reduced in proportion 
 to the reduction in statewide funding, for the purpose of 
 establishing the guaranteed floor.  

    (2) The commissioner shall regularly review the use of 
 family support fund allocations by county.  The commissioner may 
 reallocate unexpended or unencumbered money at any time to those 
 counties that have a demonstrated need for additional funding.  

    (c) County allocations under this section will be adjusted 
 for transfers that occur according to section 256.476 or when 
 the county of financial responsibility changes according to 
 chapter 256G for eligible recipients. 

    Subd. 3b.    Federal funds.  The commissioner and the 
 counties shall make every reasonable effort to maximize the use 
 of federal funds for family supports. 

    Subd. 3c.    County board responsibilities.  County 
 boards receiving funds under this section shall:  

    (1) determine the needs of families for services in 
 accordance with section 256B.092 or 256E.08 and any rules 
 adopted under those sections; 

    (2) determine the eligibility of all persons proposed for 
 program participation; 

    (3) approve a plan for items and services to be reimbursed 
 and inform families of the county's approval decision; 

    (4) issue support grants directly to, or on behalf of, 
 eligible families; 

    (5) inform recipients of their right to appeal under 
 subdivision 3e; 

    (6) submit quarterly financial reports under subdivision 3b 
 and indicate on the screening documents the annual grant level 
 for each family, the families denied grants, and the families 
 eligible but waiting for funding; and 

    (7) coordinate services with other programs offered by the 
 county. 

    Subd. 3d.    Appeals.  The denial, suspension, or 
 termination of services under this program may be appealed by a 
 recipient or application under section 256.045, subdivision 3. 

    Subd. 4. Repealed, 1997 c 203 art 7 s 29 

    Subd. 5.    Compliance.  If a county board or grantee 
 does not comply with this section, the commissioner may recover, 
 suspend, or withhold payments. 

    HIST: 1983 c 312 art 1 s 22; 1984 c 654 art 5 s 58; 1985 c 21 
 s 40; 1986 c 414 s 4; 1987 c 333 s 22; 1991 c 292 art 6 s 39; 
 1993 c 339 s 8; 1997 c 203 art 7 s 10-14; 1999 c 245 art 4 s 15; 
 2000 c 330 s 1,2 

     252.33 Client advisory committees. 

    Subdivision 1.    Definition.  For purposes of this 
 section, the following terms have the meanings given: 

    (a) "Client advisory committee" means a group of clients 
 who represent client interests to supervisors and employers in 
 vocational programs. 

    (b) "Consumer-controlled organization" means a 
 self-advocacy organization which is controlled by a board having 
 a majority of people with developmental disabilities. 

    Subd. 2.    Committees developed.  The commissioner of 
 economic security, through the division of rehabilitation 
 resources, shall contract with a consumer-controlled 
 organization to develop client advisory committees in vocational 
 settings in developmental achievement centers, and state 
 hospitals, and to allocate resources and technical assistance to 
 client advisory committees in rehabilitation facilities as 
 defined in section 268A.01. 

    Subd. 3.    Purposes.  A client advisory committee 
 enables clients working in vocational settings to advocate for 
 themselves with regard to matters of common interest.  A client 
 advisory committee may address any issue related to the 
 vocational setting, including personnel policies, wages, hours 
 of work, kinds of work, transportation to and from the 
 workplace, and behavior problems.  A client advisory committee 
 may also meet to develop the skills and knowledge needed to 
 represent fellow clients, such as decision-making skills, 
 assertiveness, and awareness of public policies affecting people 
 with developmental disabilities. 

    Subd. 4.    Membership.  Members of a client advisory 
 committee must be elected by clients who work at the vocational 
 setting. 

    HIST: 1987 c 370 art 1 s 2; 1988 c 689 art 2 s 268; 1994 c 483 
 s 1 

     252.40 Service principles and rate-setting procedures. 

    Sections 252.40 to 252.46 apply to day training and 
 habilitation services for adults with mental retardation and 
 related conditions when the services are authorized to be funded 
 by a county and provided under a contract between a county board 
 and a vendor as defined in section 252.41.  Nothing in sections 
 252.40 to 252.46 absolves intermediate care facilities for 
 persons with mental retardation or related conditions of the 
 responsibility for providing active treatment and habilitation 
 under federal regulations with which those facilities must 
 comply to be certified by the Minnesota department of health. 

    HIST: 1987 c 403 art 5 s 8; 1997 c 7 art 1 s 96 

     252.41 Definitions. 

    Subdivision 1.    Scope.  The definitions in this 
 section apply to sections 252.40 to 252.46. 

    Subd. 2.    Commissioner.  "Commissioner" means the 
 commissioner of the department of human services. 

    Subd. 3.    Day training and habilitation services for 
 adults with mental retardation, related conditions.  "Day 
 training and habilitation services for adults with mental 
 retardation and related conditions" means services that: 

    (1) include supervision, training, assistance, and 
 supported employment, work-related activities, or other 
 community-integrated activities designed and implemented in 
 accordance with the individual service and individual 
 habilitation plans required under Minnesota Rules, parts 
 9525.0015 to 9525.0165, to help an adult reach and maintain the 
 highest possible level of independence, productivity, and 
 integration into the community; 

    (2) are provided under contract with the county where the 
 services are delivered by a vendor licensed under sections 
 245A.01 to 245A.16 and 252.28, subdivision 2, to provide day 
 training and habilitation services; and 

    (3) are regularly provided to one or more adults with 
 mental retardation or related conditions in a place other than 
 the adult's own home or residence unless medically 
 contraindicated. 

    Day training and habilitation services reimbursable under 
 this section do not include special education and related 
 services as defined in the Education of the Handicapped Act, 
 United States Code, title 20, chapter 33, section 1401, clauses 
 (6) and (17), or vocational services funded under section 110 of 
 the Rehabilitation Act of 1973, United States Code, title 29, 
 section 720, as amended.  

    Subd. 4.    Independence.  "Independence" means the 
 extent to which persons with mental retardation or related 
 conditions exert control and choice over their own lives. 

    Subd. 5.    Integration.  "Integration" means that 
 persons with mental retardation and related conditions: 

    (1) use the same community resources that are used by and 
 available to individuals who are not disabled; 

    (2) participate in the same community activities in which 
 nondisabled individuals participate; and 

    (3) regularly interact and have contact with nondisabled 
 individuals. 

    Subd. 6.    Productivity.  "Productivity" means that 
 persons with mental retardation or a related condition: 

    (1) engage in income-producing work designed to improve 
 their income level, employment status, or job advancement; or 

    (2) engage in activities that contribute to a business, 
 household, or community. 

    Subd. 7.    Regional center.  "Regional center" means 
 any one of the seven state-operated facilities under the direct 
 administrative authority of the commissioner that serve persons 
 with mental retardation and related conditions.  The following 
 facilities are regional centers:  Brainerd Regional Human 
 Services Center; Cambridge Regional Treatment Center; Faribault 
 Regional Center; Fergus Falls Regional Treatment Center; Moose 
 Lake Regional Treatment Center; St. Peter Regional Treatment 
 Center; and Willmar Regional Treatment Center. 

    Subd. 8.    Supported employment.  "Supported employment"
 means employment of a person with a disability so severe that 
 the person needs ongoing training and support to get and keep a 
 job in which: 

    (1) the person engages in paid work at a work site where 
 individuals without disabilities who do not require public 
 subsidies also may be employed; 

    (2) public funds are necessary to provide ongoing training 
 and support services throughout the period of the person's 
 employment; and 

    (3) the person has the opportunity for social interaction 
 with individuals who do not have disabilities and who are not 
 paid caregivers. 

    Subd. 9.    Vendor.  "Vendor" means a nonprofit legal 
 entity that: 

    (1) is licensed under sections 245A.01 to 245A.16 and 
 252.28, subdivision 2, to provide day training and habilitation 
 services to adults with mental retardation and related 
 conditions; and 

    (2) does not have a financial interest in the legal entity 
 that provides residential services to the same person or persons 
 to whom it provides day training and habilitation services.  
 This clause does not apply to regional treatment centers, 
 state-operated, community-based programs operating according to 
 section 252.50 until July 1, 2000, or vendors licensed prior to 
 April 15, 1983. 

    HIST: 1987 c 403 art 5 s 9; 1988 c 532 s 2; 1989 c 209 art 2 s 
 1; 1989 c 282 art 6 s 20; 1Sp1993 c 1 art 4 s 3; 1997 c 7 art 1 
 s 97 

     252.42 Service principles. 

    The design and delivery of services eligible for 
 reimbursement under the rates established in section 252.46 
 should reflect the following principles: 

    (1) Services must suit a person's chronological age and be 
 provided in the least restrictive environment possible, 
 consistent with the needs identified in the person's individual 
 service and individual habilitation plans under Minnesota Rules, 
 parts 9525.0015 to 9525.0165. 

    (2) A person with mental retardation or a related condition 
 whose individual service and individual habilitation plans 
 authorize employment or employment-related activities shall be 
 given the opportunity to participate in employment and 
 employment-related activities in which nondisabled persons 
 participate. 

    (3) A person with mental retardation or a related condition 
 participating in work shall be paid wages commensurate with the 
 rate for comparable work and productivity except as regional 
 centers are governed by section 246.151. 

    (4) A person with mental retardation or a related condition 
 shall receive services which include services offered in 
 settings used by the general public and designed to increase the 
 person's active participation in ordinary community activities. 

    (5) A person with mental retardation or a related condition 
 shall participate in the patterns, conditions, and rhythms of 
 everyday living and working that are consistent with the norms 
 of the mainstream of society. 

    HIST: 1987 c 403 art 5 s 10 

     252.43 Commissioner's duties. 

    The commissioner shall supervise county boards' provision 
 of day training and habilitation services to adults with mental 
 retardation and related conditions.  The commissioner shall: 

    (1) determine the need for day training and habilitation 
 services under section 252.28; 

    (2) approve payment rates established by a county under 
 section 252.46, subdivision 1; 

    (3) adopt rules for the administration and provision of day 
 training and habilitation services under sections 252.40 to 
 252.46 and sections 245A.01 to 245A.16 and 252.28, subdivision 
 2; 

    (4) enter into interagency agreements necessary to ensure 
 effective coordination and provision of day training and 
 habilitation services; 

    (5) monitor and evaluate the costs and effectiveness of day 
 training and habilitation services; and 

    (6) provide information and technical help to county boards 
 and vendors in their administration and provision of day 
 training and habilitation services. 

    HIST: 1987 c 403 art 5 s 11; 1989 c 209 art 2 s 1; 1997 c 7 
 art 1 s 98 

     252.431 Supported employment services; departmental 
  duties; coordination. 

    The commissioners of economic security, human services, and 
 children, families, and learning shall ensure that supported 
 employment services provided as part of a comprehensive service 
 system will: 

    (1) provide the necessary supports to assist persons with 
 severe disabilities to obtain and maintain employment in 
 normalized work settings available to the general work force 
 that: 

    (i) maximize community and social integration; and 

    (ii) provide job opportunities that meet the individual's 
 career potential and interests; 

    (2) allow persons with severe disabilities to actively 
 participate in the planning and delivery of community-based 
 employment services at the individual, local, and state level; 
 and 

    (3) be coordinated among the departments of human services, 
 economic security, and children, families, and learning to: 

    (i) promote the most efficient and effective funding; 

    (ii) avoid duplication of services; and 

    (iii) improve access and transition to employability 
 services. 

    The commissioners of economic security, human services, and 
 children, families, and learning shall report to the legislature 
 by January 1993 on the steps taken to implement this section.  

    HIST: 1992 c 459 s 1; 1994 c 483 s 1; 1Sp1995 c 3 art 16 s 13 

     252.44 County board responsibilities. 

    (a) When the need for day training and habilitation 
 services in a county has been determined under section 252.28, 
 the board of commissioners for that county shall: 

    (1) authorize the delivery of services according to the 
 individual service and habilitation plans required as part of 
 the county's provision of case management services under 
 Minnesota Rules, parts 9525.0015 to 9525.0165.  For calendar 
 years for which section 252.46, subdivisions 2 to 10, apply, the 
 county board shall not authorize a change in service days from 
 the number of days authorized for the previous calendar year 
 unless there is documentation for the change in the individual 
 service plan.  An increase in service days must also be 
 supported by documentation that the goals and objectives 
 assigned to the vendor cannot be met more economically and 
 effectively by other available community services and that 
 without the additional days of service the individual service 
 plan could not be implemented in a manner consistent with the 
 service principles in section 252.42; 

    (2) contract with licensed vendors, as specified in 
 paragraph (b), under sections 256E.01 to 256E.12 and 256B.092 
 and rules adopted under those sections; 

    (3) ensure that transportation is provided or arranged by 
 the vendor in the most efficient and reasonable way possible; 

    (4) set payment rates under section 252.46; 

    (5) monitor and evaluate the cost and effectiveness of the 
 services; and 

    (6) reimburse vendors for the provision of authorized 
 services according to the rates, procedures, and regulations 
 governing reimbursement. 

    (b) With all vendors except regional centers, the contract 
 must include the approved payment rates, the projected budget 
 for the contract period, and any actual expenditures of previous 
 and current contract periods.  With all vendors, including 
 regional centers, the contract must also include the amount, 
 availability, and components of day training and habilitation 
 services to be provided, the performance standards governing 
 service provision and evaluation, and the time period in which 
 the contract is effective. 

    HIST: 1987 c 403 art 5 s 12 

     252.45 Vendor's duties. 

    A vendor's responsibility under clauses (1), (2), and (3) 
 extends only to the provision of services that are reimbursable 
 under state and federal law.  A vendor under contract with a 
 county board to provide day training and habilitation services 
 shall: 

    (1) provide the amount and type of services authorized in 
 the individual service plan under Minnesota Rules, parts 
 9525.0015 to 9525.0165; 

    (2) design the services to achieve the outcomes assigned to 
 the vendor in the individual service plan; 

    (3) provide or arrange for transportation of persons 
 receiving services to and from service sites; 

    (4) enter into agreements with community-based intermediate 
 care facilities for persons with mental retardation and related 
 conditions to ensure compliance with applicable federal 
 regulations; and 

    (5) comply with state and federal law. 

    HIST: 1987 c 403 art 5 s 13; 1991 c 292 art 6 s 58 subd 2 

     252.451 Agreements with businesses to provide support 
  and supervision of persons with mental retardation or related 
  conditions in community-based employment. 

    Subdivision 1.    Definition.  For the purposes of this 
 section, "qualified business" means a business that employs 
 primarily nondisabled persons and will employ persons with 
 mental retardation or related conditions.  For purposes of this 
 section, licensed providers of residential services for persons 
 with mental retardation or related conditions are not a 
 qualified business.  A qualified business and its employees are 
 exempt from Minnesota Rules, parts 9525.1500 to 9525.1690 and 
 9525.1800 to 9525.1930. 

    Subd. 2.    Vendor participation and reimbursement.  
 Notwithstanding requirements in chapter 245A, and sections 
 252.28, 252.40 to 252.46, and 256B.501, vendors of day training 
 and habilitation services may enter into written agreements with 
 qualified businesses to provide additional training and 
 supervision needed by individuals to maintain their employment. 

    Subd. 3.    Agreement specifications.  Agreements must 
 include the following: 

    (1) the type and amount of supervision and support to be 
 provided by the business to the individual in accordance with 
 their needs as identified in their individual service plan; 

    (2) the methods used to periodically assess the 
 individual's satisfaction with their work, training, and 
 support; 

    (3) the measures taken by the qualified business and the 
 vendor to ensure the health, safety, and protection of the 
 individual during working hours, including the reporting of 
 abuse and neglect under state law and rules; 

    (4) the training and support services the vendor will 
 provide to the qualified business, including the frequency of 
 on-site supervision and support; and 

    (5) any payment to be made to the qualified business by the 
 vendor.  Payment to the business must be limited to: 

    (i) additional costs of training coworkers and managers 
 that exceed ordinary and customary training costs and are a 
 direct result of employing a person with mental retardation or a 
 related condition; and 

    (ii) additional costs for training, supervising, and 
 assisting the person with mental retardation or a related 
 condition that exceed normal and customary costs required for 
 performing similar tasks or duties. 

    Payments made to a qualified business under this section 
 must not include incentive payments to the qualified business or 
 salary supplementation for the person with mental retardation or 
 a related condition. 

    Subd. 4.    Client protection.  Persons receiving 
 training and support under this section may not be denied their 
 rights or procedural protections under section 256.045, 
 subdivision 4a, or 256B.092, including the county agency's 
 responsibility to arrange for appropriate services, as 
 necessary, in the event that persons lose their job or the 
 contract with the qualified business is terminated. 

    Subd. 5.    Vendor payment.  (a) For purposes of this 
 section, the vendor shall bill and the commissioner shall 
 reimburse the vendor for full-day or partial-day services to a 
 client that would otherwise have been paid to the vendor for 
 providing direct services, provided that both of the following 
 criteria are met: 

    (1) the vendor provides services and payments to the 
 qualified business that enable the business to perform support 
 and supervision services for the client that the vendor would 
 otherwise need to perform; and 

    (2) the client for whom a rate will be billed will receive 
 full-day or partial-day services from the vendor and the rate to 
 be paid the vendor will allow the client to work with this 
 support and supervision at the qualified business instead of 
 receiving these services from the vendor. 

    (b) Medical assistance reimbursement of services provided 
 to persons receiving day training and habilitation services 
 under this section is subject to the limitations on 
 reimbursement for vocational services under federal law and 
 regulation. 

    HIST: 1Sp1993 c 1 art 4 s 4; 1Sp1993 c 6 s 41; 1998 c 284 s 1 

  252.452 Expired April 25 1994 

     252.46 Payment rates. 

    Subdivision 1.    Rates.  (a) Payment rates to vendors, 
 except regional centers, for county-funded day training and 
 habilitation services and transportation provided to persons 
 receiving day training and habilitation services established by 
 a county board are governed by subdivisions 2 to 19.  The 
 commissioner shall approve the following three payment rates for 
 services provided by a vendor: 

    (1) a full-day service rate for persons who receive at 
 least six service hours a day, including the time it takes to 
 transport the person to and from the service site; 

    (2) a partial-day service rate that must not exceed 75 
 percent of the full-day service rate for persons who receive 
 less than a full day of service; and 

    (3) a transportation rate for providing, or arranging and 
 paying for, transportation of a person to and from the person's 
 residence to the service site.  

    (b) The commissioner may also approve an hourly job-coach, 
 follow-along rate for services provided by one employee at or en 
 route to or from community locations to supervise, support, and 
 assist one person receiving the vendor's services to learn 
 job-related skills necessary to obtain or retain employment when 
 and where no other persons receiving services are present and 
 when all the following criteria are met: 

    (1) the vendor requests and the county recommends the 
 optional rate; 

    (2) the service is prior authorized by the county on the 
 Medicaid Management Information System for no more than 414 
 hours in a 12-month period and the daily per person charge to 
 medical assistance does not exceed the vendor's approved full 
 day plus transportation rates; 

    (3) separate full day, partial day, and transportation 
 rates are not billed for the same person on the same day; 

    (4) the approved hourly rate does not exceed the sum of the 
 vendor's current average hourly direct service wage, including 
 fringe benefits and taxes, plus a component equal to the 
 vendor's average hourly nondirect service wage expenses; and 

    (5) the actual revenue received for provision of hourly 
 job-coach, follow-along services is subtracted from the vendor's 
 total expenses for the same time period and those adjusted 
 expenses are used for determining recommended full day and 
 transportation payment rates under subdivision 5 in accordance 
 with the limitations in subdivision 3. 

    (c) Medical assistance rates for home and community-based 
 service provided under section 256B.501, subdivision 4, by 
 licensed vendors of day training and habilitation services must 
 not be greater than the rates for the same services established 
 by counties under sections 252.40 to 252.46.  For very dependent 
 persons with special needs the commissioner may approve an 
 exception to the approved payment rate under section 256B.501, 
 subdivision 4 or 8. 

    Subd. 2.    Rate minimum.  Unless a variance is granted 
 under subdivision 6, the minimum payment rates set by a county 
 board for each vendor must be equal to the payment rates 
 approved by the commissioner for that vendor in effect January 1 
 of the previous calendar year. 

    Subd. 3.    Rate maximum.  Unless a variance is granted 
 under subdivision 6, the maximum payment rates for each vendor 
 for a calendar year must be equal to the payment rates approved 
 by the commissioner for that vendor in effect December 1 of the 
 previous calendar year.  The commissioner of finance shall 
 include as a budget change request in each biennial detailed 
 expenditure budget submitted to the legislature under section 
 16A.11 annual inflation adjustments in reimbursement rates for 
 each vendor, based upon the projected percentage change in the 
 urban consumer price index, all items, published by the United 
 States Department of Labor, for the upcoming calendar year over 
 the current calendar year.  

    Subd. 4.    New vendors.  (a) Payment rates established 
 by a county for a new vendor for which there were no previous 
 rates must not exceed 95 percent of the greater of 125 percent 
 of the statewide median rates or 125 percent of the average 
 payment rates in the regional development commission district 
 under sections 462.381 to 462.396 in which the new vendor is 
 located unless the criteria in paragraph (b) are met.  

    (b) A payment rate equal to 200 percent of the statewide 
 average rates shall be assigned to persons served by the new 
 vendor when those persons are persons with very severe 
 self-injurious or assaultive behaviors, persons with medical 
 conditions requiring delivery of physician-prescribed medical 
 interventions at one-to-one staffing for at least 15 minutes 
 each time they are performed, or persons discharged from a 
 regional treatment center after May 1, 1993, to the vendor's 
 program.  All other persons for whom the new service is needed 
 must be assigned a rate equal to 95 percent of the greater of 
 125 percent of the statewide median rates or 125 percent of the 
 regional average rates, whichever is higher, and the maximum 
 payment rate that may be recommended is determined by 
 multiplying the number of clients at each limit by the rate 
 corresponding to that limit and dividing the sum by the total 
 number of clients.  When the recommended payment rates exceed 95 
 percent of 125 percent of the greater of the statewide median or 
 regional average rates, whichever is higher, the county must 
 include documentation verifying the medical or behavioral needs 
 of clients.  The approved payment rates must be based on 12 
 months budgeted expenses divided by at least 90 percent of 
 authorized service units associated with the new vendor's 
 licensed capacity.  The county must include documentation 
 verifying the person's discharge from a regional treatment 
 center and that admission of new clients to existing services 
 eligible for a rate variance under subdivision 6 was considered 
 before recommending payment rates for a new vendor.  Nothing in 
 this subdivision permits development of a new program that 
 primarily results in refinancing of services for individuals 
 already receiving services in existing programs. 

    Subd. 5.    Submitting recommended rates.  The county 
 board shall submit recommended payment rates to the commissioner 
 on forms supplied by the commissioner at least 60 days before 
 revised payment rates or payment rates for new vendors are to be 
 effective.  The forms must include the county board's written 
 verification of the individual documentation required under 
 section 252.44, clause (a).  If a vendor provides services at 
 more than one licensed site, the county board may recommend the 
 same payment rates for each site based on the average rate for 
 all sites.  The county board may also recommend differing 
 payment rates for each licensed site if it would result in a 
 total annual payment to the vendor that is equal to or less than 
 the total annual payment that would result if the average rates 
 had been used for all sites.  For purposes of this subdivision, 
 the average payment rate for all service sites used by a vendor 
 must be computed by adding the amounts that result when the 
 payment rates for each licensed site are multiplied by the 
 projected annual number of service units to be provided at that 
 site and dividing the sum of those amounts by the total units of 
 service to be provided by the vendor at all sites. 

    Subd. 6.    Variances.  (a) A variance from the minimum 
 or maximum payment rates in subdivisions 2 and 3 may be granted 
 by the commissioner when the vendor requests and the county 
 board submits to the commissioner a written variance request on 
 forms supplied by the commissioner with the recommended payment 
 rates. 

    (b) A variance to the rate maximum may be utilized for 
 costs associated with compliance with state administrative 
 rules, compliance with court orders, capital costs required for 
 continued licensure, increased insurance costs, start-up and 
 conversion costs for supported employment, direct service staff 
 salaries and benefits, transportation, and other program related 
 costs when one of the criterion in clauses (1) to (4) is also 
 met: 

    (1) A determination of need under section 252.28 is 
 approved for a significant program change that is necessary for 
 a vendor to provide authorized services to one or more clients 
 who meet one or more of the following criteria: 

    (A) the client is a new client and: 

    (i) exhibits severe behavior as indicated on the screening 
 document; 

    (ii) periodically requires one-to-one staff time for at 
 least 15 minutes at a time to deliver physician prescribed 
 medical interventions; or 

    (iii) has been discharged directly to the vendor's program 
 from a regional treatment center or the Minnesota extended 
 treatment option. 

    (B) the client is an existing client who has developed one 
 of the following changed circumstances which increases costs 
 that are not covered by the vendor's current rate, and for whom 
 a significant program change is necessary to ensure the 
 continued provision of authorized services to that client: 

    (i) severe behavior as indicated on the screening document; 

    (ii) a medical condition periodically requiring one-to-one 
 staff time for at least 15 minutes at a time to deliver 
 physician prescribed medical interventions; or 

    (iii) a permanent decrease in skill functioning, as 
 verified by medical reports or assessments; 

    (2) A licensing determination requires a program change 
 that the vendor cannot comply with due to funding restraints; 

    (3) A determination of need under section 252.28 is 
 approved for a significant and permanent decrease in licensed 
 capacity and the vendor demonstrates the need to retain certain 
 staffing levels to serve the remaining clients; or 

    (4) In cases where conditions in clauses (1) to (3) do not 
 apply, but a determination of need under section 252.28 is 
 approved for an unusual circumstance which exists that 
 significantly impacts the type or amount of services delivered, 
 as evidenced by documentation presented by the vendor and with 
 the concurrence of the commissioner.  

    (c) A variance to the rate minimum may be granted when: 

    (1) the county board contracts for increased services from 
 a vendor and for some or all individuals receiving services from 
 the vendor lower per unit fixed costs result; or 

    (2) the actual costs of delivering authorized service over 
 a 12-month contract period have decreased. 

    (d) The written variance request under this subdivision 
 must include documentation that all the following criteria have 
 been met: 

    (1) The commissioner and the county board have both 
 conducted a review and have identified a need for a change in 
 the payment rates and recommended an effective date for the 
 change in the rate. 

    (2) The vendor documents efforts to reallocate current 
 staff and any additional staffing needs cannot be met by using 
 temporary special needs rate exceptions under Minnesota Rules, 
 parts 9510.1020 to 9510.1140. 

    (3) The vendor documents that financial resources have been 
 reallocated before applying for a variance.  No variance may be 
 granted for equipment, supplies, or other capital expenditures 
 when depreciation expense for repair and replacement of such 
 items is part of the current rate. 

    (4) For variances related to loss of clientele, the vendor 
 documents the other program and administrative expenses, if any, 
 that have been reduced. 

    (5) The county board submits verification of the conditions 
 for which the variance is requested, a description of the nature 
 and cost of the proposed changes, and how the county will 
 monitor the use of money by the vendor to make necessary changes 
 in services.  

    (6) The county board's recommended payment rates do not 
 exceed 95 percent of the greater of 125 percent of the current 
 statewide median or 125 percent of the regional average payment 
 rates, whichever is higher, for each of the regional commission 
 districts under sections 462.381 to 462.396 in which the vendor 
 is located except for the following:  when a variance is 
 recommended to allow authorized service delivery to new clients 
 with severe behaviors or with medical conditions requiring 
 delivery of physician prescribed medical interventions, or to 
 persons being directly discharged from a regional treatment 
 center or Minnesota extended treatment options to the vendor's 
 program, those persons must be assigned a payment rate of 200 
 percent of the current statewide average rates.  All other 
 clients receiving services from the vendor must be assigned a 
 payment rate equal to the vendor's current rate unless the 
 vendor's current rate exceeds 95 percent of 125 percent of the 
 statewide median or 125 percent of the regional average payment 
 rates, whichever is higher.  When the vendor's rates exceed 95 
 percent of 125 percent of the statewide median or 125 percent of 
 the regional average rates, the maximum rates assigned to all 
 other clients must be equal to the greater of 95 percent of 125 
 percent of the statewide median or 125 percent of the regional 
 average rates.  The maximum payment rate that may be recommended 
 for the vendor under these conditions is determined by 
 multiplying the number of clients at each limit by the rate 
 corresponding to that limit and then dividing the sum by the 
 total number of clients. 

    (e) The commissioner shall have 60 calendar days from the 
 date of the receipt of the complete request to accept or reject 
 it, or the request shall be deemed to have been granted.  If the 
 commissioner rejects the request, the commissioner shall state 
 in writing the specific objections to the request and the 
 reasons for its rejection. 

    Subd. 7.    Rate reconsiderations.  A host county that 
 disagrees with a rate decision of the commissioner under 
 subdivision 6 or 9 may request reconsideration by the 
 commissioner within 45 days after the date the host county 
 received notification of the commissioner's decision.  The 
 request must state the reasons why the host county is requesting 
 reconsideration of the rate decision and present evidence 
 explaining the host county's disagreement with the rate decision.

    The commissioner shall review the host county's evidence 
 and provide the host county with written notification of the 
 decision on the request within 60 days.  The commissioner's 
 decision on the request is final.  

    Until a reconsideration request is decided, payments must 
 continue at a rate the commissioner determines complies with 
 this section.  If a higher rate is approved, the commissioner 
 shall order a retroactive payment as determined in the 
 commissioner's decision. 

    Subd. 8.    Commissioner's notice to boards, vendors.  
 The commissioner shall notify the county boards and vendors of 
 the average regional payment rates, 95 percent of 125 percent of 
 the average regional payments rates for each of the regional 
 development commission districts designated in sections 462.381 
 to 462.396, 95 percent of 125 percent of the statewide median 
 rates, and 200 percent of the statewide average rates. 

    Subd. 9.    Approval or denial of rates.  The 
 commissioner shall approve the county board's recommended 
 payment rates when the rates and verification justifying the 
 projected service units comply with subdivisions 2 to 18.  The 
 commissioner shall notify the county board in writing of the 
 approved payment rates within 60 days of receipt of the rate 
 recommendations.  If the rates are not approved, or if rates 
 different from those originally recommended are approved, the 
 commissioner shall within 60 days of receiving the rate 
 recommendation notify the county board in writing of the reasons 
 for denying or substituting a different rate for the recommended 
 rates.  Approved payment rates remain effective until the 
 commissioner approves different rates in accordance with 
 subdivisions 2 and 3. 

    Subd. 10.    Vendor's report; audit.  The vendor shall 
 report to the commissioner and the county board on forms 
 prescribed by the commissioner at times specified by the 
 commissioner.  The reports shall include programmatic and fiscal 
 information.  Fiscal information shall be provided in an annual 
 audit that complies with the requirements of Minnesota Rules, 
 parts 9550.0010 to 9550.0092.  The audit must be done according 
 to generally accepted auditing standards to result in statements 
 that include a balance sheet, income statement, changes in 
 financial position, and the certified public accountant's 
 opinion.  The county's annual audit shall satisfy the audit 
 required under this subdivision for any county-operated day 
 training and habilitation program.  Except for day training and 
 habilitation programs operated by a county, the audit must 
 provide supplemental statements for each day training and 
 habilitation program with an approved unique set of rates. 

    Subd. 11.    Improper transactions.  Transactions that 
 have the effect of circumventing subdivisions 1 to 18 must not 
 be considered by the commissioner for the purpose of payment 
 rate approval under the principle that the substance of the 
 transaction prevails over the form. 

    Subd. 12. Repealed, 1Sp1993 c 1 art 4 s 14 

    Subd. 13. Repealed, 1Sp1993 c 1 art 4 s 14 

    Subd. 14. Repealed, 1Sp1993 c 1 art 4 s 14 

    Subd. 15. Repealed, 1992 c 513 art 9 s 44 

    Subd. 16.    Payment rate criteria; allocation of 
 expenditures.  Payment rates approved under subdivision 9 must 
 reflect the payment rate criteria in paragraphs (a) and (b) and 
 the allocation principles in paragraph (c). 

    (a) Payment rates must be based on reasonable costs that 
 are ordinary, necessary, and related to delivery of authorized 
 client services. 

    (b) The commissioner shall not pay for:  (i) unauthorized 
 service delivery; (ii) services provided in accordance with 
 receipt of a special grant; (iii) services provided under 
 contract to a local school district; (iv) extended employment 
 services under Minnesota Rules, parts 3300.1950 to 3300.3050, or 
 vocational rehabilitation services provided under Title I, 
 section 110 or Title VI-C, Rehabilitation Act Amendments of 
 1992, as amended, and not through use of medical assistance or 
 county social service funds; or (v) services provided to a 
 client by a licensed medical, therapeutic, or rehabilitation 
 practitioner or any other vendor of medical care which are 
 billed separately on a fee for service basis. 

    (c) On an annual basis, actual and projected contract year 
 expenses must be allocated to standard budget line items 
 corresponding to direct and other program and administrative 
 expenses as submitted to the commissioner with the host county's 
 recommended payment rates.  Central or corporate office costs 
 must be allocated to licensed vendor sites within the group 
 served by the central or corporate office according to the cost 
 allocation principles under section 256B.432. 

    (d) The vendor must maintain records documenting that 
 clients received the billed services. 

    Subd. 17.    Hourly rate structure.  Counties 
 participating as host counties under the pilot study of hourly 
 rates established under Laws 1988, chapter 689, article 2, 
 section 117, may recommend continuation of the hourly rates for 
 participating vendors.  The recommendation must be made annually 
 under subdivision 5 and according to the methods and standards 
 provided by the commissioner.  The commissioner shall approve 
 the hourly rates when service authorization, billing, and 
 payment for services is possible through the Medicaid management 
 information system and the other criteria in this subdivision 
 are met.  Counties and vendors operating under the pilot study 
 of hourly rates established under Laws 1988, chapter 689, 
 article 2, section 117, shall work with the commissioner to 
 translate the hourly rates and actual expenditures into rates 
 meeting the criteria in subdivisions 1 to 16 unless hourly rates 
 are approved under this subdivision.  If the rates meeting the 
 criteria in subdivisions 1 to 16 are lower than the county's or 
 vendor's current rate, the county or vendor must continue to 
 receive the current rate. 

    Subd. 18.    Pilot study rates.  By January 1, 1994, 
 counties and vendors operating under the pilot study of hourly 
 rates established under Laws 1988, chapter 689, article 2, 
 section 117, shall work with the commissioner to translate the 
 hourly rates and actual expenditures into rates meeting the 
 criteria in subdivisions 1 to 16 unless hourly rates are 
 approved under subdivision 17. 

    Subd. 19.    Vendor appeals.  With the concurrence of 
 the county board, a vendor may appeal the commissioner's 
 rejection of a variance request which has been submitted by the 
 county under subdivision 6 and may appeal the commissioner's 
 denial under subdivision 9 of a rate which has been recommended 
 by the county.  To appeal, the vendor and county board must file 
 a written notice of appeal with the commissioner.  The notice of 
 appeal must be filed or received by the commissioner within 45 
 days of the postmark date on the commissioner's notification to 
 the vendor and county agency that a variance request or county 
 recommended rate has been denied.  The notice of appeal must 
 specify the reasons for the appeal, the dollar amount in 
 dispute, and the basis in statute or rule for challenging the 
 commissioner's decision. 

    Within 45 days of receipt of the notice of appeal, the 
 commissioner must convene a reconciliation conference to attempt 
 to resolve the rate dispute.  If the dispute is not resolved to 
 the satisfaction of the parties, the parties may initiate a 
 contested case proceeding under sections 14.57 to 14.69.  In a 
 contested case hearing held under this section, the appealing 
 party must demonstrate by a preponderance of the evidence that 
 the commissioner incorrectly applied the governing law or 
 regulations, or that the commissioner improperly exercised the 
 commissioner's discretion, in refusing to grant a variance or in 
 refusing to adopt a county recommended rate. 

    Until the appeal is fully resolved, payments must continue 
 at the existing rate pending the appeal.  Retroactive payments 
 consistent with the final decision shall be made after the 
 appeal is fully resolved. 

    Subd. 20.    Study of day training and habilitation 
 vendors.  The commissioner shall study the feasibility of 
 grouping vendors of similar size, location, direct service 
 staffing needs or performance outcomes to establish payment rate 
 limits that define cost-effective service.  Based on the 
 conclusions of the feasibility study the department shall 
 consider developing a method to redistribute dollars from less 
 cost-effective to more cost-effective services based on vendor 
 achievement of performance outcomes.  The department shall 
 report to the legislature by January 15, 1996, with results of 
 the study and recommendations for further action.  The 
 department shall consult with an advisory committee representing 
 counties, service consumers, vendors, and the legislature. 

    HIST: 1987 c 403 art 5 s 14; 1988 c 532 s 3-8; 1988 c 689 art 
 2 s 114-117; 1989 c 282 art 2 s 93-98; 1990 c 568 art 3 s 8-12; 
 1991 c 292 art 4 s 9-11; art 6 s 40; 1992 c 513 art 7 s 12; 
 1Sp1993 c 1 art 4 s 6; 1Sp1993 c 6 s 42; 1995 c 207 art 3 s 
 6-11; 1997 c 7 art 1 s 99; 1997 c 36 s 1; 1999 c 245 art 5 s 11 

  252.47 Repealed, 1995 c 207 art 7 s 43 

  252.478 Repealed, 1Sp1993 c 1 art 5 s 134 

     252.50 State-operated programs. 

    Subdivision 1.    Community-based programs established.  
 The commissioner shall establish a system of state-operated, 
 community-based programs for persons with mental retardation or 
 related conditions.  For purposes of this section, 
 "state-operated, community-based program" means a program 
 administered by the state to provide treatment and habilitation 
 in noninstitutional community settings to persons with mental 
 retardation or related conditions.  Employees of the programs 
 must be state employees under chapters 43A and 179A.  The 
 establishment of state-operated, community-based programs must 
 be within the context of a comprehensive definition of the role 
 of state-operated services in the state.  The role of 
 state-operated services must be defined within the context of a 
 comprehensive system of services for persons with mental 
 retardation or related conditions.  State-operated, 
 community-based programs may include, but are not limited to, 
 community group homes, foster care, supportive living services, 
 day training and habilitation programs, and respite care 
 arrangements.  The commissioner may operate the pilot projects 
 established under Laws 1985, First Special Session chapter 9, 
 article 1, section 2, subdivision 6, and shall, within the 
 limits of available appropriations, establish additional 
 state-operated, community-based programs for persons with mental 
 retardation or related conditions.  State-operated, 
 community-based programs may accept admissions from regional 
 treatment centers, from the person's own home, or from community 
 programs.  State-operated, community-based programs offering day 
 program services may be provided for persons with mental 
 retardation or related conditions who are living in 
 state-operated, community-based residential programs until July 
 1, 2000.  No later than 1994, the commissioner, together with 
 family members, counties, advocates, employee representatives, 
 and other interested parties, shall begin planning so that by 
 July 1, 2000, state-operated, community-based residential 
 facilities will be in compliance with section 252.41, 
 subdivision 9. 

    Subd. 2.    Authorization to build or purchase.  Within 
 the limits of available appropriations, the commissioner may 
 build, purchase, or lease suitable buildings for state-operated, 
 community-based programs.  The commissioner must develop the 
 state-operated community residential facilities authorized in 
 the worksheets of the house appropriations and senate finance 
 committees.  If financing through state general obligation bonds 
 is not available, the commissioner shall finance the purchase or 
 construction of state-operated, community-based facilities with 
 the Minnesota housing finance agency.  The commissioner shall 
 make payments through the department of administration to the 
 Minnesota housing finance agency in repayment of mortgage loans 
 granted for the purposes of this section.  Programs must be 
 adaptable to the needs of persons with mental retardation or 
 related conditions and residential programs must be homelike. 

    Subd. 2a.    Use of enhanced waivered services funds.  
 The commissioner may, within the limits of appropriations made 
 available for this purpose, use enhanced waivered services funds 
 under the home and community-based waiver for persons with 
 mental retardation or related conditions to move to 
 state-operated community programs and to private facilities. 

    Subd. 3.    Alternative funding mechanisms.  To the 
 extent possible, the commissioner may amend the medical 
 assistance home and community-based waiver and, as appropriate, 
 develop special waiver procedures for targeting services to 
 persons currently in state regional treatment centers.  

    Subd. 4.    Counties.  State-operated, community-based 
 programs may be developed in conjunction with existing county 
 responsibilities and authorities for persons with mental 
 retardation or related conditions.  Assessment, placement, 
 screening, case management responsibilities, and determination 
 of need procedures must be consistent with county 
 responsibilities established under law and rule.  Counties may 
 enter into shared service agreements with state-operated 
 programs. 

    Subd. 5.    Location of programs.  (a) In determining 
 the location of state-operated, community-based programs, the 
 needs of the individual client shall be paramount.  The 
 commissioner shall also take into account:  

    (1) the personal preferences of the persons being served 
 and their families as determined by Minnesota Rules, parts 
 9525.0015 to 9525.0165; 

    (2) location of the support services established by the 
 individual service plans of the persons being served; 

    (3) the appropriate grouping of the persons served; 

    (4) the availability of qualified staff; 

    (5) the need for state-operated, community-based programs 
 in the geographical region of the state; and 

    (6) a reasonable commuting distance from a regional 
 treatment center or the residences of the program staff. 

    (b) State-operated, community-based programs must be 
 located according to section 252.28. 

    Subd. 6.    Rates for state-operated, community-based 
 programs.  State-operated, community-based programs that meet 
 the definition of a facility in Minnesota Rules, part 9553.0020, 
 subpart 19, must be reimbursed consistent with Minnesota Rules, 
 parts 9553.0010 to 9553.0080.  State-operated, community-based 
 programs that meet the definition of vendor in section 252.41, 
 subdivision 9, must be reimbursed consistent with the rate 
 setting procedures in sections 252.41 to 252.46 and Minnesota 
 Rules, parts 9525.1200 to 9525.1330.  This subdivision does not 
 operate to abridge the statutorily created pension rights of 
 state employees or collective bargaining agreements reached 
 pursuant to chapter 179A. 

    Subd. 7.    Crisis services.  Within the limits of 
 appropriations, state-operated regional technical assistance 
 must be available in each region to assist counties, residential 
 and day programming staff, and families to prevent or resolve 
 crises that could lead to a change in placement.  Crisis 
 capacity must be provided on all regional treatment center 
 campuses serving persons with developmental disabilities.  In 
 addition, crisis capacity may be developed to serve 16 persons 
 in the Twin Cities metropolitan area.  Technical assistance and 
 consultation must also be available in each region to providers 
 and counties.  Staff must be available to provide: 

    (1) individual assessments; 

    (2) program plan development and implementation assistance; 

    (3) analysis of service delivery problems; and 

    (4) assistance with transition planning, including 
 technical assistance to counties and providers to develop new 
 services, site the new services, and assist with community 
 acceptance. 

    Subd. 8.    Spiritual care services.  An organized means 
 for providing spiritual care services and follow-up may be 
 established as part of the comprehensive health care, congruent 
 with the operational philosophy of the department of human 
 services, to residents of state-operated residential facilities 
 and former residents discharged to private facilities, by 
 persons certified for ministry in specialized settings. 

    Subd. 9.    Evaluation of community-based services 
 development.  The commissioner shall develop an integrated 
 approach to assessing and improving the quality of 
 community-based services, including state-operated programs for 
 persons with developmental disabilities. 

    The commissioner shall evaluate the progress of the 
 development and quality of community-based services to determine 
 if further development can proceed.  The commissioner shall 
 report results of the evaluation to the legislature by January 
 31, 1991, and January 31, 1993. 

    Subd. 10.    Rules and licensure.  Each state-operated 
 residential and day habilitation service site shall be 
 separately licensed and movement of residents between them shall 
 be governed by applicable rules adopted by the commissioner. 

    Subd. 11.    Agreement authorized.  The agreement 
 between the commissioner of human services, the state 
 negotiator, and the bargaining representatives of state 
 employees, dated March 10, 1989, concerning the department of 
 human services plan to restructure the regional treatment 
 centers, is ratified, subject to approval by the legislative 
 commission on employee relations. 

    HIST: 1988 c 689 art 2 s 109; 1989 c 282 art 6 s 21; 1991 c 
 292 art 6 s 41; 1992 c 513 art 9 s 22; 1Sp1993 c 1 art 7 s 34; 
 1997 c 7 art 1 s 100 

     252.51 Community planning. 

    Each community where there is a regional treatment center 
 shall establish a group to work with and advise the commissioner 
 and the counties to: 

    (1) ensure community input in the development of community 
 services for persons with developmental disabilities; 

    (2) assure consideration of family concern about choice of 
 service settings; 

    (3) assist counties in recruiting new providers, 
 capitalizing, and siting new day services and residential 
 programs; 

    (4) work with the surrounding counties to coordinate 
 development of services for persons with developmental 
 disabilities; 

    (5) facilitate community education concerning services to 
 persons with developmental disabilities; 

    (6) assist in recruiting potential supported employment 
 opportunities; 

    (7) assist in developing shared services agreements among 
 providers of service; 

    (8) coordinate with the development of state-operated 
 services; and 

    (9) seek to resolve local transportation issues for people 
 with developmental disabilities. 

    Funds appropriated to the department of human services for 
 this purpose shall be transferred to the city in which the 
 regional treatment center is located upon receipt of evidence 
 from the city that such a group has been constituted and 
 designated.  The funds shall be used to defray the expenses of 
 the group. 

    The membership of each community group must reflect a broad 
 range of community interests, including, at a minimum, families 
 of persons with developmental disabilities, state employee 
 unions, providers, advocates, and counties. 

    HIST: 1989 c 282 art 6 s 22 

     252.52 Regional center and community-based facility 
  employees. 

    In accordance with section 43A.21, the commissioner shall 
 develop procedures to assure that: 

    (1) there are workers employed at state regional centers 
 and nursing homes who are skilled in the treatment of persons 
 with severe and profound mental retardation or related 
 conditions, behavioral problems, and medical needs to facilitate 
 adjustment to community living; 

    (2) suitable training programs exist for regional treatment 
 center and state-operated, community-based residential facility 
 staff; and 

    (3) state employees under the jurisdiction of the 
 commissioner who are included in a position reduction plan have 
 the option of transferring to a community-based program; to a 
 similar, comparable classification in another regional center 
 setting; or to a position in another state agency. 

    HIST: 1988 c 689 art 2 s 110 

  252.53 Repealed, 1997 c 248 s 51