as introduced - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to human services; making changes to child 1.3 care, the Minnesota family investment program, 1.4 long-term care, and health care; amending Minnesota 1.5 Statutes 2002, sections 119B.011, by adding a 1.6 subdivision; 119B.03, subdivisions 3, 6a, by adding a 1.7 subdivision; 256.955, subdivisions 2, 2b; 256B.0911, 1.8 subdivision 4a; 256J.01, subdivision 1; 256J.08, 1.9 subdivisions 73, 82a; 256J.21, subdivision 3; 1.10 256J.415; 256J.425, subdivision 5; Minnesota Statutes 1.11 2003 Supplement, sections 119B.011, subdivisions 8, 1.12 10, 20; 119B.03, subdivision 4; 119B.05, subdivision 1.13 1; 119B.09, subdivision 7; 119B.12, subdivision 2; 1.14 119B.13, subdivisions 1, 1a; 119B.189, subdivisions 2, 1.15 4; 119B.19, subdivision 1; 119B.24; 119B.25, 1.16 subdivision 2; 245A.11, subdivision 2a; 256.01, 1.17 subdivision 2; 256.046, subdivision 1; 256.955, 1.18 subdivision 2a; 256.98, subdivision 8; 256B.06, 1.19 subdivision 4; 256B.0625, subdivision 9; 256B.0915, 1.20 subdivisions 3a, 3b; 256B.431, subdivision 32; 1.21 256D.03, subdivisions 3, 4; 256J.09, subdivision 3b; 1.22 256J.24, subdivision 5; 256J.32, subdivisions 2, 8; 1.23 256J.37, subdivision 9; 256J.425, subdivisions 1, 4, 1.24 6; 256J.49, subdivision 4; 256J.515; 256J.56; 256J.57, 1.25 subdivision 1; 256J.626, subdivision 2; 256J.751, 1.26 subdivision 2; 256J.95, subdivisions 1, 3, 11, 12, 19; 1.27 repealing Minnesota Statutes 2002, sections 119B.211; 1.28 256D.051, subdivision 17; Laws 2000, chapter 489, 1.29 article 1, section 36. 1.30 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.31 ARTICLE 1 1.32 CHILD CARE; MINNESOTA FAMILY INVESTMENT PLAN 1.33 Section 1. Minnesota Statutes 2003 Supplement, section 1.34 119B.011, subdivision 8, is amended to read: 1.35 Subd. 8. [COMMISSIONER.] "Commissioner" means the 1.36 commissioner ofeducationhuman services. 1.37 Sec. 2. Minnesota Statutes 2003 Supplement, section 2.1 119B.011, subdivision 10, is amended to read: 2.2 Subd. 10. [DEPARTMENT.] "Department" means the Department 2.3 ofEducationHuman Services. 2.4 Sec. 3. Minnesota Statutes 2002, section 119B.011, is 2.5 amended by adding a subdivision to read: 2.6 Subd. 10a. [DIVERSIONARY WORK PROGRAM.] "Diversionary work 2.7 program" means the program established under section 256J.95. 2.8 Sec. 4. Minnesota Statutes 2003 Supplement, section 2.9 119B.011, subdivision 20, is amended to read: 2.10 Subd. 20. [TRANSITION YEAR FAMILIES.](a)"Transition year 2.11 families" means families who have received MFIP assistance, or 2.12 who were eligible to receive MFIP assistance after choosing to 2.13 discontinue receipt of the cash portion of MFIP assistance under 2.14 section 256J.31, subdivision 12, or families who have received 2.15 DWP assistance under section 256J.95 for at least three of the 2.16 last six months before losing eligibility for MFIP or DWP. 2.17 Transition year child care may be used to support employment or 2.18 job search. Transition year child care is not available to 2.19 families who have been disqualified from MFIP or DWP due to 2.20 fraud. 2.21(b)Subd. 20a. "Transition year extensionyearfamilies" 2.22 means families who have completed their transition year of child 2.23 care assistance under this subdivision and who are eligible for, 2.24 but on a waiting list for, services under section 119B.03. For 2.25 purposes of sections 119B.03, subdivision 3, and 119B.05, 2.26 subdivision 1, clause (2), families participating in extended 2.27 transition year shall not be considered transition year 2.28 families. Transition year extension child care may be used to 2.29 support employment or a job search that meets the requirements 2.30 of section 119B.10 for the length of time necessary for families 2.31 to be moved from the basic sliding fee waiting list into the 2.32 basic sliding fee program. 2.33 Sec. 5. Minnesota Statutes 2002, section 119B.03, 2.34 subdivision 3, is amended to read: 2.35 Subd. 3. [ELIGIBLE PARTICIPANTS.] Families that meet the 2.36 eligibility requirements under sections 119B.07, 119B.09, and 3.1 119B.10, except MFIP participants,work first3.2participantsdiversionary work program, and transition year 3.3 families are eligible for child care assistance under the basic 3.4 sliding fee program. Families enrolled in the basic sliding fee 3.5 program shall be continued until they are no longer eligible. 3.6 Child care assistance provided through the child care fund is 3.7 considered assistance to the parent. 3.8 Sec. 6. Minnesota Statutes 2003 Supplement, section 3.9 119B.03, subdivision 4, is amended to read: 3.10 Subd. 4. [FUNDING PRIORITY.] (a) First priority for child 3.11 care assistance under the basic sliding fee program must be 3.12 given to eligible non-MFIP families who do not have a high 3.13 school or general equivalency diploma or who need remedial and 3.14 basic skill courses in order to pursue employment or to pursue 3.15 education leading to employment and who need child care 3.16 assistance to participate in the education program. Within this 3.17 priority, the following subpriorities must be used: 3.18 (1) child care needs of minor parents; 3.19 (2) child care needs of parents under 21 years of age; and 3.20 (3) child care needs of other parents within the priority 3.21 group described in this paragraph. 3.22 (b) Second priority must be given to parents who have 3.23 completed their MFIP orwork firstDWP transition year, or 3.24 parents who are no longer receiving or eligible for diversionary 3.25 work program supports. 3.26 (c) Third priority must be given to families who are 3.27 eligible for portable basic sliding fee assistance through the 3.28 portability pool under subdivision 9. 3.29 (d) Families under paragraph (b) must be added to the basic 3.30 sliding fee waiting list on the date they begin the transition 3.31 year under section 119B.011, subdivision 20, and must be moved 3.32 into the basic sliding fee program as soon as possible after 3.33 they complete their transition year. 3.34 Sec. 7. Minnesota Statutes 2002, section 119B.03, 3.35 subdivision 6a, is amended to read: 3.36 Subd. 6a. [ALLOCATION DUE TO INCREASED FUNDING.] When 4.1 funding increases are implemented within a calendar year, every 4.2 county must receive an allocation at least equaland4.3proportionateto its original allocation for the same time 4.4 period. The remainder of the allocation must be recalculated to 4.5 reflect the funding increase, according to formulas identified 4.6 in subdivision 6. 4.7 Sec. 8. Minnesota Statutes 2002, section 119B.03, is 4.8 amended by adding a subdivision to read: 4.9 Subd. 6b. [ALLOCATION DUE TO DECREASED FUNDING.] When 4.10 funding decreases are implemented within a calendar year, county 4.11 allocations must be reduced in an amount proportionate to the 4.12 reduction in the total allocation for the same time period. 4.13 This applies when a funding decrease necessitates the revision 4.14 of an existing calendar year allocation. 4.15 Sec. 9. Minnesota Statutes 2003 Supplement, section 4.16 119B.05, subdivision 1, is amended to read: 4.17 Subdivision 1. [ELIGIBLE PARTICIPANTS.] Families eligible 4.18 for child care assistance under the MFIP child care program are: 4.19 (1) MFIP participants who are employed or in job search and 4.20 meet the requirements of section 119B.10; 4.21 (2) persons who are members of transition year families 4.22 under section 119B.011, subdivision 20, and meet the 4.23 requirements of section 119B.10; 4.24 (3) families who are participating in employment 4.25 orientation or job search, or other employment or training 4.26 activities that are included in an approved employability 4.27 development plan underchapter 256Ksection 256J.95; 4.28 (4) MFIP families who are participating in work job search, 4.29 job support, employment, or training activities as required in 4.30 theirjob search support oremployment plan, or in appeals, 4.31 hearings, assessments, or orientations according to chapter 4.32 256J; 4.33 (5) MFIP families who are participating in social services 4.34 activities under chapter 256Jor 256Kas required in their 4.35 employment plan approved according to chapter 256Jor 256K; 4.36 (6) families who are participating in programs as required 5.1 in tribal contracts under section 119B.02, subdivision 2, or 5.2 256.01, subdivision 2; and 5.3 (7) families who are participating in the transition year 5.4 extension under section 119B.011, subdivision20, paragraph5.5(a)20a. 5.6 Sec. 10. Minnesota Statutes 2003 Supplement, section 5.7 119B.09, subdivision 7, is amended to read: 5.8 Subd. 7. [DATE OF ELIGIBILITY FOR ASSISTANCE.] (a) The 5.9 date of eligibility for child care assistance under this chapter 5.10 is the later of the date the application was signed; the 5.11 beginning date of employment, education, or training; or the 5.12 date a determination has been made that the applicant is a 5.13 participant in employment and training services under Minnesota 5.14 Rules, part 3400.0080, subpart 2a, or chapter 256Jor 256K. 5.15 (b) Payment of child care assistance for employed persons 5.16 on MFIP is effective the date of employment or the date of MFIP 5.17 eligibility, whichever is later. Payment of child care 5.18 assistance for MFIP orwork firstDWP participants in employment 5.19 and training services is effective the date of commencement of 5.20 the services or the date of MFIP orwork firstDWP eligibility, 5.21 whichever is later. Payment of child care assistance for 5.22 transition year child care must be made retroactive to the date 5.23 of eligibility for transition year child care. 5.24 Sec. 11. Minnesota Statutes 2003 Supplement, section 5.25 119B.12, subdivision 2, is amended to read: 5.26 Subd. 2. [PARENT FEE.] A family must be assessed a parent 5.27 fee for each service period. A family's parent fee must be a 5.28 fixed percentage of its annual gross income. Parent fees must 5.29 apply to families eligible for child care assistance under 5.30 sections 119B.03 and 119B.05. Income must be as defined in 5.31 section 119B.011, subdivision 15. The fixed percent is based on 5.32 the relationship of the family's annual gross income to 100 5.33 percent of the annual federal poverty guidelines. Parent fees 5.34 must begin at 75 percent of the poverty level. The minimum 5.35 parent fees for families between 75 percent and 100 percent of 5.36 poverty level must be $10 per month. Parent fees must provide 6.1 for graduated movement to full payment. 6.2 Sec. 12. Minnesota Statutes 2003 Supplement, section 6.3 119B.13, subdivision 1, is amended to read: 6.4 Subdivision 1. [SUBSIDY RESTRICTIONS.] The maximum rate 6.5 paid for child care assistance under the child care fund may not 6.6 exceed the 75th percentile rate for like-care arrangements in 6.7 the county as surveyed by the commissioner. A rate which 6.8 includesa provider bonus paid under subdivision 2 ora special 6.9 needs rate paid under subdivision 3 may be in excess of the 6.10 maximum rate allowed under this subdivision. The department 6.11 shall monitor the effect of this paragraph on provider rates. 6.12 The county shall pay the provider's full charges for every child 6.13 in care up to the maximum established. The commissioner shall 6.14 determine the maximum rate for each type of care on an hourly, 6.15 full-day, and weekly basis, including special needs and 6.16 handicapped care. Not less than once every two years, the 6.17 commissioner shall evaluate market practices for payment of 6.18 absences and shall establish policies for payment of absent days 6.19 that reflect current market practice. 6.20 When the provider charge is greater than the maximum 6.21 provider rate allowed, the parent is responsible for payment of 6.22 the difference in the rates in addition to any family co-payment 6.23 fee. 6.24 Sec. 13. Minnesota Statutes 2003 Supplement, section 6.25 119B.13, subdivision 1a, is amended to read: 6.26 Subd. 1a. [LEGAL NONLICENSED FAMILY CHILD CARE PROVIDER 6.27 RATES.] (a) Legal nonlicensed family child care providers 6.28 receiving reimbursement under this chapter must be paid on an 6.29 hourly basis for care provided to families receiving assistance. 6.30 (b) The maximum rate paid to legal nonlicensed family child 6.31 care providers must be 80 percent of the county maximum hourly 6.32 rate for licensed family child care providers. In counties 6.33 where the maximum hourly rate for licensed family child care 6.34 providers is higher than the maximum weekly rate for those 6.35 providers divided by 50, the maximum hourly rate that may be 6.36 paid to legal nonlicensed family child care providers is the 7.1 rate equal to the maximum weekly rate for licensed family child 7.2 care providers divided by 50 and then multiplied by 0.80. 7.3 (c) A rate which includesa provider bonus paid under7.4subdivision 2 ora special needs rate paid under subdivision 3 7.5 may be in excess of the maximum rate allowed under this 7.6 subdivision. 7.7 (d) Legal nonlicensed family child care providers receiving 7.8 reimbursement under this chapter may not be paid registration 7.9 fees for families receiving assistance. 7.10 Sec. 14. Minnesota Statutes 2003 Supplement, section 7.11 119B.189, subdivision 2, is amended to read: 7.12 Subd. 2. [INTERIM FINANCING.] "Interim financing" means 7.13 funding for up to 18 months: 7.14 (1) for activities that are necessary to receive and 7.15 maintain state child care licensing; 7.16 (2) to expand an existing child care program or to improve 7.17 program quality; and 7.18 (3) to operate for a period of six consecutive months after 7.19 a child care facility becomes licensed or satisfies standards of 7.20 the commissioner ofeducationhuman services. 7.21 Sec. 15. Minnesota Statutes 2003 Supplement, section 7.22 119B.189, subdivision 4, is amended to read: 7.23 Subd. 4. [TRAINING PROGRAM.] "Training program" means 7.24 child development courses offered by an accredited postsecondary 7.25 institution or similar training approved by a county board or 7.26 the commissioner. A training program must be a course of study 7.27 that teaches specific skills to meet licensing requirements or 7.28 requirements of the commissioner ofeducationhuman services. 7.29 Sec. 16. Minnesota Statutes 2003 Supplement, section 7.30 119B.19, subdivision 1, is amended to read: 7.31 Subdivision 1. [DISTRIBUTION OF FUNDS FOR OPERATION OF 7.32 CHILD CARE RESOURCE AND REFERRAL PROGRAMS.] The commissioner 7.33 ofeducationhuman services shall distribute funds to public or 7.34 private nonprofit organizations for the planning, establishment, 7.35 expansion, improvement, or operation of child care resource and 7.36 referral programs under this section. The commissioner must 8.1 adopt rules for programs under this section and sections 8.2 119B.189 and 119B.21. The commissioner must develop a process 8.3 to fund organizations to operate child care resource and 8.4 referral programs that includes application forms, timelines, 8.5 and standards for renewal. 8.6 Sec. 17. Minnesota Statutes 2003 Supplement, section 8.7 119B.24, is amended to read: 8.8 119B.24 [DUTIES OF COMMISSIONER.] 8.9 In addition to the powers and duties already conferred by 8.10 law, the commissioner ofeducationhuman services shall: 8.11 (1) administer the child care fund, including the basic 8.12 sliding fee program authorized under sections 119B.011 to 8.13 119B.16; 8.14 (2) monitor the child care resource and referral programs 8.15 established under section 119B.19; and 8.16 (3) encourage child care providers to participate in a 8.17 nationally recognized accreditation system for early childhood 8.18 and school-age care programs. Subject to approval by the 8.19 commissioner, family child care providers and early childhood 8.20 and school-age care programs shall be reimbursed for one-half of 8.21 the direct cost of accreditation fees, upon successful 8.22 completion of accreditation. 8.23 Sec. 18. Minnesota Statutes 2003 Supplement, section 8.24 119B.25, subdivision 2, is amended to read: 8.25 Subd. 2. [GRANTS.] The commissioner shall distribute money 8.26 provided by this section through a grant to a nonprofit 8.27 corporation organized to plan, develop, and finance early 8.28 childhood education and child care sites. The nonprofit 8.29 corporation must have demonstrated the ability to analyze 8.30 financing projects, have knowledge of other sources of public 8.31 and private financing for child care and early childhood 8.32 education sites, and have a relationship with the resource and 8.33 referral programs under section 119B.211. The board of 8.34 directors of the nonprofit corporation must include members who 8.35 are knowledgeable about early childhood education, child care, 8.36 development and improvement, and financing. The commissioners 9.1 of the Departments ofEducationHuman Services and Employment 9.2 and Economic Development, and the commissioner of the Housing 9.3 Finance Agency shall advise the board on the loan program. The 9.4 grant must be used to make loans to improve child care or early 9.5 childhood education sites, or loans to plan, design, and 9.6 construct or expand licensed and legal unlicensed sites to 9.7 increase the availability of child care or early childhood 9.8 education. All loans made by the nonprofit corporation must 9.9 comply with section 363A.16. 9.10 Sec. 19. Minnesota Statutes 2003 Supplement, section 9.11 256.046, subdivision 1, is amended to read: 9.12 Subdivision 1. [HEARING AUTHORITY.] A local agency must 9.13 initiate an administrative fraud disqualification hearing for 9.14 individuals, including child care providers caring for children 9.15 receiving child care assistance, accused of wrongfully obtaining 9.16 assistance or intentional program violations, in lieu of a 9.17 criminal action when it has not been pursued, in the aid to 9.18 families with dependent children program formerly codified in 9.19 sections 256.72 to 256.87, MFIP, the diversionary work program, 9.20 child care assistance programs, general assistance, family 9.21 general assistance program formerly codified in section 256D.05, 9.22 subdivision 1, clause (15), Minnesota supplemental aid, food 9.23 stamp programs, general assistance medical care, MinnesotaCare 9.24 for adults without children, and upon federal approval, all 9.25 categories of medical assistance and remaining categories of 9.26 MinnesotaCare except for children through age 18. The hearing 9.27 is subject to the requirements of section 256.045 and the 9.28 requirements in Code of Federal Regulations, title 7, section 9.29 273.16, for the food stamp program and title 45, section 9.30 235.112, as of September 30, 1995, for the cash grant, medical 9.31 care programs, and child care assistance under chapter 119B. 9.32 Sec. 20. Minnesota Statutes 2003 Supplement, section 9.33 256.98, subdivision 8, is amended to read: 9.34 Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person 9.35 found to be guilty of wrongfully obtaining assistance by a 9.36 federal or state court or by an administrative hearing 10.1 determination, or waiver thereof, through a disqualification 10.2 consent agreement, or as part of any approved diversion plan 10.3 under section 401.065, or any court-ordered stay which carries 10.4 with it any probationary or other conditions, in the Minnesota 10.5 family investment program, the diversionary work program, the 10.6 food stamp or food support program, the general assistance 10.7 program, the group residential housing program, or the Minnesota 10.8 supplemental aid program shall be disqualified from that 10.9 program. In addition, any person disqualified from the 10.10 Minnesota family investment program shall also be disqualified 10.11 from the food stamp or food support program. The needs of that 10.12 individual shall not be taken into consideration in determining 10.13 the grant level for that assistance unit: 10.14 (1) for one year after the first offense; 10.15 (2) for two years after the second offense; and 10.16 (3) permanently after the third or subsequent offense. 10.17 The period of program disqualification shall begin on the 10.18 date stipulated on the advance notice of disqualification 10.19 without possibility of postponement for administrative stay or 10.20 administrative hearing and shall continue through completion 10.21 unless and until the findings upon which the sanctions were 10.22 imposed are reversed by a court of competent jurisdiction. The 10.23 period for which sanctions are imposed is not subject to 10.24 review. The sanctions provided under this subdivision are in 10.25 addition to, and not in substitution for, any other sanctions 10.26 that may be provided for by law for the offense involved. A 10.27 disqualification established through hearing or waiver shall 10.28 result in the disqualification period beginning immediately 10.29 unless the person has become otherwise ineligible for 10.30 assistance. If the person is ineligible for assistance, the 10.31 disqualification period begins when the person again meets the 10.32 eligibility criteria of the program from which they were 10.33 disqualified and makes application for that program. 10.34 (b) A family receiving assistance through child care 10.35 assistance programs under chapter 119B with a family member who 10.36 is found to be guilty of wrongfully obtaining child care 11.1 assistance by a federal court, state court, or an administrative 11.2 hearing determination or waiver, through a disqualification 11.3 consent agreement, as part of an approved diversion plan under 11.4 section 401.065, or a court-ordered stay with probationary or 11.5 other conditions, is disqualified from child care assistance 11.6 programs. The disqualifications must be for periods of three 11.7 months, six months, and two years for the first, second, and 11.8 third offenses respectively. Subsequent violations must result 11.9 in permanent disqualification. During the disqualification 11.10 period, disqualification from any child care program must extend 11.11 to all child care programs and must be immediately applied. 11.12 (c) A provider caring for children receiving assistance 11.13 through child care assistance programs under chapter 119B is 11.14 disqualified from receiving payment for child care services from 11.15 the child care assistance program under chapter 119B when the 11.16 provider is found to have wrongfully obtained child care 11.17 assistance by a federal court, state court, or an administrative 11.18 hearing determination or waiver under section 256.046, through a 11.19 disqualification consent agreement, as part of an approved 11.20 diversion plan under section 401.065, or a court-ordered stay 11.21 with probationary or other conditions. The disqualification 11.22 must be for a period of one year for the first offense and two 11.23 years for the second offense. Any subsequent violation must 11.24 result in permanent disqualification. The disqualification 11.25 period must be imposed immediately after a determination is made 11.26 under this paragraph. During the disqualification period, the 11.27 provider is disqualified from receiving payment from any child 11.28 care program under chapter 119B. 11.29 (d) Any person found to be guilty of wrongfully obtaining 11.30 general assistance medical care, MinnesotaCare for adults 11.31 without children, and upon federal approval, all categories of 11.32 medical assistance and remaining categories of MinnesotaCare, 11.33 except for children through age 18, by a federal or state court 11.34 or by an administrative hearing determination, or waiver 11.35 thereof, through a disqualification consent agreement, or as 11.36 part of any approved diversion plan under section 401.065, or 12.1 any court-ordered stay which carries with it any probationary or 12.2 other conditions, is disqualified from that program. The period 12.3 of disqualification is one year after the first offense, two 12.4 years after the second offense, and permanently after the third 12.5 or subsequent offense. The period of program disqualification 12.6 shall begin on the date stipulated on the advance notice of 12.7 disqualification without possibility of postponement for 12.8 administrative stay or administrative hearing and shall continue 12.9 through completion unless and until the findings upon which the 12.10 sanctions were imposed are reversed by a court of competent 12.11 jurisdiction. The period for which sanctions are imposed is not 12.12 subject to review. The sanctions provided under this 12.13 subdivision are in addition to, and not in substitution for, any 12.14 other sanctions that may be provided for by law for the offense 12.15 involved. 12.16 Sec. 21. Minnesota Statutes 2002, section 256J.01, 12.17 subdivision 1, is amended to read: 12.18 Subdivision 1. [IMPLEMENTATION OF MINNESOTA FAMILY 12.19 INVESTMENT PROGRAM (MFIP).] Except for section 256J.95, this 12.20 chapter and chapter 256K may be cited as the Minnesota family 12.21 investment program (MFIP). MFIP is the statewide implementation 12.22 of components of the Minnesota family investment plan (MFIP) 12.23 authorized and formerly codified in section 256.031 and 12.24 Minnesota family investment plan-Ramsey County (MFIP-R) formerly 12.25 codified in section 256.047. 12.26 Sec. 22. Minnesota Statutes 2002, section 256J.08, 12.27 subdivision 73, is amended to read: 12.28 Subd. 73. [QUALIFIED NONCITIZEN.] "Qualified noncitizen" 12.29 means a person: 12.30 (1) who was lawfully admitted for permanent residence 12.31pursuantaccording to United States Code, title 8; 12.32 (2) who was admitted to the United States as a refugee 12.33pursuantaccording to United States Code, title 8; section 1157; 12.34 (3) whose deportation is being withheldpursuantaccording 12.35 to United States Code, title 8,sectionsections 1231(b)(3), 12.36 1253(h), and 1641(b)(5); 13.1 (4) who was paroled for a period of at least one year 13.2pursuantaccording to United States Code, title 8, section 13.3 1182(d)(5); 13.4 (5) who was granted conditional entrypursuantaccording to 13.5 United State Code, title 8, section 1153(a)(7); 13.6 (6) who is a Cuban or Haitian entrant as defined in section 13.7 501(e) of the Refugee Education Assistance Act of 1980, Unites 13.8 States Code, title 8, section 1641(b)(7); 13.9 (7) who was granted asylumpursuantaccording to United 13.10 States Code, title 8, section 1158; 13.11(7) determined to be a battered noncitizen by the United13.12States Attorney General according to the Illegal Immigration13.13Reform and Immigrant Responsibility Act of 1996, Title V of the13.14Omnibus Consolidated Appropriations Bill, Public Law 104-208;13.15 (8) who is achild of a noncitizen determined to be a13.16battered noncitizen by the United States Attorney General13.17according to the Illegal Immigration Reform and Responsibility13.18Act of 1996, title V, Public Law 104-200battered noncitizen 13.19 according to United States Code, title 8, section 1641(c); or 13.20 (9) whowas admitted as a Cuban or Haitian entrantis a 13.21 parent or child of a battered noncitizen according to United 13.22 States Code, title 8, section 1641(c). 13.23 Sec. 23. Minnesota Statutes 2002, section 256J.08, 13.24 subdivision 82a, is amended to read: 13.25 Subd. 82a. [SHARED HOUSEHOLD STANDARD.] "Shared household 13.26 standard" means the basic standard used when the household 13.27 includes an unrelated member. The standard also applies to a 13.28 member disqualified under section 256J.425. The cash portion of 13.29 the shared household standard is equal to 90 percent of the cash 13.30 portion of the transitional standard. The cash portion of the 13.31 shared household standard plus the food portion equals the full 13.32 shared household standard. 13.33 Sec. 24. Minnesota Statutes 2003 Supplement, section 13.34 256J.09, subdivision 3b, is amended to read: 13.35 Subd. 3b. [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 13.36 If the applicant is not diverted from applying for MFIP, and if 14.1 the applicant meets the MFIP eligibility requirements, then a 14.2 county agency must: 14.3 (1) identify an applicant who is under the age of 20 14.4 without a high school diploma or its equivalent and explain to 14.5 the applicant the assessment procedures and employment plan 14.6 requirements under section 256J.54; 14.7 (2) explain to the applicant the eligibility criteria in 14.8 section 256J.545 for the family violence waiver, and what an 14.9 applicant should do to develop an employment plan; 14.10 (3)determine if an applicant qualifies for an exemption14.11under section 256J.56 from employment and training services14.12requirementsexplain that the activities and hourly requirements 14.13 of the employment plan may be adjusted to accommodate the 14.14 personal and family circumstances of applicants who meet the 14.15 criteria in section 256J.561, subdivision 2, paragraph (d), 14.16 explain how a person should report to the county agency any 14.17 status changes, and explain that an applicant who isexemptnot 14.18 required to participate in employment services under section 14.19 256J.561 may volunteer to participate in employment and training 14.20 services; 14.21 (4) for applicants who are not exempt from the requirement 14.22 to attend orientation, arrange for an orientation under section 14.23 256J.45 and an assessment under section 256J.521; 14.24 (5) inform an applicant who is not exempt from the 14.25 requirement to attend orientation that failure to attend the 14.26 orientation is considered an occurrence of noncompliance with 14.27 program requirements and will result in an imposition of a 14.28 sanction under section 256J.46; and 14.29 (6) explain how to contact the county agency if an 14.30 applicant has questions about compliance with program 14.31 requirements. 14.32 Sec. 25. Minnesota Statutes 2002, section 256J.21, 14.33 subdivision 3, is amended to read: 14.34 Subd. 3. [INITIAL INCOME TEST.] The county agency shall 14.35 determine initial eligibility by considering all earned and 14.36 unearned income that is not excluded under subdivision 2. To be 15.1 eligible for MFIP, the assistance unit's countable income minus 15.2 the disregards in paragraphs (a) and (b) must be below the 15.3 transitional standard of assistance according to section 256J.24 15.4 for that size assistance unit. 15.5 (a) The initial eligibility determination must disregard 15.6 the following items: 15.7 (1) the employment disregard is 18 percent of the gross 15.8 earned income whether or not the member is working full time or 15.9 part time; 15.10 (2) dependent care costs must be deducted from gross earned 15.11 income for the actual amount paid for dependent care up to a 15.12 maximum of $200 per month for each child less than two years of 15.13 age, and $175 per month for each child two years of age and 15.14 older under this chapter and chapter 119B; 15.15 (3) all payments made according to a court order for 15.16 spousal support or the support of children not living in the 15.17 assistance unit's household shall be disregarded from the income 15.18 of the person with the legal obligation to pay support, provided 15.19 that, if there has been a change in the financial circumstances 15.20 of the person with the legal obligation to pay support since the 15.21 support order was entered, the person with the legal obligation 15.22 to pay support has petitioned for a modification of the support 15.23 order; and 15.24 (4) an allocation for the unmet need of an ineligible 15.25 spouse or an ineligible child under the age of 21 for whom the 15.26 caregiver is financially responsible and who lives with the 15.27 caregiver according to section 256J.36. 15.28 (b) Notwithstanding paragraph (a), when determining initial 15.29 eligibility for applicant units when at least one member has 15.30 receivedwork first orMFIP in this state within four months of 15.31 the most recent application for MFIP, apply the disregard as 15.32 defined in section 256J.08, subdivision 24, for all unit members. 15.33 After initial eligibility is established, the assistance 15.34 payment calculation is based on the monthly income test. 15.35 Sec. 26. Minnesota Statutes 2003 Supplement, section 15.36 256J.24, subdivision 5, is amended to read: 16.1 Subd. 5. [MFIP TRANSITIONAL STANDARD.] The MFIP 16.2 transitional standard is based on the number of persons in the 16.3 assistance unit eligible for both food and cash assistance 16.4 unless the restrictions in subdivision 6 on the birth of a child 16.5 apply. The following table represents the transitional 16.6 standards effective October 1,20022003. 16.7 Number of Transitional Cash Food 16.8 Eligible People Standard Portion Portion 16.9 1$370$371: $250$120$121 16.10 2$658$661: $437$221$224 16.11 3$844$852: $532$312$320 16.12 4$998$1,006: $621$377$385 16.13 5$1,135$1,146: $697$438$449 16.14 6$1,296$1,309: $773$523$536 16.15 7$1,414$1,428: $850$564$578 16.16 8$1,558$1,572: $916$642$656 16.17 9$1,700$1,715: $980$720$735 16.18 10$1,836$1,853: $1,035$801$818 16.19 over 10 add$136$137: $53$83$84 16.20 per additional member. 16.21 The commissioner shall annually publish in the State 16.22 Register the transitional standard for an assistance unit sizes 16.23 1 to 10 including a breakdown of the cash and food portions. 16.24 Sec. 27. Minnesota Statutes 2003 Supplement, section 16.25 256J.32, subdivision 2, is amended to read: 16.26 Subd. 2. [DOCUMENTATION.] The applicant or participant 16.27 must document the information required under subdivisions 4 to 6 16.28 or authorize the county agency to verify the information. The 16.29 applicant or participant has the burden of providing documentary 16.30 evidence to verify eligibility. The county agency shall assist 16.31 the applicant or participant in obtaining required documents 16.32 when the applicant or participant is unable to do so. The 16.33 county agency may acceptan affidavita signed personal 16.34 statement from the applicant or participant only for factors 16.35 specified under subdivision 8. 16.36 Sec. 28. Minnesota Statutes 2003 Supplement, section 17.1 256J.32, subdivision 8, is amended to read: 17.2 Subd. 8. [AFFIDAVITPERSONAL STATEMENT.] The county agency 17.3 may acceptan affidavita signed personal statement from the 17.4 applicant orrecipientparticipant explaining the reasons that 17.5 the documentation requested in subdivision 2 is unavailable as 17.6 sufficient documentation at the time of applicationor, 17.7 recertification, or change related to eligibility only for the 17.8 following factors: 17.9 (1) a claim of family violence if used as a basis to 17.10 qualify for the family violence waiver; 17.11 (2) information needed to establish an exception under 17.12 section 256J.24, subdivision 9; 17.13 (3) relationship of a minor child to caregivers in the 17.14 assistance unit;and17.15 (4) citizenship status from a noncitizen who reports to be, 17.16 or is identified as, a victim of severe forms of trafficking in 17.17 persons, if the noncitizen reports that the noncitizen's 17.18 immigration documents are being held by an individual or group 17.19 of individuals against the noncitizen's will. The noncitizen 17.20 must follow up with the Office of Refugee Resettlement (ORR) to 17.21 pursue certification. If verification that certification is 17.22 being pursued is not received within 30 days, the MFIP case must 17.23 be closed and the agency shall pursue overpayments. The ORR 17.24 documents certifying the noncitizen's status as a victim of 17.25 severe forms of trafficking in persons, or the reason for the 17.26 delay in processing, must be received within 90 days, or the 17.27 MFIP case must be closed and the agency shall pursue 17.28 overpayments; and 17.29 (5) other documentation unavailable for reasons beyond the 17.30 control of the applicant or participant. Reasonable attempts 17.31 must have been made to obtain the documents requested under 17.32 subdivision 2. 17.33 Sec. 29. Minnesota Statutes 2003 Supplement, section 17.34 256J.37, subdivision 9, is amended to read: 17.35 Subd. 9. [UNEARNED INCOME.] (a) The county agency must 17.36 apply unearned income to the MFIP standard of need. When 18.1 determining the amount of unearned income, the county agency 18.2 must deduct the costs necessary to secure payments of unearned 18.3 income. These costs include legal fees, medical fees, and 18.4 mandatory deductions such as federal and state income taxes. 18.5 (b) The county agency must convert unearned income received 18.6 on a periodic basis to monthly amounts by prorating the income 18.7 over the number of months represented by the frequency of the 18.8 payments. The county agency must begin counting the monthly 18.9 amount in the month the periodic payment is received and budget 18.10 it according to the assistance unit's budget cycle. 18.11 Sec. 30. Minnesota Statutes 2002, section 256J.415, is 18.12 amended to read: 18.13 256J.415 [NOTICE OF TIME LIMIT 12 MONTHS PRIOR TO 60-MONTH 18.14 TIME LIMIT EXPIRING.] 18.15 (a) The county agency shall mail a notice to each 18.16 assistance unit when the assistance unit has 12 months of TANF 18.17 assistance remaining and each month thereafter until the 18.18 60-month limit has expired. The notice must be developed by the 18.19 commissioner of human services and must contain information 18.20 about the 60-month limit, the number of months the participant 18.21 has remaining, the hardship extension policy, and any other 18.22 information that the commissioner deems pertinent to an 18.23 assistance unit nearing the 60-month limit. 18.24 (b) For applicants who have less than 12 months remaining 18.25 in the 60-month time limit because the unit previously received 18.26 TANF assistance in Minnesota or another state, the county agency 18.27 shall notify the applicant of the number of months of TANF 18.28 remaining when the application is approved and begin the process 18.29 required in paragraph (a). 18.30 Sec. 31. Minnesota Statutes 2003 Supplement, section 18.31 256J.425, subdivision 1, is amended to read: 18.32 Subdivision 1. [ELIGIBILITY.] (a) To be eligible for a 18.33 hardship extension, a participant in an assistance unit subject 18.34 to the time limit under section 256J.42, subdivision 1, must be 18.35 in compliance in the participant's 60th counted month. For 18.36 purposes of determining eligibility for a hardship extension, a 19.1 participant is in compliance in any month that the participant 19.2 has not been sanctioned. 19.3 (b) If one participant in a two-parent assistance unit is 19.4 determined to be ineligible for a hardship extension, the county 19.5 shall give the assistance unit the option of disqualifying the 19.6 ineligible participant from MFIP. In that case, the assistance 19.7 unit shall be treated as a one-parent assistance unit and the 19.8 assistance unit's MFIP grant shall be calculated using the 19.9 shared household standard under section 256J.08, subdivision 82a. 19.10 (c) Prior to denying an extension, the county must review 19.11 the sanction status and determine whether the sanction is 19.12 appropriate or if good cause exists under section 256J.57. If 19.13 the sanction was inappropriately applied or the participant is 19.14 granted a good cause exception before the end of month 60, the 19.15 participant shall be considered for an extension. 19.16 Sec. 32. Minnesota Statutes 2003 Supplement, section 19.17 256J.425, subdivision 4, is amended to read: 19.18 Subd. 4. [EMPLOYED PARTICIPANTS.] (a) An assistance unit 19.19 subject to the time limit under section 256J.42, subdivision 1, 19.20 is eligible to receive assistance under a hardship extension if 19.21 the participant who reached the time limit belongs to: 19.22 (1) a one-parent assistance unit in which the participant 19.23 is participating in work activities for at least 30 hours per 19.24 week, of which an average of at least 25 hours per week every 19.25 month are spent participating in employment; 19.26 (2) a two-parent assistance unit in which the participants 19.27 are participating in work activities for at least 55 hours per 19.28 week, of which an average of at least 45 hours per week every 19.29 month are spent participating in employment; or 19.30 (3) an assistance unit in which a participant is 19.31 participating in employment for fewer hours than those specified 19.32 in clause (1), and the participant submits verification from a 19.33 qualified professional, in a form acceptable to the 19.34 commissioner, stating that the number of hours the participant 19.35 may work is limited due to illness or disability, as long as the 19.36 participant is participating in employment for at least the 20.1 number of hours specified by the qualified professional. The 20.2 participant must be following the treatment recommendations of 20.3 the qualified professional providing the verification. The 20.4 commissioner shall develop a form to be completed and signed by 20.5 the qualified professional, documenting the diagnosis and any 20.6 additional information necessary to document the functional 20.7 limitations of the participant that limit work hours. If the 20.8 participant is part of a two-parent assistance unit, the other 20.9 parent must be treated as a one-parent assistance unit for 20.10 purposes of meeting the work requirements under this subdivision. 20.11 (b) For purposes of this section, employment means: 20.12 (1) unsubsidized employment under section 256J.49, 20.13 subdivision 13, clause (1); 20.14 (2) subsidized employment under section 256J.49, 20.15 subdivision 13, clause (2); 20.16 (3) on-the-job training under section 256J.49, subdivision 20.17 13, clause (2); 20.18 (4) an apprenticeship under section 256J.49, subdivision 20.19 13, clause (1); 20.20 (5) supported work under section 256J.49, subdivision 13, 20.21 clause (2); 20.22 (6) a combination of clauses (1) to (5); or 20.23 (7) child care under section 256J.49, subdivision 13, 20.24 clause (7), if it is in combination with paid employment. 20.25 (c) If a participant is complying with a child protection 20.26 plan under chapter 260C, the number of hours required under the 20.27 child protection plan count toward the number of hours required 20.28 under this subdivision. 20.29 (d) The county shall provide the opportunity for subsidized 20.30 employment to participants needing that type of employment 20.31 within available appropriations. 20.32 (e) To be eligible for a hardship extension for employed 20.33 participants under this subdivision, a participant must be in 20.34 compliance for at least ten out of the 12 months the participant 20.35 received MFIP immediately preceding the participant's 61st month 20.36 on assistance. If ten or fewer months of eligibility for TANF 21.1 assistance remain at the time the participant from another state 21.2 applies for assistance, the participant must be in compliance 21.3 every month. 21.4 (f) The employment plan developed under section 256J.521, 21.5 subdivision 2, for participants under this subdivision must 21.6 contain at least the minimum number of hours specified in 21.7 paragraph (a)related to employment and work activitiesfor the 21.8 purpose of meeting the requirements for an extension under this 21.9 subdivision. The job counselor and the participant must sign 21.10 the employment plan to indicate agreement between the job 21.11 counselor and the participant on the contents of the plan. 21.12 (g) Participants who fail to meet the requirements in 21.13 paragraph (a), without good cause under section 256J.57, shall 21.14 be sanctioned or permanently disqualified under subdivision 6. 21.15 Good cause may only be granted for that portion of the month for 21.16 which the good cause reason applies. Participants must meet all 21.17 remaining requirements in the approved employment plan or be 21.18 subject to sanction or permanent disqualification. 21.19 (h) If the noncompliance with an employment plan is due to 21.20 the involuntary loss of employment, the participant is exempt 21.21 from the hourly employment requirement under this subdivision 21.22 for one month. Participants must meet all remaining 21.23 requirements in the approved employment plan or be subject to 21.24 sanction or permanent disqualification. This exemption is 21.25 available toaeach participant two times in a 12-month period. 21.26 Sec. 33. Minnesota Statutes 2002, section 256J.425, 21.27 subdivision 5, is amended to read: 21.28 Subd. 5. [ACCRUAL OF CERTAIN EXEMPT MONTHS.] (a)A21.29participant who received TANF assistance that counted towards21.30the federal 60-month time limit while the participant21.31wasParticipants who meet the criteria in clause (1), (2), or (3) 21.32 and who are not eligible for assistance under a hardship 21.33 extension under subdivision 2, paragraph (a), clause (3), shall 21.34 be eligible for a hardship extension for a period of time equal 21.35 to the number of months that were counted toward the federal 21.36 60-month time limit while the participant was: 22.1 (1) a caregiver with a child or an adult in the household 22.2 who meets the disability or medical criteria for home care 22.3 services under section 256B.0627, subdivision 1, paragraph (f), 22.4 or a home and community-based waiver services program under 22.5 chapter 256B, or meets the criteria for severe emotional 22.6 disturbance under section 245.4871, subdivision 6, or for 22.7 serious and persistent mental illness under section 245.462, 22.8 subdivision 20, paragraph (c), who was subject to the 22.9 requirements in section 256J.561, subdivision 2; 22.10 (2) exempt under section 256J.56, paragraph (a), clause 22.11 (7), from employment and training services requirements and who22.12is no longer eligible for assistance under a hardship extension22.13under subdivision 2, paragraph (a), clause (3), is eligible for22.14assistance under a hardship extension for a period of time equal22.15to the number of months that were counted toward the federal22.1660-month time limit while the participant was exempt under22.17section 256J.56, paragraph (a), clause (7), from the employment22.18and training services requirements.; or 22.19 (3) exempt under section 256J.56, paragraph (a), clause 22.20 (3), and demonstrates at the time of the case review required 22.21 under section 256J.42, subdivision 6, that the participant met 22.22 the exemption criteria under section 256J.56, paragraph (a), 22.23 clause (7), during one or more months the participant was exempt 22.24 under section 256J.56, paragraph (a), clause (3). Only months 22.25 during which the participant met the criteria under section 22.26 256J.56, paragraph (a), clause (7), shall be considered. 22.27 (b) A participant who received TANF assistance that counted 22.28 towards the federal 60-month time limit while the participant 22.29 met the state time limit exemption criteria under section 22.30 256J.42, subdivision 4 or 5, is eligible for assistance under a 22.31 hardship extension for a period of time equal to the number of 22.32 months that were counted toward the federal 60-month time limit 22.33 while the participant met the state time limit exemption 22.34 criteria under section 256J.42, subdivision 4 or 5. 22.35 (c)A participant who received TANF assistance that counted22.36towards the federal 60-month time limit while the participant23.1was exempt under section 256J.56, paragraph (a), clause (3),23.2from employment and training services requirements, who23.3demonstrates at the time of the case review required under23.4section 256J.42, subdivision 6, that the participant met the23.5exemption criteria under section 256J.56, paragraph (a), clause23.6(7), during one or more months the participant was exempt under23.7section 256J.56, paragraph (a), clause (3), before or after July23.81, 2002, is eligible for assistance under a hardship extension23.9for a period of time equal to the number of months that were23.10counted toward the federal 60-month time limit during the time23.11the participant met the criteria under section 256J.56,23.12paragraph (a), clause (7)After the accrued months have been 23.13 exhausted, the county agency must determine if the assistance 23.14 unit is eligible for an extension under another extension 23.15 category in section 256J.425, subdivision 2, 3, or 4. 23.16 (d) At the time of the case review, a county agency must 23.17 explain to the participant the basis for receiving a hardship 23.18 extension based on the accrual of exempt months. The 23.19 participant must provide documentation necessary to enable the 23.20 county agency to determine whether the participant is eligible 23.21 to receive a hardship extension based on the accrual of exempt 23.22 months or authorize a county agency to verify the information. 23.23 (e) While receiving extended MFIP assistance under this 23.24 subdivision, a participant is subject to the MFIP policies that 23.25 apply to participants during the first 60 months of MFIP, unless 23.26 the participant is a member of a two-parent family in which one 23.27 parent is extended under subdivision 3 or 4. For two-parent 23.28 families in which one parent is extended under subdivision 3 or 23.29 4, the sanction provisions in subdivision 6, shall apply. 23.30 Sec. 34. Minnesota Statutes 2003 Supplement, section 23.31 256J.425, subdivision 6, is amended to read: 23.32 Subd. 6. [SANCTIONS FOR EXTENDED CASES.] (a) If one or 23.33 both participants in an assistance unit receiving assistance 23.34 under subdivision 3 or 4 are not in compliance with the 23.35 employment and training service requirements in sections 23.36 256J.521 to 256J.57, the sanctions under this subdivision 24.1 apply. For a first occurrence of noncompliance, an assistance 24.2 unit must be sanctioned under section 256J.46, subdivision 1, 24.3 paragraph (c), clause (1). For a second or third occurrence of 24.4 noncompliance, the assistance unit must be sanctioned under 24.5 section 256J.46, subdivision 1, paragraph (c), clause (2). For 24.6 a fourth occurrence of noncompliance, the assistance unit is 24.7 disqualified from MFIP. If a participant is determined to be 24.8 out of compliance, the participant may claim a good cause 24.9 exception under section 256J.57, however, the participant may 24.10 not claim an exemption under section 256J.56. 24.11 (b) If both participants in a two-parent assistance unit 24.12 are out of compliance at the same time, it is considered one 24.13 occurrence of noncompliance. 24.14 (c) When a parent in an extended two-parent assistance unit 24.15 who has not used 60 months of assistance is out of compliance 24.16 with the employment and training service requirements in 24.17 sections 256J.521 to 256J.57, sanctions must be applied as 24.18 specified in clauses (1) and (2). 24.19 (1) If the assistance unit is receiving assistance under 24.20 subdivision 3 or 4, the assistance unit is subject to the 24.21 sanction policy in this subdivision. 24.22 (2) If the assistance unit is receiving assistance under 24.23 subdivision 2, the assistance unit is subject to the sanction 24.24 policy in section 256J.46. 24.25 (d) If a two-parent assistance unit is extended under 24.26 subdivision 3 or 4, and a parent who has not reached the 24.27 60-month time limit is out of compliance with the employment and 24.28 training services requirements in section 256J.521 to 256J.57 24.29 when the case is extended, the sanction in the 61st month is 24.30 considered the first sanction for the purposes of applying the 24.31 sanctions in this subdivision, except that the sanction amount 24.32 shall be 30 percent. 24.33 Sec. 35. Minnesota Statutes 2003 Supplement, section 24.34 256J.49, subdivision 4, is amended to read: 24.35 Subd. 4. [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 24.36 "Employment and training service provider" means: 25.1 (1)a public, private, or nonprofit employment and training25.2agency certified by the commissioner of economic security under25.3sections 268.0122, subdivision 3, and 268.871, subdivision 1, or25.4is approved under section 256J.51 and is included in the county25.5service agreement submitted under section 256J.626, subdivision25.64;25.7(2)a public, private, or nonprofit agencythat is not25.8certified by the commissioner under clause (1), butwith which a 25.9 county has contracted to provide employment and training 25.10 services and which is included in the county's service agreement 25.11 submitted under section 256J.626, subdivision 4; or 25.12(3)(2) a county agency, if the county has opted to provide 25.13 employment and training services and the county has indicated 25.14 that fact in the service agreement submitted under section 25.15 256J.626, subdivision 4. 25.16 Notwithstanding section 268.871, an employment and training 25.17 services provider meeting this definition may deliver employment 25.18 and training services under this chapter. 25.19 Sec. 36. Minnesota Statutes 2003 Supplement, section 25.20 256J.515, is amended to read: 25.21 256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.] 25.22 During the first meeting with participants, job counselors 25.23 must ensure that an overview of employment and training services 25.24 is provided that: 25.25 (1) stresses the necessity and opportunity of immediate 25.26 employment; 25.27 (2) outlines the job search resources offered; 25.28 (3) outlines education or training opportunities available; 25.29 (4) describes the range of work activities, including 25.30 activities under section 256J.49, subdivision 13, clause (18), 25.31 that are allowable under MFIP to meet the individual needs of 25.32 participants; 25.33 (5) explains the requirements to comply with an employment 25.34 plan; 25.35 (6) explains the consequences for failing to comply; 25.36 (7) explains the services that are available to support job 26.1 search and work and education; and 26.2 (8) provides referral information about shelters and 26.3 programs for victims of family violence,and the time limit 26.4 exemption, and waivers of regular employment and training26.5requirementsfor family violence victims. 26.6 Failure to attend the overview of employment and training 26.7 services without good cause results in the imposition of a 26.8 sanction under section 256J.46. 26.9 An applicant who requests and qualifies for a family 26.10 violence waiver is exempt from attending a group overview. 26.11 Information usually presented in an overview must be covered 26.12 during the development of an employment plan under section 26.13 256J.521, subdivision 3. 26.14 Sec. 37. Minnesota Statutes 2003 Supplement, section 26.15 256J.56, is amended to read: 26.16 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 26.17 EXEMPTIONS.] 26.18 (a)An MFIPParagraphs (b) and (c) apply only to an MFIP 26.19 participant who was exempt from participating in employment 26.20 services as of June 30, 2004, has not been required to develop 26.21 an employment plan under section 256J.561, and continues to 26.22 qualify for an exemption under this section. All exemptions 26.23 under this section expire at the time of the participant's 26.24 recertification. No new exemptions shall be granted under this 26.25 section after June 30, 2004. 26.26 (b) A participant is exempt from the requirements of 26.27 sections 256J.515 to 256J.57 if the participantbelongs26.28 continues to belong to any of the following groups: 26.29 (1) participants who are age 60 or older; 26.30 (2) participants who are suffering from a permanent or 26.31 temporary illness, injury, or incapacity which has been 26.32 certified by a qualified professional when the illness, injury, 26.33 or incapacity is expected to continue for more than 30 days and 26.34 prevents the person from obtaining or retaining employment. 26.35 Persons in this category with a temporary illness, injury, or 26.36 incapacity must be reevaluated at least quarterly; 27.1 (3) participants whose presence in the home is required as 27.2 a caregiver because of the illness, injury, or incapacity of 27.3 another member in the assistance unit, a relative in the 27.4 household, or a foster child in the household when the illness 27.5 or incapacity and the need for a person to provide assistance in 27.6 the home has been certified by a qualified professional and is 27.7 expected to continue for more than 30 days; 27.8 (4) women who are pregnant, if the pregnancy has resulted 27.9 in an incapacity that prevents the woman from obtaining or 27.10 retaining employment, and the incapacity has been certified by a 27.11 qualified professional; 27.12 (5) caregivers of a child under the age of one year who 27.13 personally provide full-time care for the child. This exemption 27.14 may be used for only 12 months in a lifetime. In two-parent 27.15 households, only one parent or other relative may qualify for 27.16 this exemption; 27.17 (6) participants experiencing a personal or family crisis 27.18 that makes them incapable of participating in the program, as 27.19 determined by the county agency. If the participant does not 27.20 agree with the county agency's determination, the participant 27.21 may seek certification from a qualified professional, as defined 27.22 in section 256J.08, that the participant is incapable of 27.23 participating in the program. 27.24 Persons in this exemption category must be reevaluated 27.25 every 60 days. A personal or family crisis related to family 27.26 violence, as determined by the county or a job counselor with 27.27 the assistance of a person trained in domestic violence, should 27.28 not result in an exemption, but should be addressed through the 27.29 development or revision of an employment plan under section 27.30 256J.521, subdivision 3; or 27.31 (7) caregivers with a child or an adult in the household 27.32 who meets the disability or medical criteria for home care 27.33 services under section 256B.0627, subdivision 1, paragraph (f), 27.34 or a home and community-based waiver services program under 27.35 chapter 256B, or meets the criteria for severe emotional 27.36 disturbance under section 245.4871, subdivision 6, or for 28.1 serious and persistent mental illness under section 245.462, 28.2 subdivision 20, paragraph (c). Caregivers in this exemption 28.3 category are presumed to be prevented from obtaining or 28.4 retaining employment. 28.5 A caregiver who is exempt under clause (5) must enroll in 28.6 and attend an early childhood and family education class, a 28.7 parenting class, or some similar activity, if available, during 28.8 the period of time the caregiver is exempt under this section. 28.9 Notwithstanding section 256J.46, failure to attend the required 28.10 activity shall not result in the imposition of a sanction. 28.11(b)(c) The county agency must provide employment and 28.12 training services to MFIP participants who are exempt under this 28.13 section, but who volunteer to participate. Exempt volunteers 28.14 may request approval for any work activity under section 28.15 256J.49, subdivision 13. The hourly participation requirements 28.16 for nonexempt participants under section 256J.55, subdivision 1, 28.17 do not apply to exempt participants who volunteer to participate. 28.18(c)(d) This section expires on June 30,20042005. 28.19 Sec. 38. Minnesota Statutes 2003 Supplement, section 28.20 256J.57, subdivision 1, is amended to read: 28.21 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 28.22 county agency shall not impose the sanction under section 28.23 256J.46 if it determines that the participant has good cause for 28.24 failing to comply with the requirements of sections 256J.515 to 28.25 256J.57. Good cause exists when: 28.26 (1) appropriate child care is not available; 28.27 (2) the job does not meet the definition of suitable 28.28 employment; 28.29 (3) the participant is ill or injured; 28.30 (4) a member of the assistance unit, a relative in the 28.31 household, or a foster child in the household is ill and needs 28.32 care by the participant that prevents the participant from 28.33 complying with the employment plan; 28.34 (5) theparental caregiverparticipant is unable to secure 28.35 necessary transportation; 28.36 (6) theparental caregiverparticipant is in an emergency 29.1 situation that prevents compliance with the employment plan; 29.2 (7) the schedule of compliance with the employment plan 29.3 conflicts with judicial proceedings; 29.4 (8) a mandatory MFIP meeting is scheduled during a time 29.5 that conflicts with a judicial proceeding or a meeting related 29.6 to a juvenile court matter, or a participant's work schedule; 29.7 (9) theparental caregiverparticipant is already 29.8 participating in acceptable work activities; 29.9 (10) the employment plan requires an educational program 29.10 for a caregiver under age 20, but the educational program is not 29.11 available; 29.12 (11) activities identified in the employment plan are not 29.13 available; 29.14 (12) theparental caregiverparticipant is willing to 29.15 accept suitable employment, but suitable employment is not 29.16 available; or 29.17 (13) theparental caregiverparticipant documents other 29.18 verifiable impediments to compliance with the employment plan 29.19 beyond theparental caregiver'sparticipant's control. 29.20 The job counselor shall work with the participant to 29.21 reschedule mandatory meetings for individuals who fall under 29.22 clauses (1), (3), (4), (5), (6), (7), and (8). 29.23 Sec. 39. Minnesota Statutes 2003 Supplement, section 29.24 256J.626, subdivision 2, is amended to read: 29.25 Subd. 2. [ALLOWABLE EXPENDITURES.] (a) The commissioner 29.26 must restrict expenditures under the consolidated fund to 29.27 benefits and services allowed under title IV-A of the federal 29.28 Social Security Act. Allowable expenditures under the 29.29 consolidated fund may include, but are not limited to: 29.30 (1) short-term, nonrecurring shelter and utility needs that 29.31 are excluded from the definition of assistance under Code of 29.32 Federal Regulations, title 45, section 260.31, for families who 29.33 meet the residency requirement in section 256J.12, subdivisions 29.34 1 and 1a. Payments under this subdivision are not considered 29.35 TANF cash assistance and are not counted towards the 60-month 29.36 time limit; 30.1 (2) transportation needed to obtain or retain employment or 30.2 to participate in other approved work activities; 30.3 (3) direct and administrative costs of staff to deliver 30.4 employment services for MFIP or the diversionary work program, 30.5 to administer financial assistance, and to provide specialized 30.6 services intended to assist hard-to-employ participants to 30.7 transition to work; 30.8 (4) costs of education and training including functional 30.9 work literacy and English as a second language; 30.10 (5) cost of work supports including tools, clothing, boots, 30.11 and other work-related expenses; 30.12 (6) county administrative expenses as defined in Code of 30.13 Federal Regulations, title 45, section 260(b); 30.14 (7) services to parenting and pregnant teens; 30.15 (8) supported work; 30.16 (9) wage subsidies; 30.17 (10) child care needed for MFIP or diversionary work 30.18 program participants to participate in social services; 30.19 (11) child care to ensure that families leaving MFIP or 30.20 diversionary work program will continue to receive child care 30.21 assistance from the time the family no longer qualifies for 30.22 transition year child care until an opening occurs under the 30.23 basic sliding fee child care program; and 30.24 (12) services to help noncustodial parents who live in 30.25 Minnesota and have minor children receiving MFIP or DWP 30.26 assistance, but do not live in the same household as the child, 30.27 obtain or retain employment. 30.28 (b) Administrative costs that are not matched with county 30.29 funds as provided in subdivision 8 may not exceed 7.5 percent of 30.30 a county's or 15 percent of a tribe'sreimbursementallocation 30.31 under this section. The commissioner shall define 30.32 administrative costs for purposes of this subdivision. 30.33 Sec. 40. Minnesota Statutes 2003 Supplement, section 30.34 256J.751, subdivision 2, is amended to read: 30.35 Subd. 2. [QUARTERLY COMPARISON REPORT.] The commissioner 30.36 shall report quarterly to all counties on each county's 31.1 performance on the following measures: 31.2 (1) percent of MFIP caseload working in paid employment; 31.3 (2) percent of MFIP caseload receiving only the food 31.4 portion of assistance; 31.5 (3) number of MFIP cases that have left assistance; 31.6 (4) federal participation requirements as specified in 31.7 Title 1 of Public Law 104-193; 31.8 (5) median placement wage rate; 31.9 (6) caseload by months of TANF assistance; 31.10 (7) percent of MFIP and Diversionary Work Program (DWP) 31.11 cases off cash assistance or working 30 or more hours per week 31.12 at one-year, two-year, and three-year follow-up points from a 31.13 baseline quarter. This measure is called the self-support 31.14 index. Twice annually, the commissioner shall report an 31.15 expected range of performance for each county, county grouping, 31.16 and tribe on the self-support index. The expected range shall 31.17 be derived by a statistical methodology developed by the 31.18 commissioner in consultation with the counties and tribes. The 31.19 statistical methodology shall control differences across 31.20 counties in economic conditions and demographics of the MFIP and 31.21 DWP case load; and 31.22 (8) the MFIP work participation rate, defined as the 31.23 participation requirements specified in title 1 of Public Law 31.24 104-193 applied to all MFIP cases except child only cases and 31.25 cases exempt under section 256J.56. 31.26 Sec. 41. Minnesota Statutes 2003 Supplement, section 31.27 256J.95, subdivision 1, is amended to read: 31.28 Subdivision 1. [ESTABLISHING A DIVERSIONARY WORK PROGRAM 31.29 (DWP).] (a) The Personal Responsibility and Work Opportunity 31.30 Reconciliation Act of 1996, Public Law 104-193, establishes 31.31 block grants to states for temporary assistance for needy 31.32 families (TANF). TANF provisions allow states to use TANF 31.33 dollars for nonrecurrent, short-term diversionary benefits. The 31.34 diversionary work program established on July 1, 2003, is 31.35 Minnesota's TANF program to provide short-term diversionary 31.36 benefits to eligible recipients of the diversionary work program. 32.1 (b) The goal of the diversionary work program is to provide 32.2 short-term, necessary services and supports to families which 32.3 will lead to unsubsidized employment, increase economic 32.4 stability, and reduce the risk of those families needing longer 32.5 term assistance, under the Minnesota family investment program 32.6 (MFIP). 32.7 (c) When a family unit meets the eligibility criteria in 32.8 this section, the family must receive a diversionary work 32.9 program grant and is not eligible for MFIP. 32.10 (d) A family unit is eligible for the diversionary work 32.11 program for a maximum of four consecutive monthsonly once in a32.1212-month period. The 12-month period begins at the date of32.13application or the date eligibility is met, whichever is later. 32.14 During thefour-month periodfour consecutive months, family 32.15 maintenance needs as defined in subdivision 2, shall be vendor 32.16 paid, up to the cash portion of the MFIP standard of need for 32.17 the same size household. To the extent there is a balance 32.18 available between the amount paid for family maintenance needs 32.19 and the cash portion of the transitional standard, a personal 32.20 needs allowance of up to $70 per DWP recipient in the family 32.21 unit shall be issued. The personal needs allowance payment plus 32.22 the family maintenance needs shall not exceed the cash portion 32.23 of the MFIP standard of need. Counties may provide supportive 32.24 and other allowable services funded by the MFIP consolidated 32.25 fund under section 256J.626 to eligible participants during the 32.26 four-month diversionary period. 32.27 Sec. 42. Minnesota Statutes 2003 Supplement, section 32.28 256J.95, subdivision 3, is amended to read: 32.29 Subd. 3. [ELIGIBILITY FOR DIVERSIONARY WORK PROGRAM.] (a) 32.30 Except for the categories of family units listed below, all 32.31 family units who apply for cash benefits and who meet MFIP 32.32 eligibility as required in sections 256J.11 to 256J.15 are 32.33 eligible and must participate in the diversionary work program. 32.34 Family units that are not eligible for the diversionary work 32.35 program include: 32.36 (1) child only cases; 33.1 (2) a single-parent family unit that includes a child under 33.2 12 weeks of age. A parent is eligible for this exception once 33.3 in a parent's lifetime and is not eligible if the parent has 33.4 already used the previously allowed child under age one 33.5 exemption from MFIP employment services; 33.6 (3) a minor parent without a high school diploma or its 33.7 equivalent; 33.8 (4)a caregiveran 18 or 19years of ageyear old 33.9 participant without a high school diploma or its equivalent who 33.10 chooses to have an employment plan with an education option; 33.11 (5) a caregiver age 60 or over; 33.12 (6) family units with aparentcaregiver who received DWP 33.13 benefitswithin a 12-month period as defined in subdivision 1,33.14paragraph (d)in the 12 months prior to the month the family 33.15 applied for DWP, except as provided in paragraph (c);and33.16 (7) family units with aparentcaregiver who received MFIP 33.17 within thepast12 months prior to the month the family unit 33.18 applied for DWP, except as provided in paragraph (c); 33.19 (8) a family unit with a caregiver who received 60 or more 33.20 months of TANF assistance; and 33.21 (9) a family unit with a caregiver who is disqualified from 33.22 DWP or MFIP due to fraud. 33.23 (b) A two-parent family must participate in DWP unless both 33.24parentscaregivers meet the criteria for an exception under 33.25 paragraph (a), clauses (1) through (5), or the family unit 33.26 includes a parent who meets the criteria in paragraph (a), 33.27 clause (6)or, (7), (8), or (9). 33.28 (c) Once DWP eligibility is determined, the four months run 33.29 consecutively. If a participant leaves the program for any 33.30 reason and reapplies during the four-month period, the county 33.31 must redetermine eligibility for DWP. 33.32 Sec. 43. Minnesota Statutes 2003 Supplement, section 33.33 256J.95, subdivision 11, is amended to read: 33.34 Subd. 11. [UNIVERSAL PARTICIPATION REQUIRED.] (a) All DWP 33.35 caregivers, except caregivers who meet the criteria in paragraph 33.36 (d), are required to participate in DWP employment services. 34.1 Except as specified in paragraphs (b) and (c), employment plans 34.2 under DWP must, at a minimum, meet the requirements in section 34.3 256J.55, subdivision 1. 34.4 (b) A caregiver who is a member of a two-parent family that 34.5 is required to participate in DWP who would otherwise be 34.6 ineligible for DWP under subdivision 3 may be allowed to develop 34.7 an employment plan under section 256J.521, subdivision 2, 34.8 paragraph (c), that may contain alternate activities and reduced 34.9 hours. 34.10 (c) A participant whohasis a victim of family violence 34.11waivershall be allowed to develop an employment plan under 34.12 section 256J.521, subdivision 3. A claim of family violence 34.13 must be documented by the applicant or participant by providing 34.14 a sworn statement which is supported by collateral documentation 34.15 in section 256J.545, paragraph (b). 34.16 (d) One parent in a two-parent family unit that has a 34.17 natural born child under 12 weeks of age is not required to have 34.18 an employment plan until the child reaches 12 weeks of age 34.19 unless the family unit has already used the exclusion under 34.20 section 256J.561, subdivision 2, or the previously allowed child 34.21 under age one exemption under section 256J.56, paragraph (a), 34.22 clause (5). 34.23 (e) The provision in paragraph (d) ends the first full 34.24 month after the child reaches 12 weeks of age. This provision 34.25 is allowable only once in a caregiver's lifetime. In a 34.26 two-parent household, only one parent shall be allowed to use 34.27 this category. 34.28 (f) The participant and job counselor must meet within ten 34.29 working days after the child reaches 12 weeks of age to revise 34.30 the participant's employment plan. The employment plan for a 34.31 family unit that has a child under 12 weeks of age that has 34.32 already used the exclusion in section 256J.561 or the previously 34.33 allowed child under age one exemption under section 256J.56, 34.34 paragraph (a), clause (5), must be tailored to recognize the 34.35 caregiving needs of the parent. 34.36 Sec. 44. Minnesota Statutes 2003 Supplement, section 35.1 256J.95, subdivision 12, is amended to read: 35.2 Subd. 12. [CONVERSION OR REFERRAL TO MFIP.] (a) If at any 35.3 time during the DWP application process or during the four-month 35.4 DWP eligibility period, it is determined that a participant is 35.5 unlikely to benefit from the diversionary work program, the 35.6 county shall convert or refer the participant to MFIP as 35.7 specified in paragraph (d). Participants who are determined to 35.8 be unlikely to benefit from the diversionary work program must 35.9 develop and sign an employment plan. Participants who meet any 35.10 one of the criteria in paragraph (b) shall be considered to be 35.11 unlikely to benefit from DWP, provided the necessary 35.12 documentation is available to support the determination. 35.13 (b) A participant who: 35.14 (1) has been determined by a qualified professional as 35.15 being unable to obtain or retain employment due to an illness, 35.16 injury, or incapacity that is expected to last at least 60 days; 35.17 (2) is required in the home as a caregiver because of the 35.18 illness, injury, or incapacity, of a family member, or a 35.19 relative in the household, or a foster child, and the illness, 35.20 injury, or incapacity and the need for a person to provide 35.21 assistance in the home has been certified by a qualified 35.22 professional and is expected to continue more than 60 days; 35.23 (3) is determined by a qualified professional as being 35.24 needed in the home to care for a child or adult meeting the 35.25 special medical criteria in section 256J.425, subdivision 2, 35.26 clause (3); 35.27 (4) is pregnant and is determined by a qualified 35.28 professional as being unable to obtain or retain employment due 35.29 to the pregnancy; or 35.30 (5) has applied for SSI orRSDISSDI. 35.31 (c) In a two-parent family unit, both parents must be 35.32 determined to be unlikely to benefit from the diversionary work 35.33 program before the family unit can be converted or referred to 35.34 MFIP. 35.35 (d) A participant who is determined to be unlikely to 35.36 benefit from the diversionary work program shall be converted to 36.1 MFIP and, if the determination was made within 30 days of the 36.2 initial application for benefits, no additional application form 36.3 is required. A participant who is determined to be unlikely to 36.4 benefit from the diversionary work program shall be referred to 36.5 MFIP and, if the determination is made more than 30 days after 36.6 the initial application, the participant must submit a program 36.7 change request form. The county agency shall process the 36.8 program change request form by the first of the following month 36.9 to ensure that no gap in benefits is due to delayed action by 36.10 the county agency. In processing the program change request 36.11 form, the county must follow section 256J.32, subdivision 1, 36.12 except that the county agency shall not require additional 36.13 verification of the information in the case file from the DWP 36.14 application unless the information in the case file is 36.15 inaccurate, questionable, or no longer current. 36.16 (e) The county shall not request a combined application 36.17 form for a participant who has exhausted the four months of the 36.18 diversionary work program, has continued need for cash and food 36.19 assistance, and has completed, signed, and submitted a program 36.20 change request form within 30 days of the fourth month of the 36.21 diversionary work program. The county must process the program 36.22 change request according to section 256J.32, subdivision 1, 36.23 except that the county agency shall not require additional 36.24 verification of information in the case file unless the 36.25 information is inaccurate, questionable, or no longer current. 36.26 When a participant does not request MFIP within 30 days of the 36.27 diversionary work program benefits being exhausted, a new 36.28 combined application form must be completed for any subsequent 36.29 request for MFIP. 36.30 Sec. 45. Minnesota Statutes 2003 Supplement, section 36.31 256J.95, subdivision 19, is amended to read: 36.32 Subd. 19. [RECOVERY OFDWP OVERPAYMENTS AND 36.33 UNDERPAYMENTS.]WhenDWP benefits are subject to overpayments 36.34 and underpayments. Anytime an overpayment or anATM error36.35 underpayment is determined for DWP, theoverpaymentcorrection 36.36 shall berecouped orcalculated using prospective budgeting. 37.1 Corrections shall be determined based on the policy in section 37.2 256J.34, subdivision 1, paragraphs (a), (b), and (c), and 37.3 subdivision (3), paragraph (b), clause (1). ATM errors must be 37.4 recovered as specified in section 256J.38, subdivision 5. DWP 37.5 overpayments are not subject to cross program recoupment. 37.6 Sec. 46. [REPEALER.] 37.7 (a) Minnesota Statutes 2002, sections 119B.211 and 37.8 256D.051, subdivision 17, are repealed. 37.9 (b) Laws 2000, chapter 489, article 1, section 36, is 37.10 repealed. 37.11 ARTICLE 2 37.12 LONG-TERM CARE 37.13 Section 1. Minnesota Statutes 2003 Supplement, section 37.14 245A.11, subdivision 2a, is amended to read: 37.15 Subd. 2a. [ADULT FOSTER CARE LICENSE CAPACITY.] (a) An 37.16 adult foster care license holder may have a maximum license 37.17 capacity of five if all persons in care are age 55 or over and 37.18 do not have a serious and persistent mental illness or a 37.19 developmental disability. 37.20 (b) The commissioner may grant variances to paragraph (a) 37.21 to allow a foster care provider with a licensed capacity of five 37.22 persons to admit an individual under the age of 55 if the 37.23 variance complies with section 245A.04, subdivision 9, and 37.24 approval of the variance is recommended by the county in which 37.25 the licensed foster care provider is located. 37.26 (c) The commissioner may grant variances to paragraph (a) 37.27 to allow the use of a fifth bed for emergency crisis services 37.28 for a person with serious and persistent mental illness or a 37.29 developmental disability, regardless of age, if the variance 37.30 complies with section 245A.04, subdivision 9, and approval of 37.31 the variance is recommended by the county in which the licensed 37.32 foster care provider is located. 37.33 (d) Notwithstanding paragraph (a), the commissioner may 37.34 issue an adult foster care license with a capacity of five 37.35 adults when the capacity is recommended by the county licensing 37.36 agency of the county in which the facility is located and if the 38.1 recommendation verifies that: 38.2 (1) the facility meets the physical environment 38.3 requirements in the adult foster care licensing rule; 38.4 (2) the five-bed living arrangement is specified for each 38.5 resident in the resident's: 38.6 (i) individualized plan of care; 38.7 (ii) individual service plan under section 256B.092, 38.8 subdivision 1b, if required; or 38.9 (iii) individual resident placement agreement under 38.10 Minnesota Rules, part 9555.5105, subpart 19, if required; 38.11 (3) the license holder obtains written and signed informed 38.12 consent from each resident or resident's legal representative 38.13 documenting the resident's informed choice to living in the home 38.14 and that the resident's refusal to consent would not have 38.15 resulted in service termination; and 38.16 (4) the facility was licensed for adult foster care before 38.17 March 1, 2003. 38.18 (e) The commissioner shall not issue a new adult foster 38.19 care license under paragraph (d) after June 30, 2005. The 38.20 commissioner shall allow a facility with an adult foster care 38.21 license issued under paragraph (d) before June 30, 2005, to 38.22 continue with a capacity of fiveor sixadults if the license 38.23 holder continues to comply with the requirements in paragraph 38.24 (d). 38.25 Sec. 2. Minnesota Statutes 2002, section 256B.0911, 38.26 subdivision 4a, is amended to read: 38.27 Subd. 4a. [PREADMISSION SCREENING ACTIVITIES RELATED TO 38.28 NURSING FACILITY ADMISSIONS.] (a) All applicants to Medicaid 38.29 certified nursing facilities, including certified boarding care 38.30 facilities, must be screened prior to admission regardless of 38.31 income, assets, or funding sources for nursing facility care, 38.32 except as described in subdivision 4b. The purpose of the 38.33 screening is to determine the need for nursing facility level of 38.34 care as described in paragraph (d) and to complete activities 38.35 required under federal law related to mental illness and mental 38.36 retardation as outlined in paragraph (b). 39.1 (b) A person who has a diagnosis or possible diagnosis of 39.2 mental illness, mental retardation, or a related condition must 39.3 receive a preadmission screening before admission regardless of 39.4 the exemptions outlined in subdivision 4b, paragraph (b), to 39.5 identify the need for further evaluation and specialized 39.6 services, unless the admission prior to screening is authorized 39.7 by the local mental health authority or the local developmental 39.8 disabilities case manager, or unless authorized by the county 39.9 agency according to Public Law100-508101-508. 39.10 The following criteria apply to the preadmission screening: 39.11 (1) the county must use forms and criteria developed by the 39.12 commissioner to identify persons who require referral for 39.13 further evaluation and determination of the need for specialized 39.14 services; and 39.15 (2) the evaluation and determination of the need for 39.16 specialized services must be done by: 39.17 (i) a qualified independent mental health professional, for 39.18 persons with a primary or secondary diagnosis of a serious 39.19 mental illness; or 39.20 (ii) a qualified mental retardation professional, for 39.21 persons with a primary or secondary diagnosis of mental 39.22 retardation or related conditions. For purposes of this 39.23 requirement, a qualified mental retardation professional must 39.24 meet the standards for a qualified mental retardation 39.25 professional under Code of Federal Regulations, title 42, 39.26 section 483.430. 39.27 (c) The local county mental health authority or the state 39.28 mental retardation authority under Public Law Numbers 100-203 39.29 and 101-508 may prohibit admission to a nursing facility if the 39.30 individual does not meet the nursing facility level of care 39.31 criteria or needs specialized services as defined in Public Law 39.32 Numbers 100-203 and 101-508. For purposes of this section, 39.33 "specialized services" for a person with mental retardation or a 39.34 related condition means active treatment as that term is defined 39.35 under Code of Federal Regulations, title 42, section 483.440 39.36 (a)(1). 40.1 (d) The determination of the need for nursing facility 40.2 level of care must be made according to criteria developed by 40.3 the commissioner. In assessing a person's needs, consultation 40.4 team members shall have a physician available for consultation 40.5 and shall consider the assessment of the individual's attending 40.6 physician, if any. The individual's physician must be included 40.7 if the physician chooses to participate. Other personnel may be 40.8 included on the team as deemed appropriate by the county. 40.9 Sec. 3. Minnesota Statutes 2003 Supplement, section 40.10 256B.0915, subdivision 3a, is amended to read: 40.11 Subd. 3a. [ELDERLY WAIVER COST LIMITS.] (a) The monthly 40.12 limit for the cost of waivered services to an individual elderly 40.13 waiver client shall be the weighted average monthly nursing 40.14 facility rate of the case mix resident class to which the 40.15 elderly waiver client would be assigned under Minnesota Rules, 40.16 parts 9549.0050 to 9549.0059, less the recipient's maintenance 40.17 needs allowance as described in subdivision 1d, paragraph (a), 40.18 until the first day of the state fiscal year in which the 40.19 resident assessment system as described in section 256B.437 for 40.20 nursing home rate determination is implemented. Effective on 40.21 the first day of the state fiscal year in which the resident 40.22 assessment system as described in section 256B.437 for nursing 40.23 home rate determination is implemented and the first day of each 40.24 subsequent state fiscal year, the monthly limit for the cost of 40.25 waivered services to an individual elderly waiver client shall 40.26 be the rate of the case mix resident class to which the waiver 40.27 client would be assigned under Minnesota Rules, parts 9549.0050 40.28 to 9549.0059, in effect on the last day of the previous state 40.29 fiscal year, adjusted by the greater of any legislatively 40.30 adopted home and community-based servicescost-of-living40.31 percentage rate increase orany legislatively adoptedthe 40.32 average statewidepercent ratepercentage increaseforin 40.33 nursingfacilitiesfacility payment rates. 40.34 (b) If extended medical supplies and equipment or 40.35 environmental modifications are or will be purchased for an 40.36 elderly waiver client, the costs may be prorated for up to 12 41.1 consecutive months beginning with the month of purchase. If the 41.2 monthly cost of a recipient's waivered services exceeds the 41.3 monthly limit established in paragraph (a), the annual cost of 41.4 all waivered services shall be determined. In this event, the 41.5 annual cost of all waivered services shall not exceed 12 times 41.6 the monthly limit of waivered services as described in paragraph 41.7 (a). 41.8 Sec. 4. Minnesota Statutes 2003 Supplement, section 41.9 256B.0915, subdivision 3b, is amended to read: 41.10 Subd. 3b. [COST LIMITS FOR ELDERLY WAIVER APPLICANTS WHO 41.11 RESIDE IN A NURSING FACILITY.] (a) For a person who is a nursing 41.12 facility resident at the time of requesting a determination of 41.13 eligibility for elderly waivered services, a monthly conversion 41.14 limit for the cost of elderly waivered services may be 41.15 requested. The monthly conversion limit for the cost of elderly 41.16 waiver services shall be the resident class assigned under 41.17 Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident 41.18 in the nursing facility where the resident currently resides 41.19 until July 1 of the state fiscal year in which the resident 41.20 assessment system as described in section 256B.437 for nursing 41.21 home rate determination is implemented. Effective on July 1 of 41.22 the state fiscal year in which the resident assessment system as 41.23 described in section 256B.437 for nursing home rate 41.24 determination is implemented, the monthly conversion limit for 41.25 the cost of elderly waiver services shall be the per diem 41.26 nursing facility rate as determined by the resident assessment 41.27 system as described in section 256B.437 for that resident in the 41.28 nursing facility where the resident currently resides multiplied 41.29 by 365 and divided by 12, less the recipient's maintenance needs 41.30 allowance as described in subdivision 1d. The initially 41.31 approved conversion rate may be adjusted by the greater of any 41.32 subsequent legislatively adopted home and community-based 41.33 servicescost-of-livingpercentage rate increaseor any41.34subsequent legislatively adoptedthe average statewide 41.35 percentagerateincreaseforin nursingfacilitiesfacility 41.36 payment rates. The limit under this subdivision only applies to 42.1 persons discharged from a nursing facility after a minimum 42.2 30-day stay and found eligible for waivered services on or after 42.3 July 1, 1997. 42.4 (b) The following costs must be included in determining the 42.5 total monthly costs for the waiver client: 42.6 (1) cost of all waivered services, including extended 42.7 medical supplies and equipment and environmental modifications; 42.8 and 42.9 (2) cost of skilled nursing, home health aide, and personal 42.10 care services reimbursable by medical assistance. 42.11 Sec. 5. Minnesota Statutes 2003 Supplement, section 42.12 256B.431, subdivision 32, is amended to read: 42.13 Subd. 32. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 42.14 years beginning on or after July 1, 2001, the total payment rate 42.15 for a facility reimbursed under this section, section 256B.434, 42.16 or any other section for the first 90 paid days after admission 42.17 shall be: 42.18 (1) for the first 30 paid days, the rate shall be 120 42.19 percent of the facility's medical assistance rate for each case 42.20 mix class; 42.21 (2) for the next 60 paid days after the first 30 paid days, 42.22 the rate shall be 110 percent of the facility's medical 42.23 assistance rate for each case mix class; 42.24 (3) beginning with the 91st paid day after admission, the 42.25 payment rate shall be the rate otherwise determined under this 42.26 section, section 256B.434, or any other section; and 42.27 (4) payments under this paragraph apply to admissions 42.28 occurring on or after July 1, 2001, and before July 1, 2003, and 42.29 to resident days occurring before July 30, 2003. 42.30 (b) For rate years beginning on or after July 1, 2003, the 42.31 total payment rate for a facility reimbursed under this section, 42.32 section 256B.434, or any other section shall be: 42.33 (1) for the first 30 calendar days after admission, the 42.34 rate shall be 120 percent of the facility's medical assistance 42.35 rate for each RUG class; 42.36 (2) beginning with the 31st calendar day after admission, 43.1 the payment rate shall be the rate otherwise determined under 43.2 this section, section 256B.434, or any other section; and 43.3 (3) payments under this paragraph apply to admissions 43.4 occurring on or after July 1, 2003. 43.5 (c) Effective January 1, 2004, the enhanced rates under 43.6 this subdivision shall not be allowed if a resident has resided 43.7 during the previous 30 calendar days in: 43.8 (1) the same nursing facility; 43.9 (2) a nursing facility owned or operated by a related 43.10 party; or 43.11 (3) a nursing facility or part of a facility that closed or 43.12 was in the process of closing. 43.13 ARTICLE 3 43.14 HEALTH CARE 43.15 Section 1. Minnesota Statutes 2003 Supplement, section 43.16 256.01, subdivision 2, is amended to read: 43.17 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 43.18 section 241.021, subdivision 2, the commissioner of human 43.19 services shall carry out the specific duties in paragraphs (a) 43.20 through (aa): 43.21(1)(a) Administer and supervise all forms of public 43.22 assistance provided for by state law and other welfare 43.23 activities or services as are vested in the commissioner. 43.24 Administration and supervision of human services activities or 43.25 services includes, but is not limited to, assuring timely and 43.26 accurate distribution of benefits, completeness of service, and 43.27 quality program management. In addition to administering and 43.28 supervising human services activities vested by law in the 43.29 department, the commissioner shall have the authority to: 43.30(a)(1) require county agency participation in training and 43.31 technical assistance programs to promote compliance with 43.32 statutes, rules, federal laws, regulations, and policies 43.33 governing human services; 43.34(b)(2) monitor, on an ongoing basis, the performance of 43.35 county agencies in the operation and administration of human 43.36 services, enforce compliance with statutes, rules, federal laws, 44.1 regulations, and policies governing welfare services and promote 44.2 excellence of administration and program operation; 44.3(c)(3) develop a quality control program or other 44.4 monitoring program to review county performance and accuracy of 44.5 benefit determinations; 44.6(d)(4) require county agencies to make an adjustment to 44.7 the public assistance benefits issued to any individual 44.8 consistent with federal law and regulation and state law and 44.9 rule and to issue or recover benefits as appropriate; 44.10(e)(5) delay or deny payment of all or part of the state 44.11 and federal share of benefits and administrative reimbursement 44.12 according to the procedures set forth in section 256.017; 44.13(f)(6) make contracts with and grants to public and 44.14 private agencies and organizations, both profit and nonprofit, 44.15 and individuals, using appropriated funds; and 44.16(g)(7) enter into contractual agreements with federally 44.17 recognized Indian tribes with a reservation in Minnesota to the 44.18 extent necessary for the tribe to operate a federally approved 44.19 family assistance program or any other program under the 44.20 supervision of the commissioner. The commissioner shall consult 44.21 with the affected county or counties in the contractual 44.22 agreement negotiations, if the county or counties wish to be 44.23 included, in order to avoid the duplication of county and tribal 44.24 assistance program services. The commissioner may establish 44.25 necessary accounts for the purposes of receiving and disbursing 44.26 funds as necessary for the operation of the programs. 44.27(2)(b) Inform county agencies, on a timely basis, of 44.28 changes in statute, rule, federal law, regulation, and policy 44.29 necessary to county agency administration of the programs. 44.30(3)(c) Administer and supervise all child welfare 44.31 activities; promote the enforcement of laws protecting 44.32 handicapped, dependent, neglected and delinquent children, and 44.33 children born to mothers who were not married to the children's 44.34 fathers at the times of the conception nor at the births of the 44.35 children; license and supervise child-caring and child-placing 44.36 agencies and institutions; supervise the care of children in 45.1 boarding and foster homes or in private institutions; and 45.2 generally perform all functions relating to the field of child 45.3 welfare now vested in the State Board of Control. 45.4(4)(d) Administer and supervise all noninstitutional 45.5 service to handicapped persons, including those who are visually 45.6 impaired, hearing impaired, or physically impaired or otherwise 45.7 handicapped. The commissioner may provide and contract for the 45.8 care and treatment of qualified indigent children in facilities 45.9 other than those located and available at state hospitals when 45.10 it is not feasible to provide the service in state hospitals. 45.11(5)(e) Assist and actively cooperate with other 45.12 departments, agencies and institutions, local, state, and 45.13 federal, by performing services in conformity with the purposes 45.14 of Laws 1939, chapter 431. 45.15(6)(f) Act as the agent of and cooperate with the federal 45.16 government in matters of mutual concern relative to and in 45.17 conformity with the provisions of Laws 1939, chapter 431, 45.18 including the administration of any federal funds granted to the 45.19 state to aid in the performance of any functions of the 45.20 commissioner as specified in Laws 1939, chapter 431, and 45.21 including the promulgation of rules making uniformly available 45.22 medical care benefits to all recipients of public assistance, at 45.23 such times as the federal government increases its participation 45.24 in assistance expenditures for medical care to recipients of 45.25 public assistance, the cost thereof to be borne in the same 45.26 proportion as are grants of aid to said recipients. 45.27(7)(g) Establish and maintain any administrative units 45.28 reasonably necessary for the performance of administrative 45.29 functions common to all divisions of the department. 45.30(8)(h) Act as designated guardian of both the estate and 45.31 the person of all the wards of the state of Minnesota, whether 45.32 by operation of law or by an order of court, without any further 45.33 act or proceeding whatever, except as to persons committed as 45.34 mentally retarded. For children under the guardianship of the 45.35 commissioner whose interests would be best served by adoptive 45.36 placement, the commissioner may contract with a licensed 46.1 child-placing agency or a Minnesota tribal social services 46.2 agency to provide adoption services. A contract with a licensed 46.3 child-placing agency must be designed to supplement existing 46.4 county efforts and may not replace existing county programs, 46.5 unless the replacement is agreed to by the county board and the 46.6 appropriate exclusive bargaining representative or the 46.7 commissioner has evidence that child placements of the county 46.8 continue to be substantially below that of other counties. 46.9 Funds encumbered and obligated under an agreement for a specific 46.10 child shall remain available until the terms of the agreement 46.11 are fulfilled or the agreement is terminated. 46.12(9)(i) Act as coordinating referral and informational 46.13 center on requests for service for newly arrived immigrants 46.14 coming to Minnesota. 46.15(10)(j) The specific enumeration of powers and duties as 46.16 hereinabove set forth shall in no way be construed to be a 46.17 limitation upon the general transfer of powers herein contained. 46.18(11)(k) Establish county, regional, or statewide schedules 46.19 of maximum fees and charges which may be paid by county agencies 46.20 for medical, dental, surgical, hospital, nursing and nursing 46.21 home care and medicine and medical supplies under all programs 46.22 of medical care provided by the state and for congregate living 46.23 care under the income maintenance programs. 46.24(12)(l) Have the authority to conduct and administer 46.25 experimental projects to test methods and procedures of 46.26 administering assistance and services to recipients or potential 46.27 recipients of public welfare. To carry out such experimental 46.28 projects, it is further provided that the commissioner of human 46.29 services is authorized to waive the enforcement of existing 46.30 specific statutory program requirements, rules, and standards in 46.31 one or more counties. The order establishing the waiver shall 46.32 provide alternative methods and procedures of administration, 46.33 shall not be in conflict with the basic purposes, coverage, or 46.34 benefits provided by law, and in no event shall the duration of 46.35 a project exceed four years. It is further provided that no 46.36 order establishing an experimental project as authorized by the 47.1 provisions of this section shall become effective until the 47.2 following conditions have been met: 47.3(a)(1) the secretary of health and human services of the 47.4 United States has agreed, for the same project, to waive state 47.5 plan requirements relative to statewide uniformity.; and 47.6(b)(2) a comprehensive plan, including estimated project 47.7 costs, shall be approved by the Legislative Advisory Commission 47.8 and filed with the commissioner of administration. 47.9(13)(m) According to federal requirements, establish 47.10 procedures to be followed by local welfare boards in creating 47.11 citizen advisory committees, including procedures for selection 47.12 of committee members. 47.13(14)(n) Allocate federal fiscal disallowances or sanctions 47.14 which are based on quality control error rates for the aid to 47.15 families with dependent children program formerly codified in 47.16 sections 256.72 to 256.87, medical assistance, or food stamp 47.17 program in the following manner: 47.18(a)(1) one-half of the total amount of the disallowance 47.19 shall be borne by the county boards responsible for 47.20 administering the programs. For the medical assistance and the 47.21 AFDC program formerly codified in sections 256.72 to 256.87, 47.22 disallowances shall be shared by each county board in the same 47.23 proportion as that county's expenditures for the sanctioned 47.24 program are to the total of all counties' expenditures for the 47.25 AFDC program formerly codified in sections 256.72 to 256.87, and 47.26 medical assistance programs. For the food stamp program, 47.27 sanctions shall be shared by each county board, with 50 percent 47.28 of the sanction being distributed to each county in the same 47.29 proportion as that county's administrative costs for food stamps 47.30 are to the total of all food stamp administrative costs for all 47.31 counties, and 50 percent of the sanctions being distributed to 47.32 each county in the same proportion as that county's value of 47.33 food stamp benefits issued are to the total of all benefits 47.34 issued for all counties. Each county shall pay its share of the 47.35 disallowance to the state of Minnesota. When a county fails to 47.36 pay the amount due hereunder, the commissioner may deduct the 48.1 amount from reimbursement otherwise due the county, or the 48.2 attorney general, upon the request of the commissioner, may 48.3 institute civil action to recover the amount due.; and 48.4(b)(2) notwithstanding the provisions ofparagraph48.5(a)clause (1), if the disallowance results from knowing 48.6 noncompliance by one or more counties with a specific program 48.7 instruction, and that knowing noncompliance is a matter of 48.8 official county board record, the commissioner may require 48.9 payment or recover from the county or counties, in the manner 48.10 prescribed inparagraph (a)clause (1), an amount equal to the 48.11 portion of the total disallowance which resulted from the 48.12 noncompliance, and may distribute the balance of the 48.13 disallowance according toparagraph (a)clause (1). 48.14(15)(o) Develop and implement special projects that 48.15 maximize reimbursements and result in the recovery of money to 48.16 the state. For the purpose of recovering state money, the 48.17 commissioner may enter into contracts with third parties. Any 48.18 recoveries that result from projects or contracts entered into 48.19 under this paragraph shall be deposited in the state treasury 48.20 and credited to a special account until the balance in the 48.21 account reaches $1,000,000. When the balance in the account 48.22 exceeds $1,000,000, the excess shall be transferred and credited 48.23 to the general fund. All money in the account is appropriated 48.24 to the commissioner for the purposes of this paragraph. 48.25(16)(p) Have the authority to make direct payments to 48.26 facilities providing shelter to women and their children 48.27 according to section 256D.05, subdivision 3. Upon the written 48.28 request of a shelter facility that has been denied payments 48.29 under section 256D.05, subdivision 3, the commissioner shall 48.30 review all relevant evidence and make a determination within 30 48.31 days of the request for review regarding issuance of direct 48.32 payments to the shelter facility. Failure to act within 30 days 48.33 shall be considered a determination not to issue direct payments. 48.34(17)(q) Have the authority to establish and enforce the 48.35 following county reporting requirements: 48.36(a)(1) the commissioner shall establish fiscal and 49.1 statistical reporting requirements necessary to account for the 49.2 expenditure of funds allocated to counties for human services 49.3 programs. When establishing financial and statistical reporting 49.4 requirements, the commissioner shall evaluate all reports, in 49.5 consultation with the counties, to determine if the reports can 49.6 be simplified or the number of reports can be reduced.; 49.7(b)(2) the county board shall submit monthly or quarterly 49.8 reports to the department as required by the commissioner. 49.9 Monthly reports are due no later than 15 working days after the 49.10 end of the month. Quarterly reports are due no later than 30 49.11 calendar days after the end of the quarter, unless the 49.12 commissioner determines that the deadline must be shortened to 49.13 20 calendar days to avoid jeopardizing compliance with federal 49.14 deadlines or risking a loss of federal funding. Only reports 49.15 that are complete, legible, and in the required format shall be 49.16 accepted by the commissioner.; 49.17(c)(3) if the required reports are not received by the 49.18 deadlines established in clause(b)(2), the commissioner may 49.19 delay payments and withhold funds from the county board until 49.20 the next reporting period. When the report is needed to account 49.21 for the use of federal funds and the late report results in a 49.22 reduction in federal funding, the commissioner shall withhold 49.23 from the county boards with late reports an amount equal to the 49.24 reduction in federal funding until full federal funding is 49.25 received.; 49.26(d)(4) a county board that submits reports that are late, 49.27 illegible, incomplete, or not in the required format for two out 49.28 of three consecutive reporting periods is considered 49.29 noncompliant. When a county board is found to be noncompliant, 49.30 the commissioner shall notify the county board of the reason the 49.31 county board is considered noncompliant and request that the 49.32 county board develop a corrective action plan stating how the 49.33 county board plans to correct the problem. The corrective 49.34 action plan must be submitted to the commissioner within 45 days 49.35 after the date the county board received notice of 49.36 noncompliance.; 50.1(e)(5) the final deadline for fiscal reports or amendments 50.2 to fiscal reports is one year after the date the report was 50.3 originally due. If the commissioner does not receive a report 50.4 by the final deadline, the county board forfeits the funding 50.5 associated with the report for that reporting period and the 50.6 county board must repay any funds associated with the report 50.7 received for that reporting period.; 50.8(f)(6) the commissioner may not delay payments, withhold 50.9 funds, or require repayment underparagraph (c)clause (3) or 50.10(e)(5) if the county demonstrates that the commissioner failed 50.11 to provide appropriate forms, guidelines, and technical 50.12 assistance to enable the county to comply with the 50.13 requirements. If the county board disagrees with an action 50.14 taken by the commissioner underparagraph (c)clause (3) or 50.15(e)(5), the county board may appeal the action according to 50.16 sections 14.57 to 14.69.; and 50.17(g)(7) counties subject to withholding of funds under 50.18paragraph (c)clause (3) or forfeiture or repayment of funds 50.19 underparagraph (e)clause (5) shall not reduce or withhold 50.20 benefits or services to clients to cover costs incurred due to 50.21 actions taken by the commissioner underparagraph (c)clause (3) 50.22 or(e)(5). 50.23(18)(r) Allocate federal fiscal disallowances or sanctions 50.24 for audit exceptions when federal fiscal disallowances or 50.25 sanctions are based on a statewide random sample for the foster 50.26 care program under title IV-E of the Social Security Act, United 50.27 States Code, title 42, in direct proportion to each county's 50.28 title IV-E foster care maintenance claim for that period. 50.29(19)(s) Be responsible for ensuring the detection, 50.30 prevention, investigation, and resolution of fraudulent 50.31 activities or behavior by applicants, recipients, and other 50.32 participants in the human services programs administered by the 50.33 department. 50.34(20)(t) Require county agencies to identify overpayments, 50.35 establish claims, and utilize all available and cost-beneficial 50.36 methodologies to collect and recover these overpayments in the 51.1 human services programs administered by the department. 51.2(21)(u) Have the authority to administer a drug rebate 51.3 program for drugs purchased pursuant to the prescription drug 51.4 program established under section 256.955 after the 51.5 beneficiary's satisfaction of any deductible established in the 51.6 program. The commissioner shall require a rebate agreement from 51.7 all manufacturers of covered drugs as defined in section 51.8 256B.0625, subdivision 13. Rebate agreements for prescription 51.9 drugs delivered on or after July 1, 2002, must include rebates 51.10 for individuals covered under the prescription drug program who 51.11 are under 65 years of age. For each drug, the amount of the 51.12 rebate shall be equal to the rebate as defined for purposes of 51.13 the federal rebate program in United States Code, title 42, 51.14 section1396r-8(c)(1)1396r-8. The manufacturers must provide 51.15 full payment within 30 days of receipt of the state invoice for 51.16 the rebate within the terms and conditions used for the federal 51.17 rebate program established pursuant to section 1927 of title XIX 51.18 of the Social Security Act. The manufacturers must provide the 51.19 commissioner with any information necessary to verify the rebate 51.20 determined per drug. The rebate program shall utilize the terms 51.21 and conditions used for the federal rebate program established 51.22 pursuant to section 1927 of title XIX of the Social Security Act. 51.23(22)(v) Have the authority to administer the federal drug 51.24 rebate program for drugs purchased under the medical assistance 51.25 program as allowed by section 1927 of title XIX of the Social 51.26 Security Act and according to the terms and conditions of 51.27 section 1927. Rebates shall be collected for all drugs that 51.28 have been dispensed or administered in an outpatient setting and 51.29 that are from manufacturers who have signed a rebate agreement 51.30 with the United States Department of Health and Human Services. 51.31(23)(w) Have the authority to administer a supplemental 51.32 drug rebate program for drugs purchased under the medical 51.33 assistance program. The commissioner may enter into 51.34 supplemental rebate contracts with pharmaceutical manufacturers 51.35 and may require prior authorization for drugs that are from 51.36 manufacturers that have not signed a supplemental rebate 52.1 contract. Prior authorization of drugs shall be subject to the 52.2 provisions of section 256B.0625, subdivision 13. 52.3(24)(x) Operate the department's communication systems 52.4 account established in Laws 1993, First Special Session chapter 52.5 1, article 1, section 2, subdivision 2, to manage shared 52.6 communication costs necessary for the operation of the programs 52.7 the commissioner supervises. A communications account may also 52.8 be established for each regional treatment center which operates 52.9 communications systems. Each account must be used to manage 52.10 shared communication costs necessary for the operations of the 52.11 programs the commissioner supervises. The commissioner may 52.12 distribute the costs of operating and maintaining communication 52.13 systems to participants in a manner that reflects actual usage. 52.14 Costs may include acquisition, licensing, insurance, 52.15 maintenance, repair, staff time and other costs as determined by 52.16 the commissioner. Nonprofit organizations and state, county, 52.17 and local government agencies involved in the operation of 52.18 programs the commissioner supervises may participate in the use 52.19 of the department's communications technology and share in the 52.20 cost of operation. The commissioner may accept on behalf of the 52.21 state any gift, bequest, devise or personal property of any 52.22 kind, or money tendered to the state for any lawful purpose 52.23 pertaining to the communication activities of the department. 52.24 Any money received for this purpose must be deposited in the 52.25 department's communication systems accounts. Money collected by 52.26 the commissioner for the use of communication systems must be 52.27 deposited in the state communication systems account and is 52.28 appropriated to the commissioner for purposes of this section. 52.29(25)(y) Receive any federal matching money that is made 52.30 available through the medical assistance program for the 52.31 consumer satisfaction survey. Any federal money received for 52.32 the survey is appropriated to the commissioner for this 52.33 purpose. The commissioner may expend the federal money received 52.34 for the consumer satisfaction survey in either year of the 52.35 biennium. 52.36(26)(z) Incorporate cost reimbursement claims from First 53.1 Call Minnesota and Greater Twin Cities United Way into the 53.2 federal cost reimbursement claiming processes of the department 53.3 according to federal law, rule, and regulations. Any 53.4 reimbursement received is appropriated to the commissioner and 53.5 shall be disbursed to First Call Minnesota and Greater Twin 53.6 Cities United Way according to normal department payment 53.7 schedules. 53.8(27)(aa) Develop recommended standards for foster care 53.9 homes that address the components of specialized therapeutic 53.10 services to be provided by foster care homes with those services. 53.11 Sec. 2. Minnesota Statutes 2002, section 256.955, 53.12 subdivision 2, is amended to read: 53.13 Subd. 2. [DEFINITIONS.] (a) For purposes of this section, 53.14 the following definitions apply. 53.15 (b) "Health plan" has the meaning provided in section 53.16 62Q.01, subdivision 3. 53.17 (c) "Health plan company" has the meaning provided in 53.18 section 62Q.01, subdivision 4. 53.19 (d) "Qualified individual" means an individual who meets 53.20 the requirements described in subdivision 2a or 2b, and: 53.21 (1) who is not determined eligible for medical assistance 53.22 according to section 256B.0575, who is not determined eligible 53.23 for medical assistanceor general assistance medical care53.24 without a spenddown, or who is not enrolled in MinnesotaCare; 53.25 (2) is not enrolled in prescription drug coverage under a 53.26 health plan; 53.27 (3) is not enrolled in prescription drug coverage under a 53.28 Medicare supplement plan, as defined in sections 62A.31 to 53.29 62A.44, or policies, contracts, or certificates that supplement 53.30 Medicare issued by health maintenance organizations or those 53.31 policies, contracts, or certificates governed by section 1833 or 53.32 1876 of the federal Social Security Act, United States Code, 53.33 title 42, section 1395, et seq., as amended; 53.34 (4) has not had coverage described in clauses (2) and (3) 53.35 for at least four months prior to application for the program; 53.36 and 54.1 (5) is a permanent resident of Minnesota as defined in 54.2 section 256L.09. 54.3 Sec. 3. Minnesota Statutes 2003 Supplement, section 54.4 256.955, subdivision 2a, is amended to read: 54.5 Subd. 2a. [ELIGIBILITY.] An individual satisfying the 54.6 following requirements and the requirements described in 54.7 subdivision 2, paragraph (d), is eligible for the prescription 54.8 drug program: 54.9 (1) is at least 65 years of age or older; and 54.10 (2) is eligible as a qualified Medicare beneficiary 54.11 according to section 256B.057, subdivision 3 or 3a, or is 54.12 eligible under section 256B.057, subdivision 3 or 3a, and is 54.13 also eligible for medical assistanceor general assistance54.14medical carewith a spenddown as defined in section 256B.056, 54.15 subdivision 5. 54.16 Sec. 4. Minnesota Statutes 2002, section 256.955, 54.17 subdivision 2b, is amended to read: 54.18 Subd. 2b. [ELIGIBILITY.] Effective July 1, 2002, an 54.19 individual satisfying the following requirements and the 54.20 requirements described in subdivision 2, paragraph (d), is 54.21 eligible for the prescription drug program: 54.22 (1) is under 65 years of age; and 54.23 (2) is eligible as a qualified Medicare beneficiary 54.24 according to section 256B.057, subdivision 3 or 3a or is 54.25 eligible under section 256B.057, subdivision 3 or 3a and is also 54.26 eligible for medical assistanceor general assistance medical54.27carewith a spenddown as defined in section 256B.056, 54.28 subdivision 5. 54.29 Sec. 5. Minnesota Statutes 2003 Supplement, section 54.30 256B.06, subdivision 4, is amended to read: 54.31 Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 54.32 medical assistance is limited to citizens of the United States, 54.33 qualified noncitizens as defined in this subdivision, and other 54.34 persons residing lawfully in the United States. 54.35 (b) "Qualified noncitizen" means a person who meets one of 54.36 the following immigration criteria: 55.1 (1) admitted for lawful permanent residence according to 55.2 United States Code, title 8; 55.3 (2) admitted to the United States as a refugee according to 55.4 United States Code, title 8, section 1157; 55.5 (3) granted asylum according to United States Code, title 55.6 8, section 1158; 55.7 (4) granted withholding of deportation according to United 55.8 States Code, title 8, section 1253(h); 55.9 (5) paroled for a period of at least one year according to 55.10 United States Code, title 8, section 1182(d)(5); 55.11 (6) granted conditional entrant status according to United 55.12 States Code, title 8, section 1153(a)(7); 55.13 (7) determined to be a battered noncitizen by the United 55.14 States Attorney General according to the Illegal Immigration 55.15 Reform and Immigrant Responsibility Act of 1996, title V of the 55.16 Omnibus Consolidated Appropriations Bill, Public Law 104-200; 55.17 (8) is a child of a noncitizen determined to be a battered 55.18 noncitizen by the United States Attorney General according to 55.19 the Illegal Immigration Reform and Immigrant Responsibility Act 55.20 of 1996, title V, of the Omnibus Consolidated Appropriations 55.21 Bill, Public Law 104-200; or 55.22 (9) determined to be a Cuban or Haitian entrant as defined 55.23 in section 501(e) of Public Law 96-422, the Refugee Education 55.24 Assistance Act of 1980. 55.25 (c) All qualified noncitizens who were residing in the 55.26 United States before August 22, 1996, who otherwise meet the 55.27 eligibility requirements of this chapter, are eligible for 55.28 medical assistance with federal financial participation. 55.29 (d) All qualified noncitizens who entered the United States 55.30 on or after August 22, 1996, and who otherwise meet the 55.31 eligibility requirements of this chapter, are eligible for 55.32 medical assistance with federal financial participation through 55.33 November 30, 1996. 55.34 Beginning December 1, 1996, qualified noncitizens who 55.35 entered the United States on or after August 22, 1996, and who 55.36 otherwise meet the eligibility requirements of this chapter are 56.1 eligible for medical assistance with federal participation for 56.2 five years if they meet one of the following criteria: 56.3 (i) refugees admitted to the United States according to 56.4 United States Code, title 8, section 1157; 56.5 (ii) persons granted asylum according to United States 56.6 Code, title 8, section 1158; 56.7 (iii) persons granted withholding of deportation according 56.8 to United States Code, title 8, section 1253(h); 56.9 (iv) veterans of the United States armed forces with an 56.10 honorable discharge for a reason other than noncitizen status, 56.11 their spouses and unmarried minor dependent children; or 56.12 (v) persons on active duty in the United States armed 56.13 forces, other than for training, their spouses and unmarried 56.14 minor dependent children. 56.15 Beginning December 1, 1996, qualified noncitizens who do 56.16 not meet one of the criteria in items (i) to (v) are eligible 56.17 for medical assistance without federal financial participation 56.18 as described in paragraph (j). 56.19 (e) Noncitizens who are not qualified noncitizens as 56.20 defined in paragraph (b), who are lawfully residing in the 56.21 United States and who otherwise meet the eligibility 56.22 requirements of this chapter, are eligible for medical 56.23 assistance under clauses (1) to (3). These individuals must 56.24 cooperate with the Immigration and Naturalization Service to 56.25 pursue any applicable immigration status, including citizenship, 56.26 that would qualify them for medical assistance with federal 56.27 financial participation. 56.28 (1) Persons who were medical assistance recipients on 56.29 August 22, 1996, are eligible for medical assistance with 56.30 federal financial participation through December 31, 1996. 56.31 (2) Beginning January 1, 1997, persons described in clause 56.32 (1) are eligible for medical assistance without federal 56.33 financial participation as described in paragraph (j). 56.34 (3) Beginning December 1, 1996, persons residing in the 56.35 United States prior to August 22, 1996, who were not receiving 56.36 medical assistance and persons who arrived on or after August 57.1 22, 1996, are eligible for medical assistance without federal 57.2 financial participation as described in paragraph (j). 57.3 (f) Nonimmigrants who otherwise meet the eligibility 57.4 requirements of this chapter are eligible for the benefits as 57.5 provided in paragraphs (g) to (i). For purposes of this 57.6 subdivision, a "nonimmigrant" is a person in one of the classes 57.7 listed in United States Code, title 8, section 1101(a)(15). 57.8 (g) Payment shall also be made for care and services that 57.9 are furnished to noncitizens, regardless of immigration status, 57.10 who otherwise meet the eligibility requirements of this chapter, 57.11 if such care and services are necessary for the treatment of an 57.12 emergency medical condition, except for organ transplants and 57.13 related care and services and routine prenatal care. 57.14 (h) For purposes of this subdivision, the term "emergency 57.15 medical condition" means a medical condition that meets the 57.16 requirements of United States Code, title 42, section 1396b(v). 57.17 (i) Pregnant noncitizens who are undocumented or 57.18 nonimmigrants, who otherwise meet the eligibility requirements 57.19 of this chapter, are eligible for medical assistance payment 57.20 without federal financial participation for care and services 57.21 through the period of pregnancy, and 60 days postpartum, except 57.22 for labor and delivery. 57.23 (j) Qualified noncitizens as described in paragraph (d), 57.24 and all other noncitizens lawfully residing in the United States 57.25 as described in paragraph (e), who are ineligible for medical 57.26 assistance with federal financial participation and who 57.27 otherwise meet the eligibility requirements of chapter 256B and 57.28 of this paragraph, are eligible for medical assistance without 57.29 federal financial participation. Qualified noncitizens as 57.30 described in paragraph (d) are only eligible for medical 57.31 assistance without federal financial participation for five 57.32 years from their date of entry into the United States. 57.33 (k) Beginning October 1, 2003, persons who are receiving 57.34 care and rehabilitation services from a nonprofit center 57.35 established to serve victims of torture and are otherwise 57.36 ineligible for medical assistance under this chapteror general58.1assistance medical care under section 256D.03are eligible for 58.2 medical assistance without federal financial participation. 58.3 These individuals are eligible only for the period during which 58.4 they are receiving services from the center. Individuals 58.5 eligible under this paragraph shall not be required to 58.6 participate in prepaid medical assistance. 58.7 Sec. 6. Minnesota Statutes 2003 Supplement, section 58.8 256B.0625, subdivision 9, is amended to read: 58.9 Subd. 9. [DENTAL SERVICES.] (a) Medical assistance covers 58.10 dental services. Dental services include, with prior 58.11 authorization, fixed bridges that are cost-effective for persons 58.12 who cannot use removable dentures because of their medical 58.13 condition. 58.14 (b) Coverage of dental services for adults age 21 and over 58.15 who are not pregnant is subject to a $500 annual benefit limit 58.16 and covered services are limited to: 58.17 (1) diagnostic and preventative services; 58.18 (2)basicrestorative services; and 58.19 (3) emergency services. 58.20 Emergency services, dentures, and extractions related to 58.21 dentures are not included in the $500 annual benefit limit. 58.22 Sec. 7. Minnesota Statutes 2003 Supplement, section 58.23 256D.03, subdivision 3, is amended to read: 58.24 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 58.25 (a) General assistance medical care may be paid for any person 58.26 who is not eligible for medical assistance under chapter 256B, 58.27 including eligibility for medical assistance based on a 58.28 spenddown of excess income according to section 256B.056, 58.29 subdivision 5, or MinnesotaCare as defined in paragraph (b), 58.30 except as provided in paragraph (c), and: 58.31 (1) who is receiving assistance under section 256D.05, 58.32 except for families with children who are eligible under 58.33 Minnesota family investment program (MFIP), or who is having a 58.34 payment made on the person's behalf under sections 256I.01 to 58.35 256I.06; or 58.36 (2) who is a resident of Minnesota; and 59.1 (i) who has gross countable income not in excess of 75 59.2 percent of the federal poverty guidelines for the family size, 59.3 using a six-month budget period and whose equity in assets is 59.4 not in excess of $1,000 per assistance unit. Exempt assets, the 59.5 reduction of excess assets, and the waiver of excess assets must 59.6 conform to the medical assistance program in section 256B.056, 59.7 subdivision 3, with the following exception: the maximum amount 59.8 of undistributed funds in a trust that could be distributed to 59.9 or on behalf of the beneficiary by the trustee, assuming the 59.10 full exercise of the trustee's discretion under the terms of the 59.11 trust, must be applied toward the asset maximum; or 59.12 (ii) who has gross countable income above 75 percent of the 59.13 federal poverty guidelines but not in excess of 175 percent of 59.14 the federal poverty guidelines for the family size, using a 59.15 six-month budget period, whose equity in assets is not in excess 59.16 of the limits in section 256B.056, subdivision 3c, and who 59.17 applies during an inpatient hospitalization. 59.18 (b) General assistance medical care may not be paid for 59.19 applicants or recipients who meet all eligibility requirements 59.20 of MinnesotaCare as defined in sections 256L.01 to 256L.16, and 59.21 are adults with dependent children under 21 whose gross family 59.22 income is equal to or less than 275 percent of the federal 59.23 poverty guidelines. 59.24 (c) For applications received on or after October 1, 2003, 59.25 eligibility may begin no earlier than the date of application. 59.26 For individuals eligible under paragraph (a), clause (2), item 59.27 (i), a redetermination of eligibility must occur every 12 59.28 months. Individuals are eligible under paragraph (a), clause 59.29 (2), item (ii), only during inpatient hospitalization but may 59.30 reapply if there is a subsequent period of inpatient 59.31 hospitalization. Beginning January 1, 2000, Minnesota health 59.32 care program applications completed by recipients and applicants 59.33 who are persons described in paragraph (b), may be returned to 59.34 the county agency to be forwarded to the Department of Human 59.35 Services or sent directly to the Department of Human Services 59.36 for enrollment in MinnesotaCare. If all other eligibility 60.1 requirements of this subdivision are met, eligibility for 60.2 general assistance medical care shall be available in any month 60.3 during which a MinnesotaCare eligibility determination and 60.4 enrollment are pending. Upon notification of eligibility for 60.5 MinnesotaCare, notice of termination for eligibility for general 60.6 assistance medical care shall be sent to an applicant or 60.7 recipient. If all other eligibility requirements of this 60.8 subdivision are met, eligibility for general assistance medical 60.9 care shall be available until enrollment in MinnesotaCare 60.10 subject to the provisions of paragraph (e). 60.11 (d) The date of an initial Minnesota health care program 60.12 application necessary to begin a determination of eligibility 60.13 shall be the date the applicant has provided a name, address, 60.14 and Social Security number, signed and dated, to the county 60.15 agency or the Department of Human Services. If the applicant is 60.16 unable to provide a name, address, Social Security number, and 60.17 signature when health care is delivered due to a medical 60.18 condition or disability, a health care provider may act on an 60.19 applicant's behalf to establish the date of an initial Minnesota 60.20 health care program application by providing the county agency 60.21 or Department of Human Services with provider identification and 60.22 a temporary unique identifier for the applicant. The applicant 60.23 must complete the remainder of the application and provide 60.24 necessary verification before eligibility can be determined. 60.25 The county agency must assist the applicant in obtaining 60.26 verification if necessary. 60.27 (e) County agencies are authorized to use all automated 60.28 databases containing information regarding recipients' or 60.29 applicants' income in order to determine eligibility for general 60.30 assistance medical care or MinnesotaCare. Such use shall be 60.31 considered sufficient in order to determine eligibility and 60.32 premium payments by the county agency. 60.33 (f) General assistance medical care is not available for a 60.34 person in a correctional facility unless the person is detained 60.35 by law for less than one year in a county correctional or 60.36 detention facility as a person accused or convicted of a crime, 61.1 or admitted as an inpatient to a hospital on a criminal hold 61.2 order, and the person is a recipient of general assistance 61.3 medical care at the time the person is detained by law or 61.4 admitted on a criminal hold order and as long as the person 61.5 continues to meet other eligibility requirements of this 61.6 subdivision. 61.7 (g) General assistance medical care is not available for 61.8 applicants or recipients who do not cooperate with the county 61.9 agency to meet the requirements of medical assistance. 61.10 (h) In determining the amount of assets of an individual 61.11 eligible under paragraph (a), clause (2), item (i), there shall 61.12 be included any asset or interest in an asset, including an 61.13 asset excluded under paragraph (a), that was given away, sold, 61.14 or disposed of for less than fair market value within the 60 61.15 months preceding application for general assistance medical care 61.16 or during the period of eligibility. Any transfer described in 61.17 this paragraph shall be presumed to have been for the purpose of 61.18 establishing eligibility for general assistance medical care, 61.19 unless the individual furnishes convincing evidence to establish 61.20 that the transaction was exclusively for another purpose. For 61.21 purposes of this paragraph, the value of the asset or interest 61.22 shall be the fair market value at the time it was given away, 61.23 sold, or disposed of, less the amount of compensation received. 61.24 For any uncompensated transfer, the number of months of 61.25 ineligibility, including partial months, shall be calculated by 61.26 dividing the uncompensated transfer amount by the average 61.27 monthly per person payment made by the medical assistance 61.28 program to skilled nursing facilities for the previous calendar 61.29 year. The individual shall remain ineligible until this fixed 61.30 period has expired. The period of ineligibility may exceed 30 61.31 months, and a reapplication for benefits after 30 months from 61.32 the date of the transfer shall not result in eligibility unless 61.33 and until the period of ineligibility has expired. The period 61.34 of ineligibility begins in the month the transfer was reported 61.35 to the county agency, or if the transfer was not reported, the 61.36 month in which the county agency discovered the transfer, 62.1 whichever comes first. For applicants, the period of 62.2 ineligibility begins on the date of the first approved 62.3 application. 62.4 (i) When determining eligibility for any state benefits 62.5 under this subdivision, the income and resources of all 62.6 noncitizens shall be deemed to include their sponsor's income 62.7 and resources as defined in the Personal Responsibility and Work 62.8 Opportunity Reconciliation Act of 1996, title IV, Public Law 62.9 104-193, sections 421 and 422, and subsequently set out in 62.10 federal rules. 62.11 (j) Undocumented noncitizens and nonimmigrants are 62.12 ineligible for general assistance medical care, except an62.13individual eligible under paragraph (a), clause (4), remains62.14eligible through September 30, 2003. For purposes of this 62.15 subdivision, a nonimmigrant is an individual in one or more of 62.16 the classes listed in United States Code, title 8, section 62.17 1101(a)(15), and an undocumented noncitizen is an individual who 62.18 resides in the United States without the approval or 62.19 acquiescence of the Immigration and Naturalization Service. 62.20 (k) Notwithstanding any other provision of law, a 62.21 noncitizen who is ineligible for medical assistance due to the 62.22 deeming of a sponsor's income and resources, is ineligible for 62.23 general assistance medical care. 62.24 (l) Effective July 1, 2003, general assistance medical care 62.25 emergency services end. 62.26 Sec. 8. Minnesota Statutes 2003 Supplement, section 62.27 256D.03, subdivision 4, is amended to read: 62.28 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] 62.29 (a)(i) For a person who is eligible under subdivision 3, 62.30 paragraph (a), clause (2), item (i), general assistance medical 62.31 care covers, except as provided in paragraph (c): 62.32 (1) inpatient hospital services; 62.33 (2) outpatient hospital services; 62.34 (3) services provided by Medicare certified rehabilitation 62.35 agencies; 62.36 (4) prescription drugs and other products recommended 63.1 through the process established in section 256B.0625, 63.2 subdivision 13; 63.3 (5) equipment necessary to administer insulin and 63.4 diagnostic supplies and equipment for diabetics to monitor blood 63.5 sugar level; 63.6 (6) eyeglasses and eye examinations provided by a physician 63.7 or optometrist; 63.8 (7) hearing aids; 63.9 (8) prosthetic devices; 63.10 (9) laboratory and X-ray services; 63.11 (10) physician's services; 63.12 (11) medical transportation except special transportation; 63.13 (12) chiropractic services as covered under the medical 63.14 assistance program; 63.15 (13) podiatric services; 63.16 (14) dental services and dentures, subject to the 63.17 limitations specified in section 256B.0625, subdivision 9; 63.18 (15) outpatient services provided by a mental health center 63.19 or clinic that is under contract with the county board and is 63.20 established under section 245.62; 63.21 (16) day treatment services for mental illness provided 63.22 under contract with the county board; 63.23 (17) prescribed medications for persons who have been 63.24 diagnosed as mentally ill as necessary to prevent more 63.25 restrictive institutionalization; 63.26 (18) psychological services, medical supplies and 63.27 equipment, and Medicare premiums, coinsurance and deductible 63.28 payments; 63.29 (19) medical equipment not specifically listed in this 63.30 paragraph when the use of the equipment will prevent the need 63.31 for costlier services that are reimbursable under this 63.32 subdivision; 63.33 (20) services performed by a certified pediatric nurse 63.34 practitioner, a certified family nurse practitioner, a certified 63.35 adult nurse practitioner, a certified obstetric/gynecological 63.36 nurse practitioner, a certified neonatal nurse practitioner, or 64.1 a certified geriatric nurse practitioner in independent 64.2 practice, if (1) the service is otherwise covered under this 64.3 chapter as a physician service, (2) the service provided on an 64.4 inpatient basis is not included as part of the cost for 64.5 inpatient services included in the operating payment rate, and 64.6 (3) the service is within the scope of practice of the nurse 64.7 practitioner's license as a registered nurse, as defined in 64.8 section 148.171; 64.9 (21) services of a certified public health nurse or a 64.10 registered nurse practicing in a public health nursing clinic 64.11 that is a department of, or that operates under the direct 64.12 authority of, a unit of government, if the service is within the 64.13 scope of practice of the public health nurse's license as a 64.14 registered nurse, as defined in section 148.171; and 64.15 (22) telemedicine consultations, to the extent they are 64.16 covered under section 256B.0625, subdivision 3b. 64.17 (ii) Effective October 1, 2003, for a person who is 64.18 eligible under subdivision 3, paragraph (a), clause (2), item 64.19 (ii), general assistance medical care coverage is limited to 64.20 inpatient hospital services, including physician services 64.21 provided during the inpatient hospital stay. A $1,000 64.22 deductible is required for each inpatient hospitalization. 64.23 (b) Gender reassignment surgery and related services are 64.24 not covered services under this subdivision unless the 64.25 individual began receiving gender reassignment services prior to 64.26 July 1, 1995. 64.27 (c) In order to contain costs, the commissioner of human 64.28 services shall select vendors of medical care who can provide 64.29 the most economical care consistent with high medical standards 64.30 and shall where possible contract with organizations on a 64.31 prepaid capitation basis to provide these services. The 64.32 commissioner shall consider proposals by counties and vendors 64.33 for prepaid health plans, competitive bidding programs, block 64.34 grants, or other vendor payment mechanisms designed to provide 64.35 services in an economical manner or to control utilization, with 64.36 safeguards to ensure that necessary services are provided. 65.1 Before implementing prepaid programs in counties with a county 65.2 operated or affiliated public teaching hospital or a hospital or 65.3 clinic operated by the University of Minnesota, the commissioner 65.4 shall consider the risks the prepaid program creates for the 65.5 hospital and allow the county or hospital the opportunity to 65.6 participate in the program in a manner that reflects the risk of 65.7 adverse selection and the nature of the patients served by the 65.8 hospital, provided the terms of participation in the program are 65.9 competitive with the terms of other participants considering the 65.10 nature of the population served. Payment for services provided 65.11 pursuant to this subdivision shall be as provided to medical 65.12 assistance vendors of these services under sections 256B.02, 65.13 subdivision 8, and 256B.0625. For payments made during fiscal 65.14 year 1990 and later years, the commissioner shall consult with 65.15 an independent actuary in establishing prepayment rates, but 65.16 shall retain final control over the rate methodology. 65.17 (d) Recipients eligible under subdivision 3, paragraph (a), 65.18 clause (2), item (i), shall pay the following co-payments for 65.19 services provided on or after October 1, 2003: 65.20 (1) $3 per nonpreventive visit. For purposes of this 65.21 subdivision, a visit means an episode of service which is 65.22 required because of a recipient's symptoms, diagnosis, or 65.23 established illness, and which is delivered in an ambulatory 65.24 setting by a physician or physician ancillary, chiropractor, 65.25 podiatrist, nurse midwife, advanced practice nurse, audiologist, 65.26 optician, or optometrist; 65.27 (2) $25 for eyeglasses; 65.28 (3) $25 for nonemergency visits to a hospital-based 65.29 emergency room; 65.30 (4) $3 per brand-name drug prescription and $1 per generic 65.31 drug prescription, subject to a $20 per month maximum for 65.32 prescription drug co-payments. No co-payments shall apply to 65.33 antipsychotic drugs when used for the treatment of mental 65.34 illness; and 65.35 (5) 50 percent coinsurance onbasicrestorative dental 65.36 services. 66.1 (e) Co-payments shall be limited to one per day per 66.2 provider for nonpreventive visits, eyeglasses, and nonemergency 66.3 visits to a hospital-based emergency room. Recipients of 66.4 general assistance medical care are responsible for all 66.5 co-payments in this subdivision. The general assistance medical 66.6 care reimbursement to the provider shall be reduced by the 66.7 amount of the co-payment, except that reimbursement for 66.8 prescription drugs shall not be reduced once a recipient has 66.9 reached the $20 per month maximum for prescription drug 66.10 co-payments. The provider collects the co-payment from the 66.11 recipient. Providers may not deny services to recipients who 66.12 are unable to pay the co-payment, except as provided in 66.13 paragraph (f). 66.14 (f) If it is the routine business practice of a provider to 66.15 refuse service to an individual with uncollected debt, the 66.16 provider may include uncollected co-payments under this 66.17 section. A provider must give advance notice to a recipient 66.18 with uncollected debt before services can be denied. 66.19 (g) Any county may, from its own resources, provide medical 66.20 payments for which state payments are not made. 66.21 (h) Chemical dependency services that are reimbursed under 66.22 chapter 254B must not be reimbursed under general assistance 66.23 medical care. 66.24 (i) The maximum payment for new vendors enrolled in the 66.25 general assistance medical care program after the base year 66.26 shall be determined from the average usual and customary charge 66.27 of the same vendor type enrolled in the base year. 66.28 (j) The conditions of payment for services under this 66.29 subdivision are the same as the conditions specified in rules 66.30 adopted under chapter 256B governing the medical assistance 66.31 program, unless otherwise provided by statute or rule. 66.32 (k) Inpatient and outpatient payments shall be reduced by 66.33 five percent, effective July 1, 2003. This reduction is in 66.34 addition to the five percent reduction effective July 1, 2003, 66.35 and incorporated by reference in paragraph (i). 66.36 (l) Payments for all other health services except 67.1 inpatient, outpatient, and pharmacy services shall be reduced by 67.2 five percent, effective July 1, 2003. 67.3 (m) Payments to managed care plans shall be reduced by five 67.4 percent for services provided on or after October 1, 2003. 67.5 (n) A hospital receiving a reduced payment as a result of 67.6 this section may apply the unpaid balance toward satisfaction of 67.7 the hospital's bad debts.