Minnesota Legislature
Office of the Revisor of Statutes
Minnesota Session Laws - 1988, Regular Session
Key: (1) language to be deleted (2) new language
Laws of Minnesota 1988
CHAPTER 689-H.F.No. 2126
An act relating to the organization and operation of
state government; appropriating money for human
services and health and other purposes with certain
conditions; amending Minnesota Statutes 1986, sections
3.9223, subdivision 3; 3.9225, subdivision 3; 3.9226,
subdivision 3; 62A.54; 62E.04, by adding subdivisions;
129A.02, subdivision 3; 129A.09; 129A.10; 144.053, by
adding a subdivision; 144.125; 144.50, by adding a
subdivision; 144A.04, by adding a subdivision;
144A.08, by adding a subdivision; 145.43, subdivisions
1 and 1a; 145.853, subdivision 2; 145.894; 245.771, by
adding a subdivision; 245.814, subdivisions 1, 2, and
3; 245.83; 245.84, subdivision 1; 246.023, subdivision
1; 252.291, subdivisions 1 and 2; 253B.03, by adding a
subdivision; 253B.17, subdivision 1; 256.73,
subdivisions 2 and 6, and by adding subdivisions;
256.736, by adding subdivisions; 256.76, subdivision
1; 256B.08; 256B.092, subdivisions 5 and 7; 256B.14,
subdivision 2; 256B.17, subdivision 7; 256B.431, by
adding subdivisions; 256B.50, subdivision 1, and by
adding subdivisions; 256B.501, subdivision 3, and by
adding subdivisions; 256B.69, subdivisions 3 and 4;
256D.02, subdivision 7, and by adding a subdivision;
256D.06, by adding a subdivision; 256D.07; 256D.35, by
adding a subdivision; 256D.37, subdivision 2, and by
adding subdivisions; 256E.12, subdivisions 1 and 2;
256F.03, subdivision 8; 256F.07, by adding a
subdivision; 257.071, subdivisions 2, 3, 6, and by
adding a subdivision; 257.072; 260.181, subdivision 3;
268.0111, by adding a subdivision; 268.86, by adding a
subdivision; 268.91, subdivision 7; 268.911,
subdivision 3; 326.371; 462.05, by adding a
subdivision; 462A.21, by adding a subdivision; 609.72,
subdivision 1; and 611A.32, by adding a subdivision;
Minnesota Statutes 1987 Supplement, sections 3.922,
subdivision 6; 16B.08, subdivision 7; 62A.152,
subdivision 2; 62A.48, subdivision 7; 62A.50,
subdivision 3; 62D.102; 129A.01, subdivision 5, 6, and
7; 129A.03; 129A.06, subdivision 1; 129A.07,
subdivision 1; 129A.08, subdivisions 1, 4, 5, and by
adding a subdivision; 144A.071, subdivision 3;
144A.073, subdivisions 1, 7, and 8; 145.43,
subdivision 4; 145A.06, by adding a subdivision;
148B.23, subdivision 1; 148B.42, subdivision 1;
245.462, subdivisions 3, 4, 6, 17, 18, 19, 20, 21, 23,
and 25; 245.465; 245.466, subdivisions 1, 2, and 5;
245.467, by adding subdivisions; 245.469, subdivision
2; 245.471, subdivisions 2 and 3; 245.472, subdivision
2; 245.475, subdivisions 1 and 2; 245.476, subdivision
1; 245.477; 245.478, subdivisions 1, 2, and 9; 245.479;
245.482, subdivision 2; 245.696, subdivision 2;
245.697, subdivision 2, and by adding a subdivision;
252.291, subdivision 3; 252.46, subdivisions 5 and 6,
and by adding subdivisions; 253B.03, subdivision 6;
256.01, subdivision 4; 256.015, subdivision 2;
256.736, subdivisions 1b, 4, and 11; 256.936; 256.969,
subdivisions 2 and 3; 256B.02, subdivision 8;
256B.031, subdivision 5; 256B.042, subdivision 2;
256B.06, subdivisions 1 and 4; 256B.091, subdivision
4; 256B.35, subdivision 1; 256B.431, subdivisions 2b,
3, and 4; 256B.433, subdivision 1; 256B.50,
subdivision 2; 256B.501, subdivision 1; 256B.73,
subdivision 2; 256D.01, subdivision 1a; 256D.03,
subdivision 3; 256D.06, subdivisions 1 and 1b;
256D.37, subdivision 1; 256E.12, subdivision 3;
268.91, subdivisions 1, 3, 3b, 3c, 3e, 4, and 12; and
326.73; Laws 1984, chapter 654, article 5, section 57,
subdivision 1, as amended; Laws 1987, chapter 337,
section 131; Laws 1987, chapter 403, articles 1,
section 4, subdivision 4; 2, section 34; and 4,
section 13; proposing coding for new law in Minnesota
Statutes, chapters 62A; 62C; 62D; 144; 145; 153A; 157;
179A; 198; 245; 252; 256; 256B; 257; and 268;
proposing coding for new law as Minnesota Statutes,
chapter 152A; repealing Minnesota Statutes 1986,
sections 144.388; 153A.01; 153A.02; 153A.03; 153A.04;
153A.05; 153A.06; 153A.07; 153A.08; 153A.09; 153A.10;
153A.11; 153A.12; 245.84, subdivision 4; 245.86;
245.87; 246.023, subdivisions 2, 3, 4, and 5; 257.071,
subdivision 6; and 268.061; Minnesota Statutes 1987
Supplement, sections 129A.01, subdivision 8; 129A.07,
subdivision 2; 129A.08, subdivision 3; 148B.04,
subdivision 1; and 256B.73, subdivision 10.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
APPROPRIATIONS
Section 1. [HUMAN SERVICES; HEALTH; APPROPRIATIONS.]
The sums shown in the columns marked "APPROPRIATIONS" are
appropriated from the general fund, or another fund named, to
the agencies and for the purposes specified in this act, to be
available for the fiscal years indicated for each purpose. The
figures "1988" and "1989," where used in this article, mean that
the appropriation or appropriations listed under them are
available for the year ending June 30, 1988, or June 30, 1989,
respectively.
SUMMARY BY FUND
1988 1989 TOTAL
General $(17,545,900) $17,035,700 $(510,200)
Special Revenue -0- 320,300 320,300
Public Health 175,200 200,800 376,000
Trunk Highway 74,400 85,500 159,900
Metro Landfill 19,300 22,000 41,300
TOTAL $(17,277,000) $17,664,300 $ 387,300
APPROPRIATIONS
Available for the Year
Ending June 30
1988 1989
Sec. 2. HUMAN SERVICES
Subdivision 1. Appropriation
by Fund
General Fund (17,553,800) 11,722,100
This appropriation is added to the
appropriation in Laws 1987, chapter
403, article 1, section 2.
Subd. 2. Human Services
Management
$ -0- $ -0-
Subd. 3. Social Services
$ -0- $1,220,200
Any balance remaining at the end of
fiscal year 1988 in the appropriation
for chemical dependency evaluation in
Laws 1987, chapter 403, article 1,
section 2, subdivision 8, does not
cancel but is available for fiscal year
1989 to complete the incidence and
prevalence survey on the extent of drug
and alcohol problems in Minnesota.
Of this appropriation, $200,000 is for
semi-independent living services for
those people determined eligible who
have not received funding. This
appropriation may be used to fund
services for individuals who are
currently living in intermediate care
facilities for the mentally retarded,
who are receiving waivered services and
are no longer eligible for those
services, or who are living in their
family home, a foster home, or their
own home.
Of this appropriation, $50,000 is for a
grant related to attention deficit
disorder (ADD). The commissioner shall
award the grant to a nonprofit
corporation whose only purpose is to
educate people about ADD and to support
children with ADD and their families.
Grant money awarded under this
provision must be used for the
following purposes: (1) in-service
training for school personnel,
including teachers at all levels from
early childhood through college and
vocational training, on the unique
problems of children who suffer from
ADD, and (2) support groups for
children with ADD and their families.
Of this appropriation, $150,000 is for
a demonstration grant under the
community initiatives for children
program, to be awarded to a project in
the seven-county metropolitan area.
The amount of the grant may not exceed
the lesser of $150,000 or 50 percent of
capital costs incurred within a
two-year period.
Subd. 4. Mental Health
$(1,330,000) $1,395,000
Of the amount appropriated in Laws
1987, chapter 403, article 1, section
2, subdivision 5, for state mental
health grants for fiscal year 1988,
$720,000 does not cancel but is
available for fiscal year 1989 for the
same purposes and $1,330,000 is
transferred to fiscal year 1989.
Of the amount appropriated in Laws
1987, chapter 403, article 1, section
2, subdivision 5, for mental health for
fiscal year 1988, $250,000 for
information systems is transferred in
fiscal year 1988 to the state systems
account established in Minnesota
Statutes, section 256.014, subdivision
2.
Money appropriated for the children's
mental health plan is for fiscal year
1989 only. Money needed beyond June
30, 1989, to develop or implement the
plan must be requested as a change
request in the 1989 to 1991 biennial
budget.
Upon approval of the legislative audit
commission, $25,000 of this
appropriation is transferred to the
legislative auditor for a program
evaluation of the quality of treatment
provided by community residential
programs for people who are mentally
ill or mentally ill and chemically
dependent. The evaluation should
consider the extent to which facility
size and ownership structure affect the
quality of treatment; the
appropriateness of the reimbursement
and payment system, including methods
of paying for buildings and land; and
the impact of programs on residential
areas.
Subd. 5. Income Maintenance
and Residential Programs
General Fund
$(16,987,000) $5,884,300
(a) Health Care and Residential
Programs
$(11,933,200) $6,252,900
For services rendered on or after
January 1, 1989, the maximum pharmacy
dispensing fee under medical assistance
and general assistance medical care is
$4.20.
For medical assistance services
rendered on or after October 1, 1988,
payments to medical assistance vendors
for physician services, dental care,
vision care, podiatric services,
chiropractic care, physical therapy,
occupational therapy, speech
pathologists, audiologists, mental
health centers, psychologists, public
health clinics, and independent
laboratory and X-ray services must be
based on payment rates in effect on
June 30, 1987, except that the base
rate for obstetrical care is increased
by ten percent from the base rate in
effect on June 30, 1987.
For medical assistance and general
assistance medical care services
rendered on or after July 1, 1989,
payments to physicians and dentists
must be calculated at the lower of (1)
the submitted charges, or (2) the 50th
percentile of prevailing charges in
1982.
The increased payments to small
hospitals in Minnesota Statutes,
section 256.969, subdivision 3, are
authorized for fiscal year 1989 only.
Notwithstanding Minnesota Statutes
1986, section 256.969, subdivision 3,
paragraph (b), the appropriation in
Laws 1987, chapter 403, article 1,
section 2, subdivision 6, paragraph
(b), for supplemental grants to
hospitals is allocated as follows:
$51,900 to Hennepin county medical
center and $48,100 to St. Paul-Ramsey
medical center. The commissioner shall
distribute this money by June 30, 1988.
For the six-month period ending June
30, 1989, persons with serious and
persistent mental illness who, except
for their residence in a facility
licensed under Minnesota Rules, parts
9520.0500 to 9520.0690, would be
eligible for medical assistance
services, are eligible under the
general assistance medical care program
for services covered under the general
assistance medical care program plus
case management. The commissioner may,
with the approval of the governor and
after consulting with the legislative
advisory commission, transfer $711,000
of the medical assistance appropriation
to the general assistance medical care
appropriation for this purpose.
In the biennium ending on June 30,
1989, the commissioner shall not
authorize or approve more than 150
newly constructed or newly established
intermediate care beds for persons with
mental retardation or related
conditions under Minnesota Statutes,
section 252.291, subdivision 2.
One-half of the first 70 newly
constructed or newly established
intermediate care beds for persons with
mental retardation or related
conditions approved by the commissioner
must be state-operated community-based
intermediate care beds for persons with
mental retardation or related
conditions. Money appropriated to
operate and expand state-operated
community-based program pilot projects
pursuant to Laws 1987, chapter 403,
article 1, section 2, subdivision 9,
may be used to establish state-operated
community-based intermediate care beds
for persons with mental retardation or
related conditions.
Of this appropriation, $200,000 is for
a regional demonstration project under
Minnesota Statutes, section 256B.73, to
provide health coverage to low-income
uninsured persons. The appropriation
is available when the planning for the
project is complete, sufficient money
has been committed from nonstate
sources to allow the project to
proceed, and the project is prepared to
begin accepting and approving
applications from uninsured
individuals. The commissioner shall
contract with the coalition formed for
the nine counties named in Minnesota
Statutes, section 256B.73, subdivision
2.
Of this appropriation, $752,500 in
fiscal year 1988 and $5,117,000 in
fiscal year 1989 are for additional
positions required in the regional
treatment centers as a result of health
care financing administration surveys
of mental illness program staffing.
Any unexpended balance remaining in the
regional treatment center accounts for
fiscal year 1988 is available to pay
the billing for the state health
insurance trust fund and the costs of
implementing the Jarvis v. Levine court
decision. For fiscal year 1989,
$420,000 is appropriated for the costs
of implementing the decision.
$1,600,000 is appropriated in the
public health fund for medical
assistance to extend eligibility to
include pregnant women and infants to
age one with income at or below 185
percent of the federal poverty level.
On or after October 1, 1988, the
commissioner shall transfer $1,600,000
to the public health fund for the
children's health plan and $500,000 to
the preadmission screening and
alternative care grants program from
the medical assistance and general
assistance medical care programs after
any transfers necessary because of
projected deficits in the aid to
families with dependent children,
general assistance, or Minnesota
supplemental aid programs. The
transfers may occur only to the extent
possible using any surplus projected to
exist at the end of the biennium within
the appropriations for the medical
assistance and general assistance
medical care programs.
(b) Family Support Programs
$(3,551,500) $(1,376,600)
(c) Other Income Maintenance Activities
$(1,502,300) $1,008,000
Federal receipts for the alien
verification entitlement system must be
deposited in the state systems account.
Money appropriated for the medical
assistance and general assistance
medical care managed care project under
Minnesota Statutes, section 256B.74, is
available through June 30, 1989. Money
needed to implement or continue the
recommendations of the task force must
be included as a change request in the
1989 to 1991 biennial budget.
Money appropriated to develop a plan to
implement the healthspan program is
available until June 30, 1989.
By January 1, 1989, the commissioner of
the department of human services shall,
in cooperation with the commissioner of
employee relations, complete a job
evaluation study to determine the
comparable worth value of direct care
staff positions in intermediate care
facilities for the mentally retarded,
waivered residential services,
semi-independent living programs, and
developmental achievement centers that
are licensed by the department of human
services or by a county. The
commissioner shall contract with the
department of employee relations for
completion of the study. Results of
the study shall be reported to the
chair of the finance committee of the
senate and to the chair of the
appropriations committee of the house.
Notwithstanding Laws 1987, chapter 403,
article 1, section 14, subdivision 1,
the commissioner is authorized to
transfer funds as necessary from
nonsalary object of expenditure classes
to salary object of expenditure classes
in the medical assistance demonstration
project in order to efficiently educate
and enroll medical assistance
recipients in the project.
$40,000 of this appropriation must be
transferred to the commissioner of the
state planning agency for the biennium
ending June 30, 1989, to fund the local
efforts of a multicounty area in
southwest central Minnesota to plan,
organize, and design a health insurance
program demonstration project for low
income adults and their dependents.
The demonstration project shall be
designed to best meet the health
insurance needs of individuals and
families who are not eligible for any
other federally subsidized health
benefits program and who do not have
any health insurance or who do not have
adequate health insurance. The project
shall be planned and organized to make
the best use of existing community
health providers and agencies. By
February 1, 1989, the commissioner
shall report to the chairs of the
health and human services committees of
the senate and the house with a plan,
organization, and design for
implementation of the health insurance
demonstration project. The report must
be based on recommendations from the
multicounty area.
The developmental achievement center
pilot payment rate system in Minnesota
Statutes, section 252.46, subdivision
14, may operate through June 30, 1990.
Of this appropriation, $150,000 is
immediately available to contract with
the commissioner of health to implement
that part of Public Law No. 100-203
specified in section 6, subdivision 3.
Federal receipts for the independent
review of medical assistance prepaid
plans under contract with the
commissioner are appropriated to the
commissioner for the review process.
$85,000 of this appropriation must be
transferred to the commissioner of
administration to complete by February
1, 1989, (1) an operational cost
analysis, (2) an impact analysis on
other nursing homes in the area, (3) a
demographic study of the number of
veterans that would be served in the
area, (4) staffing level requirements
and the availability of staff, and (5)
a site feasibility study for the
following projects: (a) establishment
of a facility in Fergus Falls for the
housing and nursing care of veterans;
and (b) establishment of a veterans
home in southwestern Minnesota.
Money appropriated for the Faribault
regional center planning study must be
transferred to the commissioner of the
state planning agency and is available
until June 30, 1989.
Subd. 6. Veterans Homes
$ 763,200 $3,222,600
Funds appropriated for the Minnesota
veterans homes shall be transferred to
the board of directors of the homes
immediately upon licensure of the board
by the commissioner of health for the
biennium ending June 30, 1989.
During the biennium, the board of
directors of the veterans homes shall
report the results of all health
department and Veterans Administration
inspections and surveys to the
governor, the chair of the House of
Representatives appropriation
committee, the chair of the Senate
finance committee, the chair of the
House health and human services
appropriation division and the chair of
the Senate health and human services
finance division, within ten days of
receiving written notification of the
results. The report shall include
plans for correcting deficiencies.
The board of directors of the veterans
homes shall report to the legislature
by January 1, 1989, regarding efforts
to maximize use of federal Veterans
Administration funds.
Of this appropriation, $410,000 is for
the replacement of electrical
transformers and for phase 1 of the
steam retrofitting for the veterans
home.
Money appropriated for repairs and
replacement at the veterans homes is
not included in the base funding
level. The commissioner shall request
necessary funds for this purpose as a
change request to the 1989 to 1991
biennial budget.
Sec. 3. OMBUDSMAN FOR MENTAL
HEALTH AND MENTAL RETARDATION -0- 200,000
This appropriation is added to the
appropriation in Laws 1987, chapter
352, section 13.
Any balance remaining at the end of
fiscal year 1988 in the account of the
ombudsman for mental health and mental
retardation does not cancel but is
available for fiscal year 1989.
Sec. 4. JOBS AND TRAINING
Subdivision 1. Appropriation by
Fund
General Fund -0- 1,800,000
This appropriation is added to the
appropriation in Laws 1987, chapter
403, article 1, section 4.
Subd. 2. Employment and Training
General Fund
$ -0- $ 100,000
All money remaining in the emergency
interest repayment fund established
under Minnesota Statutes, section
268.061, on June 29, 1988, is
transferred to the unemployment
compensation fund established under
Minnesota Statutes, section 268.05.
Subd. 3. Rehabilitation Services
$ -0- $ 350,000
Of this appropriation, $150,000 is for
grants to certified rehabilitation
facilities to provide needed services
to eligible persons who are on a
waiting list for community-based
employment services.
Subd. 4. Community Services
$ -0- $1,350,000
Of this appropriation, $300,000 is for
Minnesota economic opportunity grants,
of which $200,000 is for the Olmsted
and Freeborn county community action
agencies. Notwithstanding Laws 1987,
chapter 403, article 1, section 4,
subdivision 4, in the event the Olmsted
and Freeborn county community action
agencies become federal-eligible
entities, the discretionary funds being
held in reserve for the Olmsted and
Freeborn county community action
agencies must be distributed to all
community action agencies.
Grants for development and
administration of life skills and
employment plans for homeless
individuals are authorized for fiscal
year 1989 only. Money needed to
continue this program must be included
as a change request in the 1989 to 1991
biennial budget document.
Sec. 5. CORRECTIONS
Subdivision 1. Total
Appropriation 7,900 521,600
This appropriation is added to the
appropriation in Laws 1987, chapter
403, article 1, section 5.
Subd. 2. Correctional Institutions
$ -0- $ 360,000
This appropriation is to replace boiler
number three at the Red Wing
correctional facility.
Of the appropriation in Laws 1987,
chapter 403, article 1, section 5,
subdivision 4, the commissioner may
transfer $41,200 in 1988 and $69,100 in
1989 from contractual services to
salaries.
The commissioner may transfer
unencumbered grant money during the
biennium to pay the department's share
of the employee insurance trust fund
deficit and for the completion of the
Lino Lakes expansion project.
Subd. 3. Community Services
$ 7,900 $161,600
Sec. 6. HEALTH
Subdivision 1. Appropriation by
Fund
General Fund -0- 2,792,000
Special Revenue Fund -0- 320,300
Public Health Fund 175,200 200,800
Trunk Highway Fund 74,400 85,500
Metro Landfill Fund 19,300 22,000
This appropriation is added to the
appropriation in Laws 1987, chapter
403, article 1, section 8.
Subd. 2. Preventive and Protective
Health Services
General Fund
$ -0- $2,002,000
Special Revenue Fund
$ -0- $ 220,300
Of the appropriation from the general
fund, $700,000 is to be used for AIDS
prevention grants for certain high-risk
populations: $350,000 for communities
of color; $250,000 for adolescents at
highest risk; and $100,000 for
intravenous drug abusers.
Of the appropriation from the general
fund, $200,000 is to establish the
Minnesota institute for addiction and
stress research. Of this total,
$160,000 will be used for a grant to
the institute and $40,000 will be
retained by the department. The
approved complement of the department
of health is increased by one position
for purposes of developing and
monitoring the institute.
Of the appropriation from the special
revenue fund, $55,000 is for
implementation of the environmental
laboratories certification program and
is available until June 30, 1992.
Of the appropriation in Laws 1987,
chapter 403, article 1, section 8,
subdivision 2, the commissioner may
transfer $142,000 in fiscal year 1989
from supplies and expense to salaries.
Of the appropriation in Laws 1987,
chapter 403, article 1, section 8,
subdivision 2, for the purchase of
equipment, $190,000 is available until
June 30, 1989.
Money appropriated for the safe
drinking water program is available
only for fiscal year 1989. The
commissioner shall study alternative
structures for funding the program
beyond fiscal year 1989 and shall
recommend a funding structure to the
legislature by January 1, 1989.
Money appropriated for a medical
screening of past employees and family
members of past employees of the Conwed
Corporation plant in Cloquet is
available until expended.
Subd. 3. Health Delivery Systems
General Fund
$ -0- $ 790,000
Special Revenue Fund
$ -0- $ 100,000
Of the appropriation from the general
fund, $400,000 is for grants to poison
information centers selected by the
commissioner under criteria established
in Minnesota Statutes, section 145.93.
The commissioner may develop a schedule
of fees for diagnostic evaluations
conducted at clinics held by the
services for children with handicaps
program.
Notwithstanding the provisions of
Minnesota Rules, part 4690.4600, an
emergency medical technician
certificate issued to a firefighter
employed by the city of Minneapolis
which expires as of December 31, 1988,
shall be effective until December 31,
1989, provided that the firefighter
does not serve as an ambulance
attendant.
The commissioner of health, in
consultation with the commissioner of
human services, shall implement the
provisions of Public Law Number
100-203, the Omnibus Budget
Reconciliation Act of 1987, that relate
to training and competency evaluation
programs and the establishment of a
registry for nurse aides in nursing
homes and boarding care homes certified
for participation in the medical
assistance or Medicare programs. The
board of nursing, at the request of the
commissioner of health, may establish
training and competency evaluation
standards and may establish a registry
of nurse aides who have completed the
programs. The board of nursing and the
commissioner of health may adopt
emergency rules that may be required
for the implementation of Public Law
Number 100-203. Emergency rulemaking
authority expires June 30, 1989. The
commissioner of human services shall
amend the interagency contract with the
commissioner of health to incorporate
these requirements.
Money appropriated for a demonstration
project relating to blood lead levels
in pregnant women is available until
June 30, 1990.
Money appropriated for a demonstration
project relating to blood lead levels
in children is available until expended.
Subd. 4. Health Support Services
Public Health Fund
$ 175,200 $ 200,800
Trunk Highway Fund
$ 74,400 $ 85,500
Metro Landfill Fund
$ 19,300 $ 22,000
Sec. 7. PROJECT LABOR
For human services and corrections
institutions, wages for project labor
may be paid if the employee is to be
engaged in a construction or repair
project of short-term and nonrecurring
nature. Minnesota Statutes, section
43A.25, does not prevent the payment of
the prevailing wage rate, as defined in
Minnesota Statutes, section 177.42,
subdivision 6, to a person hired to
work on a project, whether or not the
person is working under a contract.
ARTICLE 2
Section 1. Minnesota Statutes 1987 Supplement, section
3.922, subdivision 6, is amended to read:
Subd. 6. [DUTIES.] The primary duties of the council shall
be to:
(1) clarify for the legislature and state agencies the
nature of tribal governments, the relationship of tribal
governments to the Indian people of Minnesota;
(2) assist the secretary of state in establishing an
election of at large members of the council;
(3) make recommendations to members of the legislature on
desired and needed legislation for the benefit of the statewide
Indian community and communicate to the members of the
legislature when legislation has or will have an adverse effect
on the statewide Indian community;
(4) provide, through the elected apparatus of the council,
an effective conduit for programs, proposals, and projects to
the legislature submitted by tribal governments, organizations,
committees, groups, or individuals;
(5) provide a continuing dialogue with members of the
appropriate tribal governments in order to improve their
knowledge of the legislative process, state agencies, and
governmental due process;
(6) assist in establishing Indian advisory councils in
cooperation with state agencies delivering services to the
Indian community;
(7) assist state agencies in defining what groups,
organizations, committees, councils, or individuals are eligible
for delivery of their respective services;
(8) assist in providing resources, tribal and other, in the
delivery of services to the statewide Indian community;
(9) act as a liaison between local, state, and national
units of government in the delivery of services to the Indian
population of Minnesota;
(10) assist state agencies in the implementation and
updating of studies of services delivered to the Indian
community;
(11) provide, for the benefit of all levels of state
government, a continuing liaison between those governmental
bodies and duly elected tribal governments and officials;
(12) interreact with private organizations involved with
Indian concerns in the development and implementation of
programs designed to assist Indian people, insofar as they
affect state agencies and departments;
(13) act as an intermediary, when requested and if
necessary between Indian interests and state agencies and
departments when questions, problems, or conflicts exist or
arise;
(14) provide information for and direction to a program
designed to assist Indian citizens to assume all the rights,
privileges, and duties of citizenship, and to coordinate and
cooperate with local, state, and national private agencies
providing services to the Indian people;
(15) develop educational programs, community organization
programs, leadership development programs, motivational
programs, and business development programs for the benefit of
Indian persons who have been, are, or will be subject to
prejudice and discrimination; and
(16) cooperate and consult with appropriate commissioners
and agencies to develop plans and programs to most effectively
serve the needs of Indians; and
(17) review data provided by the commissioner of human
services under section 257.072, subdivision 5, and present
recommendations on the out-of-home placement of Indian
children. Recommendations must be presented to the commissioner
and the legislature by February 1, 1990; November 1, 1990; and
November 1 of each year thereafter.
Sec. 2. Minnesota Statutes 1986, section 3.9223,
subdivision 3, is amended to read:
Subd. 3. [DUTIES.] The council shall:
(a) Advise the governor and the legislature on the nature
of the issues and disabilities confronting Spanish-speaking
people in this state including the unique problems encountered
by Spanish-speaking migrant agricultural workers;
(b) Advise the governor and the legislature on statutes or
rules necessary to insure Spanish-speaking people access to
benefits and services provided to people in this state;
(c) Recommend to the governor and the legislature
legislation designed to improve the economic and social
condition of Spanish-speaking people in this state;
(d) Serve as a conduit to state government for
organizations of Spanish-speaking people in the state;
(e) Serve as a referral agency to assist Spanish-speaking
people in securing access to state agencies and programs;
(f) Serve as a liaison with the federal government, local
government units and private organizations on matters relating
to the Spanish-speaking people of this state;
(g) Perform or contract for the performance of studies
designed to suggest solutions to problems of Spanish-speaking
people in the areas of education, employment, human rights,
health, housing, social welfare and other related programs;
(h) Implement programs designed to solve problems of
Spanish-speaking people when so authorized by other statute,
rule or order;
(i) Review data provided by the commissioner of human
services under section 257.072, subdivision 5, and present
recommendations on the out-of-home placement of children of
Hispanic people. Recommendations must be presented to the
commissioner and the legislature by February 1, 1990; November
1, 1990; and November 1 of each year thereafter; and
(j) Publicize the accomplishments of Spanish-speaking
people and the contributions made by them to this state.
Sec. 3. Minnesota Statutes 1986, section 3.9225,
subdivision 3, is amended to read:
Subd. 3. [DUTIES.] The council shall:
(a) Advise the governor and the legislature on the nature
of the issues confronting Black people in this state;
(b) Advise the governor and the legislature on statutes or
rules necessary to insure Black people access to benefits and
services provided to people in this state;
(c) Recommend to the governor and the legislature any
revisions in the state's affirmative action program and any
other steps that are necessary to eliminate underutilization of
Blacks in the state's work force;
(d) Recommend to the governor and the legislature
legislation designed to improve the economic and social
condition of Black people in this state;
(e) Serve as a conduit to state government for
organizations of Black people in the state;
(f) Serve as a referral agency to assist Black people in
securing access to state agencies and programs;
(g) Serve as a liaison with the federal government, local
government units and private organizations on matters relating
to the Black people of this state;
(h) Perform or contract for the performance of studies
designed to suggest solutions to problems of Black people in the
areas of education, employment, human rights, health, housing,
social welfare and other related areas;
(i) Implement programs designed to solve problems of Black
people when so authorized by other statute, rule or order; and
(j) Review data provided by the commissioner of human
services under section 257.072, subdivision 5, and present
recommendations on the out-of-home placement of Black children.
Recommendations must be presented to the commissioner and the
legislature by February 1, 1990; November 1, 1990; and November
1 of each year thereafter; and
(k) Publicize the accomplishments of Black people and the
contributions made by them to this state.
Sec. 4. Minnesota Statutes 1986, section 3.9226,
subdivision 3, is amended to read:
Subd. 3. [DUTIES.] The council shall:
(1) advise the governor and the legislature on issues
confronting Asian-Pacific people in this state, including the
unique problems of non-English-speaking immigrants and refugees;
(2) advise the governor and the legislature of
administrative and legislative changes necessary to ensure
Asian-Pacific people access to benefits and services provided to
people in this state;
(3) recommend to the governor and the legislature any
revisions in the state's affirmative action program and other
steps that are necessary to eliminate underutilization of
Asian-Pacific people in the state's work force;
(4) recommend to the governor and the legislature
legislation designed to improve the economic and social
condition of Asian-Pacific people in this state;
(5) serve as a conduit to state government for
organizations of Asian-Pacific people in the state;
(6) serve as a referral agency to assist Asian-Pacific
people in securing access to state agencies and programs;
(7) serve as a liaison with the federal government, local
government units, and private organizations on matters relating
to the Asian-Pacific people of this state;
(8) perform or contract for the performance of studies
designed to suggest solutions to the problems of Asian-Pacific
people in the areas of education, employment, human rights,
health, housing, social welfare, and other related areas;
(9) implement programs designed to solve the problems of
Asian-Pacific people when authorized by other law;
(10) publicize the accomplishments of Asian-Pacific people
and their contributions to this state;
(11) work with other state and federal agencies and
organizations to develop small business opportunities and
promote economic development for Asian-Pacific Minnesotans;
(12) supervise development of an Asian-Pacific trade
primer, outlining Asian and Pacific customs, cultural
traditions, and business practices, including language usage,
for use by Minnesota's export community; and
(13) cooperate with other state and federal agencies and
organizations to develop improved state trade relations with
Asian and Pacific countries; and
(14) review data provided by the commissioner of human
services under section 257.072, subdivision 5, and present
recommendations on the out-of-home placement of Asian-Pacific
children. Recommendations must be presented to the commissioner
and the legislature by February 1, 1990; November 1, 1990; and
November 1 of each year thereafter.
Sec. 5. Minnesota Statutes 1987 Supplement, section
16B.08, subdivision 7, is amended to read:
Subd. 7. [SPECIFIC PURCHASES.] (a) The following may be
purchased without regard to the competitive bidding requirements
of this chapter:
(1) merchandise for resale at state park refectories or
facility operations;
(2) farm and garden products, which may be sold at the
prevailing market price on the date of the sale;
(3) meat for other state institutions from the vocational
school maintained at Pipestone by independent school district
No. 583; and
(4) furniture from the Minnesota correctional facilities.
(b) Supplies, materials, equipment, and utility services
for use by a community-based residential facility operated by
the commissioner of human services may be purchased or rented
without regard to the competitive bidding requirements of this
chapter.
(c) Supplies, materials, or equipment to be used in the
operation of a hospital licensed under sections 144.50 to 144.56
that are purchased under a shared service purchasing arrangement
whereby more than one hospital purchases supplies, materials, or
equipment with one or more other hospitals, either through one
of the hospitals or through another entity, may be purchased
without regard to the competitive bidding requirements of this
chapter if the following conditions are met:
(1) the hospital's governing authority authorizes the
arrangement;
(2) the shared services purchasing program purchases items
available from more than one source on the basis of competitive
bids or competitive quotations of prices; and
(3) the arrangement authorizes the hospital's governing
authority or its representatives to review the purchasing
procedures to determine compliance with these requirements.
Sec. 6. [62A.048] [DEPENDENT COVERAGE.]
A policy of accident and sickness insurance that covers an
employee who is a Minnesota resident must, if it provides
dependent coverage, allow dependent children who do not reside
with the covered employee to be covered on the same basis as if
they reside with the covered employee. Neither the amount of
support provided by the employee to the dependent child nor the
residency of the child may be used as an excluding or limiting
factor for coverage or payment for health care.
Sec. 7. Minnesota Statutes 1987 Supplement, section
62A.152, subdivision 2, is amended to read:
Subd. 2. [MINIMUM BENEFITS.] (a) All group policies and
all group subscriber contracts providing benefits for mental or
nervous disorder treatments in a hospital shall also provide
coverage on the same basis as coverage for other benefits for at
least 80 percent of the cost of the usual and customary charges
of the first ten hours of treatment incurred over a 12-month
benefit period, for mental or nervous disorder consultation,
diagnosis and treatment services delivered while the insured
person is not a bed patient in a hospital, and at least 75
percent of the cost of the usual and customary charges for any
additional hours of treatment during the same 12-month benefit
period for serious and or persistent mental or nervous
disorders, if the services are furnished by (1) a licensed or
accredited hospital, (2) a community mental health center or
mental health clinic approved or licensed by the commissioner of
human services or other authorized state agency, or (3) a
licensed consulting psychologist licensed under the provisions
of sections 148.87 to 148.98, or a psychiatrist licensed under
chapter 147. Prior authorization from an accident and health
insurance company, or a nonprofit health service corporation,
shall be required for an extension of coverage beyond ten hours
of treatment. This prior authorization must be based upon the
severity of the disorder, the patient's risk of deterioration
without ongoing treatment and maintenance, degree of functional
impairment, and a concise treatment plan. Authorization for
extended treatment may not exceed be limited to a maximum of 30
visit hours during any 12-month benefit period.
(b) For purposes of this section, covered treatment for a
minor shall include includes treatment for the family if family
therapy is recommended by a provider listed above in paragraph
(a), item (1), (2) or (3). For purposes of determining benefits
under this section, "hours of treatment" means treatment
rendered on an individual or single-family basis. If treatment
is rendered on a group basis, the hours of covered group
treatment must be provided at a ratio of no less than two group
treatment sessions to one individual treatment hour.
Sec. 8. Minnesota Statutes 1987 Supplement, section
62A.48, subdivision 7, is amended to read:
Subd. 7. [EXISTING POLICIES.] Nothing in sections 62A.46
to 62A.56 62A.58 prohibits the renewal of the following
long-term care policies:
(1) policies sold outside the state of Minnesota to persons
who at the time of sale were not residents of the state of
Minnesota;
(2) policies sold before August 1, 1986; and
(3) policies sold before July 1, 1988, by associations
exempted from sections 62A.31 to 62A.44 under section 62A.31,
subdivision 1a.
Sec. 9. Minnesota Statutes 1987 Supplement, section
62A.50, subdivision 3, is amended to read:
Subd. 3. [DISCLOSURES.] No long-term care policy shall be
offered or delivered in this state, whether or not the policy is
issued in this state, and no certificate of coverage under a
group long-term care policy shall be offered or delivered in
this state, unless a statement containing at least the following
information is delivered to the applicant at the time the
application is made:
(1) a description of the benefits and coverage provided by
the policy and the differences between this policy, a
supplemental Medicare policy and the benefits to which an
individual is entitled under parts A and B of Medicare and the
differences between policy designations A and AA;
(2) a statement of the exceptions and limitations in the
policy including the following language, as applicable, in bold
print: "THIS POLICY DOES NOT COVER ALL NURSING CARE FACILITIES
OR NURSING HOME OR, HOME CARE, OR ADULT DAY CARE EXPENSES AND
DOES NOT COVER RESIDENTIAL CARE. READ YOUR POLICY CAREFULLY TO
DETERMINE WHICH FACILITIES AND EXPENSES ARE COVERED BY YOUR
POLICY.";
(3) a statement of the renewal provisions including any
reservation by the insurer of the right to change premiums;
(4) a statement that the outline of coverage is a summary
of the policy issued or applied for and that the policy should
be consulted to determine governing contractual provisions;
(5) an explanation of the policy's loss ratio including at
least the following language: "This means that, on the average,
policyholders may expect that $........ of every $100 in premium
will be returned as benefits to policyholders over the life of
the contract."; and
(6) a statement of the out-of-pocket expenses, including
deductibles and copayments for which the insured is responsible,
and an explanation of the specific out-of-pocket expenses that
may be accumulated toward any out-of-pocket maximum as specified
in the policy;
(7) the following language, in bold print: "YOUR PREMIUMS
CAN BE INCREASED IN THE FUTURE. THE RATE SCHEDULE THAT LISTS
YOUR PREMIUM NOW CAN CHANGE.";
(8) the following language, if applicable, in bold print:
"IF YOU ARE NOT HOSPITALIZED PRIOR TO ENTERING A NURSING HOME OR
NEEDING HOME CARE, YOU WILL NOT BE ABLE TO COLLECT ANY BENEFITS
UNDER THIS PARTICULAR POLICY."; and
(9) a signed and completed copy of the application for
insurance is left with the applicant at the time the application
is made.
Sec. 10. Minnesota Statutes 1986, section 62A.54, is
amended to read:
62A.54 [PROHIBITED PRACTICES.]
Unless otherwise provided for in Laws 1986, chapter 397,
sections 2 to 8, the solicitation or sale of long-term care
policies is subject to the requirements and penalties applicable
to the sale of medicare supplement insurance policies as set
forth in sections 62A.31 to 62A.44.
It is misconduct for any agent or company to make any
misstatements concerning eligibility or coverage under the
medical assistance program, or about how long-term care costs
will or will not be financed if a person does not have long-term
care insurance. Any agent or company providing information on
the medical assistance program shall also provide information
about how to contact the county human services department or the
state department of human services.
Sec. 11. [62C.143] [DEPENDENT COVERAGE.]
A subscriber contract of a nonprofit health service plan
corporation that covers an employee who is a Minnesota resident
must, if it provides dependent coverage, allow dependent
children who do not reside with the covered employee to be
covered on the same basis as if they reside with the covered
employee. Neither the amount of support provided by the
employee to the dependent child nor the residency of the child
may be used as an excluding or limiting factor for coverage or
payment for health care.
Sec. 12. Minnesota Statutes 1987 Supplement, section
62D.102, is amended to read:
62D.102 [MINIMUM BENEFITS.]
(a) In addition to minimum requirements established in
other sections, all group health maintenance contracts providing
benefits for mental or nervous disorder treatments in a hospital
shall also provide coverage for at least ten hours of treatment
over a 12-month period with a copayment not to exceed the
greater of $10 or 20 percent of the applicable usual and
customary charge for mental or nervous disorder consultation,
diagnosis and treatment services delivered while the enrollee is
not a bed patient in a hospital and at least 75 percent of the
cost of the usual and customary charges for any additional hours
of ambulatory mental health treatment during the same 12-month
benefit period for serious and or persistent mental or nervous
disorders. Prior authorization may be required for an extension
of coverage beyond ten hours of treatment. This prior
authorization must be based upon the severity of the disorder,
the patient's risk of deterioration without ongoing treatment
and maintenance, degree of functional impairment, and a concise
treatment plan. Authorization for extended treatment may not
exceed be limited to a maximum of 30 visit hours during any
12-month benefit period.
(b) For purposes of this section, covered treatment for a
minor shall include includes treatment for the family if family
therapy is recommended by a health maintenance organization
provider. For purposes of determining benefits under this
section, "hours of treatment" means treatment rendered on an
individual or single-family basis. If treatment is rendered on
a group basis, the hours of covered group treatment must be
provided at a ratio of no less than two group treatment sessions
to one individual treatment hour. For a health maintenance
contract that is offered as a companion to a health insurance
subscriber contract, the benefits for mental or nervous
disorders must be calculated in aggregate for the health
maintenance contract and the health insurance subscriber
contract.
Sec. 13. [62D.106] [DEPENDENT COVERAGE.]
A health maintenance organization subscriber contract must,
if it provides dependent coverage, allow dependent children who
do not reside with the covered employee to be covered on the
same basis as if they reside with the covered employee. Neither
the amount of support provided by the employee to the dependent
child nor the residency of the child can be used as an excluding
or limiting factor for coverage or payment for any health care.
Coverage under this section shall apply only if the dependent
child resides within the service area of the health maintenance
organization or if the dependent child is a birth or legally
adopted child.
Sec. 14. Minnesota Statutes 1986, section 62E.04, is
amended by adding a subdivision to read:
Subd. 9. [REDUCTION OF BENEFITS BECAUSE OF ERISA
SERVICES.] No plan of health coverage including, but not limited
to, any plan under the federal Employee Retirement Income
Security Act of 1974 (ERISA), United States Code, title 29,
sections 1001 to 1461, which covers a Minnesota resident shall
deny or reduce benefits because services are rendered to a
covered person or dependent who is eligible for or receiving
benefits under chapter 256B.
Sec. 15. Minnesota Statutes 1986, section 62E.04, is
amended by adding a subdivision to read:
Subd. 10. [DEPENDENT COVERAGE.] A plan of health coverage
under the Federal Employee Retirement Income Security Act of
1974 (ERISA), United State Code, title 29, sections 1001 to
1461, which covers an employee who is a Minnesota resident must,
if it provides dependent coverage, allow dependent children who
are eligible for or receiving benefits under chapter 256B and
who do not reside with the covered employee to be covered on the
same basis as if they reside with the covered employee. Neither
the amount of support provided by the employee to the dependent
child nor the residency of the child can be used as an excluding
or limiting factor for coverage or payment for any health care.
Sec. 16. Minnesota Statutes 1987 Supplement, section
129A.01, subdivision 5, is amended to read:
Subd. 5. [HANDICAPPED PERSON PERSON WITH A
DISABILITY.] "Handicapped person" "Person with a disability"
means a person who because of a substantial physical, mental, or
emotional disability or dysfunction requires special services in
order to enjoy the benefits of society.
Sec. 17. Minnesota Statutes 1987 Supplement, section
129A.01, subdivision 6, is amended to read:
Subd. 6. [LONG-TERM SHELTERED WORKSHOP REHABILITATION
FACILITY.] "Long-term sheltered workshop Rehabilitation
facility" means a facility where any manufacture or handiwork is
carried on and an entity which meets the definition of
"rehabilitation facility" in the federal Rehabilitation Act of
1973, as amended; however, for the purposes of sections 129A.03,
paragraph (a), 129A.06, 129A.07, and 129A.08, "rehabilitation
facility" means an entity which is operated for the primary
purpose of providing remunerative employment to
those handicapped persons with a disability who, as a result of
physical or mental disability, are unable to participate in
competitive employment. A long-term sheltered workshop
rehabilitation facility shall supply such employment (1) as a
step in the rehabilitation process for those who cannot be
readily absorbed in the competitive labor market, or (2) during
such time as employment opportunities for them in the
competitive labor market do not exist.
Sec. 18. Minnesota Statutes 1987 Supplement, section
129A.01, subdivision 7, is amended to read:
Subd. 7. [WORK ACTIVITY PROGRAM.] "Work activity program"
means a program which utilizes paid work and training services
for the primary purpose of providing basic vocational skills
development for the handicapped persons with a disability and
which permits a level of production below that required for a
long-term employment program.
Sec. 19. Minnesota Statutes 1986, section 129A.02,
subdivision 3, is amended to read:
Subd. 3. [CONSUMER ADVISORY COUNCIL.] To assure that
consumer concerns are integral parts of the considerations of a
major consideration in the department department's programs,
policies, and decision making process, the commissioner shall
establish and appoint a consumer advisory council on vocational
rehabilitation which shall be composed of nine no more than 13
members. No fewer than five A majority of the members of the
council shall be handicapped persons, and there shall be with a
disability who are current or former recipients of vocational
rehabilitation services or who represent consumer/advocacy
organizations that regularly serve vocational rehabilitation
clients. If a qualified person is available to so serve, one
person shall be appointed to the council to represent each of
the following: business, labor, education, medicine and the
private not-for-profit rehabilitation industry. The remaining
members shall be public members. Under the direction of the
commissioner, the council shall organize itself and elect a
chair and other officers as it deems appropriate. The council
shall meet at the call of the chair or the commissioner as often
as necessary. The council shall expire and the terms,
compensation, and removal of members of the council shall be as
provided in section 15.059. The council shall not expire as
provided by section 15.059, subdivision 5.
Sec. 20. Minnesota Statutes 1987 Supplement, section
129A.03, is amended to read:
129A.03 [POWERS AND DUTIES.]
The commissioner shall:
(a) certify the long-term sheltered workshops
rehabilitation facilities to offer extended employment programs,
grant funds to the extended employment programs, and perform the
duties as specified in section 129A.08;
(b) provide vocational rehabilitation services such as to
persons with disabilities in accordance with the state plan for
vocational rehabilitation. These services include but are not
limited to: diagnostic and related services incidental to
determination of eligibility for services to be provided,
including medical diagnosis and vocational diagnosis; vocational
counseling, training and instruction, including personal
adjustment training; physical restoration, including corrective
surgery, therapeutic treatment, hospitalization and
prosthetic and orthotic devices, all of which shall be obtained
from appropriate established agencies; transportation;
occupational and business licenses or permits, customary tools
and equipment,; maintenance,; books, supplies and training
materials; initial stocks and supplies; placement; on-the-job
skill training and time-limited postemployment services leading
to supported employment; acquisition of vending stands or other
equipment, initial stocks and supplies for small business
enterprises; supervision and management of small business
enterprises, merchandising programs or services rendered by
severely disabled persons; establishment, improvement,
maintenance or extension of public and other nonprofit
rehabilitation facilities, centers, workshops, demonstration
projects and research. These services shall be provided for
handicapped persons in the state whose capacity to earn a living
has in any way been destroyed or impaired through industrial
accident or otherwise; these Persons with a disability are
entitled to free choice of vendor for any medical or, dental,
prosthetic, or orthotic services provided under this paragraph;
(c) expend funds and provide technical assistance for the
establishment, improvement, maintenance, or extension of public
and other nonprofit rehabilitation facilities or centers;
(d) formulate plans of cooperation with the commissioner of
labor and industry for providing services to workers covered
under the workers' compensation act;
(d) (e) maintain a contractual or regulatory relationship
with the United States as authorized by the act of Congress
approved September 1, 1954, known as the "Social Security
Amendments of 1954," Public Law Number 761, section 221, and the
act approved October 30, 1972, known as the Social Security
Amendments of 1972, Public Law Number 92-603, and subsequent
amendments Social Security Act, as amended. Under the contract
this relationship, the state will undertake to make
determinations referred to in those public laws with respect to
all individuals in Minnesota, or with respect to a class or
classes of individuals in this state that is designated in the
agreement at the state's request. It is the purpose of this
relationship to permit the citizens of this state to obtain all
benefits available under federal law;
(e) (f) provide an in-service training program for
department division of rehabilitation services employees by
paying for its direct costs with state and federal funds;
(f) (g) conduct research and demonstration projects;
provide training and instruction, including establishment and
maintenance of research fellowships and traineeships, along with
all necessary stipends and allowances; disseminate information
to the handicapped persons with a disability and the general
public; and provide technical assistance relating to vocational
rehabilitation and independent living;
(g) (h) receive and disburse pursuant to law money and
gifts available from governmental and private sources including,
but not limited to, the federal Department of Education and the
Social Security Administration, for the purpose of vocational
rehabilitation or independent living. Money received from
workers' compensation carriers for vocational rehabilitation
services to injured workers must be deposited in the general
fund;
(h) (i) design all state plans of for vocational
rehabilitation or independent living services required as a
condition to the receipt and disbursement of any money available
from the federal government;
(i) (j) cooperate with other public or private agencies or
organizations for the purpose of vocational rehabilitation or
independent living. Money received from school districts,
governmental subdivisions, mental health centers or boards, and
private nonprofit organizations is appropriated to the
commissioner for conducting joint or cooperative vocational
rehabilitation or independent living programs;
(j) (k) enter into contractual arrangements with
instrumentalities of federal, state, or local government and
with private individuals, organizations, agencies, or facilities
with respect to providing vocational rehabilitation or
independent living services;
(k) (l) take other actions required by state and federal
legislation relating to vocational rehabilitation, independent
living, and disability determination programs;
(l) (m) hire staff and arrange services and facilities
necessary to perform the duties and powers specified in this
section; and
(m) (n) adopt, amend, suspend, or repeal rules necessary to
implement or make specific programs that the commissioner by
sections 129A.01 to 129A.09 is empowered to administer.
Sec. 21. Minnesota Statutes 1987 Supplement, section
129A.06, subdivision 1, is amended to read:
Subdivision 1. Any city, town, county, nonprofit
corporation, state regional center, or any combination thereof,
may apply to the commissioner for assistance in establishing or
operating a community long-term sheltered workshop
rehabilitation facility. Application for assistance shall be on
forms supplied by the commissioner. Each applicant shall
annually submit to the commissioner its plan and budget for the
next fiscal year. No applicant shall be eligible for a grant
hereunder unless its plan and budget have been approved by the
commissioner.
Sec. 22. Minnesota Statutes 1987 Supplement, section
129A.07, subdivision 1, is amended to read:
Subdivision 1. Every city, town, county, nonprofit
corporation, or combination thereof establishing a long-term
sheltered workshop rehabilitation facility shall appoint a
long-term sheltered workshop rehabilitation facility board of no
fewer than nine members before becoming eligible for the
assistance provided by sections 129A.06 to 129A.08. When any
city, town, or county singly establishes such a
workshop rehabilitation facility, the board shall be appointed
by the chief executive officer of the city or the chair of the
governing board of the county or town. When any combination of
cities, towns, counties or nonprofit corporations establishes
a workshop rehabilitation facility, the chief executive officers
of the cities, nonprofit corporations and the chairs of the
governing bodies of the counties or towns shall appoint the
board. If a nonprofit corporation singly establishes a workshop
rehabilitation facility, the corporation shall appoint the board
of directors. Membership on a board shall be representative of
the community served and shall include a handicapped person with
a disability. One-third to one-half of the board shall be
representative of industry or business. The remaining members
should be representative of lay associations for the handicapped
persons with a disability, labor, the general public, and
education, welfare, medical, and health professions. Nothing in
sections 129A.06 to 129A.08 shall be construed to preclude the
appointment of elected or appointed public officials or members
of the board of directors of the sponsoring nonprofit
corporation to the board, so long as representation described
above is preserved. If a state regional center establishes an
extended employment program, the chief executive officer of the
state regional center shall perform the functions of the
rehabilitation facility board as prescribed in subdivision 3.
The regional center is not required to establish a separate
governing body as a board. The state regional center shall
establish an advisory committee following the membership
representation requirements of this subdivision. If a county
establishes a workshop an extended employment program and
manages the workshop program with county employees, the
governing board shall be the county board of commissioners and
other provisions of this chapter pertaining to membership on the
governing board do not apply.
Sec. 23. Minnesota Statutes 1987 Supplement, section
129A.08, subdivision 1, is amended to read:
Subdivision 1. [GRANTS.] The commissioner may make grants
to assist cities, towns, counties, nonprofit corporations, state
regional centers, or any combination thereof in the
establishment, operation, and expansion of the extended
employment programs offered by long-term sheltered workshops
rehabilitation facilities. The commissioner may accept federal
grants or aids and shall cooperate with federal agencies in any
reasonable manner necessary to qualify for federal grants or
aids for long-term sheltered workshops rehabilitation facilities
or their programs.
Sec. 24. Minnesota Statutes 1987 Supplement, section
129A.08, subdivision 4, is amended to read:
Subd. 4. [EVALUATION OF PROGRAMS.] The program evaluation
must include, but not be limited to, the following
considerations:
(a) Wages and benefits paid to sheltered employees extended
employment program participants and number of hours worked;
(b) Rate of placement in competitive employment;
(c) Opportunities for sheltered employees extended
employment program participants to participate in decisions
affecting their employment;
(d) Workshop Rehabilitation facility responsiveness to
sheltered employees extended employment program participants'
grievances;
(e) Increases in individual sheltered employee extended
employment program participants' productivity;
(f) Implementing innovative ways to increase placement and
retention of sheltered employees in competitive employment, or
in sheltered positions with competitive employers, or innovative
ways that increase sheltered employee wages;
(g) Efficiency of the workshops rehabilitation facilities;
and
(h) (g) Types and levels of disability of the sheltered
employees extended employment program participants and
willingness of the workshop rehabilitation facility to accept
and assist persons with serious behavioral, mental, sensory, or
physical disabilities.
The evaluation must take into account the disability levels
of the sheltered employees extended employment program
participants, the geographic location and size of the workshop
rehabilitation facility and the economic conditions of the
surrounding community.
Sec. 25. Minnesota Statutes 1987 Supplement, section
129A.08, is amended by adding a subdivision to read:
Subd. 4a. [FUND ALLOCATION.] Funds appropriated for the
extended employment program shall be distributed to
rehabilitation facilities in a manner prescribed in rule,
provided that 15 percent shall be allocated based on economic
conditions as defined in rule and that, for funding purposes, no
credit can be given for full-time equivalents, as defined in
rule, in excess of the number of persons in the program.
Sec. 26. Minnesota Statutes 1987 Supplement, section
129A.08, subdivision 5, is amended to read:
Subd. 5. [RULE AUTHORITY.] In addition to the powers
already conferred by law, the commissioner shall promulgate
rules on:
(a) state certification of all long-term sheltered
workshops rehabilitation facilities;
(b) allocation of state grant funds to extended employment
programs;
(c) standards for qualification of personnel and quality of
professional service and for in-service training and education
leave programs for personnel;
(d) eligibility for service so that no person will be
denied service on the basis of race, creed, or color;
(e) regulatory fees for consultation services;
(f) standards and criteria by which handicapped persons
with a disability are to be judged eligible for the services;
(g) evaluation criteria for extended employment programs;
and
(h) program evaluation criteria for work activity programs
in order to determine the extent to which these programs meet
the goals and objectives established in state and federal law
relating to work activity programs.
The rules on evaluation criteria for long-term sheltered
workshops rehabilitation facilities must be in effect by July 1,
1986. The rules must be used in making allocations for fiscal
years beginning after June 30, 1987.
Sec. 27. Minnesota Statutes 1986, section 129A.09, is
amended to read:
129A.09 [EXPENDITURE OF FEDERAL FUNDS.]
Notwithstanding the provisions of Laws 1975, chapter 433,
section 2, subdivision 9, Any additional federal funds which
become available to the state of Minnesota for vocational
rehabilitation or independent living purposes after March 1,
1976 and April 1 of each fiscal year thereafter as a result of a
reallocation of funds returned by other states or release of
additional funds may be carried over and expended in the next
fiscal year. The state of Minnesota shall have earned these
funds in the year they are received with state expenditures in
accordance with the federal-state formula in effect for that
year. These funds shall be subject to the provisions of Laws
1976, chapter 332, section 9, subdivision 8.
Sec. 28. Minnesota Statutes 1986, section 129A.10, is
amended to read:
129A.10 [INDEPENDENT LIVING SERVICES.]
Subdivision 1. [SERVICES OFFERED.] Independent living
services are those services designed to materially improve
opportunities for persons with disabilities to live and function
more independently in their home, family, and community, and the
services include:
(1) intake counseling to determine the individual's needs
for services;
(2) referral and counseling services with respect to
attendant care;
(3) counseling and advocacy with respect to legal and
economic rights and benefits;
(4) independent living skills, training, and counseling;
(5) housing and transportation referral and assistance;
(6) surveys, directories, and other activities to identify
appropriate housing and accessible transportation and other
support services;
(7) peer counseling;
(8) education and training necessary to living in the
community and participating in community affairs;
(9) individual and group social and recreational activities;
(10) attendant care and training of personnel to provide
the care; and
(11) other necessary services which are not inconsistent
with sections 62A.26 and 62E.06, subdivision 1.
Subd. 2. [ADMINISTRATION.] This section shall be
administered by the department of jobs and training through the
division of vocational rehabilitation services. The department
may employ staff as reasonably required to administer this
section and may accept and receive funds from nonstate sources
for the purpose of effectuating this section.
Subd. 3. [CERTIFICATION.] No applicant center for
independent living may receive funding under this section unless
it has received certification from the division of vocational
rehabilitation services.
The division of vocational rehabilitation services shall
involve disabled consumers persons with a disability and other
interested persons to consider performance evaluation criteria
in order to formulate rules by which centers will be certified
by July 1, 1986.
The division of vocational rehabilitation services shall
review the programs for centers of independent living receiving
funds from this section to determine their adherence to
standards adopted by rule and if the standards are substantially
met, shall issue appropriate certifications.
Subd. 4. [APPLICATION OF CENTERS FOR INDEPENDENT LIVING.]
The division of vocational rehabilitation services shall require
centers for independent living to complete application forms,
expenditure reports, and proposed plans and budgets. These
reports must be in the manner and on the form prescribed by the
division. When applying, the center for independent living
shall agree to provide reports and records, and make available
records for audit as may be required by the division of
vocational rehabilitation services.
The applicant center for independent living shall be
notified in writing by the division concerning the approval of
budgets and plans.
Sec. 29. Minnesota Statutes 1986, section 144.053, is
amended by adding a subdivision to read:
Subd. 5. The commissioner of health or the commissioner's
agent is not required to solicit information that personally
identifies persons selected to participate in an epidemiologic
study if the commissioner determines that:
(1) the study monitors incidence or prevalence of a serious
disease to detect potential health problems and predict risks,
provides specific information to develop public health
strategies to prevent serious disease, enables the targeting of
intervention resources for communities, patients, or groups at
risk of the disease, and informs health professionals about
risks, early detection, or treatment of the disease;
(2) the personally identifying information is not necessary
to validate the quality, accuracy, or completeness of the study;
or
(3) the collection of personally identifying information
may seriously jeopardize the validity of study results, as
demonstrated by an epidemiologic study.
Sec. 30. [144.056] [PLAIN LANGUAGE IN WRITTEN MATERIALS.]
(a) To the extent reasonable and consistent with the goals
of providing easily understandable and readable materials and
complying with federal and state laws governing the program, all
written materials relating to determinations of eligibility for
or amounts of benefits that will be given to applicants for or
recipients of assistance under a program administered or
supervised by the commissioner of health must be understandable
to a person who reads at the seventh-grade level, using the
Flesch scale analysis readability score as determined under
section 72C.09.
(b) All written materials relating to services and
determinations of eligibility for or amounts of benefits that
will be given to applicants for or recipients of assistance
under programs administered or supervised by the commissioner of
health must be developed to satisfy the plain language
requirements of the plain language contract act under sections
325G.29 to 325G.36. Materials may be submitted to the attorney
general for review and certification. Notwithstanding section
325G.35, subdivision 1, the attorney general shall review
submitted materials to determine whether they comply with the
requirements of section 325G.31. The remedies available
pursuant to sections 8.31 and 325G.33 to 325G.36 do not apply to
these materials. Failure to comply with this section does not
provide a basis for suspending the implementation or operation
of other laws governing programs administered by the
commissioner.
(c) The requirements of this section apply to all materials
modified or developed by the commissioner on or after July 1,
1988. The requirements of this section do not apply to
materials that must be submitted to a federal agency for
approval, to the extent that application of the requirements
prevents federal approval.
(d) Nothing in this section may be construed to prohibit a
lawsuit brought to require the commissioner to comply with this
section or to affect individual appeal rights under the special
supplemental food program for women, infants, and children
granted pursuant to federal regulations under the Code of
Federal Regulations, chapter 7, section 246.
(e) The commissioner shall report annually to the chairs of
the health and human services divisions of the senate finance
committee and the house of representatives appropriations
committee on the number and outcome of cases that raise the
issue of the commissioner's compliance with this section.
Sec. 31. Minnesota Statutes 1986, section 144.125, is
amended to read:
144.125 [TESTS OF INFANTS FOR INBORN METABOLIC ERRORS
CAUSING MENTAL RETARDATION.]
It is the duty of (1) the administrative officer or other
person in charge of each institution caring for infants 28 days
or less of age and (2) the person required in pursuance of the
provisions of section 144.215, to register the birth of a child,
to cause to have administered to every such infant or child in
its care tests for hemoglobinopathy, phenylketonuria and other
inborn errors of metabolism causing mental retardation in
accordance with rules prescribed by the state commissioner of
health. In determining which tests must be administered, the
commissioner shall take into consideration the adequacy of
laboratory methods to detect the inborn metabolic error, the
ability to treat or prevent medical conditions caused by the
inborn metabolic error, and the severity of the medical
conditions caused by the inborn metabolic error. Testing and
the recording and reporting of the results of such the tests
shall be performed at such the times and in such the manner as
may be prescribed by the state commissioner of health. The
provisions of This section shall does not apply to any an
infant whose parents object thereto on the grounds that such the
tests and treatment conflict with their religious tenets and
practices. The commissioner shall charge laboratory service
fees for conducting the tests of infants for inborn metabolic
errors so that the total of fees collected will approximate the
costs of conducting the tests. Costs associated with capital
expenditures and the development of new procedures may be
prorated over a three-year period when calculating the amount of
the fees.
Sec. 32. Minnesota Statutes 1986, section 144.50, is
amended by adding a subdivision to read:
Subd. 6. [SUPERVISED LIVING FACILITY LICENSES.] The
commissioner may license as a supervised living facility a
facility seeking medical assistance certification as an
intermediate care facility for persons with mental retardation
or related conditions for four or more persons as authorized
under section 252.291.
Sec. 33. [144.97] [DEFINITIONS.]
Subdivision 1. [APPLICATION.] The definitions in this
section apply to section 144.98.
Subd. 2. [CERTIFICATION.] "Certification" means written
acknowledgement of a laboratory's demonstrated capability to
perform tests for a specific purpose.
Subd. 3. [COMMISSIONER.] "Commissioner" means the
commissioner of health.
Subd. 4. [CONTRACT LABORATORY.] "Contract laboratory"
means a laboratory that performs tests on samples on a contract
or fee-for-service basis.
Subd. 5. [ENVIRONMENTAL SAMPLE.] "Environmental sample"
means a substance derived from a nonhuman source and collected
for the purpose of analysis.
Subd. 6. [LABORATORY.] "Laboratory" means the state, a
person, corporation, or other entity, including governmental,
that examines, analyzes, or tests samples.
Subd. 7. [SAMPLE.] "Sample" means a substance derived from
a nonhuman source and collected for the purpose of analysis, or
a tissue, blood, excretion, or other bodily fluid specimen
obtained from a human for the detection of a chemical, etiologic
agent, or histologic abnormality.
Sec. 34. [144.98] [CERTIFICATION OF ENVIRONMENTAL
LABORATORIES.]
Subdivision 1. [AUTHORIZATION.] The commissioner of health
may certify laboratories that test environmental samples.
Subd. 2. [RULES.] The commissioner may adopt rules to
implement this section, including:
(1) procedures, requirements, and fee adjustments for
laboratory certification, including provisional status and
recertification;
(2) standards and fees for certificate approval,
suspension, and revocation;
(3) standards for environmental samples;
(4) analysis methods that assure reliable test results;
(5) laboratory quality assurance, including internal
quality control, proficiency testing, and personnel training;
and
(6) criteria for recognition of certification programs of
other states and the federal government.
Subd. 3. [FEES.] (a) An application for certification
under subdivision 1 must be accompanied by the annual fee
specified in this subdivision. The fees are for:
(1) base certification fee, $250; and
(2) test category certification fees:
Test Category Certification Fee
Bacteriology $100
Inorganic chemistry, fewer than 4 constituents $ 50
Inorganic chemistry, 4 or more constituents $150
Chemistry metals, fewer than 4 constituents $100
Chemistry metals, 4 or more constituents $250
Volatile organic compounds $300
Other organic compounds $300
(b) The total annual certification fee is the base fee plus
the applicable test category fees. The annual certification fee
for a contract laboratory is 1.5 times the total certification
fee.
(c) Laboratories located outside of this state that require
an on-site survey will be assessed an additional $1,200 fee.
(d) The commissioner of health may adjust fees under
section 16A.128, subdivision 2. Fees must be set so that the
total fees support the laboratory certification program. Direct
costs of the certification service include program
administration, inspections, the agency's general support costs,
and attorney general costs attributable to the fee function.
Subd. 4. [FEES FOR LABORATORY PROFICIENCY TESTING AND
TECHNICAL TRAINING.] The commissioner of health may set fees for
proficiency testing and technical training services under
section 16A.128. Fees must be set so that the total fees cover
the direct costs of the proficiency testing and technical
training services, including salaries, supplies and equipment,
travel expenses, and attorney general costs attributable to the
fee function.
Subd. 5. [LABORATORY CERTIFICATION ACCOUNT.] There is an
account in the special revenue fund called the laboratory
certification account. Fees collected under this section and
appropriations for the purposes of this section must be
deposited in the laboratory certification account. Money in the
laboratory certification account is annually appropriated to the
commissioner of health to administer this section.
Sec. 35. Minnesota Statutes 1986, section 144A.04, is
amended by adding a subdivision to read:
Subd. 7. [MINIMUM NURSING STAFF REQUIREMENT.]
Notwithstanding the provisions of Minnesota Rules, part
4655.5600, the minimum staffing standard for nursing personnel
in nursing homes is as follows:
(a) The minimum number of hours of nursing personnel to be
provided in a nursing home is the greater of two hours per
resident per 24 hours or 0.95 hours per standardized resident
day.
(b) For purposes of this subdivision, "hours of nursing
personnel" means the paid, on-duty, productive nursing hours of
all nurses and nursing assistants, calculated on the basis of
any given 24-hour period. "Productive nursing hours" means all
on-duty hours during which nurses and nursing assistants are
engaged in nursing duties. Examples of nursing duties may be
found in Minnesota Rules, parts 4655.5900, 4655.6100, and
4655.6400. Not included are vacations, holidays, sick leave,
in-service classroom training, or lunches. Also not included
are the nonproductive nursing hours of the in-service training
director. In homes with more than 60 licensed beds, the hours
of the director of nursing are excluded. "Standardized resident
day" means the sum of the number of residents in each case mix
class multiplied by the case mix weight for that resident class,
as found in Minnesota Rules, part 9549.0059, subpart 2,
calculated on the basis of a facility's census for any given day.
(c) Calculation of nursing hours per standardized resident
day is performed by dividing total hours of nursing personnel
for a given period by the total of standardized resident days
for that same period.
Sec. 36. Minnesota Statutes 1987 Supplement, section
144A.071, subdivision 3, is amended to read:
Subd. 3. [EXCEPTIONS.] The commissioner of health, in
coordination with the commissioner of human services, may
approve the addition of a new certified bed or the addition of a
new licensed nursing home bed, under the following conditions:
(a) to replace a bed decertified after May 23, 1983 or to
address an extreme hardship situation, in a particular county
that, together with all contiguous Minnesota counties, has fewer
nursing home beds per 1,000 elderly than the number that is ten
percent higher than the national average of nursing home beds
per 1,000 elderly individuals. For the purposes of this
section, the national average of nursing home beds shall be the
most recent figure that can be supplied by the federal health
care financing administration and the number of elderly in the
county or the nation shall be determined by the most recent
federal census or the most recent estimate of the state
demographer as of July 1, of each year of persons age 65 and
older, whichever is the most recent at the time of the request
for replacement. In allowing replacement of a decertified bed,
the commissioners shall ensure that the number of added or
recertified beds does not exceed the total number of decertified
beds in the state in that level of care. An extreme hardship
situation can only be found after the county documents the
existence of unmet medical needs that cannot be addressed by any
other alternatives;
(b) to certify a new bed in a facility that commenced
construction before May 23, 1983. For the purposes of this
section, "commenced construction" means that all of the
following conditions were met: the final working drawings and
specifications were approved by the commissioner of health; the
construction contracts were let; a timely construction schedule
was developed, stipulating dates for beginning, achieving
various stages, and completing construction; and all zoning and
building permits were secured;
(c) to certify beds in a new nursing home that is needed in
order to meet the special dietary needs of its residents, if:
the nursing home proves to the commissioner's satisfaction that
the needs of its residents cannot otherwise be met; elements of
the special diet are not available through most food
distributors; and proper preparation of the special diet
requires incurring various operating expenses, including extra
food preparation or serving items, not incurred to a similar
extent by most nursing homes;
(d) to license a new nursing home bed in a facility that
meets one of the exceptions contained in clauses (a) to (c);
(e) to license nursing home beds in a facility that has
submitted either a completed licensure application or a written
request for licensure to the commissioner before March 1, 1985,
and has either commenced any required construction as defined in
clause (b) before May 1, 1985, or has, before May 1, 1985,
received from the commissioner approval of plans for phased-in
construction and written authorization to begin construction on
a phased-in basis. For the purpose of this clause,
"construction" means any erection, building, alteration,
reconstruction, modernization, or improvement necessary to
comply with the nursing home licensure rules;
(f) to certify or license new beds in a new facility that
is to be operated by the commissioner of veterans' affairs or
when the costs of constructing and operating the new beds are to
be reimbursed by the commissioner of veterans' affairs or the
United States Veterans Administration;
(g) to license or certify beds in a new facility
constructed to replace a facility that was destroyed after June
30, 1987, by fire, lightning, or other hazard provided:
(1) destruction was not caused by the intentional act of or
at the direction of a controlling person of the facility;
(2) at the time the facility was destroyed the controlling
persons of the facility maintained insurance coverage for the
type of hazard that occurred in an amount that a reasonable
person would conclude was adequate;
(3) the net proceeds from an insurance settlement for the
damages caused by the hazard are applied to the cost of the new
facility;
(4) the new facility is constructed on the same site as the
destroyed facility or on another site subject to the
restrictions in section 144A.073, subdivision 5; and
(5) the number of licensed and certified beds in the new
facility does not exceed the number of licensed and certified
beds in the destroyed facility;
(h) to license or certify beds that are moved from one
location to another within a nursing home facility, provided the
total costs of remodeling performed in conjunction with the
relocation of beds does not exceed ten percent of the appraised
value of the facility or $200,000, whichever is less, or to
license or certify beds in a facility for which the total costs
of remodeling or renovation exceed ten percent of the appraised
value of the facility or $200,000, whichever is less, if the
facility makes a written commitment to the commissioner of human
services that it will not seek to receive an increase in its
property-related payment rate by reason of the remodeling or
renovation;
(i) to license or certify beds in a facility that has been
involuntarily delicensed or decertified for participation in the
medical assistance program, provided that an application for
relicensure or recertification is submitted to the commissioner
within 120 days after delicensure or decertification;
(j) to license or certify beds in a project recommended for
approval by the interagency board for quality assurance under
section 144A.073;
(k) to license nursing home beds in a hospital facility
that are relocated from a different hospital facility under
common ownership or affiliation, provided: (1) the hospital in
which the nursing home beds were originally located ceases to
function as an acute care facility, or necessary support
services for nursing homes as required for licensure under
sections 144A.02 to 144A.10, such as dietary service, physical
plant, housekeeping, physical therapy, occupational therapy, and
administration, are no longer available from the original
hospital site; and (2) the nursing home beds are not certified
for participation in the medical assistance program;
(1) to license or certify beds that are moved from one
location to another within an existing identifiable complex of
hospital buildings, from a hospital-attached nursing home to the
hospital building, or from a separate nursing home under common
ownership with or control of a hospital to the hospital when a
hospital-attached nursing home is moved simultaneously to the
hospital to a building formerly used as a hospital, provided the
original nursing home building will no longer be operated as a
nursing home and the building to which the beds are moved will
no longer be operated as a hospital. As a condition of
receiving a license or certification under this clause, the
facility must make a written commitment to the commissioner of
human services that it will not seek to receive an increase in
its property-related payment rate as a result of the
relocation. At the time of the licensure and certification of
the nursing home beds, the commissioner of health shall
delicense the same number of acute care beds within the existing
complex of hospital buildings or building. When a separate
nursing home and a hospital-attached nursing home under common
ownership or control are simultaneously relocated to a hospital
building, a combined cost report must be submitted for the cost
reporting year ending September 30, 1987, and the freestanding
nursing home limits apply. Relocation of nursing home beds
under this clause is subject to the limitations in section
144A.073, subdivision 5;
(m) to license or certify beds that are moved from an
existing state nursing home to a different state facility,
provided there is no net increase in the number of state nursing
home beds;
(n) to license new nursing home beds in a continuing care
retirement community affiliated with a national referral center
engaged in substantial programs of patient care, medical
research, and medical education meeting state and national needs
that receives more than 40 percent of its residents from outside
the state for the purpose of meeting contractual obligations to
residents of the retirement community, provided the facility
makes a written commitment to the commissioner of human services
that it will not seek medical assistance certification for the
new beds; or
(o) to certify or license new beds in a new facility on the
Red Lake Indian reservation for which payments will be made
under the Indian Health Care Improvement Act, Public Law Number
94-437, at the rates specified in United States Code, title 42,
section 1396d(b);
(p) to certify and license as nursing home beds boarding
care beds in a certified boarding care facility if the beds meet
the standards for nursing home licensure and if the cost of any
remodeling of the facility does not exceed ten percent of the
appraised value of the facility or $200,000, whichever is less.
If boarding care beds are licensed as nursing home beds, the
number of boarding care beds in the facility must not increase
in the future. The provisions contained in section 144A.073
regarding the upgrading of the facilities do not apply to
facilities that satisfy these requirements; or
(q) to license and certify up to 40 beds transferred from
an existing facility owned and operated by the Amherst H. Wilder
Foundation in the city of Saint Paul to a new unit at the same
location as the existing facility that will serve persons with
Alzheimer's disease and other related disorders. The transfer
of beds may occur gradually or in stages, provided the total
number of beds transferred does not exceed 40. At the time of
licensure and certification of a bed or beds in the new unit,
the commissioner of health shall delicense and decertify the
same number of beds in the existing facility. As a condition of
receiving a license or certification under this clause, the
facility must make a written commitment to the commissioner of
human services that it will not seek to receive an increase in
its property-related payment rate as a result of the transfers
allowed under this clause.
Sec. 37. Minnesota Statutes 1987 Supplement, section
144A.073, subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For purposes of this
section, the following terms have the meanings given them:
(a) "Conversion" means the relocation of a nursing home bed
from a nursing home to an attached hospital.
(b) "Renovation" means extensive remodeling of, or
construction of an addition to, a facility on an existing site
with a total cost exceeding ten percent of the appraised value
of the facility or $200,000, whichever is less.
(c) "Replacement" means the demolition and reconstruction
of all or part of an existing facility.
(d) "Upgrading" means a change in the level of licensure of
a bed from a boarding care bed to a nursing home bed in a
certified boarding care facility that is attached to a nursing
home or a boarding care bed in a freestanding boarding care
facility that currently meets all health department standards
for a nursing home.
Sec. 38. Minnesota Statutes 1987 Supplement, section
144A.073, subdivision 7, is amended to read:
Subd. 7. [UPGRADING RESTRICTIONS.] Proposals submitted or
approved under this section involving upgrading must satisfy the
following conditions:
(a) No proposal for upgrading may be approved after June
30, 1989.
(b) No more than one proposal for upgrading may be approved
for a facility.
(c) Upgrading is limited to a total of ten beds.
(d) The facility must meet minimum nursing home care
standards.
(e) Upgrading must not result in an increase in per diem
operating costs, except for the upgrading of those freestanding
boarding care facilities which currently meet existing nursing
home building and space standards.
(f) (b) If beds are upgraded to nursing home beds, the
number of boarding care beds in a facility must not increase in
the future.
(g) (c) The average occupancy rate in the existing nursing
home beds in an attached facility must be greater than 96
percent according to the most recent annual statistical report
of the department of health.
(h) The cost of remodeling the facility to meet current
nursing home construction standards must not exceed ten percent
of the appraised value of the facility or $200,000, whichever is
less.
Sec. 39. Minnesota Statutes 1987 Supplement, section
144A.073, subdivision 8, is amended to read:
Subd. 8. [RULEMAKING.] The commissioner of health shall
adopt emergency or permanent rules to implement this
section. The authority to adopt emergency rules continues until
December 30, 1988.
Sec. 40. Minnesota Statutes 1986, section 144A.08, is
amended by adding a subdivision to read:
Subd. 1b. [SUMMER TEMPERATURE AND HUMIDITY.] A nursing
home, or part of a nursing home that includes resident-occupied
space, constructed after June 30, 1988, must meet the interior
summer design temperature and humidity recommendations in
chapter 7 of the 1982 applications of the handbook published by
the American Society of Heating, Refrigerating and
Air-Conditioning Engineers, Inc., as amended.
Sec. 41. Minnesota Statutes 1986, section 145.43,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITION.] "Hearing aid" means any
instrument or device designed for or represented as aiding
defective human hearing, and its any parts, attachments, or
accessories of the instrument or device, including but not
limited to ear molds. Batteries and cords shall not be
considered parts, attachments, or accessories of a hearing aid.
Sec. 42. Minnesota Statutes 1986, section 145.43,
subdivision 1a, is amended to read:
Subdivision 1a. [30-DAY GUARANTEE AND BUYER RIGHT TO
CANCEL.] No person shall sell a hearing aid in this state unless:
(a) The seller provides the buyer with a 30-day written
money-back guarantee. The guarantee must: (1) permit the buyer
to cancel the purchase for any reason within 30 days after
receiving the hearing aid by giving or mailing written notice of
cancellation to the seller; (2). If the hearing aid must be
repaired, remade, or adjusted during the 30-day money-back
guarantee period, the running of the 30-day period is suspended
one day for each 24-hour period that the hearing aid is not in
the buyer's possession. A repaired, remade, or adjusted hearing
aid must be claimed by the buyer within three working days after
notification of availability, after which time the running of
the 30-day period resumes. The guarantee must entitle the
buyer, upon cancellation, to receive a full refund of payment
within 30 days of return of the hearing aid to the seller;
provided, however, that. The seller may retain as a
cancellation fee the actual cost of any custom ear molds made
for the canceled hearing aid so long as this cancellation fee
does not exceed ten percent of the buyer's total payment for the
hearing aid;.
(b) The seller shall provide the buyer with a contract
written receipt or contract to the buyer which includes, in
plain English, that contains uniform language and provisions
that meet the requirements and are certified by the attorney
general under the Plain Language Contract Act, sections 325G.29
to 325G.36. The contract must include, but is not limited to,
the following: in immediate proximity to the space reserved for
the signature of the buyer, or on the first page if there is no
space reserved for the signature of the buyer, a clear and
conspicuous disclosure of the following specific statement in
all capital letters of no less than 12-point boldface
type: MINNESOTA STATE LAW GIVES THE BUYER HAS THE RIGHT TO
CANCEL THIS PURCHASE FOR ANY REASON AT ANY TIME PRIOR TO
MIDNIGHT OF THE 30TH CALENDAR DAY AFTER RECEIPT OF THE HEARING
AID(S). IF THE BUYER DECIDES TO RETURN THE HEARING AID(S)
WITHIN THIS 30-DAY PERIOD, THE BUYER WILL RECEIVE A REFUND OF
$....... (State the dollar amount of refund.)
Sec. 43. Minnesota Statutes 1987 Supplement, section
145.43, subdivision 4, is amended to read:
Subd. 4. [ITEMIZED REPAIR BILL.] (a) Any person or company
who agrees to repair a hearing aid must provide the customer
owner of the hearing aid, or the owner's representative, with a
billing bill that specifically itemizes all parts and labor
charges for services rendered. The bill must also include the
person's or company's name, address, and phone number.
(b) This subdivision does not apply to:
(1) a person or company that repairs a hearing aid pursuant
to an express warranty covering the entire hearing aid and the
warranty covers the entire costs, both parts and labor, of the
repair; and
(2) a person or company that repairs a hearing aid and the
repair entire hearing aid, after being repaired, is expressly
warranted for a period of at least one year six months, the
warranty covers the entire costs, both parts and labor, of the
repair, and a copy of the express warranty is given to the
customer owner or the owner's representative. The owner of the
hearing aid or the owner's representative must be given a
written express warranty that includes the name, address, and
phone number of the repairing person or company; the make,
model, and serial number of the hearing aid repaired; the exact
date of the last day of the warranty period; and the terms of
the warranty.
Sec. 44. Minnesota Statutes 1986, section 145.853,
subdivision 2, is amended to read:
Subd. 2. In seeking to determine whether a disabled person
suffers from an illness, a law enforcement officer shall make a
reasonable search for an identifying device and an
identification card of the type described in section 145.852,
subdivision 2 and examine them for emergency information. The
law enforcement officer may not search for an identifying device
or an identification card in a manner or to an extent that would
appear to a reasonable person in the circumstances to cause an
unreasonable risk of worsening the disabled person's condition.
The law enforcement officer may not remove an identifying device
or an identification card from the possession of a disabled
person unless the removal is necessary for law enforcement
purposes or to protect the safety of the disabled person.
Sec. 45. Minnesota Statutes 1986, section 145.894, is
amended to read:
145.894 [STATE COMMISSIONER OF HEALTH; DUTIES,
RESPONSIBILITIES.]
The commissioner of health shall:
(a) Develop a comprehensive state plan for the delivery of
nutritional supplements to pregnant and lactating women,
infants, and children;
(b) Contract with existing local public or private
nonprofit organizations for the administration of the
nutritional supplement program;
(c) Develop and implement a public education program
promoting the provisions of sections 145.891 to 145.897, and
provide for the delivery of individual and family nutrition
education and counseling at project sites;
(d) Develop in cooperation with other agencies and vendors
a uniform state voucher system for the delivery of nutritional
supplements;
(e) Authorize local health agencies to issue vouchers
bimonthly to some or all eligible individuals served by the
agency, provided the agency demonstrates that the federal
minimum requirements for providing nutrition education will
continue to be met and that the quality of nutrition education
and health services provided by the agency will not be adversely
impacted;
(f) Investigate and implement an infant formula cost
reduction system that will reduce the cost of nutritional
supplements so that by October 1, 1988, additional mothers and
children will be served;
(g) Develop, analyze and evaluate the health aspects of the
nutritional supplement program and establish nutritional
guidelines for the program;
(f) (h) Apply for, administer, and annually expend at least
99 percent of available federal or private funds;
(g) (i) Aggressively market services to eligible
individuals by conducting ongoing outreach activities and by
coordinating with and providing marketing materials and
technical assistance to local human services and community
service agencies and nonprofit service providers;
(h) (j) Determine, on July 1 of each year, the number of
pregnant women participating in each special supplemental food
program for women, infants, and children (W.I.C.) and, in 1986,
1987, and 1988, at the commissioner's discretion, designate a
different food program deliverer if the current deliverer fails
to increase the participation of pregnant women in the program
by at least ten percent over the previous year's participation
rate;
(i) (k) Promulgate all rules necessary to carry out the
provisions of sections 145.891 to 145.897; and
(j) (l) Report to the legislature by November 15 of every
year on the expenditures and activities under sections 145.891
to 145.897 of the state and local health agencies for the
preceding fiscal year.
Sec. 46. [145.924] [AIDS PREVENTION GRANTS.]
The commissioner may award grants to local boards of
health, state agencies, state councils, or nonprofit
corporations to provide evaluation and counseling services to
populations at risk for acquiring human immunodeficiency virus
infection, including, but not limited to, minorities,
adolescents, intravenous drug users, and homosexual men.
Sec. 47. Minnesota Statutes 1987 Supplement, section
145A.06, is amended by adding a subdivision to read:
Subd. 5. [DEADLY INFECTIOUS DISEASES.] The commissioner
shall promote measures aimed at preventing businesses from
facilitating sexual practices that transmit deadly infectious
diseases by providing technical advice to boards of health to
assist them in regulating these practices or closing
establishments that constitute a public health nuisance.
Sec. 48. Minnesota Statutes 1987 Supplement, section
148B.23, subdivision 1, is amended to read:
Subdivision 1. [EXEMPTION FROM EXAMINATION.] For two years
from July 1, 1987, the board shall issue a license without
examination to an applicant:
(1) for a licensed social worker, if the board determines
that the applicant has received a baccalaureate degree from an
accredited program of social work, or that the applicant has at
least a baccalaureate degree from an accredited college or
university and two years in full-time employment or 4,000 hours
of experience in the supervised practice of social work within
the five years before July 1, 1987 1989;
(2) for a licensed graduate social worker, if the board
determines that the applicant has received a master's degree
from an accredited program of social work or doctoral degree in
social work; or a master's or doctoral degree from a graduate
program in a human service discipline, as approved by the board;
(3) for a licensed independent social worker, if the board
determines that the applicant has received a master's degree
from an accredited program of social work or doctoral degree in
social work; or a master's or doctoral degree from a graduate
program in a human service discipline, as approved by the board;
and, after receiving the degree, has practiced social work for
at least two years in full-time employment or 4,000 hours under
the supervision of a social worker meeting these requirements,
or of another qualified professional; and
(4) for a licensed independent clinical social worker, if
the board determines that the applicant has received a master's
degree from an accredited program of social work or doctoral
degree in social work; or a master's or doctoral degree from a
graduate program in a human service discipline as approved by
the board; and, after receiving the degree, has practiced
clinical social work for at least two years in full-time
employment or 4,000 hours under the supervision of a clinical
social worker meeting these requirements, or of another
qualified mental health professional.
Sec. 49. Minnesota Statutes 1987 Supplement, section
148B.42, subdivision 1, is amended to read:
Subdivision 1. [FILING.] All mental health service
providers shall file with the state, on a form provided by the
board, their name; home and business address; telephone number;
degrees held, if any, major field, and whether the degrees are
from an accredited institution and how the institution is
accredited; and any other relevant experience. An applicant for
filing who has practiced in another state shall authorize, in
writing, the licensing or regulatory entity in the other state
or states to release to the board any information on complaints
or disciplinary actions pending against that individual, as well
as any final disciplinary actions taken against that individual.
The board shall provide a form for this purpose. The board may
reject a filing if there is evidence of a violation of or
failure to comply with this chapter. Filings under this
subdivision are public data.
Sec. 50. [152A.01] [INSTITUTE ESTABLISHED; STRUCTURE;
BOARD OF DIRECTORS.]
Subdivision 1. [INSTITUTE ESTABLISHED; NAME.] The
Minnesota Institute for Addiction and Stress Research is
established. For purpose of sections 152A.01 to 152A.05,
"institute" means the Minnesota Institute for Addiction and
Stress Research. All business of the institute must be
conducted under the name "Minnesota Institute for Addiction and
Stress Research." The institute is funded by a grant from the
commissioner of health.
Subd. 2. [BOARD OF DIRECTORS.] The institute must be
governed by a board of nine directors appointed by the governor.
Terms are for three years. Three of the initial directors must
be appointed for three-year terms, three for two-year terms, and
three for one-year terms.
Subd. 3. [BOARD COMPOSITION; EXECUTIVE COMMITTEE.] (a) The
board must include representatives from the Minnesota department
of health, the medical and scientific teams of the institute,
established health organizations, private citizens, and
corporate representatives. The vice president for finance and
operations of the institute shall serve as an ex-officio member
of the board.
(b) An executive committee of four members of the board and
the vice president for finance and operations of the institute
shall oversee the regular activities of the institute and keep
the board informed of progress and new developments at the
institute.
Subd. 4. [OPERATING PROCEDURES.] The board shall adopt
operating procedures necessary to conduct the business of the
institute, consistent with sections 152A.01 to 152A.05.
Adoption of operating procedures under this subdivision is not
subject to the administrative procedure act under chapter 14.
Subd. 5. [PLACES OF BUSINESS.] The board shall locate and
maintain the institute's places of business within the state.
Subd. 6. [MEETINGS AND ACTIONS OF THE BOARD.] The board
shall hold meetings as determined necessary by the executive
committee, upon giving notice as provided in the operating
procedures adopted by the board.
Sec. 51. [152A.02] [INSTITUTE PERSONNEL.]
Subdivision 1. [PRESIDENT.] The board shall appoint and
set the compensation for a president, who serves as chief
executive officer of the institute. Subject to the control of
the board, the president may appoint subordinate employees and
agents.
Subd. 2. [STATUS OF EMPLOYEES.] The president serves in
the unclassified state civil service and is excluded from
collective bargaining. All other employees of the board are
subject to chapters 43A and 179A.
Sec. 52. [152A.03] [POWERS OF THE INSTITUTE.]
In addition to other powers granted by sections 152A.01 to
152A.05, the institute may:
(1) sue, and be sued;
(2) have a seal and alter it at will;
(3) acquire and dispose of personal property, including
inchoate and intellectual property, royalties, stock, and stock
warrants;
(4) enter into contracts or agreements with a federal or
state agency, person, business, or other organization;
(5) acquire and dispose of real property or an interest in
real property;
(6) purchase insurance;
(7) sell, at public or private sale, any note, mortgage, or
other instrument or obligation;
(8) consent to the modification of a contract or agreement
to which the institute is a party;
(9) borrow money to carry out its purposes and issue
negotiable notes, which it may refund, guarantee, or insure in
whole or in part with money from the fund, other assets of the
institute, or an account created by the institute for that
purpose;
(10) develop, buy, and possess financial and technical
information, including credit reports and financial statements;
(11) accept gifts, grants, and bequests and use or dispose
of them for its purposes; and
(12) receive payments in the form of royalties, dividends,
or other proceeds in connection with the ownership, license, or
lease of products or businesses.
Sec. 53. [152A.04] [OPERATIONS PLAN; REPORTS.]
Subdivision 1. [OPERATIONS PLAN.] The board shall submit a
progress report and an operations plan to the governor and the
legislature by January 1, 1989. The plan must include the
board's operating procedures, accounting procedures, personnel
procedures, investment procedures, and rules of conduct and
ethics.
Subd. 2. [REPORTS.] The board shall report quarterly to
the commissioner of finance, on forms provided by the
commissioner of finance, information about fiscal performance
and status. The board shall also report quarterly to the
commissioner of health, on forms provided by the commissioner of
health, information about the institute's status, research and
clinical projects and findings, and performance.
Sec. 54. [152A.05] [MONITORING; TERMINATION.]
Subdivision 1. [MONITORING.] All relevant records and the
performance of the institute shall be monitored by the
commissioner of health to assure that the institute continues to
demonstrate the following:
(1) the ability to carry out task-oriented basic and
clinical neurobiological research on addictive disorders and the
commitment to develop an integrated, comprehensive program of
basic and clinical research;
(2) the institute's involvement in basic and clinical
research of stress especially as it relates to addictive
disorders and chronic viral infections;
(3) the ability to work with other research and education
programs;
(4) the ability to cooperate with interested health
professionals throughout the state to implement the research
findings;
(5) the ability to seek and receive outside funding;
(6) a significant ongoing treatment program based on a
medical model capable of statewide application;
(7) the relatively close proximity to a major medical
educational institution; and
(8) the commitment to develop a program to educate the
public about addictive and stress-related medical disorders and
also to train therapists in Minnesota.
Subd. 2. [TERMINATION.] If the commissioner of health
finds that the institute is not continuing to meet the
requirements in subdivision 1, the commissioner of health may
terminate the grant to the institute upon 90 days' notice to the
board.
Sec. 55. [153A.13] [DEFINITIONS.]
Subdivision 1. [APPLICABILITY.] The definitions in this
section apply to sections 153A.13 to 153A.18.
Subd. 2. [COMMISSIONER.] "Commissioner" means the
commissioner of health.
Subd. 3. [HEARING INSTRUMENT.] "Hearing instrument" means
an instrument designed to or represented as being able to aid
defective human hearing. "Hearing instrument" includes the
instrument's parts, attachments, and accessories, including, but
not limited to, ear molds. Batteries and cords are not parts,
attachments, or accessories of a hearing instrument. Surgically
implanted hearing instruments, and assistive listening devices
that do not require testing, fitting, or the use of ear molds
and are not worn within the ear canal, are not hearing
instruments.
Subd. 4. [HEARING INSTRUMENT SELLING.] "Hearing instrument
selling" means fitting and selling hearing instruments,
assisting the consumer in instrument selection, selling hearing
instruments at retail, and testing human hearing in connection
with these activities.
Subd. 5. [SELLER OF HEARING INSTRUMENTS.] "Seller of
hearing instruments" means a natural person who engages in
hearing instrument selling whether or not registered by the
commissioner of health or licensed by an existing health-related
board.
Sec. 56. [153A.14] [REGULATION.]
Subdivision 1. [APPLICATION FOR PERMIT.] A seller of
hearing instruments shall apply to the commissioner for a permit
to sell hearing instruments. The commissioner shall provide
applications for permits. At a minimum, the information that an
applicant must provide includes the seller's name, social
security number, business address and phone number, employer,
and information about the seller's education, training, and
experience in testing human hearing and fitting hearing
instruments. The commissioner may reject an application for a
permit if there is evidence of a violation or failure to comply
with sections 153A.13 to 153A.16.
Subd. 2. [ISSUANCE OF PERMIT.] The commissioner shall
issue a permit to each seller of hearing instruments who applies
under subdivision 1 if the commissioner determines that the
applicant is in compliance with sections 153A.13 to 153A.16.
Subd. 3. [NONTRANSFERABILITY OF PERMIT.] The permit cannot
be transferred.
Subd. 4. [SALE OF HEARING INSTRUMENTS WITHOUT PERMIT.] It
is unlawful for any person not holding a valid permit to sell a
hearing instrument as defined in section 153A.13, subdivision
3. A person who sells a hearing instrument without the permit
required by this section is guilty of a gross misdemeanor.
Subd. 5. [RULEMAKING AUTHORITY.] The commissioner shall
adopt rules under chapter 14 to implement sections 153A.13 to
153A.18.
Subd. 6. [HEARING INSTRUMENTS TO COMPLY WITH FEDERAL AND
STATE REQUIREMENTS.] The commissioner shall ensure that hearing
instruments are sold in compliance with state requirements and
the requirements of the United States Food and Drug
Administration. Failure to comply with state or federal
regulations may be grounds for enforcement actions.
Subd. 7. [CONTESTED CASES.] The commissioner shall comply
with the contested case procedures in chapter 14 when
suspending, revoking, or refusing to issue a permit under this
section.
Sec. 57. [153A.15] [PROHIBITED ACTS; ENFORCEMENT; AND
PENALTY.]
Subdivision 1. [PROHIBITED ACTS.] The commissioner may
reject an application for a permit or may act under subdivision
2 against a seller of hearing instruments for failure to comply
with sections 153A.13 to 153A.16. Failure to apply to the
commissioner for a permit, or supplying false or misleading
information on the application for a permit, is a ground for
action under subdivision 2. The following acts and conduct are
also grounds for action under subdivision 2:
(1) prescribing or otherwise recommending to a consumer or
potential consumer the use of a hearing instrument, unless the
prescription from a physician or recommendation from a hearing
instrument seller or audiologist is in writing, is delivered to
the consumer or potential consumer, and bears the following
information in all capital letters of 12-point or larger
bold-face type: "THIS PRESCRIPTION OR RECOMMENDATION MAY BE
FILLED BY, AND HEARING INSTRUMENTS MAY BE PURCHASED FROM, THE
DISPENSER, AUDIOLOGIST, OR PHYSICIAN OF YOUR CHOICE." A
prescription or written recommendation must include, upon the
authorization of the consumer or potential consumer, the
audiogram upon which the prescription or recommendation is based
if there has been a charge for the audiogram;
(2) representing through any advertising or communication
to a consumer or potential consumer, that a person's permit to
sell hearing instruments indicates state approval, endorsement,
or satisfaction of standards of training or skill;
(3) being disciplined through a revocation, suspension,
restriction, or limitation, by another state for conduct subject
to action under subdivision 2;
(4) presenting advertising that is false or misleading;
(5) providing the commissioner with false or misleading
statements of credentials, training, or experience;
(6) engaging in conduct likely to deceive, defraud, or harm
the public; or demonstrating a willful or careless disregard for
the health, welfare, or safety of a consumer;
(7) splitting fees or promising to pay a portion of a fee
to any other professional other than a fee for services rendered
by the other professional to the client;
(8) engaging in abusive or fraudulent billing practices,
including violations of federal Medicare and Medicaid laws, Food
and Drug Administration regulations, or state medical assistance
laws;
(9) obtaining money, property, or services from a consumer
through the use of undue influence, high pressure sales tactics,
harassment, duress, deception, or fraud; or
(10) failing to comply with restrictions on sales of
hearing aids in section 145.43.
Subd. 2. [ENFORCEMENT ACTIONS.] When the commissioner
finds that a seller of hearing instruments has violated one or
more provisions of sections 153A.13 to 153A.16, the commissioner
may do one or more of the following:
(1) deny or reject the application for a permit;
(2) revoke the permit;
(3) suspend the permit;
(4) impose, for each violation, a civil penalty that
deprives the seller of any economic advantage gained by the
violation and that reimburses the department of health for costs
of the investigation and proceeding; and
(5) censure or reprimand the dispenser.
Subd. 3. [PROCEDURES.] The commissioner shall establish,
in writing, internal operating procedures for receiving and
investigating complaints and imposing enforcement actions.
Establishment of the operating procedures are not subject to
rulemaking procedures under chapter 14.
Subd. 4. [PENALTY.] A person violating sections 153A.13 to
153A.16 is guilty of a misdemeanor.
Sec. 58. [153A.16] [BOND REQUIRED.]
A sole proprietor, partnership, association, or corporation
engaged in hearing instrument sales shall provide a surety bond
in favor of the state of Minnesota in the amount of $5,000 for
every individual engaged in the practice of selling hearing
instruments, up to a maximum of $25,000. The bond required by
this section must be in favor of the state for the benefit of
any person who suffers loss of payments for the purchase or
repair of a hearing instrument after July 1, 1988, due to
insolvency or cessation of the business of the sole proprietor,
partnership, association, or corporation engaged in hearing
instrument sales. A copy of the bond must be filed with the
attorney general. A person claiming against the bond may
maintain an action at law against the surety and the sole
proprietor, partnership, association, or corporation. The
aggregate liability of the surety to all persons for all
breaches of the conditions of the bonds provided herein must not
exceed the amount of the bond.
Sec. 59. [153A.17] [EXPENSES.]
The expenses for administering the permit requirements for
hearing aid sellers in section 153A.14 and the consumer
information center under section 153A.18, must be paid from
permit fees collected under the authority granted in section
214.06, subdivision 1.
Sec. 60. [153A.18] [CONSUMER INFORMATION CENTER.]
The commissioner shall establish a consumer information
center to assist actual and potential purchasers of hearing aids
by providing them with information regarding hearing instrument
sales. The consumer information center shall disseminate
information about consumers' legal rights related to hearing
instrument sales, provide information relating to complaints
about sellers of hearing instruments, and provide information
about outreach and advocacy services for consumers of hearing
instruments. In establishing the center and developing the
information, the commissioner shall consult with representatives
of hearing instrument sellers, audiologists, physicians, and
consumers.
Sec. 61. [157.081] [FINES.]
Subdivision 1. [FINES FOR VIOLATIONS; LIMITS.] The
commissioner shall impose a civil fine for repeated or egregious
violation of rules relating to facilities licensed under chapter
157 or 327. The fine shall be assessed for each day the
licensed facility fails to comply with the rules. A fine for a
specific violation shall not exceed $50 per day.
Subd. 2. [SCHEDULE OF FINES; RULES.] The commissioner
shall establish a schedule of fines by adopting rules.
Subd. 3. [NOTICE OF FINE; APPEAL.] A licensed facility
that is fined under subdivision 1 shall be notified of the fine
by certified mail. The notice must be mailed to the address
shown on the application for the license or the last known
address of the licensed facility. The notice must state the
reasons for the fine and must inform the licensed facility of
the right to a contested case hearing under chapter 14.
Sec. 62. [179A.30] [REGIONAL TREATMENT CENTER, NURSING
HOME, AND COMMUNITY-BASED FACILITY EMPLOYEES.]
Subdivision 1. [EXCLUSIVE REPRESENTATIVE.] The exclusive
representative of employees may meet and negotiate with the
commissioner of employee relations, in consultation with the
commissioner of human services, concerning possible changes in
hours or work schedules that could produce cost reductions in
the regional treatment centers.
Subd. 2. [COMMISSIONER OF EMPLOYEE RELATIONS.] The
commissioner of employee relations shall meet and negotiate in
accordance with chapter 179A with the appropriate exclusive
representative of the regional treatment center employees
concerning the terms and conditions of employment that result
from state-operated, community-based residential programs
established under section 252.035.
Sec. 63. [198.35] [VETERANS HOME; SILVER BAY.]
Subdivision 1. [ESTABLISHMENT.] The commissioner may
establish a veterans home in Silver Bay by renovating an
existing facility owned by the city of Silver Bay if the city
donates the building to the commissioner at no cost. Contracts
made by the commissioner for the purposes of this subdivision
are subject to chapter 16B. Buildings used for the veterans
home must comply with requirements established by federal
agencies as conditions for the receipt of federal funds for the
nursing and boarding care of veterans. The city of Silver Bay
shall secure the state match requirement from sources other than
the state general fund. Money from other sources must equal at
least 35 percent of the total cost of the renovation with the
remainder of the funds to be provided by the United States
Veterans Administration.
Subd. 2. [OPERATION.] The home must provide beds for
nursing or boarding and nursing care in conformance with
licensing rules of the department of health. The home must be
under the management of an administrator appointed by the
commissioner in the unclassified service.
Sec. 64. Minnesota Statutes 1987 Supplement, section
245.462, subdivision 3, is amended to read:
Subd. 3. [CASE MANAGEMENT ACTIVITIES.] "Case management
activities" means activities that are part of coordinated with
the community support services program as defined in subdivision
6 and are designed to help people with serious and persistent
mental illness in gaining access to needed medical, social,
educational, vocational, and other necessary services as they
relate to the client's mental health needs. Case management
activities include obtaining a diagnostic assessment, developing
an individual community support plan, referring the person to
needed mental health and other services, coordinating ensuring
coordination of services, and monitoring the delivery of
services.
Sec. 65. Minnesota Statutes 1987 Supplement, section
245.462, subdivision 4, is amended to read:
Subd. 4. [CASE MANAGER.] "Case manager" means an
individual employed by the county or other entity authorized by
the county board to provide the case management activities as
part of a community support services program specified in
sections 245.462, subdivision 3; 245.471; and 245.475. A case
manager must be qualified at the mental health practitioner
level, have a bachelor's degree in one of the behavioral
sciences or related fields from an accredited college or
university and have at least 2,000 hours of supervised
experience in the delivery of services to persons with mental
illness, must be skilled in the process of identifying and
assessing a wide range of client needs, and must be
knowledgeable about local community resources and how to use
those resources for the benefit of the client. The case manager
shall meet in person with a mental health professional at least
once each month to obtain clinical supervision of the case
manager's activities. Case managers with a bachelor's degree
but without 2,000 hours of supervised experience in the delivery
of services to persons with mental illness must complete 40
hours of training approved by the commissioner of human services
in case management skills and in the characteristics and needs
of persons with serious and persistent mental illness and must
receive clinical supervision regarding individual service
delivery from a mental health professional at least once each
week until the requirement of 2,000 hours of supervised
experience is met. Clinical supervision must be documented in
the client record.
Sec. 66. Minnesota Statutes 1987 Supplement, section
245.462, subdivision 6, is amended to read:
Subd. 6. [COMMUNITY SUPPORT SERVICES PROGRAM.] "Community
support services program" means services, other than inpatient
or residential treatment services, provided or coordinated by an
identified program and staff under the clinical supervision of a
mental health professional designed to help people with serious
and persistent mental illness to function and remain in the
community. A community support services program includes case
management activities provided to persons with serious and
persistent mental illness,:
(1) client outreach,
(2) medication management,
(3) assistance in independent living skills,
(4) development of employability and supportive work
opportunities,
(5) crisis assistance,
(6) psychosocial rehabilitation,
(7) help in applying for government benefits, and
(8) the development, identification, and monitoring of
living arrangements.
The community support services program must be coordinated
with the case management activities specified in sections
245.462, subdivision 3; 245.471; and 245.475.
Sec. 67. Minnesota Statutes 1987 Supplement, section
245.462, subdivision 17, is amended to read:
Subd. 17. [MENTAL HEALTH PRACTITIONER.] "Mental health
practitioner" means a person providing services to persons with
mental illness who is qualified in at least one of the following
ways:
(1) holds a bachelor's degree in one of the behavioral
sciences or related fields from an accredited college or
university, and has at least 2,000 hours of supervised
experience in the delivery of services to persons with mental
illness;
(2) has at least 6,000 hours of supervised experience in
the delivery of services to persons with mental illness;
(3) is a graduate student in one of the behavioral sciences
or related fields and is formally assigned by an accredited
college or university to an agency or facility for clinical
training by an accredited college or university; or
(4) holds a master's or other graduate degree in one of the
behavioral sciences or related fields from an accredited college
or university with and has less than 4,000 hours post-master's
experience in the treatment of mental illness.
Sec. 68. Minnesota Statutes 1987 Supplement, section
245.462, subdivision 18, is amended to read:
Subd. 18. [MENTAL HEALTH PROFESSIONAL.] "Mental health
professional" means a person providing clinical services in the
treatment of mental illness who is qualified in at least one of
the following ways:
(1) in psychiatric nursing: a registered nurse with a
master's degree in one of the behavioral sciences or related
fields from an accredited college or university or its
equivalent, who is licensed under sections 148.171 to 148.285,
with at least 4,000 hours of post-master's supervised experience
in the delivery of clinical services in the treatment of mental
illness;
(2) in clinical social work: a person licensed as an
independent clinical social worker under section 148B.21,
subdivision 6, or a person with a master's degree in social work
from an accredited college or university, with at least 4,000
hours of post-master's supervised experience in the delivery of
clinical services in the treatment of mental illness;
(3) in psychology: a psychologist licensed under sections
148.88 to 148.98 who has stated to the board of psychology
competencies in the diagnosis and treatment of mental illness;
(4) in psychiatry: a physician licensed under chapter 147
and certified by the American board of psychiatry and neurology
or eligible for board certification in psychiatry; or
(5) in allied fields: a person with a master's degree from
an accredited college or university in one of the behavioral
sciences or related fields, with at least 4,000 hours of
post-master's supervised experience in the delivery of clinical
services in the treatment of mental illness.
Sec. 69. Minnesota Statutes 1987 Supplement, section
245.462, subdivision 19, is amended to read:
Subd. 19. [MENTAL HEALTH SERVICES.] "Mental health
services" means at least all of the treatment services and case
management activities that are provided to persons with mental
illness and are described in sections 245.468 245.461 to 245.476
245.486.
Sec. 70. Minnesota Statutes 1987 Supplement, section
245.462, subdivision 20, is amended to read:
Subd. 20. [MENTAL ILLNESS.] (a) "Mental illness" means an
organic disorder of the brain or a clinically significant
disorder of thought, mood, perception, orientation, memory, or
behavior that is listed in the clinical manual of the
International Classification of Diseases (ICD-9-CM), current
edition, code range 290.0 to 302.99 or 306.0 to 316.0 or the
corresponding code in the American Psychiatric Association's
Diagnostic and Statistical Manual of Mental Disorders (DSM-MD),
current edition, Axes I, II, or III, and that seriously limits a
person's capacity to function in primary aspects of daily living
such as personal relations, living arrangements, work, and
recreation.
(b) A "person with acute mental illness" means a person who
has a mental illness that is serious enough to require prompt
intervention.
(c) For purposes of sections 245.461 to 245.486 case
management and community support services, a "person with
serious and persistent mental illness" means a person who has a
mental illness and meets at least one of the following criteria:
(1) the person has undergone two or more episodes of
inpatient care for a mental illness within the preceding 24
months.;
(2) the person has experienced a continuous psychiatric
hospitalization or residential treatment exceeding six months'
duration within the preceding 12 months.;
(3) the person:
(i) has had a history of recurring inpatient or residential
treatment episodes of a frequency described in clause (1) or
(2), but not within the preceding 24 months. There must also be
a diagnosis of schizophrenia, bipolar disorder, major
depression, or borderline personality disorder;
(ii) indicates a significant impairment in functioning; and
(iii) has a written opinion of from a mental health
professional stating that the person is reasonably likely to
have future episodes requiring inpatient or residential
treatment, of a frequency described in clause (1) or (2), unless
an ongoing community support services program is provided; or
(4) the person has been committed by a court as a mentally
ill person under chapter 253B, or the person's commitment has
been stayed or continued.
Sec. 71. Minnesota Statutes 1987 Supplement, section
245.462, subdivision 21, is amended to read:
Subd. 21. [OUTPATIENT SERVICES.] "Outpatient services"
means mental health services, excluding day treatment and
community support services programs, provided by or under the
clinical supervision of a mental health professional to persons
with a mental illness who live outside a hospital or residential
treatment setting. Outpatient services include clinical
activities such as individual, group, and family therapy;
individual treatment planning; diagnostic assessments;
medication management; and psychological testing.
Sec. 72. Minnesota Statutes 1987 Supplement, section
245.462, subdivision 23, is amended to read:
Subd. 23. [RESIDENTIAL TREATMENT.] "Residential treatment"
means a 24-hour-a-day residential program under the clinical
supervision of a mental health professional, in a community
residential setting other than an acute care hospital or
regional treatment center, which that must be licensed as a
residential treatment facility for mentally ill persons with
mental illness under Minnesota Rules, parts 9520.0500 to
9520.0690 for adults, 9545.0900 to 9545.1090 for children, or
other rule adopted by the commissioner.
Sec. 73. Minnesota Statutes 1987 Supplement, section
245.462, subdivision 25, is amended to read:
Subd. 25. [CLINICAL SUPERVISION.] "Clinical
supervision," when referring to the responsibilities of a mental
health professional, means the oversight responsibility of a
mental health professional for individual treatment plans, and
individual service delivery, and program activities including
that provided by the case manager. Clinical supervision may
must be accomplished by full or part-time employment of or
contracts with mental health professionals. Clinical
supervision must be documented by the mental health professional
cosigning individual treatment plans and evidence of input into
service delivery and program development by entries in the
client's record regarding supervisory activities.
Sec. 74. Minnesota Statutes 1987 Supplement, section
245.465, is amended to read:
245.465 [DUTIES OF COUNTY BOARD.]
The county board in each county shall use its share of
mental health and community social service act funds allocated
by the commissioner according to a biennial local mental health
service proposal approved by the commissioner. The county board
must:
(1) develop and coordinate a system of affordable and
locally available mental health services in accordance with
sections 245.466 245.461 to 245.474 245.486;
(2) provide for case management services to persons with
serious and persistent mental illness in accordance with section
245.475 sections 245.462, subdivisions 3 and 4; 245.471;
245.475; and 245.486;
(3) provide for screening of persons specified in section
245.476 upon admission to a residential treatment facility or
acute care hospital inpatient, or informal admission to a
regional treatment center; and
(4) prudently administer grants and purchase-of-service
contracts that the county board determines are necessary to
fulfill its responsibilities under sections 245.461 to 245.486.
Sec. 75. Minnesota Statutes 1987 Supplement, section
245.466, subdivision 1, is amended to read:
Subdivision 1. [DEVELOPMENT OF SERVICES.] The county board
in each county is responsible for using all available resources
to develop and coordinate a system of locally available and
affordable mental health services. The county board may provide
some or all of the mental health services and activities
specified in subdivision 2 directly through a county agency or
under contracts with other individuals or agencies. A county or
counties may enter into an agreement with a regional treatment
center under section 246.57 to enable the county or counties to
provide the treatment services in subdivision 2. Services
provided through an agreement between a county and a regional
treatment center must meet the same requirements as services
from other service providers. County boards shall demonstrate
their continuous progress toward full implementation of sections
245.461 to 245.486 during the period July 1, 1987 to January 1,
1990. County boards must develop fully each of the treatment
services and management activities prescribed by sections
245.461 to 245.486 by January 1, 1990, according to the
priorities established in section 245.464 and the local mental
health services proposal approved by the commissioner under
section 245.478.
Sec. 76. Minnesota Statutes 1987 Supplement, section
245.466, subdivision 2, is amended to read:
Subd. 2. [MENTAL HEALTH SERVICES.] The mental health
service system developed by each county board must include the
following treatment services:
(1) education and prevention services in accordance with
section 245.468;
(2) emergency services in accordance with section 245.469;
(3) outpatient services in accordance with section 245.470;
(4) community support program services in accordance with
sections 245.471 and 245.475;
(5) residential treatment services in accordance with
section 245.472;
(6) acute care hospital inpatient treatment services in
accordance with section 245.473;
(7) regional treatment center inpatient services in
accordance with section 245.474; and
(8) screening in accordance with section 245.476; and
(9) case management in accordance with sections 245.462,
subdivision 3; 245.471; and 245.475.
Sec. 77. Minnesota Statutes 1987 Supplement, section
245.466, subdivision 5, is amended to read:
Subd. 5. [LOCAL ADVISORY COUNCIL.] The county board,
individually or in conjunction with other county boards, shall
establish a local mental health advisory council or mental
health subcommittee of an existing advisory council. The
council's members must reflect a broad range of community
interests. They must include at least one consumer, one family
member of a person with mental illness, one mental health
professional, and one community support services program
representative. The local mental health advisory council or
mental health subcommittee of an existing advisory council shall
meet at least quarterly to review, evaluate, and make
recommendations regarding the local mental health system.
Annually, the local advisory council or mental health
subcommittee of an existing advisory council shall arrange for
input from the regional treatment center review board center's
mental illness program unit regarding coordination of care
between the regional treatment center and community-based
services. The county board shall consider the advice of its
local mental health advisory council or mental health
subcommittee of an existing advisory council in carrying out its
authorities and responsibilities.
Sec. 78. Minnesota Statutes 1987 Supplement, section
245.467, is amended by adding a subdivision to read:
Subd. 4. [REFERRAL FOR CASE MANAGEMENT.] Each provider of
emergency services, outpatient treatment, community support
services, residential treatment, acute care hospital inpatient
treatment, or regional treatment center inpatient treatment must
inform each of its clients with serious and persistent mental
illness of the availability and potential benefits to the client
of case management. If the client consents, the provider must
refer the client by notifying the county employee designated by
the county board to coordinate case management activities of the
client's name and address and by informing the client of whom to
contact to request case management. The provider must document
compliance with this subdivision in the client's record.
Sec. 79. Minnesota Statutes 1987 Supplement, section
245.467, is amended by adding a subdivision to read:
Subd. 5. [INFORMATION FOR BILLING.] Each provider of
outpatient treatment, community support services, emergency
services, residential treatment, or acute care hospital
inpatient treatment must include the name and home address of
each client for whom services are included on a bill submitted
to a county, if the client has consented to the release of that
information and if the county requests the information. Each
provider shall attempt to obtain each client's consent and must
explain to the client that the information can only be released
with the client's consent and may be used only for purposes of
payment and maintaining provider accountability. The provider
shall document the attempt in the client's record.
Sec. 80. Minnesota Statutes 1987 Supplement, section
245.467, is amended by adding a subdivision to read:
Subd. 6. [RESTRICTED ACCESS TO DATA.] The county board
shall establish procedures to ensure that the names and
addresses of persons receiving mental health services are
disclosed only to:
(1) county employees who are specifically responsible for
determining county of financial responsibility or making
payments to providers; and
(2) staff who provide treatment services or case management
and their clinical supervisors.
Release of mental health data on individuals submitted
under section 245.467, subdivisions 4 and 5, to persons other
than those specified in this subdivision, or use of this data
for purposes other than those stated in section 245.467,
subdivisions 4 and 5, results in civil or criminal liability
under the standards in sections 13.08 or 13.09.
Sec. 81. Minnesota Statutes 1987 Supplement, section
245.469, subdivision 2, is amended to read:
Subd. 2. [SPECIFIC REQUIREMENTS.] The county board shall
require that all service providers of emergency services provide
immediate direct access to a mental health professionals
professional during regular business hours. For evenings,
weekends, and holidays, the service may be by direct toll free
telephone access to a mental health professional, a mental
health practitioner, or a designated person with training in
human services who is under the receives clinical supervision of
from a mental health professional. Whenever emergency service
during nonbusiness hours is provided by anyone other than a
mental health professional, a mental health professional must be
available for at least telephone consultation within 30 minutes.
Sec. 82. Minnesota Statutes 1987 Supplement, section
245.471, subdivision 2, is amended to read:
Subd. 2. [CASE MANAGEMENT ACTIVITIES.] (a) By January 1,
1989, the county board shall develop case management activities
must be developed as part of the community support program
available to for all persons with serious and persistent mental
illness residing in the county who request or consent to the
services. Staffing ratios must be sufficient to serve the needs
of the clients. The case manager must at a minimum qualify as a
mental health practitioner meet the requirements in section
245.462, subdivision 4.
(b) All providers of case management activities must
develop an individual community support plan. The individual
community support plan must state for each of their clients:
(1) the goals of each service;
(2) the activities for accomplishing each goal;
(3) a schedule for each activity; and
(4) the frequency of face-to-face client contacts, as
appropriate to client need and the implementation of the
community support plan.
The case manager must develop an individual community
support plan must incorporate for each client that incorporates
the client's individual treatment plan. The individual
treatment plan may not be a substitute for the development of an
individual community support plan. The individual community
support plan must be developed within 30 days of client intake
and reviewed every 90 days after it is developed. The case
manager is responsible for developing the individual community
support plan based on a diagnostic assessment and for
implementing and monitoring the delivery of services according
to the individual community support plan. To the extent
possible, the person with serious and persistent mental illness,
the person's family, advocates, service providers, and
significant others must be involved in all phases of development
and implementation of the individual community support plan.
(c) The client's individual community support plan must
state:
(1) the goals of each service;
(2) the activities for accomplishing each goal;
(3) a schedule for each activity; and
(4) the frequency of face-to-face contacts by the case
manager, as appropriate to client need and the implementation of
the community support plan.
(d) The county board must establish procedures that ensure
ongoing contact and coordination between the case manager and
the community support program as well as other mental health
services.
Sec. 83. Minnesota Statutes 1987 Supplement, section
245.471, subdivision 3, is amended to read:
Subd. 3. [DAY TREATMENT ACTIVITIES SERVICES PROVIDED.] (a)
By July 1, 1989, day treatment activities services must be
developed as a part of the community support program available
to persons with serious and persistent mental illness residing
in the county. Day treatment services must be available to
persons with serious and persistent mental illness residing in
the county as part of the community support program of each
county. Clients may be required to pay a fee. Day treatment
services must be designed to:
(1) provide a structured environment for treatment;
(2) provide family and community support;
(3) prevent placement in settings that are more intensive,
costly, or restrictive than necessary and appropriate to meet
client need; and
(4) establish fee schedules approved by the county board
that are based on a client's ability to pay.
(b) County boards may request a waiver from including day
treatment services if they can document that:
(1) an alternative plan of care exists through the county's
community support program for clients who would otherwise need
day treatment services;
(2) that day treatment, if included, would be duplicative
of other components of the community support program; and
(3) that county demographics and geography make the
provision of day treatment services cost ineffective and
unfeasible.
Sec. 84. Minnesota Statutes 1987 Supplement, section
245.472, subdivision 2, is amended to read:
Subd. 2. [SPECIFIC REQUIREMENTS.] Providers of residential
services must be licensed under applicable rules adopted by the
commissioner and must be clinically supervised by a mental
health professional. Persons employed in facilities licensed
under Minnesota Rules, parts 9520.0500 to 9520.0690, in the
capacity of program director as of July 1, 1987, in accordance
with Minnesota Rules, parts 9520.0500 to 9520.0690, may be
allowed to continue providing clinical supervision within a
facility until July 1, 1991, provided they continue to be
employed as a program director in a facility licensed under
Minnesota Rules, parts 9520.0500 to 9520.0690.
Sec. 85. Minnesota Statutes 1987 Supplement, section
245.475, subdivision 1, is amended to read:
Subdivision 1. [CLIENT ELIGIBILITY CASE MANAGEMENT.] By
January 1, 1989, the county board shall provide case management
and other appropriate community support services to all persons
each person with serious and persistent mental illness who
requests services or is referred by a provider under section
245.467, subdivision 4, and to each person for whom the court
appoints a case manager. Case management services provided to
people with serious and persistent mental illness eligible for
medical assistance must be billed to the medical assistance
program under section 256B.02, subdivision 8.
Sec. 86. Minnesota Statutes 1987 Supplement, section
245.475, subdivision 2, is amended to read:
Subd. 2. [DESIGNATION OF CASE MANAGER NOTIFICATION OF CASE
MANAGEMENT ELIGIBILITY.] The county board shall designate a
notify the client of the person's potential eligibility for case
manager management services within five working days after
receiving an application for community support services or
immediately after authorizing payment for residential, acute
care hospital inpatient, or regional treatment center services
under section 245.476 a request from an individual or a referral
from a provider under section 245.467, subdivision 4.
The county board shall send a written notice to the
applicant client and the applicant's client's representative, if
any, that identifies the designated case manager management
providers.
Sec. 87. Minnesota Statutes 1987 Supplement, section
245.476, subdivision 1, is amended to read:
Subdivision 1. [SCREENING REQUIRED.] By No later than
January 1, 1989 1991, the county board shall screen all persons
before they may be admitted for treatment of mental illness to a
residential treatment facility, an acute care hospital, or
informally admitted to a regional treatment center if public
funds are used to pay for the services. Screening prior to
admission must occur within ten days. If a person is admitted
for treatment of mental illness on an emergency basis to a
residential facility or acute care hospital or held for
emergency care by a regional treatment center under section
253B.05, subdivision 1, screening must occur within five days of
the admission. Persons must be screened within ten days before
or within five days after admission to ensure that:
(1) an admission is necessary,
(2) the length of stay is as short as possible consistent
with individual client need, and
(3) a the case manager, if assigned, is immediately
assigned to individuals with serious and persistent mental
illness and developing an individual community support plan is
developed.
The screening process and placement decision must be
documented in the client's record.
An alternate review process may be approved by the
commissioner if the county board demonstrates that an alternate
review process has been established by the county board and the
times of review, persons responsible for the review, and review
criteria are comparable to the standards specified in clauses
(1) to (3).
Sec. 88. Minnesota Statutes 1987 Supplement, section
245.477, is amended to read:
245.477 [APPEALS.]
Any person who applies for requests mental health services
under sections 245.461 to 245.486 must be advised of services
available and the right to appeal at the time of application the
request and each time the community service plan is reviewed.
Any person whose application request for mental health services
under sections 245.468 245.461 to 245.476 245.486 is denied, not
acted upon with reasonable promptness, or whose services are
suspended, reduced, or terminated may contest that action before
the state agency as specified in section 256.045. The
commissioner shall monitor the nature and frequency of
administrative appeals under this section.
Sec. 89. Minnesota Statutes 1987 Supplement, section
245.478, subdivision 1, is amended to read:
Subdivision 1. [TIME PERIOD.] The first local mental
health proposal period is from July 1, 1988, to December 31,
1989. The county board shall submit its first proposal to the
commissioner by January 1, 1988. Subsequent proposals must be
on the same two-year cycle as community social service plans.
If a proposal complies with sections 245.461 to 245.486, it
satisfies the requirement of the community social service plan
for the mental illness target population as required by section
256E.09. The proposal must be made available upon request to
all residents of the county at the same time it is submitted to
the commissioner.
Sec. 90. Minnesota Statutes 1987 Supplement, section
245.478, subdivision 2, is amended to read:
Subd. 2. [PROPOSAL CONTENT.] The local mental health
proposal must include:
(1) the local mental health advisory council's or mental
health subcommittee of an existing advisory council's report on
unmet needs and any other needs assessment used by the county
board in preparing the local mental health proposal;
(2) a description of the local mental health advisory
council's or the mental health subcommittee of an existing
advisory council's involvement in preparing the local mental
health proposal and methods used by the county board to obtain
participation of citizens, mental health professionals, and
providers in development of the local mental health proposal;
(3) information for the preceding year, including the
actual number of clients who received each of the mental health
services listed in sections 245.468 to 245.476, and actual
expenditures and revenues for each mental health service;
(4) for the first proposal period only, information for the
year during which the proposal is being prepared:
(i) a description of the current mental health system
identifying each mental health service listed in sections
245.468 to 245.476;
(ii) a description of each service provider, including a
listing of the professional qualifications of the staff involved
in service delivery, that is either the sole provider of one of
the treatment mental health services or management activities
described in sections 245.468 to 245.476 or that provides over
$10,000 of mental health services per year for the county;
(iii) a description of how the mental health services in
the county are unified and coordinated;
(iv) the estimated number of clients receiving each mental
health service;
(v) estimated expenditures and revenues for each mental
health service; and
(5) the following information describing how the county
board intends to meet the requirements of sections 245.461 to
245.486 during the proposal period:
(i) specific objectives and outcome goals for each mental
health service listed in sections 245.468 to 245.476;
(ii) a description of each service provider, including
county agencies, contractors, and subcontractors, that is
expected to either be the sole provider of one of the treatment
mental health services or management activities described in
sections 245.468 to 245.476 or to provide over $10,000 of mental
health services per year, including a listing of the
professional qualifications of the staff involved in service
delivery for the county;
(iii) a description of how the mental health services in
the county will be unified and coordinated;
(iv) the estimated number of clients who will receive each
mental health service; and
(v) estimated expenditures and revenues for each mental
health service and revenues for the entire proposal.
Sec. 91. Minnesota Statutes 1987 Supplement, section
245.478, subdivision 9, is amended to read:
Subd. 9. [PLAN AMENDMENT.] If the county board finds it
necessary to make significant changes in the approved local
proposal, it must present the proposed changes to the
commissioner for approval at least 60 30 days before the changes
take effect. "Significant changes" means:
(1) the county board proposes to provide a mental health
service through a provider other than the provider listed for
that service in the approved local proposal;
(2) the county board expects the total annual expenditures
for any single mental health service to vary more than ten
percent or $5,000, whichever is greater, from the amount in the
approved local proposal;
(3) the county board expects a combination of changes in
expenditures per mental health service to exceed more than ten
percent of the total mental health services expenditures; or
(4) the county board proposes a major change in the
specific objectives and outcome goals listed in the approved
local proposal.
Sec. 92. Minnesota Statutes 1987 Supplement, section
245.479, is amended to read:
245.479 [COUNTY OF FINANCIAL RESPONSIBILITY.]
For purposes of section 245.476 sections 245.461 to
245.486, the county of financial responsibility is the same as
that for community social services determined under
section 256E.08, subdivision 7 256G.02, subdivision 4. Disputes
between counties regarding financial responsibility must be
resolved by the commissioner in accordance with section 256D.18,
subdivision 4 256G.09.
Sec. 93. Minnesota Statutes 1987 Supplement, section
245.482, subdivision 2, is amended to read:
Subd. 2. [PROGRAM REPORTS.] The commissioner shall develop
a unified format for a semiannual an annual program report that
will include information that the commissioner determines
necessary to carry out sections 245.461 to 245.486 and section
256E.10. The county board shall submit a completed program
report in the required format no later than 75 days after each
six-month period by March 15 of each year.
Sec. 94. Minnesota Statutes 1987 Supplement, section
245.696, subdivision 2, is amended to read:
Subd. 2. [SPECIFIC DUTIES.] In addition to the powers and
duties already conferred by law, the commissioner of human
services shall:
(1) review and evaluate local programs and the performance
of administrative and mental health personnel and make
recommendations to county boards and program administrators;
(2) provide consultative staff service to communities and
advocacy groups to assist in ascertaining local needs and in
planning and establishing community mental health programs;
(3) employ qualified personnel to implement this chapter;
(4) as part of the biennial budget process, report to the
legislature on staff use and staff performance, including in the
report a description of duties performed by each person in the
mental health division;
(5) adopt rules for minimum standards in community mental
health services as directed by the legislature;
(6) cooperate with the commissioners of health and jobs and
training to coordinate services and programs for people with
mental illness;
(7) convene meetings with the commissioners of corrections,
health, education, and commerce at least four times each year
for the purpose of coordinating services and programs for
children with mental illness and children with emotional or
behavioral disorders;
(8) evaluate the needs of people with mental illness as
they relate to assistance payments, medical benefits, nursing
home care, and other state and federally funded services;
(8) (9) provide data and other information, as requested,
to the advisory council on mental health;
(9) (10) develop and maintain a data collection system to
provide information on the prevalence of mental illness, the
need for specific mental health services and other services
needed by people with mental illness, funding sources for those
services, and the extent to which state and local areas are
meeting the need for services;
(10) (11) apply for grants and develop pilot programs to
test and demonstrate new methods of assessing mental health
needs and delivering mental health services;
(11) (12) study alternative reimbursement systems and make
waiver requests that are deemed necessary by the commissioner;
(12) (13) provide technical assistance to county boards to
improve fiscal management and accountability and quality of
mental health services, and consult regularly with county
boards, public and private mental health agencies, and client
advocacy organizations for purposes of implementing this chapter;
(13) (14) promote coordination between the mental health
system and other human service systems in the planning, funding,
and delivery of services; entering into cooperative agreements
with other state and local agencies for that purpose as deemed
necessary by the commissioner;
(14) (15) conduct research regarding the relative
effectiveness of mental health treatment methods as the
commissioner deems appropriate, and for this purpose, enter
treatment facilities, observe clients, and review records in a
manner consistent with the Minnesota government data practices
act, chapter 13; and
(15) (16) enter into contracts and promulgate rules the
commissioner deems necessary to carry out the purposes of this
chapter.
Sec. 95. Minnesota Statutes 1987 Supplement, section
245.697, subdivision 2, is amended to read:
Subd. 2. [DUTIES.] The state advisory council on mental
health shall:
(1) advise the governor, the legislature, and heads of
state departments and agencies about policy, programs, and
services affecting people with mental illness;
(2) advise the commissioner of human services on all phases
of the development of mental health aspects of the biennial
budget;
(3) advise the governor and the legislature about the
development of innovative mechanisms for providing and financing
services to people with mental illness;
(4) encourage state departments and other agencies to
conduct needed research in the field of mental health;
(5) review recommendations of the subcommittee on
children's mental health;
(6) educate the public about mental illness and the needs
and potential of people with mental illness; and
(6) (7) review and comment on all grants dealing with
mental health and on the development and implementation of state
and local mental health plans.
Sec. 96. Minnesota Statutes 1987 Supplement, section
245.697, is amended by adding a subdivision to read:
Subd. 2a. [SUBCOMMITTEE ON CHILDREN'S MENTAL HEALTH.] The
state advisory council on mental health (the "advisory council")
must have a subcommittee on children's mental health. The
subcommittee must make recommendations to the advisory council
on policies, laws, regulations, and services relating to
children's mental health. Members of the subcommittee must
include:
(1) the commissioners or designees of the commissioners of
the departments of human services, health, education, and
corrections;
(2) the commissioner of commerce or a designee of the
commissioner who is knowledgeable about medical insurance issues;
(3) at least one representative of an advocacy group for
children with mental illness;
(4) providers of children's mental health services,
including at least one provider of services to preadolescent
children, one provider of services to adolescents, and one
hospital-based provider;
(5) parents of children who have mental illness or
emotional or behavioral disorders;
(6) a present or former consumer of adolescent mental
health services;
(7) educators experienced in working with emotionally
disturbed children;
(8) people knowledgeable about the needs of emotionally
disturbed children of minority races and cultures;
(9) people experienced in working with emotionally
disturbed children who have committed status offenses;
(10) members of the advisory council; and
(11) county commissioners and social services agency
representatives.
The chair of the advisory council shall appoint
subcommittee members described in clauses (3) through (11)
through the process established in section 15.0597. The chair
shall appoint members to ensure a geographical balance on the
subcommittee. Terms, compensation, removal, and filling of
vacancies are governed by subdivision 1, except that terms of
subcommittee members who are also members of the advisory
council are coterminous with their terms on the advisory
council. The subcommittee shall meet at the call of the
subcommittee chair, who is elected by the subcommittee from
among its members. The subcommittee expires with the expiration
of the advisory council.
Sec. 97. [245.698] [CHILDREN'S MENTAL HEALTH SERVICE
SYSTEM.]
The commissioner of human services shall create and ensure
a unified, accountable, comprehensive children's mental health
service system that:
(a) identifies children who are eligible for mental health
services;
(b) makes preventive services available to a wide range of
children, including those who are not eligible for more
intensive services;
(c) assures access to a continuum of services that:
(1) educate the community about the mental health needs of
children;
(2) address the unique physical, emotional, social, and
educational needs of children;
(3) are coordinated with other social and human services
provided to children and their families;
(4) are appropriate to the developmental needs of children;
and
(5) are sensitive to cultural differences and special needs;
(d) includes early screening and prompt intervention in
order to:
(1) identify and treat the mental health needs of children
in the least restrictive setting appropriate to their needs; and
(2) prevent further deterioration;
(e) provides services to children and their families in the
context in which the children live and go to school;
(f) addresses the unique problems of paying for mental
health services for children, including:
(1) access to private insurance coverage; and
(2) public funding;
(g) to every extent possible, includes children and their
families in planning the child's program of mental health
services; and
(h) when necessary, assures a smooth transition to the
adult services system.
For purposes of this section, "child" means a person under
age 18.
The commissioner shall begin implementing the goals and
objectives of this section by February 15, 1990, and shall fully
implement the goals and objectives by February 15, 1992. By
February 15, 1989, the commissioner shall present a report to
the legislature outlining recommendations for full
implementation. The report must include a timetable for
implementing the recommendations and identify additional
resources needed for full implementation. The report must be
updated annually by February 15 of 1990, 1991, and 1992.
Sec. 98. Minnesota Statutes 1986, section 245.771, is
amended by adding a subdivision to read:
Subd. 3. [EMPLOYMENT AND TRAINING PROGRAMS.] The
commissioner of human services may contract with the
commissioner of jobs and training to implement and supervise
employment and training programs for food stamp recipients that
are required by federal regulations.
Sec. 99. Minnesota Statutes 1986, section 245.814,
subdivision 1, is amended to read:
Subdivision 1. [INSURANCE FOR FOSTER PARENTS HOME
PROVIDERS.] The commissioner of human services shall within the
appropriation provided purchase and provide insurance to
individuals licensed as foster parents home providers to cover
their liability for:
(1) injuries or property damage caused or sustained by
foster children persons in foster care in their home; and
(2) actions arising out of alienation of affections
sustained by the natural parents of a foster child or natural
parents or children of a foster adult.
Sec. 100. Minnesota Statutes 1986, section 245.814,
subdivision 2, is amended to read:
Subd. 2. [APPLICATION OF COVERAGE.] Coverage shall apply
to all foster boarding homes licensed by the department of human
services, licensed by a federally recognized tribal government,
or established by the juvenile court and certified by the
commissioner of corrections pursuant to section 260.185,
subdivision 1, clause (c)(5), to the extent that the liability
is not covered by the provisions of the standard homeowner's or
automobile insurance policy. The insurance shall not cover
property owned by the individual foster parents home provider,
damage caused intentionally by a child person over 12 years of
age, or property damage arising out of business pursuits or the
operation of any vehicle, machinery, or equipment.
Sec. 101. Minnesota Statutes 1986, section 245.814,
subdivision 3, is amended to read:
Subd. 3. [COMPENSATION PROVISIONS.] If the commissioner of
human services is unable to obtain insurance through ordinary
methods for coverage of foster parents home providers, the
appropriation shall be returned to the general fund and the
state shall pay claims subject to the following limitations.
(a) Compensation shall be provided only for injuries,
damage, or actions set forth in subdivision 1.
(b) Compensation shall be subject to the conditions and
exclusions set forth in subdivision 2.
(c) The state shall provide compensation for bodily injury,
property damage, or personal injury resulting from the foster
parent's home providers activities as a foster parent home
provider while the foster child or adult is in the care,
custody, and control of the foster parent home provider in an
amount not to exceed $250,000 for each occurrence.
(d) The state shall provide compensation for damage or
destruction of property caused or sustained by a foster child or
adult in an amount not to exceed $250 for each occurrence.
(e) The compensation in clauses (c) and (d) is the total
obligation for all damages because of each occurrence regardless
of the number of claims made in connection with the same
occurrence, but compensation applies separately to each foster
home. The state shall have no other responsibility to provide
compensation for any injury or loss caused or sustained by any
foster parent home provider or foster child or foster adult.
This coverage is extended as a benefit to foster parents
home providers to encourage care of children persons who need
out-of-home care. Nothing in this section shall be construed to
mean that foster parents home providers are agents or employees
of the state nor does the state accept any responsibility for
the selection, monitoring, supervision, or control of
foster parents home providers which is exclusively the
responsibility of the counties which shall regulate
foster parents home providers in the manner set forth in the
rules of the commissioner of human services.
Sec. 102. [245.827] [COMMUNITY INITIATIVES FOR CHILDREN.]
Subdivision 1. [PROGRAM ESTABLISHED.] The commissioner of
human services shall establish a demonstration program of grants
for community initiatives for children. The goal of the program
is to enlist the resources of a community to promote the healthy
physical, educational, and emotional development of children who
are living in poverty. Community initiatives for children
accomplish the goal by offering support services that enable a
family to provide the child with a nurturing home environment.
The commissioner shall award grants to nonprofit organizations
based on the criteria in subdivision 3.
Subd. 2. [DEFINITION.] "Community initiatives for children"
are programs that promote the healthy development of children by
increasing the stability of their home environment. They
include support services such as child care, parenting
education, respite activities for parents, counseling,
recreation, and other services families may need to maintain a
nurturing environment for their children. Community initiatives
for children must be planned by members of the community who are
concerned about the future of children.
Subd. 3. [CRITERIA.] In order to qualify for a community
initiatives for children grant, a nonprofit organization must:
(1) involve members of the community and use community
resources in planning and executing all aspects of the program;
(2) provide a central location that is accessible to
low-income families and is available for informal as well as
scheduled activities during the day and on evenings and weekends;
(3) provide a wide range of services to families living at
or below the poverty level, including but not limited to,
quality affordable child care and training in parental skills;
(4) demonstrate that the organization is using and
coordinating existing resources of the community;
(5) demonstrate that the organization has applied to
private foundations for funding;
(6) ensure that services are focused on development of the
whole child; and
(7) have a governing structure that includes consumer
families and members of the community.
Subd. 4. [COVERED EXPENSES.] Grants awarded under this
section may be used for the capital costs of establishing or
improving a program that meets the criteria listed in
subdivision 3. Capital costs include land and building
acquisition, planning, site preparation, design fees,
rehabilitation, construction, and equipment costs.
Sec. 103. Minnesota Statutes 1986, section 245.83, is
amended to read:
245.83 [CHILD CARE SERVICES; DEFINITIONS.]
Subdivision 1. As used in sections 245.83 to 245.87
245.858 the words defined in this section shall have the
meanings given them.
Subd. 2. [CHILD CARE SERVICES.] "Child care services"
means child care provided in family day care homes, group day
care centers homes, nursery schools, day nurseries, child day
care centers, play groups, head start and parent cooperatives,
as defined by rules of the commissioner, and in-home child care
as defined in the Minnesota plan for social services to families
and children.
Subd. 3. [CHILD.] "Child" means any a person 14 12 years
of age old or younger, or a person age 13 or 14 who is
handicapped, as defined in section 120.03.
Subd. 3a. [CHILD CARE.] "Child care" means the care of a
child by someone other than a parent or legal guardian outside
the child's own home for gain or otherwise, on a regular basis,
for any part of a 24-hour day.
Subd. 3b. [CHILD CARE WORKER.] "Child care worker" means a
person who cares for children for compensation, including a
licensed provider of child care services, an employee of a
provider and a person who has applied for a license as a
provider.
Subd. 4. [COMMISSIONER.] "Commissioner" means the
commissioner of human services.
Subd. 4a. [FACILITY IMPROVEMENT EXPENSES.] "Facility
improvement expenses" means building improvements, equipment,
toys, and supplies needed to establish, expand, or improve a
licensed child care facility.
Subd. 5. [INTERIM FINANCING.] "Interim financing" means
funds to carry out such activities as are necessary for family
day care homes, group family day care homes and cooperative
child care centers to receive and maintain state licensing, to
expand an existing program or to improve program quality and to
provide operating funds for a period of six consecutive months
following receipt of state licensing by a family day care home,
group family day care home, or cooperative child care
center. Interim financing may not exceed a period of 18 months.
Subd. 6. [RESOURCE AND REFERRAL PROGRAM.] "Resource and
referral program" means a program that provides information to
parents, including referrals and coordination of community child
care resources for parents and public or private providers of
care. Services may include parent education, technical
assistance for providers, staff development programs, and
referrals to social services.
Subd. 7. [STAFF TRAINING OR DEVELOPMENT EXPENSES.] "Staff
training or development expenses" include the cost to a child
care worker of tuition, transportation, required materials and
supplies, and wages for a substitute while the child care worker
is engaged in a training program.
Subd. 8. [TRAINING PROGRAM.] "Training program" means
child development courses offered by an accredited
post-secondary institution or similar training approved by a
county board or the department of human services. To qualify as
a training program under this section, a course of study must
teach specific skills that a child care worker needs to meet
licensing requirements.
Sec. 104. [245.871] [DUTIES OF COMMISSIONER.]
In addition to the powers and duties already conferred by
law, the commissioner of human services shall:
(1) by September 1, 1990, and by September 1 of each
subsequent even-numbered year, survey and report on all
components of the child care system including, but not limited
to, availability of licensed child care slots; numbers of
children in various kinds of child care settings; staff wages,
rate of staff turnover, and qualifications of child care
workers; cost of child care by type of service and ages of
children; and child care availability through school systems;
(2) by September 1, 1990, and September 1 of each
subsequent even-numbered year, survey and report on the extent
to which existing child care services fulfill the need for child
care, giving particular attention to the need for part-time care
and for care of infants, sick children, children with special
needs, and low-income children;
(3) administer the child care fund, including the sliding
fee program, authorized under section 268.91;
(4) monitor the child care resource and referral programs
established under section 268.911; and
(5) encourage child care providers to participate in a
nationally-recognized accreditation system for early childhood
programs.
Sec. 105. [245.872] [GRANTS FOR CHILD CARE SERVICES.]
Subdivision 1. [GRANTS ESTABLISHED.] The commissioner
shall award grants to develop child care services, including
facility improvement expenses, interim financing, resource and
referral programs, and staff training expenses. The
commissioner shall develop a grant application form, inform
county social service agencies about the availability of child
care services grants, and set a date by which applications must
be received by the commissioner.
Subd. 2. [DISTRIBUTION OF FUNDS.] The commissioner shall
allocate grant money appropriated for child care services among
the 12 development regions designated by the governor under
section 462.385, in proportion to the ratio of the number of
children to the number of licensed child care slots available in
each region. Out of the amount allocated for each development
region the commissioner shall award grants based on the
recommendation of the grant review advisory task force. In
addition, the commissioner shall:
(1) award no more than 75 percent of the money either to
child care facilities for the purpose of facility improvement or
interim financing or to child care workers for staff training
expenses; and
(2) redistribute funds not awarded by January 1, 1989,
without regard to the distribution formula in this subdivision.
Subd. 3. [GRANT REVIEW ADVISORY TASK FORCE.] The
commissioner shall appoint a child care grant review advisory
task force. Members appointed under this subdivision must be
parents of children in child care, providers of child care, or
citizens with a demonstrated interest in child care issues. The
grant review advisory task force shall review and make
recommendations to the commissioner on applications for grants
under this section. Task force members do not receive a per
diem but may be reimbursed for expenses in accordance with
section 15.059, subdivision 6. The advisory task force does not
expire but is otherwise governed by section 15.059.
Subd. 4. [FUNDING PRIORITIES; FACILITY IMPROVEMENT AND
INTERIM FINANCING.] In evaluating applications for funding and
making recommendations to the commissioner, the grant review
advisory task force shall give priority to:
(1) new programs or projects, or the expansion or
enrichment of existing programs or projects;
(2) programs or projects in areas where a demonstrated need
for child care facilities has been shown, with special emphasis
on programs or projects in areas where there is a shortage of
licensed child care;
(3) programs and projects that serve sick children,
infants, children with special needs, and children from
low-income families; and
(4) unlicensed providers who wish to become licensed.
Subd. 5. [FUNDING PRIORITIES; TRAINING GRANTS.] In
evaluating applications for training grants and making
recommendations to the commissioner, the grant review advisory
task force shall give priority to:
(1) applicants who will work in facilities caring for sick
children, infants, children with special needs, and children
from low-income families;
(2) applicants who will work in geographic areas where
there is a shortage of child care;
(3) unlicensed providers who wish to become licensed;
(4) child care providers seeking accreditation; and
(5) entities that will use grant money for scholarships for
child care workers attending educational or training programs
sponsored by the entity.
Sec. 106. Minnesota Statutes 1986, section 245.84,
subdivision 1, is amended to read:
Subdivision 1. [AUTHORITY.] The county board is authorized
to provide child care services, to make grants from the
community social service fund, special tax revenue, or its
general fund, or other sources to any municipality, corporation
or combination thereof for the cost of providing technical
assistance and child care services, or to contract for services
with any licensed day care facility, as the board deems
necessary or proper to carry out the purposes of sections 245.83
to 245.87 245.856.
The board is further authorized to make grants to or
contract with any municipality, incorporated licensed child care
facility or resource and referral program, or corporation or
combination thereof for any of the following purposes:
(a) For creating new licensed day care facilities and
expanding existing facilities including, but not limited to,
supplies, equipment, and facility renovation and remodeling;
(b) For improving licensed day care facility programs,
including, but not limited to, staff specialists, staff
training, supplies, equipment, and facility renovation and
remodeling. In awarding grants for training, counties must give
priority to child care workers caring for infants, toddlers,
sick children, children in low-income families, and children
with special needs;
(c) For supportive child development services including,
but not limited to, in-service training, curriculum development,
consulting specialist, resource centers, and program and
resource materials;
(d) For carrying out programs including, but not limited
to, staff, supplies, equipment, facility renovation, and
training;
(e) For interim financing; and
(f) For carrying out the resource and referral program
services identified in section 268.911, subdivision 3.
Sec. 107. [245.873] [INTERAGENCY ADVISORY COMMITTEE ON
CHILD CARE.]
Subdivision 1. [MEMBERSHIP.] By July 1, 1988, the
commissioner of the state planning agency shall convene and
chair an interagency advisory committee on child care. In
addition to the commissioner, members of the committee are the
commissioners of each of the following agencies and
departments: health, human services, jobs and training, public
safety, education, and the higher education coordinating board.
The purpose of the committee is to improve the quality and
quantity of child care and the coordination of child care
related activities among state agencies.
Subd. 2. [DUTIES.] The committee shall advise its member
agencies on matters related to child care policy and planning.
Specifically, the committee shall:
(1) develop a consistent policy on issues related to child
care;
(2) advise the member agencies on implementing policies and
developing rules that are consistent with the committee's policy
on child care;
(3) advise the member agencies on state efforts to increase
the supply and improve the quality of child care facilities and
options; and
(4) perform other advisory tasks related to improving child
care options throughout the state.
Subd. 3. [MEETINGS.] The committee shall meet as often as
necessary to perform its duties.
Sec. 108. Minnesota Statutes 1986, section 246.023,
subdivision 1, is amended to read:
Subdivision 1. [LEGISLATIVE POLICY.] It is recognized that
closure and consolidation of state hospitals regional treatment
centers have negative economic effects upon public employees and
communities. It is the policy of the state that
deinstitutionalization policies shall be carried out in a manner
that ensures fair and equitable arrangements to protect the
interests of employees and communities affected by
deinstitutionalization of state hospitals.
Sec. 109. [252.50] [STATE-OPERATED, COMMUNITY-BASED
RESIDENTIAL PROGRAMS.]
Subdivision 1. [RESIDENTIAL PROGRAMS ESTABLISHED.] The
commissioner may establish a system of noninstitutional,
state-operated, community-based residential services for persons
with mental retardation or related conditions. For purposes of
this section, "state-operated, community-based residential
facility" means a residential program administered by the state
to provide treatment and habilitation in noninstitutional
community settings to persons with mental retardation or related
conditions. Employees of the facilities must be state employees
under chapters 43A and 179A. The establishment of
state-operated, community-based residential facilities must be
within the context of a comprehensive definition of the role of
state-operated services in the state. The role of
state-operated services must be defined within the context of a
comprehensive system of services for persons with mental
retardation or related conditions. Services may include, but
are not limited to, community group homes, foster care,
supportive living arrangements, and respite care arrangements.
The commissioner may operate the pilot projects established
under Laws 1985, First Special Session chapter 9, article 1,
section 2, subdivision 6, and may, within the limits of
available appropriations, establish additional state-operated,
community-based services for regional treatment center residents
with mental retardation or related conditions. Day program
services for clients living in state-operated, community-based
residential facilities must not be provided by a regional
treatment center or a state-operated, community-based program.
Subd. 2. [AUTHORIZATION TO BUILD OR PURCHASE.] Within the
limits of available appropriations, the commissioner may build,
purchase or lease suitable buildings for state-operated,
community-based residential facilities. Facilities must be
homelike and adaptable to the needs of persons with mental
retardation or related conditions.
Subd. 3. [ALTERNATIVE FUNDING MECHANISMS.] To the extent
possible, the commissioner may amend the medical assistance home
and community-based waiver and, as appropriate, develop special
waiver procedures for targeting services to persons currently in
state regional centers.
Subd. 4. [COUNTIES.] State-operated, community-based
residential facilities may be developed in conjunction with
existing county responsibilities and authorities for persons
with mental retardation. Assessment, placement, screening, case
management responsibilities, and determination of need
procedures must be consistent with county responsibilities
established under law and rule. Counties may enter into shared
service agreements with state-operated programs.
Sec. 110. [252.52] [REGIONAL CENTER AND COMMUNITY-BASED
FACILITY EMPLOYEES.]
In accordance with section 43A.21, the commissioner shall
develop procedures to assure that:
(1) there are workers employed at state regional centers
and nursing homes who are skilled in the treatment of persons
with severe and profound mental retardation or related
conditions, behavioral problems, and medical needs, to
facilitate adjustment to community living;
(2) suitable training programs exist for regional treatment
center and state-operated, community-based residential facility
staff; and
(3) state employees under the jurisdiction of the
commissioner who are included in a position reduction plan have
the option of transferring to a community-based program; to a
similar, comparable classification in another regional center
setting; or to a position in another state agency.
Sec. 111. Minnesota Statutes 1986, section 252.291,
subdivision 1, is amended to read:
Subdivision 1. [MORATORIUM.] Notwithstanding section
252.28, subdivision 1, or any other law or rule to the contrary,
the commissioner of human services shall deny any request for a
determination of need and refuse to grant a license pursuant to
section 245.782 for any new intermediate care facility for
persons with mental retardation or related conditions or for an
increase in the licensed capacity of an existing facility except
as provided in this subdivision and subdivision 2. In no event
shall The total number of certified intermediate care beds for
persons with mental retardation or related conditions in
community facilities and state hospitals shall not exceed 7,500
beds as of July 1, 1983, and 7,000 beds as of July 1, 1986
except that, to the extent that federal authorities disapprove
any applications of the commissioner for home and
community-based waivers under United States Code, title 42,
section 1396n, as amended through December 31, 1987, the
commissioner may authorize new intermediate care beds, as
necessary, to serve persons with mental retardation or related
conditions who would otherwise have been served under a proposed
waiver. "Certified bed" means an intermediate care bed for
persons with mental retardation or related conditions certified
by the commissioner of health for the purposes of the medical
assistance program under United States Code, title 42, sections
1396 to 1396p, as amended through December 31, 1982 1987.
Sec. 112. Minnesota Statutes 1986, section 252.291,
subdivision 2, is amended to read:
Subd. 2. [EXCEPTIONS.] The commissioner of human services
in coordination with the commissioner of health may approve
a new newly constructed or newly established publicly or
privately operated community intermediate care facility for six
or fewer persons with mental retardation or related conditions
only in when the following circumstances exist:
(a) when the facility is developed in accordance with a
request for proposal system established pursuant to subdivision
3, clause (b) approved by the commissioner of human services;
(b) when the facility is necessary to serve the needs of
identifiable identified persons with mental retardation or
related conditions who are seriously behaviorally disordered or
who are seriously physically or sensorily impaired. At least 50
percent of the capacity of the facility must be used for persons
coming from regional treatment centers; or and
(c) to license beds in new facilities where need was
determined by the commissioner prior to June 10, 1983 when the
commissioner determines that the need for increased service
capacity cannot be met by the use of alternative resources or
the modification of existing facilities.
Sec. 113. Minnesota Statutes 1987 Supplement, section
252.291, subdivision 3, is amended to read:
Subd. 3. [DUTIES OF COMMISSIONER OF HUMAN SERVICES.] The
commissioner shall:
(a) establish standard admission criteria for state
hospitals and county utilization targets to limit and reduce the
number of intermediate care beds in state hospitals and
community facilities in accordance with approved waivers under
United States Code, title 42, sections 1396 to 1396p, as amended
through December 31, 1982 1987, to assure that appropriate
services are provided in the least restrictive setting;
(b) define services, including respite care, that may be
needed in meeting individual service plan objectives;
(c) provide technical assistance so that county boards may
establish a request for proposal system for meeting individual
service plan objectives through home and community-based
services; alternative community services; or, if no other
alternative will meet the needs of identifiable individuals for
whom the county is financially responsible, a new intermediate
care facility for persons with mental retardation or related
conditions;
(d) establish a client tracking and evaluation system as
required under applicable federal waiver regulations, Code of
Federal Regulations, title 42, sections 431, 435, 440, and 441,
as amended through December 31, 1982 1987; and
(e) develop a state plan for the delivery and funding of
residential day and support services to persons with mental
retardation or related conditions in Minnesota and submit that
plan to the clerk of each house of the Minnesota legislature on
or before the 15th of January of each biennium beginning January
15, 1985. The biennial mental retardation plan shall include
but not be limited to:
(1) county by county maximum intermediate care bed
utilization quotas;
(2) plans for the development of the number and types of
services alternative to intermediate care beds;
(3) procedures for the administration and management of the
plan;
(4) procedures for the evaluation of the implementation of
the plan; and
(5) the number, type, and location of intermediate care
beds targeted for decertification.
The commissioner shall modify the plan to ensure
conformance with the medical assistance home and community-based
services waiver.
Sec. 114. Minnesota Statutes 1987 Supplement, section
252.46, subdivision 5, is amended to read:
Subd. 5. [SUBMITTING RECOMMENDED RATES.] The county board
shall submit recommended payment rates to the commissioner on
forms supplied by the commissioner by November 1, 1987, and at
least 60 days before revised payment rates or payment rates for
new vendors are to be effective. The forms must require the
county board's written verification of the individual
documentation required under section 252.44, clause (a). If the
number of days of service provided by a licensed vendor are
projected to increase, the county board must recommend payment
rates based on the projected increased days of attendance and
resulting lower per unit fixed costs. Recommended increases in
payment rates for vendors whose approved payment rates are ten
or more than ten percent below the statewide median payment
rates must be equal to the maximum increases allowed for that
vendor under subdivision 3. If a vendor provides services at
more than one licensed site, the county board may recommend the
same payment rates for each site based on the average rate for
all sites. The county board may also recommend differing
payment rates for each licensed site if it would result in a
total annual payment to the vendor that is equal to or less than
the total annual payment that would result if the average rates
had been used for all sites. For purposes of this subdivision,
the average payment rate for all service sites used by a vendor
must be computed by adding the amounts that result when the
payment rates for each licensed site are multiplied by the
projected annual number of service units to be provided at that
site and dividing the sum of those amounts by the total units of
service to be provided by the vendor at all sites.
Sec. 115. Minnesota Statutes 1987 Supplement, section
252.46, subdivision 6, is amended to read:
Subd. 6. [VARIANCES.] A variance from the minimum or
maximum payment rates in subdivisions 2 and 3 may be granted by
the commissioner when the vendor requests and the county board
submits to the commissioner a written variance request with the
recommended payment rates. A variance may be utilized for costs
associated with compliance with state administrative rules,
compliance with court orders, increased insurance costs,
start-up and conversion costs for supported employment, direct
service staff salaries, and transportation. The county board
shall review all vendors' payment rates that are 20 ten or more
than ten percent lower than the average rates for the regional
development commission district to which the county
belongs statewide median payment rates. If the county
determines that the payment rates do not provide sufficient
revenue to the vendor for authorized service delivery the county
must recommend a variance under this section. This review must
occur prior to November 1, 1987. When the county board
contracts for increased services from any vendor for some or all
individuals receiving services from the vendor, the county board
shall review the vendor's payment rates to determine whether the
increase requires that a variance to the minimum rates be
recommended under this section to reflect the vendor's lower per
unit fixed costs. The written variance request must include
documentation that all the following criteria have been met:
(1) The commissioner and the county board have both
conducted a review and have identified a need for a change in
the payment rates to change the number of direct service staff
or the level of qualifications of the staff.
(2) The proposed changes are required for the vendor to
deliver authorized individual services in an effective and
efficient manner.
(3) The proposed changes are necessary to demonstrate
compliance with minimum licensing standards governing minimum
staffing ratios and staff qualifications.
(4) The vendor documents that the change in staff numbers
or qualifications changes cannot be achieved by reallocating
current staff or by reallocating financial resources to provide
or purchase the necessary services.
(5) The county board submits evidence that the need for
additional staff cannot be met by using temporary special needs
rate exceptions under Minnesota Rules, parts 9510.1020 to
9510.1140.
(6) The county board submits a description of the nature
and cost of the proposed changes, and how the county will
monitor the use of money by the vendor to make necessary changes
in services. Allowable costs are limited to salaries, related
fringe benefits, and payroll taxes.
(7) The county board's recommended payment rates do not
exceed 125 percent of the average current calendar year's
statewide median payment rates in the regional development
commission district in which the vendor is located.
Sec. 116. Minnesota Statutes 1987 Supplement, section
252.46, is amended by adding a subdivision to read:
Subd. 13. [REVIEW AND REVISION OF PROCEDURES FOR RATE
EXCEPTIONS FOR VERY DEPENDENT PERSONS WITH SPECIAL NEEDS.] The
commissioner shall review the procedures established in
Minnesota Rules, parts 9510.1020 to 9510.1140, that counties
must follow to seek authorization for a medical assistance rate
exception for services for very dependent persons with special
needs. The commissioner shall appoint an advisory task force to
work with the commissioner. Members of the task force must
include vendors, providers, advocates, and consumers. After
considering the recommendations of the advisory task force and
county rate setting procedures developed under this section, the
commissioner shall:
(1) revise administrative procedures as necessary;
(2) implement new review procedures for county applications
for medical assistance rate exceptions for services for very
dependent persons with special needs in a manner that accounts
for services available to the person within the approved payment
rates of the vendor;
(3) provide training and technical assistance to vendors,
providers, and counties in use of procedures governing medical
assistance rate exceptions for very dependent persons with
special needs and in county rate setting procedures established
under this subdivision; and
(4) develop a strategy and implementation plan for uniform
data collection for use in establishing equitable payment rates
and medical assistance rate exceptions for services provided by
vendors.
Sec. 117. Minnesota Statutes 1987 Supplement, section
252.46, is amended by adding a subdivision to read:
Subd. 14. [PILOT STUDY.] The commissioner may initiate a
pilot payment rate system under section 252.47. The pilot
project may establish training and demonstration sites. The
pilot payment rate system must include actual transfers of
funds, not simulated transfers. The pilot payment rate system
may involve up to four counties and four vendors representing
different geographic regions and rates of reimbursement.
Participation in the pilot project is voluntary. Selection of
participants by the commissioner is based on the vendor's
submission of a complete application form provided by the
commissioner. The application must include letters of agreement
from the host county, counties of financial responsibility, and
residential service providers. Evaluation of the pilot project
must include consideration of the effectiveness of procedures
governing establishment of equitable payment rates.
Implementation of the pilot payment rate system is contingent
upon federal approval and systems feasibility. The policies and
procedures governing administration, participation, evaluation,
service utilization, and payment for services under the pilot
payment rate system are not subject to the rulemaking
requirements of chapter 14.
Sec. 118. Minnesota Statutes 1987 Supplement, section
253B.03, subdivision 6, is amended to read:
Subd. 6. [CONSENT FOR MEDICAL PROCEDURE.] A patient has
the right to prior consent to any medical or surgical treatment,
other than the treatment of mental illness or chemical
dependency. A patient with mental retardation or the patient's
guardian or conservator has the right to give or withhold
consent before:
(1) the implementation of any aversive or deprivation
procedure except for emergency procedures permitted in rules of
the commissioner adopted under section 245.825; or
(2) the administration of psychotropic medication.
The following procedures shall be used to obtain consent
for any treatment necessary to preserve the life or health of
any committed patient:
(a) The written, informed consent of a competent adult
patient for the treatment is sufficient.
(b) If the patient is subject to guardianship or
conservatorship which includes the provision of medical care,
the written, informed consent of the guardian or conservator for
the treatment is sufficient.
(c) If the head of the treatment facility determines that
the patient is not competent to consent to the treatment and the
patient has not been adjudicated incompetent, written, informed
consent for the surgery or medical treatment shall be obtained
from the nearest proper relative. For this purpose, the
following persons are proper relatives, in the order listed:
the patient's spouse, parent, adult child, or adult sibling. If
the nearest proper relatives cannot be located or refuse to
consent to the procedure, the head of the treatment facility or
an interested person may petition the committing court for
approval for the treatment or may petition an appropriate a
court of competent jurisdiction for the appointment of a
guardian or conservator. The determination that the patient is
not competent, and the reasons for the determination, shall be
documented in the patient's clinical record.
(d) Consent to treatment of any minor patient shall be
secured in accordance with sections 144.341 to 144.346, except
that a minor 16 years of age or older may give valid consent for
hospitalization, routine diagnostic evaluation, and emergency or
short-term acute care.
(e) In the case of an emergency and when the persons
ordinarily qualified to give consent cannot be located, the head
of the treatment facility may give consent.
No person who consents to treatment pursuant to the
provisions of this subdivision shall be civilly or criminally
liable for the performance or the manner of performing the
treatment. No person shall be liable for performing treatment
without consent if written, informed consent was given pursuant
to this subdivision. This provision shall not affect any other
liability which may result from the manner in which the
treatment is performed.
Sec. 119. Minnesota Statutes 1986, section 253B.03, is
amended by adding a subdivision to read:
Subd. 6a. [ADMINISTRATION OF NEUROLEPTIC MEDICATIONS.] (a)
Neuroleptic medications may be administered to persons committed
as mentally ill or mentally ill and dangerous only as described
in this subdivision.
(b) A neuroleptic medication may be administered to a
patient who is competent to consent to neuroleptic medications
only if the patient has given written, informed consent to
administration of the neuroleptic medication.
(c) A neuroleptic medication may be administered to a
patient who is not competent to consent to neuroleptic
medications only if a court approves the administration of the
neuroleptic medication or:
(1) the patient does not object to or refuse the medication;
(2) a guardian ad litem appointed by the court with
authority to consent to neuroleptic medications gives written,
informed consent to the administration of the neuroleptic
medication; and
(3) a multidisciplinary treatment review panel composed of
persons who are not engaged in providing direct care to the
patient gives written approval to administration of the
neuroleptic medication.
(d) A person who consents to treatment pursuant to this
subdivision is not civilly or criminally liable for the
performance of or the manner of performing the treatment. A
person is not liable for performing treatment without consent if
written, informed consent was given pursuant to this
subdivision. This provision does not affect any other liability
that may result from the manner in which the treatment is
performed.
Sec. 120. Minnesota Statutes 1986, section 253B.17,
subdivision 1, is amended to read:
Subdivision 1. [PETITION.] Any patient, except one
committed as mentally ill and dangerous to the public, or any
interested person may petition the committing court or the court
to which venue has been transferred for an order that the
patient is not in need of continued institutionalization or for
an order that an individual is no longer mentally ill, mentally
retarded, or chemically dependent, or for any other relief as
the court deems just and equitable. A patient committed as
mentally ill or mentally ill and dangerous may petition the
committing court or the court to which venue has been
transferred for a hearing concerning the administration of
neuroleptic medication. A hearing may also be held pursuant to
sections 253B.09 and 253B.12.
Sec. 121. Minnesota Statutes 1987 Supplement, section
256.01, subdivision 4, is amended to read:
Subd. 4. [DUTIES AS STATE AGENCY.] The state agency shall:
(1) supervise the administration of assistance to dependent
children under Laws 1937, chapter 438, by the county agencies in
an integrated program with other service for dependent children
maintained under the direction of the state agency;
(2) may subpoena witnesses and administer oaths, make
rules, and take such action as may be necessary, or desirable
for carrying out the provisions of Laws 1937, chapter 438. All
rules made by the state agency shall be binding on the counties
and shall be complied with by the respective county agencies;
(3) establish adequate standards for personnel employed by
the counties and the state agency in the administration of Laws
1937, chapter 438, and make the necessary rules to maintain such
standards;
(4) prescribe the form of and print and supply to the
county agencies blanks for applications, reports, affidavits,
and such other forms as it may deem necessary and advisable;
(5) cooperate with the federal government and its public
welfare agencies in any reasonable manner as may be necessary to
qualify for federal aid for aid to dependent children and in
conformity with the provisions of Laws 1937, chapter 438,
including the making of such reports and such forms and
containing such information as the Federal Social Security Board
may from time to time require, and comply with such provisions
as such board may from time to time find necessary to assure the
correctness and verification of such reports; and
(6) may cooperate with other state agencies in establishing
reciprocal agreements in instances where a child receiving aid
to dependent children moves or contemplates moving into or out
of the state, in order that such child may continue to receive
supervised aid from the state moved from until the child shall
have resided for one year in the state moved to; and
(7) on or before October 1 in each even-numbered year make
a biennial report to the governor concerning the activities of
the agency; and
(8) design, develop, and administer an intake, referral,
and inventory system that provides localized, single-point
intake with a direct access to a statewide data base to match
client needs with employment opportunities and public and
private services. The system must include information on all
available public and private programs for employment and
training services and income maintenance and support services as
defined in section 268.0111. The state agency shall cooperate
with the department of jobs and training, counties and other
local service units, service providers, and clients in the
development and operation of the system. The system is not
subject to sections 16B.40 to 16B.45;
(9) enter into agreements with other departments of the
state as necessary to meet all requirements of the federal
government.
Sec. 122. Minnesota Statutes 1987 Supplement, section
256.015, subdivision 2, is amended to read:
Subd. 2. [PERFECTION; ENFORCEMENT.] The state agency may
perfect and enforce its lien under sections 514.69, 514.70, and
514.71, and must file the verified lien statement with the
appropriate court administrator in the county of financial
responsibility. The verified lien statement must contain the
following: the name and address of the person to whom medical
care, subsistence, or other payment was furnished; the date of
injury; the name and address of vendors furnishing medical care;
the dates of the service or payment; the amount claimed to be
due for the care or payment; and to the best of the state
agency's knowledge, the names and addresses of all persons,
firms, or corporations claimed to be liable for damages arising
from the injuries.
This section does not affect the priority of any attorney's
lien. The state agency is not subject to any limitations period
referred to in section 514.69 or 514.71 and has one year from
the date notice is received by it under subdivision 4, paragraph
(c), or one year from the date medical bills are first paid by
the state agency, whichever is later, to file its verified lien
statement. The state agency may commence an action to enforce
the lien within one year of (1) the date the notice required by
subdivision 4, paragraph (c), is received, or (2) the date the
person's cause of action is concluded by judgment, award,
settlement, or otherwise, whichever is later.
Sec. 123. [256.016] [PLAIN LANGUAGE IN WRITTEN MATERIALS.]
(a) To the extent reasonable and consistent with the goals
of providing easily understandable and readable materials and
complying with federal and state laws governing the programs,
all written materials relating to services and determinations of
eligibility for or amounts of benefits that will be given to
applicants for or recipients of assistance under a program
administered or supervised by the commissioner of human services
must be understandable to a person who reads at the
seventh-grade level, using the Flesch scale analysis readability
score as determined under section 72C.09.
(b) All written materials relating to determinations of
eligibility for or amounts of benefits that will be given to
applicants for or recipients of assistance under programs
administered or supervised by the commissioner of human services
must be developed to satisfy the plain language requirements of
the plain language contract act under sections 325G.29 to
325G.36. Materials may be submitted to the attorney general for
review and certification. Notwithstanding section 325G.35,
subdivision 1, the attorney general shall review submitted
materials to determine whether they comply with the requirements
of section 325G.31. The remedies available pursuant to sections
8.31 and 325G.33 to 325G.36 do not apply to these materials.
Failure to comply with this section does not provide a basis for
suspending the implementation or operation of other laws
governing programs administered by the commissioner.
(c) The requirements of this section apply to all materials
modified or developed by the commissioner on or after July 1,
1988. The requirements of this section do not apply to
materials that must be submitted to a federal agency for
approval, to the extent that application of the requirements
prevents federal approval.
(d) Nothing in this section may be construed to prohibit a
lawsuit brought to require the commissioner to comply with this
section or to affect individual appeal rights granted pursuant
to section 256.045.
(e) The commissioner shall report annually to the chairs of
the health and human services divisions of the senate finance
committee and the house of representatives appropriations
committee on the number and outcome of cases that raise the
issue of the commissioner's compliance with this section.
Sec. 124. Minnesota Statutes 1986, section 256.73,
subdivision 2, is amended to read:
Subd. 2. [ALLOWANCE BARRED BY OWNERSHIP OF PROPERTY.]
Ownership by an assistance unit of property as follows is a bar
to any allowance under sections 256.72 to 256.87:
(1) The value of real property other than the homestead,
which when combined with other assets exceeds the limits of
paragraph (2), unless the assistance unit is making a good faith
effort to sell the nonexcludable real property. The time period
for disposal must not exceed nine months and the assistance unit
shall execute an agreement to dispose of the property to repay
assistance received during the nine months up to the amount of
the net sale proceeds. The payment must be made when the
property is sold. If the property is not sold within the
required time or the assistance unit becomes ineligible for any
reason the entire amount received during the nine months is an
overpayment and subject to recovery. For the purposes of this
section "homestead" means the house home owned and occupied by
the child, relative or other member of the assistance unit as a
dwelling place, together with the land upon which it is situated
in an area no greater than two contiguous lots in a platted or
laid out city or town or all contiguous acres in rural
areas surrounding property which is not separated from the home
by intervening property owned by others. Public rights-of-way,
such as roads which run through the surrounding property and
separate it from the home, will not affect the exemption of the
property; or
(2) Personal property of an equity value in excess of
$1,000 for the entire assistance unit, exclusive of personal
property used as the home, one motor vehicle of an equity value
not exceeding $1,500 or the entire equity value of a motor
vehicle determined to be necessary for the operation of a
self-employment business, one burial plot for each member of the
assistance unit, one prepaid burial contract with an equity
value of no more than $1,000 for each member of the assistance
unit, clothing and necessary household furniture and equipment
and other basic maintenance items essential for daily living, in
accordance with rules promulgated by and standards established
by the commissioner of human services.
Sec. 125. Minnesota Statutes 1986, section 256.73,
subdivision 6, is amended to read:
Subd. 6. [REPORTS BY RECIPIENT.] (a) An assistance unit
with a recent work history or with earned income shall report
monthly to the local agency on income received and other
circumstances affecting eligibility or assistance amounts. All
other assistance units shall report on income and other
circumstances affecting eligibility and assistance amounts at
less frequent intervals, as specified by the state agency. All
income not specifically disregarded by the Social Security Act,
the Code of Federal Regulations, or state law and rules, shall
be income applicable to the budgetary needs of the family. If
any amount of aid to families with dependent children assistance
is paid to a recipient thereof in excess of the payment due it
shall be recoverable by the local agency. The agency shall give
written notice to the recipient of its intention to recover the
overpayment. Overpayments to a current assistance unit shall be
recovered either through repayment by the individual in part or
in full or by reducing the amount of aid payable to the
assistance unit of which the individual is a member. For any
month in which an overpayment must be recovered, recoupment may
be made by reducing the grant but only if the reduced assistance
payment, together with the assistance unit's liquid assets and
total income after deducting actual work expenses equals at
least 95 percent of the standard of need for the assistance
unit, except that if the overpayment is due solely to agency
error, this total after deducting actual work expenses shall
equal at least 99 percent of the standard of need. In cases
when there is both an overpayment and underpayment the local
agency shall offset one against the other in correcting the
payment. The local agency shall make reasonable efforts to
recover overpayments made to persons no longer on assistance in
accordance with standards established by the commissioner of
human services. The local agency need not attempt to recover
overpayments of less than $35 paid to an individual no longer on
assistance if the individual does not receive assistance again
within three years, unless the individual has been convicted of
fraud under section 256.98. The recipient may appeal the
agency's determination that an overpayment has occurred in
accordance with section 256.045. The county agency shall
promptly repay the recipient for any underpayment and shall
disregard that payment when determining the assistance unit's
income and resources in the month when the payment is made and
the following month.
(b) An assistance unit required to submit a report on the
form designated by the commissioner is considered to have
continued its application for assistance effective the date the
required report is received by the local agency, if a complete
report is received within a calendar month after the month in
which assistance was received, except that no assistance shall
be paid for the period beginning with the end of the month in
which the report was due and ending with the date the report was
received by the local agency.
Sec. 126. Minnesota Statutes 1986, section 256.73, is
amended by adding a subdivision to read:
Subd. 8. [RECOVERY OF OVERPAYMENTS.] (a) If an amount of
aid to families with dependent children assistance is paid to a
recipient in excess of the payment due, it shall be recoverable
by the local agency. The agency shall give written notice to
the recipient of its intention to recover the overpayment.
(b) When an overpayment occurs, the local agency shall
recover the overpayment from a current recipient by reducing the
amount of aid payable to the assistance unit of which the
recipient is a member for one or more monthly assistance
payments until the overpayment is repaid. For any month in
which an overpayment must be recovered, recoupment may be made
by reducing the grant but only if the reduced assistance
payment, together with the assistance unit's total income after
deducting work expenses as allowed under section 256.74,
subdivision 1, clauses (3) and (4), equals at least 95 percent
of the standard of need for the assistance unit, except that if
the overpayment is due solely to agency error, this total after
deducting allowable work expenses must equal at least 99 percent
of the standard of need. Notwithstanding the preceding
sentence, beginning on the date on which the commissioner
implements a computerized client eligibility and information
system in one or more counties, all local agencies in the state
shall reduce the assistance payment by three percent of the
assistance unit's standard of need or the amount of the monthly
payment, whichever is less, for all overpayments whether or not
the overpayment is due solely to agency error. In cases when
there is both an overpayment and underpayment, the local agency
shall offset one against the other in correcting the payment.
(c) Overpayments may also be voluntarily repaid, in part or
in full, by the individual, in addition to the above aid
reductions, until the total amount of the overpayment is repaid.
(d) The local agency shall make reasonable efforts to
recover overpayments to persons no longer on assistance in
accordance with standards adopted in rule by the commissioner of
human services. The local agency need not attempt to recover
overpayments of less than $35 paid to an individual no longer on
assistance if the individual does not receive assistance again
within three years, unless the individual has been convicted of
fraud under section 256.98.
Sec. 127. Minnesota Statutes 1986, section 256.73, is
amended by adding a subdivision to read:
Subd. 9. [APPEAL OF OVERPAYMENT DETERMINATIONS.] The
recipient may appeal the agency's determination that an
overpayment has occurred in accordance with section 256.045.
Sec. 128. Minnesota Statutes 1986, section 256.73, is
amended by adding a subdivision to read:
Subd. 10. [UNDERPAYMENTS.] The local agency shall promptly
repay the recipient for any underpayment. The local agency
shall disregard that payment when determining the assistance
unit's income and resources in the month when the payment is
made and the following month.
Sec. 129. Minnesota Statutes 1986, section 256.73, is
amended by adding a subdivision to read:
Subd. 11. [COMPLIANCE WITH FEDERAL LAW AND REGULATION.]
None of the provisions in this section shall be implemented to
the extent that they violate federal law or regulation.
Sec. 130. Minnesota Statutes 1987 Supplement, section
256.736, subdivision 1b, is amended to read:
Subd. 1b. [WORK INCENTIVE SUBSIDIZED HOUSING PROGRAM.]
Within the limit of available appropriations, employed
recipients of aid to families with dependent children who meet
eligibility requirements established by the commissioner of
human services are eligible for a state housing subsidy as an
incentive to seek and retain employment. The commissioner of
human services shall adopt rules for the work incentive
subsidized housing program using eligibility criteria, subsidy
amounts, and an administrative system developed jointly by the
commissioner of human services and the commissioner of jobs and
training. Unless superseded by permanent rules, emergency rules
adopted to implement this section remain in effect until July 1,
1989. The rules must:
(1) target recipients who are or are likely to become
long-term recipients or who experience substantial barriers to
employment;
(2) establish a fixed or sliding scale subsidy amount that
will create a significant work incentive yet enable the program
to serve the greatest possible number of recipients;
(3) limit the subsidy to persons who become employed while
receiving assistance; and
(4) provide for continued subsidy payments for up to one
year after termination of assistance to ease the transition from
assistance to self-sufficiency.
The program must be coordinated with existing work and
training programs and must be designed to maximize savings in
the aid to families with dependent children program. The
subsidy must be provided as in-kind assistance, and it is not
available if it would be considered countable income under state
and federal requirements.
Sec. 131. Minnesota Statutes 1986, section 256.736, is
amended by adding a subdivision to read:
Subd. 3b. [MANDATORY SCHOOL ATTENDANCE FOR MINOR PARENTS.]
(a) [DEFINITIONS.] The definitions in this paragraph apply to
this subdivision.
(1) "Minor parent" means a recipient of AFDC who is under
age 18, and who is the natural or adoptive parent of a child
living with the minor parent.
(2) "School" means:
(i) an educational program which leads to a high school
diploma. The program or coursework may be, but is not limited
to, a program under the post-secondary enrollment options of
section 123.3514, a regular or alternative program of an
elementary or secondary school, a technical institute, or a
college;
(ii) coursework for a general educational development (GED)
diploma of not less than six hours of classroom instruction per
week; or
(iii) any other post-secondary educational program that is
approved by the public school or the local agency under
subdivision 11.
(b) [SCHOOL ATTENDANCE REQUIRED.] Notwithstanding section
256.736, subdivision 3, a minor parent must attend school if all
of the following apply:
(1) the minor parent has no child living with the parent
who is younger than six weeks of age;
(2) transportation services needed to enable the minor
parent to attend school are available;
(3) licensed or legal nonlicensed child care services
needed to enable the minor parent to attend school are available;
(4) the minor parent has not already graduated from high
school and has not received a general educational development
(GED) diploma; and
(5) the minor parent does not have good cause for failing
to attend school, as provided in paragraph (d).
(c) [ENROLLMENT AND ATTENDANCE.] The minor parent must be
enrolled in school and meeting the school's attendance
requirements. The minor parent is considered to be attending
when the minor parent is enrolled but the school is not in
regular session, including during holiday and summer breaks.
(d) [GOOD CAUSE FOR NOT ATTENDING SCHOOL.] The local
agency shall determine whether good cause for not attending or
not enrolling in school exists, according to this paragraph:
(1) Good cause exists when the minor parent is ill or
injured seriously enough to prevent the minor parent from
attending school.
(2) Good cause exists when the minor parent's child is ill
or injured and the minor parent's presence in the home is
required to care for the child.
(3) Good cause exists when the local agency has verified
that the only available school program requires round trip
commuting time from the minor parent's residence of more than
two hours by available means of transportation, excluding the
time necessary to transport children to and from child care.
(4) Good cause exists when there is an interruption in
availability of child care services.
(5) Good cause exists when the minor parent has indicated a
desire to attend school, but the public school system is not
providing for the minor parent's education and alternative
programs are not available.
(6) Good cause exists when the school does not cooperate
with the local agency in providing verification of the minor
parent's education or attendance.
(7) Good cause exists when the minor parent or the minor
parent's child has a medical appointment or an appointment with
the local welfare agency, is required to appear in court during
the minor parent's normal school hours, or has any other
obligation consistent with the case management contract.
(8) For the minor parent of a child between six and twelve
weeks of age, good cause exists when child care is not available
on the premises of the school, or a medical doctor certifies
that it would be better for the health of either the parent or
the child for the parent to remain at home with the child for a
longer period of time.
(e) [FAILURE TO COMPLY.] If the school notifies the local
agency that the minor parent is not enrolled or is not meeting
the school's attendance requirements, and the local agency
determines that the minor parent does not have good cause, the
local agency shall apply the sanctions listed in subdivision 4
beginning with the first payment month after issuance of notice.
(f) [NOTICE AND HEARING.] A right to notice and fair
hearing shall be provided in accordance with section 256.045 and
the Code of Federal Regulations, title 45, section 205.10.
(g) [SOCIAL SERVICES.] When a minor parent has failed to
attend school and does not have good cause, the local agency
shall refer the minor parent to social services for services, as
provided in section 257.33.
(h) [VERIFICATION.] No less often than quarterly, the
local agency must verify that the minor parent is meeting the
requirements of this subdivision. Notwithstanding section
13.32, subdivision 3, when the local agency notifies the school
that a minor parent is subject to this subdivision, the school
must furnish verification of school enrollment and attendance to
the local agency.
Sec. 132. Minnesota Statutes 1986, section 256.736, is
amended by adding a subdivision to read:
Subd. 3c. [MINOR PARENTS NOT LIVING WITH RELATIVES.] (a)
This subdivision applies to a minor parent who is not living
with a parent or other adult relative and who is not living in a
group or foster home licensed by the commissioner.
(b) For purposes of this subdivision, the following terms
have the meanings given them:
(1) "Minor parent" means an applicant for or recipient of
AFDC who is under age 18, and who is the natural or adoptive
parent of a child living with the minor parent.
(2) "Other adult relative" means a person who qualifies to
be an eligible relative caretaker for AFDC, as specified in
federal regulations.
(c) The agency shall determine, for each minor parent who
applies for or receives AFDC, whether this section applies. For
a minor parent to whom this section applies, the local agency
shall refer the minor parent to its social services unit within
30 days of the date the application for assistance is approved
for development of a social service plan as required in section
257.33. The agency shall notify the minor parent of the
referral to social services and that cooperation in developing
and participating in a social service plan is required in order
for AFDC eligibility to continue.
(d) In addition to meeting the requirements of section
257.33, the social service plan may, based upon the social
service unit's evaluation of the minor caretaker's needs and
parenting abilities, and the health, safety, and parenting needs
of the minor caretaker's child, require the minor caretaker to
live in a group or foster home or participate in available
programs which teach skills in parenting or independent living.
(e) If the minor parent fails to cooperate in developing or
participating in the social service plan, the social services
unit shall notify the income maintenance unit of the local
agency, which shall then notify the minor parent of the
determination and of the sanctions in subdivision 4 that will be
applied.
Sec. 133. Minnesota Statutes 1987 Supplement, section
256.736, subdivision 4, is amended to read:
Subd. 4. [CONDITIONS OF CERTIFICATION.] The commissioner
of human services shall:
(1) Arrange for or provide any caretaker or child required
to participate in employment and training services pursuant to
this section with child-care services, transportation, and other
necessary family services;
(2) Pay 10 percent of the cost of the work incentive
program and any other costs that are required of that agency by
federal regulation for employment and training services for
recipients of aid to families with dependent children;
(3) Provide that in determining a recipient's needs any
monthly incentive training payment made to the recipient by the
department of jobs and training is disregarded and the
additional expenses attributable to participation in a program
are taken into account in grant determination to the extent
permitted by federal regulation; and
(4) Provide that when it has been certified by the county
board that a caretaker or child required to participate in an
employment and training program has been found by the employment
and training service provider to have refused without good cause
to participate in appropriate employment and training services
or to have refused without good cause to accept a bona fide
offer of public or other employment, the county board shall
provide that the county board shall impose the sanctions in
clause (5) or (6) when the county board:
(a) is notified that a caretaker or child required to
participate in employment and training services has been found
by the employment and training service provider to have failed
without good cause to participate in appropriate employment and
training services or to have failed without good cause to accept
a bona fide offer of public or other employment;
(b) determines that a minor parent who is required to
attend school under subdivision 3b has, without good cause,
failed to attend school;
(c) determines that subdivision 3c applies to a minor
parent and the minor parent has, without good cause, failed to
cooperate with development of a social service plan or to
participate in execution of the plan, to live in a group or
foster home, or to participate in a program that teaches skills
in parenting and independent living; or
(d) determines that a caretaker has, without good cause,
failed to attend orientation.
(5) To the extent permissible by federal law, the following
sanctions must be imposed for a recipient's failure to
participate in required employment and training services,
education, orientation, or the requirements of subdivision 3c:
(a) For the first failure, 50 percent of the grant provided
to the family for the month following the failure shall be made
in the form of protective or vendor payments;
(b) For the second and subsequent failures, the entire
grant provided to the family must be made in the form of
protective or vendor payments. Assistance provided to the
family must be in the form of protective or vendor payments
until the recipient complies with the requirement; and
(c) When protective payments are required, the local agency
may continue payments to the caretaker if a protective payee
cannot reasonably be found.
(6) When the sanctions provided by clause (5) are not
permissible under federal law, the following sanctions shall be
imposed for a recipient's failure to participate in required
employment and training services, education, orientation, or the
requirements of subdivision 3c:
(a) If the caretaker makes the refusal fails to
participate, the caretaker's needs shall not be taken into
account in making the grant determination, and aid for any
dependent child in the family will be made in the form of
protective or vendor payments, except that when protective
payments are made, the local agency may continue payments to the
caretaker if a protective payee cannot reasonably be found. The
standard of assistance for the remaining eligible members of the
assistance unit is the standard that is used in other instances
in which the caretaker is excluded from the assistance unit for
noncompliance with a program requirement.
(b) Aid with respect to a dependent child will be denied if
a child who makes the refusal fails to participate is the only
child receiving aid in the family.
(c) If there is more than one child receiving aid in the
family, aid for the child who makes the refusal fails to
participate will be denied and the child's needs will not be
taken into account in making the grant determination.
(d) If the assistance unit's eligibility is based on the
nonexempt principal earner's unemployment and this principal
earner fails or refuses without good cause to participate or to
accept employment, the entire assistance unit is ineligible for
benefits under sections 256.72 to 256.87.
Sec. 134. Minnesota Statutes 1987 Supplement, section
256.736, subdivision 11, is amended to read:
Subd. 11. [CASE MANAGEMENT SERVICES.] (a) For clients
described in subdivision 2a, the case manager shall:
(1) Assess the education, skills, and ability of the
caretaker to secure and retain a job which, when added to child
support, will support the caretaker's family. The case manager
must work with the caretaker in completing this task;
(2) Set goals and develop a timetable for completing
education and employment goals. The case manager must work with
the caretaker in completing this task. For caretakers who are
not literate or who have not completed high school, the first
goal for the caretaker must be to complete literacy training or
a general education diploma. Caretakers who are literate and
have completed high school shall be counseled to set realistic
attainable goals, taking into account the long-term needs of
both the caretaker and the caretaker's family;
(3) Coordinate services such as child care, transportation,
and education assistance necessary to enable the caretaker to
work toward the goals developed in clause (2). When a client
needs child care services in order to attend a Minnesota public
or nonprofit college, university or technical institute, the
case manager shall contact the appropriate agency to reserve
child care funds for the client. A caretaker who needs child
care services in order to complete high school or a general
education diploma is eligible for child care under section
268.91;
(4) Develop, execute, and monitor a contract between the
local agency and the caretaker. The contract must include: (a)
specific goals of the caretaker including stated measurements of
progress toward each goal; (b) specific services provided by the
county agency; and (c) conditions under which the county will
withdraw the services provided;
The contract may include other terms as desired or needed
by either party. In all cases, however, the case manager must
ensure that the caretaker has set forth in the contract
realistic goals consistent with the ultimate goal of
self-sufficiency for the caretaker's family; and
(5) Develop and refer caretakers to counseling or peer
group networks for emotional support while participating in
work, education, or training.
(b) In addition to the duties in paragraph (a), for minor
parents and pregnant minors, the case manager shall:
(1) Ensure that the contract developed under paragraph
(a)(4) considers all factors set forth in section 257.33,
subdivision 2; and
(2) Assess the housing and support systems needed by the
caretaker in order to provide the dependent children with
adequate parenting. The case manager shall encourage minor
parents and pregnant minors who are not living with friends or
relatives to live in a group home or foster care setting. If
minor parents and pregnant minors are unwilling to live in a
group home or foster care setting or if no group home or foster
care setting is available, the case manager shall assess the
minor parent's their need for training in parenting and
independent living skills and when appropriate shall refer
appropriate minor parents them to available counseling programs
designed to teach needed skills; and
(3) Inform minor parents or pregnant minors of, and assist
them in evaluating the appropriateness of, the high school
graduation incentives program under section 126.22, including
post-secondary enrollment options, and the employment related
and community based instruction programs.
(c) A caretaker may request a conciliation conference to
attempt to resolve disputes regarding the contents of a contract
developed under this section or a housing and support systems
assessment conducted under this section. The caretaker may
request a hearing pursuant to section 256.045 to dispute the
contents of a contract or assessment developed under this
section. The caretaker need not request a conciliation
conference in order to request a hearing pursuant to section
256.045.
Sec. 135. Minnesota Statutes 1986, section 256.76,
subdivision 1, is amended to read:
Subdivision 1. Upon the completion of such the
investigation the county agency shall decide whether the child
is eligible for assistance under the provisions of sections
256.72 to 256.87, and determine the amount of such the
assistance, and the date on which such the assistance shall
begin begins. A decision on an application for assistance must
be made as promptly as possible and no more than 30 days from
the date of application. Notwithstanding section 393.07, the
county agency shall not delay approval or issuance of assistance
pending formal action of the county board of commissioners. The
first month's grant shall be based upon that portion of the
month from the date of application, or from the date that the
applicant meets all eligibility factors, whichever occurs later,
provided that on the date that assistance is first requested,
the local agency shall inquire and determine whether the person
requesting assistance is in immediate need of food, shelter,
clothing, or other emergency assistance. If an emergency need
is found to exist, the applicant shall be granted assistance
pursuant to section 256.871 within a reasonable period of time.
It shall make a grant of assistance which shall be binding upon
the county and be complied with by the county until such the
grant is modified or vacated. If the applicant is subsequently
found to have been eligible for assistance under sections 256.72
to 256.87, assistance rendered under section 256.871 must be
considered as a regular AFDC payment and not a payment under
section 256.871. The county agency shall notify the applicant
of its decision in writing. Such The assistance shall be paid
monthly to the applicant or to the vendor of medical care upon
order of the county agency from funds appropriated to the county
agency for this purpose. The county agency shall, upon the
granting of assistance under these sections, file an order on
the form to be approved by the state agency with the auditor of
the county and thereafter. After the order is filed, warrants
shall be drawn and payments made only in accordance with this
order to or for recipients of this assistance or in accordance
with any subsequent order.
Sec. 136. [256.925] [OPTIONAL VOTER REGISTRATION FOR
PUBLIC ASSISTANCE APPLICANTS AND RECIPIENTS.]
A county agency shall provide voter registration cards to
every individual eligible to vote who applies for a public
assistance program at the time application is made. The agency
shall also make voter registration cards available to a public
assistance recipient upon the recipient's request or at the time
of the recipient's eligibility redetermination. The county
agency shall assist applicants and recipients in completing the
voter registration cards, as needed. Applicants must be
informed that completion of the cards is optional. Completed
forms shall be collected by agency employees and submitted to
proper election officials.
Sec. 137. Minnesota Statutes 1987 Supplement, section
256.936, is amended to read:
256.936 [CHILDREN'S HEALTH PLAN.]
Subdivision 1. [DEFINITIONS.] For purposes of this section
the following terms shall have the meanings given them:
(a) "Eligible persons" means pregnant women and children
under six years old who are one year of age or older but less
than nine years of age who have gross family incomes that are
equal to or less than 185 percent of the federal poverty
guidelines and who are not eligible for medical assistance under
chapter 256B or general assistance medical care under chapter
256D and who are not otherwise insured for the covered services.
Eligibility for pregnant women shall continue for 60 days
postpartum to allow for follow-up visits. The period of
eligibility extends from the first day of the month in which the
child's first birthday occurs to the last day of the month in
which the child becomes nine years old.
(b) "Covered services" means prenatal care services and
children's health services.
(c) "Prenatal care services" means the outpatient services
provided to pregnant women which are medically necessary for the
pregnancy. Physician or certified nurse-midwife services for
delivery are included but inpatient hospital services are not
included.
(d) "Children's health services" means the health services
reimbursed under chapter 256B, with the exception of inpatient
hospital services, private duty nursing services, orthodontic
services, medical transportation services, personal care
assistant and case management services, hospice care services,
nursing home or intermediate care facilities services, and
mental health and chemical dependency services.
(e) (d) "Eligible providers" means those health care
providers who provide prenatal care services and children's
health services to medical assistance clients under rules
established by the commissioner for that program. Reimbursement
under this section shall be at the same rates and conditions
established for medical assistance. A provider of prenatal care
services shall assess whether the pregnant woman is at risk of
delivering a low birth weight baby or has a health condition
which may increase the probability of a problem birth.
(f) (e) "Commissioner" means the commissioner of human
services.
Subd. 2. [PLAN ADMINISTRATION.] The children's health plan
is established to promote access to appropriate primary health
care for pregnant women and to assure healthy babies and healthy
children. The commissioner shall establish an office for the
state administration of this plan. The plan shall be used to
provide prenatal care and children's health services for
eligible persons. Payment for these services shall be made to
all eligible providers. The commissioner shall establish
marketing efforts to encourage potentially eligible persons to
receive information about the program and about other medical
care programs administered or supervised by the department of
human services. A toll-free telephone number must be used to
provide information about the plan medical programs and to
promote access to the covered services. The commissioner must
make a quarterly assessment of the expected expenditures for the
covered services and the appropriation. Based on this
assessment the commissioner may limit enrollments and target
former aid to families with dependent children recipients. If
sufficient money is not available to cover all costs incurred in
one quarter, the commissioner may seek an additional
authorization for funding from the legislative advisory
committee.
Subd. 3. [APPLICATION PROCEDURES.] Applications and other
information must be made available in to provider offices, local
human services agencies, school districts, public and private
elementary schools in which 25 percent or more of the students
receive free or reduced price lunches, community health offices,
and Women, Infants and Children (WIC) program sites. These
sites may accept applications, collect the enrollment fee, and
forward the forms and fees to the commissioner. Otherwise,
applicants may apply directly to the commissioner. The
commissioner may use individuals' social security numbers as
identifiers for purposes of administering the plan and conduct
data matches to verify income. Applicants shall submit evidence
of family income, earned and unearned, that will be used to
verify income eligibility. Notwithstanding any other law to the
contrary, benefits under this section are secondary to any a
plan of insurance or benefit program under which an eligible
person may have coverage. The commissioner shall identify
eligible persons who may have coverage or benefits under other
plans of insurance or who become eligible for medical assistance.
Subd. 4. [ENROLLMENT FEE.] An enrollment fee of $35 is
required from eligible persons for prenatal care services and an
annual enrollment fee of $25, not to exceed $150 per family, is
required from eligible persons for children's health
services. The fees may be paid together at the time of
enrollment or as two payment installments. Enrollment fees must
be deposited in the public health fund and are appropriated to
the commissioner for the children's health plan program. The
commissioner shall make an annual redetermination of continued
eligibility and identify people who may become eligible for
medical assistance.
Sec. 138. [256.9655] [PAYMENTS TO MEDICAL PROVIDERS.]
The commissioner shall establish procedures to analyze and
correct problems associated with medical care claims preparation
and processing under the medical assistance, general assistance
medical care, and children's health plan programs. At a
minimum, the commissioner shall:
(1) designate a full-time position as a liaison between the
department of human services and providers;
(2) analyze impediments to timely processing of claims,
provide information and consultation to providers, and develop
methods to resolve or reduce problems;
(3) provide to each acute-care hospital a quarterly listing
of claims received and identify claims that have been suspended
and the reason the claims were suspended;
(4) provide education and information on reasons for
rejecting and suspending claims and identify methods that would
avoid multiple submissions of claims; and
(5) for each acute-care hospital, identify and prioritize
claims that are in jeopardy of exceeding time factors that
eliminate payment.
Sec. 139. Minnesota Statutes 1987 Supplement, section
256.969, subdivision 2, is amended to read:
Subd. 2. [RATES FOR INPATIENT HOSPITALS.] On July 1, 1984,
the commissioner shall begin to utilize to the extent possible
existing classification systems, including Medicare. The
commissioner may incorporate the grouping of hospitals with
similar characteristics for uniform rates upon the development
and implementation of the diagnostic classification system.
Prior to implementation of the diagnostic classification system,
the commissioner shall report the proposed grouping of hospitals
to the senate health and human services committee and the house
health and welfare committee. The computation of the base year
cost per admission and the computation of the relative values of
the diagnostic categories must include identified outlier cases
and their weighted costs up to the point that they become
outlier cases, but must exclude costs and days beyond that
point. Claims paid for care provided on or after August 1,
1985, shall be adjusted to reflect a recomputation of rates,
unless disapproved by the federal Health Care Financing
Administration. The state shall pay the state share of the
adjustment for care provided on or after August 1, 1985, up to
and including June 30, 1987, whether or not the adjustment is
approved by the federal Health Care Financing Administration.
The commissioner may reconstitute the diagnostic categories to
reflect actual hospital practices, the specific character of
specialty hospitals, or to reduce variances within the
diagnostic categories after notice in the State Register and a
30-day comment period. After May 1, 1986, acute care hospital
billings under the medical assistance and general assistance
medical care programs must not be submitted until the recipient
is discharged. However, the commissioner shall establish
monthly interim payments with inpatient hospitals that have
individual patient lengths of stay in excess of 30 days
regardless of diagnosis-related group. For purposes of
establishing interim rates, the commissioner is exempt from the
requirements of chapter 14. Medical assistance and general
assistance medical care reimbursement for treatment of mental
illness shall be reimbursed based upon diagnosis
classifications. The commissioner may selectively contract with
hospitals for services within the diagnostic classifications
relating to mental illness and chemical dependency under
competitive bidding when reasonable geographic access by
recipients can be assured. No physician shall be denied the
privilege of treating a recipient required to utilize a hospital
under contract with the commissioner, as long as the physician
meets credentialing standards of the individual hospital.
Effective July 1, 1988, the commissioner shall limit the annual
increase in pass-through cost payments for depreciation, rents
and leases, and interest expense to the annual growth in the
consumer price index for all urban consumers (CPI-U) hospital
cost index described in section 256.969, subdivision 1. When
computing budgeted pass-through cost payments, the commissioner
shall use the annual increase in the CPI-U hospital cost index
forecasted by Data Resources, Inc. consistent with the quarter
of the hospital's fiscal year end. In final settlement of
pass-through cost payments, the commissioner shall use the CPI-U
hospital cost index for the month in which the hospital's fiscal
year ends compared to the same month one year earlier.
Sec. 140. Minnesota Statutes 1987 Supplement, section
256.969, subdivision 3, is amended to read:
Subd. 3. [SPECIAL CONSIDERATIONS.] (a) In determining the
rate the commissioner of human services will take into
consideration whether the following circumstances exist:
(1) minimal medical assistance and general assistance
medical care utilization;
(2) unusual length of stay experience; and
(3) disproportionate numbers of low-income patients served.
(b) To the extent of available appropriations, the
commissioner shall provide supplemental grants directly to a
hospital described in section 256B.031, subdivision 10,
paragraph (a), that receives medical assistance payments through
a county-managed health plan that serves only residents of the
county. The payments must be designed to compensate for
actuarially demonstrated higher health care costs within the
county, for the population served by the plan, that are not
reflected in the plan's rates under section 256B.031,
subdivision 4.
(c) For inpatient hospital originally paid admissions,
excluding medicare cross-overs, provided from July 1, 1988,
through June 30, 1989, hospitals with 100 or fewer medical
assistance annualized paid admissions, excluding medicare
cross-overs, that were paid by March 1, 1988, for admissions
paid during the period January 1, 1987, to June 30, 1987, shall
have medical assistance inpatient payments increased 30 percent.
Hospitals with more than 100 but fewer than 250 medical
assistance annualized paid admissions, excluding medicare
cross-overs, that were paid by March 1, 1988, for admissions
paid during the period January 1, 1987, to June 30, 1987, shall
have medical assistance inpatient payments increased 20 percent
for inpatient hospital originally paid admissions, excluding
medicare cross-overs, provided from July 1, 1988, through June
30, 1989. This provision applies only to hospitals that have
100 or fewer licensed beds on March 1, 1988.
Sec. 141. Minnesota Statutes 1987 Supplement, section
256B.02, subdivision 8, is amended to read:
Subd. 8. [MEDICAL ASSISTANCE; MEDICAL CARE.] "Medical
assistance" or "medical care" means payment of part or all of
the cost of the following care and services identified in
subdivisions 8a to 8y, for eligible individuals whose income and
resources are insufficient to meet all of this cost:.
(1) Subd. 8a. [INPATIENT HOSPITAL SERVICES.] Medical
assistance covers inpatient hospital services. A second medical
opinion is required prior to reimbursement for elective
surgeries requiring a second opinion. The commissioner shall
publish in the State Register a list of elective surgeries that
require a second medical opinion prior to reimbursement, and the
criteria and standards for deciding whether an elective surgery
should require a second medical opinion. The list and the
criteria and standards are not subject to the requirements of
sections 14.01 to 14.69. The commissioner's decision whether a
second medical opinion is required, made in accordance with
rules governing that decision, is not subject to administrative
appeal;.
(2) Subd. 8b. [SKILLED AND INTERMEDIATE NURSING
CARE.] Medical assistance covers skilled nursing home services
and services of intermediate care facilities, including training
and habilitation services, as defined in section 252.41,
subdivision 3, for persons with mental retardation or related
conditions who are residing in intermediate care facilities for
persons with mental retardation or related conditions. Medical
assistance must not be used to pay the costs of nursing care
provided to a patient in a swing bed as defined in section
144.562;, unless (a) the facility in which the swing bed is
located is eligible as a sole community provider, as defined in
Code of Federal Regulations, title 42, section 412.92, or the
facility is a public hospital owned by a governmental entity
with 15 or fewer licensed acute-care beds; (b) the health care
financing administration approves the necessary state plan
amendments; (c) the patient was screened as provided in section
256B.091; (d) the patient no longer requires acute-care
services; and (e) no nursing home beds are available within 25
miles of the facility. The daily medical assistance payment for
nursing care for the patient in the swing bed is the statewide
average medical assistance skilled nursing care per diem as
computed annually by the commissioner on July 1 of each year.
(3) Subd. 8c. [PHYSICIANS' SERVICES.] Medical assistance
covers physicians' services;.
(4) Subd. 8d. [OUTPATIENT AND CLINIC SERVICES.] Medical
assistance covers outpatient hospital or nonprofit community
health clinic services or physician-directed clinic services.
The physician-directed clinic staff shall include at least two
physicians, one of whom is on the premises whenever the clinic
is open, and all services shall be provided under the direct
supervision of the physician who is on the premises. Hospital
outpatient departments are subject to the same limitations and
reimbursements as other enrolled vendors for all services,
except initial triage, emergency services, and services not
provided or immediately available in clinics, physicians'
offices, or by other enrolled providers. A second medical
opinion is required before reimbursement for elective surgeries
requiring a second opinion. The commissioner shall publish in
the State Register a list of elective surgeries that require a
second medical opinion before reimbursement and the criteria and
standards for deciding whether an elective surgery should
require a second surgical opinion. The list and the criteria
and standards are not subject to the requirements of sections
14.01 to 14.69. The commissioner's decision whether a second
medical opinion is required, made in accordance with rules
governing that decision, is not subject to administrative
appeal. "Emergency services" means those medical services
required for the immediate diagnosis and treatment of medical
conditions that, if not immediately diagnosed and treated, could
lead to serious physical or mental disability or death or are
necessary to alleviate severe pain. Neither the hospital, its
employees, nor any physician or dentist, shall be liable in any
action arising out of a determination not to render emergency
services or care if reasonable care is exercised in determining
the condition of the person, or in determining the
appropriateness of the facilities, or the qualifications and
availability of personnel to render these services consistent
with this section;.
(5) Subd. 8e. [COMMUNITY HEALTH CENTER SERVICES.] Medical
assistance covers community mental health center services, as
defined in rules adopted by the commissioner pursuant to section
256B.04, subdivision 2, and provided by a community mental
health center as defined in section 245.62, subdivision 2;.
(6) Subd. 8f. [HOME HEALTH CARE.] Medical assistance
covers home health care services;.
(7) Subd. 8g. [PRIVATE DUTY NURSING.] Medical assistance
covers private duty nursing services;.
(8) Subd. 8h. [PHYSICAL THERAPY.] Medical assistance
covers physical therapy and related services;.
(9) Subd. 8i. [DENTAL SERVICES.] Medical assistance covers
dental services, excluding cast metal restorations;.
(10) Subd. 8j. [LABORATORY AND X-RAY SERVICES.] Medical
assistance covers laboratory and X-ray services;.
(11) Subd. 8k. [NURSE ANESTHETIST SERVICES.] Medical
assistance covers nurse anesthetist services.
Subd. 8l. [EYEGLASSES, DENTURES, AND PROSTHETIC
DEVICES.] The following Medical assistance covers eyeglasses,
dentures, and prosthetic devices if prescribed by a licensed
practitioner: drugs, eyeglasses, dentures, and prosthetic
devices.
Subd. 8m. [DRUGS.] (a) Medical assistance covers drugs if
prescribed by a licensed practitioner. The commissioner shall
designate a formulary committee which shall to advise the
commissioner on the names of drugs for which payment shall be is
made, recommend a system for reimbursing providers on a set fee
or charge basis rather than the present system, and develop
methods encouraging use of generic drugs when they are less
expensive and equally effective as trademark drugs. The
commissioner shall appoint the formulary committee members no
later than 30 days following July 1, 1981. The formulary
committee shall consist of nine members, four of whom shall be
physicians who are not employed by the department of human
services, and a majority of whose practice is for persons paying
privately or through health insurance, three of whom shall be
pharmacists who are not employed by the department of human
services, and a majority of whose practice is for persons paying
privately or through health insurance, a consumer
representative, and a nursing home representative. Committee
members shall serve two-year terms and shall serve without
compensation. The commissioner may establish a drug formulary.
Its establishment and publication shall not be subject to the
requirements of the administrative procedure act, but the
formulary committee shall review and comment on the formulary
contents. Prior authorization may be required by the
commissioner, with the consent of the drug formulary committee,
before certain formulary drugs are eligible for payment. The
formulary shall not include: drugs or products for which there
is no federal funding; over-the-counter drugs, except for
antacids, acetaminophen, family planning products, aspirin,
insulin, prenatal vitamins, and vitamins for children under the
age of seven; or any other over-the-counter drug identified by
the commissioner, in consultation with the appropriate
professional consultants under contract with or employed by the
state agency, as necessary, appropriate and cost effective for
the treatment of certain specified chronic diseases, conditions
or disorders, and this determination shall not be subject to the
requirements of chapter 14, the administrative procedure act;
nutritional products, except for those products needed for
treatment of phenylketonuria, hyperlysinemia, maple syrup urine
disease, a combined allergy to human milk, cow milk, and soy
formula, or any other childhood or adult diseases, conditions,
or disorders identified by the commissioner as requiring a
similarly necessary nutritional product; anorectics; and drugs
for which medical value has not been established. Separate
payment shall not be made for nutritional products for residents
of long-term care facilities; payment for dietary requirements
is a component of the per diem rate paid to these facilities.
Payment to drug vendors shall not be modified before the
formulary is established except that the commissioner shall not
permit payment for any drugs which may not by law be included in
the formulary, and the commissioner's determination shall not be
subject to chapter 14, the administrative procedure act. The
commissioner shall publish conditions for prohibiting payment
for specific drugs after considering the formulary committee's
recommendations.
(b) The basis for determining the amount of payment shall
be the lower of the actual acquisition costs of the drugs plus a
fixed dispensing fee established by the commissioner, the
maximum allowable cost set by the federal government or by the
commissioner plus the fixed dispensing fee or the usual and
customary price charged to the public. Actual acquisition cost
includes quantity and other special discounts except time and
cash discounts. The actual acquisition cost of a drug may be
estimated by the commissioner. The maximum allowable cost of a
multisource drug may be set by the commissioner and it shall be
comparable to, but no higher than, the maximum amount paid by
other third party payors in this state who have maximum
allowable cost programs. Establishment of the amount of payment
for drugs shall not be subject to the requirements of the
administrative procedure act. An additional dispensing fee of
$.30 may be added to the dispensing fee paid to pharmacists for
prescriptions dispensed to residents of long-term care
facilities when a unit dose blister card system, approved by the
department, is used. Under this type of dispensing system, the
pharmacist must dispense a 30-day supply of drug. The National
Drug Code (NDC) from the drug container used to fill the blister
card must be identified on the claim to the department. The
unit dose blister card containing the drug must meet the
packaging standards set forth in Minnesota Rules, part
6800.2700, that govern the return of unused drugs to the
pharmacy for reuse. The pharmacy provider will be required to
credit the department for the actual acquisition cost of all
unused drugs that are eligible for reuse. Whenever a
generically equivalent product is available, payment shall be on
the basis of the actual acquisition cost of the generic drug,
unless the prescriber specifically indicates "dispense as
written" on the prescription as required by section 151.21,
subdivision 2. Notwithstanding the above provisions,
Implementation of any change in the fixed dispensing fee which
that has not been subject to the administrative procedure
act shall be is limited to not more than 180 days, unless,
during that time, the commissioner shall have
initiated initiates rulemaking through the administrative
procedure act;.
(12) Subd. 8n. [DIAGNOSTIC, SCREENING, AND PREVENTIVE
SERVICES.] Medical assistance covers diagnostic, screening, and
preventive services. "Preventive services" include services
related to pregnancy, including services for those conditions
which may complicate a pregnancy and which may be available to a
pregnant woman determined to be at risk of poor pregnancy
outcome. Preventive services available to a woman at risk of
poor pregnancy outcome may differ in an amount, duration, or
scope from those available to other individuals eligible for
medical assistance;.
(13) Subd. 8o. [HEALTH PLAN PREMIUMS.] Medical assistance
covers health care prepayment plan premiums and insurance
premiums if paid directly to a vendor and supplementary medical
insurance benefits under Title XVIII of the Social Security
Act. For purposes of obtaining Medicare part B, expenditures
may be made even if federal funding is not available;.
(14) Subd. 8p. [ABORTION SERVICES.] Medical assistance
covers abortion services, but only if one of the following
conditions is met:
(a) The abortion is a medical necessity. "Medical
necessity" means (1) the signed written statement of two
physicians indicating the abortion is medically necessary to
prevent the death of the mother, and (2) the patient has given
her consent to the abortion in writing unless the patient is
physically or legally incapable of providing informed consent to
the procedure, in which case consent will be given as otherwise
provided by law;
(b) The pregnancy is the result of criminal sexual conduct
as defined in section 609.342, clauses (c), (d), (e)(i), and
(f), and the incident is reported within 48 hours after the
incident occurs to a valid law enforcement agency for
investigation, unless the victim is physically unable to report
the criminal sexual conduct, in which case the report shall be
made within 48 hours after the victim becomes physically able to
report the criminal sexual conduct; or
(c) The pregnancy is the result of incest, but only if the
incident and relative are reported to a valid law enforcement
agency for investigation prior to the abortion;.
(15) Subd. 8q. [TRANSPORTATION COSTS.] Medical assistance
covers transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by
nonambulatory persons in obtaining emergency or nonemergency
medical care when paid directly to an ambulance company, common
carrier, or other recognized providers of transportation
services. For the purpose of this clause, a person who is
incapable of transport by taxicab or bus shall be considered to
be nonambulatory;.
(16) Subd. 8r. [BUS OR TAXICAB TRANSPORTATION.] To the
extent authorized by rule of the state agency, medical
assistance covers costs of bus or taxicab transportation
incurred by any ambulatory eligible person for obtaining
nonemergency medical care;.
(17) Subd. 8s. [PERSONAL CARE ASSISTANTS.] Medical
assistance covers personal care assistant services provided by
an individual, not a relative, who is qualified to provide the
services, where the services are prescribed by a physician in
accordance with a plan of treatment and are supervised by a
registered nurse. Payments to personal care assistants shall be
adjusted annually to reflect changes in the cost of living or of
providing services by the average annual adjustment granted to
vendors such as nursing homes and home health agencies;.
(18) Subd. 8t. [MENTAL ILLNESS CASE MANAGEMENT.] To the
extent authorized by rule of the state agency, medical
assistance covers case management services to persons with
serious and persistent mental illness;.
(19) Subd. 8u. [CASE MANAGEMENT FOR BRAIN INJURED
PERSONS.] To the extent authorized by rule of the state
agency, medical assistance covers case management services to
persons with brain injuries;.
(20) Subd. 8v. [HOSPICE CARE.] Medical assistance covers
hospice care services under Public Law Number 99-272, section
9505, to the extent authorized by rule; and.
(21) Subd. 8w. [DAY TREATMENT SERVICES.] Medical
assistance covers day treatment services as specified in
sections 245.462, subdivision 8, and 245.471, subdivision 3,
that are provided under contract with the county board.
Subd. 8x. [OTHER MEDICAL OR REMEDIAL CARE.] Medical
assistance covers any other medical or remedial care licensed
and recognized under state law unless otherwise prohibited by
law, except licensed chemical dependency treatment programs or
primary treatment or extended care treatment units in hospitals
that are covered under Laws 1986, chapter 394, sections 8 to
20. The commissioner shall include chemical dependency services
in the state medical assistance plan for federal reporting
purposes, but payment must be made under Laws 1986, chapter 394,
sections 8 to 20. The commissioner shall publish in the State
Register a list of elective surgeries that require a second
medical opinion before medical assistance reimbursement, and the
criteria and standards for deciding whether an elective surgery
should require a second medical opinion. The list and criteria
and standards are not subject to the requirements of sections
14.01 to 14.69.
Subd. 8y. [SECOND OPINION OR PRIOR AUTHORIZATION
REQUIRED.] The commissioner shall publish in the State Register
a list of health services that require prior authorization, as
well as the criteria and standards used to select health
services on the list. The list and the criteria and standards
used to formulate it are not subject to the requirements of
sections 14.01 to 14.69. The commissioner's decision whether
prior authorization is required for a health service or a second
medical opinion is required for an elective surgery is not
subject to administrative appeal.
Sec. 142. Minnesota Statutes 1987 Supplement, section
256B.031, subdivision 5, is amended to read:
Subd. 5. [FREE CHOICE LIMITED.] (a) The commissioner may
require recipients of aid to families with dependent children,
except those recipients who are refugees and whose health
services are reimbursed 100 percent by the federal government
for the first 31 months after entry into the United States, to
enroll in a prepaid health plan and receive services from or
through the prepaid health plan, with the following exceptions:
(1) recipients who are refugees and whose health services
are reimbursed 100 percent by the federal government for the
first 24 months after entry into the United States; and
(2) recipients who are placed in a foster home or
facility. If placement occurs before the seventh day prior to
the end of any month, the recipient will be disenrolled from the
recipient's prepaid health plan effective the first day of the
following month. If placement occurs after the seventh day
before the end of any month, that recipient will be disenrolled
from the prepaid health plan on the first day of the second
month following placement. The prepaid health plan must provide
all services set forth in subdivision 2 during the interim
period.
Enrollment in a prepaid health plan is mandatory only when
recipients have a choice of at least two prepaid health plans.
(b) Recipients who become eligible on or after December 1,
1987, must choose a health plan within 30 days of the date
eligibility is determined. At the time of application, the
local agency shall ask the recipient whether the recipient has a
primary health care provider. If the recipient has not chosen a
health plan within 30 days but has provided the local agency
with the name of a a primary health care provider, the local
agency shall determine whether the provider participates in a
prepaid health plan available to the recipient and, if so, the
local agency shall select that plan on the recipient's behalf.
If the recipient has not provided the name of a primary health
care provider who participates in an available prepaid health
plan, commissioner shall randomly assign the recipient to a
health plan.
(c) Recipients who are eligible on November 30, 1987, must
choose a prepaid health plan by January 15, 1988. If possible,
the local agency shall ask whether the recipient has a primary
health care provider and the procedures under paragraph (b)
shall apply. If a recipient does not choose a prepaid health
plan by this date, the commissioner shall randomly assign the
recipient to a health plan.
(d) Each recipient must be enrolled in the health plan for
a minimum of six months following the effective date of
enrollment, except that the recipient may change health plans
once within the first 60 days after initial enrollment. The
commissioner shall request a waiver from the federal Health Care
Financing Administration to extend the minimum period to 12
months to limit a recipient's ability to change health plans to
once every six or 12 months. If such a waiver is obtained, each
recipient must be enrolled in the health plan for a minimum of
six or 12 months. A recipient may change health plans once
within the first 60 days after initial enrollment.
(e) Women who are receiving medical assistance due to
pregnancy and later become eligible for aid to families with
dependent children are not required to choose a prepaid health
plan until 60 days postpartum. An infant born as a result of
that pregnancy must be enrolled in a prepaid health plan at the
same time as the mother.
(f) If third-party coverage is available to a recipient
through enrollment in a prepaid health plan through employment,
through coverage by the former spouse, or if a duty of support
has been imposed by law, order, decree, or judgment of a court
under section 518.551, the obligee or recipient shall
participate in the prepaid health plan in which the obligee has
enrolled provided that the commissioner has contracted with the
plan.
Sec. 143. Minnesota Statutes 1987 Supplement, section
256B.042, subdivision 2, is amended to read:
Subd. 2. [LIEN ENFORCEMENT.] The state agency may perfect
and enforce its lien by following the procedures set forth in
sections 514.69, 514.70 and 514.71, and its verified lien
statement shall be filed with the appropriate court
administrator in the county of financial responsibility. The
verified lien statement shall contain the following: the name
and address of the person to whom medical care was furnished,
the date of injury, the name and address of the vendor or
vendors furnishing medical care, the dates of the service, the
amount claimed to be due for the care, and, to the best of the
state agency's knowledge, the names and addresses of all
persons, firms, or corporations claimed to be liable for damages
arising from the injuries. This section shall not affect the
priority of any attorney's lien. The state agency is not
subject to any limitations period referred to in section 514.69
or 514.71 and has one year from the date notice is received by
it under subdivision 4, paragraph (c), or one year from the date
medical bills are first paid by the state agency, whichever is
later, to file its verified lien statement. The state agency
may commence an action to enforce the lien within one year of
(1) the date the notice required by subdivision 4, paragraph
(c), is received or (2) the date the recipient's cause of action
is concluded by judgment, award, settlement, or otherwise,
whichever is later.
Sec. 144. Minnesota Statutes 1987 Supplement, section
256B.06, subdivision 1, is amended to read:
Subdivision 1. [CHILDREN ELIGIBLE FOR SUBSIDIZED ADOPTION
ASSISTANCE.] Medical assistance may be paid for any person: (1)
who is a child eligible for or receiving adoption assistance
payments under Title IV-E of the Social Security Act, United
States Code, title 42, sections 670 to 676 under Minnesota
Statutes, section 259.40 or 259.431; or.
(2) who is Subd. 1a. [SUBSIDIZED FOSTER CHILDREN.] Medical
assistance may be paid for a child eligible for or receiving
foster care maintenance payments under Title IV-E of the Social
Security Act, United States Code, title 42, sections 670 to 676;
or.
(3) Subd. 1b. [AFDC FAMILIES.] Medical assistance may be
paid for a person who is eligible for or receiving public
assistance under the aid to families with dependent children
program,.
Subd. 1c. [RECIPIENTS OF MINNESOTA SUPPLEMENTAL
AID.] Medical assistance may be paid for a person who is
receiving public assistance under the Minnesota supplemental aid
program, except for those persons eligible for Minnesota
supplemental aid because the local agency waived excess assets
under section 256D.37, subdivision 2; or.
(4) who is Subd. 1d. [PREGNANT WOMEN; DEPENDENT UNBORN
CHILD.] Medical assistance may be paid for a pregnant woman, as
certified in writing by a physician or nurse midwife, and who
(a) meets the other eligibility criteria of this section, and
(b) who would be categorically eligible for assistance under the
aid to families with dependent children program if the child had
been born and was living with the woman. For purposes of
this section subdivision, a woman is considered pregnant for 60
days postpartum; or.
(5) who is Subd. 1e. [PREGNANT WOMEN; NEEDY UNBORN CHILD.]
Medical assistance may be paid for a pregnant woman, as
certified in writing by a physician or nurse midwife, who meets
the other eligibility criteria of this section and whose unborn
child would be eligible as a needy child under clause (8) if
born and living with the woman. For purposes of this section
subdivision, a woman is considered pregnant for 60 days
postpartum; or.
(6) Subd. 1f. [AGED, BLIND, OR DISABLED PERSONS.] Medical
assistance may be paid for a person who meets the categorical
eligibility requirements of the supplemental security income
program and the other eligibility requirements of this section;
or. The methodology for calculating disregards and deductions
from income must be as specified in section 256D.37,
subdivisions 6 to 14.
(7) Subd. 1g. [MEDICALLY NEEDY PERSONS WITH EXCESS INCOME
OR ASSETS.] Medical assistance may be paid for a person who,
except for the amount of income or assets, would qualify for
supplemental security income for the aged, blind and disabled,
or aid to families with dependent children, and who meets the
other eligibility requirements of this section. However, in the
case of families and children who meet the categorical
eligibility requirements for aid to families with dependent
children, the methodology for calculating assets shall be as
specified in section 256.73, subdivision 2, except that the
exclusion for an automobile shall be as in clause (13)(g) as
long as acceptable to the health care financing administration,
and the methodology for calculating deductions from earnings for
child care and work expenses shall be as specified in section
256.74, subdivision 1; or.
(8) Subd. 1h. [CHILDREN.] Medical assistance may be paid
for a person who is under 21 years of age and in need of medical
care that neither the person nor the person's relatives
responsible under sections 256B.01 to 256B.26 are financially
able to provide; or.
(9) who is Subd. 1i. [INFANTS.] Medical assistance may be
paid for an infant less than one year of age born on or after
October 1, 1984, whose mother was eligible at the time of birth
and who remains in the mother's household. Eligibility under
this clause subdivision is concurrent with the mother's and does
not depend on the father's income except as the income affects
the mother's eligibility; or.
(10) Subd. 1j. [ELDERLY HOSPITAL INPATIENTS.] Medical
assistance may be paid for a person who is residing in a
hospital for treatment of mental disease or tuberculosis and is
65 years of age or older and without means sufficient to pay the
per capita hospital charge; and.
(11) who resides Subd. 1k. [RESIDENCY.] To be eligible for
medical assistance, a person must reside in Minnesota, or, if
absent from the state, is be deemed to be a resident of
Minnesota in accordance with the rules of the state agency; and.
(12) who alone, Subd. 1l. [HOMESTEAD.] To be eligible for
medical assistance, a person must not own, individually or
together with the person's spouse, does not own real property
other than the homestead. For the purposes of this section,
"homestead" means the house owned and occupied by the applicant
or recipient as a primary place of residence, together with the
contiguous land upon which it is situated. The homestead shall
continue to be excluded for persons residing in a long-term care
facility if it is used as a primary residence by the spouse,
minor child, or disabled child of any age. The homestead is
also excluded for the first six calendar months of the person's
stay in the long-term care facility. The homestead must be
reduced to an amount within limits or excluded on another basis
if the person remains in the long-term care facility for a
period longer than six months. Real estate not used as a home
may not be retained unless the property is not salable, the
equity is $6,000 or less and the income produced by the property
is at least six percent of the equity, or the excess real
property is exempted for a period of nine months if there is a
good faith effort to sell the property and a legally binding
agreement is signed to repay the amount of assistance issued
during that nine months; and.
(13) who Subd. 1m. [ASSET LIMITATIONS.] To be eligible for
medical assistance, a person must not individually does not own
more than $3,000 in cash or liquid assets, or if a member of a
household with two family members (husband and wife, or parent
and child), does the household must not own more than $6,000 in
cash or liquid assets, plus $200 for each additional legal
dependent. In addition to these maximum amounts, an eligible
individual or family may accrue interest on these amounts, but
they must be reduced to the maximum at the time of an
eligibility redetermination. For residents of long-term care
facilities, the accumulation of the clothing and personal needs
allowance pursuant to section 256B.35 must also be reduced to
the maximum at the time of the eligibility redetermination.
Cash and liquid assets may include a prepaid funeral contract
and insurance policies with cash surrender value. The value of
the following shall not be included:
(a) the homestead, (b) household goods and furniture in use
in the home personal effects with a total equity value of $2,000
or less, (c) wearing apparel, (d) personal property used as a
regular abode by the applicant or recipient, (e) (d) a lot in a
burial plot for each member of the household, (f) personal
jewelry acquired more than 24 months immediately prior to the
period of medical assistance eligibility and personal jewelry
acquired within 24 months immediately prior to the period of
medical assistance eligibility and not purchased with assets of
the applicant or recipient, (g) (e) capital and operating assets
of a trade or business that the local agency determines are
necessary to the person's ability to earn an income, (h) (f) for
a period of six months, insurance settlements to repair or
replace damaged, destroyed, or stolen property, (i) (g) one
motor vehicle that is licensed pursuant to chapter 168 and
defined as: (1) passenger automobile, (2) station wagon, (3)
motorcycle, (4) motorized bicycle or (5) truck of the weight
found in categories A to E, of section 168.013, subdivision 1e,
and that is used primarily for the person's benefit, and (j) (h)
other items which may be required by federal law or statute. To
be excluded, the vehicle must have a market value of less than
$4,500; be necessary to obtain medically necessary health
services; be necessary for employment; be modified for operation
by or transportation of a handicapped person; or be necessary to
perform essential daily tasks because of climate, terrain,
distance, or similar factors. The equity value of other motor
vehicles is counted against the cash or liquid asset limit; and.
(14) who has Subd. 1n. [INCOME.] To be eligible for
medical assistance, a person must not have, or anticipates
anticipate receiving a, semiannual income not in excess of 115
percent of the income standards by family size used in the aid
to families with dependent children program, except that
families and children may have an income up to 133-1/3 percent
of the AFDC income standard. Notwithstanding any laws or rules
to the contrary, in computing income to determine eligibility of
persons who are not residents of long-term care facilities, the
commissioner shall disregard increases in income as required by
Public Law Numbers 94-566, section 503; 99-272; and 99-509; and.
(15) Subd. 1o. [EXCESS INCOME.] A person who has monthly
excess income is eligible for medical assistance if the person
has expenses for medical care that are more than the amount of
the person's excess income, computed on a monthly basis, in
which case eligibility may be established and medical assistance
payments may be made to cover the monthly unmet medical need by
deducting incurred medical expenses from the excess income to
reduce the excess to the income standard specified in clause
(14). The person shall elect to have the medical expenses
deducted monthly or at the beginning of the budget period; or
who is a pregnant woman or infant up to one year of age who
meets the requirements of clauses (1) to (8) except that her
anticipated income is in excess of the income standards by
family size used in the aid to families with dependent children
program, but is equal to or less than 133-1/3 185 percent of
that income standard the federal poverty guideline for the same
family size. Eligibility for a pregnant woman or infant up to
one year of age with respect to this clause shall be without
regard to the asset standards specified in clauses (12) and
(13). For persons who reside in licensed nursing homes,
regional treatment centers, or medical institutions, the income
over and above that required in section 256B.35 for personal
needs allowance is to be applied to the cost of institutional
care. In addition, income may be retained by an
institutionalized person (a) to support dependents in the amount
that, together with the income of the spouse and child under age
18, would provide net income equal to the medical assistance
standard for the family size of the dependents excluding the
person residing in the facility; or (b) for a period of up to
three calendar months, in an amount equal to the medical
assistance standard for a family size of one if the person was
not living together with a spouse or child under age 21 at the
time the person entered a long-term care facility, if the person
has expenses of maintaining a residence in the community, and if
a physician certifies that the person is expected to reside in
the long-term care facility on a short-term basis. For purposes
of this section, persons are determined to be residing in
licensed nursing homes, regional treatment centers, or medical
institutions if the persons are expected to remain for a period
expected to last longer than three months. The commissioner of
human services may establish a schedule of contributions to be
made by the spouse of a nursing home resident to the cost of
care; and.
(16) who Subd. 1p. [ASSIGNMENT OF BENEFITS.] has To be
eligible for medical assistance a person must have applied or
agrees must agree to apply all proceeds received or receivable
by the person or the person's spouse from any third person
liable for the costs of medical care for the person, the spouse,
and children. The state agency shall require from any applicant
or recipient of medical assistance the assignment of any rights
to medical support and third party payments. Persons must
cooperate with the state in establishing paternity and obtaining
third party payments. By signing an application for medical
assistance, a person assigns to the department of human services
all rights the person may have to medical support or payments
for medical expenses from any other person or entity on their
own or their dependent's behalf and agrees to cooperate with the
state in establishing paternity and obtaining third party
payments. Any rights or amounts so assigned shall be applied
against the cost of medical care paid for under this chapter.
Any assignment takes effect upon the determination that the
applicant is eligible for medical assistance and up to three
months prior to the date of application if the applicant is
determined eligible for and receives medical assistance
benefits. The application must contain a statement explaining
this assignment. Any assignment shall not be effective as to
benefits paid or provided under automobile accident coverage and
private health care coverage prior to notification of the
assignment by the person or organization providing the benefits;
and.
(17) Subd. 1q. [DISABLED CHILDREN.] A person is eligible
for medical assistance if the person is under age 19 and
qualifies as a disabled individual under United States Code,
title 42, section 1382c(a), and would be eligible for medical
assistance under the state plan if residing in a medical
institution, and who requires a level of care provided in a
hospital, skilled nursing facility, intermediate care facility,
or intermediate care facility for persons with mental
retardation or related conditions, for whom home care is
appropriate, provided that the cost to medical assistance for
home care services is not more than the amount that medical
assistance would pay for appropriate institutional care.
Subd. 1r. [PERIOD OF INELIGIBILITY.] Eligibility is
available for the month of application and for three months
prior to application if the person was eligible in those prior
months. A redetermination of eligibility must occur every 12
months.
Sec. 145. Minnesota Statutes 1987 Supplement, section
256B.06, subdivision 4, is amended to read:
Subd. 4. [CITIZENSHIP REQUIREMENTS.] Eligibility for
medical assistance is limited to citizens of the United States
and aliens lawfully admitted for permanent residence or
otherwise permanently residing in the United States under the
color of law. Aliens who are seeking legalization under the
Immigration Reform and Control Act of 1986, Public Law Number
99-603, who are under age 18, over age 65, blind, disabled, or
Cuban or Haitian, and who meet the eligibility requirements of
medical assistance under subdivision 1 and section 256B.17 are
eligible to receive medical assistance. Pregnant women who are
aliens seeking legalization under the Immigration Reform and
Control Act of 1986, Public Law Number 99-603, and who meet the
eligibility requirements of medical assistance under subdivision
1 are eligible for payment of care and services through the
period of pregnancy and six weeks postpartum. Payment shall
also be made for care and services that are furnished to an
alien, regardless of immigration status, who otherwise meets the
eligibility requirements of this section if such care and
services are necessary for the treatment of an emergency medical
condition. For purposes of this subdivision, the term
"emergency medical condition" means a medical condition,
including labor and delivery, that if not immediately treated
could cause a person physical or mental disability, continuation
of severe pain, or death.
Sec. 146. Minnesota Statutes 1986, section 256B.08, is
amended to read:
256B.08 [APPLICATION.]
Subdivision 1. [APPLICATION PROCESS.] An applicant for
medical assistance hereunder, or a person acting in the
applicant's behalf, shall file an application with a county
local agency in such the manner and form as shall be prescribed
by the state agency. When a married applicant resides in a
nursing home or applies for medical assistance for nursing home
services, the county local agency shall consider an application
on behalf of the applicant's spouse only upon specific request
of the applicant or upon specific request of the spouse and
separate filing of an application.
Subd. 2. [EXPEDITED REVIEW FOR PREGNANT WOMEN.] A pregnant
woman who may be eligible for assistance under section 256B.06,
subdivision 1, must receive an appointment for eligibility
determination no later than five working days from the date of
her request for assistance from the local agency. The local
agency shall expedite processing her application for assistance
and shall make a determination of eligibility on a completed
application no later than ten working days following the
applicant's initial appointment. The local agency shall assist
the applicant to provide all necessary information and
documentation in order to process the application within the
time period required under this subdivision. The state agency
shall provide for the placement of applications for medical
assistance in eligible provider offices, community health
offices, and Women, Infants and Children (WIC) program sites.
Sec. 147. Minnesota Statutes 1987 Supplement, section
256B.091, subdivision 4, is amended to read:
Subd. 4. [SCREENING OF PERSONS.] Prior to nursing home or
boarding care home admission, screening teams shall assess the
needs of all applicants, except (1) patients transferred from
other certified nursing homes or boarding care homes; (2)
patients who, having entered acute care facilities from nursing
homes or boarding care homes, are returning to a nursing home or
boarding care home; (3) persons entering a facility described in
section 256B.431, subdivision 4, paragraph (c); (4) individuals
not eligible for medical assistance whose length of stay is
expected to be 30 days or less based on a physician's
certification, if the facility notifies the screening team upon
admission and provides an update to the screening team on the
30th day after admission; (5) individuals who have a contractual
right to have their nursing home care paid for indefinitely by
the veteran's administration; or (6) persons entering a facility
conducted by and for the adherents of a recognized church or
religious denomination for the purpose of providing care and
services for those who depend upon spiritual means, through
prayer alone, for healing. The cost for screening applicants
who are receiving medical assistance must be paid by the medical
assistance program. The total screening cost for each county
for applicants who are not eligible for medical assistance and
residents of nursing homes who request a screening must be paid
monthly by nursing homes and boarding care homes participating
in the medical assistance program in the county. The monthly
amount to be paid by each nursing home and boarding care home
must be determined by dividing the county's estimate of the
total annual cost of screenings allowed by the commissioner in
the county for the following rate year by 12 to determine the
monthly cost estimate and allocating the monthly cost estimate
to each nursing home and boarding care home based on the number
of licensed beds in the nursing home or boarding care home. The
monthly cost estimate for each nursing home or boarding care
home must be submitted to the nursing home or boarding care home
and the state by the county no later than February 15 of each
year for inclusion in the nursing home's or boarding care home's
payment rate on the following rate year. The commissioner shall
include the reported annual estimated cost of screenings for
each nursing home or boarding care home as an operating cost of
that nursing home in accordance with section 256B.431,
subdivision 2b, clause (g). For all individuals regardless of
payment source, if delay-of-screening timelines are not met
because a county is late in screening an individual who meets
the delay-of-screening criteria, the county is solely
responsible for paying the cost of the preadmission screening.
Notwithstanding section 256B.0641, overpayments attributable to
payment of the screening costs under the medical assistance
program may not be recovered from a facility. Any other
interested person may be screened under this subdivision if the
person pays a fee for the screening based upon a sliding fee
scale determined by the commissioner.
Sec. 148. Minnesota Statutes 1986, section 256B.092,
subdivision 5, is amended to read:
Subd. 5. [FEDERAL WAIVERS.] The commissioner shall apply
for any federal waivers necessary to secure, to the extent
allowed by law, federal financial participation under United
States Code, title 42, sections 1396 to 1396p, as amended
through December 31, 1982 1987, for the provision of services to
persons who, in the absence of the services, would need the
level of care provided in a state hospital or a community
intermediate care facility for persons with mental retardation
or related conditions. The commissioner may seek amendments to
the waivers or apply for additional waivers under United States
Code, title 42, sections 1396 to 1396p, as amended through
December 31, 1982 1987, to contain costs. The commissioner
shall ensure that payment for the cost of providing home and
community-based alternative services under the federal waiver
plan shall not exceed the cost of intermediate care services
that would have been provided without the waivered services.
Sec. 149. Minnesota Statutes 1986, section 256B.092,
subdivision 7, is amended to read:
Subd. 7. [SCREENING TEAMS ESTABLISHED.] Each county agency
shall establish a screening team which, under the direction of
the county case manager, shall make an evaluation of need for
home and community-based services of persons who are entitled to
the level of care provided by an intermediate care facility for
persons with mental retardation or related conditions or for
whom there is a reasonable indication that they might require
the level of care provided by an intermediate care facility.
The screening team shall make an evaluation of need within 15
working days of the request for service date that the assessment
is completed or within 60 working days of a request for service
by a person with mental retardation or related conditions,
whichever is the earlier, and within five working days of an
emergency admission of an individual to an intermediate care
facility for persons with mental retardation or related
conditions. The screening team shall consist of the case
manager, the client, a parent or guardian, a qualified mental
retardation professional, as defined in the Code of Federal
Regulations, title 42, section 442.401, as amended through
December 31, 1982 1987. For individuals determined to have
overriding health care needs, a registered nurse must be
designated as either the case manager or the qualified mental
retardation professional. The case manager shall consult with
the client's physician, other health professionals or other
persons as necessary to make this evaluation. The case manager,
with the concurrence of the client or the client's legal
representative, may invite other persons to attend meetings of
the screening team. No member of the screening team shall have
any direct or indirect service provider interest in the case.
Sec. 150. Minnesota Statutes 1986, section 256B.14,
subdivision 2, is amended to read:
Subd. 2. [ACTIONS TO OBTAIN PAYMENT.] The state agency
shall promulgate rules to determine the ability of responsible
relatives to contribute partial or complete repayment of medical
assistance furnished to recipients for whom they are
responsible. In determining the No resource contribution is
required of a spouse at the time of the first approved medical
assistance application, all medical assistance exclusions shall
be allowed, and a resource limit of $10,000 for nonexcluded
resources shall be implemented. Above these limits, a
contribution of one-third of the excess resources shall be
required. These rules shall not require repayment when payment
would cause undue hardship to the responsible relative or that
relative's immediate family. These rules shall be consistent
with the requirements of section 252.27, subdivision 2, for
parents of children whose eligibility for medical assistance was
determined without deeming of the parents' resources and
income. For parents of children receiving services under a
federal medical assistance waiver or under section 134 of the
Tax Equity and Fiscal Responsibility Act of 1982, United States
Code, title 42, section 1396a(e)(3), while living in their
natural home, including in-home family support services, respite
care, homemaker services, and minor adaptations to the home, the
state agency shall take into account the room, board, and
services provided by the parents in determining the parental
contribution to the cost of care. The county agency shall give
the responsible relative notice of the amount of the repayment.
If the state agency or county agency finds that notice of the
payment obligation was given to the responsible relative, but
that the relative failed or refused to pay, a cause of action
exists against the responsible relative for that portion of
medical assistance granted after notice was given to the
responsible relative, which the relative was determined to be
able to pay.
The action may be brought by the state agency or the county
agency in the county where assistance was granted, for the
assistance, together with the costs of disbursements incurred
due to the action.
In addition to granting the county or state agency a money
judgment, the court may, upon a motion or order to show cause,
order continuing contributions by a responsible relative found
able to repay the county or state agency. The order shall be
effective only for the period of time during which the recipient
receives medical assistance from the county or state agency.
Sec. 151. Minnesota Statutes 1986, section 256B.17,
subdivision 7, is amended to read:
Subd. 7. [EXCEPTION FOR ASSET TRANSFERS.] Notwithstanding
the provisions of subdivisions 1 to 6, an institutionalized
spouse who applies for medical assistance on or after July 1,
1983, may transfer liquid assets to a noninstitutionalized
spouse without loss of eligibility if all of the following
conditions apply:
(a) The noninstitutionalized spouse is not applying for or
receiving assistance;
(b) Either (1) the noninstitutionalized spouse has less
than $10,000 in liquid assets, including assets singly owned and
50 percent of assets owned jointly with the institutionalized
spouse; or (2) the noninstitutionalized spouse has less than 50
percent of the total value of nonexempt assets owned by both
parties, jointly or individually;
(c) The amount transferred, together with the
noninstitutionalized spouse's own assets, totals no more
than one-half of the total value of the liquid assets of the
parties or $10,000 in liquid assets, whichever is greater; and
(d) The transfer may be effected only once, at the time of
initial medical assistance application.
Sec. 152. [256B.31] [CONTINUED HOSPITAL CARE FOR LONG-TERM
POLIO PATIENT.]
A medical assistance recipient who has been a polio patient
in an acute care hospital for a period of not less than 25
consecutive years is eligible to continue receiving hospital
care, whether or not the care is medically necessary for
purposes of federal reimbursement. The cost of continued
hospital care not reimbursable by the federal government must be
paid with state money allocated for the medical assistance
program. The rate paid to the hospital is the rate per day
established using Medicare principles for the hospital's fiscal
year ending December 31, 1981, adjusted each year by the annual
hospital cost index established under section 256.969,
subdivision 1, or by other limits in effect at the time of the
adjustment. This section does not prohibit a voluntary move to
another living arrangement by a recipient whose care is
reimbursed under this section.
Sec. 153. Minnesota Statutes 1987 Supplement, section
256B.35, subdivision 1, is amended to read:
Subdivision 1. [PERSONAL NEEDS ALLOWANCE.] (a)
Notwithstanding any law to the contrary, welfare allowances for
clothing and personal needs for individuals receiving medical
assistance while residing in any skilled nursing home,
intermediate care facility, or medical institution including
recipients of supplemental security income, in this state shall
not be less than $40 $45 per month from all sources. When
benefit amounts for social security or supplemental security
income recipients are increased pursuant to United States Code,
title 42, sections 415(i) and 1382f, the commissioner shall,
effective in the month in which the increase takes effect,
increase by the same percentage to the nearest whole dollar the
clothing and personal needs allowance for individuals receiving
medical assistance while residing in any skilled nursing home,
medical institution, or intermediate care facility. The
commissioner shall provide timely notice to local agencies,
providers, and recipients of increases under this provision.
Provided that this (b) The personal needs allowance may be
paid as part of the Minnesota supplemental aid program,
notwithstanding the provisions of section 256D.37, subdivision
2, and payments to the recipients from of Minnesota supplemental
aid funds may be made once each three months beginning in
October 1977, covering liabilities that accrued during the
preceding three months.
Sec. 154. Minnesota Statutes 1987 Supplement, section
256B.431, subdivision 2b, is amended to read:
Subd. 2b. [OPERATING COSTS, AFTER JULY 1, 1985.] (a) For
rate years beginning on or after July 1, 1985, the commissioner
shall establish procedures for determining per diem
reimbursement for operating costs.
(b) The commissioner shall contract with an econometric
firm with recognized expertise in and access to national
economic change indices that can be applied to the appropriate
cost categories when determining the operating cost payment rate.
(c) The commissioner shall analyze and evaluate each
nursing home's cost report of allowable operating costs incurred
by the nursing home during the reporting year immediately
preceding the rate year for which the payment rate becomes
effective.
(d) The commissioner shall establish limits on actual
allowable historical operating cost per diems based on cost
reports of allowable operating costs for the reporting year that
begins October 1, 1983, taking into consideration relevant
factors including resident needs, geographic location, size of
the nursing home, and the costs that must be incurred for the
care of residents in an efficiently and economically operated
nursing home. In developing the geographic groups for purposes
of reimbursement under this section, the commissioner shall
ensure that nursing homes in any county contiguous to the
Minneapolis-St. Paul seven-county metropolitan area are included
in the same geographic group. The limits established by the
commissioner shall not be less, in the aggregate, than the 60th
percentile of total actual allowable historical operating cost
per diems for each group of nursing homes established under
subdivision 1 based on cost reports of allowable operating costs
in the previous reporting year. For rate years beginning on or
after July 1, 1987, or until the new base period is established,
facilities located in geographic group I as described in
Minnesota Rules, part 9549.0052 (Emergency), on January 1, 1987,
may choose to have the commissioner apply either the care
related limits or the other operating cost limits calculated for
facilities located in geographic group II, or both, if either of
the limits calculated for the group II facilities is higher.
The efficiency incentive for geographic group I nursing homes
must be calculated based on geographic group I limits. The
phase-in must be established utilizing the chosen limits. For
purposes of these exceptions to the geographic grouping
requirements, the definitions in Minnesota Rules, parts
9549.0050 to 9549.0059 (Emergency), and 9549.0010 to 9549.0080,
apply. The limits established under this paragraph remain in
effect until the commissioner establishes a new base period.
Until the new base period is established, the commissioner shall
adjust the limits annually using the appropriate economic change
indices established in paragraph (e). In determining allowable
historical operating cost per diems for purposes of setting
limits and nursing home payment rates, the commissioner shall
divide the allowable historical operating costs by the actual
number of resident days, except that where a nursing home is
occupied at less than 90 percent of licensed capacity days, the
commissioner may establish procedures to adjust the computation
of the per diem to an imputed occupancy level at or below 90
percent. The commissioner shall establish efficiency incentives
as appropriate. The commissioner may establish efficiency
incentives for different operating cost categories. The
commissioner shall consider establishing efficiency incentives
in care related cost categories. The commissioner may combine
one or more operating cost categories and may use different
methods for calculating payment rates for each operating cost
category or combination of operating cost categories. For the
rate year beginning on July 1, 1985, the commissioner shall:
(1) allow nursing homes that have an average length of stay
of 180 days or less in their skilled nursing level of care, 125
percent of the care related limit and 105 percent of the other
operating cost limit established by rule; and
(2) exempt nursing homes licensed on July 1, 1983, by the
commissioner to provide residential services for the physically
handicapped under Minnesota Rules, parts 9570.2000 to 9570.3600,
from the care related limits and allow 105 percent of the other
operating cost limit established by rule.
For the purpose of calculating the other operating cost
efficiency incentive for nursing homes referred to in clause (1)
or (2), the commissioner shall use the other operating cost
limit established by rule before application of the 105 percent.
(e) The commissioner shall establish a composite index or
indices by determining the appropriate economic change
indicators to be applied to specific operating cost categories
or combination of operating cost categories.
(f) Each nursing home shall receive an operating cost
payment rate equal to the sum of the nursing home's operating
cost payment rates for each operating cost category. The
operating cost payment rate for an operating cost category shall
be the lesser of the nursing home's historical operating cost in
the category increased by the appropriate index established in
paragraph (e) for the operating cost category plus an efficiency
incentive established pursuant to paragraph (d) or the limit for
the operating cost category increased by the same index. If a
nursing home's actual historic operating costs are greater than
the prospective payment rate for that rate year, there shall be
no retroactive cost settle-up. In establishing payment rates
for one or more operating cost categories, the commissioner may
establish separate rates for different classes of residents
based on their relative care needs.
(g) The commissioner shall include the reported actual real
estate tax liability or payments in lieu of real estate tax of
each nursing home as an operating cost of that nursing
home. Except as provided in Minnesota Rules, parts 9549.0010 to
9549.0080, the commissioner shall allow an amount for payments
in lieu of real estate tax assessed by a municipality, city,
township, or county that does not exceed an amount equivalent to
a similar assessment for fire, police, or sanitation services
assessed to all other nonprofit or governmental entities located
in the municipality, city, township, or county in which a
nursing home to be assessed is located. For rate years
beginning on or after July 1, 1987, the reported actual real
estate tax liability or payments in lieu of real estate tax of
nursing homes shall be adjusted to include an amount equal to
one-half of the dollar change in real estate taxes from the
prior year. The commissioner shall include a reported actual
special assessment, and reported actual license fees required by
the Minnesota department of health, for each nursing home as an
operating cost of that nursing home. Total adjusted real estate
tax liability, payments in lieu of real estate tax, actual
special assessments paid, and license fees paid as required by
the Minnesota department of health, for each nursing home (1)
shall be divided by actual resident days in order to compute the
operating cost payment rate for this operating cost category,
(2) shall not be used to compute the 60th percentile or other
operating cost limits established by the commissioner, and (3)
shall not be increased by the composite index or indices
established pursuant to paragraph (e).
(h) For rate years beginning on or after July 1, 1987, the
commissioner shall adjust the rates of a nursing home that meets
the criteria for the special dietary needs of its residents as
specified in section 144A.071, subdivision 3, clause (c), and
the requirements in section 31.651. The adjustment for raw food
cost shall be the difference between the nursing home's
allowable historical raw food cost per diem and 115 percent of
the median historical allowable raw food cost per diem of the
corresponding geographic group.
The rate adjustment shall be reduced by the applicable
phase-in percentage as provided under subdivision 2h.
Sec. 155. Minnesota Statutes 1986, section 256B.431, is
amended by adding a subdivision to read:
Subd. 2i. [OPERATING COSTS AFTER JULY 1, 1988.] (a)
[OTHER-OPERATING-COST LIMITS.] For the rate year beginning July
1, 1988, the commissioner shall increase the
other-operating-cost limits established in Minnesota Rules, part
9549.0055, subpart 2, item E, to 110 percent of the median of
the array of allowable historical other-operating-cost per diems
and index these limits as in Minnesota Rules, part 9549.0056,
subparts 3 and 4. The limits must be established in accordance
with subdivision 2b, paragraph (d). For rate years beginning on
or after July 1, 1989, the adjusted other-operating-cost limits
must be indexed as in Minnesota Rules, part 9549.0056, subparts
3 and 4.
(b) [CARE-RELATED OPERATING COST LIMITS.] For the rate year
beginning July 1, 1988, the commissioner shall increase the
care-related operating cost limits established in Minnesota
Rules, part 9549.0055, subpart 2, items A and B, to 125 percent
of the median of the array of the allowable historical case mix
operating cost standardized per diems and the allowable
historical other-care-related operating cost per diems and index
those limits as in Minnesota Rules, part 9549.0056, subparts 1
and 2. The limits must be established in accordance with
subdivision 2b, paragraph (d). For rate years beginning on or
after July 1, 1989, the adjusted care-related limits must be
indexed as in Minnesota Rules, part 9549.0056, subparts 1 and 2.
(c) [SALARY ADJUSTMENT PER DIEM.] For the rate period
October 1, 1988, through June 30, 1990, the commissioner shall
add the appropriate salary adjustment per diem calculated in
clause (1) or (2) to the total operating cost payment rate of
each nursing home. The salary adjustment per diem for each
nursing home must be determined as follows:
(1) for each nursing home that reports salaries for
registered nurses, licensed practical nurses, and aides,
orderlies and attendants separately, the commissioner shall
determine the salary adjustment per diem by multiplying the
total salaries, payroll taxes, and fringe benefits allowed in
each operating cost category, except management fees and
administrator and central office salaries and the related
payroll taxes and fringe benefits, by 3.5 percent and then
dividing the resulting amount by the nursing home's actual
resident days; and
(2) for each nursing home that does not report salaries for
registered nurses, licensed practical nurses, aides, orderlies,
and attendants separately, the salary adjustment per diem is the
weighted average salary adjustment per diem increase determined
under clause (1).
Each nursing home that receives a salary adjustment per
diem pursuant to this subdivision shall adjust nursing home
employee salaries by a minimum of the amount determined in
clause (1) or (2). The commissioner shall review allowable
salary costs, including payroll taxes and fringe benefits, for
the reporting year ending September 30, 1989, to determine
whether or not each nursing home complied with this
requirement. The commissioner shall report the extent to which
each nursing home complied with the legislative commission on
long-term care by August 1, 1990.
(d) [PENSION CONTRIBUTIONS.] For rate years beginning on or
after July 1, 1989, the commissioner shall exempt allowable
employee pension contributions separately reported by a nursing
home on its annual cost report from the care-related operating
cost limits and the other-operating-cost limits.
Hospital-attached homes that provide allowable employee pension
contributions may report the costs that are allocated to nursing
home operations independently for verification by the
commissioner. For rate years beginning on or after July 1,
1989, amounts verified as allowable employee pension
contributions are exempt from care-related operating cost limits
and other-operating-cost limits. For purposes of this
paragraph, "employee pension contributions" means contributions
required under the Public Employee Retirement Act and
contributions to other employee pension plans if the pension
plan existed on March 1, 1988.
(e) [NEW BASE YEAR.] The commissioner shall establish the
reporting year ending September 30, 1989, as a new base year.
Sec. 156. Minnesota Statutes 1987 Supplement, section
256B.431, subdivision 3, is amended to read:
Subd. 3. [PROPERTY-RELATED COSTS, 1983-1985.] (a) For rate
years beginning July 1, 1983 and July 1, 1984, property-related
costs shall be reimbursed to each nursing home at the level
recognized in the most recent cost report received by December
31, 1982 and audited by March 1, 1983, and may be subsequently
adjusted to reflect the costs recognized in the final rate for
that cost report, adjusted for rate limitations in effect before
the effective date of this section. Effective for rate years
beginning on or after July 1, 1988, a rate limitation ratio that
is based on historical limitations resulting from the
application of the regional maximum rate, private-pay rate, or
ten percent cap on rate increases, must not be less than .90.
Property-related costs include: depreciation, interest,
earnings or investment allowance, lease, or rental payments. No
adjustments shall be made as a result of sales or
reorganizations of provider entities.
(b) Adjustments for the cost of repairs, replacements,
renewals, betterments, or improvements to existing buildings,
and building service equipment shall be allowed if:
(1) the cost incurred is reasonable, necessary, and
ordinary;
(2) the net cost is greater than $5,000. "Net cost" means
the actual cost, minus proceeds from insurance, salvage, or
disposal;
(3) the nursing home's property-related costs per diem is
equal to or less than the average property-related costs per
diem within its group; and
(4) the adjustment is shown in depreciation schedules
submitted to and approved by the commissioner.
(c) Annual per diem shall be computed by dividing total
property-related costs by 96 percent of the nursing home's
licensed capacity days for nursing homes with more than 60 beds
and 94 percent of the nursing home's licensed capacity days for
nursing homes with 60 or fewer beds. For a nursing home whose
residents' average length of stay is 180 days or less, the
commissioner may waive the 96 or 94 percent factor and divide
the nursing home's property-related costs by the actual resident
days to compute the nursing home's annual property-related per
diem. The commissioner shall promulgate emergency and permanent
rules to recapture excess depreciation upon sale of a nursing
home.
Sec. 157. Minnesota Statutes 1986, section 256B.431, is
amended by adding a subdivision to read:
Subd. 3d. [BETTERMENTS AND ADDITIONS.] Notwithstanding any
contrary provision of chapter 256B, or a rule adopted under
chapter 256B, a nursing home that commenced construction on a
betterment and addition costing $700,000 or more prior to the
expiration of Minnesota Rules, 12 MCAR 2.05001 to 2.05016
(Temporary)(1983) shall have its property-related payment rate
step-up as a result of the betterment and addition calculated as
set forth in 12 MCAR 2.05011.B.3 in the case of betterments, and
12 MCAR 2.05011.D in the case of additions. For purposes of
this subdivision, the terms "betterment" and "addition" have the
meaning set forth in 12 MCAR 2.05002 and the term "commenced
construction" has the meaning set forth in section 144A.071,
subdivision 3.
Sec. 158. Minnesota Statutes 1986, section 256B.431, is
amended by adding a subdivision to read:
Subd. 3e. [HOSPITAL ATTACHED CONVALESCENT AND NURSING CARE
FACILITIES.] If a community-operated hospital and attached
convalescent and nursing care facility suspend operation of the
hospital, the surviving nursing care facility must be allowed to
continue its status as a hospital-attached convalescent and
nursing care facility for reimbursement purposes in three
subsequent rate years.
Sec. 159. Minnesota Statutes 1986, section 256B.431, is
amended by adding a subdivision to read:
Subd. 3f. [PROPERTY COSTS AFTER JULY 1, 1988.] (a)
[INVESTMENT PER BED LIMIT.] For the rate year beginning July 1,
1988, the replacement-cost-new per bed limit must be $32,571 per
licensed bed in multiple bedrooms and $48,857 per licensed bed
in a single bedroom. Beginning January 1, 1989, the
replacement-cost-new per bed limits must be adjusted annually as
specified in Minnesota Rules, part 9549.0060, subpart 4, item A,
subitem (1).
(b) [RENTAL FACTOR.] For the rate year beginning July 1,
1988, the commissioner shall increase the rental factor as
established in Minnesota Rules, part 9549.0060, subpart 8, item
A, by 6.2 percent rounded to the nearest 100th percent for the
purpose of reimbursing nursing homes for soft costs and
entrepreneurial profits not included in the cost valuation
services used by the state's contracted appraisers. For rate
years beginning on or after July 1, 1989, the rental factor is
the amount determined under this paragraph for the rate year
beginning July 1, 1988.
(c) [OCCUPANCY FACTOR.] For rate years beginning on or
after July 1, 1988, in order to determine property-related
payment rates under Minnesota Rules, part 9549.0060, for all
nursing homes except those whose average length of stay in a
skilled level of care within a nursing home is 180 days or less,
the commissioner shall use 95 percent of capacity days. For a
nursing home whose average length of stay in a skilled level of
care within a nursing home is 180 days or less, the commissioner
shall use the greater of resident days or 80 percent of capacity
days but in no event shall the divisor exceed 95 percent of
capacity days.
(d) [EQUIPMENT ALLOWANCE.] For rate years beginning on July
1, 1988, and July 1, 1989, the commissioner shall add ten cents
per resident per day to each nursing home's property-related
payment rate. The ten-cent property-related payment rate
increase is not cumulative from rate year to rate year. For the
rate year beginning July 1, 1990, the commissioner shall
increase each nursing home's equipment allowance as established
in Minnesota Rules, part 9549.0060, subpart 10, by ten cents per
resident per day. For rate years beginning on or after July 1,
1991, the adjusted equipment allowance must be adjusted annually
for inflation as in Minnesota Rules, part 9549.0060, subpart 10,
item E.
(e) [REFINANCING.] If a nursing home is refinanced, the
commissioner shall adjust the nursing home's property-related
payment rate for the savings that result from refinancing. The
adjustment to the property-related payment rate must be as
follows:
(1) The commissioner shall recalculate the nursing home's
rental per diem by substituting the new allowable annual
principle and interest payments for those of the refinanced debt.
(2) The nursing home's property-related payment rate must
be decreased by the difference between the nursing home's
current rental per diem and the rental per diem determined under
clause (1).
If a nursing home payment rate is adjusted according to
this paragraph, the adjusted payment rate is effective the first
of the month following the date of the refinancing for both
medical assistance and private paying residents. The nursing
home's adjusted property-related payment rate is effective until
June 30, 1990.
Sec. 160. Minnesota Statutes 1986, section 256B.431, is
amended by adding a subdivision to read:
Subd. 3g. [PROPERTY COSTS AFTER JULY 1, 1990, FOR CERTAIN
FACILITIES.] For rate years beginning on or after July 1, 1990,
non-hospital-attached nursing homes that, on or after January 1,
1976, but prior to December 31, 1985, were newly licensed after
new construction, or increased their licensed beds by a minimum
of 35 percent through new construction, and whose building
capital allowance is less than their allowable annual principal
and interest on allowable debt prior to the application of the
replacement-cost-new per bed limit and whose remaining weighted
average debt amortization schedule as of January 1, 1988,
exceeded 15 years, must receive a property-related payment rate
equal to the greater of their rental per diem or their annual
allowable principal and allowable interest without application
of the replacement-cost-new per bed limit plus their equipment
allowance. A nursing home that is eligible for a
property-related payment rate under this subdivision and whose
property-related payment rate in a subsequent rate year is its
rental per diem must continue to have its property-related
payment rates established for all future rate years based on the
rental reimbursement method in Minnesota Rules, part 9549.0060.
The commissioner may require the nursing home to apply for
refinancing as a condition of receiving special rate treatment
under this subdivision.
Sec. 161. Minnesota Statutes 1987 Supplement, section
256B.431, subdivision 4, is amended to read:
Subd. 4. [SPECIAL RATES.] (a) For the rate years beginning
July 1, 1983, and July 1, 1984, a newly constructed nursing home
or one with a capacity increase of 50 percent or more may, upon
written application to the commissioner, receive an interim
payment rate for reimbursement for property-related costs
calculated pursuant to the statutes and rules in effect on May
1, 1983, and for operating costs negotiated by the commissioner
based upon the 60th percentile established for the appropriate
group under subdivision 2a, to be effective from the first day a
medical assistance recipient resides in the home or for the
added beds. For newly constructed nursing homes which are not
included in the calculation of the 60th percentile for any
group, subdivision 2f, the commissioner shall establish by rule
procedures for determining interim operating cost payment rates
and interim property-related cost payment rates. The interim
payment rate shall not be in effect for more than 17 months.
The commissioner shall establish, by emergency and permanent
rules, procedures for determining the interim rate and for
making a retroactive cost settle-up after the first year of
operation; the cost settled operating cost per diem shall not
exceed 110 percent of the 60th percentile established for the
appropriate group. Until procedures determining operating cost
payment rates according to mix of resident needs are
established, the commissioner shall establish by rule procedures
for determining payment rates for nursing homes which provide
care under a lesser care level than the level for which the
nursing home is certified.
(b) For the rate years beginning on or after July 1, 1985,
a newly constructed nursing home or one with a capacity increase
of 50 percent or more may, upon written application to the
commissioner, receive an interim payment rate for reimbursement
for property related costs, operating costs, and real estate
taxes and special assessments calculated under rules promulgated
by the commissioner.
(c) For rate years beginning on or after July 1, 1983, the
commissioner may exclude from a provision of 12 MCAR S 2.050 any
facility that is licensed by the commissioner of health only as
a boarding care home, certified by the commissioner of health as
an intermediate care facility, is licensed by the commissioner
of human services under Minnesota Rules, parts 9520.0500 to
9520.0690, and has less than five percent of its licensed
boarding care capacity reimbursed by the medical assistance
program. Until a permanent rule to establish the payment rates
for facilities meeting these criteria is promulgated, the
commissioner shall establish the medical assistance payment rate
as follows:
(1) The desk audited payment rate in effect on June 30,
1983, remains in effect until the end of the facility's fiscal
year. The commissioner shall not allow any amendments to the
cost report on which this desk audited payment rate is based.
(2) For each fiscal year beginning between July 1, 1983,
and June 30, 1985, the facility's payment rate shall be
established by increasing the desk audited operating cost
payment rate determined in clause (1) at an annual rate of five
percent.
(3) For fiscal years beginning on or after July 1, 1985,
but before January 1, 1988, the facility's payment rate shall be
established by increasing the facility's payment rate in the
facility's prior fiscal year by the increase indicated by the
consumer price index for Minneapolis and St. Paul.
(4) For the fiscal year beginning on January 1, 1988, the
facility's payment rate must be established using the following
method: The commissioner shall divide the real estate taxes and
special assessments payable as stated in the facility's current
property tax statement by actual resident days to compute a real
estate tax and special assessment per diem. Next, the prior
year's payment rate must be adjusted by the higher of (1) the
percentage change in the consumer price index (CPI-U U.S. city
average) as published by the Bureau of Labor Statistics between
the previous two Septembers, new series index (1967-100), or (2)
2.5 percent, to determine an adjusted payment rate. The
facility's payment rate is the adjusted prior year's payment
rate plus the real estate tax and special assessment per diem.
(5) For fiscal years beginning on or after January 1, 1989,
the facility's payment rate must be established using the
following method: The commissioner shall divide the real estate
taxes and special assessments payable as stated in the
facility's current property tax statement by actual resident
days to compute a real estate tax and special assessment per
diem. Next, the prior year's payment rate less the real estate
tax and special assessment per diem must be adjusted by the
higher of (1) the percentage change in the consumer price index
(CPI-U U.S. city average) as published by the Bureau of Labor
Statistics between the previous two Septembers, new series index
(1967-100), or (2) 2.5 percent, to determine an adjusted payment
rate. The facility's payment rate is the adjusted payment rate
plus the real estate tax and special assessment per diem.
(6) For the purpose of establishing payment rates under
this paragraph, the facility's rate and reporting years coincide
with the facility's fiscal year.
A facility that meets the criteria of this paragraph shall
submit annual cost reports on forms prescribed by the
commissioner.
For the rate year beginning July 1, 1985, each nursing home
total payment rate must be effective two calendar months from
the first day of the month after the commissioner issues the
rate notice to the nursing home. From July 1, 1985, until the
total payment rate becomes effective, the commissioner shall
make payments to each nursing home at a temporary rate that is
the prior rate year's operating cost payment rate increased by
2.6 percent plus the prior rate year's property-related payment
rate and the prior rate year's real estate taxes and special
assessments payment rate. The commissioner shall retroactively
adjust the property-related payment rate and the real estate
taxes and special assessments payment rate to July 1, 1985, but
must not retroactively adjust the operating cost payment rate.
(d) For the purposes of Minnesota Rules, part 9549.0060,
subpart 13, item F, the following types of transactions shall
not be considered a sale or reorganization of a provider entity:
(1) the sale or transfer of a nursing home upon death of an
owner;
(2) the sale or transfer of a nursing home due to serious
illness or disability of an owner as defined under the social
security act;
(3) the sale or transfer of the nursing home upon
retirement of an owner at 62 years of age or older;
(4) any transaction in which a partner, owner, or
shareholder acquires an interest or share of another partner,
owner, or shareholder in a nursing home business provided the
acquiring partner, owner, or shareholder has less than 50
percent ownership after the acquisition;
(5) a sale and leaseback to the same licensee which does
not constitute a change in facility license;
(6) a transfer of an interest to a trust;
(7) gifts or other transfers for no consideration;
(8) a merger of two or more related organizations;
(9) a transfer of interest in a facility held in
receivership;
(10) a change in the legal form of doing business other
than a publicly held organization which becomes privately held
or vice versa;
(11) the addition of a new partner, owner, or shareholder
who owns less than 20 percent of the nursing home or the
issuance of stock; or
(12) an involuntary transfer including foreclosure,
bankruptcy, or assignment for the benefit of creditors.
Any increase in allowable debt or allowable interest
expense or other cost incurred as a result of the foregoing
transactions shall be a nonallowable cost for purposes of
reimbursement under Minnesota Rules, parts 9549.0010 to
9549.0080.
(e) For rate years beginning on or after July 1, 1986, the
commissioner may exclude from a provision of Minnesota Rules,
parts 9549.0010 to 9549.0080, any facility that is certified by
the commissioner of health as an intermediate care facility,
licensed by the commissioner of human services as a chemical
dependency treatment program, and enrolled in the medical
assistance program as an institution for mental disease. The
commissioner of human services shall establish a medical
assistance payment rate for these facilities. Chapter 14 does
not apply to the procedures and criteria used to establish the
ratesetting structure. The ratesetting method is not appealable.
Sec. 162. Minnesota Statutes 1987 Supplement, section
256B.433, subdivision 1, is amended to read:
Subdivision 1. [SETTING PAYMENT; MONITORING USE OF THERAPY
SERVICES.] The commissioner shall promulgate rules pursuant to
the administrative procedure act to set the amount and method of
payment for ancillary materials and services provided to
recipients residing in nursing homes. Payment for materials and
services may be made to either the nursing home in the operating
cost per diem, to the vendor of ancillary services pursuant to
Minnesota Rules, parts 9500.0750 to 9500.1080 or to a nursing
home pursuant to Minnesota Rules, parts 9500.0750 to 9500.1080.
Payment for the same or similar service to a recipient shall not
be made to both the nursing home and the vendor. The
commissioner shall ensure the avoidance of double payments
through audits and adjustments to the nursing home's annual cost
report as required by section 256B.47, and that charges and
arrangements for ancillary materials and services are cost
effective and as would be incurred by a prudent and
cost-conscious buyer. Therapy services provided to a recipient
must be medically necessary and appropriate to the medical
condition of the recipient. If the vendor, nursing home, or
ordering physician cannot provide adequate medical necessity
justification, as determined by the commissioner, in
consultation with an advisory committee that meets the
requirements of section 256B.064, subdivision 1a, the
commissioner may recover or disallow the payment for the
services and may require prior authorization for therapy
services as a condition of payment or may impose administrative
sanctions to limit the vendor, nursing home, or ordering
physician's participation in the medical assistance program. If
the provider number of a nursing home is used to bill services
provided by a vendor of therapy services that is not related to
the nursing home by ownership, control, affiliation or
employment status, no withholding of payment shall be imposed
against the nursing home for services not medically necessary
except for funds due the unrelated vendor of therapy services as
provided in subdivision 3, paragraph (c). For the purpose of
this subdivision, no monetary recovery may be imposed against
the nursing home for funds paid to the unrelated vendor of
therapy services as provided in subdivision 3, paragraph (c),
for services not medically necessary.
Sec. 163. Minnesota Statutes 1986, section 256B.50,
subdivision 1, is amended to read:
Subdivision 1. [SCOPE.] A nursing home provider may appeal
from a decision arising from the application of standards or
methods determination of a payment rate established pursuant
to sections 256B.41 and 256B.47 this chapter and reimbursement
rules of the commissioner if the appeal, if successful, would
result in a change to the nursing home's provider's payment
rate, or appraised value. The appeal procedures also apply to
appeals of payment rates calculated under Minnesota Rules, parts
9510.0010 to 9510.0480 filed with the commissioner on or after
May 1, 1984. Appeals must be filed in accordance with
procedures in this section. This section does not apply to a
request from a resident or nursing home for reconsideration of
the classification of a resident under section 144.0722.
Subd. 1a. [DEFINITIONS.] For the purposes of this section,
the following terms have the meanings given.
(a) "Determination of a payment rate" means the process by
which the commissioner establishes the payment rate paid to a
provider pursuant to this chapter, including determinations made
in desk audit, field audit, or pursuant to an amendment filed by
the provider.
(b) "Provider" means a nursing home as defined in section
256B.421, subdivision 7, or a facility as defined in section
256B.501, subdivision 1.
(c) "Reimbursement rules" means Minnesota Rules, parts
9510.0010 to 9510.0480, 9510.0500 to 9510.0890, and rules
adopted by the commissioner pursuant to sections 256B.41 and
256B.501, subdivision 3.
Subd. 1b. [FILING AN APPEAL.] To appeal, the nursing home
provider shall notify file with the commissioner in writing of
its intent to appeal within 30 days and submit a written notice
of appeal; the appeal request must be received by the
commissioner within 60 days of receiving notice of the date
the payment rate determination or decision of the payment rate
was mailed. The notice of appeal request shall must specify
each disputed item,; the reason for the dispute, an estimate of;
the total dollar amount involved for each disputed item, and the
dollar amount per bed in dispute for each separate disallowance,
allocation, or adjustment of each cost item or part of a cost
item; the computation that the nursing home provider believes is
correct,; the authority in statute or rule upon which the
nursing home provider relies for each disputed item,; the name
and address of the person or firm with whom contacts may be made
regarding the appeal,; and other information required by the
commissioner.
Subd. 1c. [CONTESTED CASE PROCEDURES.] Except as provided
in subdivision 2, the appeal shall must be heard by an
administrative law judge according to sections 14.48 to 14.56,
or upon agreement by both parties according to a modified
appeals procedure established by the commissioner and the
administrative law judge. In any proceeding under this section,
the appealing party must demonstrate by a preponderance of the
evidence that the commissioner's determination is incorrect.
Regardless of any rate appeal, the rate established shall must
be the rate paid and shall must remain in effect until final
resolution of the appeal or subsequent desk or field audit
adjustment, notwithstanding any provision of law or rule to the
contrary. To challenge the validity of rules established by the
commissioner pursuant to this section and sections 256B.41,
256B.421, 256B.431, 256B.47, 256B.48, 256B.501, and 256B.502, a
nursing home provider shall comply with section 14.44.
Sec. 164. Minnesota Statutes 1986, section 256B.50, is
amended by adding a subdivision to read:
Subd. 1d. [EXPEDITED APPEAL REVIEW PROCESS.] (a) Within
120 days of the date an appeal is due according to subdivision
1b, the department shall review an appealed adjustment equal to
or less than $100 annually per licensed bed of the provider,
make a determination concerning the adjustment, and notify the
provider of the determination. Except as allowed in paragraph
(g), this review does not apply to an appeal of an adjustment
made to, or proposed on, an amount already paid to the
provider. In this subdivision, an adjustment is each separate
disallowance, allocation, or adjustment of a cost item or part
of a cost item as submitted by a provider according to forms
required by the commissioner.
(b) For an item on which the provider disagrees with the
results of the determination of the department made under
paragraph (a), the provider may, within 60 days of the date of
the review notice, file with the office of administrative
hearings and the department its written argument and documents,
information, or affidavits in support of its appeal. If the
provider fails to make a submission in accordance with this
paragraph, the department's determinations on the disputed items
must be upheld.
(c) Within 60 days of the date the department received the
provider's submission under paragraph (b), the department may
file with the office of administrative hearings and serve upon
the provider its written argument and documents, information,
and affidavits in support of its determination. If the
department fails to make a submission in accordance with this
paragraph, the administrative law judge shall proceed pursuant
to paragraph (d) based on the provider's submission.
(d) Upon receipt by the office of administrative hearings
of the department's submission made under paragraph (c) or upon
the expiration of the 60-day filing period, whichever is
earlier, the chief administrative law judge shall assign the
matter to an administrative law judge. The administrative law
judge shall consider the submissions of the parties and all
relevant rules, statutes, and case law. The administrative law
judge may request additional argument from the parties if it is
deemed necessary to reach a final decision, but shall not allow
witnesses to be presented or discovery to be made in the
proceeding. Within 60 days of receipt by the office of
administrative hearings of the department's submission or the
expiration of the 60-day filing period in paragraph (c),
whichever is earlier, the administrative law judge shall make a
final decision on the items in issue, and shall notify the
provider and the department by first-class mail of the decision
on each item. The decision of the administrative law judge is
the final administrative decision, is not appealable, and does
not create legal precedent, except that the department may make
an adjustment contrary to the decision of the administrative law
judge based upon a subsequent cost report amendment or field
audit that reveals information relating to the adjustment that
was not known to the department at the time of the final
decision.
(e) For a disputed item otherwise subject to the review set
forth in this subdivision, the department and the provider may
mutually agree to bypass the expedited review process and
proceed to a contested case hearing at any time prior to the
time for the department's submission under paragraph (c).
(f) When the department determines that the appeals of two
or more providers otherwise subject to the review set forth in
this subdivision present the same or substantially the same
adjustment, the department may remove the disputed items from
the review in this subdivision, and the disputed items shall
proceed in accordance with subdivision 1c. The department's
decision to remove the appealed adjustments to contested case
proceeding is final and is not reviewable.
(g) For a disputed item otherwise subject to the review in
this subdivision, the department or a provider may petition the
chief administrative law judge to issue an order allowing the
petitioning party to bypass the expedited review process. If
the petition is granted, the disputed item must proceed in
accordance with subdivision 1c. In making the determination,
the chief administrative law judge shall consider the potential
impact and precedential and monetary value of the disputed
item. A petition for removal to contested case hearing must be
filed with the chief administrative law judge and the opposing
party on or before the date on which its submission is due under
paragraph (b) or (c). Within 20 days of receipt of the
petition, the opposing party may submit its argument opposing
the petition. Within 20 days of receipt of the argument
opposing the petition, or if no argument is received, within 20
days of the date on which the argument was due, the chief
administrative law judge shall issue a decision granting or
denying the petition. If the petition is denied, the
petitioning party has 60 days from the date of the denial to
make a submission under paragraph (b) or (c).
(h) The department and a provider may mutually agree to use
the procedures set forth in this subdivision for any disputed
item not otherwise subject to this subdivision.
(i) Nothing shall prevent either party from making its
submissions and arguments under this subdivision through a
person who is not an attorney.
(j) This subdivision applies to all appeals for rate years
beginning after June 30, 1988.
Sec. 165. Minnesota Statutes 1986, section 256B.50, is
amended by adding a subdivision to read:
Subd. 1e. [ATTORNEY'S FEES AND COSTS.] (a) Notwithstanding
section 3.762, paragraph (a), for an issue appealed under
subdivision 1, the prevailing party in a contested case
proceeding or, if appealed, in subsequent judicial review, must
be awarded reasonable attorney's fees and costs incurred in
litigating the appeal, if the prevailing party shows that the
position of the opposing party was not substantially justified.
The procedures for awarding fees and costs set forth in section
3.764 must be followed in determining the prevailing party's
fees and costs except as otherwise provided in this
subdivision. For purposes of this subdivision, "costs" means
subpoena fees and mileage, transcript costs, court reporter
fees, witness fees, postage and delivery costs, photocopying and
printing costs, amounts charged the commissioner by the office
of administrative hearings, and direct administrative costs of
the department; and "substantially justified" means that a
position had a reasonable basis in law and fact, based on the
totality of the circumstances prior to and during the contested
case proceeding and subsequent review.
(b) When an award is made to the department under this
subdivision, attorney fees must be calculated at the cost to the
department. When an award is made to a provider under this
subdivision, attorney fees must be calculated at the rate
charged to the provider except that attorney fees awarded must
be the lesser of the attorney's normal hourly fee or $100 per
hour.
(c) In contested case proceedings involving more than one
issue, the administrative law judge shall determine what portion
of each party's attorney fees and costs is related to the issue
or issues on which it prevailed and for which it is entitled to
an award. In making that determination, the administrative law
judge shall consider the amount of time spent on each issue, the
precedential value of the issue, the complexity of the issue,
and other factors deemed appropriate by the administrative law
judge.
(d) When the department prevails on an issue involving more
than one provider, the administrative law judge shall allocate
the total amount of any award for attorney fees and costs among
the providers. In determining the allocation, the
administrative law judge shall consider each provider's monetary
interest in the issue and other factors deemed appropriate by
the administrative law judge.
(e) Attorney fees and costs awarded to the department for
proceedings under this subdivision must not be reported or
treated as allowable costs on the provider's cost report.
(f) Fees and costs awarded to a provider for proceedings
under this subdivision must be reimbursed to them by reporting
the amount of fees and costs awarded as allowable costs on the
provider's cost report for the reporting year in which they were
awarded. Fees and costs reported pursuant to this subdivision
must be included in the general and administrative cost category
but are not subject to either the general and administrative or
other-operating-cost limits.
(g) If the provider fails to pay the awarded attorney fees
and costs within 120 days of the final decision on the award of
attorney fees and costs, the department may collect the amount
due through any method available to it for the collection of
medical assistance overpayments to providers. Interest charges
must be assessed on balances outstanding after 120 days of the
final decision on the award of attorney fees and costs. The
annual interest rate charged must be the rate charged by the
commissioner of revenue for late payment of taxes that is in
effect on the 121st day after the final decision on the award of
attorney fees and costs.
(h) Amounts collected by the commissioner pursuant to this
subdivision must be deemed to be recoveries pursuant to section
256.01, subdivision 2, clause 15.
(i) This subdivision applies to all contested case
proceedings set on for hearing by the commissioner on or after
the effective date of this section, regardless of the date the
appeal was filed.
Sec. 166. Minnesota Statutes 1986, section 256B.50, is
amended by adding a subdivision to read:
Subd. 1f. [LEGAL AND RELATED EXPENSES.] Legal and related
expenses for unresolved challenges to decisions by governmental
agencies shall be separately identified and explained on the
provider's cost report for each year in which the expenses are
incurred. When the challenge is resolved in favor of the
governmental agency, the provider shall notify the department of
the extent to which its challenge was unsuccessful or the cost
report filed for the reporting year in which the challenge was
resolved. In addition, the provider shall inform the department
of the years in which it claimed legal and related expenses and
the amount of the expenses claimed in each year relating to the
unsuccessful challenge. The department shall reduce the
provider's medical assistance rate in the subsequent rate year
by the total amount claimed by the provider for legal and
related expenses incurred in an unsuccessful challenge to a
decision by a governmental agency.
Sec. 167. Minnesota Statutes 1986, section 256B.50, is
amended by adding a subdivision to read:
Subd. 1g. [APPEAL SUPPLEMENT.] (a) For an appeal filed
with the commissioner regarding payment rates calculated
pursuant to Minnesota Rules, parts 9510.0010 to 9510.0480, or
parts 9510.0500 to 9510.0890, or prior provisions of these
rules, that was not subject to the provisions of this section or
section 256B.501, subdivision 3, at the time it was filed, the
appellant must file an appeal supplement. The appeal supplement
must be filed no later than December 31, 1988, and must specify
each disputed item, the reason for the dispute, an estimate of
the dollar amount involved for each disputed item, the
computation that the provider believes is correct, the authority
in statute or rule upon which the provider relies for each
disputed item, the name and address of the person or firm with
whom contacts may be made regarding the appeal, and any other
information required by the commissioner. Failure to file the
appeal supplement is jurisdictional and the commissioner may
accordingly dismiss the appeal, and the rate established by the
commissioner shall take effect.
(b) Filing of an appeal supplement must not be construed to
correct any legal defect in the original appeal.
(c) An appeal for which an appeal supplement is filed
pursuant to this subdivision must be set on for a contested case
hearing, made part of the expedited appeal process with the
agreement of both the provider and the department, or otherwise
resolved by December 31, 1989.
Sec. 168. Minnesota Statutes 1987 Supplement, section
256B.50, subdivision 2, is amended to read:
Subd. 2. [APPRAISED VALUE.] (a) An A nursing home may
appeal the determination of its appraised value, as determined
by the commissioner pursuant to section 256B.431 and rules
established thereunder. A written notice of appeal request
concerning the appraised value of a nursing home's real estate
as established by an appraisal conducted after July 1, 1986,
shall must be filed with the commissioner within 60 days of the
date the determination was made and shall state the appraised
value the nursing home believes is correct for the building,
land improvements, and attached equipment and the name and
address of the firm with whom contacts may be made regarding the
appeal. The appeal request shall include a separate appraisal
report prepared by an independent appraiser of real estate which
supports the total appraised value claimed by the nursing home.
The appraisal report shall be based on an on-site inspection of
the nursing home's real estate using the depreciated replacement
cost method, must be in a form comparable to that used in the
commissioner's appraisal, and must pertain to the same time
period covered by the appealed appraisal. The appraisal report
shall include information related to the training, experience,
and qualifications of the appraiser who conducted and prepared
the appraisal report for the nursing home.
(b) A nursing home which has filed an appeal request prior
to the effective date of Laws 1987, chapter 403, concerning the
appraised value of its real estate as established by an
appraisal conducted before July 1, 1986, must submit to the
commissioner the information described under paragraph (a)
within 60 days of the effective date of Laws 1987, chapter 403,
in order to preserve the appeal.
(c) An appeal request which has been filed pursuant to the
provisions of paragraph (a) or (b) shall be finally resolved
through an agreement entered into by and between the
commissioner and the nursing home or by the determination of an
independent appraiser based upon an on-site inspection of the
nursing home's real estate using the depreciated replacement
cost method, in a form comparable to that used in the
commissioner's appraisal, and pertaining to the same time period
covered by the appealed appraisal. The appraiser shall be
selected by the commissioner and the nursing home by alternately
striking names from a list of appraisers approved for state
contracts by the commissioner of administration. The appraiser
shall make assurances to the satisfaction of the commissioner
and the nursing home that the appraiser is experienced in the
use of the depreciated cost method of appraisals and that the
appraiser is free of any personal, political, or economic
conflict of interest that may impair the ability to function in
a fair and objective manner. The commissioner shall pay costs
of the appraiser through a negotiated rate for services of the
appraiser.
(d) The decision of the appraiser is final and is not
appealable. Exclusive jurisdiction for appeals of the appraised
value of nursing homes lies with the procedures set out in this
subdivision. No court of law shall possess subject matter
jurisdiction to hear appeals of appraised value determinations
of nursing homes.
Sec. 169. Minnesota Statutes 1987 Supplement, section
256B.501, subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For the purposes of this
section, the following terms have the meaning given them.
(a) "Commissioner" means the commissioner of human services.
(b) "Facility" means a facility licensed as a mental
retardation residential facility under section 252.28, licensed
as a supervised living facility under chapter 144, and certified
as an intermediate care facility for persons with mental
retardation or related conditions.
(c) "Waivered service" means home or community-based
service authorized under United States Code, title 42, section
1396n(c), as amended through December 31, 1982 1987, and defined
in the Minnesota state plan for the provision of medical
assistance services. Waivered services include, at a minimum,
case management, family training and support, developmental
training homes, supervised living arrangements, semi-independent
living services, respite care, and training and habilitation
services.
Sec. 170. Minnesota Statutes 1986, section 256B.501,
subdivision 3, is amended to read:
Subd. 3. [RATES FOR INTERMEDIATE CARE FACILITIES FOR
PERSONS WITH MENTAL RETARDATION OR RELATED CONDITIONS.] The
commissioner shall establish, by rule, procedures for
determining rates for care of residents of intermediate care
facilities for persons with mental retardation or related
conditions. The procedures shall be based on methods and
standards that the commissioner finds are adequate to provide
for the costs that must be incurred for the care of residents in
efficiently and economically operated facilities. In developing
the procedures, the commissioner shall include:
(a) cost containment measures that assure efficient and
prudent management of capital assets and operating cost
increases which do not exceed increases in other sections of the
economy;
(b) limits on the amounts of reimbursement for property,
general and administration, and new facilities;
(c) requirements to ensure that the accounting practices of
the facilities conform to generally accepted accounting
principles;
(d) incentives to reward accumulation of equity; and
(e) a revaluation on sale for a facility that, for at least
three years before its use as an intermediate care facility, has
been used by the seller as a single family home and been claimed
by the seller as a homestead, and was not revalued immediately
prior to or upon entering the medical assistance program,
provided that the facility revaluation not exceed the amount
permitted by the Social Security Act, section 1902(a)(13); and
(f) appeals procedures that satisfy the requirements of
section 256B.50 for appeals of decisions arising from the
application of standards or methods pursuant to Minnesota Rules,
parts 9510.0500 to 9510.0890, 9553.0010 to 9553.0080, and 12
MCAR 2.05301 to 2.05315 (temporary).
In establishing rules and procedures for setting rates for
care of residents in intermediate care facilities for persons
with mental retardation or related conditions, the commissioner
shall consider the recommendations contained in the February 11,
1983, Report of the Legislative Auditor on Community Residential
Programs for the Mentally Retarded and the recommendations
contained in the 1982 Report of the Department of Public Welfare
Rule 52 Task Force. Rates paid to supervised living facilities
for rate years beginning during the fiscal biennium ending June
30, 1985, shall not exceed the final rate allowed the facility
for the previous rate year by more than five percent.
Sec. 171. Minnesota Statutes 1986, section 256B.501, is
amended by adding a subdivision to read:
Subd. 3a. [INTERIM RATES.] For rate years beginning
October 1, 1988, and October 1, 1989, the commissioner shall
establish an interim program operating cost payment rate for
care of residents in intermediate care facilities for persons
with mental retardation.
(a) For the rate year beginning October 1, 1988, the
interim program operating cost payment rate is the greater of
the facility's 1987 reporting year allowable program operating
costs per resident day increased by the composite forecasted
index in section 256B.501, subdivision 3c, or the facility's
January 1, 1988, program operating cost payment rate increased
by the composite forecasted index in section 256B.501,
subdivision 3c, except that the composite forecasted index is
established based on the midpoint of the period January 1, 1988,
through September 30, 1988, to the midpoint of the following
rate year.
(b) For the rate year beginning October 1, 1989, the
interim program operating cost payment rate is the greater of
the facility's 1988 reporting year allowable program operating
costs per resident day increased by the composite forecasted
index in section 256B.501, subdivision 3c, or the facility's
October 1, 1988, program operating cost payment rate increased
by the composite forecasted index in section 256B.501,
subdivision 3c, except that the composite forecasted index is
established based on the midpoint of the rate year beginning
October 1, 1988, to the midpoint of the following rate year.
Sec. 172. Minnesota Statutes 1986, section 256B.501, is
amended by adding a subdivision to read:
Subd. 3b. [SETTLE-UP OF COSTS.] The facility's program
operating costs are subject to a retroactive settle-up for the
1988 and 1989 reporting years, determined by the following
method:
(a) If a facility's program operating costs, including
one-time adjustment program operating costs for the facility's
1988 or 1989 reporting year, are less than 98 percent of the
facility's total program operating cost payments for facilities
with 20 or fewer licensed beds, or less than 99 percent of the
facility's total program operating cost payments for facilities
with more than 20 licensed beds, then the facility must repay
the difference to the state according to the desk audit
adjustment procedures in Minnesota Rules, part 9553.0041,
subpart 13, items B to E. For the purpose of determining the
retroactive settle-up amounts, the facility's total program
operating cost payments must be computed by multiplying the
facility's program operating cost payment rates, including
one-time program operating cost adjustment rates for those
reporting years, by the prorated resident days that correspond
to those program operating cost payment rates paid during those
reporting years.
(b) If a facility's program operating costs, including
one-time adjustment program operating costs for the facility's
1989 reporting year are between 102 and 105 percent of the
amount computed by multiplying the facility's program operating
cost payment rates, including one-time program operating cost
adjustment rates for those reporting years, by the prorated
resident days that correspond to those program operating cost
payment rates paid during that reporting year, the state must
repay the difference to the facility according to the desk audit
adjustment procedures in Minnesota Rules, part 9553.0041,
subpart 13, items B to E.
A facility's retroactive settle-up must be calculated by
October 1, 1990.
Sec. 173. Minnesota Statutes 1986, section 256B.501, is
amended by adding a subdivision to read:
Subd. 3c. [COMPOSITE FORECASTED INDEX.] For rate years
beginning on or after October 1, 1988, the commissioner shall
establish a statewide composite forecasted index to take into
account economic trends and conditions between the midpoint of
the facility's reporting year and the midpoint of the rate year
following the reporting year. The statewide composite index
must incorporate the forecast by Data Resources, Inc. of
increases in the average hourly earnings of nursing and personal
care workers indexed in Standard Industrial Code 805 in
"Employment and Earnings," published by the Bureau of Labor
Statistics, United States Department of Labor. This portion of
the index must be weighted annually by the proportion of total
allowable salaries and wages to the total allowable operating
costs in the program, maintenance, and administrative operating
cost categories for all facilities.
For adjustments to the other operating costs in the
program, maintenance, and administrative operating cost
categories, the statewide index must incorporate the Data
Resources, Inc. forecast for increases in the national CPI-U.
This portion of the index must be weighted annually by the
proportion of total allowable other operating costs to the total
allowable operating costs in the program, maintenance, and
administrative operating cost categories for all facilities.
The commissioner shall use the indices as forecasted by Data
Resources, Inc., in the fourth quarter of the reporting year.
Sec. 174. Minnesota Statutes 1986, section 256B.501, is
amended by adding a subdivision to read:
Subd. 3d. [LIMITS ON ADMINISTRATIVE OPERATING COSTS.] For
the rate year beginning October 1, 1989, the administrative
operating cost per bed limit shall be calculated according to
paragraphs (a) to (d).
(a) The commissioner shall classify a facility into one of
two groups based on the number of licensed beds reported on the
facility's cost report. Group one includes facilities with more
than 20 licensed beds. Group two includes facilities with 20 or
fewer licensed beds.
(b) The commissioner shall determine the allowable
administrative historical operating cost per licensed bed for
each facility in the two groups by dividing the allowable
administrative historical operating cost in each facility by the
number of licensed beds in each facility.
(c) The commissioner shall establish the administrative
cost per licensed bed limit by multiplying the median of the
array of allowable administrative historical operating costs per
licensed bed for each group by the percentage that establishes
the limit at the 75th percentile of the array of each group.
(d) For the rate year beginning October 1, 1989, the
maximum allowable administrative historical operating cost shall
be the facility's allowable administrative historical operating
cost or the amount in paragraph (c) multiplied by the facility's
licensed beds, whichever is less.
Sec. 175. Minnesota Statutes 1986, section 256B.501, is
amended by adding a subdivision to read:
Subd. 3e. [INCREASE IN LIMITS.] For rate years beginning
on or after October 1, 1990, the commissioner shall increase the
administrative cost per licensed bed limit in section 256B.501,
subdivision 3d, paragraph (c), and the maintenance operating
cost limit in Minnesota Rules, part 9553.0050, subpart 1, item
A, subitem (2), by multiplying the administrative operating cost
per bed limit and the maintenance operating cost limit by the
composite forecasted index in section 256B.501, subdivision 3c
except that the index shall be based on the 12 months between
the midpoints of the two preceding reporting years.
Sec. 176. Minnesota Statutes 1986, section 256B.501, is
amended by adding a subdivision to read:
Subd. 3f. [RATE ADJUSTMENTS.] For rate years beginning
October 1, 1989, the commissioner may develop a method to adjust
facility rates to meet new licensing or certification standards
or regulations adopted by the state or federal government that
result in significant cost increases. The commissioner may also
consider establishing separate administrative cost limits based
on other factors including difficulty of care of residents and
licensure classification.
Sec. 177. Minnesota Statutes 1986, section 256B.501, is
amended by adding a subdivision to read:
Subd. 3g. [ASSESSMENT OF RESIDENTS.] For rate years
beginning on or after October 1, 1990, the commissioner shall
establish program operating cost rates for care of residents in
facilities that take into consideration service characteristics
of residents in those facilities. To establish the service
characteristics of residents, the quality assurance and review
teams in the department of health shall assess all residents
annually beginning January 1, 1989, using a uniform assessment
instrument developed by the commissioner. This instrument shall
include assessment of the client's behavioral needs, integration
into the community, ability to perform activities of daily
living, medical and therapeutic needs, and other relevant
factors determined by the commissioner. The commissioner may
establish procedures to adjust the program operating costs of
facilities based on a comparison of client services
characteristics, resource needs, and costs.
Sec. 178. Minnesota Statutes 1986, section 256B.501, is
amended by adding a subdivision to read:
Subd. 3h. [WAIVING INTEREST CHARGES.] The commissioner may
waive interest charges on overpayments incurred by intermediate
care facilities for persons with mental retardation and related
conditions for the period October 1, 1987, through February 29,
1988, if the overpayments resulted from the continuation of the
desk audit rate in effect on September 30, 1987, through the
period.
Sec. 179. Minnesota Statutes 1986, section 256B.501, is
amended by adding a subdivision to read:
Subd. 3i. [SCOPE.] Subdivisions 3a to 3h do not apply to
facilities whose payment rates are governed by Minnesota Rules,
part 9553.0075.
Sec. 180. Minnesota Statutes 1986, section 256B.501, is
amended by adding a subdivision to read:
Subd. 3j. [RULES.] The commissioner shall adopt rules to
implement this section. The commissioner shall consult with
provider groups, advocates, and legislators to develop these
rules.
Sec. 181. [256B.64] [ATTENDANTS TO VENTILATOR-DEPENDENT
RECIPIENTS.]
A ventilator-dependent recipient of medical assistance who
has been receiving the services of a private duty nurse or
personal care assistant in the recipient's home may continue to
have a private duty nurse or personal care assistant present
upon admission to a hospital licensed under chapter 144. The
personal care assistant or private duty nurse shall perform only
the services of communicator or interpreter for the
ventilator-dependent patient during a transition period of up to
120 hours to assure adequate training of the hospital staff to
communicate with the patient and to understand the unique
comfort, safety, and personal care needs of the patient. The
personal care assistant or private duty nurse may offer
nonbinding advice to the health care professionals in charge of
the ventilator-dependent patient's care and treatment on matters
pertaining to the comfort and safety of the patient. After the
120 hour transition period, an assessment may be made by the
ventilator-dependent patient, the attending physician, and the
patient's primary care nurse to determine whether continued
services of communicator or interpreter for the patient by the
private duty nurse or personal care assistant are necessary and
appropriate for the patient's needs. If continued service is
necessary and appropriate, the physician must certify this need
to the commissioner of human services in order for payments to
continue. The commissioner may adopt rules necessary to
implement this section. Reimbursement under this section must
be at the payment rate and in a manner consistent with the
payment rate and manner used in reimbursing these providers for
home care services for the ventilator-dependent recipient under
the medical assistance program.
Sec. 182. Minnesota Statutes 1986, section 256B.69,
subdivision 3, is amended to read:
Subd. 3. [GEOGRAPHIC AREA.] The commissioner shall
designate the geographic areas in which eligible individuals may
be included in the demonstration project. The geographic areas
shall may include one urban, one suburban, and at least one
rural county. In order to encourage the participation of
long-term care providers, the project area may be expanded
beyond the designated counties for eligible individuals over age
65.
Sec. 183. Minnesota Statutes 1986, section 256B.69,
subdivision 4, is amended to read:
Subd. 4. [LIMITATION OF CHOICE.] The commissioner shall
develop criteria to determine when limitation of choice may be
implemented in the experimental counties. The criteria shall
ensure that all eligible individuals in the county have
continuing access to the full range of medical assistance
services as specified in subdivision 6. The commissioner shall
exempt the following persons from participation in the project,
in addition to those who do not meet the criteria for limitation
of choice: (1) persons eligible for medical assistance
according to section 256B.06, subdivision 1, clause (1) or who
are in foster placement; and (2) persons eligible for medical
assistance due to blindness or disability as determined by the
social security administration or the state medical review team,
unless they are 65 years of age or older. Before limitation of
choice is implemented, eligible individuals shall be notified
and after notification, shall be allowed to choose only among
demonstration providers. After initially choosing a provider,
the recipient is allowed to change that choice only at specified
times as allowed by the commissioner.
Sec. 184. Minnesota Statutes 1987 Supplement, section
256B.73, subdivision 2, is amended to read:
Subd. 2. [ESTABLISHMENT: GEOGRAPHIC AREA.] The
commissioner of human services shall cooperate with a local
coalition to establish a demonstration project to provide low
cost medical insurance to uninsured low income persons in
Cook, Crow Wing, Lake, St. Louis, Carlton, Aitkin, Pine, Itasca,
and Koochiching counties except an individual county may be
excluded as determined by the county board of commissioners.
The coalition shall work with the commissioner and potential
demonstration providers as well as other public and private
organizations to determine program design, including enrollee
eligibility requirements, benefits, and participation.
Sec. 185. Minnesota Statutes 1987 Supplement, section
256D.01, subdivision 1a, is amended to read:
Subd. 1a. [STANDARDS.] (1) A principal objective in
providing general assistance is to provide for persons
ineligible for federal programs who are unable to provide for
themselves. The minimum standard of assistance determines the
total amount of the general assistance grant without separate
standards for shelter, utilities, or other needs.
(2) The commissioner shall set the standard of assistance
for an assistance unit consisting of an adult recipient who is
childless and unmarried or living apart from children and spouse
and who does not live with a parent or parents or a legal
custodian. When the other standards specified in this
subdivision increase, this standard shall also be increased by
the same percentage.
(3) For an assistance unit consisting of an a single adult
who is childless and unmarried or living apart from children and
spouse, but who lives with a parent or parents, the general
assistance standard of assistance shall be equal to the amount
that the aid to families with dependent children standard of
assistance would increase if the recipient were added as an
additional minor child to an assistance unit consisting of the
recipient's parent and all of that parent's family members,
provided that the standard shall not exceed the standard for a
general assistance recipient living alone. Benefits received by
a responsible relative of the assistance unit under the
supplemental security income program, a workers' compensation
program, the Minnesota supplemental aid program, or any other
program based on the responsible relative's disability, and any
benefits received by a responsible relative of the assistance
unit under the social security retirement program, shall not be
counted in the determination of eligibility or benefit level for
the assistance unit. An adult child shall be The assistance
unit is ineligible for general assistance if the available
resources or the countable income of the adult child assistance
unit and the parent or parents with whom the adult child
assistance unit lives are such that a family consisting of the
adult child's assistance unit's parent or parents, the parent or
parents' other family members and the adult child assistance
unit as the only or additional minor child would be financially
ineligible for general assistance. For the purposes of
calculating the countable income of the assistance unit's parent
or parents, use the calculation methods, income deductions,
exclusions, and disregards used when calculating the countable
income for a single adult or childless couple.
(4) For an assistance unit consisting of a married
childless couple who are childless or who live apart from any
child or children of whom either of the married couple is a
parent or legal custodian, the standards of assistance shall be
equal to the first and second adult standards of the aid to
families with dependent children program. If one member of the
couple is not included in the general assistance grant, then the
standard of assistance for the other shall be equal to the
second adult standard of the aid to families with dependent
children program, except that, when one member of the couple is
not included in the general assistance grant because that member
is not categorically eligible for general assistance under
section 256D.05, subdivision 1, and has exhausted work readiness
eligibility under section 256D.051, subdivision 4 or 5, for the
period of time covered by the general assistance grant, then the
standard of assistance for the remaining member of the couple
shall be equal to the first adult standard of the aid to
families with dependent children program.
(5) For an assistance unit consisting of all members of a
family, the standards of assistance shall be the same as the
standards of assistance applicable to a family under the aid to
families with dependent children program if that family had the
same number of parents and children as the assistance unit under
general assistance and if all members of that family were
eligible for the aid to families with dependent children
program. If one or more members of the family are not included
in the assistance unit for general assistance, the standards of
assistance for the remaining members shall be equal to the
standards of assistance applicable to an assistance unit
composed of the entire family, less the standards of assistance
applicable to a family of the same number of parents and
children as those members of the family who are not in the
assistance unit for general assistance. Notwithstanding the
foregoing, if an assistance unit consists solely of the minor
children because their parent or parents have been sanctioned
from receiving benefits from the aid to families with dependent
children program, the standard for the assistance unit shall be
equal to the special child standard of the aid to families with
dependent children program. A child shall not be excluded from
the assistance unit unless income intended for its benefit is
received from a federally aided categorical assistance
program; or supplemental security income; retirement, survivors,
and disability income; other assistance programs; or child
support and maintenance payments. The income of a child who is
excluded from the assistance unit shall not be counted in the
determination of eligibility or benefit level for the assistance
unit.
Sec. 186. Minnesota Statutes 1986, section 256D.02,
subdivision 7, is amended to read:
Subd. 7. "Childless couple" means two individuals who are
related by marriage and who are living married to each other,
live in a place of residence maintained by them as their own
home, and are either childless or living apart from their
children.
Sec. 187. Minnesota Statutes 1986, section 256D.02, is
amended by adding a subdivision to read:
Subd. 16. "Single adult" means an individual 18 years or
older who is childless and unmarried or living apart from the
individual's children and spouse.
Sec. 188. Minnesota Statutes 1987 Supplement, section
256D.03, subdivision 3, is amended to read:
Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.]
(a) General assistance medical care may be paid for any person:
(1) who is eligible for assistance under section 256D.05 or
256D.051 and is not eligible for medical assistance under
chapter 256B; or
(2) who is a resident of Minnesota; whose income as
calculated under chapter 256B is not in excess of the medical
assistance standards or whose excess income is spent down
pursuant to chapter 256B; and whose equity in resources is not
in excess of $1,000 per assistance unit. Exempt real and liquid
assets, the reduction of excess assets, and the waiver of excess
assets must conform to the medical assistance program in chapter
256B.
(b) Eligibility is available for the month of application
and for three months prior to application if the person was
eligible in those prior months. A redetermination of
eligibility must occur every 12 months.
(c) General assistance medical care may be paid for a
person, regardless of age, who is detained by law for less than
one year in a county correctional or detention facility as a
person accused or convicted of a crime, or admitted as an
inpatient to a hospital on a criminal hold order, if the person
is a recipient of general assistance medical care at the time
the person is detained by law or admitted on a criminal hold
order and as long as the person continues to meet other
eligibility requirements of this subdivision.
(d) General assistance medical care is not available for
applicants or recipients who do not cooperate with the local
agency to meet the requirements of medical assistance.
Sec. 189. Minnesota Statutes 1987 Supplement, section
256D.06, subdivision 1, is amended to read:
Subdivision 1. General assistance shall be granted in such
an amount that when added to the nonexempt income actually
available to the individual, married couple, or
family assistance unit, the total amount equals the applicable
standard of assistance for general assistance. In determining
eligibility for and the amount of assistance for an individual
or married couple, the local agency shall disregard the first
$50 of earned income per month.
Sec. 190. Minnesota Statutes 1987 Supplement, section
256D.06, subdivision 1b, is amended to read:
Subd. 1b. [EARNED INCOME SAVINGS ACCOUNT.] In addition to
the $50 disregard required under subdivision 1, the local agency
shall disregard an additional earned income up to a maximum of
$150 per month for persons residing in facilities licensed under
Minnesota Rules, parts 9520.0500 to 9520.0690 and 9530.2500 to
9530.4000, and for whom discharge and work are part of a
treatment plan and for persons living in supervised apartments
with services funded under Minnesota Rules, parts 9535.0100 to
9535.1600, and for whom discharge and work are part of a
treatment plan. The additional amount disregarded must be
placed in a separate savings account by the eligible individual,
to be used upon discharge from the residential facility into the
community. A maximum of $1,000, including interest, of the
money in the savings account must be excluded from the resource
limits established by section 256D.08, subdivision 1, clause (1).
Amounts in that account in excess of $1,000 must be applied to
the resident's cost of care. If excluded money is removed from
the savings account by the eligible individual at any time
before the individual is discharged from the facility into the
community, the money is income to the individual in the month of
receipt and a resource in subsequent months. If an eligible
individual moves from a community facility to an inpatient
hospital setting, the separate savings account is an excluded
asset for up to 18 months. During that time, amounts that
accumulate in excess of the $1,000 savings limit must be applied
to the patient's cost of care. If the patient continues to be
hospitalized at the conclusion of the 18-month period, the
entire account must be applied to the patient's cost of care.
Sec. 191. Minnesota Statutes 1986, section 256D.06, is
amended by adding a subdivision to read:
Subd. 1c. [ELIGIBILITY OF FAMILIES.] Notwithstanding any
other provisions of sections 256D.01 to 256D.22, general
assistance for an assistance unit consisting of members of a
family must be granted in an amount that is equal to the amount
of assistance which would be paid to an aid to families with
dependent children assistance unit which has the same size,
composition, income, and other circumstances relevant to the
computation of an AFDC grant. Income for an assistance unit
consisting of members of a family applying for or receiving
general assistance must be determined in the same manner as for
persons applying for or receiving aid to families with dependent
children, except that the first $50 per month of total child
support paid on behalf of family members is excluded and the
balance is counted as unearned income, and nonrecurring lump
sums received by the family shall be considered income in the
month received and a resource thereafter.
Sec. 192. Minnesota Statutes 1986, section 256D.07, is
amended to read:
256D.07 [TIME OF PAYMENT OF ASSISTANCE.]
An applicant for general assistance or general assistance
medical care authorized by section 256D.03, subdivision 3 shall
be deemed eligible if the application and the verification of
the statement on that application demonstrate that the applicant
is within the eligibility criteria established by sections
256D.01 to 256D.21 and any applicable rules of the
commissioner. Any person requesting general assistance or
general assistance medical care shall be permitted by the local
agency to make an application for assistance as soon as
administratively possible and in no event later than the fourth
day following the date on which assistance is first requested,
and no local agency shall require that a person requesting
assistance appear at the offices of the local agency more than
once prior to the date on which the person is permitted to make
the application. The application shall be in writing in the
manner and upon the form prescribed by the commissioner and
attested to by the oath of the applicant or in lieu thereof
shall contain the following declaration which shall be signed by
the applicant: "I declare that this application has been
examined by me and to the best of my knowledge and belief is a
true and correct statement of every material point." On the
date that general assistance is first requested, the local
agency shall inquire and determine whether the person requesting
assistance is in immediate need of food, shelter, clothing,
assistance for necessary transportation, or other emergency
assistance pursuant to section 256D.06, subdivision 2. A person
in need of emergency assistance shall be granted emergency
assistance immediately, and necessary emergency assistance shall
continue until either the person is determined to be ineligible
for general assistance or the first grant of general assistance
is paid to the person. A determination of an applicant's
eligibility for general assistance shall be made by the local
agency as soon as the required verifications are received by the
local agency and in no event later than 30 days following the
date that the application is made. Any verifications required
of the applicant shall be reasonable, and the commissioner shall
by rule establish reasonable verifications. General assistance
shall be granted to an eligible applicant without the necessity
of first securing action by the board of the local agency. The
amount of the first grant of general assistance awarded to an
applicant shall be computed to cover the time period starting
with the date that assistance is first requested or if the
applicant is not eligible on that date, the date on which the
applicant first becomes eligible, and the first grant may be
reduced by the amount of emergency general assistance provided
to the applicant. The first month's grant must be computed to
cover the time period starting with the date a signed
application form is received by the local agency or from the
date that the applicant meets all eligibility factors, whichever
occurs later. The first grant may be reduced by the amount of
emergency general assistance provided to the applicant.
If upon verification and due investigation it appears that
the applicant provided false information and the false
information materially affected the applicant's eligibility for
general assistance or general assistance medical care provided
pursuant to section 256D.03, subdivision 3 or the amount of the
applicant's general assistance grant, the local agency may refer
the matter to the county attorney. The county attorney may
commence a criminal prosecution or a civil action for the
recovery of any general assistance wrongfully received, or both.
Sec. 193. Minnesota Statutes 1986, section 256D.35, is
amended by adding a subdivision to read:
Subd. 9. [HOMESTEAD.] "Homestead" means a shelter in which
the individual or the spouse with whom the individual lives has
an ownership interest, and that is the principal residence of
the individual, spouse, or the individual's minor or disabled
child. The home may be either real or personal property, fixed
or mobile, and located on land or water. The home includes all
the land that appertains to it and buildings located on that
land.
Sec. 194. Minnesota Statutes 1987 Supplement, section
256D.37, subdivision 1, is amended to read:
Subdivision 1. (a) For all individuals who apply to the
appropriate local agency for supplemental aid, the local agency
shall determine whether the individual meets the eligibility
criteria prescribed in subdivision 2. For each individual who
meets the relevant eligibility criteria prescribed in
subdivision 2, the local agency shall certify to the
commissioner the amount of supplemental aid to which the
individual is entitled in accordance with all of the standards
in effect December 31, 1973, for the appropriate categorical aid
program.
(b) When a recipient is an adult with mental illness in a
facility licensed under Minnesota Rules, parts 9520.0500 to
9520.0690, a resident of a state hospital or a dwelling with a
negotiated rate, the recipient is not eligible for a shelter
standard, a basic needs standard, or for special needs
payments. The state standard of assistance for those recipients
is the clothing and personal needs allowance for medical
assistance recipients under section 256B.35. Minnesota
supplemental aid may be paid to negotiated rate facilities at
the rates in effect on March 1, 1985, for services provided
under the supplemental aid program to residents of the facility,
up to the maximum negotiated rate specified in this section.
The rate for room and board for a licensed facility must not
exceed $800. The maximum negotiated rate does not apply to a
facility that, on August 1, 1984, was licensed by the
commissioner of health only as a boarding care home, certified
by the commissioner of health as an intermediate care facility,
and licensed by the commissioner of human services under
Minnesota Rules, parts 9520.0500 to 9520.0690 or a facility
that, on August 1, 1984, was licensed by the commissioner of
human services under Minnesota Rules, parts 9525.0520 to
9525.0660, but funded as a supplemental aid negotiated rate
facility under this chapter. The following facilities are
exempt from the limit on negotiated rates and must be reimbursed
for documented actual costs, until an alternative reimbursement
system covering services excluding room and board maintenance
services is developed by the commissioner:
(1) a facility that only provides services to persons with
mental retardation; and
(2) a facility not certified to participate in the medical
assistance program that is licensed as a boarding care facility
as of March 1, 1985, and does not receive supplemental program
funding under Minnesota Rules, parts 9535.2000 to 9535.3000 or
parts 9553.0010 to 9553.0080. Beginning July 1, 1987, the
facilities under clause (1) are subject to applicable
supplemental aid limits, and must meet all applicable licensing
and reimbursement requirements for programs for persons with
mental retardation. The negotiated rates may be paid for
persons who are placed by the local agency or who elect to
reside in a room and board facility or a licensed facility for
the purpose of receiving physical, mental health, or
rehabilitative care, provided the local agency agrees that this
care is needed by the person. When Minnesota supplemental aid
is used to pay a negotiated rate, the rate payable to the
facility must not exceed the rate paid by an individual not
receiving Minnesota supplemental aid. To receive payment for a
negotiated rate, the dwelling must comply with applicable laws
and rules establishing standards necessary for health, safety,
and licensure. The negotiated rate must be adjusted by the
annual percentage change in the consumer price index (CPI-U U.S.
city average), as published by the Bureau of Labor Statistics
between the previous two Septembers, new series index (1967-100)
or 2.5 percent, whichever is less. In computing the amount of
supplemental aid under this section, the local agency shall
deduct from the gross amount of the individual's determined
needs all income, subject to the criteria for income disregards
in effect December 31, 1973, for the appropriate categorical aid
program, except that the earned income disregard for disabled
persons who are not residents of long-term care facilities must
be the same as the earned income disregard available to disabled
persons in the supplemental security income program and all
actual work expenses must be deducted when determining the
amount of income for the individual. From the first of the
month in which an effective application is filed, the state and
the county shall share responsibility for the payment of the
supplemental aid to which the individual is entitled under this
section as provided in section 256D.36.
Sec. 195. Minnesota Statutes 1986, section 256D.37,
subdivision 2, is amended to read:
Subd. 2. [RESOURCE STANDARDS.] The resource standards and
restrictions for supplemental aid under this section shall be
those used to determine eligibility for disabled individuals in
the supplemental security income program. The local agency
shall apply the relevant criteria to each application. The
local agency in its discretion may permit eligibility of an
applicant having assets in excess of the amount prescribed in
this section if liquidation of the assets would cause undue loss
or hardship.
Sec. 196. Minnesota Statutes 1986, section 256D.37, is
amended by adding a subdivision to read:
Subd. 6. [TRANSFERS.] (a) In determining the resources of
an individual and an eligible spouse, if any, a person shall
include a resource or interest that exceeds the limits set out
in subdivision 2 and that was given away or sold for less than
fair market value within the 24 months preceding application for
Minnesota supplemental aid or during the period of eligibility.
(b) A transaction described in this subdivision is presumed
to have been made to establish eligibility for benefits or
assistance under this chapter unless the individual or eligible
spouse gives convincing evidence to establish that the
transaction was made exclusively for another purpose.
(c) For purposes of this subdivision, the value of a
resource or interest is the fair market value when it was sold
or given away, less the amount of compensation received.
(d) For any uncompensated transfer, the period of
ineligibility must be calculated by dividing the amount of the
uncompensated transferred amount by the statewide average
monthly skilled nursing facility payment for the previous
calendar year to determine the number of months of
ineligibility. The individual is ineligible until the fixed
period of ineligibility has expired. The period of
ineligibility may exceed 24 months, and a reapplication for
benefits after 24 months from the date of the transfer does not
result in eligibility unless and until the period of
ineligibility has expired.
(e) The period of ineligibility must not be applied if the
local agency determines that it would create an immediate threat
to the health or safety of the assistance unit.
Sec. 197. Minnesota Statutes 1986, section 256D.37, is
amended by adding a subdivision to read:
Subd. 7. [EXCLUSIONS.] The following must not be included
as income in determining eligibility:
(1) the value of food stamps;
(2) home-produced food used by the household;
(3) Indian claim payments made by the United States
Congress to compensate members of Indian tribes for the taking
of tribal lands by the federal government;
(4) cash payments to displaced persons who face relocation
as a result of the Housing Act of 1965, the Housing and Urban
Development Act of 1965, or the Uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970;
(5) one-third of child support payments received by an
eligible child from an absent parent;
(6) displaced homemaker payments;
(7) reimbursement received for maintenance costs of
providing foster care to adults or children;
(8) benefits received under Title IV and Title VII of the
Older Americans Act of 1965;
(9) Minnesota renter or homeowner property tax refunds;
(10) infrequent, irregular income that does not total more
than $20 per person in a month;
(11) reimbursement payments received from the VISTA program;
(12) in-kind income;
(13) payments received for providing volunteer services
under Title I, Title II, and Title III of the Domestic Volunteer
Service Act of 1973;
(14) loans that have to be repaid;
(15) federal low income heating assistance program
payments; and
(16) any other type of funds excluded as income by state
law.
The local agency shall exclude the first $20 of earned or
unearned income.
Sec. 198. Minnesota Statutes 1986, section 256D.37, is
amended by adding a subdivision to read:
Subd. 8. [APPLICATION FOR FEDERALLY FUNDED BENEFITS.]
Persons for whom the applicant or recipient has financial
responsibility and who have unmet needs must apply for, and if
eligible, accept aid to families with dependent children and
other federally funded benefits before allocation of earned and
unearned income from the applicant or recipient to meet the
needs of those persons. If the persons are determined
potentially eligible for these benefits, the applicant or
recipient may not allocate earned or unearned income to those
persons.
Sec. 199. Minnesota Statutes 1986, section 256D.37, is
amended by adding a subdivision to read:
Subd. 9. [ALLOCATION OF INCOME.] The rate of allocation
for the financially responsible relatives of applicants or
recipients is one-half the individual supplemental security
income standard of assistance, except as restricted in
subdivision 8.
If the applicant or recipient shares a residence with
another person who has financial responsibility for the
applicant or recipient, the income of the responsible relative
must be considered available to the applicant or recipient after
allowing the deductions in subdivisions 11 and 12.
Sec. 200. Minnesota Statutes 1986, section 256D.37, is
amended by adding a subdivision to read:
Subd. 10. [EARNED INCOME DISREGARDS.] From the assistance
unit's gross earned income, the local agency shall disregard $65
plus one-half of the remaining income.
Sec. 201. Minnesota Statutes 1986, section 256D.37, is
amended by adding a subdivision to read:
Subd. 11. [EARNED INCOME DEDUCTIONS.] From the assistance
unit's gross earned income, the local agency shall subtract work
expenses allowed by the supplemental security income program.
Sec. 202. Minnesota Statutes 1986, section 256D.37, is
amended by adding a subdivision to read:
Subd. 12. [SELF-EMPLOYMENT EARNINGS.] A local agency must
determine gross earned income from self-employment by
subtracting business costs from gross receipts.
Sec. 203. Minnesota Statutes 1986, section 256D.37, is
amended by adding a subdivision to read:
Subd. 13. [RENTAL PROPERTY.] Income from rental property
must be considered self-employment earnings for each month that
an average of at least ten hours a week of labor is expended by
the owner of the property. When no labor is expended, income
from rental property must be considered as unearned income and
an additional deduction must be allowed for actual, reasonable,
and necessary labor costs for upkeep and repair.
Sec. 204. Minnesota Statutes 1986, section 256D.37, is
amended by adding a subdivision to read:
Subd. 14. [GROSS INCOME TEST.] The local agency shall
apply a gross income test prospectively for each month of
program eligibility. An assistance unit is ineligible when
nonexcluded income, before applying any disregards or
deductions, exceeds 300 percent of the supplemental security
income standard for the assistance unit.
Sec. 205. Minnesota Statutes 1986, section 256E.12,
subdivision 1, is amended to read:
Subdivision 1. The commissioner shall establish an
experimental a statewide program to assist counties in providing
services to chronically mentally ill persons with serious and
persistent mental illness as defined in section 245.462,
subdivision 20. The commissioner shall make grants to counties
to establish, operate, or contract with private providers to
provide services designed to help chronically mentally ill
persons with serious and persistent mental illness remain and
function in their own communities. Grants received pursuant to
this section may be used to fund innovative community support
services programs, relating to physical fitness programs
designed as part of a mental health treatment plan as specified
in section 245.462, subdivision 6, and case management
activities that cannot be billed to the medical assistance
program under section 256B.02, subdivision 8.
Sec. 206. Minnesota Statutes 1986, section 256E.12,
subdivision 2, is amended to read:
Subd. 2. To apply for a grant a county board shall submit
an application and budget for the use of the money in the form
specified by the commissioner. The commissioner shall make
grants only to counties whose applications and budgets are
approved by the commissioner. A county receiving a grant under
this section shall finance at least ten percent of the cost of
services for chronically mentally ill persons with serious and
persistent mental illness from local resources, which may
include private contributions and federal money.
Sec. 207. Minnesota Statutes 1987 Supplement, section
256E.12, subdivision 3, is amended to read:
Subd. 3. The commissioner shall allocate grants under this
section to finance up to 90 percent of each county's costs for
services for chronically mentally ill to persons with serious
and persistent mental illness. The commissioner shall
promulgate emergency and permanent rules to govern grant
applications, approval of applications, allocation of grants,
and maintenance of financial statements by grant recipients.
The commissioner shall require collection of data and periodic
reports as the commissioner deems necessary to demonstrate the
effectiveness of the services in helping chronically mentally
ill persons with serious and persistent mental illness remain
and function in their own communities. The experimental program
shall expire no later than June 30, 1989.
Sec. 208. Minnesota Statutes 1986, section 256F.03,
subdivision 8, is amended to read:
Subd. 8. [PLACEMENT PREVENTION AND FAMILY REUNIFICATION
SERVICES.] "Placement prevention and family reunification
services" means a continuum of services designed to help
children remain with their families or to facilitate
reunification of children with their parents. Placement
prevention and family reunification services available to a
minority family must reflect and support family models that are
accepted within the culture of the particular minority.
Sec. 209. Minnesota Statutes 1986, section 256F.07, is
amended by adding a subdivision to read:
Subd. 3a. [MINORITY FAMILY SERVICES.] In addition to
services listed in subdivision 3, placement prevention and
family reunification services for minority children include:
(1) development of foster and adoptive placement resources,
including recruitment, licensing, and support;
(2) advocacy in working with the county and private social
service agencies, and activities to help provide access to
agency services;
(3) family and community involvement strategies to combat
child abuse and chronic neglect of children;
(4) coordinated child welfare and mental health services to
minority families; and
(5) other activities and services approved by the
commissioner that further the goals of the minority heritage
preservation act.
Sec. 210. [257.066] [RULES.]
By December 31, 1989, the commissioner of human services
shall revise Minnesota Rules, parts 9545.0750 to 9545.0830,
9560.0010 to 9560.0180, and 9560.0500 to 9560.0670 to ensure
that, as conditions of licensure, social services and
child-placing agencies meet the requirements of section 257.072,
subdivisions 7 and 8, and keep records in compliance with
sections 257.01 and 259.46.
Sec. 211. Minnesota Statutes 1986, section 257.071,
subdivision 2, is amended to read:
Subd. 2. [SIX MONTH REVIEW OF PLACEMENTS.] There shall be
an administrative review of the case plan of each child placed
in a residential facility no later than 180 days after the
initial placement of the child in a residential facility and at
least every six months thereafter if the child is not returned
to the home of the parent or parents within that time. The case
plan must be monitored and updated at each administrative
review. As an alternative to the administrative review, the
social service agency responsible for the placement may bring a
petition as provided in section 260.131, subdivision 1a, to the
court for review of the foster care to determine if placement is
in the best interests of the child. This petition must be
brought to the court within the applicable six months and is not
in lieu of the requirements contained in subdivision 3 or 4.
Sec. 212. Minnesota Statutes 1986, section 257.071,
subdivision 3, is amended to read:
Subd. 3. [REVIEW OF VOLUNTARY PLACEMENTS.] Subject to the
provisions of subdivision 4, if the child has been placed in a
residential facility pursuant to a voluntary release by the
parent or parents, and is not returned home within 18 months
after initial placement in the residential facility, the social
service agency responsible for the placement shall:
(a) Return the child to the home of the parent or parents;
or
(b) File an appropriate petition pursuant to section
260.131, subdivision 1, or 260.231, and if the petition is
dismissed, petition the court within two years, pursuant to
section 260.131, subdivision 1a, to determine if the placement
is in the best interests of the child.
The case plan must be updated when a petition is filed and
must include a specific plan for permanency.
Sec. 213. Minnesota Statutes 1986, section 257.071,
subdivision 6, is amended to read:
Subd. 6. [ANNUAL FOSTER CARE REPORT.] The commissioner of
human services shall publish annually a report on children in
residential facilities as defined in subdivision 1. The report
shall include, by county and statewide, information on legal
status, living arrangement, age, sex, race, accumulated length
of time in foster care, and other demographic information deemed
appropriate on all children placed in residential facilities.
The report shall also state the extent to which authorized child
placing agencies comply with sections 257.072 and 259.455 and
include descriptions of the methods used to comply with those
sections. The commissioner shall publish the report for each
calendar year by June 1 of the following year.
Sec. 214. Minnesota Statutes 1986, section 257.071, is
amended by adding a subdivision to read:
Subd. 7. [RULES.] By December 31, 1988, the commissioner
shall revise Minnesota Rules, parts 9545.0010 to 9545.0269, the
rules setting standards for family and group family foster care.
The commissioner shall:
(1) require that, as a condition of licensure, foster care
providers attend training on the importance of protecting
cultural heritage within the meaning of Laws 1983, chapter 278,
the Indian Child Welfare Act, Public Law Number 95-608, and the
Minnesota Indian family preservation act, sections 257.35 to
257.357; and
(2) review and, where necessary, revise foster care rules
to reflect sensitivity to cultural diversity and differing
lifestyles. Specifically, the commissioner shall examine
whether space and other requirements discriminate against
single-parent, minority, or low-income families who may be able
to provide quality foster care reflecting the values of their
own respective cultures.
Sec. 215. Minnesota Statutes 1986, section 257.072, is
amended to read:
257.072 [RECRUITMENT OF FOSTER FAMILIES WELFARE OF MINORITY
CHILDREN.]
Subdivision 1. [RECRUITMENT OF FOSTER FAMILIES.] Each
authorized child placing agency shall make special efforts to
recruit a foster family from among the child's relatives, except
as authorized in section 260.181, subdivision 3, and among
families of the same minority racial or minority ethnic
heritage. Special efforts include contacting and working with
community organizations and religious organizations, utilizing
local media and other local resources, and conducting outreach
activities, and increasing the number of minority recruitment
staff employed by the agency. The agency may accept any gifts,
grants, offers of services, and other contributions to use in
making special recruitment efforts.
Subd. 2. [DUTIES OF COMMISSIONER.] The commissioner of
human services shall:
(1) in cooperation with child-placing agencies, develop a
cost-effective campaign using radio and television to recruit
minority adoptive and foster families;
(2) require that agency staff people who work in the area
of minority adoption and foster family recruitment attend
cultural sensitivity training; and
(3) monitor the record keeping, licensing, placement
preference, recruitment, review, and reporting requirements of
the minority child heritage protection act, Laws 1983, chapter
278.
Subd. 3. [MINORITY RECRUITMENT SPECIALIST.] The
commissioner shall designate a permanent professional staff
position for a minority recruitment specialist. The minority
recruitment specialist shall provide services to child-placing
agencies seeking to recruit minority adoptive and foster care
families and qualified minority professional staff. The
minority recruitment specialist shall:
(1) develop materials for use by the agencies in training
staff;
(2) conduct in-service workshops for agency personnel;
(3) provide consultation, technical assistance, and other
appropriate services to agencies wishing to improve service
delivery to minority populations;
(4) conduct workshops for foster care and adoption
recruiters to evaluate the effectiveness of techniques for
recruiting minority families; and
(5) perform other duties as assigned by the commissioner to
implement the minority child heritage protection act and the
Minnesota Indian family preservation act.
Upon recommendation of the minority recruitment specialist,
the commissioner may contract for portions of these services.
Subd. 4. [CONSULTATION WITH MINORITY REPRESENTATIVES.] The
commissioner of human services shall, after seeking and
considering advice from representatives from the councils
established under sections 3.922, 3.9223, 3.9225, and 3.9226:
(1) review, and where necessary, revise the department of
human services social service manual and practice guide to
reflect the scope and intent of Laws 1983, chapter 278;
(2) develop criteria for determining whether a prospective
adoptive or foster family is "knowledgeable and appreciative" as
the term is used in section 260.181, subdivision 3;
(3) develop a standardized training curriculum for adoption
and foster care workers, family-based providers and
administrators who work with minority and special needs
children. Training must address the following subjects:
(a) developing and maintaining sensitivity to other
cultures;
(b) assessing values and their cultural implications; and
(c) implementing the minority child heritage protection
act, Laws 1983, chapter 278, and the Minnesota Indian family
preservation act, sections 257.35 to 257.357;
(4) develop a training curriculum for family and extended
family members of minority adoptive and foster children. The
curriculum must address issues relating to cross-cultural
placements as well as issues that arise after a foster or
adoptive placement is made; and
(5) develop and provide to agencies an assessment tool to
be used in combination with group interviews and other
preplacement activities to evaluate prospective adoptive and
foster families of minority children. The tool must assess
problem-solving skills; identify parenting skills; and, when
required by section 260.181, subdivision 3, evaluate the degree
to which the prospective family is knowledgeable and
appreciative of racial and ethnic differences.
Subd. 5. [MINORITY PLACEMENTS.] Beginning December 1,
1989, the commissioner shall provide to the Indian affairs
council, the council on affairs of Spanish-Speaking people, the
council on Black Minnesotans, and the council on Asian-Pacific
Minnesotans the semiannual reports required under section 216.
Subd. 6. [ADVISORY TASK FORCE.] The commissioner of human
services may convene and meet periodically with an advisory task
force on minority child welfare. The task force may advise the
commissioner on issues related to minority child welfare,
including, but not limited to, adoption and foster care, the use
of citizen review boards, infant mortality in minority
communities, and placement prevention. The task force should
include minority adoption and foster care workers and minority
adoptive and foster parents.
Subd. 7. [DUTIES OF CHILD-PLACING AGENCIES.] Each
authorized child-placing agency must:
(1) develop and follow procedures for implementing the
order of preference prescribed by section 260.181, subdivision 3;
(2) have a written plan for recruiting minority adoptive
and foster families. The plan must include (a) strategies for
using existing resources in minority communities, (b) use of
minority outreach staff wherever possible, (c) use of minority
foster homes for placements after birth and before adoption, and
(d) other techniques as appropriate;
(3) have a written plan for training adoptive and foster
families of minority children;
(4) if located in an area with a significant minority
population, have a written plan for employing minority social
workers in adoption and foster care. The plan must include
staffing goals and objectives; and
(5) ensure that adoption and foster care workers attend
training offered or approved by the department of human services
regarding cultural diversity and the needs of special needs
children.
Subd. 8. [REPORTING REQUIREMENTS.] Each authorized
child-placing agency shall provide to the commissioner of human
services all data needed by the commissioner for the report
required by section 216. The agency shall provide the data
within 60 days of the end of the six-month period for which the
data is applicable.
Sec. 216. [257.0725] [SEMIANNUAL REPORT.]
The commissioner of human services shall publish a
semiannual report on children in out-of-home placement. The
report shall include, by county and statewide, information on
legal status, living arrangement, age, sex, race, accumulated
length of time in placement, reason for most recent placement,
race of family with whom placed, number of families from the
child's own culture in the placement pool during the period for
which data is provided, and other demographic information deemed
appropriate on all children in out-of-home placement. The
commissioner shall provide the required data for children who
entered placement during the previous quarter and for children
who are in placement at the end of the quarter. Out-of-home
placement includes placement in any facility by an authorized
child-placing agency. By December 1, 1989, and by December 1 of
each successive year, the commissioner shall publish a report
covering the first six months of the calendar year. By June 1,
1990, and by June 1 of each successive year, the commissioner
shall publish a report covering the last six months of the
calendar year.
Sec. 217. [257.075] [GRANTS FOR SUPPORT SERVICES.]
The commissioner of human services may make grants to
authorized child-placing agencies that provide services to
minority children in out-of-home placements. Support services
may include, but are not limited to:
(1) development of foster and adoptive placement resources,
including recruitment, licensing, and support;
(2) advocacy in working with the county and private social
service agencies, and activities to help provide access to
agency services;
(3) family and community involvement strategies to combat
child abuse and chronic neglect of children;
(4) coordinated child welfare and mental health services to
minority families;
(5) preadoption, postadoption, and foster care support
groups for minority children and prospective adoptive and foster
families;
(6) the use of minority foster parents as continuing
support for children returned to birth homes;
(7) information, counseling, and support groups to assist
minority children approaching age 18 in setting permanent goals
for independent living;
(8) minority adolescent support groups for children in
long-term foster care, new adoptive placements, and nonminority
homes where identity issues threaten the adoptive relationship
and adjustment;
(9) services listed at section 256F.07; and
(10) other activities and services approved by the
commissioner that further the goals of the minority heritage
preservation act.
Sec. 218. Minnesota Statutes 1986, section 260.181,
subdivision 3, is amended to read:
Subd. 3. [PROTECTION OF RACIAL OR ETHNIC HERITAGE, OR
RELIGIOUS AFFILIATION.] The policy of the state is to ensure
that the best interests of children are met by requiring due
consideration of the child's minority race or minority ethnic
heritage in foster care placements.
The court, in transferring legal custody of any child or
appointing a guardian for the child under the laws relating to
juvenile courts, shall place the child, in the following order
of preference, in the absence of good cause to the contrary, in
the legal custody or guardianship of an individual who (a) is
the child's relative, or if that would be detrimental to the
child or a relative is not available, who (b) is of the same
racial or ethnic heritage as the child, or if that is not
possible, who (c) is knowledgeable and appreciative of the
child's racial or ethnic heritage. The court may require the
county welfare agency to continue efforts to find a guardian of
the child's minority racial or minority ethnic heritage when
such a guardian is not immediately available. For purposes of
this subdivision, "relative" includes members of a child's
extended family and important friends with whom the child has
resided or had significant contact.
If the child's genetic parent or parents explicitly request
that the preference described in clause (a) or in clauses (a)
and (b) not be followed, the court shall honor that request
consistent with the best interests of the child.
If the child's genetic parent or parents express a
preference for placing the child in a foster or adoptive home of
the same or a similar religious background to that of the
genetic parent or parents, in following the preferences in
clause (a) or (b), the court shall order placement of the child
with an individual who meets the genetic parent's religious
preference. Only if no individual is available who is described
in clause (a) or (b) may the court give preference to an
individual described in clause (c) who meets the parent's
religious preference.
Sec. 219. Minnesota Statutes 1986, section 268.0111, is
amended by adding a subdivision to read:
Subd. 4a. [HOMELESS INDIVIDUAL.] "Homeless individual," or
"homeless person" means:
(1) an individual who lacks a fixed, regular, and adequate
nighttime residence; and
(2) an individual who has a primary nighttime residence
that is:
(i) a supervised publicly or privately operated shelter or
dwelling designed to provide temporary living accommodations,
(ii) an institution that provides a temporary residence for
individuals intended to be institutionalized, or
(iii) a public or private place not designed for, or
ordinarily used as, a regular sleeping accommodation for humans.
The term "homeless individual" does not include any
individual imprisoned or otherwise detained pursuant to federal
or state law.
Sec. 220. [268.0124] [PLAIN LANGUAGE IN WRITTEN
MATERIALS.]
(a) To the extent reasonable and consistent with the goals
of providing easily understandable and readable materials and
complying with federal and state laws governing the programs,
all written materials relating to services and determinations of
eligibility for or amounts of benefits that will be given to
applicants for or recipients of assistance under a program
administered or supervised by the commissioner of jobs and
training must be understandable to a person who reads at the
seventh-grade level, using the Flesch scale analysis readability
score as determined under section 72C.09.
(b) All written materials relating to determinations of
eligibility for or amounts of benefits that will be given to
applicants for or recipients of assistance under programs
administered or supervised by the commissioner of jobs and
training must be developed to satisfy the plain language
requirements of the plain language contract act under sections
325G.29 to 325G.36. Materials may be submitted to the attorney
general for review and certification. Notwithstanding section
325G.35, subdivision 1, the attorney general shall review
submitted materials to determine whether they comply with the
requirements of section 325G.31. The remedies available
pursuant to sections 8.31 and 325G.33 to 325G.36 do not apply to
these materials. Failure to comply with this section does not
provide a basis for suspending the implementation or operation
of other laws governing programs administered by the
commissioner.
(c) The requirements of this section apply to all materials
modified or developed by the commissioner on or after July 1,
1988. The requirements of this section do not apply to
materials that must be submitted to a federal agency for
approval, to the extent that application of the requirements
prevents federal approval.
(d) Nothing in this section may be construed to prohibit a
lawsuit brought to require the commissioner to comply with this
section or to affect individual appeal rights granted pursuant
to section 268.10.
(e) The commissioner shall report annually to the chairs of
the health and human services divisions of the senate finance
committee and the house of representatives appropriations
committee on the number and outcome of cases that raise the
issue of the commissioner's compliance with this section.
Sec. 221. [268.39] [LIFE SKILLS AND EMPLOYMENT GRANTS.]
The commissioner may provide grants to organizations for
the development and administration of life skills and employment
plans for homeless individuals that reside in residential units
constructed or rehabilitated under section 462A.05, subdivision
29. Grants awarded under this section may also be used for the
management of these residential units. The organizations that
receive grants under this section must coordinate their efforts
with organizations that receive grants under section 462A.05,
subdivision 29.
A life skills and employment plan must be developed for
each tenant residing in a dwelling that receives funding under
section 462A.05, subdivision 29. The plan may include
preapprentice and apprenticeship training in the area of housing
rehabilitation. If preapprentice and apprenticeship training is
part of a plan, the organization must consult with labor
organizations experienced in working with apprenticeship
programs. The completion or compliance with the individual life
skills and employment plan must be required for a tenant to
remain in a unit constructed or rehabilitated under section
462A.05, subdivision 29.
The application for a grant under this section must include
a plan that must provide for:
(1) training for tenants in areas such as cleaning and
maintenance, payment of rent, and roommate skills, and
(2) tenant selection and rental policies that insure rental
of units to people who are homeless if applicable.
The applicant must provide a proposed occupancy contract if
applicable, the name and address of the rental agent if
applicable, and other information the commissioner considers
necessary with the application.
The commissioner may adopt permanent rules to administer
this grant program.
Sec. 222. Minnesota Statutes 1986, section 268.86, is
amended by adding a subdivision to read:
Subd. 10. [INVENTORY, REFERRAL, AND INTAKE SERVICES.] The
commissioner of jobs and training, in cooperation with the
commissioner of human services, shall develop an inventory,
referral, and intake system. The system must provide for
coordinated delivery of employment and training and income
maintenance support services, efficient client referral among
programs and services, reduction of duplicate data collection,
coordinated program intake by local agencies, and effective
evaluation of employment and training services. The system
must, at a minimum, include the following:
(1) a listing of all available public and private
employment and training services, income maintenance and support
services, and vocationally directed education and training
programs;
(2) the capability to assess client needs and match those
needs with employment opportunities, education and training
programs, and employment and training and income maintenance and
support services, and to refer the client to the appropriate
employer, educational institution, or service provider;
(3) a coordinated intake procedure for employment and
training services, and income maintenance and support services;
(4) access to a statewide data base for client tracking and
program evaluation; and
(5) internal security measures to protect private data from
unauthorized access.
In developing the system, the commissioner shall consult
with the public post-secondary educational systems, local
agencies, employment and training service providers, and client
and employer representatives. The system must be available in
each local agency or service provider delivering programs
administered by the commissioner of jobs and training or the
commissioner of human services. Access by intake workers, state
agency personnel, clients, and any other system users to
information contained in the system must conform with all
applicable federal and state data privacy requirements.
Sec. 223. Minnesota Statutes 1987 Supplement, section
268.91, subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For the purposes of this
section the following terms have the meanings given.
(a) "Child care services" means child care provided in
family day care homes, group day care homes, nursery schools,
day nurseries, child day care centers, play groups, head start,
and parent cooperatives, or in the child's home.
(b) "Child" means a person 12 years old or younger, or a
person age 13 or 14 who is handicapped, as defined in section
120.03.
(c) "Commissioner" means the commissioner of human services.
(d) "Child care" means the care of a child by someone other
than a parent or legal guardian in or outside the child's own
home for gain or otherwise, on a regular basis, for any part of
a 24-hour day.
(e) "County board" means the board of county commissioners
in each county.
(f) "Education program" means remedial or basic education
or English as a second language instruction, high school
education, a program leading to a general equivalency diploma,
and post-secondary education excluding post-baccalaureate
programs.
(g) "Employment program" means employment of recipients
financially eligible for the child care sliding fee program,
vocational assessment, and job readiness and job search
activities.
(h) "Family" means parents, stepparents, guardians, or
other caretaker relatives, and their blood related dependent
children and adoptive siblings under the age of 18 years living
in the same home including children temporarily absent from the
household in settings such as schools, foster care, and
residential treatment facilities. When a minor parent or
parents and his, her, or their child or children are living with
other relatives, and the minor parent or parents apply for a
child care subsidy, "family" means only the minor parent or
parents and the child or children. An adult may be considered a
dependent member of the family unit if 50 percent of the adult's
support is being provided by the parents, stepparents,
guardians, or other caregiver relatives residing in the same
household. An adult age 18 who is a full-time high school
student and can reasonably be expected to graduate before age 19
may be considered a dependent member of the family unit.
(i) "Human services board" means a board established under
section 402.02, Laws 1974, chapter 293, or Laws 1976, chapter
340.
(j) "Income" means earned or unearned income received by
all family members 16 years or older, including public
assistance benefits, unless specifically excluded. The
following are excluded from income: scholarships and grants
that cover costs for tuition, fees, books, and educational
supplies; student loans for tuition, fees, books, supplies, and
living expenses; in-kind income such as food stamps, energy
assistance, medical assistance, and housing subsidies; income
from summer or part-time employment of 16-, 17-, and 18-year-old
full-time secondary school students; grant awards under the
family subsidy program; and nonrecurring lump sum income only to
the extent that it is earmarked and used for the purpose for
which it is paid.
(i) (k) "Provider" means the child care license holder or
the legal nonlicensed caregiver who operates a family day care
home, a group family day care home, a day care center, a nursery
school, or a day nursery, or who functions in the child's home.
(j) (l) "Post-secondary educational systems" means the
University of Minnesota board of regents, the state university
board, the state board for community colleges, and the state
board of vocational technical education.
(k) (m) "AFDC priority groups" means the recipients defined
in section 256.736, subdivision 2a.
(l) (n) "AFDC" means aid to families with dependent
children.
Sec. 224. Minnesota Statutes 1987 Supplement, section
268.91, subdivision 3, is amended to read:
Subd. 3. [ALLOCATION.] (a) By June 1 of each odd-numbered
year, the commissioner shall notify all county and human
services boards and post-secondary educational systems of their
allocation. If the appropriation is insufficient to meet the
needs in all counties, the amount must be prorated among the
counties. Each county that receives funds under this section
must keep a written record and report to the commissioner the
number of eligible families who have applied for a child care
subsidy. Counties shall perform a cursory determination of
eligibility when a family requests information about child care
assistance. A family that appears to be eligible must be put on
a waiting list if funds are not immediately available.
(b) Except for set-aside money allocated under subdivisions
3a, 3b, 3c, and 3d, the commissioner shall allocate money
appropriated between the metropolitan area, comprising the
counties of Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and
Washington, and the area outside the metropolitan area so that
no more than 55 percent of the total appropriation goes to
either area after excluding allocations for statewide
administrative costs. The commissioner shall allocate 50
percent of the money among counties on the basis of the number
of families below the poverty level, as determined from the most
recent special census, and 50 percent on the basis of caseloads
of aid to families with dependent children for the preceding
fiscal year, as determined by the commissioner of human services.
(c) Once each quarter, the commissioner shall review the
use of child care fund allocations by county. In accordance
with the formula found in paragraph (b), The commissioner may
reallocate unexpended or unencumbered money among those counties
who have expended their full portion. Any unexpended money from
the first year of the biennium may be carried forward to the
second year of the biennium.
Sec. 225. Minnesota Statutes 1987 Supplement, section
268.91, subdivision 3b, is amended to read:
Subd. 3b. [SET-ASIDE MONEY FOR AFDC PRIORITY GROUPS.] (a)
Set-aside money for AFDC priority groups must be allocated among
the counties based on the average monthly number of caretakers
receiving AFDC under the age of 21 and the average monthly
number of AFDC cases open 24 or more consecutive months. For
each fiscal year the average monthly caseload shall be based on
the 12-month period ending March 31 of the previous fiscal year.
The commissioner may reallocate quarterly unexpended or
unencumbered set-aside money to counties that expend their full
allocation. The county shall use the set-aside money for AFDC
priority groups and for former AFDC recipients who (1) have had
their child care subsidized under the set-aside for AFDC
priority groups; (2) continue to require a child care subsidy in
order to remain employed; and (3) are on a waiting list for the
basic sliding fee program.
(b) The county shall develop cooperative agreements with
the employment and training service provider for coordination of
child care funding with employment, training, and education
programs for aid to families with dependent children priority
groups. The cooperative agreement shall specify that
individuals receiving employment, training, and education
services under an employability plan from the employment and
training service provider shall, as resources permit, be
guaranteed set-aside money for child care assistance from the
county of their residence.
(c) Counties may contract for administration of the program
or may arrange for or contract for child care funds to be used
by other appropriate programs, in accordance with this section
and as permitted by federal law and regulations.
(d) If the commissioner finds, on or after January 1 of a
fiscal year, that set-aside money for AFDC priority groups is
not being fully utilized, the commissioner may permit counties
to use set-aside money for other eligible applicants, as long as
priority for use of the money will continue to be given to the
AFDC priority groups.
(e) A county may claim federal reimbursement under the AFDC
special needs program for money spent for persons listed in
subdivision 3a, clause (1). The commissioner shall allocate any
federal earnings to the county. The county shall use the money
to expand services to AFDC recipients child care sliding fee
services under the child care sliding fee program this
subdivision.
Sec. 226. Minnesota Statutes 1987 Supplement, section
268.91, subdivision 3c, is amended to read:
Subd. 3c. [SET-ASIDE MONEY FOR AFDC POST-SECONDARY
STUDENTS.] (a) For the fiscal year ending June 30, 1988,
set-aside money for persons listed in subdivision 3a, clause
(2), shall be allocated to the counties based on caseloads of
aid to families with dependent children for the preceding fiscal
year, as determined by the commissioner. For succeeding fiscal
years, the commissioner shall, in cooperation with the director
of the higher education coordinating board, develop a formula
for allocation of the funds to counties based on the number of
AFDC caretakers in each county who are enrolled at
post-secondary institutions.
(b) Money allocated in paragraph (a) must be used for child
care expenses of AFDC recipients attending post-secondary
educational programs, excluding post-baccalaureate programs, and
making satisfactory progress towards completion of the program.
(c) Once each quarter the commissioner shall review the use
of child care fund allocations under this subdivision by
county. The commissioner may reallocate unexpended or
unencumbered money among those counties that have expended their
full portion for the purposes of this subdivision.
(d) A county may claim federal reimbursement under the AFDC
special needs program for money spent for persons listed in
subdivision 3a, clause (2). The commissioner shall allocate any
federal earnings to the county. The county shall use the money
to expand child care sliding fee services to AFDC recipients
under the child care sliding fee program under this subdivision.
(e) Recipients of AFDC who have completed their
post-secondary education and had received child care funds
during that education shall be assured, to the extent of
available resources allocations, of sliding fee money for
employment programs after graduation if they meet sliding fee
program eligibility standards.
Sec. 227. Minnesota Statutes 1987 Supplement, section
268.91, subdivision 3e, is amended to read:
Subd. 3e. [USE OF MONEY.] Money for persons listed in
subdivision 3a, clauses (2) and (3), shall be used to reduce the
costs of child care for students, including the costs of child
care for students while employed if enrolled in an eligible
education program at the same time and making satisfactory
progress towards completion of the program. The county may plan
for and provided child care assistance to persons listed in
subdivision 3a, clauses (2) and (3), from the regular sliding
fee fund to supplement the set-aside funds. Financially
eligible students provided who have received child care
assistance for one academic year shall be provided child care
assistance in the following academic year, providing they remain
financially eligible if funds allocated under subdivision 3c or
3d are available.
Sec. 228. Minnesota Statutes 1987 Supplement, section
268.91, subdivision 4, is amended to read:
Subd. 4. [FINANCIAL ELIGIBILITY.] (a) Child care services
must be available to families who need child care to find or
keep employment or to obtain the training or education necessary
to find employment and who:
(1) receive aid to families with dependent children;
(2) have household income below the eligibility levels for
aid to families with dependent children; or
(3) have household income within a range established by the
commissioner.
(b) Child care services for the families receiving aid to
families with dependent children must be made available as
in-kind services, to cover any difference between the actual
cost and the amount disregarded under the aid to families with
dependent children program. Child care services to families
whose incomes are below the threshold of eligibility for aid to
families with dependent children, but that are not receiving aid
to families with dependent children, must be made available
without cost to the families.
(c) Child care services to families with incomes in the
commissioner's established range must be made available on a
sliding fee basis. The lower limit of the sliding fee range
must be the eligibility limit for aid to families with dependent
children. The upper limit of the range must be neither less
than 70 percent nor more than 90 percent of the state median
income for a family of four, adjusted for family size.
(d) If a disproportionate amount of the available money is
provided to any one of the groups described in subdivision 4,
paragraph (a), the county board shall document to the
commissioner the reason the group received a disproportionate
share. If a county projects that its child care allocation is
insufficient to meet the needs of all eligible groups, it may
prioritize among the groups to be served. Counties shall assure
that a person receiving child care assistance from the sliding
fee program prior to July 1, 1987, continues to receive
assistance, providing the person meets all other eligibility
criteria. Set-aside money must be prioritized by the state, and
counties do not have discretion over the use of this money.
(e) Annual income of the applicant family is the current
monthly income of the family multiplied by 12 or the income for
the 12-month period immediately preceding the date of
application, whichever provides the most accurate assessment of
income available to the family. Self-employment income must be
calculated based on gross receipts less operating expenses.
Income must be redetermined when the family's income changes,
but no less often than every six months. Income must be
verified with documentary evidence. If the applicant does not
have sufficient evidence of income, verification must be
obtained from the source of the income.
Sec. 229. Minnesota Statutes 1986, section 268.91,
subdivision 7, is amended to read:
Subd. 7. [SLIDING FEE SCALE.] In setting the sliding fee
schedule, the commissioner shall exclude from the amount of
income used to determine eligibility an amount for federal and
state income and social security taxes attributable to that
income level according to federal and state standardized tax
tables. The commissioner shall base the parent fee on the
ability of the family to pay for child care. The fee schedule
must be designed to use any available tax credits and to
progress smoothly from appropriated assistance to assistance
through tax credits.
Sec. 230. Minnesota Statutes 1987 Supplement, section
268.91, subdivision 12, is amended to read:
Subd. 12. [FAIR HEARING PROCESS.] (a) Applicants and
recipients have the option to request the county to conduct a
conciliation conference to attempt to resolve complaints arising
from any of the following actions:
(1) a determination of ineligibility for child care
assistance;
(2) unauthorized termination of child care assistance;
(3) determination of the factors considered in setting the
family fee; and
(4) income redetermination resulting in change of a family
fee.
(b) The county shall notify the applicant or the recipient,
in writing, of any adverse action. The determination described
in paragraph (a), clauses (1) and (3), must include written
notice of the applicant's or recipient's right to the election
described in paragraph (c), where and how to request the
election, the time limit within which to make the request, and
the reasons for the determination. Notice of the proposed
actions described in paragraph (a), clauses (2) and (4), must be
mailed to the applicant or recipient at least 15 calendar days
before the effective date of the action. The notice must
clearly state what action the county proposes to take, the
effective date of the proposed action, the reasons for the
proposed action, the necessary corrective measures, the option
to request either a conciliation conference or an administrative
hearing, where and how to make the request, the time limits
within which a request must be made, and the consequence of the
action.
(c) An applicant or recipient who receives a determination
or notice of proposed action under paragraph (b) must mail or
deliver either a written notice of request for a conciliation
conference to the administering agency or a written notice of
request for the hearing specified under paragraph (e) to the
administering agency on or before the effective date of the
proposed action or the date specified in the notice, or the
action will be final.
(d) The county shall provide a conciliation conference
within 30 days of receipt of a written request.
The county shall give the applicant or recipient ten
calendar days' notice of the conference date. The applicant or
recipient and the county's representative have the right to
appear, to bring witnesses, and to submit documentation. The
written request and the resolution, if any, of the conference
shall be maintained as part of the official record. The
county's representative shall issue a written resolution only if
mutual agreement is reached between the county's representative
and the applicant or recipient. The resolution must be signed
by both parties and issued the same day as the conciliation
conference is held. Participating in a conciliation conference
or signing a resolution does not constitute a waiver of the
right to an administrative hearing.
An applicant or recipient may, within 15 calendar days of
the conference, mail or deliver a written request to the
administering agency for an administrative hearing. Unless an
appeal is requested, a determination, proposed action, or
resolution of a conciliation conference will be final after the
15-day period has passed.
(e) A fair hearing shall be conducted in the manner
prescribed by section 268.10, subdivision 3. A right to review
will be provided in accordance with section 268.10, subdivision
5. The proposed action will not take effect until the appeal is
decided by the administrative hearing process.
(a) An applicant or recipient adversely affected by a
county agency action may request a fair hearing in accordance
with section 256.045, subdivision 3.
(b) The county agency shall offer an informal conference to
applicants and recipients adversely affected by an agency action
to attempt to resolve the dispute. The county agency shall
advise adversely affected applicants and recipients that a
request for a conference with the agency is optional and does
not delay or replace the right to a fair hearing.
Sec. 231. Minnesota Statutes 1986, section 268.911,
subdivision 3, is amended to read:
Subd. 3. [PROGRAM SERVICES.] The commissioner may make
grants to public or private nonprofit entities to fund child
care resource and referral programs. Child care resource and
referral programs must serve a defined geographic area.
(a) Each program shall identify all existing child care
services through information provided by all relevant public and
private agencies in the areas of service, and shall develop a
resource file of the services which shall be maintained and
updated at least quarterly. These services must include family
day care homes; public and private day care programs; full-time
and part-time programs; infant, preschool, and extended care
programs; and programs for school age children.
The resource file must include: the type of program, hours
of program service, ages of children served, fees, location of
the program, eligibility requirements for enrollment, and
transportation available to the program. The file may also
include program information and special needs services.
(b) Each program shall establish a referral process which
responds to parental need for information and which fully
recognizes confidentiality rights of parents. The referral
process must afford parents maximum access to all referral
information. This access must include telephone referral
available for no less than 20 hours per week.
Each child care resource and referral agency shall
publicize its services through popular media sources, agencies,
employers, and other appropriate methods.
(c) Each program shall maintain ongoing documentation of
requests for service. All child care resource and referral
agencies must maintain documentation of the number of calls and
contacts to the child care information and referral agency or
component. A program may collect and maintain the following
information:
(1) ages of children served;
(2) time category of child care request for each child;
(3) special time category, such as nights, weekends, and
swing shift; and
(4) reason that the child care is needed.
(d) Each program shall have available the following
information as an educational aid to parents:
(1) information on aspects of evaluating the quality and
suitability of child care services, including licensing
regulation, financial assistance available, child abuse
reporting procedures, appropriate child development information;
(2) information on available parent, early childhood, and
family education programs in the community.
(e) A program may provide technical assistance to existing
and potential providers of all types of child care services and
employers. This assistance shall include:
(1) information on all aspects of initiating new child care
services including licensing, zoning, program and budget
development, and assistance in finding information from other
sources;
(2) information and resources which help existing child
care providers to maximize their ability to serve the children
and parents of their community;
(3) dissemination of information on current public issues
affecting the local and state delivery of child care services;
(4) facilitation of communication between existing child
care providers and child-related services in the community
served; and
(5) recruitment of licensed providers; and
(6) options, and the benefits available to employers
utilizing the various options, to expand child care services to
employees.
Services prescribed by this section must be designed to
maximize parental choice in the selection of child care and to
facilitate the maintenance and development of child care
services and resources.
(f) Child care resource and referral information must be
provided to all persons requesting services and to all types of
child care providers and employers.
(g) Public or private entities may apply to the
commissioner for funding. The maximum amount of money which may
be awarded to any entity for the provision of service under this
subdivision is $60,000 per year. A local match of up to 25
percent is required.
Sec. 232. Minnesota Statutes 1986, section 326.371, is
amended to read:
326.371 [BAN ON LEAD IN PLUMBING.]
Lead pipe, solders, and flux containing more than 0.2
percent lead, and pipes and pipe fittings containing more than
eight percent lead shall not be used in any plumbing
installation which conveys a potable water supply. A Minnesota
seller of lead solder, except for a seller whose primary
business is contracting in plumbing, heating, and air
conditioning, shall not sell any solder containing 0.2 percent
lead unless the seller displays a sign which states,
"Contains Lead
Minnesota law prohibits the use of this solder in any
plumbing installation which is connected to a potable water
supply."
Sec. 233. Minnesota Statutes 1987 Supplement, section
326.73, is amended to read:
326.73 [EMPLOYEE ASBESTOS CERTIFICATIONS.]
Before an employee performs asbestos-related work, the
employee shall first obtain a certificate from the commissioner
certifying that the employee is qualified to perform the work.
No certificate shall be issued unless the employee has shown
evidence of training or experience in the general commercial
building construction trades, has taken a course of training in
asbestos control and removal, passed an examination in those
subjects, and demonstrated to the commissioner the ability to
perform asbestos-related work safely in accordance with the
current state-of-the-art technology. The commissioner shall
specify the course of training necessary. The certificate
issued by the commissioner shall be in writing, be dated when
issued, contain an expiration date, be signed by the
commissioner, and contain the name and address of the employee
to whom it is issued. The certificate shall be carried by the
employee and be readily available for inspection by the
commissioner, other public officials charged with the health,
safety, and welfare of the state's citizens, and the contracting
entity.
Sec. 234. Minnesota Statutes 1986, section 462A.05, is
amended by adding a subdivision to read:
Subd. 29. [HOUSING GRANTS FOR HOMELESS INDIVIDUALS.] The
agency may provide grants to eligible mortgagors for the purpose
of purchasing, rehabilitating, and constructing housing for
homeless individuals as defined in section 268.0111, subdivision
4a. The agency may determine the conditions, if any, under
which all or a portion of the grant will be repaid and
appropriate security, if any, for repayment of the grant. In
establishing this grant program, the agency must consult the
commissioner of jobs and training. The applicant must consult
with advocates for the homeless, representatives from
neighborhood groups and representatives of labor organizations
in preparing the proposal.
Grants awarded under this section may not exceed $25,000
per residential unit. Priority must be given to viable
proposals with the lowest total cost. Applicants must consider
the use of donated or leased, abandoned or empty dwellings owned
by a public entity including, but not limited to, a housing
redevelopment authority, community development authority, public
housing authority, the federal Department of Housing and Urban
Development, or the Farmers Home Administration. Any
residential unit purchased, rehabilitated, or constructed under
this section must be allocated in the following order:
(1) homeless families with at least one dependent,
(2) other homeless individuals,
(3) other very low income families or individuals whose
incomes are equal to or less than 30 percent of the median
income for the Minneapolis-St. Paul metropolitan area, and
(4) families or individuals that receive public assistance
and do not qualify in any other priority group.
Proposals must include a plan for (a) maintaining the
ownership of the property and managing the dwelling for rental
to homeless individuals and families and very low income
families; (b) selling rehabilitated dwellings to homeless
individuals and families or very low income families; or (c)
selling, leasing, or conveying to organizations that will manage
the dwelling for rental to homeless individuals and families and
very low income families. These organizations may include
organizations awarded grants under section 268.39. The homeless
individuals or families or very low income families that may
purchase dwellings under (b) must have incomes that are equal to
or less than 30 percent of the median income for the
Minneapolis-St. Paul metropolitan area.
Eligible mortgagors must demonstrate that the grants
awarded under this section will not exceed 50 percent of the
project's total cost. A project's total cost includes, but is
not limited to, acquisition costs, rehabilitation costs, and
related costs. In cases where the property is donated, the
acquisition costs are the prerehabilitated estimated market
value as established for property tax purposes. Donated
property may be used to satisfy the match requirement.
Sec. 235. Minnesota Statutes 1986, section 462A.21, is
amended by adding a subdivision to read:
Subd. 14. It may make housing grants for homeless
individuals as provided in section 462A.05, subdivision 29, and
may pay the costs and expenses for the development and operation
of the program.
Sec. 236. Minnesota Statutes 1986, section 609.72,
subdivision 1, is amended to read:
Subdivision 1. Whoever does any of the following in a
public or private place, knowing, or having reasonable grounds
to know that it will, or will tend to, alarm, anger or disturb
others or provoke an assault or breach of the peace, is guilty
of disorderly conduct, which is a misdemeanor:
(1) Engages in brawling or fighting; or
(2) Disturbs an assembly or meeting, not unlawful in its
character; or
(3) Engages in offensive, obscene, or abusive language or
in boisterous and noisy conduct tending reasonably to arouse
alarm, anger, or resentment in others.
A person does not violate this section if the person's
disorderly conduct was caused by an epileptic seizure.
Sec. 237. Minnesota Statutes 1986, section 611A.32, is
amended by adding a subdivision to read:
Subd. 1a. [PROGRAM FOR AMERICAN INDIAN WOMEN.] The
commissioner shall establish at least one program under this
section to provide emergency shelter services and support
services to battered American Indian women. The commissioner
shall grant continuing operating expenses to the program
established under this subdivision in the same manner as
operating expenses are granted to programs established under
subdivision 1.
Sec. 238. Laws 1984, chapter 654, article 5, section 57,
subdivision 1, as amended by Laws 1987, chapter 75, section 1,
is amended to read:
Subdivision 1. [RESTRICTED CONSTRUCTION OR MODIFICATION.]
Through June 30, 1990, the following construction or
modification may not be commenced:
(1) any erection, building, alteration, reconstruction,
modernization, improvement, extension, lease, or other
acquisition by or on behalf of a hospital that increases the bed
capacity of a hospital, relocates hospital beds from one
physical facility, complex, or site to another, or otherwise
results in an increase or redistribution of hospital beds within
the state; and
(2) the establishment of a new hospital.
This section does not apply to:
(1) construction or relocation within a county by a
hospital, clinic, or other health care facility that is a
national referral center engaged in substantial programs of
patient care, medical research, and medical education meeting
state and national needs that receives more than 40 percent of
its patients from outside the state of Minnesota;
(2) a project for construction or modification for which a
health care facility held an approved certificate of need on May
1, 1984, regardless of the date of expiration of the certificate;
(3) a project for which a certificate of need was denied
prior to the date of enactment of this act if a timely appeal
results in an order reversing the denial;
(4) a project exempted from certificate of need
requirements by Laws 1981, chapter 200, section 2;
(5) a project involving consolidation of pediatric
specialty hospital services within the Minneapolis-St. Paul
metropolitan area that would not result in a net increase in the
number of pediatric specialty hospital beds among the hospitals
being consolidated;
(6) a project involving the temporary relocation of
pediatric-orthopedic hospital beds to an existing licensed
hospital that will allow for the reconstruction of a new
philanthropic, pediatric-orthopedic hospital on an existing site
and that will not result in a net increase in the number of
hospital beds. Upon completion of the reconstruction, the
licenses of both hospitals must be reinstated at the capacity
that existed on each site prior to the relocation;
(7) the relocation or redistribution of hospital beds
within a hospital building or identifiable complex of buildings
provided the relocation or redistribution does not result in:
(i) an increase in the overall bed capacity at that site; (ii)
relocation of hospital beds from one physical site or complex to
another, or (iii) redistribution of hospital beds within the
state or a region of the state; or
(8) relocation or redistribution of hospital beds within a
hospital corporate system that involves the transfer of beds
from a closed facility site or complex to an existing site or
complex provided that: (i) no more than 50 percent of the
capacity of the closed facility is transferred; (ii) the
capacity of the site or complex to which the beds are
transferred does not increase by more than 50 percent; (iii) the
beds are not transferred outside of a federal health systems
agency boundary in place on July 1, 1983; and (iv) the
relocation or redistribution does not involve the construction
of a new hospital building; or
(9) a construction project involving up to 35 new beds in a
psychiatric hospital in Rice county that primarily serves
adolescents and that receives more than 70 percent of its
patients from outside the state of Minnesota.
Sec. 239. Laws 1987, chapter 337, section 131, is amended
to read:
Sec. 131. [REPEALER.]
Minnesota Statutes 1986, sections 62A.12; and 67A.43,
subdivision 3, are repealed.
Minnesota Rules, parts 2700.2400; 2700.2410; 2700.2420;
2700.2430; and 2700.2440, are repealed.
Section 123 is repealed effective July 1, 1988, if the
project implementation phase has not begun by that date.
Sec. 240. Laws 1987, chapter 403, article 1, section 4,
subdivision 4, is amended to read:
Subd. 4. Community Services
$ 1,921,000 $ 1,520,000
Of this appropriation, $200,000 the
first year and $200,000 the second year
are to provide for the local storage,
transportation, processing, and
distribution of United States
Department of Agriculture surplus
commodities. The department of jobs
and training shall report on the
surplus commodities program to the
state legislature by January 15 of each
year.
Notwithstanding any law to the
contrary, for the biennium ending June
30, 1989, the commissioner of jobs and
training shall transfer to the
community services block grant program
ten percent of the money received under
the low-income home energy assistance
block grant in each year of the
biennium and shall expend all of the
transferred money during the year of
the transfer or the year following the
transfer. None of the transferred
money may be used by the commissioner
of jobs and training for administrative
costs, except that up to two Up to 3.75
percent of the transferred money may be
used by the commissioner of jobs and
training for administrative costs,
except that up to 4.25 percent of the
funds used to supplement the federal
funding for Project Head Start may be
used for administrative costs.
Twenty-five percent of the money
transferred by the commissioner of jobs
and training from the low-income home
energy assistance block grant to the
community services block grant shall be
used to supplement the federal funding
of Project Head Start for children from
low-income families. Notwithstanding
any law to the contrary, these
transferred funds shall be allocated
through the existing Project Head Start
formula to existing Project Head Start
grantees for the purpose of expanding
services to additional low-income
families. The transferred funds shall
be expended according to the federal
regulations governing Project Head
Start, including Code of Federal
Regulations, title 45, sections 1302
through 1305. Each local Project Head
Start shall expend the supplemental
funds during the year of their receipt
or the year following their receipt.
The commissioner of jobs and training
shall prepare an annual report to the
legislature describing the uses and
impacts of the Project Head Start
supplemental funding. The first annual
report shall be delivered to the
appropriate committees of the
legislature on January 1 following the
first full school year for which
supplemental funding is available.
For the biennium ending June 30, 1989,
the commissioner of jobs and training
shall shift to the low-income home
weatherization program at least five
percent of money received under the
low-income home energy assistance block
grant in each year of the biennium and
shall expend all of the transferred
funds during the year of the transfer
or the year following the transfer.
None Up to 1.63 percent of the
transferred money may be used by the
commissioner of jobs and training for
administrative costs.
To the extent allowed by federal
regulations, the commissioner of jobs
and training shall ensure that the same
income eligibility criteria apply to
both the weatherization program and the
energy assistance program.
For the biennium ending June 30, 1989,
no more than 1.11 percent of funds
received under the total low-income
home energy assistance program may be
used by the commissioner for
departmental administrative costs 1.63
percent of funds remaining under the
low-income home energy assistance
program after transfers to community
services block grants and the
weatherization program may be used by
the department for administrative costs.
Discretionary money from the community
services block grant (regular) must be
used to supplement the appropriation
for local storage, transportation,
processing, and distribution of United
States Department of Agriculture
surplus commodities to the extent
supplementary funding is required. Any
remaining funds shall be allocated to
state-designated and state-recognized
community action agencies, Indian
reservations, and the Minnesota migrant
council.
In the event that the federal office of
community services does not recognize
the Olmsted and Freeborn county
community action agencies as eligible
entities for full funding, the
commissioner shall provide full funding
for those agencies from discretionary
funds resulting from block grant
transfers to the community services
block grant. The balance of these
funds may be used by the commissioner
for discretionary purposes consistent
with federal community services block
grant guidelines stated in Public Law
Number 97-35. The commissioner shall
by January 1, 1988, report to the
legislature on the use of these funds.
The commissioner shall by January 1,
1988, provide to the chairs of the
health and human services divisions of
the house appropriations committee and
the senate finance committee a written
plan describing how the department's
division of community services will
issue one contract for human service
programs, with the community action
agencies, the Indian reservations, and
the Minnesota migrant council,
including but not limited to, the
community services block grant program,
the low-income home weatherization
program, the low-income energy
assistance program, the USDA Surplus
Commodities Program, and all other
programs for which the division has
contractual responsibility.
Sec. 241. Laws 1987, chapter 403, article 2, section 34,
is amended to read:
Sec. 34. [245.48] [MAINTENANCE OF EFFORT.]
Counties must continue to spend for mental health services,
according to generally accepted budgeting and accounting
principles, an amount equal to the total expenditures shown in
the county's approved 1987 Community Social Services Act plan
under "State CSSA, Title XX and County Tax" for services to
persons with mental illness plus the total comparable figure for
Rule 5 facilities under target populations other than mental
illness in the approved 1987 CSSA plan.
Sec. 242. Laws 1987, chapter 403, article 4, section 13,
is amended to read:
Sec. 13. [STUDY AND REPORT.]
(a) The interagency board for quality assurance shall study
the following issues and report to the legislature by December
15, 1988, on its findings and recommendations:
(1) the advisability of changing the definition of
"hardship" for purposes of the nursing home moratorium;
(2) the advisability of defining the need for nursing home
beds in terms of the population aged 75 and older; and
(3) the existence of a geographic maldistribution of
long-term care beds and alternative care services in the state.
(b) In addition to the issues in paragraph (a), the
interagency board shall study and make recommendations
concerning the policy and fiscal impact of the changes made in
Public Law Number 100-203 relating to the elimination of the
intermediate care facility certification level in 1990. The
interagency board shall consider at least the following: the
need for continuation of the services currently offered by
certified boarding care home beds, the need for additional beds
in state licensed nursing homes, the fiscal impact associated
with the reconstruction or replacement of facilities that do not
meet nursing home standards, the costs of establishing an
alternative funding source for the payment of services currently
provided in these facilities, and the need to promulgate
licensure standards. If the interagency board recommends that
facilities be licensed as nursing homes, the interagency board
shall recommend specific procedures for the granting of the
licenses and identify methods for the licensing or funding of
facilities that may be considered out of compliance with federal
law on October 1, 1990. The board shall provide recommendations
to the legislature for legislative changes that are necessary to
implement the board's recommendations. The costs associated
with the board's recommendations must be provided to the
commissioner of human services and included in the medical
assistance forecast and the agency budget requests for the
biennium ending June 30, 1991.
Sec. 243. [MEDICAL ASSISTANCE; QUALIFIED OCCUPATIONAL
THERAPIST.]
Notwithstanding Minnesota Rules, part 9500.1070, subpart
13, item B, for purposes of medical assistance reimbursement,
the term "qualified occupational therapist" includes a person
who:
(1) has completed an occupational therapy educational
program in a foreign school approved by the World Federation of
Occupational Therapists;
(2) has at least ten years' experience working as a paid
occupational therapist in the United States; and
(3) is eligible to write the national certification
examination administered by the American Occupational Therapy
Association for registration as an occupational therapist.
Sec. 244. [NURSING HOME SPECIAL ASSESSMENT FOR SEWER
RENTAL.]
Notwithstanding contrary provisions of Minnesota Statutes,
section 256B.431, for purposes of determining the amount of a
reported actual special assessment to be included in a nursing
home's operating cost, the commissioner of human services shall
include an expense charged to a nursing home by the municipality
of Minneota through a sewer rental charge assessed against the
nursing home for a wastewater treatment facility.
Sec. 245. [REPORT ON HOSPITAL-ATTACHED NURSING HOME
PROPERTY PAYMENTS.]
The commissioner of human services shall study
property-related payments for hospital-attached nursing homes
and report to the legislative commission on long-term health
care by February 1, 1989, with recommendations on appropriate
cost allocation methods to be used for property-related
reimbursement.
Sec. 246. [MEDICAL SCREENING.]
Subdivision 1. [SCREENINGS.] The commissioner of health
shall conduct a medical screening of a sample of people and
family members of people who were employed at the Conwed
Corporation plant in Cloquet, Minnesota, from January 1, 1958 to
December 31, 1974. The purpose of the screening is to study the
existence of asbestos-related diseases among people employed at
the plant during that time, evaluate their health care needs,
and provide medical and scientific data to coordinate future
health screening, counseling, and treatment activities among
these people and their families.
Subd. 2. [EXPERTS.] The commissioner of health may
contract with local, state, or nationally recognized experts in
the diagnosis and treatment of asbestos-related diseases for
medical examinations of workers, scientific evaluations of data
and consultations on the screening results.
Subd. 3. [REPORT AND RECOMMENDATIONS.] The commissioner of
health shall present a report and recommendations to the
legislature on or before March 1, 1989, based on the findings of
the medical screenings specified above. The report shall
address, but not be limited to:
(1) the actual and estimated extent and risks of
asbestos-related disease among the people screened;
(2) the types of counseling and prevention services that
the people screened may need and the methods of administering
the services; and
(3) the estimated cost and effectiveness of screening,
counseling, and preventive services for people described in
subdivision 1 who were not included in the sample of people
screened.
Sec. 247. [157.045] [INCREASE IN FEES.]
For licenses issued for 1989 and succeeding years, the
commissioner of health shall increase license fees for
facilities licensed under chapters 157 and 327 to a level
sufficient to recover all expenses related to the licensing,
inspection, and enforcement activities prescribed in those
chapters. In calculating the fee increase, the commissioner
shall include the salaries and expenses of 5.5 new positions
required to meet the inspection frequency prescribed in
Minnesota Statutes, section 157.04. Fees collected must be
deposited in the special revenue account.
Sec. 248. [LOCAL INCOME ASSISTANCE FROM FEDERAL FOOD
STAMPS.]
To the extent of available appropriations, the commissioner
of human services shall contract with community outreach
programs to encourage participation in the food stamp program of
seniors, farmers, veterans, unemployed workers, low-income
working heads of households, battered women residing in
shelters, migrant workers, families with children, and other
eligible individuals who are homeless. For purposes of this
section, "homeless" means that the individual lacks a fixed and
regular nighttime residence or has a primary nighttime residence
that is:
(1) a publicly supervised or privately operated shelter,
including a welfare hotel or congregate shelter, designed to
provide temporary living accommodations;
(2) an institution that provides a temporary residence for
individuals who will be institutionalized;
(3) a temporary accommodation in the residence of another
individual; or
(4) a public or private place not designed for, or
ordinarily used as, a regular sleeping accommodation for human
beings.
The commissioner shall seek federal reimbursement for state
money used for grants and contracts under this section. Federal
money received is appropriated to the commissioner for purposes
of this section. The commissioner shall convene an advisory
committee to help establish criteria for awarding grants, to
make recommendations regarding grant proposals, to assist in the
development of training and educational materials, and to
participate in the evaluation of grant programs. The grantees
shall provide training for program workers, offer technical
assistance, and prepare educational materials. Grantees must
demonstrate that grants were used to increase participation in
the food stamp program by creating new outreach activities, and
not by replacing existing activities. No more than five percent
of the appropriation for community outreach programs shall be
used by the commissioner for the department's administrative
costs. The rulemaking requirements of Minnesota Statutes,
chapter 14 do not apply to the procedures used by the
commissioner to request and evaluate grant proposals and to
award grants and contracts under this section. Distribution of
grant money must begin within three months after any transfer of
funds from the commissioner of health to the commissioner of
human services.
Sec. 249. [HEALTHSPAN IMPLEMENTATION PLAN.]
The commissioner of human services, in consultation with
the commissioners of health and commerce, shall develop a plan
to implement the healthspan program to provide health coverage
to uninsured individuals. The plan must include at least the
following:
(1) estimates of the number of people eligible for the
program, the expected number of individuals who will enroll, and
the costs of the program;
(2) a description of benefits to be offered;
(3) recommendations for methods to determine eligibility
and collect premiums;
(4) strategies for contracting and marketing;
(5) strategies to preserve and enhance employer
participation in the provision of health care coverage;
(6) strategies to coordinate or merge the program with
health care programs such as general assistance medical care,
the university hospital papers program at the University of
Minnesota hospitals, Minnesota comprehensive health association,
medical assistance, Medicare, the catastrophic health expense
protection program, the children's health plan, and other
similar programs;
(7) timelines for implementing the program, with specific
implementation plans for the 1989-1991 biennium;
(8) methods of financing the program; and
(9) recommendations for legislation to implement the
program.
The commissioner shall report to the legislature by January
1, 1989, on options to implement the program.
Sec. 250. [TRANSFER FOR ENVIRONMENTAL LABORATORY
CERTIFICATION PROGRAM.]
An amount equal to the appropriation from the special
revenue fund to the commissioner of health for implementation of
the environmental laboratory certification program must be
transferred from the laboratory certification account to the
special revenue fund by June 30, 1992.
Sec. 251. [DEMONSTRATION PROJECT.]
The commissioner of human services shall establish a
demonstration project to increase the independence of people
with epilepsy by providing training in independent living. The
commissioner shall award a grant for the demonstration project
to a nonresidential program that provides medical monitoring and
living skills training to people with epilepsy who live
independently. The grant awarded under this section must be
used for salaries, administration, transportation, and other
program costs. The developmental disabilities planning section
of the state planning agency shall consult with the commissioner
of human services and shall evaluate the effectiveness of the
epilepsy demonstration project in increasing independence of the
people with epilepsy who are served by the project. By December
1, 1989, the developmental disabilities planning section shall
present a report to the legislature with the evaluation and a
recommendation on whether there is a need to continue or expand
the program.
Sec. 252. [PURPOSE FOR MINNESOTA INSTITUTE FOR ADDICTION
AND STRESS RESEARCH.]
To place Minnesota in a leadership role for neurobiological
research of addictive disorders and stress-related diseases, the
legislature finds it necessary to establish a research institute
dedicated to clinical and basic scientific investigation of
addictive disorders and stress-related diseases. Because of the
critical relationship between addictive and stress-related
disorders, the institute will study the neurobiological origins
of stress and will investigate and develop therapies for other
stress-related medical disorders that are not responsive to
available medical therapies. Regarding addictive disorders, the
institute's primary objective is to develop and test new
scientifically based therapy to reduce the rate of recidivism in
the addicted population and lower the costs of therapy.
Furthermore, the institute will stimulate and attract
significant new research activity to Minnesota.
Sec. 253. [LEAD CONTAMINATION; DEMONSTRATION PROJECTS.]
The department of health shall fund and participate in a
two-year demonstration project to be undertaken by an
organization serving a population at risk from lead
contamination to monitor blood lead levels in pregnant women,
provide information to pregnant patients about how to avoid high
blood lead levels, and to provide intervention for pregnant
patients whose blood lead levels exceed 12 micrograms per
deciliter. The purpose of the project is to establish an
effective prototype method of monitoring, education, and
intervention to prevent or reduce high blood lead levels in
pregnant women. By November 1, 1990, the center and the
department shall report to the legislature on the outcome of the
project.
The department shall also fund a project for the purpose of
demonstrating the impact on blood lead levels in children, of
soil, dust, paint, and interior and exterior lead cleanup and
use of educational materials on proper handling of lead paint
removal and cleanup. The project must be undertaken by a
community based organization and must include:
(1) neighborhood involvement and an educational community
outreach component;
(2) a cost-benefit analysis;
(3) planning for a centrally located information and
educational center to serve the community; and
(4) a final evaluation on the effectiveness of the project
based on routes of exposure, statistical design of the project,
and geographical distribution. The project must include cleanup
of lead contamination in a targeted portion of a neighborhood
with known lead contamination. Cleanup includes soil removal
and replacement, landscaping and removal of loose paint. The
department shall test children who reside in the project area
before cleanup and one year following cleanup for blood lead
levels. The evaluation required as part of the project must be
presented to the legislature by January 1, 1990.
Sec. 254. [REVIEW OF SMALL HOSPITAL RATES.]
The commissioner of human services shall, in conjunction
with hospitals, review the adequacy of reimbursement for
catastrophic cases for hospitals described in section 140,
paragraph (c), in light of changes in case mix from the base
year.
Sec. 255. [STUDY OF RURAL HOSPITALS.]
The commissioner of health shall study the rural hospital
system in the state and report to the legislature by February 1,
1989, with a description of the financial condition of rural
hospitals, including the identification of regions in the state
where the closing of a financially distressed hospital will
result in access problems for rural residents.
Sec. 256. [ALTERNATIVE CARE GRANTS PILOT PROJECTS.]
Subdivision 1. [SELECTION OF PROJECTS.] The commissioner
of human services shall establish pilot projects to demonstrate
the feasibility and cost-effectiveness of alternatives to
nursing home care that involve providing coordinated alternative
care grant services for all eligible residents in an identified
apartment building or complex or other congregate residential
setting. The commissioner shall solicit proposals from counties
and shall select up to four counties to participate, including
at least one metropolitan county and one county in greater
Minnesota. The commissioner shall select counties for
participation based on the extent to which a proposed project is
likely to:
(1) meet the needs of low-income, frail elderly;
(2) enable clients to live as independently as possible;
(3) result in cost-savings by reducing the per person cost
of alternative care grant services through the efficiencies of
coordinated services; and
(4) facilitate the discharge of elderly persons from
nursing homes to less restrictive settings or delay their entry
into nursing homes.
Participating counties shall use existing alternative care
grant allocations to pay for pilot project services. The
counties must contract with a medical assistance-certified home
care agency to coordinate and deliver services and must
demonstrate to the commissioner that quality assurance and
auditing systems have been established. Notwithstanding
Minnesota Statutes, section 256B.091, and rules of the
commissioner of human services relating to the alternative care
grants program, the commissioner may authorize pilot projects to
use pre-capitated rates; to provide expanded services such as
chore services, activities, and meal planning, preparation, and
serving; and to waive freedom of choice of vendor to the extent
necessary to allow one vendor to provide services to all
eligible persons in a residence or building. The commissioner
may apply for a waiver of federal requirements as necessary to
implement the pilot projects.
Subd. 2. [ELIGIBLE INDIVIDUALS.] An individual is eligible
to receive project services if the individual:
(1) is receiving medical assistance or would be eligible
for medical assistance within 180 days after admission to a
nursing home;
(2) is residing in a nursing home or is at risk of nursing
home placement;
(3) is able to direct his or her own care;
(4) has been prescreened by the county for eligibility and
for appropriateness of service; and
(5) is otherwise eligible for alternative care grant
services.
Subd. 3. [REPORT.] The commissioner shall monitor and
evaluate the pilot projects and report to the legislature by
January 31, 1991. The report must address at least the
following:
(1) the extent to which each pilot project succeeded in
moving elderly persons out of nursing homes into less
restrictive settings or in delaying placement in a nursing home;
(2) the ability of each project to target low-income, frail
elderly;
(3) the cost-effectiveness of each project, including the
financial impact on the resident, the state, and the county;
(4) the success of each project in meeting other goals
established by the commissioner; and
(5) recommendations on whether the pilot projects should be
continued or expanded.
Sec. 257. [FEASIBILITY STUDY FOR HABILITATION SERVICES.]
The commissioner of human services, in consultation with
the commissioner of jobs and training, shall study the
feasibility of providing medical assistance reimbursement to
work activity programs for training and habilitative services
provided to participants. The commissioner shall report the
findings to the legislature by December 1, 1988. For the
purposes of this section, a work activity program is as defined
in section 129A.01.
Sec. 258. [REPORT ON INTERMEDIATE CARE FACILITY RATES.]
The commissioner of human services shall report to the
legislature by February 1, 1989, on the status of rulemaking to
establish a new rate system for payments to intermediate care
facilities for persons with mental retardation and related
conditions, including a description of the proposed rules and an
estimate of their fiscal impact.
Sec. 259. [STUDY OF MEDICAL ASSISTANCE PAYMENTS FOR SWING
BED CARE.]
The interagency board for quality assurance shall include
in its report on nursing home bed distribution required under
Laws 1987, chapter 403, article 4, section 13, a recommendation
on whether medical assistance payments for swing bed care should
continue beyond June 30, 1990.
Sec. 260. [REPORT ON HUMAN IMMUNODEFICIENCY VIRUS
TESTING.]
The commissioner of health shall submit a report to the
legislature by February 15, 1989, that:
(1) identifies existing quality controls and standards for
laboratories that perform human immunodeficiency virus testing
and specifies whether additional quality assurance measures are
needed to ensure accurate test results; and
(2) identifies the level of counseling and education that
is occurring for individuals who are tested for the human
immunodeficiency virus and specifies whether additional measures
are needed to ensure that individuals tested for the human
immunodeficiency virus are adequately counseled about the
meaning of the test, test results, and steps the individual
should take to protect the individual and others from infection.
Sec. 261. [CHILD CARE SERVICES STUDY.]
The commissioner of human services shall study the existing
public and private funding sources for child care services and
the development of child care services, including the AFDC
special needs program, the sliding fee child care program, the
maternal and child nutrition program, county funding, Title XX
funding, and private foundation, corporate, community social
services act, or nonprofit funding to child care services
providers and parents. The study shall determine the extent to
which:
(i) individual funding sources meet existing needs and what
level of funding comes from each source;
(ii) the need for subsidized child care services for
low-income parents is being met;
(iii) present funding mechanisms are efficient or can be
made more efficient;
(iv) alternative or improved methods may encourage private
funding for child care services;
(v) the funding level has an impact on availability of
child care facilities; and
(vi) child care reimbursement rates are meeting actual
costs for quality child care.
The commissioner shall report the results of the study,
together with any proposed legislation to implement study
recommendations, to the legislature by January 1, 1990.
Sec. 262. [CHILD CARE INFORMATION NUMBER.]
By January 1, 1989, the council on children, youth, and
families shall study and report to the legislature on the need
for and the feasibility of a toll-free number to provide
information and technical assistance to parents, child care
providers, and potential child care providers. The study shall
include an assessment of need, cost, and potential impact.
Sec. 263. [FARIBAULT REGIONAL CENTER.]
Subdivision 1. [TASK FORCE.] The commissioner of the state
planning agency shall appoint a 13-member task force to develop
a plan to expand the use of the Faribault regional center. The
task force shall include four community representatives and one
representative from each of the following entities: Faribault
regional center, Faribault Technical Institute, Faribault public
schools, Academies for the Deaf and Blind, Wilson Center, Rice
county, city of Faribault, Rice county district No. 1 hospital,
and the department of human services.
Subd. 2. [DUTIES OF COMMISSIONER.] The commissioner of the
state planning agency shall provide a grant for a Faribault
community task force to develop a plan for the future use of
Faribault regional center. The plan must assess the feasibility
of providing educational services, nonresidential services, and
care to a number of populations including, but not limited to,
adolescents, veterans, and people who have developmental
disabilities, chemical dependency, mental illness, or
communicable diseases.
Subd. 3. [REPORT.] The Faribault community task force must
report the plan to the chairs of the health and human services
committees of the house of representatives and senate by
November 1, 1988. The report must include a list of recommended
services to be provided at Faribault regional center and must
evaluate each recommendation.
Sec. 264. [STUDY OF MANAGED CARE FOR MEDICAL ASSISTANCE
AND GENERAL ASSISTANCE MEDICAL CARE RECIPIENTS.]
Subdivision 1. [STUDY.] The commissioner of human services
shall study the utilization patterns of individuals in the
medical assistance and general assistance medical care
programs. The study will examine the applicability and
usefulness of focused utilization review, case management
services, and other managed care approaches to all or parts of
these populations.
Subd. 2. [FORMATION OF TASK FORCE.] The commissioner shall
convene a task force composed of representatives from expert and
interested parties to advise and assist the commissioner with
the study in subdivision 1. The task force shall include, at a
minimum, representatives from the provider community, recipient
groups, the departments of health and finance, and the
University of Minnesota. The analysis will be conducted by
staff from the department of human services.
Subd. 3. [OBJECTIVES.] The specific objectives of the task
force shall be determined by the commissioner in consultation
with the task force, and shall include at a minimum:
(a) to identify in the state and in selected geographic
areas, patterns of utilization of health services, especially
high frequency, high-cost use, and possible underutilization.
(b) to recommend interventions and an implementation plan
consistent with the goals of the medical assistance and general
assistance medical care programs to improve the management of
health services to recipients identified as at-risk of
inappropriately high or low utilization of care.
Subd. 4. [REPORTING DATE.] The task force shall report its
findings and recommendations to the commissioner and the
legislature by September 30, 1988.
Sec. 265. [APPROVED COMPLEMENT INCREASED.]
The complement of the office of administrative hearings is
increased by one full-time equivalent position.
Sec. 266. [RULES.]
The commissioner of human services may adopt rules to
administer and implement the provisions of section 245.836.
Sec. 267. [RULE CHANGES.]
The commissioner of jobs and training shall adopt rule
amendments to Minnesota Rules, chapter 3300, including changes
in the allocation formula for funds appropriated for extended
employment programs, as necessary to effect the changes required
by the legislature in sections 129A.01, subdivisions 5, 6, and
7; 129A.02, subdivision 3; 129A.03; 129A.06, subdivision 1;
129A.07, subdivision 1; 129A.08, subdivisions 1, 4, 4a, and 5;
129A.09; and 129A.10.
This rule is exempt from the rulemaking provisions of
Minnesota Statutes, chapter 14. The commissioner must comply
with Minnesota Statutes, section 14.38, subdivision 7, when
adopting this rule amendment.
Sec. 268. [INSTRUCTION TO REVISOR.]
(a) In the next edition of Minnesota Statutes, the revisor
of statutes shall substitute in chapter 129A the term
"rehabilitation facility" for the terms "long-term sheltered
workshop," "workshop," or "sheltered workshop" in the form
appropriate for the context.
In the next edition of Minnesota Statutes, the revisor of
statutes shall substitute in chapter 129A the term "extended
employment program participant" for the term "sheltered
employee" in the form appropriate for the context.
The revisor shall make the substitutions required by this
section in other places in Minnesota Statutes where the terms
appear if they refer to the subject matter covered by chapter
129A.
(b) In accordance with Minnesota Statutes 1986, section
3C.10, the revisor of statutes shall renumber section 141,
subdivisions 8a to 8y as a new section of Minnesota Statutes,
chapter 256B.
The revisor of statutes shall renumber section 144,
subdivisions 1j to 1r as a new section of Minnesota Statutes,
chapter 256B.
The revisor of statutes shall correct cross-references in
Minnesota Statutes and Minnesota Rules consistent with the
renumbering.
Sec. 269. [REPEALER.]
Subdivision 1. Minnesota Statutes 1986, sections 144.388;
153A.01; 153A.02; 153A.03; 153A.04; 153A.05; 153A.06; 153A.07;
153A.08; 153A.09; 153A.10; 153A.11; 153A.12; 245.84, subdivision
4; 245.86; 245.87; 246.023, subdivisions 2, 3, 4, and 5; and
268.061; Minnesota Statutes 1987 Supplement, sections 129A.01,
subdivision 8; 129A.07, subdivision 2; 129A.08, subdivision 3;
148B.04, subdivision 1; and 256B.73, subdivision 10, are
repealed. Minnesota Statutes 1986, section 257.071, subdivision
6, is repealed effective July 1, 1989.
Subd. 2. Section 248 is repealed effective July 1, 1990.
Subd. 3. Section 243 is repealed July 1, 1989.
Subd. 4. Section 141, subdivision 8b, is repealed
effective July 1, 1990.
Subd. 5. Sections 50 to 54, and 252, are repealed
effective July 1, 1991.
Sec. 270. [EFFECTIVE DATE.]
Subdivision 1. Sections 6, 11, 13, and 15 apply to any
policy, plan, or contract issued or renewed on or after the date
following final enactment.
Subd. 2. Section 14 is effective the day after final
enactment except that in the case of a plan maintained under one
or more collective bargaining agreements between employee
representatives and one or more employers ratified on or before
April 7, 1986, section 14 is effective on the earlier of:
(1) the date on which the last of the collective bargaining
agreements under which the plan is maintained, which were in
effect on April 7, 1986, ends without regard to any extension of
the agreement agreed to after April 7, 1986; or
(2) April 7, 1989.
Subd. 3. Section 144, subdivisions 1f and 1m, are
effective February 1, 1989.
Subd. 4. Sections 193 to 204 are effective February 1,
1989.
Subd. 5. Sections 16 to 28, 267, and 268 are effective the
day following final enactment and apply to allocations of funds
appropriated for the extended employment programs administered
under Minnesota Statutes, chapter 129A, made after July 1, 1988.
Subd. 6. Sections 29, 32, 33 to 40, 46, 48, 49, 61, 62,
84, 118 to 121, 158, 161, 163 to 168, 170, 178, 222, 238, 242 to
244, 247, 249, and 263 to 265 are effective the day after final
enactment.
Subd. 7. Sections 150 and 151 are effective upon receiving
approval of the health care financing administration.
Subd. 8. Section 157 is effective, and applies to nursing
home rate years that begin on or after, July 1, 1988.
Subd. 9. Section 151 and that portion of section 150
relating to the resource contribution of a spouse are effective
upon receiving approval from the health care financing
administration.
Approved April 28, 1988
Official Publication of the State of Minnesota
Revisor of Statutes