Minnesota Legislature
Office of the Revisor of Statutes
Minnesota Session Laws - 1989, Regular Session
Key: (1) language to be deleted (2) new language
CHAPTER 282-H.F.No. 1759
An act relating to the organization and operation of
state government; appropriating money for human
services, jobs and training, corrections, health,
veterans nursing homes, and other purposes with
certain conditions; amending Minnesota Statutes 1988,
sections 13.46, subdivision 2; 16B.06, by adding a
subdivision; 43A.27, subdivision 2; 62A.045; 62A.046;
62D.041, subdivision 1, and by adding a subdivision;
62D.042, subdivision 1; 62D.05, subdivision 6;
144.122; 144.50, subdivision 6, and by adding a
subdivision; 144.562, subdivisions 2 and 3; 144.651,
subdivision 2; 144.698, subdivision 1; 144.701;
144.702, subdivision 2, and by adding subdivisions;
144A.01, subdivision 5, and by adding subdivisions;
144A.04, subdivision 7, and by adding subdivisions;
144A.071, subdivision 3; 144A.073, subdivision 1;
144A.10, by adding subdivisions; 144A.11, subdivision
3, and by adding a subdivision; 144A.12, subdivision
1; 144A.15, subdivision 1, and by adding subdivisions;
144A.45, subdivision 2; 144A.46; 144A.61; 144A.611;
145.38, subdivision 1; 145.39, subdivision 1; 145.61,
subdivision 5; 145.63; 145.882, subdivisions 1, 3, and
7; 145.894; 146.13; 147.02, subdivision 1; 148B.23,
subdivision 1; 148B.27, subdivision 2; 148B.32,
subdivision 2; 148B.40, subdivision 3; 149.02; 149.06;
153A.13, subdivision 4; 153A.15, subdivision 3;
153A.16; 157.14; 176.136, subdivisions 1 and 5;
214.04, subdivision 3; 214.06, subdivision 1; 237.70,
subdivision 7; 237.701, subdivision 1; 245.461;
245.462; 245.463, subdivision 2, and by adding
subdivisions; 245.464; 245.465; 245.466, subdivisions
1, 2, 5, and 6; 245.467, subdivisions 3, 4, and 5;
245.468; 245.469; 245.470, subdivision 1; 245.472,
subdivision 1, and by adding a subdivision; 245.473,
subdivision 1; 245.474; 245.476, subdivisions 1, 3,
and by adding subdivisions; 245.477; 245.478,
subdivisions 2 and 3; 245.479; 245.48; 245.482;
245.483; 245.484; 245.485; 245.486; 245.62,
subdivision 3; 245.696, subdivision 2; 245.697,
subdivisions 1, 2, and 2a; 245.713, subdivision 2;
245.73, subdivisions 1, 2, and 4; 245.771, subdivision
3; 245.91, by adding a subdivision; 245.94,
subdivision 1, and by adding a subdivision; 245A.02,
subdivisions 3, 9, 10, 14, and by adding subdivisions;
245A.03, subdivisions 1, 2, and 3; 245A.04,
subdivisions 1, 3, 5, 6, 7, and by adding
subdivisions; 245A.06, subdivisions 1, 5, and by
adding a subdivision; 245A.07, subdivision 2; 245A.08,
subdivision 5; 245A.095; 245A.12; 245A.13; 245A.14,
subdivision 3, and by adding subdivisions; 245A.16,
subdivision 1; 246.18, subdivision 4, and by adding a
subdivision; 246.36; 246.50, subdivisions 3, 4, and 5;
246.51, by adding a subdivision; 246.54; 246.57,
subdivision 1; 251.011, subdivision 4, and by adding a
subdivision; 252.025, by adding a subdivision; 252.27,
subdivision 1; 252.291, subdivision 2; 252.31; 252.41,
subdivision 9; 252.46, subdivisions 1, 2, 3, 4, 6, and
12; 252.47; 252.50; 252A.03, by adding a subdivision;
253.015; 253B.03, subdivision 6a; 254A.08, subdivision
2; 254B.02, subdivision 1; 254B.03, subdivisions 1 and
4; 254B.04, by adding a subdivision; 254B.06,
subdivision 1; 254B.09, subdivisions 1, 4, and 5;
256.01, subdivision 2, and by adding a subdivision;
256.014, subdivision 1; 256.018; 256.045, subdivisions
1, 3, 4, 4a, 5, 6, 7, 10, and by adding a subdivision;
256.12, subdivision 14; 256.73, subdivision 3a;
256.736, subdivisions 3, 3b, 4, 10, 11, 14, 16, and by
adding subdivisions; 256.737; 256.74, subdivisions 1,
1a, and by adding a subdivision; 256.85; 256.87,
subdivision 1a; 256.936, subdivisions 1, 2, and 4;
256.969; 256.974; 256.9741, subdivisions 3, 5, and by
adding a subdivision; 256.9742; 256.9744, subdivision
1; 256.975, subdivision 2; 256B.031, subdivision 5;
256B.04, subdivision 14, and by adding a subdivision;
256B.055, subdivisions 7 and 8; 256B.056, subdivisions
3, 4, and 5; 256B.062; 256B.0625, subdivisions 2, 13,
17, and by adding subdivisions; 256B.091, subdivision
3; 256B.092, subdivisions 7 and 8; 256B.14; 256B.25,
by adding a subdivision; 256B.421, subdivision 14;
256B.431, subdivisions 2b, 2e, 2i, 3a, 3f, 3g, 4, and
by adding subdivisions; 256B.47, subdivision 3;
256B.48, subdivisions 1, 6, and 8; 256B.501,
subdivisions 3, 3g, and by adding a subdivision;
256B.69, subdivisions 4, 5, 11, and by adding a
subdivision; 256C.28, subdivision 3, and by adding
subdivisions; 256D.01, subdivisions 1, 1a, 1b, and 1c;
256D.02, subdivisions 1, 4, and by adding a
subdivision; 256D.03, subdivisions 2, 3, and 4;
256D.05, subdivision 1, and by adding a subdivision;
256D.051, subdivisions 1, 2, 3, 6, 8, 13, and by
adding subdivisions; 256D.052, subdivisions 1, 2, 3,
and 4; 256D.101; 256D.111, subdivision 5; 256D.35,
subdivisions 1, 7, and by adding subdivisions;
256D.36, subdivision 1, and by adding a subdivision;
256D.37, subdivision 1; 256E.03, subdivision 2;
256E.05, subdivision 3; 256E.08, subdivision 5;
256E.09, subdivisions 1 and 3; 256F.05, subdivisions
2, 3, and 4; 256G.03, subdivision 1; 256H.01,
subdivisions 1, 2, 7, 8, 11, and 12; 256H.02; 256H.03;
256H.05; 256H.07, subdivision 1; 256H.08; 256H.09;
256H.10, subdivision 3, and by adding a subdivision;
256H.11; 256H.12; 256H.15; 256H.18; 256H.20,
subdivision 3; 257.071, subdivision 7; 257.55,
subdivision 1; 257.57, subdivision 1; 257.62,
subdivision 5; 259.47, subdivision 5; 259.49,
subdivision 2; 260.251, subdivision 1; 268.0111,
subdivision 4, and by adding a subdivision; 268.0122,
subdivisions 2 and 3; 268.08, subdivision 1; 268.31;
268.37, by adding a subdivision; 268.86, subdivision
2; 268.871, subdivision 5; 268.88; 287.12; 297.13,
subdivision 1; 326.78, subdivision 2; 327C.02,
subdivision 2; 357.021, subdivisions 2 and 2a; 517.08,
subdivisions 1b and 1c; 518.54, subdivision 6;
518.551, subdivision 10, and by adding a subdivision;
518.611, subdivision 4; 518.613, subdivisions 1, 2, 4,
and by adding subdivisions; 540.08; 609.378; 626.556,
subdivisions 2 and 10e; and 626.558; Laws 1984,
chapter 654, article 5, section 57, subdivision 1, as
amended; Laws 1987, chapter 403, article 3, section
98; Laws 1988, chapter 689, article 2, sections 248
and 269, subdivision 2; Laws 1988, chapter 719,
article 8, section 32; proposing coding for new law in
Minnesota Statutes, chapters 144; 144A; 145; 157; 196;
245; 246; 251; 252; 253; 254A; 256; 256B; 256D; 256E;
256F; 256H; 259; 268; and 626; proposing coding for
new law as Minnesota Statutes, chapter 256I; repealing
Minnesota Statutes 1988, sections 144A.10, subdivision
4a; 144A.61, subdivision 6; 245.462, subdivision 25;
245.471; 245.475; 245.64; 245.698; 245.83; 245.84;
245.85; 245.871; 245.872; 245.873; 245A.095,
subdivision 3; 246.50, subdivisions 3a, 4a, and 9;
254B.09, subdivision 3; 254B.10; 256.87, subdivision
4; 256.969, subdivisions 2a, 3, 4, 5, and 6;
256B.0625, subdivision 21; 256B.17, subdivisions 1, 2,
3, 4, 5, 6, 7, and 8; 256B.69, subdivisions 12, 13,
14, and 15; 256D.01, subdivision 1c; 256D.051,
subdivision 6a; 256D.052, subdivisions 5, 6, and 7;
256D.06, subdivisions 3, 4, 6, and 6a; 256D.35,
subdivisions 2, 3, 4, and 8; 256D.36, subdivision 2;
256D.37, subdivisions 2, 4, 6, 7, 8, 9, 10, 11, 12,
13, and 14; 256D.38; 256D.39; 256D.41; 256D.42;
256D.43; 256F.05, subdivision 1; 256H.04; 256H.05,
subdivision 4; 256H.06; 256H.07, subdivisions 2, 3,
and 4; 256H.13; 268.86, subdivision 7; 518.613,
subdivision 5; Laws 1987, chapter 403, article 5,
section 1; Laws 1988, chapter 689, article 2, section
269, subdivision 4; Laws 1988, chapter 719, article 8,
section 34.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
APPROPRIATIONS
Section 1. [HUMAN RESOURCES; APPROPRIATIONS.]
The sums shown in the columns marked "APPROPRIATIONS" are
appropriated from the general fund, or any other fund named, to
the agencies and for the purposes specified in the following
sections of this act, to be available for the fiscal years
indicated for each purpose. The figures "1989," "1990," and
"1991," where used in this act, mean that the appropriation or
appropriations listed under them are available for the year
ending June 30, 1989, June 30, 1990, or June 30, 1991,
respectively.
SUMMARY BY FUND
1990 1991 TOTAL
General
$1,306,847,000 $1,361,394,000 $2,668,241,000
Special Revenue
$ 5,345,000 $ 5,391,000 $ 10,736,000
Metropolitan
Landfill
$ 167,000 $ 167,000 $ 334,000
Trunk Highway
$ 1,488,000 $ 1,488,000 $ 2,976,000
Total
$1,313,847,000 $ 1,368,440,000 $2,682,287,000
APPROPRIATIONS
Available for the Year
Ending June 30,
1990 1991
Sec. 2. COMMISSIONER OF HUMAN
SERVICES
Subdivision 1. Appropriation by
Fund
General Fund 1,104,499,000 1,160,516,000
The amounts that may be spent from this
appropriation for each program and
activity are more specifically
described in the following subdivisions.
During the biennium ending June 30,
1991, the commissioner shall notify the
chairs of the house health and human
services appropriations committee and
the senate health and human services
finance committee whenever
implementation of legislation by the
department is likely to result in
expenditures $1,000,000 or more than
the amount authorized by the
legislature.
Federal money received in excess of the
estimates shown in the 1989 department
of human services budget document
reduces the state appropriation by the
amount of the excess receipts, unless
otherwise directed by the governor,
after consulting with the legislative
advisory commission.
For the fiscal year ending June 30,
1989, the appropriations for the
medical assistance and general
assistance medical care programs in
Laws 1988, chapter 689, article 1,
section 2, subdivision 5, paragraph
(a), are increased by the amount
necessary to fully cover the
expenditure requirements of these
programs.
For the biennium ending June 30, 1991,
federal receipts as shown in the
biennial budget document or in working
papers of the two appropriations
committees to be used for financing
activities, programs, and projects
under the supervision and jurisdiction
of the commissioner must be accredited
to and become a part of the
appropriations provided for in this
section.
Positions and administrative money may
be transferred within the department of
human services as the commissioner
considers necessary, with the advance
approval of the commissioner of finance.
Estimates of federal money that will be
earned by the various accounts of the
department of human services and
deposited in the general fund are
detailed on the worksheets of the
conferees of the senate and house of
representatives, a true copy of which
is on file in the office of the
commissioner of finance. If federal
money anticipated is less than that
shown on the official worksheets, the
commissioner of finance shall reduce
the amount available from the direct
appropriation a corresponding amount.
The reductions must be noted in the
budget document submitted to the 77th
legislature in addition to an estimate
of similar federal money anticipated
for the biennium ending June 30, 1993.
The commissioner of human services,
with the approval of the commissioner
of finance and by direction of the
governor after consulting with the
legislative advisory commission, may
transfer unencumbered appropriation
balances among the aid to families with
dependent children, general assistance,
general assistance medical care,
medical assistance, Minnesota
supplemental aid, and work readiness
programs and between fiscal years of
the biennium.
During the biennium ending June 30,
1991, the commissioner shall report
annually to the chair of the house of
representatives appropriations
committee and the chair of the senate
finance committee regarding information
systems authorized under Minnesota
Statutes, section 256.014, subdivision
3, including implementation schedules,
the nature and amount of systems
expenditures, projected and actual
savings, evidence of
cost-effectiveness, comparison with
anticipated program goals and
objectives, impact on affected
consumers and providers, and future
development plans.
For the biennium ending June 30, 1991,
information system project
appropriations for development and
federal receipts for the alien
verification entitlement system must be
deposited in the special systems
account authorized in Minnesota
Statutes, section 256.014. Money
appropriated for computer projects
approved by the Information Policy
Office, funded by the legislature, and
approved by the commissioner of finance
may be transferred from one project to
another and from development to
operations as the commissioner
considers necessary. Any unexpended
balance in the appropriation for these
projects does not cancel in the first
year but is available in the second
year of the biennium.
Subd. 2. Human Services
Administration 12,985,000 11,174,000
The state planning agency, the
department of human services, and the
department of finance shall conduct a
study to determine the extent to which
changes in health care program
rate-setting rules are increasing state
expenditures beyond the amount
appropriated for the programs and
report to the legislature by February
1, 1990, regarding possible changes in
state law to prevent major increases in
state expenditures through the
rulemaking process.
Subd. 3. Legal and
Intergovernmental Programs 4,182,000 4,274,000
By January 1, 1990, the commissioner
shall report to the legislature
regarding the activities and
effectiveness of the county community
service evaluation staff, including
additional funding necessary to
continue the function if the report
indicates the activities have improved
or have the potential to improve
delivery of county social services.
Subd. 4. Social Services 120,519,000 124,284,000
For the biennium ending June 30, 1991,
this appropriation includes one
position in fiscal year 1990 and two
positions in fiscal year 1991 which are
to be regionally based positions to
assist in developing privately and
publicly operated services for persons
with developmental disabilities who are
being relocated from regional treatment
centers. The four positions authorized
to improve the quality of regional
treatment center services must also be
regionally based.
By February 15, 1990, the board on
aging shall submit a report to the
legislature containing an analysis of
the need for expanding congregate
housing services and an evaluation of
existing congregate housing service
programs.
During the biennium ending June 30,
1991, juvenile detention facilities
must provide or arrange for a chemical
use assessment for juveniles who
request such an assessment and for
juveniles petitioned or adjudicated for
alcohol- or drug-related unlawful acts
in juvenile court.
For the biennium ending June 30, 1991,
any balance remaining in the first year
for the nonrecurring adoption expense
reimbursement appropriation does not
cancel, but is available for the second
year of the biennium.
For the biennium ending June 30, 1991,
$447,000 each year of the county
allocation for Title XX community
social services is for migrant child
care.
For the biennium ending June 30, 1991,
one complement position in the
department of human services program
for administration of child care fund
grants shall be for the purpose of
coordinating and expediting the review
of applications and for expediting the
dispersal of funds to grantees of child
care service development grants.
By September 1, 1991, the Higher
Education Coordinating Board shall
report to the legislature on the
percentage of non-AFDC, post-secondary
funds expended for administrative
purposes during fiscal year 1990.
In the event that money appropriated
for foster care liability insurance for
fiscal year 1990 is insufficient to
cover increased premium costs in that
year, the commissioner may use funds
appropriated for fiscal year 1991 to
cover the costs.
By July 1, 1990, each county shall
report to the commissioner on efforts
made to implement Minnesota Statutes,
section 256F.07, subdivision 3a,
regarding placement prevention and
family reunification services for
minority children. The report must
include specific information on the
number of foster and adoptive
placements involving minority children,
including information on the number of
minority families who have become
foster or adoptive parents and the
number of minority families who have
left the foster family system, with
reasons for their departure from the
system. The commissioner shall report
to the legislature by November 1, 1990,
with a summary and analysis of the
county reports and an evaluation of
county efforts.
In the event that the commissioner
determines that the duties of regional
services specialists have been assumed
by county case managers and screening
teams established under Minnesota
Statutes, section 256B.092, subdivision
7, the commissioner may reassign the
regional services specialists to other
duties.
Subd. 5. Mental Health 21,555,000 25,572,000
Funding to continue the family-based
community support pilot project shall
be included as a base adjustment in the
fiscal year 1992 and 1993 detailed
expenditure budget submitted to the
legislature under Minnesota Statutes,
section 16A.11. The funding level
shall be adjusted to reflect the full
biennial costs of operating the project.
Of this appropriation, $10,000 is for
camping activities for people with
mental illness from the mental health
special project account.
Of this appropriation, $53,000 is for
the depression awareness, recognition,
and treatment program from the mental
health special projects account.
Of the appropriation for therapeutic
foster care programs, one grant must be
awarded to Olmsted county for an
existing program.
The commissioner may, with the written
approval of the governor after
consulting with the legislative
advisory commission, transfer all or
part of the appropriation for
alternative placements for persons who
must be moved out of nursing homes due
to federal requirements to other
appropriations if the commissioner
determines that other funding
mechanisms will more appropriately meet
the needs of the persons being moved.
Subd. 6. Family Support
Programs 181,169,000 189,755,000
The amounts that may be spent from this
appropriation for each activity are as
follows:
(a) Aid to Families with Dependent
Children, General Assistance, Work
Readiness, Minnesota Supplemental Aid
$154,500,000 $156,236,000
The commissioner shall set the monthly
standard of assistance for general
assistance and work readiness
assistance units consisting of an adult
recipient who is childless and
unmarried or living apart from his or
her parents or a legal guardian at $203.
The $100,000 appropriated for literacy
training for the biennium ending June
30, 1991, shall be used for pilot
demonstration projects. Each grantee
of funds must report back to the
commissioner of human services at the
end of the grant period with a summary
of expenditures and a detailed analysis
of persons served, literacy programs
used, and outcomes achieved. The
commissioner shall report back to the
legislature by January 1, 1992, with an
evaluation of the program.
The commissioner of human services
shall include as a budget change
request in the fiscal year 1992 and
1993 detailed expenditure budget
submitted to the legislature under
Minnesota Statutes, section 16A.11, an
annual adjustment in the aid to
families with dependent children,
general assistance, and work readiness
grants as of July 1 of each year,
beginning July 1, 1991, by a percentage
amount equal to the percentage
increase, if any, in the consumer price
index (CPI-U-U.S.) city average, as
published by the Bureau of Labor
Statistics, United States Department of
Labor, during the preceding calendar
year for the biennium ending June 30,
1993.
During the biennium ending June 30,
1991, the commissioner of human
services shall provide supplementary
grants not to exceed $816,800 a year
for aid to families with dependent
children and include the following
costs in determining the amount of the
supplementary grants: major home
repairs; repair of major home
appliances; utility recaps;
supplementary dietary needs not covered
by medical assistance; replacement of
essential household furnishings and
essential major appliances; and
employment-related transportation and
educational expenses. Of this amount,
$616,800 is for employment-related
transportation and educational expenses.
For the biennium ending June 30, 1991,
the maximum room and board rate for a
facility that enters into an initial
negotiated rate agreement with a county
on or after June 1, 1989, may not
exceed 90 percent of the maximum rate
established under Minnesota Statutes,
section 256D.37.
(b) Family Support Programs
Administration
$ 26,669,000 $ 33,519,000
Federal financial reimbursement
received during fiscal year 1989 for
work readiness services expenditures by
counties must be credited to the work
readiness account and is appropriated
to the commissioner of human services
for work readiness program purposes.
Amounts not needed to reimburse
counties must be canceled to the
general fund.
Any balance remaining in the first year
for the welfare fraud eligibility
verification program appropriation does
not cancel but is available in the
second year of the biennium ending June
30, 1991.
In implementing the requirements of
Minnesota Statutes, section 256.01,
subdivision 2, clause (c), the
commissioner shall develop specific
program measures to assess county
compliance with fraud initiatives and
provide technical assistance to enforce
fraud program requirements.
Any balance remaining at the end of the
first year in the appropriation for
social adjustment services for refugees
and child welfare services for refugees
does not cancel but is available for
the second year.
Money appropriated in Laws 1988,
chapter 689, article 1, section 2,
subdivision 5, for food stamp outreach
programs does not cancel to the general
fund but is available in fiscal year
1990.
Federal financial participation
received during fiscal year 1989 for
work readiness service expenditures is
appropriated to the commissioner for
work readiness program purposes and
must be used to reimburse counties for
work readiness expenditures.
For the biennium ending June 30, 1991,
federal food stamp employment and
training funds received for the work
readiness program are appropriated to
the commissioner to reimburse counties
for work readiness service expenditures.
During the biennium ending June 30,
1991, money appropriated from the
general fund to the department of human
services for the work incentive program
shall transfer to the job opportunity
and basic skills program upon
acceptance by the federal government of
Minnesota's welfare reform plan.
Any unexpended balance remaining in the
first year of the appropriation for the
AFDC self-employment investment
demonstration project appropriation
does not cancel but is available for
the second year of the biennium.
For the biennium ending June 30, 1991,
federal funds received for direct
employment services provided to
refugees and immigrants is appropriated
to the commissioner to provide
bicultural employment service case
managers to PATHS eligible refugees and
immigrants. The commissioner of human
services shall review expenditures of
bilingual case management funds at the
end of the third quarter of the second
year of the biennium and may reallocate
unencumbered funds to those counties
which can demonstrate a need for
additional funds. Funds shall be
reallocated according to the same
formula used initially to allocate
funds to counties.
Any unexpended balance up to $2,000,000
remaining in the first year for the
PATHS case management and employment
and training services appropriation
does not cancel and is available for
the second year of the biennium ending
June 30, 1991.
In planning for the operation of the
child support enforcement clearinghouse
information system, the commissioner
shall issue a request for a proposal
for the operation of the system and, in
consultation with the information
policy office, review responses to the
solicitation. After review of the
proposals, the commissioner may award a
service contract for operation of the
system or continue processing through
the department of administration. In
the event the projected costs for
systems operation exceed the available
appropriation, the commissioner shall
notify the chairs of the house health
and human services division of
appropriations and the senate health
and human services division of finance.
For the child support enforcement
activity, during the biennium ending
June 30, 1991, money received from the
counties for providing data processing
services must be deposited in that
activity's account. The money is
appropriated to the commissioner for
the purposes of the child support
enforcement activity.
Federal financial participation from
the United States Department of
Agriculture for expenditures that are
eligible for reimbursement through the
food stamp employment and training
program for nonpublic assistance
recipients is appropriated to the
commissioner to operate the food stamp
employment and training program for
nonpublic assistance recipients.
For the biennium ending June 30, 1991,
federal money received for the
operating costs of the statewide MAXIS
automated eligibility information
system is appropriated to the
commissioner to pay for the development
and operation of the MAXIS system and
the counties' share of the operating
costs.
Subd. 7. Health Care Programs
General Fund 553,384,000 593,448,000
The amounts that may be spent from this
appropriation for each activity are as
follows:
(a) Medical Assistance and General
Assistance Medical Care
$506,808,000 $545,894,000
The developmental achievement center
pilot payment rate system in Minnesota
Statutes, section 252.46, subdivision
14, may operate through June 30, 1991.
The commissioner of human services
shall seek federal financial
participation to reimburse the costs of
family therapy necessary to the mental
health of an adoptive child who prior
to adoption had been under the
guardianship of the commissioner under
Minnesota Statutes, section 260.242.
Notwithstanding any law to the
contrary, the commissioner shall
include as budget change requests in
the fiscal year 1992 and 1993 detailed
expenditure budget submitted to the
legislature under Minnesota Statutes,
section 16A.11, all annual inflationary
adjustments in the medical assistance,
general assistance medical care, and
Minnesota supplemental aid programs.
Of this appropriation, $300,000 in
fiscal year 1991 is for the increased
costs of exceptions to the moratorium
on licensure and certification of
long-term care beds. The commissioner
of health may license or certify beds
through the exception review process,
provided the projected total annual
increased state medical assistance
costs of all licenses or certifications
granted during the biennium under any
exception to the moratorium do not
exceed an annual amount of $300,000.
The amount appropriated for medical
assistance is based on projected
inflationary increases for Minnesota
nursing homes of 5.1 percent the first
year and 5.2 percent the second year.
The inflationary increases are required
under current law in Minnesota
Statutes, chapter 256B. The projected
increases include increases of 4.8
percent the first year and 5.1 percent
the second year for nursing home wages,
including nursing staff wages. The
projected state general fund cost for
inflationary increases is $11,314,000
the first year and $19,821,000 the
second year. The actual inflationary
increases will be based on the index
established under Minnesota Statutes,
chapter 256B. The commissioner shall
annually report, in the manner
prescribed by the commissioner, on the
home's use of that portion of the
inflationary increase that is
attributable to the wage increase.
During the biennium ending June 30,
1991, the commissioner may determine
the need for conversion of a home and
community-based service program to an
intermediate care facility for people
with mental retardation if the
conversion is cost-effective and the
people receiving home and
community-based services choose to
receive services in an intermediate
care facility for people with mental
retardation. After the commissioner
has determined the need to convert the
program, the commissioner of health
shall certify the program as an
intermediate care facility for people
with mental retardation if the program
meets applicable certification
standards. Notwithstanding the
provisions of Minnesota Statutes,
section 246.18, receipts collected for
state-operated community services are
appropriated to the commissioner and
are dedicated to the operation of
state-operated community services which
are converted in this section or which
were authorized in Laws 1988, chapter
689, article 1, section 2, subdivision
5. Any balance remaining in this
account at the end of the fiscal year
does not cancel and is available for
the second year of the biennium. The
commissioner may, after consultation
with the legislative advisory
commission and approval of the
governor, transfer funds from the
Minnesota supplemental aid program to
the medical assistance program to fund
services converted under this section.
The maximum pharmacy dispensing fee
under medical assistance and general
assistance medical care is $4.20.
Payments to 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 in either
the medical assistance or general
assistance medical care programs must
continue to be calculated at the lower
of (1) the submitted charges, or (2)
the 50th percentile of prevailing
charges in 1982.
Effective with services rendered on or
after July 1, 1989, payments to
dentists for medical assistance
recipients shall be increased by 7.5
percent for diagnostic and routine
preventive services and by five percent
for all other dental services.
Federal money received during the
biennium for administration of the home
and community-based services waiver for
persons with mental retardation is
appropriated to the commissioner of
human services for administration of
the home and community-based services
program and must be deposited in that
activity's account.
(b) Preadmission Screening and
Alternative Care Grants
$16,530,000 $16,530,000
Any balance remaining in the first year
of the appropriation for the
preadmission screening-alternative care
grants program does not cancel but is
available for the second year.
During the biennium ending June 30,
1991, the commissioner shall include in
the forecast of health care entitlement
program expenditures submitted to the
commissioner of finance and the
legislature, an estimate of projected
expenditures for that portion of the
preadmission screening and alternative
care grant funded through the medical
assistance program.
(c) Children's Health Plan
$ 4,297,000 $ 6,736,000
Of this appropriation, $20,000 in
fiscal year 1990 is for a study of the
utilization of outpatient mental health
services by children eligible for
medical assistance. The results of the
study must be used to prepare
recommendations for the legislature to
structure an appropriate and
cost-effective outpatient mental health
benefit under the children's health
plan. $480,000 in fiscal year 1991 is
appropriated to add an outpatient
mental health benefit to the children's
health plan in fiscal year 1991.
(d) Health Care Programs
Administration
$25,749,000 $24,288,000
For the biennium ending June 30, 1991,
$200,000 in fiscal year 1990 and
$200,000 in fiscal year 1991 is
appropriated for contracting with
private or public entities for case
management services for those medical
assistance and general assistance
recipients identified by the
commissioner as inappropriately using
health care services. To implement the
project, the commissioner shall seek
appropriate waivers. The commissioner
may enter into risk-based contracts and
contract for a full range of health
services for medical assistance and
general assistance medical care
recipients. Federal receipts received
for this purpose shall be dedicated to
this activity.
By February 1, 1990, the commissioner
may develop a plan to minimize turnover
of direct care employees in privately
operated day training and habilitation
services, intermediate care facilities
for persons with mental retardation,
semi-independent living services, and
waivered services programs. The plan
must be provided to the chairs of the
health and human services divisions of
the senate finance committee and the
house of representatives appropriations
committee. The plan must specify the
amount of appropriations required to
implement the plan and may provide for
a phase-in period of up to five years.
The commissioner may develop the plan
in collaboration with representatives
of public and private facilities and
service providers, clients and family
members, advocacy organizations,
employees, and other interested persons
and organizations.
During the biennium ending June 30,
1991, the appropriation in the
preadmission screening and annual
resident review account shall be used
to cover the nonfederal share of costs
for conducting diagnostic assessments,
reassessments, and screening which are
required by Public Law Number 100-203
and which are federally reimbursable as
a state medical assistance expense at
75 percent. This provision is
effective July 1, 1989, and does not
include screening costs covered under
Minnesota Statutes, section 256B.091.
Federal receipts for this activity are
dedicated to the department for this
purpose.
The interagency board for quality
assurance shall study the following
issues and report to the legislature by
November 1, 1990, on its findings and
recommendations: (1) identifying
indicators of high quality long-term
care service provided in Minnesota
nursing homes and boarding care homes;
and (2) establishing a program of
incentive payments to reward nursing
facilities that provide the highest
quality care to residents. A study
advisory committee consisting of
nursing home consumers and
representatives of the nursing home
industry must be appointed by the
executive director of the interagency
board for quality assurance to
participate in the study process.
The commissioner shall work with Care
Providers of Minnesota, the Minnesota
Association of Homes for the Aging, and
consumer groups to seek assistance from
the Minnesota congressional delegation
and the United States Department of
Health and Human Services to obtain
recognition of the Minnesota case mix
system as an alternative to the current
Medicare payment system, or other
appropriate solutions. The
commissioner shall report to the
legislative commission on long-term
care by November 1, 1989, regarding
efforts to resolve the conflicts
between the Medicare and medical
assistance nursing home reimbursement
systems. The commissioner shall report
on the extent of the conflict and the
potential impact on Minnesota nursing
homes and shall make recommendations
regarding necessary state and federal
actions.
Recoveries obtained by the provider
appeals unit shall be dedicated to the
medical assistance account during the
biennium ending June 30, 1991.
Federal receipts received for the
phone-in system for prior authorization
for health care providers and the
provider relations unit within the
health care management division are
appropriated to the commissioner for
those purposes.
The receipts realized for the sale of
the provider manual are appropriated to
the commissioner for printing and
distribution of the materials.
Any balance remaining in the first year
of the appropriation for the review of
medical assistance prepayment programs
does not cancel but is available for
the second year.
Of this appropriation, $45,000 each
year is for the establishment of a
statewide resource center on caregiver
support and respite care services. The
complement of the department is
increased by one position for this
purpose. This appropriation and
complement increase are not included in
the base funding level. The
commissioner shall report to the
legislature by February 15, 1990, with
an analysis of the activities of the
resource center, information on the
need for respite care services, a
projection of the need for respite care
services, and an evaluation of existing
caregiver support and respite care
programs.
Money appropriated in Laws 1988,
chapter 689, article 1, section 2,
subdivision 5, for a regional
demonstration project to provide health
care coverage to low-income uninsured
persons does not cancel but is
available for fiscal year 1990. The
appropriation is available when
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.
The MA and GAMC managed care project
shall continue through June 30, 1990.
Subd. 8. State Residential
Facilities 210,705,000 212,009,000
The amounts that may be spent from this
appropriation for each activity are as
follows:
(a) Regional Treatment Centers and
State-operated Community Services
Approved Complement
June 30, 1990 June 30, 1991
4,763 4,687
(1) Salaries
$169,617,000 $169,005,000
(2) Current Expense
$ 14,150,000 $ 15,699,000
(3) Repairs and Betterments
$ 2,772,000 $ 1,772,000
(4) Special Equipment
$ 680,000 $ 1,150,000
(5) Personnel Mitigation
$ -0- $ 2,000,000
Money appropriated for personnel
mitigation expenses in fiscal year 1991
may be used to cover expenses occurring
in fiscal year 1990.
The commissioner shall prepare and
present a plan to the legislature by
February 15, 1990, on methods of
increasing the use of staff and
resources at the Willmar Regional
Treatment Center to serve children with
severe emotional disturbance who would
otherwise be placed in treatment in
other states.
Regional treatment center and
state-operated nursing home employees,
except temporary or emergency
employees, affected by changes in the
department of human services delivery
system must receive, along with other
options, priority consideration in
order to transfer to vacant or newly
created positions at the Minneapolis
and Hastings veterans homes and at
facilities operated by the commissioner
of corrections. The veterans homes
board, in cooperation with the
commissioners of human services and
corrections, shall develop procedures
to facilitate these transfers.
The legislative audit commission shall
evaluate the regional treatment center
systems project and report findings and
recommendations to the chair of the
house health and human services
division of appropriations and the
senate health and human services
division of finance by January 15, 1992.
Provided there is no conflict with any
collective bargaining agreement, any
regional treatment center or state
nursing home reduction in the human
services technician classifications and
other nonprofessional, nonsupervisory
direct care positions must only be
accomplished through attrition,
transfers, and retirement and must not
be accomplished through layoff, unless
the position reduction is due to the
relocation of residents to a different
state facility and the employee
declines to accept a transfer to a
comparable position in another state
facility.
Any regional treatment center employee
position identified as being vacant by
the regional treatment center and the
commissioner of human services may only
be declared so after review of the
chair of the house human services
division of appropriations and the
chair of the senate health and human
services division of finance.
The legislative auditor shall study the
admission and discharge policies for
persons with mental retardation or
related conditions in regional
treatment centers, state-operated
community-based services, and privately
operated facilities and report to the
legislature by February 1, 1990.
Notwithstanding any other law to the
contrary, the commissioner may transfer
money between nonsalary object of
expenditure classes to salary object of
expenditure classes for staff training
and personnel mitigation during the
biennium ending June 30, 1991.
With the approval of the commissioner
of finance, the commissioner of human
services may transfer any unencumbered
balance from any department account,
except an income maintenance
entitlement account, to the regional
treatment salary account during fiscal
year 1989. The amounts transferred
must be identified to the chairs of the
senate finance division on health and
human services and the house
appropriations division on health and
human services.
For the biennium ending June 30, 1991,
this appropriation includes $40,000 in
the second year to be transferred to
the commissioner of health for
licensure of additional community-based
supervised living facilities.
During the biennium ending June 30,
1991, employees of residential
facilities who are eligible for
retraining funds may use those funds to
attend an approved program in any
public or private adult education or
post-secondary institution.
Of this appropriation, $546,000 each
year shall be available to the
commissioner for contingency situations
related to chemical dependency programs
operated by regional treatment centers
during the biennium ending June 30,
1991.
The commissioner shall consolidate both
program and support functions at each
of the regional centers and state
nursing homes to ensure efficient and
effective space utilization that is
consistent with applicable licensing
and certification standards. The
commissioner may transfer residents and
positions between the regional center
and state nursing home system as
necessary to promote the most efficient
use of available state buildings.
Surplus buildings shall be reported to
the commissioner of administration for
appropriate disposition according to
Minnesota Statutes, section 16B.24.
Any unencumbered balances in special
equipment and repairs and betterments
remaining in the first year do not
cancel but are available for the second
year of the biennium.
(b) Nursing Homes
Approved Complement - 569.5 534.5
(1) Salaries
$18,477,000 $17,649,000
(2) Current Expense
$ 2,486,000 $ 2,474,000
(3) Repairs and Betterments
$ 378,000 $ 222,000
(4) Special Equipment
$ 66,000 $ 0
(c) Other State Residential Facilities
Administration Activities
$ 2,079,000 $ 2,038,000
Sec. 3. OMBUDSMAN FOR MENTAL
HEALTH AND MENTAL RETARDATION 888,000 921,000
Sec. 4. VETERANS NURSING HOMES
BOARD
Subdivision 1. Total
Appropriation 18,876,000 21,041,000
The amounts that may be spent from this
appropriation for each program are more
specifically described in the following
subdivisions.
Subd. 2. Veterans Nursing
Homes 18,731,000 20,896,000
At least 80 percent of the new
positions at the Hastings and
Minneapolis veterans homes must be
nonsupervisory positions in direct care
services, rehabilitation services,
psychological services, social
services, pharmaceutical services, food
services, housekeeping services, and
internal auditing as recommended in the
governor's 1989-1991 biennial budget
document. Any remaining portion of the
appropriation for new positions may be
used to fund other positions.
The appropriation for geriatric
research and teaching is not included
in the base funding level.
Subd. 3. Veterans Nursing
Homes Board 145,000 145,000
Sec. 5. COMMISSIONER OF JOBS
AND TRAINING
Subdivision 1. Total
Appropriation 37,755,000 32,349,000
The amounts that may be spent from this
appropriation for each program are more
specifically described in the following
subdivisions.
Subd. 2. Rehabilitation
Services 18,305,000 18,380,000
Any balance remaining in the first year
does not cancel but is available for
the second year.
The commissioner shall report to the
legislature by January 15, 1990, on
grants for the rehabilitation of
injured workers, including the number
of workers served and the outcome on
injured workers of the services
provided.
Subd. 3. Services for the Blind 3,380,000 3,383,000
Subd. 4. Economic Opportunity
Office 7,257,000 7,257,000
For the biennium ending June 30, 1991,
the commissioner 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. Up to 3.75 percent of the
transferred money may be used by the
commissioner for administrative
purposes.
For the biennium ending June 30, 1991,
the commissioner shall transfer 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 money during the year
of the transfer or the year following
the transfer. Up to 1.63 percent of
the transferred money may be used by
the commissioner for administrative
purposes.
For the biennium ending June 30, 1991,
no more than 1.63 percent of money
remaining under the low-income home
energy assistance program after
transfers to the community services
block grant and the weatherization
program may be used by the commissioner
for administrative purposes.
For the biennium ending June 30, 1991,
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
supplemental funding is required. Any
remaining money shall be allocated to
state-designated and state-recognized
community action agencies, Indian
reservations, and the Minnesota migrant
council.
The commissioner shall, by January 1 of
each year of the biennium, report to
the legislature on the use of
discretionary money from the community
services block grant (regular) and
discretionary money resulting from
block grant transfers to the community
services block grant.
Subd. 5. Employment and Training 8,813,000 3,329,000
Of this amount, $250,000 in each year
is to be distributed to organizations
applying for grants through the
governor's job council to provide
services and support to dislocated
workers. The governor's job council
may award grants to organizations to
assist dislocated workers who have been
dislocated as a result of a plant
closing or layoff that did not meet the
threshold levels as provided in article
2, section 177, subdivisions 6 and 8,
if the council determines that the
plant closing or layoff has a
significant effect on the community.
An additional $15,000 each year is for
prefeasibility study grants related to
this provision. Any balance remaining
in the first year of the appropriation
for dislocated workers does not cancel
but is available for the second year.
The appropriations increase for the
summer youth employment program must be
spent on transitional services.
Of the money appropriated for the
summer youth employment programs for
fiscal year 1990, $750,000 is
immediately available. Any remaining
balance of the immediately available
money is available for the year in
which it is appropriated. If the
appropriation for either year of the
biennium is insufficient, money may be
transferred from the appropriation for
the other year.
Any balance remaining in the first year
of the appropriation for the Minnesota
employment and economic development
program does not cancel but is
available for the second year.
Any balance remaining at the end of the
fiscal year ending June 30, 1989, in
the appropriation in Laws 1987, article
1, section 4, subdivision 2, for
Minnesota employment and economic
development wage subsidies does not
cancel and is available for the fiscal
year ending June 30, 1990.
Any balance remaining in the Minnesota
wage subsidy account established under
Minnesota Statutes, section 268.681,
subdivision 4, at the end of the fiscal
years ending June 30, 1989, and June
30, 1990, does not cancel and is
available for the second year.
Sec. 6. COMMISSIONER OF
CORRECTIONS
Subdivision 1. Appropriation by
Fund
General Fund 104,822,000 104,505,000
The amounts that may be spent from the
appropriation for each program and
activity are more specifically
described in the following subdivisions.
Positions and administrative money may
be transferred within the department of
corrections as the commissioner
considers necessary, upon the advance
approval of the commissioner of finance.
Subd. 2. Correctional
Institutions 75,733,000 75,477,000
Any unencumbered balances in special
equipment, repairs and replacement,
food provisions, and central office
health care remaining in the first year
do not cancel but are available for the
second year.
Employees of the St. Paul-Ramsey
Medical Center who perform the
functions of psychologist and director
of the mental health unit at the
Minnesota correctional facility-Oak
Park Heights and psychiatric social
worker at the Minnesota correctional
facility-Stillwater shall be
transferred to the state classified
service without competitive or
qualifying examination and shall be
placed by the commissioner of employee
relations, with no loss in salary, in
the proper classifications. These
transferred employees shall begin on
the date of transfer to serve a
probationary period appropriate to the
classification to which each is
assigned according to a collective
bargaining agreement or plans
established under Minnesota Statutes,
section 43A.16.
Subd. 3. Community Services 25,041,000 24,950,000
Base level funding in the probation and
supervised release activity for
services to Dakota and Rice counties
must be transferred to the community
corrections act appropriation upon the
entry of those counties into the
community corrections program. An
incumbent whose position is transferred
under this subdivision retains the
wages and benefits of the former
position under the applicable state
plan or collective bargaining agreement
until the date upon which a collective
bargaining agreement under Minnesota
Statutes, chapter 179A, covering the
new position is renewed or adjusted.
The commissioners of corrections and
human services shall study the funding
structure of general assistance per
diems for emergency shelters for
battered women and report to the
legislature by January 15, 1991.
The commissioner is encouraged to
direct a portion of the increase in
funding to battered women's programs
toward pay increases for employees of
the programs.
Of the appropriation for battered
women's programs, $34,000 in fiscal
year 1990 is to pay startup costs for
an American Indian battered women's
shelter.
Subd. 4. Management Services 4,048,000 4,078,000
Sec. 7. SENTENCING GUIDELINES
COMMISSION 218,000 218,000
Sec. 8. CORRECTIONS OMBUDSMAN 369,000 364,000
Sec. 9. COMMISSIONER OF HEALTH
Subdivision 1. Appropriation by
Fund
General Fund 39,345,000 41,480,000
Metropolitan Landfill Contingency Fund 167,000 167,000
Special Revenue Fund 435,000 375,000
Trunk Highway Fund 1,488,000 1,488,000
The appropriation from the metropolitan
landfill contingency fund is for
monitoring well water supplies and
conducting health assessments in the
metropolitan area.
The appropriation from the trunk
highway fund is for emergency medical
services activities.
Positions and administrative money may
be transferred within the department of
health as the commissioner considers
necessary, with the advance approval of
the commissioner of finance.
The amounts that may be spent from this
appropriation for each program and
activity are more specifically
described in the following subdivisions.
Subd. 2. Preventive and Protective
Health Services
General Fund 11,610,000 11,751,000
Metropolitan Landfill Contingency Fund 145,000 145,000
Special Revenue Fund 255,000 255,000
Trunk Highway Fund 61,000 61,000
Of this amount, $135,000 in 1990 and
$115,000 in 1991 from the general fund
are one-time appropriations to conduct
a follow-up study of asbestos-related
lung disease among Conwed Corporation
employees and spouses. The
commissioner shall by January 1, 1990,
present to the legislature a report
addressing recommendations and plans
for a comprehensive feasibility study
of a statewide occupational disease
surveillance system.
Of this amount, $65,000 in 1990 from
the general fund is a one-time
appropriation to develop and pilot test
the feasibility of an epidemiologic
study of the relationship between
emissions of sulfur dioxide and other
air contaminants and the prevalence and
severity of asthma in the city of Inver
Grove Heights and surrounding areas of
Dakota County. The commissioner of
health shall, by February 1, 1990,
submit to the legislature a report
including the results of this study and
specific recommendations related to any
future epidemiologic studies.
For the biennium ending June 30, 1991,
no less than $2,000,000 from the
general fund shall be used by the
commissioner for AIDS prevention grants
and contracts for certain high risk
populations, including communities of
color, adolescents at high risk,
homosexual men, intravenous drug users,
and others as determined by the
commissioner. By October 1, 1990, and
October 1, 1991, the commissioner shall
report to the chairs of the health and
human services divisions of the house
appropriations committee and the senate
finance committee regarding the amounts
of state and federal money spent by the
department in fiscal years 1990 and
1991 on grants and contracts to assist
each of the above groups.
The $47,000 required to be transferred
to the general fund by Laws 1987,
chapter 388, section 9, paragraph (c),
shall be transferred not later than
June 30, 1992.
The commissioner shall present to the
legislature by January 1, 1990, a plan
for implementing the hazardous
substance exposure provisions required
under Minnesota Statutes, section
145.94. The plan shall include
proposals for funding and
recommendations for coordinating the
implementation efforts of the state
department of health, the pollution
control agency, and local health
departments.
Subd. 3. Health Delivery Systems
General Fund 24,028,000 26,028,000
Special Revenue Fund 180,000 120,000
Trunk Highway Fund 1,341,000 1,341,000
Of this amount, $80,000 in 1990 and
$20,000 in 1991 from the health
occupations licensing account within
the state government special revenue
fund are to pay start-up and ongoing
costs associated with registering
contact lens technicians and
respiratory therapists. These and all
subsequent costs related to this
provision shall be returned to the
health occupations licensing account
through fees. The commissioner may use
unencumbered balances in the health
occupations licensing account to pay
start-up costs associated with the
registration of any additional
occupational groups, except
acupuncturists, for which the
commissioner determines registration is
appropriate. All such costs shall be
returned to the health occupations
licensing account through fees.
Of this amount, $5,000 from the general
fund is available as a state match for
a grant program to community-based
organizations to purchase and provide
paint removal equipment.
Of this amount, $10,000 from the
general fund in each year is to
contract with local health boards to
provide safe housing for residents who
are relocated due to a paint-related or
plaster-related lead contamination
threat in their place of residence.
Of this amount, $35,000 from the
general fund in each year is to conduct
assessments to determine sources of
lead contamination in the residences of
children and pregnant women whose blood
lead levels exceed 25 micrograms per
deciliter or the Centers for Disease
Control recommendation for elevated
blood level, and to provide education
on ways of reducing the danger of lead
contamination.
Of this amount, $50,000 from the
general fund in each year is to
implement a lead education strategy and
to fund lead abatement advocates.
Of this amount, $5,000 from the general
fund is transferred to the commissioner
of state planning for a task force to
study lead abatement costs. The task
force shall consist of representatives
of the Minnesota housing finance
agency, the pollution control agency,
the department of health, the state
planning agency, abatement contractors,
realtors, community residents including
both tenants and landowners, lead
advocacy organizatons, and cultural
groups at high risk of lead poisoning.
The task force shall evaluate the costs
of providing assistance to property
owners and local communities required
to do lead paint, soil, and dust
abatement; and of providing subsidized
programs to assist the property owners
and communities. The task force shall
present recommendations for a statewide
subsidized abatement service program.
The task force shall report its
findings and recommendations to the
legislature by January 15, 1990.
Of the appropriation to supplement the
federal Women, Infants and Children
(WIC) program, any balance remaining in
the first year does not cancel but is
available for the second year.
For the biennium ending June 30, 1991,
the commissioner of finance may
authorize the transfer of money to the
community health services activity from
other programs in this section if the
transferred money is to be used to
supplement the community health
services subsidy.
For the biennium ending June 30, 1991,
if the appropriation for community
health services or services to children
with handicaps is insufficient for
either year, the appropriation for the
other year is available by direction of
the governor after consulting with the
legislative advisory commission.
For the biennium ending June 30, 1991,
community health services boards should
give priority consideration in the
allocation of increased community
health services subsidy funds to
activities consistent with
recommendations of the state community
health services advisory committee and
the commissioner's statewide goals
relating to prevention of human
immunodeficiency virus.
For the biennium ending June 30, 1991,
community health services boards are
encouraged to use a portion of their
community health services subsidy
increases to conduct erythrocyte
protoporphyrin and blood lead
screenings among children at high risk
for lead toxicity.
Until the start of the 1992 licensure
year, the commissioner of health shall
not apply the provisions of Minnesota
Statutes, section 144.55, subdivision
6, paragraph (b), to the Minnesota
Veterans Home at Hastings.
The commissioner shall report to the
legislature by December 15, 1989, on
the commissioner's enforcement of
section 144A.10, subdivision 2,
relating to the coordination of nursing
home inspections, and on the
commissioner's enforcement of section
144.55, subdivision 5, relating to the
coordination of hospital inspections.
The report must include a list of the
agencies inspecting nursing homes and
hospitals, the frequency of
inspections, the legal authority for
the inspections, the purpose of the
inspections, and recommendations for
consolidating and coordinating the
inspections. The report must also
include recommendations for improving
the enforcement of sections 144A.10,
subdivision 2, and 144.55, subdivision
5.
Subd. 4. Health Support Services
General Fund 3,707,000 3,701,000
Metropolitan Landfill Contingency Fund 22,000 22,000
Trunk Highway Fund 86,000 86,000
Sec. 10. HEALTH-RELATED BOARDS
Subdivision 1. Total
Appropriation
Special Revenue Fund 4,910,000 5,016,000
General Fund 75,000
Notwithstanding any law to the
contrary, all fees generated by the
health-related licensing boards or the
commissioner of health under Minnesota
Statutes, section 214.06, and all
unobligated balances in the
direct-appropriated special revenue
fund on June 30, 1989, attributable to
fees generated by the health-related
licensing boards, shall be credited to
the health occupations licensing
account within the state government
special revenue fund.
Unless otherwise designated, all
appropriations in this section are from
the special revenue fund.
Subd. 2. Board of Chiropractic
Examiners 264,000 252,000
Subd. 3. Board of Dentistry 400,000 400,000
Subd. 4. Board of Medical
Examiners 1,760,000 1,920,000
Of this amount, $210,000 in 1990 and
$262,000 in 1991 are for the purpose of
purchasing additional legal services
from the office of the attorney
general. This money is available only
in the event that the board requires
legal services above and beyond a level
equivalent to that provided by the
office of the attorney general during
1989. Unencumbered balances in the
appropriation for purchasing additional
legal services may be transferred
between fiscal years of the biennium.
For the biennium ending June 30, 1991,
fees set by the board of medical
examiners pursuant to Minnesota
Statutes, section 214.06, must be fixed
by rule. The procedure for
noncontroversial rules in Minnesota
Statutes, sections 14.22 to 14.28, may
be used except that, notwithstanding
the requirements of Minnesota Statutes,
section 14.22, clause (3), no public
hearing may be held. The notice of
intention to adopt the rules must state
that no hearing will be held. This
procedure may be used only when the
total fees estimated for the biennium
do not exceed the sum of direct
appropriations, indirect costs,
transfers in, and salary supplements
for that purpose. A public hearing is
required for adjustments of fees spent
under open appropriations of dedicated
receipts.
Subd. 5. Board of Nursing 1,055,000 1,019,000
Subd. 6. Board of Examiners for
Nursing Home Administrators 141,000 141,000
Subd. 7. Board of Optometry 57,000 59,000
Subd. 8. Board of Pharmacy 445,000 431,000
Subd. 9. Board of Podiatry 26,000 26,000
Subd. 10. Board of Psychology 181,000 187,000
Subd. 11. Social Work and
Mental Health Boards
Special Revenue Fund 485,000 485,000
General Fund 75,000
(a) Board of Marriage and Family Therapy
$ 82,000 $ 82,000
(b) Board of Social Work
$ 87,000 $ 87,000
(c) Board of Unlicensed Mental Health
Service Providers
Special Revenue Fund
$ 93,000 $ 93,000
General Fund
$ 75,000 $
The fee for filing as an unlicensed
mental health service provider is $50
until permanent rules establishing the
amount of the fee are adopted.
(d) The Office of Social Work and Mental
Health Boards
$ 223,000 $ 223,000
Subd. 12. Board of Veterinary
Medicine 96,000 96,000
Subd. 13. Revenue
The commissioner of finance shall not
permit the allotment, encumbrance, or
expenditure of money appropriated in
this section in excess of the
anticipated biennial revenues from fees
collected by the boards, except that
the board of unlicensed mental health
service providers may spend from
appropriated money in excess of fees
collected. Neither this provision nor
Minnesota Statutes, section 214.06,
applies to transfers from the general
contingent account, if the amount
transferred does not exceed the amount
of surplus revenue accumulated by the
transferee during the previous five
years.
Sec. 11. COMMISSIONER OF FINANCE
During the biennium ending June 30,
1991, the commissioner of finance shall
forward to the chairs of the house
health and human services
appropriations committee and the senate
health and human services finance
committee all reports of projected
funding deficiencies in programs
operated or supervised by the
departments of human services, health,
jobs and training, and corrections, and
the offices of ombudsman for
corrections and for mental health and
mental retardation, the sentencing
guidelines commission, the
health-related boards, and the
department of veterans affairs. If no
deficiency funding recommendations are
made by the governor, the commissioner
shall notify the legislature of any
projected deficiencies by February 1 of
each year.
For the governor's recommended budget
for fiscal year 1992 and fiscal year
1993, in those instances where the
governor recommends funding for a
change request but at a level different
from the agency request, the
commissioner of finance shall include
in the governor's recommendation detail
information commensurate with that
provided by the agency. This includes
a breakout of spending items if more
than one provision is included in the
request and rationale for the request.
The commissioner of finance shall also
adjust the long range implications
expenditure projections to coincide
with the revised governor's
recommendation.
Sec. 12. TRANSFERS OF MONEY
Subdivision 1. Governor's Approval
Required
For the biennium ending June 30, 1991,
the commissioners of human services,
corrections, jobs and training, and
health and the veterans nursing homes
board shall not transfer money to or
from the object of expenditure
"personal services" to or from the
object of expenditure "grants and aid,"
as shown on the official worksheets of
the conferees of the senate and house
of representatives, a true copy of
which is on file in the office of the
commissioner of finance, except upon
the written approval of the governor
after consulting with the legislative
advisory commission. Notwithstanding
this limitation, money may be
transferred to "grants and aid" without
approval of the governor in the
following programs: services for the
blind, basic client rehabilitation
services, and rehabilitation services
for workers' compensation recipients.
Subd. 2. Transfers of Unencumbered
Appropriations
For the biennium ending June 30, 1991,
the commissioners of human services,
corrections, health, and jobs and
training by direction of the governor
after consulting with the legislative
advisory commission may transfer
unencumbered appropriation balances and
positions among all programs.
Sec. 13. 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.
Sec. 14. PROVISIONS
For the biennium ending June 30, 1991,
money appropriated to the commissioner
of corrections and the commissioner of
human services in this act for the
purchase of provisions within the item
"current expense" must be used solely
for that purpose. Money provided and
not used for purchase of provisions
must be canceled into the fund from
which appropriated, except that money
provided and not used for the purchase
of provisions because of population
decreases may be transferred and used
for the purchase of medical and
hospital supplies with the written
approval of the governor after
consulting with the legislative
advisory commission.
The allowance for food may be adjusted
annually according to the United States
Department of Labor, Bureau of Labor
Statistics publication, producer price
index, with the approval of the
commissioner of finance. Adjustments
for fiscal year 1990 and fiscal year
1991 must be based on the June 1989 and
June 1990 producer price index
respectively, but the adjustment must
be prorated if the wholesale food price
index adjustment would require money in
excess of this appropriation.
Sec. 15. PUBLIC HEALTH FUND
Any balance remaining in the public
health fund at the close of fiscal year
1989, regardless of any dedicated
purpose, shall be transferred to the
general fund.
Sec. 16. Minnesota Statutes 1988, section 144.122, is
amended to read:
144.122 [LICENSE AND PERMIT FEES.]
(a) The state commissioner of health, by rule, may
prescribe reasonable procedures and fees for filing with the
commissioner as prescribed by statute and for the issuance of
original and renewal permits, licenses, registrations, and
certifications issued under authority of the commissioner. The
expiration dates of the various licenses, permits,
registrations, and certifications as prescribed by the rules
shall be plainly marked thereon. Fees may include application
and examination fees and a penalty fee for renewal applications
submitted after the expiration date of the previously issued
permit, license, registration, and certification. The
commissioner may also prescribe, by rule, reduced fees for
permits, licenses, registrations, and certifications when the
application therefor is submitted during the last three months
of the permit, license, registration, or certification period.
Fees proposed to be prescribed in the rules shall be first
approved by the department of finance. All fees proposed to be
prescribed in rules shall be reasonable. The fees shall be in
an amount so that the total fees collected by the commissioner
will, where practical, approximate the cost to the commissioner
in administering the program. All fees collected shall be
deposited in the state treasury and credited to the general fund
unless otherwise specifically appropriated by law for specific
purposes.
(b) The commissioner may charge a fee for voluntary
certification of medical laboratories and environmental
laboratories, and for environmental and medical laboratory
services provided by the department, without complying with
subdivision 1 or chapter 14. Fees charged for environment and
medical laboratory services provided by the department must be
approximately equal to the costs of providing the services.
(c) The commissioner may develop a schedule of fees for
diagnostic evaluations conducted at clinics held by the services
for children with handicaps program. All receipts generated by
the program are annually appropriated to the commissioner for
use in the maternal and child health program.
Sec. 17. Minnesota Statutes 1988, 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;
(h) Apply for, administer, and annually expend at least 99
percent of available federal or private funds;
(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;
(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;
(k) Promulgate all rules necessary to carry out the
provisions of sections 145.891 to 145.897; and
(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; and
(m) Ensure that any state appropriation to supplement the
federal program is spent consistent with federal requirements.
Sec. 18. Minnesota Statutes 1988, section 268.37, is
amended by adding a subdivision to read:
Subd. 6. [ELIGIBILITY CRITERIA.] To the extent allowed by
federal regulations, the commissioner shall ensure that the same
income eligibility criteria apply to both the weatherization
program and the energy assistance program.
Sec. 19. Minnesota Statutes 1988, section 287.12, is
amended to read:
287.12 [TAXES, HOW APPORTIONED.]
All taxes paid to the county treasurer under the provisions
of sections 287.01 to 287.12 shall be credited to the county
revenue fund.
On or before the tenth day of each month the county
treasurer shall determine the receipts from the mortgage
registration tax during the preceding month. The treasurer
shall report to the county welfare agency on or before the tenth
day of each month 97 percent of the receipts attributable to the
statutory rate in section 287.05. That amount, in addition to
97 percent of the amount determined under section 287.29, must
be shown as a deduction from the report filed with the
department of human services as required by section 256.82. The
net receipts from the preceding month must be credited to the
county welfare fund by the tenth day of each month. If a
county's mortgage and deed tax receipts exceed the state share
of AFDC grants for the county, the excess amount must be offset
against state payments to the county for the state share of the
income maintenance programs. Any excess remaining after
offsetting all state payments for income maintenance programs
must be paid to the commissioner of human services and credited
to the AFDC account.
ARTICLE 2
SOCIAL SERVICES, HEALTH, AND ADMINISTRATION
Section 1. Minnesota Statutes 1988, section 16B.06, is
amended by adding a subdivision to read:
Subd. 2a. [EXCEPTION.] The requirements of subdivision 2
do not apply to state contracts distributing state or federal
funds pursuant to the federal economic dislocation and worker
adjustment assistance act, United States Code, title 29, section
1651 et seq., or sections 268.973 and 268.974. For these
contracts, the commissioner of jobs and training is authorized
to directly enter into state contracts with approval of the
governor's job training council, and encumber available funds to
ensure a rapid response to the needs of dislocated workers. The
commissioner shall adopt internal procedures to administer and
monitor funds distributed under these contracts.
Sec. 2. Minnesota Statutes 1988, section 43A.27,
subdivision 2, is amended to read:
Subd. 2. [ELECTIVE ELIGIBILITY.] The following persons, if
not otherwise covered by section 43A.24, may elect coverage for
themselves or their dependents at their own expense:
(a) a state employee, including persons on layoff from a
civil service position as provided in collective bargaining
agreements or a plan established pursuant to section 43A.18;
(b) an employee of the board of regents of the University
of Minnesota, including persons on layoff, as provided in
collective bargaining agreements or by the board of regents;
(c) an officer or employee of the state agricultural
society, state horticultural society, Sibley house association,
Minnesota humanities commission, Minnesota international center,
Minnesota academy of science, science museum of Minnesota,
Minnesota safety council, state office of disabled American
veterans, state office of the American Legion and its auxiliary,
or state office of veterans of foreign wars and its auxiliary,
or state office of the Military Order of the Purple Heart;
(d) a civilian employee of the adjutant general who is paid
from federal funds and who is not eligible for benefits from any
federal civilian employee group life insurance or health
benefits program; and
(e) an officer or employee of the state capitol credit
union or the highway credit union.
Sec. 3. Minnesota Statutes 1988, section 62D.041,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITION.] (a) For the purposes of this
section, the term "uncovered expenditures" means the costs of
health care services that are covered by a health maintenance
organization for which an enrollee would also be liable in the
event of the organization's insolvency, and that are not
guaranteed, insured, or assumed by a person other than the
health maintenance organization.
(b) For purposes of this section, if a health maintenance
organization offers supplemental benefits as described in
section 62D.05, subdivision 6, "uncovered expenditures" excludes
any expenditures attributable to the supplemental benefit.
Sec. 4. Minnesota Statutes 1988, section 62D.041, is
amended by adding a subdivision to read:
Subd. 10. [SUPPLEMENTAL DEPOSIT.] A health maintenance
organization offering supplemental benefits as described in
section 62D.05, subdivision 6, must maintain an additional
deposit in the first year such benefits are offered equal to
$50,000. At the end of the second year such benefits are
offered, the health maintenance organization must maintain an
additional deposit equal to $150,000. At the end of the third
year such benefits are offered and every year thereafter, the
health maintenance organization must maintain an additional
deposit of $250,000.
Sec. 5. Minnesota Statutes 1988, section 62D.042,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] (a) For purposes of this
section, "guaranteeing organization" means an organization that
has agreed to make necessary contributions or advancements to
the health maintenance organization to maintain the health
maintenance organization's statutorily required net worth.
(b) For this section, "working capital" means current
assets minus current liabilities.
(c) For purposes of this section, if a health maintenance
organization offers supplemental benefits as described in
section 62D.05, subdivision 6, "expenses" does not include any
expenses attributable to the supplemental benefit.
Sec. 6. Minnesota Statutes 1988, section 62D.05,
subdivision 6, is amended to read:
Subd. 6. [SUPPLEMENTAL BENEFITS.] (a) A health maintenance
organization may, as a supplemental benefit, provide coverage to
its enrollees for health care services and supplies received
from providers who are not employed by, under contract with, or
otherwise affiliated with the health maintenance organization.
Supplemental benefits may be provided if the following
conditions are met:
(1) a health maintenance organization desiring to offer
supplemental benefits must at all times comply with the
requirements of sections 62D.041 and 62D.042;
(2) a health maintenance organization offering supplemental
benefits must maintain an additional surplus in the first year
supplemental benefits are offered equal to the lesser of
$500,000 or 33 percent of the supplemental benefit expenses. At
the end of the second year supplemental benefits are offered,
the health maintenance organization must maintain an additional
surplus equal to the lesser of $1,000,000 or 33 percent of the
supplemental benefit expenses. At the end of the third year
benefits are offered and every year after that, the health
maintenance organization must maintain an additional surplus
equal to the greater of $1,000,000 or 33 percent of the
supplemental benefit expenses. When in the judgment of the
commissioner the health maintenance organization's surplus is
inadequate, the commissioner may require the health maintenance
organization to maintain additional surplus;
(3) claims relating to supplemental benefits must be
processed in accordance with the requirements of section
72A.201; and
(4) in marketing supplemental benefits, the health
maintenance organization shall fully disclose and describe to
enrollees and potential enrollees the nature and extent of the
supplemental coverage, and any claims filing and other
administrative responsibilities in regard to supplemental
benefits.
(b) The commissioner may, pursuant to chapter 14, adopt,
enforce, and administer rules relating to this subdivision,
including: rules insuring that these benefits are supplementary
and not substitutes for comprehensive health maintenance
services by addressing percentage of out-of-plan coverage; rules
relating to protection against insolvency, including the
establishment of necessary financial reserves; rules relating to
appropriate standards for claims processing; rules relating to
marketing practices; and other rules necessary for the effective
and efficient administration of this subdivision. The
commissioner, in adopting rules, shall give consideration to
existing laws and rules administered and enforced by the
department of commerce relating to health insurance
plans. Except as otherwise provided by law, a health
maintenance organization may not advertise, offer, or enter into
contracts for the coverage described in this subdivision until
30 days after the effective date of rules adopted by the
commissioner of health to implement this subdivision.
Sec. 7. [144.0535] [ENTRY FOR INSPECTION.]
For the purposes of performing their official duties, all
officers and employees of the state department of health shall
have the right to enter any building, conveyance, or place where
contagion, infection, filth, or other source or cause of
preventable disease exists or is reasonably suspected.
Sec. 8. Minnesota Statutes 1988, section 144.50,
subdivision 6, is amended to read:
Subd. 6. [SUPERVISED LIVING FACILITY LICENSES.] (a) 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.
(b) Class B supervised living facilities for six or less
persons seeking medical assistance certification as an
intermediate care facility for persons with mental retardation
or related conditions shall meet Group R, Division 3, occupancy
requirements of the state building code, the fire protection
provisions of chapter 21 of the 1985 life safety code, NFPA 101,
for facilities housing persons with impractical evacuation
capabilities, and shall provide the necessary physical plant
accommodations to meet the needs and functional disabilities of
the residents.
Sec. 9. Minnesota Statutes 1988, section 144.562,
subdivision 2, is amended to read:
Subd. 2. [ELIGIBILITY FOR LICENSE CONDITION.] A hospital
is not eligible to receive a license condition for swing beds
unless (1) it either has a licensed bed capacity of less than 50
beds defined in the federal medicare regulations, Code of
Federal Regulations, title 42, section 405.1041 482.66, or it
has a licensed bed capacity of 50 beds or more and has swing
beds that were approved for medicare reimbursement before May 1,
1985 or it has a licensed bed capacity of less than 65 beds and,
as of the effective date, the available nursing homes within 50
miles have had occupancy rates of 96 percent or higher in the
past two years; (2) it is located in a rural area as defined in
the federal medicare regulations, Code of Federal Regulations,
title 42, section 405.1041 482.66; and (3) it agrees to utilize
no more than four hospital beds as swing beds at any one time,
except that the commissioner may approve the utilization of up
to three additional beds at the request of a hospital if no
medicare certified skilled nursing facility beds are available
within 25 miles of that hospital.
Sec. 10. Minnesota Statutes 1988, section 144.562,
subdivision 3, is amended to read:
Subd. 3. [APPROVAL OF LICENSE CONDITION.] The commissioner
of health shall approve a license condition for swing beds if
the hospital meets all of the criteria of this subdivision:
(a) The hospital must meet the eligibility criteria in
subdivision 2.
(b) The hospital must be in compliance with the medicare
conditions of participation for swing beds under Code of Federal
Regulations, title 42, section 405.1041 482.66.
(c) The hospital must agree, in writing, to limit the
length of stay of a patient receiving services in a swing bed to
not more than 40 days, or the duration of medicare eligibility,
unless the commissioner of health approves a greater length of
stay in an emergency situation. To determine whether an
emergency situation exists, the commissioner shall require the
hospital to provide documentation that continued services in the
swing bed are required by the patient; that no skilled nursing
facility beds are available within 25 miles from the patient's
home, or in some more remote facility of the resident's choice,
that can provide the appropriate level of services required by
the patient; and that other alternative services are not
available to meet the needs of the patient. If the commissioner
approves a greater length of stay, the hospital shall develop a
plan providing for the discharge of the patient upon the
availability of a nursing home bed or other services that meet
the needs of the patient. Permission to extend a patient's
length of stay must be requested by the hospital at least ten
days prior to the end of the maximum length of stay.
(d) The hospital must agree, in writing, to limit admission
to a swing bed only to (1) patients who have been hospitalized
and not yet discharged from the facility, or (2) patients who
are transferred directly from an acute care hospital.
(e) The hospital must agree, in writing, to report to the
commissioner of health by December 1, 1985, and annually
thereafter, in a manner required by the commissioner (1) the
number of patients readmitted to a swing bed within 60 days of a
patient's discharge from the facility, (2) the hospital's
charges for care in a swing bed during the reporting period with
a description of the care provided for the rate charged, and (3)
the number of beds used by the hospital for transitional care
and similar subacute inpatient care.
(f) The hospital must agree, in writing, to report
statistical data on the utilization of the swing beds on forms
supplied by the commissioner. The data must include the number
of swing beds, the number of admissions to and discharges from
swing beds, medicare reimbursed patient days, total patient
days, and other information required by the commissioner to
assess the utilization of swing beds.
Sec. 11. Minnesota Statutes 1988, section 144.698,
subdivision 1, is amended to read:
Subdivision 1. [YEARLY REPORTS.] Each hospital and each
outpatient surgical center, which has not filed the financial
information required by this section with a voluntary, nonprofit
reporting organization pursuant to section 144.702, shall file
annually with the commissioner of health after the close of the
fiscal year:
(a) (1) a balance sheet detailing the assets, liabilities,
and net worth of the hospital;
(b) (2) a detailed statement of income and expenses;
(c) (3) a copy of its most recent cost report, if any,
filed pursuant to requirements of Title XVIII of the United
States Social Security Act; and
(d) (4) a copy of all changes to articles of incorporation
or bylaws;
(5) information on services provided to benefit the
community, including services provided at no cost or for a
reduced fee to patients unable to pay, teaching and research
activities, or other community or charitable activities;
(6) information required on the revenue and expense report
form set in effect on July 1, 1989; and
(7) other information required by the commissioner in rule.
Sec. 12. Minnesota Statutes 1988, section 144.701, is
amended to read:
144.701 [RATE DISCLOSURE.]
Subdivision 1. [CONSUMER INFORMATION.] The commissioner of
health shall ensure that the total costs, total revenues, and
total services of each hospital and each outpatient surgical
center are reported to the public in a form understandable to
consumers.
Subd. 2. [DATA FOR POLICY MAKING.] The commissioner of
health shall compile relevant financial and accounting data
concerning hospitals and outpatient surgical centers in order to
have statistical information available for legislative policy
making.
Subd. 3. [RATE SCHEDULE.] The commissioner of health shall
obtain from each hospital and outpatient surgical center a
current rate schedule. Any subsequent amendments or
modifications of that schedule shall be filed with the
commissioner of health at least 60 days in advance of on or
before their effective date.
Subd. 4. [FILING FEES.] Each report which is required to
be submitted to the commissioner of health under sections
144.695 to 144.703 and which is not submitted to a voluntary,
nonprofit reporting organization in accordance with section
144.702 shall be accompanied by a filing fee in an amount
prescribed by rule of the commissioner of health. Fees received
pursuant to this subdivision shall be deposited in the general
fund of the state treasury. Upon the withdrawal of approval of
a reporting organization, or the decision of the commissioner to
not renew a reporting organization, fees collected under section
144.702 shall be submitted to the commissioner and deposited in
the general fund. The commissioner shall report the termination
or nonrenewal of the voluntary reporting organization to the
chair of the health and human services subdivision of the
appropriations committee of the house of representatives, to the
chair of the health and human services division of the finance
committee of the senate, and the commissioner of finance.
Sec. 13. Minnesota Statutes 1988, section 144.702,
subdivision 2, is amended to read:
Subd. 2. [APPROVAL OF ORGANIZATION'S REPORTING
PROCEDURES.] The commissioner of health may approve voluntary
reporting procedures which are substantially equivalent to
reporting requirements and procedures adopted by the
commissioner of health for reporting procedures under sections
144.695 to 144.703. consistent with written operating
requirements for the voluntary, nonprofit reporting organization
which shall be established annually by the commissioner. These
written operating requirements shall specify reports, analyses,
and other deliverables to be produced by the voluntary,
nonprofit reporting organization, and the dates on which those
deliverables must be submitted to the commissioner. The
commissioner of health shall, by rule, prescribe standards
for approval of voluntary reporting procedures, which submission
of data by hospitals and outpatient surgical centers to the
voluntary, nonprofit reporting organization or to the
commissioner. These standards shall provide for:
(a) The filing of appropriate financial information with
the reporting organization;
(b) Adequate analysis and verification of that financial
information; and
(c) Timely publication of the costs, revenues, and rates of
individual hospitals and outpatient surgical centers prior to
the effective date of any proposed rate increase. The
commissioner of health shall annually review the procedures
approved pursuant to this subdivision.
Sec. 14. Minnesota Statutes 1988, section 144.702, is
amended by adding a subdivision to read:
Subd. 7. [STAFF SUPPORT.] The commissioner may require as
part of the written operating requirements for the voluntary,
nonprofit reporting organization that the organization provide
sufficient funds to cover the costs of one professional staff
position who will directly administer the health care cost
information system.
Sec. 15. Minnesota Statutes 1988, section 144.702, is
amended by adding a subdivision to read:
Subd. 8. [TERMINATION OR NONRENEWAL OF REPORTING
ORGANIZATION.] The commissioner may withdraw approval of any
voluntary, nonprofit reporting organization for failure on the
part of the voluntary, nonprofit reporting organization to
comply with the written operating requirements under subdivision
2. Upon the effective date of the withdrawal, all funds
collected by the voluntary, nonprofit reporting organization
under section 144.701, subdivision 4, but not expended shall be
deposited in the general fund.
The commissioner may choose not to renew approval of a
voluntary, nonprofit reporting organization if the organization
has failed to perform its obligations satisfactorily under the
written operating requirements under subdivision 2.
Sec. 16. [144.851] [DEFINITIONS.]
Subdivision 1. [APPLICABILITY.] The definitions in this
section apply to sections 144.851 to 144.862.
Subd. 2. [ABATEMENT.] "Abatement" means the use of the
best available technology to remove or encapsulate deteriorating
or intact lead paint or to reduce the availability of lead in
soil and house dust, medicine, water, and any other sources
considered a lead hazard by the commissioner.
Subd. 3. [BOARD OF HEALTH.] "Board of health" means an
administrative authority established under section 145A.03 or
145A.07.
Subd. 4. [COMMISSIONER.] "Commissioner" means the
commissioner of health.
Subd. 5. [ELEVATED BLOOD LEAD LEVEL.] "Elevated blood lead
level" means at least 25 micrograms per deciliter.
Subd. 6. [ENCAPSULATION.] "Encapsulation" refers to the
covering or containment of a lead source in soil or paint to
prevent harmful exposure to lead. Encapsulation includes, but
is not limited to, covering of bare soil that contains more than
acceptable levels of lead under rules adopted under section
144.862 with sod or soil that contains acceptable parts per
million lead under rules adopted under section 144.862, seeding,
and treatment for walkways and parking areas.
Subd. 7. [LEAD ABATEMENT CONTRACTOR.] "Lead abatement
contractor" means an employer or other person or entity who, for
financial gain, directly performs or causes to be performed,
through subcontracting or similar delegation, work related to
lead hazard abatement or immediate hazard removal.
Sec. 17. [144.852] [PROACTIVE LEAD EDUCATION STRATEGY.]
The commissioner shall contract with boards of health in
communities at high risk for toxic lead exposure to children,
lead advocacy organizations, and businesses to design and
implement a uniform, proactive educational program to introduce
sections 144.851 to 144.861 and promote the prevention of
exposure to all sources of lead to target populations. Priority
shall be given to provide ongoing education to health care and
social service providers, registered lead abatement contractors,
building trades professionals and nonprofessionals, property
owners, and parents. Educational materials shall be
multilingual and multicultural to meet the needs of diverse
populations.
Sec. 18. [144.853] [LEAD SCREENING FOR CHILDREN.]
Within limits of available appropriations, the commissioner
shall contract with the boards of health in Minneapolis, St.
Paul, and Duluth to promote and subsidize a baseline blood lead
test of all children at risk who live in the high risk areas
served by these boards of health and who are under six years of
age. The lead screening shall be advocated on a statewide basis
through the proactive education efforts of boards of health.
The lead screening shall be promoted to be carried out in
conjunction with routine blood tests.
Medical laboratories performing blood lead analyses must
provide copies of the laboratory report form for all blood
levels of at least ten micrograms per deciliter to the
commissioner and to the board of health of the city or county in
which the patient resides.
The information obtained from the screenings shall be
reported by census tract and made available for research and to
the public.
The commissioner shall work through the statewide WIC
program to ensure that erythrocyte protoporphyrin testing of
children for lead toxicity is integrated as a state reimbursed
screening component of WIC services. The commissioner shall
also evaluate the accessibility and affordability of lead
screening for children throughout the state as provided by other
health care providers and report the findings to the legislature
by January 1990.
Sec. 19. [144.854] [ASSESSMENT AND ABATEMENT.]
Subdivision 1. [RESIDENCE ASSESSMENT.] If a child or
pregnant woman is identified as having a blood lead level that
exceeds 25 micrograms per deciliter or the Center for Disease
Control recommendation for elevated blood level, the board of
health must do a timely assessment of the child's or pregnant
woman's residence to determine the sources of lead contamination
and must provide education to the residents and the owner on the
best means of reducing the danger of the lead sources.
Subd. 2. [ABATEMENT ORDERS.] If the level of lead in
paint, soil, or dust found during the assessment conducted under
subdivision 1 exceeds the toxic level of lead standards
established in rules adopted under section 144.862, the board of
health must order the property owner to abate the lead sources.
Subd. 3. [PROVISION OF EQUIPMENT.] State matching funds
shall be made available for a grant program to community-based
organizations to purchase and provide paint removal equipment.
Equipment shall include: drop cloth, secure containers, power
water sprayers, scrapers, and any other equipment required by
local health department or state health department rules.
Equipment shall be made available to low-income households on a
priority basis.
Subd. 4. [PROTECTION OF RESIDENT AND YARD.] No person
shall be required to scrape loose paint or remove intact paint
in response to a housing code violation order or environmental
health or abatement order unless the municipality provides:
(1) specific information regarding personal safety
precautions, and proper removal, containment, and cleanup of
lead paint and debris;
(2) a referral to an organization with proper removal
equipment; and
(3) a lead paint removal hot-line phone number for
information and technical assistance.
Subd. 5. [WARNING NOTICE.] A warning notice must be posted
on all entrances to properties for which an order to abate a
lead source has been issued by a board of health. This notice
must remain posted until the abatement has been completed in
accordance with the order, or until the board of health removes
it. This warning must be at least 8-1/2 by 11 inches in size,
and must include the following provisions, or provisions using
substantially similar language:
(a) "This property contains dangerous amounts of lead to
which children under age six and pregnant women should not be
exposed."
(b) "It is unlawful to remove or deface this warning. This
warning may be removed only upon the direction of the board of
health."
Subd. 6. [RELOCATION OF RESIDENTS.] Relocation of
residents is required from rooms or dwellings for removal of
intact paint and the removal or disruption of lead painted
surfaces and plaster walls during construction or remodeling
projects. The commissioner shall contract with boards of health
for safe housing for relocation requirements. Efforts must be
made to minimize disruption and ensure that a family may return
to their place of residence if they desire, after abatement is
completed.
Subd. 7. [RETESTING REQUIRED.] After completion of the
abatement as ordered, the board of health must retest the paint,
soil, and dust previously in violation to assure the violations
no longer exist.
Sec. 20. [144.856] [REGISTRATION OF ABATEMENT
CONTRACTORS.]
After July 1, 1989, abatement contractors who contract for
the removal of leaded soil, dust, or deteriorating paint must
register by phone, mail, or in person with the commissioner and
notify the board of health of all abatement projects undertaken
in response to an abatement order. All abatement contractors
shall be given instructional materials on safe abatement methods
and the requirements of relocation from rooms or dwellings by
residents. By July 1, 1990, the commissioner shall develop a
training program for abatement contractors and adopt rules
specifying the abatement methods that must be used by
contractors to provide for the safe collection, handling,
storage, encapsulation, removal, transportation, and disposal of
lead containing material. The commissioner shall adopt
emergency rules for abatement methods and standards for paint,
bare soil, dust, and drinking water from public fountains for
cities of the first class. By January 1, 1991, the commissioner
shall report to the legislature concerning the need for
licensure or certification of lead abatement contractors.
Sec. 21. [144.860] [LEAD ABATEMENT ADVOCATE.]
The commissioner shall create and administer a program to
fund locally based advocates who, following the issuance of an
abatement order, will visit the family in their residence to
instruct them about safety measures, materials, and methods to
be followed before, during, and after the abatement process.
Sec. 22. [144.861] [STUDY ON ABATEMENT COSTS.]
The commissioner of state planning shall convene a task
force of representatives of the Minnesota housing finance
agency, the pollution control agency, the department of health,
the state planning agency, abatement contractors, realtors,
community residents including both tenants and landowners, lead
advocacy organizations, and cultural groups at high risk of lead
poisoning to evaluate the costs of providing assistance to
property owners and local communities required to do abatement
under this law and of providing subsidized programs to assist
them. The task force shall also present recommendations for a
statewide subsidized abatement service program. The agency
shall report its findings and recommendations to the legislature
by January 1990.
Sec. 23. [144.862] [RULES.]
By June 30, 1990, the commissioner of the pollution control
agency and the commissioner of health shall jointly adopt rules
to set toxic lead levels for paint, bare soil, dust, and
drinking water from public fountains.
Sec. 24. Minnesota Statutes 1988, section 144A.01,
subdivision 5, is amended to read:
Subd. 5. "Nursing home" means a facility or that part of a
facility which provides nursing care to five or more persons.
"Nursing home" does not include a facility or that part of a
facility which is a hospital, a hospital with approved swing
beds as defined in section 144.562, clinic, doctor's office,
diagnostic or treatment center, or a residential facility
program licensed pursuant to sections 245.781 to 245.821 245A.01
to 245A.16 or 252.28.
Sec. 25. Minnesota Statutes 1988, section 144A.45,
subdivision 2, is amended to read:
Subd. 2. [REGULATORY FUNCTIONS.] (a) The commissioner
shall:
(1) evaluate, monitor, and license home care providers in
accordance with sections 144A.45 to 144A.49;
(2) inspect the office and records of a provider during
regular business hours, provided that when conducting routine
office visits or inspections, the commissioner shall provide at
least 48 hours without advance notice to the home care provider;
(3) with the consent of the consumer, visit the home where
services are being provided;
(4) issue correction orders and assess civil penalties in
accordance with section 144.653, subdivisions 5 to 8; and
(5) take other action reasonably required to accomplish the
purposes of sections 144A.43 to 144A.49.
(b) In the exercise of the authority granted in sections
144A.43 to 144A.49, the commissioner shall comply with the
applicable requirements of section 144.122, the government data
practices act, and the administrative procedure act.
Sec. 26. Minnesota Statutes 1988, section 144A.46, is
amended to read:
144A.46 [LICENSURE.]
Subdivision 1. [LICENSE REQUIRED.] (a) A home care
provider may not operate in the state without a current license
issued by the commissioner of health.
(b) Within ten days after receiving an application for a
license, the commissioner shall acknowledge receipt of the
application in writing. The acknowledgment must indicate
whether the application appears to be complete or whether
additional information is required before the application will
be considered complete. Within 90 days after receiving a
complete application, the commissioner shall either grant or
deny the license. If an applicant is not granted or denied a
license within 90 days after submitting a complete application,
the license must be deemed granted. An applicant whose license
has been deemed granted must provide written notice to the
commissioner before providing a home care service.
(c) Each application for a home care provider license, or
for a renewal of a license, shall be accompanied by a fee to be
set by the commissioner under section 144.122.
Subd. 2. [EXEMPTIONS.] The following individuals or
organizations are exempt from the requirement to obtain a home
care provider license:
(1) a person who is licensed under sections 148.171 to
148.285 and who independently provides nursing services in the
home without any contractual or employment relationship to a
home care provider or other organization;
(2) a personal care assistant who provides services under
the medical assistance program as authorized under section
256B.0625, subdivision 19, and section 256B.04, subdivision 16;
(3) a person or organization that exclusively offers,
provides, or arranges for personal care assistant services under
the medical assistance program as authorized under section
256B.0625, subdivision 19, and section 256B.04, subdivision 16;
(4) a person who is registered under sections 148.65 to
148.78 and who independently provides physical therapy services
in the home without any contractual or employment relationship
to a home care provider or other organization;
(5) a person who provides services to a person with mental
retardation under a program of semi-independent living services
regulated by Minnesota Rules, parts 9525.0500 to 9525.0660; or
(6) a person who provides services to a person with mental
retardation under contract with a county to provide home and
community-based services that are reimbursed under the medical
assistance program, chapter 256B, and regulated by Minnesota
Rules, parts 9525.1800 to 9525.1930.
An exemption under this subdivision does not excuse the
individual from complying with applicable provisions of the home
care bill of rights.
Subd. 3. [ENFORCEMENT.] The commissioner may refuse to
grant or renew a license, or may suspend or revoke a license,
for violation of statutes or rules relating to home care
services or for conduct detrimental to the welfare of the
consumer. Prior to any suspension, revocation, or refusal to
renew a license, the home care provider shall be entitled to
notice and a hearing as provided by sections 14.57 to 14.70. In
addition to any other remedy provided by law, the commissioner
may, without a prior contested case hearing, temporarily suspend
a license or prohibit delivery of services by a provider for not
more than 60 days if the commissioner determines that the health
or safety of a consumer is in imminent danger, provided (1)
advance notice is given to the provider; (2) after notice, the
provider fails to correct the problem; (3) the commissioner has
reason to believe that other administrative remedies are not
likely to be effective; and (4) there is an opportunity for a
contested case hearing within the 60 days. The process of
suspending or revoking a license must include a plan for
transferring affected clients to other providers.
Subd. 3a. [INJUNCTIVE RELIEF.] In addition to any other
remedy provided by law, the commissioner may bring an action in
district court to enjoin a person who is involved in the
management, operation, or control of a home care provider, or an
employee of the home care provider from illegally engaging in
activities regulated by sections 144A.43 to 144A.48. The
commissioner may bring an action under this subdivision in the
district court in Ramsey county or in the district in which a
home care provider is providing services. The court may grant a
temporary restraining order in the proceeding if continued
activity by the person who is involved in the management,
operation, or control of a home care provider, or by an employee
of the home care provider, would create an imminent risk of harm
to a recipient of home care services.
Subd. 3b. [SUBPOENA.] In matters pending before the
commissioner under sections 144A.43 to 144A.48, the commissioner
may issue subpoenas and compel the attendance of witnesses and
the production of all necessary papers, books, records,
documents, and other evidentiary material. If a person fails or
refuses to comply with a subpoena or order of the commissioner
to appear or testify regarding any matter about which the person
may be lawfully questioned or to produce any papers, books,
records, documents, or evidentiary materials in the matter to be
heard, the commissioner may apply to the district court in any
district, and the court shall order the person to comply with
the commissioner's order or subpoena. The commissioner of
health may administer oaths to witnesses, or take their
affirmation. Depositions may be taken in or outside the state
in the manner provided by law for the taking of depositions in
civil actions. A subpoena or other process or paper may be
served upon a named person anywhere within the state by an
officer authorized to serve subpoenas in civil actions, with the
same fees and mileage and in the same manner as prescribed by
law for process issued out of a district court. A person
subpoenaed under this subdivision shall receive the same fees,
mileage, and other costs that are paid in proceedings in
district court.
Subd. 4. [RELATION TO OTHER REGULATORY PROGRAMS.] In the
exercise of the authority granted under sections 144A.43 to
144A.49, the commissioner shall not duplicate or replace
standards and requirements imposed under another state
regulatory program. The commissioner shall not impose
additional training or education requirements upon members of a
licensed or registered occupation or profession, except as
necessary to address or prevent problems that are unique to the
delivery of services in the home or to enforce and protect the
rights of consumers listed in section 144A.44. For home care
providers certified under the Medicare program, the state
standards must not be inconsistent with the Medicare standards
for Medicare services. To the extent possible, the commissioner
shall coordinate the inspections required under sections 144A.45
to 144A.48 with the health facility licensure inspections
required under sections 144.50 to 144.58 or 144A.10 when the
health care facility is also licensed under the provisions of
Laws 1987, chapter 378.
Subd. 5. [PRIOR CRIMINAL CONVICTIONS.] An applicant for a
home care provider license shall disclose to the commissioner
all criminal convictions of persons involved in the management,
operation, or control of the provider. A home care provider
shall require employees of the provider and applicants for
employment in positions that involve contact with recipients of
home care services to disclose all criminal convictions. The
commissioner may adopt rules that may require a person who must
disclose criminal convictions under this subdivision to provide
fingerprints and releases that authorize law enforcement
agencies, including the bureau of criminal apprehension and the
federal bureau of investigation, to release information about
the person's criminal convictions to the commissioner and home
care providers. The bureau of criminal apprehension, county
sheriffs, and local chiefs of police shall, if requested,
provide the commissioner with criminal conviction data available
from local, state, and national criminal record repositories,
including the criminal justice data communications network. No
person may be employed by a home care provider or in a position
that involves contact with recipients of home care services nor
may any person be involved in the management, operation, or
control of a provider, if the person has been convicted of a
crime that relates to the provision of home care services or to
the position, duties, or responsibilities undertaken by that
person in the operation of the home care provider, unless the
person can provide sufficient evidence of rehabilitation. The
commissioner shall adopt rules for determining what types of
employment positions, including volunteer positions, involve
contact with recipients of home care services, and whether a
crime relates to home care services and what constitutes
sufficient evidence of rehabilitation. The rules must require
consideration of the nature and seriousness of the crime; the
relationship of the crime to the purposes of home care licensure
and regulation; the relationship of the crime to the ability,
capacity, and fitness required to perform the duties and
discharge the responsibilities of the person's position;
mitigating circumstances or social conditions surrounding the
commission of the crime; the length of time elapsed since the
crime was committed; the seriousness of the risk to the home
care client's person or property; and other factors the
commissioner considers appropriate. Data collected under this
subdivision shall be classified as private data under section
13.02, subdivision 12.
Sec. 27. [144A.465] [LICENSURE; PENALTY.]
A person involved in the management, operation, or control
of a home care provider who violates section 144A.46,
subdivision 1, paragraph (a), is guilty of a misdemeanor. This
section does not apply to a person who had no legal authority to
affect or change decisions related to the management, operation,
or control of a home care provider.
Sec. 28. Minnesota Statutes 1988, section 145.38,
subdivision 1, is amended to read:
Subdivision 1. No person shall sell to a person under 19
18 years of age any glue or, cement, or aerosol paint containing
toluene, benzene, xylene, amyl nitrate, butyl nitrate, nitrous
oxide, or other aromatic hydrocarbon solvents, or any similar
substance which the state commissioner of health has, by rule
adopted pursuant to sections 14.02, 14.04 to 14.36, 14.38, and
14.44 to 14.45, declared to have potential for abuse and toxic
effects on the central nervous system. This section does not
apply if the glue or, cement, or aerosol paint is contained in a
packaged kit for the construction of a model automobile,
airplane, or similar item.
Sec. 29. [145.385] [WARNING SIGNS.]
A business establishment that offers for sale at retail any
item as described in section 145.38, subdivision 1, must display
a conspicuous sign that contains the following, or substantially
similar, language:
"NOTICE
It is unlawful for a person to sell glue, cement, or aerosol
paint containing intoxicating substances to a person under 18
years of age, except as provided by law. Such an offense is a
misdemeanor. It is also unlawful for a person to use or possess
glue, cement, or aerosol paint with the intent of inducing
intoxication, excitement, or stupefaction of the central nervous
system. Such an offense is a misdemeanor. Such use can be
harmful or fatal."
Sec. 30. Minnesota Statutes 1988, section 145.39,
subdivision 1, is amended to read:
Subdivision 1. No person under 19 years of age shall use
or possess any glue, cement, aerosol paint, or any other
substance containing toluene, benzene, xylene, amyl nitrate,
butyl nitrate, nitrous oxide, or other aromatic hydrocarbon
solvents, or any similar substance which the state commissioner
of health has, by rule adopted pursuant to sections 14.02, 14.04
to 14.36, 14.38, and 14.44 to 14.45, declared to have potential
for abuse and toxic effects on the central nervous system with
the intent of inducing intoxication, excitement or stupefaction
of the central nervous system, except under the direction and
supervision of a medical doctor.
Sec. 31. [145.406] [INFORMATION ON THE SALE AND USE OF
TOXIC SUBSTANCES.]
The commissioner of health shall prepare and distribute
materials designed to provide information to retail businesses
on the requirements of sections 145.38 to 145.40.
Sec. 32. [145.867] [PERSONS REQUIRING SPECIAL DIETS.]
Subdivision 1. [PUBLIC FACILITY.] "Public facility" means
an auditorium, concert hall, sports stadium, sports arena, or
theater.
Subd. 2. [IDENTIFICATION CARD FOR INDIVIDUALS NEEDING A
SPECIAL DIET.] The commissioner of health shall make special
diet identification cards available to physicians and to persons
with diabetes and other conditions requiring special diets. The
identification card must contain spaces for: (1) the person's
name, address, and signature; (2) the physician's name, phone
number, and signature; (3) a description of the person's medical
condition; and (4) an expiration date. The card must also
contain the following provision, in identical or substantially
similar language: "The owner of this card is exempted by the
commissioner of health from prohibitions on bringing outside
food and drink into a public facility." Persons with medical
conditions requiring a special diet may ask their physician to
fill out and sign the card. The physician shall fill out and
sign the card if, in the physician's medical judgment, the
person has a medical condition that requires a special diet.
Persons with diabetes shall be automatically assumed by
physicians to require special diets. Special diet
identification cards shall be valid for five years. Persons
with a medical condition requiring a special diet may request a
new card from their physician up to six months before the
expiration date.
Subd. 3. [EXEMPTION FROM FOOD AND DRINK
PROHIBITIONS.] Persons with medical conditions requiring a
special diet who present a valid special diet identification
card to any employee of a public facility shall be allowed to
bring in outside food and drink, subject to the limitations in
subdivision 4. To be valid, the card must be filled out
according to subdivision 2 and must be current. Persons with
special diet identification cards must obey all other food and
drink regulations established by a public facility including
prohibitions on eating or drinking in certain areas of the
public facility.
Subd. 4. [LIMITATION ON EXEMPTION.] Public facilities may
limit the amount of food and drink that may be brought into a
public facility by a person with a special diet identification
card to the amount that can reasonably be consumed by a single
individual. Public facilities may also place limits on the size
of any food or drink container carried in, if the container
would be a safety hazard or interfere with other patrons or
customers. Public facilities may also require persons
displaying a special diet identification card to show some other
form of identification.
Sec. 33. Minnesota Statutes 1988, section 145.882,
subdivision 1, is amended to read:
Subdivision 1. [CONTINUATION OF 1983 PROJECTS FUNDING
LEVELS AND ADVISORY TASK FORCE REVIEW.] (a) Notwithstanding
subdivisions 2 and 3, recipients of maternal and child health
grants for special projects in state fiscal year 1983 shall
continue to be funded at the same level as in state fiscal year
1983 until December 31, 1987. Beginning January 1, 1988,
recipients of maternal and child health special project grants
awarded in state fiscal year 1983 must receive:
(1) for calendar year 1988, no less than 80 percent of the
amount awarded in state fiscal year 1983; and
(2) for calendar year 1989, no less than 70 percent of the
amount awarded in state fiscal year 1983.
(b) The amount of grants awarded under this subdivision
must be deducted from the allocation under subdivisions 3 and 4
for the community health services area within which the grantee
is located. In order to receive money under this subdivision,
recipients must continue to comply with sections 145.881 and
145.882 to 145.888. These recipients are also eligible to apply
for grants under subdivisions 2, 3, and 4. Any decrease in the
amount of federal funding to the state for the maternal and
child health block grant must be apportioned to reflect a
proportional decrease for each recipient. Any increase in the
amount of federal funding to the state must be distributed under
subdivisions 2, 3, and 4.
(c) The advisory task force shall review and recommend the
proportion of maternal and child health block grant funds to be
expended for indirect costs, direct services and special
projects.
Sec. 34. Minnesota Statutes 1988, section 145.882,
subdivision 3, is amended to read:
Subd. 3. [ALLOCATION TO COMMUNITY HEALTH SERVICES AREAS.]
(a) The maternal and child health block grant money remaining
after distributions made under subdivisions 1 and subdivision 2
must be allocated according to the formula in subdivision 4 to
community health services areas for distribution by community
health boards as defined in section 145A.02, subdivision 5, to
qualified programs that provide essential services within the
community health services area as long as:
(1) the Minneapolis community health service area is
allocated at least $1,626,215 per year;
(2) the St. Paul community health service area is allocated
at least $822,931 per year; and
(3) all other community health service areas are allocated
at least $30,000 per county per year or their 1988-1989 funding
cycle award, whichever is less.
(b) Notwithstanding paragraph (a), if the total amount of
maternal and child health block grant funding decreases, the
decrease must be apportioned to reflect a proportional decrease
for each recipient, including recipients who would otherwise
receive a guaranteed minimum allocation under paragraph (a).
Sec. 35. Minnesota Statutes 1988, section 145.882,
subdivision 7, is amended to read:
Subd. 7. [USE OF BLOCK GRANT MONEY.] (a) Maternal and
child health block grant money allocated to a community health
board or community health services area under this section must
be used for qualified programs for high risk and low income
individuals. Block grant money must be used for programs that:
(1) specifically address the highest risk populations,
particularly low income and minority groups with a high rate of
infant mortality and children with low birth weight, by
providing services calculated to produce measurable decreases in
infant mortality rates, instances of children with low birth
weight, and medical complications associated with pregnancy and
childbirth;
(2) specifically target pregnant women whose age, medical
condition, or maternal history substantially increases the
likelihood of complications associated with pregnancy and
childbirth or the birth of a child with an illness, disability,
or special medical needs;
(3) specifically address the health needs of young children
who have or are likely to have a chronic disease or disability
or special medical needs; or
(4) provide family planning and preventive medical care for
specifically identified target populations, such as minority and
low income teenagers, in a manner calculated to decrease the
occurrence of inappropriate pregnancy and minimize the risk of
complications associated with pregnancy and childbirth.; or
(5) specifically address the frequency and severity of
childhood injuries in high risk target populations by providing
services calculated to produce measurable decreases in mortality
and morbidity. However, money may be used for this purpose only
if the community health board's application includes program
components for the purposes in clauses (1) to (4) in the
proposed geographic service area and the total expenditure for
injury-related programs under this clause does not exceed ten
percent of the total allocation under subdivision 3.
(b) Maternal and child health block grant money may be used
for purposes other than the purposes listed in this subdivision
only if under the following conditions:
(1) the community health board or community health services
area can demonstrate that existing programs fully address the
needs of the highest risk target populations described in this
subdivision.; or
(2) the money is used to continue projects that received
funding before creation of the maternal and child health block
grant in 1981.
(c) Projects that received funding before creation of the
maternal and child health block grant in 1981, must be allocated
at least the amount of maternal and child health special project
grant funds received in 1989, unless (1) the local board of
health provides equivalent alternative funding for the project
from another source; or (2) the local board of health
demonstrates that the need for the specific services provided by
the project has significantly decreased as a result of changes
in the demographic characteristics of the population, or other
factors that have a major impact on the demand for services. If
the amount of federal funding to the state for the maternal and
child health block grant is decreased, these projects must
receive a proportional decrease as required in subdivision 1.
Increases in allocation amounts to local boards of health under
subdivision 4 may be used to increase funding levels for these
projects.
Sec. 36. [145.898] [SUDDEN INFANT DEATH.]
The department of health shall develop uniform
investigative guidelines and protocols for coroners and medical
examiners conducting death investigations and autopsies of
children under two years of age.
Sec. 37. [145.9245] [GRANTS FOR CASE MANAGEMENT SERVICES
FOR AIDS INFECTED PERSONS.]
The commissioner may award special grants to community
health boards as defined in section 145A.02, subdivision 5, or
nonprofit corporations for the development, implementation, and
evaluation of case management services for individuals infected
with the human immunodeficiency virus to assist in preventing
transmission of the human immunodeficiency virus to others.
Sec. 38. Minnesota Statutes 1988, section 146.13, is
amended to read:
146.13 [REGISTRATION FEES.]
Every person not hereinafter excepted from the provisions
of this chapter authorized to practice healing in this state
shall, in the month of January each year, annually register with
the director of the particular board of examiners which examined
and registered or licensed the person to practice that branch or
system of healing pursued; and shall, at that time, for the
purpose of making such registration, sign and send to such
director in writing the following: name, the name of the place,
and the address, at which the practice of healing is engaged in,
and pay to the director each year a fee in an amount to be fixed
by rule of the respective board of examiners. Any person who
shall change the address or place of practice during the year
shall forthwith notify such director in writing of such change,
giving such new address or place. The director of each board of
examiners shall keep a proper register of all such persons and
to each person so registering the proper board shall issue a
certificate for the current year, signed by the president and
the director and sealed with the seal of such board, setting
forth name, the name of the place and the address at which the
practice of healing is engaged in, and the branch or system of
healing pursued. Any person not hereinafter excepted from the
provisions of this chapter lawfully entitled to engage in the
practice of healing in this state after the month of January in
any year, and who shall not be currently registered as provided
in this section, shall, within 30 days after first so engaging
in the practice of healing, register with the proper examining
board in the manner provided in this chapter, pay to the
director of such board the fee above required, and received from
such board a certificate as above prescribed for the balance of
such year. Every person receiving a certificate, as herein
provided, shall display the same in a conspicuous place in the
office or other corresponding place where the practice of
healing is pursued.
All fees received by the director of any examining board
for registration required by this section shall be paid to the
general fund. The expenses of keeping proper registers,
furnishing the certificates herein provided for, employing
inspectors for procuring evidence of any violation of the laws
administered thereby and aiding in the enforcement of such laws,
and for such other expenses as may be necessarily paid or
incurred in the exercise of its powers or performance of its
duties, shall be paid from the appropriation made to the
examining board.
Sec. 39. Minnesota Statutes 1988, section 147.02,
subdivision 1, is amended to read:
Subdivision 1. [UNITED STATES OR CANADIAN MEDICAL SCHOOL
GRADUATES.] The board shall, with the consent of six of its
members, issue a license to practice medicine to a person who
meets the following requirements:
(a) An applicant for a license shall file a written
application on forms provided by the board, showing to the
board's satisfaction that the applicant is of good moral
character and satisfies the requirements of this section.
(b) The applicant shall present evidence satisfactory to
the board of being a graduate of a medical or osteopathic school
located in the United States, its territories or Canada, and
approved by the board based upon its faculty, curriculum,
facilities, accreditation by a recognized national accrediting
organization approved by the board, and other relevant data, or
is currently enrolled in the final year of study at the school.
(c) The applicant must have passed an a comprehensive
examination for initial licensure prepared and graded by the
national board of medical examiners or the federation of state
medical boards. The board shall by rule determine what
constitutes a passing score in the examination.
(d) The applicant shall present evidence satisfactory to
the board of the completion of one year of graduate, clinical
medical training in a program accredited by a national
accrediting organization approved by the board or other graduate
training approved in advance by the board as meeting standards
similar to those of a national accrediting organization.
(e) The applicant shall make arrangements with the
executive director to appear in person before the board or its
designated representative to show that the applicant satisfies
the requirements of this section. The board may establish as
internal operating procedures the procedures or requirements for
the applicant's personal presentation.
(f) The applicant shall pay a fee established by the board
by rule. The fee may not be refunded.
(g) The applicant must not have engaged in conduct
warranting disciplinary action against a licensee. If the
applicant does not satisfy the requirements of this paragraph,
the board may refuse to issue a license unless it determines
that the public will be protected through issuance of a license
with conditions and limitations the board considers appropriate.
Sec. 40. Minnesota Statutes 1988, 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, 1989, or within a longer time
period as specified by the board;
(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. 41. Minnesota Statutes 1988, section 148B.27,
subdivision 2, is amended to read:
Subd. 2. [USE OF TITLES.] After the board adopts rules, no
individual shall be presented to the public by any title
incorporating the words "social work" or "social worker" unless
that individual holds a valid license issued under sections
148B.18 to 148B.28. City, county, and state agency social
workers who are not licensed under sections 148B.18 to 148B.28
may use the title city agency social worker or county agency
social worker or state agency social worker. Hospital social
workers who are not licensed under sections 148B.18 to 148B.28
may use the title hospital social worker while acting within the
scope of their employment.
Sec. 42. Minnesota Statutes 1988, section 148B.32,
subdivision 2, is amended to read:
Subd. 2. [APPEARANCE AS LICENSEE PROHIBITED.] After
adoption of rules by the board implementing sections 148B.29 to
148B.39, no individual shall be held out to be a marriage and
family therapist unless that individual holds a valid license
issued under sections 148B.29 to 148B.39, is a psychologist
licensed by the board of psychology with a competency in
marriage and family therapy, or is a person providing marriage
and family therapy who is employed by a hospital licensed under
chapter 144 and who is acting within the scope of the person's
employment.
Sec. 43. Minnesota Statutes 1988, section 148B.40,
subdivision 3, is amended to read:
Subd. 3. [MENTAL HEALTH SERVICE PROVIDER.] "Mental health
service provider" or "provider" means any person who provides,
for a remuneration, mental health services as defined in
subdivision 4. It does not include persons licensed by the
board of medical examiners under chapter 147; the board of
nursing under sections 148.171 to 148.285; or the board of
psychology under sections 148.88 to 148.98; the board of social
work under sections 148B.18 to 148B.28; the board of marriage
and family therapy under sections 148B.29 to 148B.39; or another
licensing board if the person is practicing within the scope of
the license. In addition, the term does not include employees
of the state of Minnesota or any of its political subdivisions
while acting within the scope of their public employment;
hospital and nursing home social workers exempt from licensure
by the board of social work under section 148B.28, subdivision
6, including hospital and nursing home social workers acting as
marriage and family counselors within the scope of their
employment by the hospital or nursing home; persons employed by
a program licensed by the commissioner of human services who are
acting as mental health service providers within the scope of
their employment; and persons certified as chemical dependency
professionals by the Institute for Chemical Dependency
Professionals of Minnesota, Inc. The Institute for Chemical
Dependency Professionals shall provide the board of unlicensed
mental health service providers with the name and address of any
person whose certification has been discontinued, along with the
reason for the discontinuance. Any chemical dependency
treatment professional who does not maintain a current and valid
certification with the Institute of Chemical Treatment
Professionals of Minnesota, Inc., must register with the board
of unlicensed mental health service providers in order to
provide chemical dependency treatment services.
Sec. 44. Minnesota Statutes 1988, section 149.02, is
amended to read:
149.02 [EXAMINATION; LICENSING.]
The state commissioner of health is hereby authorized and
empowered to examine, upon submission of an application therefor
and fee as prescribed by the commissioner pursuant to section
144.122, all applicants for license to practice mortuary science
or funeral directing and to determine whether or not the
applicants possess the necessary qualifications to practice
mortuary science or funeral directing. If upon examination the
commissioner shall determine that an applicant is properly
qualified to practice mortuary science or funeral directing, the
commissioner shall grant a license to the person to practice
mortuary science or funeral directing. Licenses shall expire
and be renewed as prescribed by the commissioner pursuant to
section 144.122.
On or after the thirty-first day of December, 1955,
separate licenses as embalmer or funeral director shall not be
issued, except that a license as funeral director shall be
issued to those apprentices who have been registered under rules
of the commissioner as apprentice funeral directors on the first
day of July, 1955, qualify by examination for licensure under
such rules as funeral directors before the first day of August,
1957. Such applicants shall file an application for license as
a funeral director in the manner as is required in section
149.03 for a license in mortuary science. It shall be
accompanied by a fee in an amount prescribed by the commissioner
pursuant to section 144.122. However, a single license as a
funeral director shall be issued to those persons whose custom,
rites, or religious beliefs forbid the practice of embalming.
An applicant for a single license as a funeral director under
this exception shall submit to the commissioner of health two
affidavits substantiating the beliefs and convictions of the
applicant and shall meet any other standards for licensure as
are required by law or by rule of the commissioner. Such a
funeral director shall only direct funerals for persons of the
same customs, rites or religious beliefs as those of the funeral
director. In the case of a funeral conducted for persons of
such customs, rites or religious beliefs where embalming and
funeral directing is necessary according to law, such embalming
and funeral directing shall be performed only by a person
licensed to do so in this state.
All licensees who on the thirty-first day of December,
1955, hold licenses as embalmers only shall be granted licenses
to practice mortuary science and may renew their licenses at the
times and in the manner specified by the commissioner pursuant
to section 144.122.
All licensees who on the thirty-first day of December,
1955, hold licenses as funeral director only may continue to
renew their licenses at the times and in the manner specified by
the commissioner pursuant to section 144.122. If a licensee
fails to renew, as in this chapter required, that person's
license as a funeral director shall not thereafter be reinstated.
To assist in the holding of the examination and enforcement
of the provisions of this chapter, the commissioner shall
establish a mortuary sciences advisory council and shall appoint
four five members to it. Two members shall be licensed in
mortuary science and shall have had at least five years
experience immediately preceding their appointment in the
preparation and disposition of dead human bodies and in the
practice of mortuary science. A third member shall be a
representative of the commissioner Two members must be public
members as defined by section 214.02, and the fourth fifth
member shall be a full-time academic staff member of the course
in mortuary science of the University of Minnesota. The terms,
compensation and removal of members and expiration of the
council shall be as provided in section 15.059.
Sec. 45. Minnesota Statutes 1988, section 149.06, is
amended to read:
149.06 [VIOLATIONS, PENALTIES.]
Any person who shall embalm a dead human body, or who shall
hold out as a mortician, embalmer, funeral director, or trainee,
without being licensed or registered, shall be guilty of a
misdemeanor and punished accordingly. This chapter shall not
apply to or in any way interfere with the duties of any officer
of any public institution, or with the duties of any officer of
a medical college, county medical society, anatomical
association, accredited college of mortuary science, or to any
person engaged in the performance of duties prescribed by law
relating to the conditions under which the indigent dead human
bodies are held subject to anatomical study, or to the custom or
rites of any religious sect in the burial of their dead.
The name of a person registered as a trainee must not be
used or caused or permitted to be used by the person, in any
way, in the name, designation, or title, or in the advertising
of the funeral establishment with which the person is associated
or in which the person may have acquired a proprietary or
financial interest.
Nothing in this chapter shall in any way affect the
operation of corporations or burial associations, providing all
work of embalming or funeral directing is done by licensed
morticians or funeral directors, as provided by this chapter.
It shall be unlawful for any such corporation or burial
association to:
(1) Violate any of the laws of this state relative to the
burial or disposal of dead human bodies, or any of the rules of
the state commissioner of health in relation to the care,
custody, or disposition of dead human bodies, or the
disinfecting of premises where contagion exists;
(2) Publish or disseminate misleading advertising;
(3) Directly or indirectly pay or cause to be paid any sum
of money or other valuable consideration for the securing of
business, other than by advertising, or for obtaining authority
to dispose of any dead human bodies;
(4) Permit unlicensed persons to render or perform any of
the services required to be performed by persons licensed under
the provisions of this chapter.
Any corporation or burial association violating any of the
provisions of this chapter shall be deemed guilty of a
misdemeanor.
Nothing in this chapter shall be construed as repealing any
of the laws of this state in regard to the organizing or
incorporating of cooperative associations.
Sec. 46. Minnesota Statutes 1988, section 153A.13,
subdivision 4, is amended to read:
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 or testing human hearing in
connection with these activities.
Sec. 47. Minnesota Statutes 1988, section 153A.15,
subdivision 3, is amended to read:
Subd. 3. [PROCEDURES.] The commissioner shall establish,
in writing, internal operating procedures for receiving and
investigating complaints and imposing enforcement actions. The
written internal operating procedures may include procedures for
sharing complaint information with government agencies in this
and other states. Establishment of the operating procedures are
not subject to rulemaking procedures under chapter
14. Procedures for sharing complaint information shall be
consistent with the requirements for handling government data
under chapter 13.
Sec. 48. Minnesota Statutes 1988, section 153A.16, is
amended to read:
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 commissioner of health. 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. 49. [157.031] [ADDITIONAL LICENSE REQUIRED FOR BOARD
AND LODGING ESTABLISHMENTS; SPECIAL SERVICES.]
Subdivision 1. [DEFINITIONS.] (a) "Supportive services"
means the provision of supervision and minimal assistance with
independent living skills such as social and recreational
opportunities, assistance with transportation, arranging for
meetings and appointments, arranging for medical and social
services, and dressing, grooming, or bathing. Supportive
services also include providing reminders to residents to take
medications that are self administered or providing storage for
medications if requested.
(b) "Health supervision services" means the provision of
assistance in the preparation and administration of medications
other than injectables, the provision of therapeutic diets,
taking vital signs, or providing assistance in bathing or with
walking devices.
Subd. 2. [REGISTRATION.] A board and lodging establishment
that provides supportive services or health supervision services
must register with the commissioner by September 1, 1989. The
registration must include the name, address, and telephone
number of the establishment, the types of services that are
being provided, a description of the residents being served, the
type and qualifications of staff in the facility, and other
information that is necessary to identify the needs of the
residents and the types of services that are being provided.
The commissioner shall develop and furnish to the board and
lodging establishment the necessary form for submitting the
registration. The requirement for registration is effective
until the special license rules required by subdivision 5 are
effective.
Subd. 3. [RESTRICTION ON THE PROVISION OF SERVICES.]
Effective September 1, 1989, and until the rules required under
subdivision 5 are adopted, a board and lodging establishment may
provide health supervision services only if a licensed nurse is
on site in the facility for at least four hours a week to
provide supervision and health monitoring of the residents. A
board and lodging facility that admits or retains residents
using wheelchairs or walkers must have the necessary clearances
from the office of the state fire marshal.
Subd. 4. [SPECIAL LICENSE REQUIRED.] Upon adoption of the
rules required by subdivision 5, a board and lodging
establishment that provides either supportive care or health
supervision services must obtain a special license from the
commissioner. The special license is required until rules
resulting from the recommendations made in accordance with
section 213 are implemented.
Subd. 5. [RULES.] By July 1, 1990, the commissioner of
health shall adopt rules necessary to implement the special
license provisions. The rules may address the type of services
that can be provided, staffing requirements, and the training
and qualifications of staff. The rules must set a fee for the
issuance of the special service license. The special license
fee is in addition to the license fee prescribed in section
157.03. Nothing in section 157.031 and sections 213 and 214 is
intended to prevent the promulgation of rules by the
commissioner of human services governing the licensure or
delivery of services to persons with mental illness or the
requirement to comply with those rules.
Subd. 6. [SERVICES THAT MAY NOT BE PROVIDED IN A BOARD AND
LODGING ESTABLISHMENT.] A board and lodging establishment may
not admit or retain individuals who:
(1) would require assistance from facility staff because of
the following needs: incontinence, catheter care, use of
injectable or parenteral medications, wound care, or dressing
changes or irrigations of any kind; or
(2) require a level of care and supervision beyond
supportive services or health supervision services.
Subd. 7. [CERTAIN INDIVIDUALS MAY PROVIDE SERVICES.] This
section does not prohibit the provision of health care services
to residents of a board and lodging establishment by family
members of the resident or by a registered or licensed home care
agency employed by the resident.
Subd. 8. [EXEMPTION FOR ESTABLISHMENTS WITH A HUMAN
SERVICES LICENSE.] This section does not apply to a board and
lodging establishment that is licensed by the commissioner of
human services under chapter 245A.
Subd. 9. [VIOLATIONS.] The commissioner may revoke both
the special service license, when issued, and the establishment
license, if the establishment is found to be in violation of
this section. Violation of this section is a gross misdemeanor.
Sec. 50. Minnesota Statutes 1988, section 157.14, is
amended to read:
157.14 [EXEMPTIONS.]
This chapter shall not be construed to apply to interstate
carriers under the supervision of the United States Department
of Health, Education and Welfare or to any building constructed
and primarily used for religious worship, nor to any building
owned, operated and used by a college or university in
accordance with regulations promulgated by the college or
university. Any person, firm or corporation whose principal
mode of business is licensed under sections 28A.04 and 28A.05 is
exempt at that premises from licensure as a place of refreshment
or restaurant; provided, that the holding of any license
pursuant to sections 28A.04 and 28A.05 shall not exempt any
person, firm, or corporation from the applicable provisions of
the chapter or the rules of the state commissioner of health
relating to food and beverage service establishments. This
chapter does not apply to family day care homes or group family
day care homes governed by sections 245.781 to 245.812 and does
not apply to nonprofit senior citizen centers for the sale of
home-baked goods.
Sec. 51. Minnesota Statutes 1988, section 176.136,
subdivision 1, is amended to read:
Subdivision 1. [SCHEDULE.] The commissioner shall by rule
establish procedures for determining whether or not the charge
for a health service is excessive. In order to accomplish this
purpose, the commissioner shall consult with insurers,
associations and organizations representing the medical and
other providers of treatment services and other appropriate
groups. The procedures established by the commissioner shall
limit the charges allowable for medical, chiropractic,
podiatric, surgical, hospital and other health care provider
treatment or services, as defined and compensable under section
176.135, to the 75th percentile of usual and customary fees or
charges based upon billings for each class of health care
provider during all of the calendar year preceding the year in
which the determination is made of the amount to be paid the
health care provider for the billing. The procedures
established by the commissioner for determining whether or not
the charge for a health service is excessive shall be structured
to encourage providers to develop and deliver services for
rehabilitation of injured workers. The procedures shall
incorporate the provisions of sections 144.701, 144.702, and
144.703 to the extent that the commissioner finds that these
provisions effectively accomplish the intent of this section or
are otherwise necessary to insure that quality hospital care is
available to injured employees.
Sec. 52. Minnesota Statutes 1988, section 176.136,
subdivision 5, is amended to read:
Subd. 5. [PERMANENT RULES.] Where permanent rules have
been adopted to implement this section, the commissioner shall
annually give notice in the State Register of the 75th
percentile reimbursement allowance to meet the requirements of
subdivision 1. The notice shall be in lieu of the requirements
of chapter 14 if the 75th percentile for the service meets and
shall be set at the 75th percentile of the billings for each
service in the data base; provided that the requirements of
paragraphs (a) to (e) are met.
(a) The data base includes at least three different
providers of the service.
(b) The data base contains at least 20 billings for the
service.
(c) The standard deviation as a percentage of the mean of
billings for the service is 50 percent or less. data is taken
from the data base of Blue Cross and Blue Shield of Minnesota
where available; if not available from Blue Cross and Blue
Shield of Minnesota, the data will be taken directly from the
health care providers, professional associations, or other
available sources.
(d) The means of the Blue Cross and Blue Shield data base
and of the department of human services data base for the
service are within 20 percent of each other. standard deviation
is less than or equal to 50 percent of the mean of the billings
for each service in the data base or the value of the 75th
percentile is not greater than or equal to three times the value
of the 25th percentile of the billings for each service in the
data base.
(e) The data is taken from the data base of Blue Cross and
Blue Shield or the department of human services 75th percentile
logically reflects the usual and customary charges for the
service.
Sec. 53. [196.27] [AGENT ORANGE SETTLEMENT PAYMENTS.]
(a) Payments received by veterans or their dependents
because of settlements between them and the manufacturers of
Agent Orange or other chemical agents, as defined in section
196.21, must not be treated as income (or an available resource)
of the veterans or their dependents for the purposes of any
program of public assistance or benefit program administered by
the department of veterans affairs, the department of human
services, or other agencies of the state or political
subdivisions of the state, except as provided in paragraph (b).
(b) The income and resource exclusion in paragraph (a) does
not apply to the medical assistance, food stamps, or aid to
families with dependent children programs until the commissioner
of human services receives formal approval from the United
States Department of Health and Human Services, for the medical
assistance and aid to families with dependent children programs,
and from the United States Department of Agriculture, for the
food stamps program. The income exclusion does not apply to the
Minnesota supplemental aid program until the commissioner
receives formal federal approval of the exclusion for the
medical assistance program.
Sec. 54. Minnesota Statutes 1988, section 214.04,
subdivision 3, is amended to read:
Subd. 3. The executive secretary of each health-related
and non-health-related board shall be the chief administrative
officer for the board but shall not be a member of the board.
The executive secretary shall maintain the records of the board,
account for all fees received by it, supervise and direct
employees servicing the board, and perform other services as
directed by the board. The executive secretaries and other
employees of the following boards shall be hired by the board,
and the executive secretaries shall be in the unclassified civil
service, except as provided in this subdivision:
(1) dentistry;
(2) medical examiners;
(3) nursing;
(4) pharmacy;
(5) accountancy;
(6) architecture, engineering, land surveying and landscape
architecture;
(7) barber examiners;
(8) cosmetology;
(9) electricity;
(10) teaching;
(11) peace officer standards and training;
(12) social work;
(13) marriage and family therapy;
(14) unlicensed mental health service providers; and
(15) office of social work and mental health boards.
The board of medical examiners shall set the salary of its
executive director, which may not exceed 95 percent of the top
of the salary range set for the commissioner of health in
section 15A.081, subdivision 1. The board of dentistry shall
set the salary of its executive director, which may not exceed
80 percent of the top of the salary range set for the
commissioner of health in section 15A.081, subdivision 1. The
board shall submit a proposed salary increase to the legislative
commission on employee relations and the full legislature for
approval, modification, or rejection in the manner provided in
section 43A.18, subdivision 2.
The executive secretaries serving the remaining boards are
hired by those boards and are in the unclassified civil service,
except for part-time executive secretaries, who are not required
to be in the unclassified service. Boards not requiring
full-time executive secretaries may employ them on a part-time
basis. To the extent practicable, the sharing of part-time
executive secretaries by boards being serviced by the same
department is encouraged. Persons providing services to those
boards not listed in this subdivision, except executive
secretaries of the boards and employees of the attorney general,
are classified civil service employees of the department
servicing the board. To the extent practicable, the
commissioner shall ensure that staff services are shared by the
boards being serviced by the department. If necessary, a board
may hire part-time, temporary employees to administer and grade
examinations.
Sec. 55. Minnesota Statutes 1988, section 245.73,
subdivision 1, is amended to read:
Subdivision 1. [COMMISSIONER'S DUTY.] The commissioner
shall establish a statewide program to assist counties in
ensuring provision of services to adult mentally ill persons.
The commissioner shall make grants to county boards to provide
community based services to mentally ill persons through
facilities programs licensed under sections 245.781 to 245.812
245A.01 to 245A.16.
Sec. 56. Minnesota Statutes 1988, section 245.73,
subdivision 2, is amended to read:
Subd. 2. [APPLICATION; CRITERIA.] County boards may submit
an application and budget for 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 for residential facilities programs
for adult mentally ill persons to meet licensing requirements
pursuant to sections 245.781 to 245.812 245A.01 to 245A.16.
Funds shall not be used to supplant or reduce local, state, or
federal expenditure levels supporting existing resources unless
the reduction in available moneys is the result of a state or
federal decision not to refund an existing program. State funds
received by a county pursuant to this section shall be used only
for direct service costs. Both direct service and other costs,
including but not limited to renovation, construction or rent of
buildings, purchase or lease of vehicles or equipment as
required for licensure as a facility residential program for
adult mentally ill persons under sections 245.781 to 245.812
245A.01 to 245A.16, may be paid out of the matching funds
required under subdivision 3. Neither the state funds nor the
matching funds shall be used for room and board costs.
Sec. 57. Minnesota Statutes 1988, section 245.91, is
amended by adding a subdivision to read:
Subd. 6. [SERIOUS INJURY.] "Serious injury" means:
(1) fractures;
(2) dislocations;
(3) evidence of internal injuries;
(4) head injuries with loss of consciousness;
(5) lacerations involving injuries to tendons or organs,
and those for which complications are present;
(6) extensive second degree or third degree burns, and
other burns for which complications are present;
(7) extensive second degree or third degree frost bite, and
others for which complications are present;
(8) irreversible mobility or avulsion of teeth;
(9) injuries to the eyeball;
(10) ingestion of foreign substances and objects that are
harmful;
(11) near drowning;
(12) heat exhaustion or sunstroke; and
(13) all other injuries considered serious by a physician.
Sec. 58. Minnesota Statutes 1988, section 245.94,
subdivision 1, is amended to read:
Subdivision 1. [POWERS.] (a) The ombudsman may prescribe
the methods by which complaints to the office are to be made,
reviewed, and acted upon. The ombudsman may not levy a
complaint fee.
(b) The ombudsman may mediate or advocate on behalf of a
client.
(c) The ombudsman may investigate the quality of services
provided to clients and determine the extent to which quality
assurance mechanisms within state and county government work to
promote the health, safety, and welfare of clients, other than
clients in acute care facilities who are receiving services not
paid for by public funds.
(d) At the request of a client, or upon receiving a
complaint or other information affording reasonable grounds to
believe that the rights of a client who is not capable of
requesting assistance have been adversely affected, the
ombudsman may gather information about and analyze, on behalf of
the client, the actions of an agency, facility, or program.
(e) The ombudsman may examine, on behalf of a client,
records of an agency, facility, or program if the records relate
to a matter that is within the scope of the ombudsman's
authority. If the records are private and the client is capable
of providing consent, the ombudsman shall first obtain the
client's consent. The ombudsman is not required to obtain
consent for access to private data on clients with mental
retardation or a related condition.
(f) The ombudsman may subpoena a person to appear, give
testimony, or produce documents or other evidence that the
ombudsman considers relevant to a matter under inquiry. The
ombudsman may petition the appropriate court to enforce the
subpoena. A witness who is at a hearing or is part of an
investigation possesses the same privileges that a witness
possesses in the courts or under the law of this state. Data
obtained from a person under this paragraph are private data as
defined in section 13.02, subdivision 12.
(f) (g) The ombudsman may, at reasonable times in the
course of conducting a review, enter and view premises within
the control of an agency, facility, or program.
(g) (h) The ombudsman may attend department of human
services review board and special review board proceedings;
proceedings regarding the transfer of patients or residents, as
defined in section 246.50, subdivisions 4 and 4a, between
institutions operated by the department of human services; and,
subject to the consent of the affected client, other proceedings
affecting the rights of clients. The ombudsman is not required
to obtain consent to attend meetings or proceedings and have
access to private data on clients with mental retardation or a
related condition.
(h) (i) The ombudsman shall have access to data of
agencies, facilities, or programs classified as private or
confidential as defined in section 13.02, subdivisions 12 and
13, regarding services provided to clients with mental
retardation or a related condition.
(i) (j) To avoid duplication and preserve evidence, the
ombudsman shall inform relevant licensing or regulatory
officials before undertaking a review of an action of the
facility or program.
(j) (k) Sections 245.91 to 245.97 are in addition to other
provisions of law under which any other remedy or right is
provided.
Sec. 59. Minnesota Statutes 1988, section 245.94, is
amended by adding a subdivision to read:
Subd. 2a. [MANDATORY REPORTING.] Within 24 hours after a
client suffers death or serious injury, the facility or program
director shall notify the ombudsman of the death or serious
injury.
Sec. 60. Minnesota Statutes 1988, section 245A.02,
subdivision 3, is amended to read:
Subd. 3. [APPLICANT.] "Applicant" means an individual,
corporation, partnership, voluntary association, controlling
individual, or other organization that has applied for licensure
under sections 245A.01 to 245A.16 and the rules of the
commissioner.
Sec. 61. Minnesota Statutes 1988, section 245A.02, is
amended by adding a subdivision to read:
Subd. 5a. [CONTROLLING INDIVIDUAL.] "Controlling
individual" means a public body, governmental agency, business
entity, officer, program administrator, or director whose
responsibilities include the direction of the management or
policies of a program. Controlling individual also means an
individual who, directly or indirectly, beneficially owns an
interest in a corporation, partnership, or other business
association that is a controlling individual. Controlling
individual does not include:
(1) a bank, savings bank, trust company, building and loan
association, savings and loan association, credit union,
industrial loan and thrift company, investment banking firm, or
insurance company unless the entity operates a program directly
or through a subsidiary;
(2) an individual who is a state or federal official, or
state or federal employee, or a member or employee of the
governing body of a political subdivision of the state or
federal government that operates one or more programs, unless
the individual is also an officer or director of the program,
receives remuneration from the program, or owns any of the
beneficial interests not excluded in this subdivision;
(3) an individual who owns less than five percent of the
outstanding common shares of a corporation:
(i) whose securities are exempt under section 80A.15,
subdivision 1, clause (f); or
(ii) whose transactions are exempt under section 80A.15,
subdivision 2, clause (b); or
(4) an individual who is a member of an organization exempt
from taxation under section 290.05, unless the individual is
also an officer or director of the program or owns any of the
beneficial interests not excluded in this subdivision. This
clause does not exclude from the definition of controlling
individual an organization that is exempt from taxation.
Sec. 62. Minnesota Statutes 1988, section 245A.02, is
amended by adding a subdivision to read:
Subd. 6a. [DROP-IN CHILD CARE PROGRAM.] "Drop-in child
care program" means a nonresidential program of child care
provided to children for a maximum per child of five hours in
any one day and 40 hours in any one calendar month at a child
care center that does not have a regularly scheduled, ongoing
child care program with a stable enrollment, and that is
licensed exclusively for that purpose.
Sec. 63. Minnesota Statutes 1988, section 245A.02,
subdivision 9, is amended to read:
Subd. 9. [LICENSE HOLDER.] "License holder" means an
individual, corporation, partnership, voluntary association, or
other organization that is legally responsible for the operation
of the program and, has been granted a license by the
commissioner under sections 245A.01 to 245A.16 and the rules of
the commissioner, and is a controlling individual.
Sec. 64. Minnesota Statutes 1988, section 245A.02,
subdivision 10, is amended to read:
Subd. 10. [NONRESIDENTIAL PROGRAM.] "Nonresidential
program" means care, supervision, rehabilitation, training or
habilitation of a person provided outside the person's own home
and provided for fewer than 24 hours a day, including adult day
care programs; a nursing home that receives public funds to
provide services for five or more persons whose primary
diagnosis is mental retardation or a related condition or mental
illness and who do not have a significant physical or medical
problem that necessitates nursing home care; a nursing home or
hospital that was licensed by the commissioner on July 1, 1987,
to provide a program for persons with a physical handicap that
is not the result of the normal aging process and considered to
be a chronic condition; and chemical dependency or chemical
abuse programs that are located in a nursing home or hospital
and receive public funds for providing chemical abuse or
chemical dependency treatment services under chapter 254B.
Nonresidential programs include home and community-based
services and semi-independent living services for persons with
mental retardation or a related condition that are provided in
or outside of a person's own home.
Sec. 65. Minnesota Statutes 1988, section 245A.02,
subdivision 14, is amended to read:
Subd. 14. [RESIDENTIAL PROGRAM.] "Residential program"
means a program that provides 24-hour-a-day care, supervision,
food, lodging, rehabilitation, training, education,
habilitation, or treatment outside a person's own home,
including a nursing home or hospital that receives public funds,
administered by the commissioner, to provide services for five
or more persons whose primary diagnosis is mental retardation or
a related condition or mental illness and who do not have a
significant physical or medical problem that necessitates
nursing home care; a program in an intermediate care facility
for four or more persons with mental retardation or a related
condition; a nursing home or hospital that was licensed by the
commissioner on July 1, 1987, to provide a program for persons
with a physical handicap that is not the result of the normal
aging process and considered to be a chronic condition; and
chemical dependency or chemical abuse programs that are located
in a hospital or nursing home and receive public funds for
providing chemical abuse or chemical dependency treatment
services under chapter 254B. Residential programs include home
and community-based services and semi-independent living
services for persons with mental retardation or a related
condition that are provided in or outside of a person's own home.
Sec. 66. Minnesota Statutes 1988, section 245A.03,
subdivision 1, is amended to read:
Subdivision 1. [LICENSE REQUIRED.] Unless licensed by the
commissioner, an individual, corporation, partnership, voluntary
association or, other organization, or controlling individual
must not:
(1) operate a residential or a nonresidential program;
(2) receive a child or adult for care, supervision, or
placement in foster care or adoption;
(3) help plan the placement of a child or adult in foster
care or adoption; or
(4) advertise a residential or nonresidential program.
Sec. 67. Minnesota Statutes 1988, section 245A.03,
subdivision 2, is amended to read:
Subd. 2. [EXCLUSION FROM LICENSURE.] Sections 245A.01 to
245A.16 do not apply to:
(1) residential or nonresidential programs that are
provided to a person by an individual who is related;
(2) nonresidential programs that are provided by an
unrelated individual to persons from a single related family;
(3) residential or nonresidential programs that are
provided to adults who do not abuse chemicals or who do not have
a chemical dependency, a mental illness, mental retardation or a
related condition, a functional impairment, or a physical
handicap;
(4) sheltered workshops or work activity programs that are
certified by the commissioner of jobs and training;
(5) programs for children enrolled in kindergarten to the
12th grade and prekindergarten special education programs that
are operated by the commissioner of education or a school as
defined in section 120.101, subdivision 4;
(6) nonresidential programs for children that provide care
or supervision for periods of less than three hours a day while
the child's parent or legal guardian is in the same building or
present on property that is contiguous with the physical
facility where the nonresidential program is provided;
(7) nursing homes or hospitals licensed by the commissioner
of health except as specified under section 245A.02;
(8) board and lodge facilities licensed by the commissioner
of health that provide services for five or more persons whose
primary diagnosis is mental illness who have refused an
appropriate residential program offered by a county agency.
This exclusion expires on July 1, 1989 1990;
(9) homes providing programs for persons placed there by a
licensed agency for legal adoption, unless the adoption is not
completed within two years;
(10) programs licensed by the commissioner of corrections;
(11) recreation programs for children or adults that
operate for fewer than 40 calendar days in a calendar year;
(12) programs not located in family or group family day
care homes whose primary purpose is to provide social or
recreational activities outside of the regular school day for
adults or school-age children age five and older, until such
time as appropriate rules have been adopted by the
commissioner such as scouting, boys clubs, girls clubs, sports,
or the arts; except that a program operating in a school
building is not excluded unless it is approved by the district's
school board;
(13) head start nonresidential programs which operate for
less than 31 days in each calendar year;
(14) noncertified boarding care homes unless they provide
services for five or more persons whose primary diagnosis is
mental illness or mental retardation;
(15) nonresidential programs for nonhandicapped children
provided for a cumulative total of less than 30 days in any
12-month period; or
(16) residential programs for persons with mental illness,
that are located in hospitals, until the commissioner adopts
appropriate rules;
(17) the religious instruction of school-age children;
Sabbath or Sunday schools; or the congregate care of children by
a church, congregation, or religious society during the period
used by the church, congregation, or religious society for its
regular worship;
(18) camps licensed by the commissioner of health under
Minnesota Rules, chapter 4630;
(19) until July 1, 1991, nonresidential programs for
persons with mental illness; or
(20) residential programs serving school-age children whose
sole purpose is cultural or educational exchange, until the
commissioner adopts appropriate rules.
Sec. 68. Minnesota Statutes 1988, section 245A.03,
subdivision 3, is amended to read:
Subd. 3. [UNLICENSED PROGRAMS.] (a) It is a misdemeanor
for an individual, corporation, partnership, voluntary
association, or other organization, or a controlling individual
to provide a residential or nonresidential program without a
license and in willful disregard of sections 245A.01 to 245A.16
unless the program is excluded from licensure under subdivision
2.
(b) If, after receiving notice that a license is required,
the individual, corporation, partnership, voluntary association,
or other organization, or controlling individual has failed to
apply for a license, the commissioner may ask the appropriate
county attorney or the attorney general to begin proceedings to
secure a court order against the continued operation of the
program. The county attorney and the attorney general have a
duty to cooperate with the commissioner.
Sec. 69. Minnesota Statutes 1988, section 245A.04,
subdivision 1, is amended to read:
Subdivision 1. [APPLICATION FOR LICENSURE.] (a) An
individual, corporation, partnership, voluntary association, or
other organization or controlling individual that is subject to
licensure under section 245A.03 must apply for a license. The
application must be made on the forms and in the manner
prescribed by the commissioner. The commissioner shall provide
the applicant with instruction in completing the application and
provide information about the rules and requirements of other
state agencies that affect the applicant.
The commissioner shall act on the application within 90
working days after a complete application and any required
reports have been received from other state agencies or
departments, counties, municipalities, or other political
subdivisions.
(b) An application for licensure must specify one or more
controlling individuals as an agent who is responsible for
dealing with the commissioner of human services on all matters
provided for in this chapter and on whom service of all notices
and orders must be made. The agent must be authorized to accept
service on behalf of all of the controlling individuals of the
program. Service on the agent is service on all of the
controlling individuals of the program. It is not a defense to
any action arising under this chapter that service was not made
on each controlling individual of the program. The designation
of one or more controlling individuals as agents under this
paragraph does not affect the legal responsibility of any other
controlling individual under this chapter.
Sec. 70. Minnesota Statutes 1988, section 245A.04,
subdivision 3, is amended to read:
Subd. 3. [STUDY OF THE APPLICANT.] (a) Before issuing the
commissioner issues a license, the commissioner shall conduct a
study of the applicant individuals specified in clauses (1) to
(4) according to rules of the commissioner. The applicant,
license holder, the bureau of criminal apprehension, county
attorneys, county sheriffs, and county agencies, and local
chiefs of police, after written notice to the individual who is
the subject of the data study, shall help with the study by
giving the commissioner criminal conviction data, arrest
information, and reports about abuse or neglect of children or
adults, and investigation results available from local, state,
and national criminal record repositories, including the
criminal justice data communications network,
about substantiated under section 626.557 and the maltreatment
of minors substantiated under section 626.556. The individuals
to be studied shall include:
(1) the applicant;
(2) persons over the age of 13 living in the household
where the licensed program will be provided;
(3) current employees or contractors of the applicant who
will have direct contact with persons served by the program; and
(4) volunteers who have direct contact with persons served
by the program to provide program services, if the contact is
not directly supervised by the individuals listed in clause (1)
or (3).
The commissioner and agencies required to help conduct the
study may charge the applicant or the subject of the data a
reasonable fee for conducting the study.
For purposes of this subdivision, "direct contact" means
providing face-to-face care, training, supervision, counseling,
consultation, or medication assistance to persons served by a
program. For purposes of this subdivision, "directly supervised"
means an individual listed in clause (1) or (3) is within sight
or hearing of a volunteer to the extent that the individual
listed in clause (1) or (3) is capable at all times of
intervening to protect the health and safety of the persons
served by the program who have direct contact with the volunteer.
A study of an individual in clauses (1) to (4) shall be
conducted on at least an annual basis. No applicant, license
holder, or individual who is the subject of the study shall pay
any fees required to conduct the study.
(b) The individual who is the subject of the study must
provide the applicant or license holder with sufficient
information to ensure an accurate study including the
individual's first, middle, and last name; home address, city,
county, and state of residence; zip code; sex; date of birth;
and driver's license number. The applicant or license holder
shall provide this information about an individual in paragraph
(a), clauses (1) to (4), on forms prescribed by the
commissioner. The commissioner may request additional
information of the individual, which shall be optional for the
individual to provide, such as the individual's social security
number or race.
(c) A study must meet the following minimum criteria:
(1) if the subject of the data has resided in the same
county for at least the past five years, the study must include
information from the county sheriff, the local chief of police,
and the county agency
(2) if the subject of the data has resided in the state,
but not in the same county, for the past five years, the study
must include agency's record of substantiated abuse of adults,
neglect of adults, and the maltreatment of minors, and
information from the agencies listed in clause (1) and the
bureau of criminal apprehension; and
(3) if the subject of the data has not resided in the state
for at least five years, the study must include information from
the agencies listed in clauses (1) and (2) and the national
criminal records repository and the state law enforcement
agencies in the states where the subject of the data has
maintained a residence during the past five years.
The commissioner may also review arrest and investigative
information from the bureau of criminal apprehension, a county
attorney, county sheriff, county agency, local chief of police,
other states, the courts, or a national criminal record
repository if the commissioner has reasonable cause to believe
the information is pertinent to the disqualification of an
individual listed in paragraph (a), clauses (1) to (4).
(c) (d) An applicant's or license holder's failure or
refusal to cooperate with the commissioner is reasonable cause
to deny an application or immediately suspend, suspend, or
revoke or suspend a license. Failure or refusal of an
individual to cooperate with the study is just cause for denying
or terminating employment of the individual if the individual's
failure or refusal to cooperate could cause the applicant's
application to be denied or the license holder's license to be
immediately suspended, suspended, or revoked.
(d) (e) The commissioner shall not consider an application
to be complete until all of the information required to be
provided under this subdivision has been received.
(f) No person in paragraph (a), clause (1), (2), (3), or
(4) who is disqualified as a result of this act may be retained
by the agency in a position involving direct contact with
persons served by the program.
(g) The commissioner shall not implement the procedures
contained in this subdivision until appropriate rules have been
adopted, except for the applicants and license holders for child
foster care, adult foster care, and family day care homes.
(h) Termination of persons in paragraph (a), clause (1),
(2), (3), or (4) made in good faith reliance on a notice of
disqualification provided by the commissioner shall not subject
the applicant or license holder to civil liability.
(i) The commissioner may establish records to fulfill the
requirements of this section. The information contained in the
records is only available to the commissioner for the purpose
authorized in this section.
Sec. 71. Minnesota Statutes 1988, section 245A.04, is
amended by adding a subdivision to read:
Subd. 3a. [NOTIFICATION TO SUBJECT OF STUDY RESULTS.] The
commissioner shall notify the applicant or license holder and
the individual who is the subject of the study, in writing, of
the results of the study. When the study is completed, a notice
that the study was undertaken and completed shall be maintained
in the personnel files of the program.
The commissioner shall notify the individual studied if the
information contained in the study could cause disqualification
from direct contact with persons served by the program. The
commissioner shall disclose the information to the individual
studied. An applicant or license holder who is not the subject
of the study shall be informed that the commissioner has found
information that could cause disqualification of the subject
from direct contact with persons served by the program.
However, the applicant or license holder shall not be told what
that information is unless the data practices act provides for
release of the information and the individual studied authorizes
the release of the information.
Sec. 72. Minnesota Statutes 1988, section 245A.04, is
amended by adding a subdivision to read:
Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a)
Within 30 days after receiving notice of possible
disqualification under subdivision 3a, the individual who is the
subject of the study may request reconsideration of the notice
of possible disqualification. The individual must submit the
request for reconsideration to the commissioner in writing. The
individual must present information to show that:
(1) the information the commissioner relied upon is
incorrect; or
(2) the subject of the study does not pose a risk of harm
to any person served by the applicant or license holder.
(b) The commissioner may set aside the disqualification if
the commissioner finds that the information the commissioner
relied upon is incorrect or the individual does not pose a risk
of harm to any person served by the applicant or license holder
and rules adopted by the commissioner do not preclude
reconsideration. The commissioner shall review the consequences
of the event or events that could lead to disqualification, the
vulnerability of the victim at the time of the event, the time
elapsed without a repeat of the same or similar event, and
documentation of successful completion by the individual studied
of training or rehabilitation pertinent to the event.
(c) The commissioner shall respond in writing to all
reconsideration requests within 15 working days after receiving
the request for reconsideration. If the disqualification is set
aside, the commissioner shall notify the applicant or license
holder in writing of the decision.
(d) Except as provided in subdivision 3c, the
commissioner's decision to grant or deny a reconsideration of
disqualification under this subdivision, or to set aside or
uphold the results of the study under subdivision 3, is the
final administrative agency action.
Sec. 73. Minnesota Statutes 1988, section 245A.04, is
amended by adding a subdivision to read:
Subd. 3c. [CONTESTED CASE.] If a disqualification is not
set aside, a person who, on or after the effective date of rules
adopted under subdivision 3, paragraph (i), is an employee of an
employer, as defined in section 179A.03, subdivision 15, may
request a contested case hearing under chapter 14. Rules
adopted under this chapter may not preclude an employee in a
contested case hearing for disqualification from submitting
evidence concerning information gathered under subdivision 3,
paragraph (e).
Sec. 74. Minnesota Statutes 1988, section 245A.04,
subdivision 5, is amended to read:
Subd. 5. [COMMISSIONER'S RIGHT OF ACCESS.] When the
commissioner is exercising the powers conferred by sections
245A.01 to 245A.15, the commissioner must be given access to the
physical plant and grounds where the program is provided,
documents, persons served by the program, and staff whenever the
program is in operation and the information is relevant to
inspections or investigations conducted by the commissioner.
The commissioner must be given access without prior notice and
as often as the commissioner considers necessary if the
commissioner is conducting an investigation of allegations of
abuse, neglect, maltreatment, or other violation of applicable
laws or rules. In conducting inspections, the commissioner may
request and shall receive assistance from other state, county,
and municipal governmental agencies and departments. The
applicant or license holder shall allow the commissioner to
photocopy, photograph, and make audio and video tape recordings
during the inspection of the program at the commissioner's
expense. The commissioner shall obtain a court order or the
consent of the subject of the records or the parents or legal
guardian of the subject before photocopying hospital medical
records.
Persons served by the program have the right to refuse to
consent to be interviewed, photographed, or audio or videotaped.
Failure or refusal of an applicant or license holder to fully
comply with this subdivision is reasonable cause for the
commissioner to deny the application or immediately suspend or
revoke the license.
Sec. 75. Minnesota Statutes 1988, section 245A.04,
subdivision 6, is amended to read:
Subd. 6. [COMMISSIONER'S EVALUATION.] Before granting,
suspending, revoking, or making probationary a license, the
commissioner shall evaluate information gathered under this
section. The commissioner's evaluation shall consider facts,
conditions, or circumstances concerning the program's operation,
the well-being of persons served by the program, consumer
evaluations of the program, and information about the character
and qualifications of the personnel employed by the applicant or
license holder.
The commissioner shall evaluate the results of the study
required in subdivision 3 and determine whether a risk of harm
to the persons served by the program exists. In conducting this
evaluation, the commissioner shall apply the disqualification
standards set forth in rules adopted under this chapter. If any
rule currently does not include these disqualification
standards, the commissioner shall apply the standards in section
364.03, subdivision 2 3, until the rule is revised to include
disqualification standards. The commissioner shall revise all
rules authorized by this chapter to include disqualification
standards. Prior to the adoption of rules establishing
disqualification standards, the commissioner shall forward the
proposed rules to the commissioner of human rights for review
and recommendation concerning the protection of individual
rights. The recommendation of the commissioner of human rights
is not binding on the commissioner of human services. The
provisions of chapter 364 do not apply to applicants or license
holders governed by sections 245A.01 to 245A.16 except as
provided in this subdivision.
Sec. 76. Minnesota Statutes 1988, section 245A.04,
subdivision 7, is amended to read:
Subd. 7. [ISSUANCE OF A LICENSE; PROVISIONAL LICENSE.] (a)
If the commissioner determines that the program complies with
all applicable rules and laws, the commissioner shall issue a
license. At minimum, the license shall state:
(1) the name of the license holder;
(2) the address of the program;
(3) the effective date and expiration date of the license;
(4) the type of license;
(5) the maximum number and ages of persons that may receive
services from the program; and
(6) any special conditions of licensure.
(b) The commissioner may issue a provisional license for a
period not to exceed one year if:
(1) the commissioner is unable to conduct the evaluation or
observation required by subdivision 4, paragraph (a), clauses (3)
and (4), because the program is not yet operational;
(2) certain records and documents are not available because
persons are not yet receiving services from the program; and
(3) the applicant complies with applicable laws and rules
in all other respects.
A provisional license must not be issued except at the time that
a license is first issued to an applicant.
A license shall not be transferable to another individual,
corporation, partnership, voluntary association or, other
organization, or controlling individual, or to another
location. All licenses expire at 12:01 a.m. on the day after
the expiration date stated on the license. A license holder
must apply for and be granted a new license to operate the
program or the program must not be operated after the expiration
date.
Sec. 77. Minnesota Statutes 1988, section 245A.06,
subdivision 1, is amended to read:
Subdivision 1. [CONTENTS OF CORRECTION ORDERS.] (a) If the
commissioner finds that the applicant or license holder has
failed to comply with an applicable law or rule and this failure
does not imminently endanger the health, safety, or rights of
the persons served by the program, the commissioner may issue a
correction order to the applicant or license holder. The
correction order must state:
(1) the conditions that constitute a violation of the law
or rule;
(2) the specific law or rule violated; and
(3) the time allowed to correct each violation.
(b) Nothing in this section prohibits the commissioner from
proposing a sanction as specified in section 245A.07, prior to
issuing a correction order or fine.
Sec. 78. Minnesota Statutes 1988, section 245A.06,
subdivision 5, is amended to read:
Subd. 5. [FORFEITURE OF FINES.] The license holder shall
pay the fines assessed within 15 calendar days of receipt of
notice of on or before the payment date specified in the
commissioner's order. If the license holder fails to fully
comply with the order, the commissioner shall suspend the
license until the license holder complies. If the license
holder receives state funds, the state, county, or municipal
agencies or departments responsible for administering the funds
shall withhold payments and recover any payments made while the
license is suspended for failure to pay a fine.
Sec. 79. Minnesota Statutes 1988, section 245A.06, is
amended by adding a subdivision to read:
Subd. 5a. [ACCRUAL OF FINES.] A license holder shall
promptly notify the commissioner of human services, in writing,
when a violation specified in an order to forfeit is corrected.
A fine assessed for a violation shall stop accruing when the
commissioner receives the written notice. The commissioner
shall reinspect the program within three working days after
receiving the notice. If upon reinspection the commissioner
determines that a violation has not been corrected as indicated
by the order to forfeit, accrual of the daily fine resumes on
the date of reinspection and the amount of fines that otherwise
would have accrued between the date the commissioner received
the notice and date of the reinspection is added to the total
assessment due from the license holder. The commissioner shall
notify the license holder by certified mail that accrual of the
fine has resumed. The license holder may challenge the
resumption in a contested case under chapter 14 by written
request within 15 days after receipt of the notice of
resumption. Recovery of the resumed fine must be stayed if a
controlling individual or a legal representative on behalf of
the license holder makes a written request for a hearing. The
request for hearing, however, may not stay accrual of the daily
fine for violations that have not been corrected. The cost of
reinspection conducted under this subdivision for uncorrected
violations must be added to the total amount of accrued fines
due from the license holder.
Sec. 80. Minnesota Statutes 1988, section 245A.07,
subdivision 2, is amended to read:
Subd. 2. [IMMEDIATE SUSPENSION IN CASES OF IMMINENT DANGER
TO HEALTH, SAFETY, OR RIGHTS.] If the license holder's failure
to comply with applicable law or rule has placed the health,
safety, or rights of persons served by the program in imminent
danger, the commissioner shall act immediately to suspend the
license. No state funds shall be made available or be expended
by any agency or department of state, county, or municipal
government for use by a license holder regulated under sections
245A.01 to 245A.16 while a license is under immediate
suspension. A notice stating the reasons for the immediate
suspension and informing the license holder of the right to a
contested case hearing under chapter 14 must be delivered by
personal service to the address shown on the application or the
last known address of the license holder. The license holder
may appeal an order immediately suspending a license by
notifying the commissioner in writing by certified mail within
five calendar days after receiving notice that the license has
been immediately suspended. A license holder and any
controlling individual shall discontinue operation of the
program upon receipt of the commissioner's order to immediately
suspend the license.
Sec. 81. Minnesota Statutes 1988, section 245A.08,
subdivision 5, is amended to read:
Subd. 5. [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After
considering the findings of fact, conclusions, and
recommendations of the administrative law judge, the
commissioner shall issue a final order. The commissioner shall
consider, but shall not be bound by, the recommendations of the
administrative law judge. The appellant must be notified of the
commissioner's final order as required by chapter 14. The
notice must also contain information about the appellant's
rights under chapter 14. The institution of proceedings for
judicial review of the commissioner's final order shall not stay
the enforcement of the final order except as provided in section
14.65. A license holder and each controlling individual of a
license holder whose license has been revoked because of
noncompliance with applicable law or rule must not be granted a
license for five years following the revocation.
Sec. 82. Minnesota Statutes 1988, section 245A.12, is
amended to read:
245A.12 [VOLUNTARY RECEIVERSHIP FOR RESIDENTIAL
FACILITIES PROGRAMS.]
A majority of controlling persons individuals of a
residential program may at any time ask the commissioner to
assume operation of the residential program through appointment
of a receiver. On receiving the request for a receiver, the
commissioner may enter into an agreement with a majority of
controlling persons individuals and provide for the appointment
of a receiver to operate the residential program under
conditions acceptable to both the commissioner and the majority
of controlling persons. The agreement must specify the terms
and conditions of the receivership and preserve the rights of
the persons being served by the residential program. A
receivership set up under this section terminates at the time
specified by the parties to the agreement or 30 days after
either of the parties gives written notice to the other party of
termination of the receivership agreement.
Sec. 83. Minnesota Statutes 1988, section 245A.13, is
amended to read:
245A.13 [INVOLUNTARY RECEIVERSHIP FOR RESIDENTIAL
FACILITIES PROGRAMS.]
Subdivision 1. [APPLICATION.] In addition to any other
remedy provided by law, the commissioner may petition the
district court in the county where the residential program is
located for an order directing the controlling
persons individuals of the residential program to show cause why
the commissioner or the commissioner's designated representative
should not be appointed receiver to operate the residential
program. The petition to the district court must contain proof
by affidavit: (1) that the commissioner has either begun
license suspension or revocation proceedings, suspended or
revoked a license, or has decided to deny an application for
licensure of the residential program; or (2) it appears to the
commissioner that the health, safety, or rights of the residents
may be in jeopardy because of the manner in which the
residential program may close, the residential program's
financial condition, or violations committed by the residential
program of federal or state laws or rules. If the license
holder or, applicant, or controlling individual operates more
than one residential program, the commissioner's petition must
specify and be limited to the residential program for which the
commissioner has either begun license suspension or revocation
proceedings, suspended or revoked a license, or has decided to
deny an application for licensure of the residential program it
seeks receivership. The affidavit submitted by the commissioner
must set forth alternatives to receivership that have been
considered, including rate adjustments. The order to show cause
is returnable not less than five days after service is completed
and must provide for personal service of a copy to the
residential program administrator and to the persons designated
as agents by the controlling persons individuals to accept
service on their behalf.
Subd. 2. [APPOINTMENT OF RECEIVER; RENTAL.] If the court
finds that involuntary receivership is necessary as a means of
protecting the health, safety, or rights of persons being served
by the residential program, the court shall appoint the
commissioner or the commissioner's designated representative as
a receiver to operate the residential program. In the event
that no receiver can be found who meets the conditions of this
section, the commissioner or commissioner's designated
representative may serve as the receiver. The court shall
determine a fair monthly rental for the physical plant, taking
into account all relevant factors including necessary to meet
required arms-length obligations of controlling individuals such
as mortgage payments, real estate taxes, special assessments,
and the conditions of the physical plant. The rental fee must
be paid by the receiver to the appropriate controlling persons
individuals for each month that the receivership remains in
effect. No payment made to a controlling person individual by
the receiver or any state agency during a period of involuntary
receivership shall include any allowance for profit or be based
on any formula that includes an allowance for profit.
Subd. 3. [POWERS AND DUTIES OF THE RECEIVER.] Within 18 36
months after the receivership order, a receiver appointed to
operate a residential program during a period of involuntary
receivership shall provide for the orderly transfer of the
persons served by the residential program to other residential
programs or make other provisions to protect their health,
safety, and rights. The receiver shall correct or eliminate
deficiencies in the residential program that the commissioner
determines endanger the health, safety, or welfare of the
persons being served by the residential program unless the
correction or elimination of deficiencies involves major
alteration in the structure of the physical plant. If the
correction or elimination of the deficiencies requires major
alterations in the structure of the physical plant, the receiver
shall take actions designed to result in the immediate transfer
of persons served by the residential program. During the period
of the receivership, the receiver shall operate the residential
program in a manner designed to guarantee preserve the health,
safety, rights, adequate care, and supervision of the persons
served by the residential program. The receiver may make
contracts and incur lawful expenses. The receiver shall collect
incoming payments from all sources and apply them to the cost
incurred in the performance of the receiver's functions
including the receiver's fee set under subdivision 4. No
security interest in any real or personal property comprising
the residential program or contained within it, or in any
fixture of the physical plant, shall be impaired or diminished
in priority by the receiver. The receiver shall pay all valid
obligations of the residential program and may deduct these
expenses, if necessary, from rental payments owed to any
controlling person individual by virtue of the receivership.
Subd. 4. [RECEIVER'S FEE; LIABILITY; ASSISTANCE FROM THE
COMMISSIONER.] A receiver appointed under an involuntary
receivership is entitled to a reasonable receiver's fee as
determined by the court. The receiver's fee is governed by
section 256B.495. The receiver is liable only in an official
capacity for injury to person and property by reason of the
conditions of the residential program. The receiver is not
personally liable, except for gross negligence and intentional
acts.
Subd. 5. [TERMINATION.] An involuntary receivership
terminates 12 36 months after the date on which it was ordered
or at any other time designated by the court or when any of the
following events occurs:
(1) the commissioner determines that the residential
program's license application should be granted or should not be
suspended or revoked;
(2) a new license is granted to the residential program; or
(3) the commissioner determines that all persons residing
in the residential program have been provided with alternative
residential programs.
Subd. 6. [EMERGENCY PROCEDURE.] If it appears from the
petition filed under subdivision 1, from an affidavit or
affidavits filed with the petition, or from testimony of
witnesses under oath if the court determines it necessary, that
there is probable cause to believe that an emergency exists in a
residential program, the court shall issue a temporary order for
appointment of a receiver within five days after receipt of the
petition. Notice of the petition must be served on the
residential program administrator and on the persons designated
as agents by the controlling individuals to accept service on
their behalf. A hearing on the petition must be held within
five days after notice is served unless the administrator or
designated agent consents to a later date. After the hearing,
the court may continue, modify, or terminate the temporary order.
Subd. 7. [RATE RECOMMENDATION.] The commissioner of human
services may review rates of a residential program participating
in the medical assistance program which is in involuntary
receivership and that has needs or deficiencies documented by
the department of health or the department of human services.
If the commissioner of human services determines that a review
of the rate established under section 256B.501 is needed, the
commissioner shall:
(1) review the order or determination that cites the
deficiencies or needs; and
(2) determine the need for additional staff, additional
annual hours by type of employee, and additional consultants,
services, supplies, equipment, repairs, or capital assets
necessary to satisfy the needs or deficiencies.
Subd. 8. [ADJUSTMENT TO THE RATE.] Upon review of rates
under subdivision 7, the commissioner may adjust the residential
program's payment rate. The commissioner shall review the
circumstances, together with the residential program cost
report, to determine whether or not the deficiencies or needs
can be corrected or met by reallocating residential program
staff, costs revenues, or other resources including any
investments, efficiency incentives, or allowances. If the
commissioner determines that any deficiency cannot be corrected
or the need cannot be met, the commissioner shall determine the
payment rate adjustment by dividing the additional annual costs
established during the commissioner's review by the residential
program's actual resident days from the most recent desk-audited
cost report or the estimated resident days in the projected
receivership period. The payment rate adjustment must meet the
conditions in Minnesota Rules, parts 9553.0010 to 9553.0080, and
remains in effect during the period of the receivership or until
another date set by the commissioner. Upon the subsequent sale
or transfer of the residential program, the commissioner may
recover amounts that were paid as payment rate adjustments under
this subdivision. The buyer or transferee shall repay this
amount to the commissioner within 60 days after the commissioner
notifies the buyer or transferee of the obligation to repay.
This provision does not limit the liability of the seller to the
commissioner pursuant to section 256B.0641.
Sec. 84. Minnesota Statutes 1988, section 245A.14,
subdivision 3, is amended to read:
Subd. 3. [CONDITIONAL LICENSE.] Until such time as the
commissioner adopts appropriate rules for conditional licenses,
no license holder or applicant for a family or group family day
care license is required to spend more than $100 to meet fire
safety rules in excess of those required to meet Group "R"
occupancies under the Uniform Building Code, chapter 12, as
incorporated by reference in Minnesota Rules, part 1305.0100.
When the commissioner determines that an applicant or
license holder of a family or group family day care license
would be required to spend over $100 for physical changes to
ensure fire safety, the commissioner may issue a conditional
license when all of the following conditions have been met:
(a) The commissioner shall notify the provider license
holder or applicant in writing of the fire safety deficiencies.
(b) The commissioner shall notify the provider license
holder or applicant in writing of alternative compliance
standards that would correct deficiencies, if available.
(c) The provider license holder or applicant agrees in
writing to notify each parent, on a form prescribed by the
commissioner that requires the signature of the parent, of the
fire safety deficiencies, and the existence of the conditional
license.
Sec. 85. Minnesota Statutes 1988, section 245A.14, is
amended by adding a subdivision to read:
Subd. 6. [DROP-IN CHILD CARE PROGRAMS.] Except as
expressly set forth in this subdivision, drop-in child care
programs must be licensed as a drop-in program under the rules
governing child care programs operated in a center. Drop-in
child care programs are exempt from the requirements in
Minnesota Rules, parts 9503.0040; 9503.0045, subpart 1, items F
and G; 9503.0050, subpart 6, except for children less than two
and one-half years old; one-half the requirements of 9503.0060,
subpart 4, item A, subitems (2), (5), and (8), subpart 5, item
A, subitems (2), (3), and (7), and subpart 6, item A, subitems
(3) and (6); 9507.0070; and 9503.0090, subpart 2. A drop-in
child care program must be operated under the supervision of a
person qualified as a director and a teacher. A drop-in child
care program must maintain a minimum staff ratio for children
age two and one-half or greater of one staff person for each ten
children, except that there must be at least two persons on
staff whenever the program is operating. If the program has
additional staff who are on call as a mandatory condition of
their employment, the minimum ratio may be exceeded only for
children age two and one-half or greater, by a maximum of four
children, for no more than 20 minutes while additional staff are
in transit. The minimum staff-to-child ratio for infants up to
16 months of age is one staff person for every four infants.
The minimum staff-to-child ratio for children age 17 months to
30 months is one staff for every seven children. In drop-in
care programs that serve both infants and older children,
children up to age two and one-half may be supervised by
assistant teachers, as long as other staff are present in
appropriate ratios. The minimum staff distribution pattern for
a drop-in child care program serving children age two and
one-half or greater is: the first staff member must be a
teacher; the second, third, and fourth staff members must have
at least the qualifications of a child care aide; the fifth
staff member must have at least the qualifications of an
assistant teacher; the sixth, seventh, and eighth staff members
must have at least the qualifications of a child care aide; and
the ninth staff person must have at least the qualifications of
an assistant teacher. A drop-in child care program serving
children less than two and one-half years of age must serve
these children in an area separated from older children.
Children age two and one-half and older may be cared for in the
same child care group.
Sec. 86. Minnesota Statutes 1988, section 245A.16,
subdivision 1, is amended to read:
Subdivision 1. [DELEGATION OF AUTHORITY TO AGENCIES.] (a)
County agencies and private agencies that have been designated
or licensed by the commissioner to perform licensing functions
and activities under section 245A.04, to recommend denial of
applicants under section 245A.05, to recommend correction orders
and fines under section 245A.06, or to recommend suspending,
revoking, and making licenses probationary under section
245A.07, shall comply with rules and directives of the
commissioner governing those functions and with this section.
(b) By January 1, 1991, the commissioner shall study and
make recommendations to the legislature regarding the licensing
and provision of support services to child foster homes. In
developing the recommendations, the commissioner shall consult
licensed private agencies, county agencies, and licensed foster
home providers.
Sec. 87. Minnesota Statutes 1988, section 246.50,
subdivision 3, is amended to read:
Subd. 3. [REGIONAL TREATMENT CENTER STATE FACILITY.]
"Regional treatment center State facility" means a any state
facility for treating persons with mental illness, mental
retardation, or chemical dependency now existing or hereafter
established. owned or operated by the state of Minnesota and
under the programmatic direction or fiscal control of the
commissioner. State facility includes regional treatment
centers; the state nursing homes; state-operated,
community-based programs; and other facilities owned or operated
by the state and under the commissioner's control.
Sec. 88. Minnesota Statutes 1988, section 246.50,
subdivision 4, is amended to read:
Subd. 4. [PATIENT OR RESIDENT CLIENT.] "Patient Client"
means any person with mental illness or chemical
dependency. receiving services at a state facility, whether or
not those services require occupancy of a bed overnight.
Sec. 89. Minnesota Statutes 1988, section 246.50,
subdivision 5, is amended to read:
Subd. 5. [COST OF CARE.] "Cost of care" means the
commissioner's determination of the anticipated average per
capita cost of all maintenance, treatment and expense, including
depreciation of buildings and equipment, interest paid on bonds
issued for capital improvements to state facilities, and
indirect costs related to the operation other than that paid
from the Minnesota state building fund, at all of the state
facilities during the current year for which billing is being
made. The commissioner shall determine the anticipated average
per capita cost. The commissioner may establish one all
inclusive rate or separate rates for each patient or resident
disability group, and may establish separate charges for each
facility. "Cost of care" for outpatient or day care patients or
residents shall be on a cost for service basis under a schedule
the commissioner shall establish.
For purposes of this subdivision "resident patient" means a
person who occupies a bed while housed in a state facility for
observation, care, diagnosis, or treatment.
For purposes of this subdivision "outpatient" or "day care"
patient or resident means a person who makes use of diagnostic,
therapeutic, counseling, or other service in a state facility or
through state personnel but does not occupy a bed overnight.
For the purposes of collecting from the federal government
for the care of those patients eligible for medical care under
the Social Security Act "cost of care" shall be determined as
set forth in the rules and regulations of the Department of
Health and Human Services or its successor agency. charge for
services provided to any person admitted to a state facility.
For purposes of this subdivision, "charge for services"
means the cost of services, treatment, maintenance, bonds issued
for capital improvements, depreciation of buildings and
equipment, and indirect costs related to the operation of state
facilities. The commissioner may determine the charge for
services on an anticipated average per diem basis as an all
inclusive charge per facility, per disability group, or per
treatment program. The commissioner may determine a charge per
service, using a method that includes direct and indirect costs.
Sec. 90. Minnesota Statutes 1988, section 246.51, is
amended by adding a subdivision to read:
Subd. 3. [APPLICABILITY.] The commissioner may recover,
under sections 246.50 to 246.55, the cost of any care provided
in a state facility, including care provided prior to the
effective date of this section regardless of the terminology
used to designate the status or condition of the person
receiving the care or the terminology used to identify the
facility. For purposes of recovering the cost of care provided
prior to the effective date of this section, the term "state
facility" as used in sections 246.50 to 246.55 includes "state
hospital," "regional treatment center," or "regional center";
and the term "client" includes, but is not limited to, persons
designated as "mentally deficient," "inebriate," "chemically
dependent," or "intoxicated."
Sec. 91. Minnesota Statutes 1988, section 246.54, is
amended to read:
246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.]
Except for chemical dependency services provided under
sections 254B.01 to 254B.09, the patient's or resident's county
shall pay to the state of Minnesota a portion of the cost of
care provided in a regional treatment center to a patient or
resident legally settled in that county. A county's payment
shall be made from the county's own sources of revenue and
payments shall be paid as follows: payments to the state from
the county shall equal ten percent of the per capita rate cost
of care, as determined by the commissioner, for each day, or the
portion thereof, that the patient or resident spends at a
regional treatment center. If payments received by the state
under sections 246.50 to 246.53 exceed 90 percent of the per
capita rate cost of care, the county shall be responsible for
paying the state only the remaining amount. The county shall
not be entitled to reimbursement from the patient or resident,
the patient's or resident's estate, or from the patient's or
resident's relatives, except as provided in section 246.53. No
such payments shall be made for any patient or resident who was
last committed prior to July 1, 1947.
Sec. 92. Minnesota Statutes 1988, section 252.27,
subdivision 1, is amended to read:
Subdivision 1. Whenever any child who has mental
retardation or a related condition, or a physical or emotional
handicap is in 24 hour care outside the home including respite
care, in a facility licensed by the commissioner of human
services, the cost of care shall be paid by the county of
financial responsibility determined pursuant to section 256E.08,
subdivision 7 chapter 256G. If the child's parents or guardians
do not reside in this state, the cost shall be paid by the
county in which the child is found the responsible governmental
agency in the state from which the child came, by the parents or
guardians of the child if they are financially able, or, if no
other payment source is available, by the commissioner of human
services.
Subd. 1a. [DEFINITIONS.] A person has a "related
condition" if that person has a severe, chronic disability that
is (a) attributable to cerebral palsy, epilepsy,
autism, prader-willi syndrome, or any other condition, other
than mental illness, found to be closely related to mental
retardation because the condition results in impairment of
general intellectual functioning or adaptive behavior similar to
that of persons with mental retardation or requires treatment or
services similar to those required for persons with mental
retardation; (b) is likely to continue indefinitely; and (c)
results in substantial functional limitations in three or more
of the following areas of major life activity: self-care,
understanding and use of language, learning, mobility,
self-direction, or capacity for independent living. For the
purposes of this section, a child has an "emotional handicap" if
the child has a psychiatric or other emotional disorder which
substantially impairs the child's mental health and requires 24
hour treatment or supervision.
Sec. 93. Minnesota Statutes 1988, section 252.46,
subdivision 1, is amended to read:
Subdivision 1. [RATES FOR CALENDAR YEARS 1988 AND 1989 AND
1990.] Payment rates to vendors, except regional centers, for
county-funded day training and habilitation services and
transportation provided to persons receiving day training and
habilitation services established by a county board for calendar
years 1988 and 1989 and 1990 are governed by subdivisions 2 to
10.
"Payment rate" as used in subdivisions 2 to 10 refers to
three kinds of payment rates: a full-day service rate for
persons who receive at least six service hours a day, including
the time it takes to transport the person to and from the
service site; a partial-day service rate that must not exceed 75
percent of the full-day service rate for persons who receive
less than a full day of service; and a transportation rate for
providing, or arranging and paying for, transportation of a
person to and from the person's residence to the service site.
Sec. 94. Minnesota Statutes 1988, section 252.46,
subdivision 2, is amended to read:
Subd. 2. [1988 AND 1989 AND 1990 MINIMUM.] Unless a
variance is granted under subdivision 6, the minimum payment
rates set by a county board for each vendor for calendar
years 1988 and 1989 and 1990 must be equal to the payment rates
approved by the commissioner for that vendor in effect January
1, 1987 1988, and January 1, 1988 1989, respectively.
Sec. 95. Minnesota Statutes 1988, section 252.46,
subdivision 3, is amended to read:
Subd. 3. [1988 AND 1989 AND 1990 MAXIMUM.] Unless a
variance is granted under subdivision 6, the maximum payment
rates for each vendor for calendar years 1988 and 1989 and 1990
must be equal to the payment rates approved by the commissioner
for that vendor in effect December 1, 1987 1988, and December 1,
1988 1989, respectively, increased by no more than the projected
percentage change in the urban consumer price index, all items,
published by the United States Department of Labor, for the
upcoming calendar year over the current calendar year.
Sec. 96. Minnesota Statutes 1988, section 252.46,
subdivision 4, is amended to read:
Subd. 4. [NEW VENDORS.] Payment rates established by a
county for calendar years 1988 and 1989 and 1990, for a new
vendor for which there were no previous rates must not exceed
125 percent of the average payment rates in the regional
development commission district under sections 462.381 to
462.396 in which the new vendor is located.
Sec. 97. Minnesota Statutes 1988, 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. The commissioner shall develop by
October 1, 1989, a uniform format for submission of
documentation for the variance requests. This format shall be
used by each vendor requesting a variance. The form shall be
developed by the commissioner and shall be reviewed by
representatives of advocacy and provider groups and counties. A
variance may be utilized for costs associated with compliance
with state administrative rules, compliance with court
orders, capital costs required for continued licensure,
increased insurance costs, start-up and conversion costs for
supported employment, direct service staff salaries and
benefits, and transportation. The county board shall review all
vendors' payment rates that are ten or more than ten percent
lower than the 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. 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 and recommended an effective date for the
change in the rate.
(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., or to provide
community-integrated and supported employment services after a
change in the vendor's existing services has been approved as
provided in section 252.28.
(4) The vendor documents that the changes cannot be
achieved by reallocating current staff or by reallocating
financial resources.
(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.
(7) The county board's recommended payment rates do not
exceed 125 percent of the current calendar year's statewide
median payment rates.
The commissioner shall have 60 calendar days from the date
of the receipt of the complete request to accept or reject it,
or the request shall be deemed to have been granted. If the
commissioner rejects the request, the commissioner shall state
in writing the specific objections to the request and the
reasons for its rejection.
Sec. 98. Minnesota Statutes 1988, section 252.46,
subdivision 12, is amended to read:
Subd. 12. [RATES ESTABLISHED AFTER 1989 1990.] Payment
rates established by a county board to be paid to a vendor on or
after January 1, 1990 1991, must be determined under permanent
rules adopted by the commissioner. No county shall pay a rate
that is less than the minimum rate determined by the
commissioner.
In developing procedures for setting minimum payment rates
and procedures for establishing payment rates, the commissioner
shall consider the following factors:
(1) a vendor's payment rate and historical cost in the
previous year;
(2) current economic trends and conditions;
(3) costs that a vendor must incur to operate efficiently,
effectively and economically and still provide training and
habilitation services that comply with quality standards
required by state and federal regulations;
(4) increased liability insurance costs;
(5) costs incurred for the development and continuation of
supported employment services;
(6) cost variations in providing services to people with
different needs;
(7) the adequacy of reimbursement rates that are more than
15 percent below the statewide average; and
(8) other appropriate factors.
The commissioner may develop procedures to establish
differing hourly rates that take into account variations in the
number of clients per staff hour, to assess the need for day
training and habilitation services, and to control the
utilization of services.
In developing procedures for setting transportation rates,
the commissioner may consider allowing the county board to set
those rates or may consider developing a uniform standard.
Medical assistance rates for home and community-based
services provided under section 256B.501 by licensed vendors of
day training and habilitation services must not be greater than
the rates for the same services established by counties under
sections 252.40 to 252.47.
Sec. 99. Minnesota Statutes 1988, section 252.47, is
amended to read:
252.47 [RULES.]
To implement sections 252.40 to 252.47, the commissioner
shall adopt permanent rules under sections 14.01 to 14.38. The
rules may include a plan for phasing in implementation of the
procedures and rates established by the rules. The phase-in may
occur prior to calendar year 1990 1991. The commissioner shall
establish an advisory task force to advise and make
recommendations to the commissioner during the rulemaking
process. The advisory task force must include legislators,
vendors, residential service providers, counties, consumers,
department personnel, and others as determined by the
commissioner.
Sec. 100. Minnesota Statutes 1988, section 253B.03,
subdivision 6a, is amended 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.
(e) The court may allow and order paid to a guardian ad
litem a reasonable fee for services provided under paragraph
(c), or the court may appoint a volunteer guardian ad litem.
Sec. 101. Minnesota Statutes 1988, section 254A.08,
subdivision 2, is amended to read:
Subd. 2. For the purpose of this section, a detoxification
program means a social rehabilitation program established for
the purpose of facilitating access into care and treatment by
detoxifying and evaluating the person and providing entrance
into a comprehensive program. Such a Evaluation of the person
shall include verification by a professional, after preliminary
examination, that the person is intoxicated or has symptoms of
chemical dependency and appears to be in imminent danger of
harming self or others. A detoxification program shall have
available the services of a licensed physician for medical
emergencies and routine medical surveillance. A detoxification
program licensed by the department of human services to serve
both adults and minors at the same site must provide for
separate sleeping areas for adults and minors.
Sec. 102. [254A.145] [INHALANT ABUSE DEMONSTRATION
PROJECT.]
Within the limits of the available appropriation and
notwithstanding the requirements of chapter 254B, the
commissioner of human services shall create a demonstration
project to provide intervention and to coordinate community
services for inhalant abusers aged seven to 14. The project
shall be established in a community that has been shown to be at
great risk of such inhalant abuse and shall include assessment,
education, and case management components. For individuals
identified as inhalant abusers, case managers shall make
referrals to services otherwise offered in the community. The
case manager shall also monitor the progress of the individuals
referred.
As part of this project, the commissioner of human services
shall work with other agencies that provide services to youth
and children, including education agencies and other drug
treatment and counseling agencies, to increase public awareness
concerning inhalant abuse among youth and children.
Sec. 103. Minnesota Statutes 1988, section 254B.02,
subdivision 1, is amended to read:
Subdivision 1. [CHEMICAL DEPENDENCY TREATMENT ALLOCATION.]
The chemical dependency funds appropriated for allocation shall
be placed in a special revenue account. For the fiscal year
beginning July 1, 1987, funds shall be transferred to operate
the vendor payment, invoice processing, and collections system
for one year. The commissioner shall annually transfer funds
from the chemical dependency fund to pay for operation of the
drug and alcohol abuse normative evaluation system and to pay
for all costs incurred by adding two positions for licensing of
chemical dependency treatment and rehabilitation programs
located in hospitals for which funds are not otherwise
appropriated. The commissioner shall annually divide the money
available in the chemical dependency fund that is not held in
reserve by counties from a previous allocation. Twelve percent
of the remaining money must be reserved for treatment of
American Indians by eligible vendors under section 254B.05. The
remainder of the money must be allocated among the counties
according to the following formula, using state demographer data
and other data sources determined by the commissioner:
(a) The county non-Indian and over age 14 per capita-months
of eligibility for aid to families with dependent children,
general assistance, and medical assistance is divided by the
total state non-Indian and over age 14 per capita-months of
eligibility to determine the caseload factor for each county.
(b) The average median family married couple income for the
previous three years for the state is divided by the average
median family married couple income for the previous three years
for each county to determine the income factor.
(c) The non-Indian and over age 14 population of the county
is multiplied by the sum of the income factor and the caseload
factor to determine the adjusted population.
(d) $15,000 shall be allocated to each county.
(e) The remaining funds shall be allocated proportional to
the county adjusted population.
Sec. 104. Minnesota Statutes 1988, section 254B.03,
subdivision 1, is amended to read:
Subdivision 1. [LOCAL AGENCY DUTIES.] (a) Every local
agency shall provide chemical dependency services to persons
residing within its jurisdiction who meet criteria established
by the commissioner for placement in a chemical dependency
residential or nonresidential treatment service. Chemical
dependency money must be administered by the local agencies
according to law and rules adopted by the commissioner under
sections 14.01 to 14.69.
(b) In order to contain costs, the county board shall, with
the approval of the commissioner of human services, select
eligible vendors of chemical dependency services who can provide
economical and appropriate treatment. Unless the local agency
is a social services department directly administered by a
county or human services board, the local agency shall not be an
eligible vendor under section 254B.05. The commissioner may
approve proposals from county boards to provide services in an
economical manner or to control utilization, with safeguards to
ensure that necessary services are provided. If a county
implements a demonstration or experimental medical services
funding plan, the commissioner shall transfer the money as
appropriate. If a county selects a vendor located in another
state, the county shall ensure that the vendor is in compliance
with the rules governing licensure of programs located in the
state.
(c) A culturally specific vendor that provides assessments
under a variance under Minnesota Rules, part 9530.6610, shall be
allowed to provide assessment services to persons not covered by
the variance.
Sec. 105. Minnesota Statutes 1988, section 254B.03,
subdivision 4, is amended to read:
Subd. 4. [DIVISION OF COSTS.] Except for services provided
by a county under section 254B.09, subdivision 1, the county
shall, out of local money, pay the state for 15 percent of the
cost of chemical dependency services. Counties may use the
indigent hospitalization levy for treatment and hospital
payments made under this section. Fifteen percent of any state
collections from private or third-party pay, less 15 percent of
the cost of payment and collections, must be distributed to the
county that paid for a portion of the treatment under this
section. If all funds allocated according to section 254B.02
are exhausted by a county and the county has met or exceeded the
base level of expenditures under section 254B.02, subdivision 3,
the county shall pay the state for 15 percent of the costs paid
by the state under this section. The commissioner may refuse to
pay state funds for services to persons not eligible under
section 254B.04, subdivision 1, if the county financially
responsible for the persons has exhausted its allocation.
Sec. 106. Minnesota Statutes 1988, section 254B.04, is
amended by adding a subdivision to read:
Subd. 3. [AMOUNT OF CONTRIBUTION.] The commissioner shall
adopt a sliding fee scale to determine the amount of
contribution to be required from persons whose income is greater
than the standard of assistance under sections 256B.055,
256B.056, 256B.06, and 256D.01 to 256D.21. The commissioner may
adopt rules to amend existing fee scales. The commissioner may
establish a separate fee scale for recipients of chemical
dependency transitional and extended care rehabilitation
services that provides for the collection of fees for board and
lodging expenses. The fee schedule shall ensure that employed
persons are allowed the income disregards and savings accounts
that are allowed residents of community mental illness
facilities under section 256D.06, subdivisions 1 and 1b. The
fee scale must not provide assistance to persons whose income is
more than 115 percent of the state median income. Payments of
liabilities under this section are medical expenses for purposes
of determining spend-down under sections 256B.055, 256B.056,
256B.06, and 256D.01 to 256D.21. The required amount of
contribution established by the fee scale in this subdivision is
also the cost of care responsibility subject to collection under
section 254B.06, subdivision 1.
Sec. 107. Minnesota Statutes 1988, section 254B.06,
subdivision 1, is amended to read:
Subdivision 1. [STATE COLLECTIONS.] The commissioner is
responsible for all collections from persons determined to be
partially responsible for the cost of care of an eligible person
receiving services under Laws 1986, chapter 394, sections 8 to
20. The commissioner may initiate, or request the attorney
general to initiate, necessary civil action to recover the
unpaid cost of care. The commissioner may collect all
third-party payments for chemical dependency services provided
under Laws 1986, chapter 394, sections 8 to 20, including
private insurance and federal medicaid and medicare financial
participation. The commissioner shall deposit in a dedicated
account a percentage of collections to pay for the cost of
operating the chemical dependency consolidated treatment fund
invoice processing and vendor payment system, billing, and
collections. The remaining receipts must be deposited in the
chemical dependency fund.
Sec. 108. Minnesota Statutes 1988, section 254B.09,
subdivision 1, is amended to read:
Subdivision 1. [AMERICAN INDIAN CHEMICAL DEPENDENCY
ACCOUNT.] The commissioner shall pay eligible vendors for
chemical dependency services to American Indians on the same
basis as other payments, except that no local match is required
when an invoice is submitted by the governing authority of a
federally recognized American Indian tribal body or a county if
the tribal governing body has not entered into an agreement
under subdivision 2 on behalf of a current resident of the
reservation under this section.
Sec. 109. Minnesota Statutes 1988, section 254B.09,
subdivision 4, is amended to read:
Subd. 4. [TRIBAL ALLOCATION.] Forty-two and one-half
percent of the American Indian chemical dependency account must
be allocated to the federally recognized American Indian tribal
governing bodies that have entered into an agreement under
subdivision 2 as follows: $10,000 must be allocated to each
governing body and the remainder must be allocated in direct
proportion to the population of the reservation according to the
most recently available estimates from the federal Bureau of
Indian Affairs. When a tribal governing body has not entered
into an agreement with the commissioner under subdivision 2, the
county may use funds allocated to the reservation to pay for
chemical dependency services for a current resident of the
county and of the reservation.
Sec. 110. Minnesota Statutes 1988, section 254B.09,
subdivision 5, is amended to read:
Subd. 5. [TRIBAL RESERVE ACCOUNT.] The commissioner shall
reserve 7.5 percent of the American Indian chemical dependency
account. The reserve must be allocated to those tribal units
that have used all money allocated under subdivision 4 according
to agreements made under subdivision 2 and to counties
submitting invoices for American Indians under subdivision 1
when all money allocated under subdivision 4 has been used. An
American Indian tribal governing body or a county submitting
invoices under subdivision 1 may receive not more than 30
percent of the reserve account in a year. The commissioner may
refuse to make reserve payments for persons not eligible under
section 254B.04, subdivision 1, if the tribal governing body
responsible for treatment placement has exhausted its
allocation. Money must be allocated as invoices are received.
Sec. 111. Minnesota Statutes 1988, section 256.01,
subdivision 2, is amended to read:
Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of
section 241.021, subdivision 2, the commissioner of human
services shall:
(1) Administer and supervise all forms of public assistance
provided for by state law and other welfare activities or
services as are vested in the commissioner. Administration and
supervision of human services activities or services includes,
but is not limited to, assuring timely and accurate distribution
of benefits, completeness of service, and quality program
management. In addition to administering and supervising human
services activities vested by law in the department, the
commissioner shall have the authority to:
(a) require local agency participation in training and
technical assistance programs to promote compliance with
statutes, rules, federal laws, regulations, and policies
governing human services;
(b) monitor, on an ongoing basis, the performance of local
agencies in the operation and administration of human services,
enforce compliance with statutes, rules, federal laws,
regulations, and policies governing welfare services and promote
excellence of administration and program operation;
(c) develop a quality control program or other monitoring
program to review county performance and accuracy of benefit
determinations;
(d) require local agencies to make an adjustment to the
public assistance benefits issued to any individual consistent
with federal law and regulation and state law and rule and to
issue or recover benefits as appropriate;
(e) delay or deny payment of all or part of the state and
federal share of benefits and administrative reimbursement
according to the procedures set forth in section 256.017; and
(f) make contracts with and grants to public and private
agencies and organizations, both profit and nonprofit, and
individuals, using appropriated funds.
(2) Inform local agencies, on a timely basis, of changes in
statute, rule, federal law, regulation, and policy necessary to
local agency administration of the programs.
(3) Administer and supervise all child welfare activities;
promote the enforcement of laws protecting handicapped,
dependent, neglected and delinquent children, and children born
to mothers who were not married to the children's fathers at the
times of the conception nor at the births of the children;
license and supervise child-caring and child-placing agencies
and institutions; supervise the care of children in boarding and
foster homes or in private institutions; and generally perform
all functions relating to the field of child welfare now vested
in the state board of control.
(4) Administer and supervise all noninstitutional service
to handicapped persons, including those who are visually
impaired, hearing impaired, or physically impaired or otherwise
handicapped. The commissioner may provide and contract for the
care and treatment of qualified indigent children in facilities
other than those located and available at state hospitals when
it is not feasible to provide the service in state hospitals.
(5) Assist and actively cooperate with other departments,
agencies and institutions, local, state, and federal, by
performing services in conformity with the purposes of Laws
1939, chapter 431.
(6) Act as the agent of and cooperate with the federal
government in matters of mutual concern relative to and in
conformity with the provisions of Laws 1939, chapter 431,
including the administration of any federal funds granted to the
state to aid in the performance of any functions of the
commissioner as specified in Laws 1939, chapter 431, and
including the promulgation of rules making uniformly available
medical care benefits to all recipients of public assistance, at
such times as the federal government increases its participation
in assistance expenditures for medical care to recipients of
public assistance, the cost thereof to be borne in the same
proportion as are grants of aid to said recipients.
(7) Establish and maintain any administrative units
reasonably necessary for the performance of administrative
functions common to all divisions of the department.
(8) The commissioner is Act as designated as guardian of
both the estate and the person of all the wards of the state of
Minnesota, whether by operation of law or by an order of court,
without any further act or proceeding whatever, except as to
persons committed as mentally retarded.
(9) Act as coordinating referral and informational center
on requests for service for newly arrived immigrants coming to
Minnesota.
(10) The specific enumeration of powers and duties as
hereinabove set forth shall in no way be construed to be a
limitation upon the general transfer of powers herein contained.
(11) Establish county, regional, or statewide schedules of
maximum fees and charges which may be paid by local agencies for
medical, dental, surgical, hospital, nursing and nursing home
care and medicine and medical supplies under all programs of
medical care provided by the state and for congregate living
care under the income maintenance programs.
(12) Have the authority to conduct and administer
experimental projects to test methods and procedures of
administering assistance and services to recipients or potential
recipients of public welfare. To carry out such experimental
projects, it is further provided that the commissioner of human
services is authorized to waive the enforcement of existing
specific statutory program requirements, rules, and standards in
one or more counties. The order establishing the waiver shall
provide alternative methods and procedures of administration,
shall not be in conflict with the basic purposes, coverage, or
benefits provided by law, and in no event shall the duration of
a project exceed four years. It is further provided that no
order establishing an experimental project as authorized by the
provisions of this section shall become effective until the
following conditions have been met:
(a) The proposed comprehensive plan including estimated
project costs and the proposed order establishing the waiver
shall be filed with the secretary of the senate and chief clerk
of the house of representatives at least 60 days prior to its
effective date.
(b) The secretary of health, education, and welfare of the
United States has agreed, for the same project, to waive state
plan requirements relative to statewide uniformity.
(c) A comprehensive plan, including estimated project
costs, shall be approved by the legislative advisory commission
and filed with the commissioner of administration.
(13) In accordance with federal requirements establish
procedures to be followed by local welfare boards in creating
citizen advisory committees, including procedures for selection
of committee members.
(14) Allocate federal fiscal disallowances or sanctions
which are based on quality control error rates for the aid to
families with dependent children, medical assistance, or food
stamp program in the following manner:
(a) One-half of the total amount of the disallowance shall
be borne by the county boards responsible for administering the
programs. For the medical assistance and AFDC programs,
disallowances shall be shared by each county board in the same
proportion as that county's expenditures for the sanctioned
program are to the total of all counties' expenditures for the
AFDC and medical assistance programs. For the food stamp
program, sanctions shall be shared by each county board, with 50
percent of the sanction being distributed to each county in the
same proportion as that county's administrative costs for food
stamps are to the total of all food stamp administrative costs
for all counties, and 50 percent of the sanctions being
distributed to each county in the same proportion as that
county's value of food stamp benefits issued are to the total of
all benefits issued for all counties. Each county shall pay its
share of the disallowance to the state of Minnesota. When a
county fails to pay the amount due hereunder, the commissioner
may deduct the amount from reimbursement otherwise due the
county, or the attorney general, upon the request of the
commissioner, may institute civil action to recover the amount
due.
(b) Notwithstanding the provisions of paragraph (a), if the
disallowance results from knowing noncompliance by one or more
counties with a specific program instruction, and that knowing
noncompliance is a matter of official county board record, the
commissioner may require payment or recover from the county or
counties, in the manner prescribed in paragraph (a), an amount
equal to the portion of the total disallowance which resulted
from the noncompliance, and may distribute the balance of the
disallowance according to paragraph (a).
(15) Develop and implement special projects that maximize
reimbursements and result in the recovery of money to the
state. For the purpose of recovering state money, the
commissioner may enter into contracts with third parties. Any
recoveries that result from projects or contracts entered into
under this paragraph shall be deposited in the state treasury
and credited to a special account until the balance in the
account reaches $400,000. When the balance in the account
exceeds $400,000, the excess shall be transferred and credited
to the general fund. All money in the account is appropriated
to the commissioner for the purposes of this paragraph.
(16) Have the authority to make direct payments to
facilities providing shelter to women and their children
pursuant to section 256D.05, subdivision 3. Upon the written
request of a shelter facility that has been denied payments
under section 256.05, subdivision 3, the commissioner shall
review all relevant evidence and make a determination within 30
days of the request for review regarding issuance of direct
payments to the shelter facility. Failure to act within 30 days
shall be considered a determination not to issue direct payments.
(17) Allocate federal fiscal disallowances or sanctions for
audit exceptions when federal fiscal disallowances or sanctions
are based on a statewide random sample for the foster care
program under title IV-E of the Social Security Act, United
States Code, title 42, in direct proportion to each county's
title IV-E foster care maintenance claim for that period.
Sec. 112. Minnesota Statutes 1988, section 256.01, is
amended by adding a subdivision to read:
Subd. 12. [CHILD MORTALITY REVIEW PANEL.] (a) The
commissioner shall establish a child mortality review panel for
reviewing deaths of children in Minnesota, including deaths
attributed to maltreatment or in which maltreatment may be a
contributing cause. The commissioners of health, education, and
public safety and the attorney general shall each designate a
representative to the child mortality review panel. Other panel
members shall be appointed by the commissioner, including a
board-certified pathologist and a physician who is a coroner or
a medical examiner. The purpose of the panel shall be to make
recommendations to the state and to local agencies for improving
the child protection system, including modifications in statute,
rule, policy, and procedure.
(b) The commissioner may require a local agency to
establish a local child mortality review panel. The
commissioner may establish procedures for conducting local
reviews and may require that all professionals with knowledge of
a child mortality case participate in the local review. In this
section, "professional" means a person licensed to perform or a
person performing a specific service in the child protective
service system. "Professional" includes law enforcement
personnel, social service agency attorneys, educators, and
social service, health care, and mental health care providers.
(c) If the commissioner of human services has reason to
believe that a child's death was caused by maltreatment or that
maltreatment was a contributing cause, the commissioner has
access to not public data under chapter 13 maintained by state
agencies, statewide systems, or political subdivisions that are
related to the child's death or circumstances surrounding the
care of the child. The commissioner shall also have access to
records of private hospitals as necessary to carry out the
duties prescribed by this section. Access to data under this
paragraph is limited to police investigative data; autopsy
records and coroner or medical examiner investigative data;
hospital, public health, or other medical records of the child;
hospital and other medical records of the child's parent that
relate to prenatal care; and records created by social service
agencies that provided services to the child or family within
three years preceding the child's death. A state agency,
statewide system, or political subdivision shall provide the
data upon request of the commissioner. Not public data may be
shared with members of the state or local child mortality review
panel in connection with an individual case.
(d) Notwithstanding the data's classification in the
possession of any other agency, data acquired by a local or
state child mortality review panel in the exercise of its duties
is protected nonpublic or confidential data as defined in
section 13.02, but may be disclosed as necessary to carry out
the purposes of the review panel. The data is not subject to
subpoena or discovery. The commissioner may disclose
conclusions of the review panel, but shall not disclose data
that was classified as confidential or private data on
decedents, under section 13.10, or private, confidential, or
protected nonpublic data in the disseminating agency.
(e) A person attending a child mortality review panel
meeting shall not disclose what transpired at the meeting,
except to carry out the purposes of the mortality review panel.
The proceedings and records of the mortality review panel are
protected nonpublic data as defined in section 13.02,
subdivision 13, and are not subject to discovery or introduction
into evidence in a civil or criminal action against a
professional, the state or a local agency, arising out of the
matters the panel is reviewing. Information, documents, and
records otherwise available from other sources are not immune
from discovery or use in a civil or criminal action solely
because they were presented during proceedings of the review
panel. A person who presented information before the review
panel or who is a member of the panel shall not be prevented
from testifying about matters within the person's knowledge.
However, in a civil or criminal proceeding a person shall not be
questioned about the person's presentation of information to the
review panel or opinions formed by the person as a result of the
review meetings.
Sec. 113. Minnesota Statutes 1988, section 256.018, is
amended to read:
256.018 [COUNTY PUBLIC ASSISTANCE INCENTIVE FUND.]
Beginning in 1990, $1,000,000 is appropriated from the
general fund to the department in each fiscal year for The
commissioner shall grant incentive awards of money specifically
appropriated for this purpose to counties: (1) that have not
been assessed an administrative penalty under section 256.017 in
the corresponding fiscal year; and (2) that perform
satisfactorily according to indicators established by the
commissioner.
After consultation with local agencies, the commissioner
shall inform local agencies in writing of the performance
indicators that govern the awarding of the incentive fund for
each fiscal year by April of the preceding fiscal year.
The commissioner may set performance indicators to govern
the awarding of the total fund, may allocate portions of the
fund to be awarded by unique indicators, or may set a sole
indicator to govern the awarding of funds.
The funds shall be awarded to qualifying local agencies
according to their share of benefits for the programs related to
the performance indicators governing the distribution of the
fund or part of it as compared to the total benefits of all
qualifying local agencies for the programs related to the
performance indicators governing the distribution of the fund or
part of it.
Sec. 114. Minnesota Statutes 1988, section 256.87,
subdivision 1a, is amended to read:
Subd. 1a. [CONTINUING SUPPORT CONTRIBUTIONS.] 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 support contributions by a parent found able to
reimburse the county or state agency. Except as provided in
subdivision 4, The order shall be effective for the period of
time during which the recipient receives public assistance from
any county or state agency and for five months thereafter. The
order shall require support according to chapter 518. An order
for continuing contributions is reinstated without further
hearing upon notice to the parent by any county or state agency
that assistance is again being provided for the child of the
parent under sections 256.72 to 256.87. The notice shall be in
writing and shall indicate that the parent may request a hearing
for modification of the amount of support or maintenance.
Sec. 115. Minnesota Statutes 1988, section 256.974, is
amended to read:
256.974 [OFFICE OF OMBUDSMAN FOR OLDER MINNESOTANS; LOCAL
PROGRAMS.]
The ombudsman for older Minnesotans serves in the
classified service under section 256.01, subdivision 7, in an
office within the Minnesota board on aging that incorporates the
long-term care ombudsman program required by the Older Americans
Act, Public Law Number 98-456 100-75, United States Code, title
42, section 3027(a)(12), and established within the Minnesota
board on aging. The Minnesota board on aging may make grants to
and designate local programs or area agencies on aging for the
provision of ombudsman services to clients in county or
multicounty areas. Individuals providing local ombudsman
services must be qualified to perform the duties required by
section 256.9742. The local program may not be an agency engaged
in the provision of nursing home care, hospital care, or home
care services either directly or by contract, or have the
responsibility for planning, coordinating, funding, or
administering nursing home care, hospital care, or home care
services.
Sec. 116. Minnesota Statutes 1988, section 256.9741,
subdivision 3, is amended to read:
Subd. 3. "Client" means an individual who requests, or on
whose behalf a request is made for, ombudsman services and is (a)
a resident of a long-term care facility or (b) a patient in an
acute care facility who is eligible for Medicare and beneficiary
who requests assistance relating to admission or discharge from
an acute care facility access, discharge, or denial of inpatient
or outpatient services, or (c) an individual reserving or
requesting a home care service.
Sec. 117. Minnesota Statutes 1988, section 256.9741,
subdivision 5, is amended to read:
Subd. 5. "Office" means the office of ombudsman
established within the Minnesota board on aging or local
ombudsman programs that the board on aging designates.
Sec. 118. Minnesota Statutes 1988, section 256.9741, is
amended by adding a subdivision to read:
Subd. 6. "Home care service" means health, social, or
supportive services provided to an individual for a fee in the
individual's residence and in the community to promote,
maintain, or restore health, or maximize the individual's level
of independence, while minimizing the effects of disability and
illness.
Sec. 119. Minnesota Statutes 1988, section 256.9742, is
amended to read:
256.9742 [DUTIES AND POWERS OF THE OFFICE.]
Subdivision 1. [DUTIES.] The ombudsman shall:
(1) gather information and evaluate any act, practice,
policy, procedure, or administrative action of a long-term care
facility, acute care facility, home care service provider, or
government agency that may adversely affect the health, safety,
welfare, or rights of any client;
(2) mediate or advocate on behalf of clients;
(3) monitor the development and implementation of federal,
state, or local laws, rules, regulations, and policies affecting
the rights and benefits of clients;
(4) comment on and recommend to the legislature and public
and private agencies regarding laws, rules, regulations, and
policies affecting clients;
(5) inform public agencies about the problems of clients;
(6) provide for training of volunteers and promote the
development of citizen participation in the work of the office;
(7) conduct public forums to obtain information about and
publicize issues affecting clients;
(8) provide public education regarding the health, safety,
welfare, and rights of clients; and
(9) collect and analyze data relating to complaints and,
conditions in long-term care facilities, and services.
Subd. 1a. [DESIGNATION; LOCAL OMBUDSMAN
REPRESENTATIVES.] (a) In designating an individual to perform
duties under this section, the ombudsman must determine that the
individual is qualified to perform the duties required by this
section.
(b) An individual designated under this section must
successfully complete an orientation training conducted under
the direction of the ombudsman or approved by the ombudsman.
Orientation training shall be at least 20 hours and will consist
of training in: investigation, dispute resolution, health care
regulation, confidentiality, resident and patients' rights, and
health care reimbursement.
(c) The ombudsman shall develop and implement a continuing
education program for individuals designated under this
section. The continuing education program shall be at least 60
hours annually.
(d) The ombudsman may withdraw an individual's designation
if the individual fails to perform duties of this section or
meet continuing education requirements. The individual may
request a reconsideration of such action by the board on aging
whose decision shall be final.
Subd. 2. [IMMUNITY FROM LIABILITY.] A person designated as
an The ombudsman or designee under this section is immune from
civil liability that otherwise might result from the person's
actions or omissions if the person's actions are in good faith,
are within the scope of the person's responsibilities as an
ombudsman, and do not constitute willful or reckless misconduct.
Subd. 3. [POSTING.] Every long-term care facility and
acute care facility shall post in a conspicuous place the
address and telephone number of the office. A home care service
provider shall provide all recipients with the address and
telephone number of the office. The posting or notice is
subject to approval by the ombudsman.
Subd. 4. [ACCESS TO LONG-TERM CARE AND ACUTE CARE
FACILITIES AND CLIENTS.] The ombudsman or designee may:
(1) enter any long-term care facility without notice at any
time;
(2) enter any acute care facility without notice during
normal business hours;
(3) enter any acute care facility without notice at any
time to interview a patient or observe services being provided
to the patient as part of an investigation of a matter that is
within the scope of the ombudsman's authority, but only if the
ombudsman's or designee's presence does not intrude upon the
privacy of another patient or interfere with routine hospital
services provided to any patient in the facility;
(4) communicate privately and without restriction with any
client in accordance with section 144.651; and
(4) (5) inspect records of a long-term care facility, home
care service provider, or acute care facility that pertain to
the care of the client according to sections 144.335 and
144.651.; and
(6) with the consent of a client or client's legal
guardian, have access to review records pertaining to the care
of the client according to sections 144.335 and 144.651. If a
client cannot consent and has no legal guardian, access to the
records is authorized by this section.
A person who denies access to the ombudsman or designee in
violation of this subdivision or aids, abets, invites, compels,
or coerces another to do so is guilty of a misdemeanor.
Subd. 5. [ACCESS TO STATE RECORDS.] The ombudsman or
designee has access to data of a state agency necessary for the
discharge of the ombudsman's duties, including records
classified confidential or private under chapter 13, or any
other law. The data requested must be related to a specific
case and is subject to section 13.03, subdivision 4. If the
data concerns an individual, the ombudsman or designee shall
first obtain the individual's consent. If the individual cannot
consent and has no legal guardian, then access to the data is
authorized by this section.
Each state agency responsible for licensing, regulating,
and enforcing state and federal laws and regulations concerning
long-term care, home care service providers, and acute care
facilities shall forward to the ombudsman on a quarterly basis,
copies of all correction orders, penalty assessments, and
complaint investigation reports, for all long-term care
facilities and, acute care facilities, and home care service
providers.
Subd. 6. [PROHIBITION AGAINST DISCRIMINATION OR
RETALIATION.] (a) No entity shall take discriminatory,
disciplinary, or retaliatory action against an employee or
volunteer, or a patient, resident, or guardian or family member
of a patient, resident, or guardian for filing in good faith a
complaint with or providing information to the ombudsman or
designee. A person who violates this subdivision or who aids,
abets, invites, compels, or coerces another to do so is guilty
of a misdemeanor.
(b) There shall be a rebuttable presumption that any
adverse action, as defined below, within 90 days of report, is
discriminatory, disciplinary, or retaliatory. For the purpose
of this clause, the term "adverse action" refers to action taken
by the entity involved in a report against the person making the
report or the person with respect to whom the report was made
because of the report, and includes, but is not limited to:
(1) discharge or transfer from a facility;
(2) termination of service;
(3) restriction or prohibition of access to the facility or
its residents;
(4) discharge from or termination of employment;
(5) demotion or reduction in remuneration for services; and
(6) any restriction of rights set forth in section 144.651
or 144A.44.
Sec. 120. Minnesota Statutes 1988, section 256.9744,
subdivision 1, is amended to read:
Subdivision 1. [CLASSIFICATION.] Except as provided in
this section, data maintained by the office under sections
256.974 to 256.9744 are private data on individuals or nonpublic
data as defined in section 13.02, subdivision 9 or 12, and must
be maintained in accordance with the requirements of Public Law
Number 98-459 100-75, United States Code, title 42, section
3027(a)(12)(D).
Sec. 121. Minnesota Statutes 1988, section 256.975,
subdivision 2, is amended to read:
Subd. 2. [DUTIES.] The board shall carry out the following
duties:
(a) to advise the governor and heads of state departments
and agencies regarding policy, programs, and services affecting
the aging;
(b) to provide a mechanism for coordinating plans and
activities of state departments and citizens' groups as they
pertain to aging;
(c) to create public awareness of the special needs and
potentialities of older persons;
(d) to gather and disseminate information about research
and action programs, and to encourage state departments and
other agencies to conduct needed research in the field of aging;
(e) to stimulate, guide, and provide technical assistance
in the organization of local councils on aging;
(f) to provide continuous review of ongoing services,
programs and proposed legislation affecting the elderly in
Minnesota; and
(g) to administer and to make policy relating to all
aspects of the older americans act of 1965, as amended,
including implementation thereof.; and
(h) to award grants, enter into contracts, and adopt rules
the Minnesota board on aging deems necessary to carry out the
purposes of this section.
Sec. 122. Minnesota Statutes 1988, section 256C.28,
subdivision 3, is amended to read:
Subd. 3. [DUTIES.] The council shall:
(1) advise the commissioner, the governor, and the
legislature on the nature of the issues and disabilities
confronting hearing impaired persons in Minnesota;
(2) advise the commissioner and, the governor, and the
legislature on the development of policies, programs, and
services affecting the hearing impaired persons, and on the use
of appropriate federal and state money;
(2) (3) create a public awareness of the special needs and
potential of hearing impaired persons; and
(3) (4) provide the commissioner and, the governor, and
the legislature with a review of ongoing services, programs, and
proposed legislation affecting the hearing impaired. persons;
(5) advise the commissioner, the governor, and the
legislature on statutes or rules necessary to ensure that
hearing impaired persons have access to benefits and services
provided to individuals in Minnesota;
(6) recommend to the commissioner, the governor, and the
legislature legislation designed to improve the economic and
social conditions of hearing impaired persons in Minnesota;
(7) propose solutions to problems of hearing impaired
persons in the areas of education, employment, human rights,
human services, health, housing, and other related programs;
(8) recommend to the governor and the legislature any
needed revisions in the state's affirmative action program and
any other steps necessary to eliminate the underemployment or
unemployment of hearing impaired persons in the state's work
force;
(9) work with other state and federal agencies and
organizations to promote economic development for hearing
impaired Minnesotans; and
(10) coordinate its efforts with other state and local
agencies serving hearing impaired persons.
Sec. 123. Minnesota Statutes 1988, section 256C.28, is
amended by adding a subdivision to read:
Subd. 4. [STAFF.] The council may appoint, subject to the
approval of the governor, an executive director who must be
experienced in administrative activities and familiar with the
problems and needs of hearing impaired persons. The council may
delegate to the executive director any powers and duties under
this section that do not require council approval. The
executive director serves in the unclassified service and may be
removed at any time by a majority vote of the council. The
executive director shall coordinate the provision of necessary
support services to the council with the state department of
human services.
Sec. 124. Minnesota Statutes 1988, section 256C.28, is
amended by adding a subdivision to read:
Subd. 5. [POWERS.] The council may contract in its own
name. Contracts must be approved by a majority of the members
of the council and executed by the chair and the executive
director. The council may apply for, receive, and expend in its
own name grants and gifts of money consistent with the powers
and duties specified in this section.
Sec. 125. Minnesota Statutes 1988, section 256C.28, is
amended by adding a subdivision to read:
Subd. 6. [REPORT.] The council shall prepare and
distribute a report to the commissioner, the governor, and the
legislature by December 31 of each even-numbered year. The
report must summarize the activities of the council since its
prior report, list receipts and expenditures, identify the major
problems and issues confronting hearing impaired persons, make
recommendations regarding needed policy and program development
on behalf of hearing impaired individuals in Minnesota, and list
the specific objectives the council seeks to attain during the
next biennium.
Sec. 126. Minnesota Statutes 1988, section 256E.03,
subdivision 2, is amended to read:
Subd. 2. (a) "Community social services" means services
provided or arranged for by county boards to fulfill the
responsibilities prescribed in section 256E.08, subdivision 1 to
the following groups of persons:
(a) (1) families with children under age 18, who are
experiencing child dependency, neglect or abuse, and also
pregnant adolescents, adolescent parents under the age of 18,
and their children;
(b) (2) persons who are under the guardianship of the
commissioner of human services as dependent and neglected wards;
(c) (3) adults who are in need of protection and vulnerable
as defined in section 626.557;
(d) (4) persons age 60 and over who are experiencing
difficulty living independently and are unable to provide for
their own needs;
(e) (5) emotionally disturbed children and adolescents,
chronically and acutely mentally ill persons who are unable to
provide for their own needs or to independently engage in
ordinary community activities;
(f) (6) persons with mental retardation as defined in
section 252A.02, subdivision 2, or with related conditions as
defined in section 252.27, subdivision 1, who are unable to
provide for their own needs or to independently engage in
ordinary community activities;
(g) (7) drug dependent and intoxicated persons as defined
in section 254A.02, subdivisions 5 and 7, and persons at risk of
harm to self or others due to the ingestion of alcohol or other
drugs;
(h) (8) parents whose income is at or below 70 percent of
the state median income and who are in need of child care
services in order to secure or retain employment or to obtain
the training or education necessary to secure employment; and
(i) (9) other groups of persons who, in the judgment of the
county board, are in need of social services.
(b) Except as provided in section 256E.08, subdivision 5,
community social services do not include public assistance
programs known as aid to families with dependent children,
Minnesota supplemental aid, medical assistance, general
assistance, general assistance medical care, or community health
services authorized by sections 145A.09 to 145A.13.
Sec. 127. Minnesota Statutes 1988, section 256E.05,
subdivision 3, is amended to read:
Subd. 3. [ADDITIONAL DUTIES.] The commissioner shall also:
(a) Provide necessary forms and instructions to the
counties for plan format and information;
(b) Identify and then amend or repeal the portions of all
applicable department rules which mandate counties to provide
specific community social services or programs, unless state or
federal law requires the commissioner to mandate a service or
program. The commissioner shall be exempt from the rulemaking
provisions of chapter 14 in amending or repealing rules pursuant
to this clause. However, when the commissioner proposes to
amend or repeal any rule under the authority granted by this
clause, notice shall be provided by publication in the State
Register. When the commissioner proposes to amend a rule, the
notice shall include that portion of the existing rule necessary
to provide adequate notice of the nature of the proposed
change. On proposing to repeal an entire rule, the commissioner
need only publish that fact, giving the exact citation to the
rule to be repealed. In all cases, the notice shall contain a
statement indicating that interested persons may submit comment
on the proposed repeal or amendment for a period of 30 days
after publication of the notice. The commissioner shall take no
final action until after the close of the comment period. The
commissioner's actions shall not be effective until five days
after the commissioner publishes notice of adoption in the State
Register. If the final action is the same as the action
originally proposed, publication may be made by notice in the
State Register that the amendment and repeals have been adopted
as proposed, and by citing the prior publication. If the final
action differs from the action as previously proposed in the
State Register, the text which differs from the original
proposal shall be included in the notice of adoption together
with a citation to the prior State Register publication. The
commissioner shall provide to all county boards separate notice
of all final actions which become effective under this clause,
advising the boards with respect to services or programs which
have now become optional, to be provided at county
discretion; To the extent possible, coordinate other categorical
social service grant applications and plans required of counties
so that the applications and plans are included in and are
consistent with the timetable and other requirements for the
community social services plan in subdivision 2 and section
256E.09;
(c) Provide to the chair of each county board, in addition
to notice required pursuant to sections 14.05 to 14.36, timely
advance notice and a written summary of the fiscal impact of any
proposed new rule or changes in existing rule which will have
the effect of increasing county costs for community social
services;
(d) Provide training, technical assistance, and other
support services to county boards to assist in needs assessment,
planning, implementing, and monitoring social services programs
in the counties;
(e) Design and implement a method of monitoring and
evaluating social services, including site visits that utilize
quality control audits to assure county compliance with
applicable standards, guidelines, and the county and state
social services plans; and
(f) Annually publish a report on community social services
which shall reflect the contents of the individual county
reports. The report shall be submitted to the governor and the
legislature with an evaluation of community social services and
recommendations for changes needed to fully implement state
social service policies; and
(g) Request waivers from federal programs as necessary to
implement sections 256E.01 to 256E.12.
Sec. 128. Minnesota Statutes 1988, section 256E.08,
subdivision 5, is amended to read:
Subd. 5. [COMMUNITY SOCIAL SERVICES FUND.] In the accounts
and records of each county there shall be created a community
social services fund. All moneys provided for community social
services programs under sections 256E.06 and 256E.07 and all
other revenues,; fees,; grants-in-aid, including those from
public assistance programs identified in section 256E.03,
subdivision 2, paragraph (b), that pay for services such as
child care, waivered services under the medical assistance
programs, alternative care grants, and other services funded by
these programs through federal or state waivers; gifts,; or
bequests designated for community social services purposes shall
be identified in the record of the fund and in the report
required in subdivision 8. This fund shall be used exclusively
for planning and delivery of community social services as
defined in section 256E.03, subdivision 2. If county boards
have joined for purposes of administering community social
services, the county boards may create a joint community social
services fund. If a human service board has been established,
the human service board shall account for community social
services money as required in chapter 402.
Sec. 129. Minnesota Statutes 1988, section 256E.09,
subdivision 1, is amended to read:
Subdivision 1. [PLAN PROPOSAL.] In 1988, the county board
shall publish a one-year update to its 1987-1988 biennial plan
for calendar year 1989, and make it available upon request to
all residents of the county. Beginning in 1989, and every two
years after that, the county board shall publish and make
available upon request to all county residents a proposed
biennial community social services plan for the next two
calendar years.
Sec. 130. Minnesota Statutes 1988, section 256E.09,
subdivision 3, is amended to read:
Subd. 3. [PLAN CONTENT.] The biennial community social
services plan published by the county shall include:
(a) A statement of the goals of community social service
programs in the county;
(b) Methods used pursuant to subdivision 2 to encourage
participation of citizens and providers in the development of
the plan and the allocation of money;
(c) Methods used to identify persons in need of service and
the social problems to be addressed by the community social
service programs, including efforts the county proposes to make
in providing for early intervention, prevention and education
aimed at minimizing or eliminating the need for services for
groups of persons identified in section 256E.03, subdivision 2;
(d) A statement describing how the county will fulfill its
responsibilities identified in section 256E.08, subdivision 1,
to the groups of persons described in section 256E.03,
subdivision 2, and a description of each community social
service proposed and identification of the agency or person
proposed to provide the service;
(e) A statement describing how the county proposes to make
the following services available for persons identified by the
county as in need of services: daytime developmental
achievement services for children,; day training and
habilitation services for adults,; extended employment program
services for persons with disabilities,; supported employment
services as defined in section 252.41, subdivision 8;
community-based employment programs as defined in section
129A.01, subdivision 12; subacute detoxification services,; and
residential services and nonresidential social support services
as appropriate for the groups identified in section 256E.03,
subdivision 2;
(f) A statement specifying how the county will
collaboratively plan the development of supported employment
services and community-based employment services with local
representatives of public rehabilitation agencies and local
education agencies, including, if necessary, how existing day or
employment services could be modified to provide supported
employment services and community-based employment services;
(g) A statement describing how the county is fulfilling its
responsibility to establish a comprehensive and coordinated
system of early intervention services as required under section
120.17, subdivisions 11a, 12, and 14;
(g) (h) The amount of money proposed to be allocated to
each service;
(h) (i) An inventory of public and private resources
including associations of volunteers which are available to the
county for social services;
(i) (j) Evidence that serious consideration was given to
the purchase of services from private and public agencies; and
(j) (k) Methods whereby community social service programs
will be monitored and evaluated by the county.
Sec. 131. [256E.115] [SAFE HOUSES.]
The commissioner shall have authority to make grants for
pilot programs when the legislature authorizes money to
encourage innovation in the development of safe house programs
to respond to the needs of homeless youth.
Sec. 132. Minnesota Statutes 1988, section 256F.05,
subdivision 2, is amended to read:
Subd. 2. [ADDITIONAL MONEY AVAILABLE.] Additional Money
appropriated for family-based services permanency planning
grants to counties, together with an amount as determined by the
commissioner of title IV-B funds distributed to Minnesota
according to the Social Security Act, United States Code, title
42, section 621, must be distributed to counties according to
the formula in subdivision 3.
Sec. 133. Minnesota Statutes 1988, section 256F.05,
subdivision 4, is amended to read:
Subd. 4. [PAYMENTS.] The commissioner shall make grant
payments to each county whose biennial community social services
plan includes a permanency plan under section 256F.04,
subdivision 2. The payment must be made in four installments
per year. The commissioner may certify the payments for the
first three months of a calendar year. Subsequent payments must
be made on April 1 30, July 1 30, and October 1 30, of each
calendar year. When an amount of title IV-B funds as determined
by the commissioner is made available, it shall be reimbursed to
counties on October 30.
Sec. 134. [256F.08] [GRANTS FOR PLACEMENT PREVENTION AND
FAMILY REUNIFICATION; AMERICAN INDIAN AND MINORITY CHILDREN.]
Subdivision 1. [GRANT PROGRAM.] Within the limits of funds
appropriated for this purpose, the commissioner shall establish
a specialized grants program for placement prevention and family
reunification for American Indian and minority children.
Subd. 2. [REQUEST FOR PROPOSALS.] The commissioner shall
request proposals for the development and provision of services
listed in 256F.07, subdivisions 3 and 3a.
Subd. 3. [GRANT APPLICATIONS.] Local social services
agencies may apply for American Indian and minority children
placement prevention and family reunification grants.
Application may be made alone or in combination with neighboring
local social services agencies.
Subd. 4. [FORMS AND INSTRUCTIONS.] The commissioner shall
provide necessary forms and instructions to the counties to
apply for an American Indian and minority child placement
prevention and family reunification grant.
Subd. 5. [MONITORING.] The commissioner shall design and
implement methods for monitoring, delivering, and evaluating the
effectiveness of placement prevention and family reunification
services for American Indian and minority children.
Sec. 135. Minnesota Statutes 1988, section 256H.01,
subdivision 1, is amended to read:
Subdivision 1. [SCOPE.] For the purposes of sections
256H.01 to 265H.19 256H.19, the following terms have the
meanings given.
Sec. 136. Minnesota Statutes 1988, section 256H.01,
subdivision 2, is amended to read:
Subd. 2. [CHILD CARE SERVICES.] "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, and
extended day school age child care programs or in or out of the
child's home.
Sec. 137. Minnesota Statutes 1988, section 256H.01,
subdivision 7, is amended to read:
Subd. 7. [EDUCATION PROGRAM.] "Education program" means
remedial or basic education or English as a second language
instruction, high school education, a program leading to a
general equivalency or high school diploma, and post-secondary
education excluding post-baccalaureate programs and other
education and training needs as documented in an employability
plan that is developed by an employment and training service
provider certified by the commissioner of jobs and training or
an individual designated by the county to provide employment and
training services. The employability plan must outline
education and training needs of a recipient, meet state
requirements for employability plans, and meet the requirements
of other programs that provide federal reimbursement for child
care services. The county must incorporate into a recipient's
employability plan an educational plan developed by a
post-secondary institution for a nonpriority AFDC recipient who
is enrolled or planning to enroll at that institution.
Sec. 138. Minnesota Statutes 1988, section 256H.01,
subdivision 8, is amended to read:
Subd. 8. [EMPLOYMENT PROGRAM.] "Employment program" means
employment of recipients financially eligible for the child care
sliding fee program, vocational assessment, and job readiness
and job search activities. assistance, preemployment activities,
or other activities approved in an employability plan that is
developed by an employment and training service provider
certified by the commissioner of jobs and training or an
individual designated by the county to provide employment and
training services. The plans must meet the requirements of
other programs that provide federal reimbursement for child care
services.
Sec. 139. Minnesota Statutes 1988, section 256H.01,
subdivision 11, is amended to read:
Subd. 11. [INCOME.] "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, work study income, and grants that cover costs for
tuition, fees, books, and educational supplies; student loans
for tuition, fees, books, supplies, and living expenses; earned
income tax credits; 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.
Sec. 140. Minnesota Statutes 1988, section 256H.01,
subdivision 12, is amended to read:
Subd. 12. [PROVIDER.] "Provider" means the a 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, an extended day
school age child care program; a person exempt from licensure
who meets child care standards established by the state board of
education; or who functions in the child's home a legal
nonlicensed caregiver who is at least 18 years of age.
Sec. 141. Minnesota Statutes 1988, section 256H.02, is
amended to read:
256H.02 [DUTIES OF COMMISSIONER.]
The commissioner shall develop standards for county and
human services boards, and post-secondary educational systems ,
to provide child care services to enable eligible families to
participate in employment, training, or education programs.
Within the limits of available appropriations, the commissioner
shall distribute money to counties to reduce the costs of child
care for eligible families. The commissioner shall adopt rules
to govern the program in accordance with this section. The
rules must establish a sliding schedule of fees for parents
receiving child care services. The commissioner shall maximize
the use of federal money under the AFDC employment special needs
program in section 256.736, subdivision 8, and other programs
that provide federal reimbursement for child care services for
recipients of aid to families with dependent children who are in
education, training, job search, or other activities allowed
under that program those programs. Money appropriated under
this section must be coordinated with the AFDC employment
special needs program and other programs that provide federal
reimbursement for child care services to accomplish this
purpose. Federal reimbursement obtained must be allocated to
the county that spent money for child care that is federally
reimbursable under the AFDC employment special needs program or
other programs that provide federal reimbursement for child care
services. The counties shall use the federal money to expand
services to AFDC recipients under this section.
Sec. 142. Minnesota Statutes 1988, section 256H.03, is
amended to read:
256H.03 [ALLOCATION OF FUNDS BASIC SLIDING FEE PROGRAM.]
Subdivision 1. [COUNTIES; NOTICE OF ALLOCATION; REPORT.]
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. When the commissioner
notifies county and human service boards of the forms and
instructions they are to follow in the development of their
biennial community social services plans required under section
256E.08, the commissioner shall also notify county and human
services boards of their estimated child care fund program
allocation for the two years covered by the plan. By June 1 of
each year, the commissioner shall notify all counties of their
final child care fund program allocation.
Subd. 1a. [WAITING LIST.] Each county that receives funds
under this section and section 256H.05 must keep a written
record and report to the commissioner the number of eligible
families who have applied for a child care subsidy or have
requested child care assistance. 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. The waiting list must identify students
in need of child care. When money is available counties shall
expedite the processing of student applications during key
enrollment periods.
Subd. 2. [ALLOCATION; LIMITATIONS.] Except for set-aside
money allocated under sections 256H.04, 256H.05, 256H.06, and
256H.07, the commissioner shall allocate money appropriated The
commissioner shall allocate 66 percent of the money appropriated
under the child care fund for the basic sliding fee program and
shall allocate those funds 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. as follows:
(1) 50 percent of the money shall be allocated among the
counties on the basis of the number of families below the
poverty level, as determined from the most recent census or
special census; and
(2) 50 percent of the money shall be allocated among the
counties on the basis of the counties' portion of the AFDC
caseload for the preceding state fiscal year .
If under the preceding formula, either the seven-county
metropolitan area consisting of Anoka, Carver, Dakota, Hennepin,
Ramsey, Scott, and Washington counties or the area consisting of
counties outside the seven-county metropolitan area is allocated
more than 55 percent of the basic sliding fee funds, each
county's allocation in that area shall be proportionally reduced
until the total for the area is no more than 55 percent of the
basic sliding fee funds. The amount of the allocations
proportionally reduced shall be used to proportionally increase
each county's allocation in the other area.
Subd. 2a. [ELIGIBLE RECIPIENTS.] Families that meet the
eligibility requirements under sections 256H.10 and 256H.11 are
eligible for child care assistance under the basic sliding fee
program. Counties shall make vendor payments to the child care
provider or pay the parent directly for eligible child care
expenses on a reimbursement basis.
Subd. 2b. [FUNDING PRIORITY.] (a) First priority for child
care assistance under the basic sliding fee program must be
given to eligible recipients who do not have a high school or
general equivalency diploma or who need remedial and basic skill
courses in order to pursue employment or to pursue education
leading to employment. Priority for child care assistance under
the basic sliding fee program must be given to non-AFDC families
for this first priority unless a county can demonstrate that
funds available in the AFDC child care program allocation are
inadequate to serve all AFDC families needing child care
services. Within this priority, the following subpriorities
must be used:
(1) child care needs of minor parents;
(2) child care needs of parents under 21 years of age; and
(3) child care needs of other parents within the priority
group described in this paragraph.
(b) Second priority must be given to all other parents who
are eligible for the basic sliding fee program.
Subd. 3. [REVIEW OF USE OF FUNDS; REALLOCATION.] Once
After each quarter, the commissioner shall review the use
of child care fund basic sliding fee program and AFDC child care
program allocations by county. The commissioner may reallocate
unexpended or unencumbered money among those counties who have
expended their full portion allocation. Any unexpended money
from the first year of the biennium may be carried forward to
the second year of the biennium.
Sec. 143. Minnesota Statutes 1988, section 256H.05, is
amended to read:
256H.05 [SET-ASIDE MONEY FOR AFDC PRIORITY GROUPS AFDC
CHILD CARE PROGRAM.]
Subdivision 1. [ALLOCATIONS; USE NOTICE OF ALLOCATION.]
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. By
June 1 of each year, the commissioner shall notify all county
and human services boards of their allocation under the AFDC
child care fund program.
Subd. 1a. [COUNTY ALLOCATION; LIMITATIONS.] The
commissioner shall allocate 34 percent of the money appropriated
under the child care fund for the AFDC child care program and
shall allocate those funds among the counties as follows:
(1) 50 percent of the funds shall be allocated to the
counties based on the average number of AFDC caretakers less
than 21 years of age and the average number of AFDC cases which
were open 24 or more consecutive months during the preceding
fiscal year; and
(2) 50 percent of the funds shall be allocated to the
counties based on the average number of AFDC recipients for the
preceding state fiscal year. For each fiscal year the average
monthly caseload AFDC caseloads shall be based on counts taken
at three-month intervals during the 12-month period ending March
31 December 31 of the previous state 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.
Subd. 1b. [ELIGIBLE RECIPIENTS.] Families eligible for
child care assistance under the AFDC child care program are
families receiving AFDC and former AFDC recipients who, during
their first year of employment, continue to require a child care
subsidy in order to retain employment. The commissioner shall
designate between 20 to 60 percent of the AFDC child care
program as the minimum to be reserved for AFDC recipients in an
educational program. If a family meets the eligibility
requirements of the AFDC child care program and the caregiver
has an approved employability plan that meets the requirements
of appropriate federal reimbursement programs, that family is
eligible for child care assistance.
Subd. 1c. [FUNDING PRIORITY.] Priority for child care
assistance under the AFDC child care program shall be given to
AFDC priority groups who are engaged in an employment or
education program consistent with their employability plan. If
the AFDC recipient is employed, the AFDC child care disregard
shall be applied before the remaining child care costs are
subsidized by the AFDC child care program. AFDC recipients
leaving AFDC due to their earned income, who have been on AFDC
three out of the last six months and who apply for child care
assistance under subdivision 1b within the first year after
leaving AFDC, shall be entitled to one year of child care
subsidies during the first year of employment. AFDC recipients
must be put on a waiting list for the basic sliding fee program
when they leave AFDC due to their earned income.
Subd. 2. [COOPERATION WITH OTHER PROGRAMS.] 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 all AFDC
recipients. 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.
Subd. 3. [CONTRACTS; OTHER USES ALLOWED.] 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.
Subd. 3a. [AFDC CHILD CARE PROGRAM REALLOCATION.] The
commissioner shall review the use of child care funds allocated
under this section after every quarter. Priority for use of
this money shall continue to be given to the AFDC priority
groups.
The commissioner may reallocate to other counties AFDC
child care program funds which a county has failed to encumber
or expend according to the following procedure:
(a) Unexpended or unencumbered funds reserved for
recipients in educational programs may be reallocated to
counties that have expended their funds for recipients in
educational programs.
(b) If any funds reserved for recipients in educational
programs remain after this reallocation, or any funds remain
unencumbered or unexpended from the entire AFDC child care
program, the funds may be reallocated to counties that have
expended their full allocation for the AFDC child care program.
(c) If any AFDC child care program funds remain after this
reallocation, they may be reallocated to counties who have
expended their full allocation for the basic sliding fee program.
Subd. 4. [USE OF FUNDS FOR OTHER APPLICANTS.] 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.
Subd. 5. [FEDERAL REIMBURSEMENT.] A county may claim
Counties shall maximize their federal reimbursement under the
AFDC special needs program or other federal reimbursement
programs for money spent for persons listed in this section
256H.04, subdivision 1, clause (1) and section 256H.03. The
commissioner shall allocate any federal earnings to the county.
The county shall use the money to be used to expand child care
sliding fee services under this subdivision these sections.
Sec. 144. Minnesota Statutes 1988, section 256H.07,
subdivision 1, is amended to read:
Subdivision 1. [ALLOCATION; USE.] Each post-secondary
educational system shall be allocated a portion of the set-aside
money for persons listed in section 256H.04, subdivision 1,
clause (3), based on the number of students with dependent
children enrolled in each system in the preceding fiscal year.
The post-secondary educational systems shall allocate their
money among institutions under their authority based on the
number of students with dependent children enrolled in each
institution in the last fiscal year. For the purposes of this
subdivision, "students with dependent children" means the sum of
all Minnesota residents enrolled in public post-secondary
institutions who report dependents on their applications to the
state scholarship and grant program. The commissioner shall
transfer the allocation for each post-secondary institution to
the county board of the county in which the institution is
located, to be held in an account for students found eligible
for child care sliding fee assistance and attending the
institution. The higher education coordinating board will
administer the non-AFDC post-secondary child care program
utilizing the sliding fee scale developed by the department of
human services. The board will determine eligibility for the
child care subsidy based on family income and family size. For
purposes of this determination, "income" means the income amount
used to calculate eligibility for state scholarships and grants
under section 136A.121. "Family size" means the family size
used to calculate eligibility for state scholarships and grants
under section 136A.121.
Students receiving subsidies shall:
(1) choose providers utilizing a licensed or legal
unlicensed provider that meets the needs of their family;
(2) continue to receive a subsidy as long as they are
eligible, to the limit of the allocation; and
(3) receive a subsidy to cover all eligible hours of
education and employment.
The higher education coordinating board shall consult with
the commissioner to ensure a program comparable to the child
care subsidy program administered by the commissioner.
Sec. 145. Minnesota Statutes 1988, section 256H.08, is
amended to read:
256H.08 [USE OF MONEY.]
Money for persons listed in section 256H.04, subdivision 1,
clauses (2) and (3) sections 256H.03, subdivision 2a, and
256H.05, subdivision 1b, 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
provide child care assistance to persons listed in section
256H.04, subdivision 1, clauses (2) and (3), from the regular
sliding fee fund to supplement the set-aside funds. Counties
may not limit the duration of child care subsidies for a person
in an employment or educational program, except when the person
is found to be ineligible under the child care fund eligibility
standards. Any limitation must be based on a person's
employability plan in the case of an AFDC recipient, and county
policies included in the child care allocation plan.
Financially eligible students who have received child care
assistance for one academic year shall be provided child care
assistance in the following academic year if funds allocated
under section 256H.06 or 256H.07 are available sections 256H.03
and 256H.05. If a student who is receiving AFDC child care
assistance under this chapter moves to another county as
specified in their employability plan, continues to be enrolled
in a post-secondary institution, and continues to be eligible
for AFDC child care assistance under this chapter, the student
must receive continued child care assistance from their county
of origin without interruption to the limit of the county's
allocation.
Sec. 146. Minnesota Statutes 1988, section 256H.09, is
amended to read:
256H.09 [REPORTING AND PAYMENTS.]
Subdivision 1. [QUARTERLY REPORTS.] Counties and
post-secondary educational systems shall submit on forms
prescribed by the commissioner a quarterly financial and program
activity report which is due 20 calendar days after the end of
each quarter. The failure to submit a complete report by the
end of the quarter in which the report is due may result in a
reduction of child care fund allocations equal to the next
quarter's allocation. The financial and program activity report
must include:
(1) a detailed accounting of the expenditures and revenues
for the program during the preceding quarter by funding source
and by eligibility group;
(2) a description of activities and concomitant
expenditures that are federally reimbursable under the AFDC
employment special needs program and other federal reimbursement
programs;
(3) a description of activities and concomitant
expenditures of set-aside child care money;
(4) information on money encumbered at the quarter's end
but not yet reimbursable, for use in adjusting allocations as
provided in section sections 256H.03, subdivision 3, and
256H.05, subdivision 4 1a; 256H.06, subdivision 3; and 256H.07,
subdivision 3; and
(5) other data the commissioner considers necessary to
account for the program or to evaluate its effectiveness in
preventing and reducing participants' dependence on public
assistance and in providing other benefits, including
improvement in the care provided to children.
Subd. 2. [QUARTERLY PAYMENTS.] The commissioner shall make
payments to each county in quarterly installments. The
commissioner may certify an advance for the first quarter of the
fiscal year. Later payments must be based on actual
expenditures as reported in the quarterly financial and program
activity report. The commissioner may make payments to each
county in quarterly installments. The commissioner may certify
an advance up to 25 percent of the allocation. Subsequent
payments shall be made on a reimbursement basis for reported
expenditures, and may be adjusted for anticipated spending
patterns. Payments may be withheld if quarterly reports are
incomplete or untimely.
Subd. 3. [CHILD CARE FUND PLAN.] Effective January 1,
1992, the county will include the plan required under this
subdivision in its biennial community social services plan
required in this section, for the group described in section
256E.03, subdivision 2, paragraph (h). For the period July 1,
1989, to December 31, 1991, the county shall submit separate
child care fund plans required under this subdivision for the
periods July 1, 1989, to June 30, 1990; and July 1, 1990, to
December 31, 1991. The commissioner shall establish the dates
by which the county must submit these plans. The county and
designated administering agency shall submit to the commissioner
an annual child care fund allocation plan. The plan shall
include:
(1) a narrative of the total program for child care
services, including all policies and procedures that affect
eligible families and are used to administer the child care
funds;
(2) the number of families that requested a child care
subsidy in the previous year, the number of families receiving
child care assistance, the number of families on a waiting list,
and the number of families projected to be served during the
fiscal year;
(3) the methods used by the county to inform eligible
groups of the availability of child care assistance and related
services;
(4) the provider rates paid for all children by provider
type;
(5) the county prioritization policy for all eligible
groups under the basic sliding fee program and AFDC child care
program;
(6) a report of all funds available to be used for child
care assistance, including demonstration of compliance with the
maintenance of funding effort required under section 256H.12;
and
(7) other information as requested by the department to
insure compliance with the child care fund statutes and rules
promulgated by the commissioner.
The commissioner shall notify counties within 60 days of
the date the plan is submitted whether the plan is approved or
the corrections or information needed to approve the plan. The
commissioner shall withhold a county's allocation until it has
an approved plan. Plans not approved by the end of the second
quarter after the plan is due may result in a 25 percent
reduction in allocation. Plans not approved by the end of the
third quarter after the plan is due may result in a 100 percent
reduction in the allocation to the county. Counties are to
maintain services despite any reduction in their allocation due
to plans not being approved.
Subd. 4. [TERMINATION OF ALLOCATION.] The commissioner may
withhold, reduce, or terminate the allocation of any county or
post-secondary educational system that does not meet the
reporting or other requirements of this program. The
commissioner shall reallocate to other counties or
post-secondary educational systems money so reduced or
terminated.
Sec. 147. Minnesota Statutes 1988, section 256H.10,
subdivision 3, is amended to read:
Subd. 3. [PRIORITIES; ALLOCATIONS.] If a disproportionate
amount more than 75 percent of the available money is provided
to any one of the groups described in subdivision 1 section
256H.03 or 256H.05, the county board shall document to the
commissioner the reason the group received a disproportionate
share unless approved in the plan. 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 that
remain to be served after the county has complied with the
priority requirements of sections 256H.03 and 256H.05. 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. Counties that have established a priority must
submit the policy in the annual allocation plan.
Sec. 148. Minnesota Statutes 1988, section 256H.10, is
amended by adding a subdivision to read:
Subd. 5. [PROVIDER CHOICE.] Parents may choose child care
providers as defined under section 256H.01, subdivision 12, that
best meet the needs of their family. Counties shall make
resources available to parents in choosing quality child care
services. Counties may require a parent to sign a release
stating their knowledge and responsibilities in choosing a legal
provider described under section 256H.01, subdivision 12. When
a county knows that a particular provider is unsafe, or that the
circumstances of the child care arrangement chosen by the parent
are unsafe, the county may deny a child care subsidy. A county
may not restrict access to a general category of provider
allowed under section 256H.01, subdivision 12.
Sec. 149. Minnesota Statutes 1988, section 256H.11, is
amended to read:
256H.11 [EMPLOYMENT OR TRAINING ELIGIBILITY.]
Subdivision 1. [ASSISTANCE FOR PERSONS SEEKING AND
RETAINING EMPLOYMENT.] Persons who are seeking employment and
who are eligible for assistance under this section are eligible
to receive the equivalent of one month of child care. Employed
persons who work at least ten hours a week and receive at least
a minimum wage for all hours worked are eligible for continued
child care assistance.
Subd. 2. [FINANCIAL ELIGIBILITY REQUIRED.] Persons
participating in employment programs, training programs, or
education programs are eligible for continued assistance from
the child care sliding fee program fund, if they are financially
eligible under the sliding fee scale set by the commissioner in
section 256H.14. Counties shall assure that a person receiving
child care assistance from the sliding fee program while
attending a post-secondary institution prior to July 1, 1987,
continues to receive assistance from the regular sliding fee
program, or the set-asides in section 256H.06 or 256H.07,
providing the person meets all other eligibility criteria.
Sec. 150. Minnesota Statutes 1988, section 256H.12, is
amended to read:
256H.12 [COUNTY CONTRIBUTION.]
Subdivision 1. [COUNTY CONTRIBUTIONS REQUIRED.] In
addition to payments from parents, the program must be funded by
county contributions. Except for set-aside money, counties
shall contribute from county tax or other sources a minimum of
15 percent of the cost of the basic sliding fee program. The
commissioner shall recover funds from the county as necessary to
bring county expenditures into compliance with this subdivision.
Subd. 2. [FEDERAL MONEY; STATE RECOVERY.] The commissioner
shall recover from counties any state or federal money that was
spent for persons found to be ineligible. If a federal audit
exception is taken based on a percentage of federal earnings,
all counties shall pay a share proportional to their respective
federal earnings during the period in question.
Subd. 3. [OTHER SOURCES MUST BE MAINTAINED MAINTENANCE OF
FUNDING EFFORT.] To receive money through this program, each
county shall certify, in its annual plan to the commissioner,
that the county has not reduced allocations from other federal,
state, and county sources, which, in the absence of the child
care sliding fee or wage subsidy money fund, would have been
available for child care services assistance.
Sec. 151. Minnesota Statutes 1988, section 256H.15, is
amended to read:
256H.15 [CHILD CARE RATES.]
Subdivision 1. [SUBSIDY RESTRICTIONS.] The county board
may limit the subsidy allowed by setting a maximum on the
provider child care rate that the county shall subsidize.
The maximum rate set by any county shall not be lower than 110
percent or higher than 125 percent of the median rate in that
county for like care arrangements in that county for all types
of care, including special needs and handicapped care, as
determined by the commissioner. If the county sets a maximum
rate, it must pay the provider's rate for each child receiving a
subsidy, up to the maximum rate set by the county. In order to
be reimbursed for more than 110 percent of the median rate, a
provider with employees must pay wages for teachers, assistants,
and aides that are more than 110 percent of the county average
rate for child care workers. If a county does not set a maximum
provider rate, it shall pay the provider's rate for every child
in care. The maximum state payment is 125 percent of the median
provider rate. If the county has not set a maximum provider
rate and the provider rate is greater than 125 percent of the
median provider rate in the county, the county shall pay the
amount in excess of 125 percent of the median provider rate from
county funding sources. When the provider charge is greater
than the maximum provider rate set by the county, the parent is
responsible for payment of the difference in the rates in
addition to any family copayment fee.
Subd. 2. [PROVIDER RATE BONUS FOR ACCREDITATION.]
Currently accredited child care centers shall be paid a five
percent bonus above the maximum rate established by the county
in subdivision 1, if the center can demonstrate that its staff
wages are greater than 110 percent of the average wages in the
county for similar care, up to the actual provider rate. A
family day care provider shall be paid a five percent bonus
above the maximum rate established by the county in subdivision
1, if the provider holds a current child development associate
certificate, up to the actual provider rate. A county is not
required to review wages under this subdivision unless the
county has set a maximum above 110 percent for all providers
with employees in their county.
Subd. 3. [PROVIDER RATE FOR CARE OF CHILDREN WITH
HANDICAPS OR SPECIAL NEEDS.] Counties shall reimburse providers
for the care of children with handicaps or special needs, at a
special rate to be set by the county for care of these children,
subject to the approval of the commissioner.
Sec. 152. Minnesota Statutes 1988, section 256H.18, is
amended to read:
256H.18 [ADMINISTRATIVE EXPENSES.]
A county must may not use more than seven percent of its
allocation for its administrative expenses under this section,
except a county may not use any of its allocation of the
set-aside funds under subdivisions 3b and 3c for administrative
expenses the basic sliding fee program. A county may use up to
four percent of the funds transferred to it under subdivision 3d
for administrative expenses.
Sec. 153. Minnesota Statutes 1988, section 256H.20,
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.
Subd. 3a. [GRANT REQUIREMENTS AND PRIORITY.] Priority for
awarding resource and referral grants shall be given in the
following order:
(1) start up resource and referral programs in areas of the
state where they do not exist; and
(2) improve resource and referral programs.
Resource and referral programs shall meet the following
requirements:
(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, special
needs services, and transportation available to the program.
The file may also include program information and special needs
services program features.
(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 shall 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 make 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) On or after one year of operation a program may shall
provide technical assistance to employers and 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;
(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. 154. [256H.21] [CHILD CARE SERVICES GRANT
DEFINITIONS.]
Subdivision 1. [DEFINITIONS.] As used in sections 256H.20
to 256H.23, the words defined in this section shall have the
meanings given them.
Subd. 2. [CHILD.] "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.
Subd. 3. [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. 4. [CHILD CARE SERVICES.] "Child care services"
means child care provided in family day care homes, group day
care homes, nursery schools, day nurseries, child day care
centers, head start, and extended day school age child care
programs.
Subd. 5. [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, a person who has applied for a license as a provider,
or a person who meets the standards established by the state
board of education.
Subd. 6. [COMMISSIONER.] "Commissioner" means the
commissioner of human services.
Subd. 7. [FACILITY IMPROVEMENT EXPENSES.] "Facility
improvement expenses" means funds for building improvements,
equipment, toys, and supplies needed to establish, expand, or
improve a licensed child care facility or a child care program
under the jurisdiction of the state board of education.
Subd. 8. [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 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 after a
family day care home, group family day care home, or child care
center becomes licensed or satisfies standards of the state
board of education. Interim financing may not exceed a period
of 18 months.
Subd. 9. [MINI-GRANTS.] "Mini-grants" means child care
grants for facility improvements that are less than $1,000.
Mini-grants include, but are not limited to, improvements to
meet licensing requirements, improvements to expand a child care
facility or program, toys and equipment, start-up costs, staff
training, and development costs.
Subd. 10. [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. 11. [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. 12. [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 meet licensing requirements or
requirements of the state board of education.
Sec. 155. [256H.22] [CHILD CARE SERVICES GRANTS.]
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. Child care
services grants may include mini-grants up to $1,000. 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.
The commissioner may renew grants to existing resource and
referral agencies that have met state standards and have been
designated as the child care resource and referral service for a
particular geographical area. The recipients of renewal grants
are exempt from the proposal review process.
Subd. 2. [DISTRIBUTION OF FUNDS.] (a) The commissioner
shall allocate grant money appropriated for child care service
(development and resource and referral services) among the
development regions designated by the governor under section
462.385, as follows:
(1) 50 percent of the child care service development grant
appropriation shall be allocated to the metropolitan area; and
(2) 50 percent of the child care service development grant
appropriation shall be allocated to greater Minnesota counties.
(b) The following formulas shall be used to allocate grant
appropriations among the counties:
(1) 50 percent of the funds shall be allocated in
proportion to the ratio of children under 12 years of age in
each county to the total number of children under 12 years of
age in all counties; and
(2) 50 percent of the funds shall be allocated in
proportion to the ratio of children under 12 years of age in
each county to the number of licensed child care spaces
currently available in each county.
(c) Out of the amount allocated for each development region
and county, the commissioner shall award grants based on the
recommendation of the grant review advisory task force. In
addition, the commissioner shall 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. The commissioner shall
award no more than 50 percent of the money for resource and
referral services to maintain or improve an existing resource
and referral until all regions are served by resource and
referral programs.
(d) Any funds unobligated may be used by the commissioner
to award grants to proposals that received funding
recommendations by the advisory task force but were not awarded
due to insufficient funds.
Subd. 3. [CHILD CARE REGIONAL ADVISORY COMMITTEES.] Child
care regional advisory committees shall review and make
recommendations to the commissioner on applications for service
development grants under this section. The commissioner shall
appoint the child care regional advisory committees in each
governor's economic development regions. People appointed under
this subdivision must represent the following constituent
groups: family child care providers, group center providers,
parent users, health services, social services, public schools,
and other citizens with demonstrated interest in child care
issues. Members of the advisory task force with a direct
financial interest in a pending grant proposal may not provide a
recommendation or participate in the ranking of that grant
proposal. Committee members may be reimbursed for their actual
travel expenses for up to six committee meetings per year. The
child care regional advisory committees shall complete their
reviews and forward their recommendations to the commissioner by
the date specified by the commissioner.
Subd. 4. [PURPOSES FOR WHICH A CHILD CARE SERVICES GRANT
MAY BE AWARDED.] The commissioner may award grants for any of
the following purposes:
(1) for creating new licensed day care facilities and
expanding existing facilities, including, but not limited to,
supplies, equipment, facility renovation, and remodeling;
(2) 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, priority must be
given to child care workers caring for infants, toddlers, sick
children, children in low-income families, and children with
special needs;
(3) for supportive child development services including,
but not limited to, in-service training, curriculum development,
consulting specialist, resource centers, and program and
resource materials;
(4) for carrying out programs including, but not limited
to, staff, supplies, equipment, facility renovation, and
training;
(5) for interim financing; and
(6) for carrying out the resource and referral program
services identified in section 256H.20, subdivision 3.
Subd. 5. [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 rank and give priority to:
(1) new programs or projects, or the expansion or
improvement of existing 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;
(2) new programs and projects, or the expansions or
enrichment of existing programs or projects that serve sick
children, infants or toddlers, children with special needs, and
children from low-income families;
(3) unlicensed providers who wish to become licensed; and
(4) improvement of existing programs.
Subd. 6. [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, toddlers, 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 programs seeking accreditation and child
care providers seeking certification; and
(5) entities that will use grant money for scholarships for
child care workers attending educational or training programs
sponsored by the entity.
Subd. 7. [ELIGIBLE GRANT RECIPIENTS.] Eligible recipients
of child care grants are licensed providers of child care, or
those in the process of being licensed, resource and referral
programs, or corporations or public agencies, or any combination
thereof. With the exception of mini-grants, priority for child
care grants shall be given to grant applicants as follows:
(1) public and private nonprofit agencies;
(2) employer-based child care centers;
(3) for-profit child care centers; and
(4) family day care providers.
Subd. 8. [GRANT MATCH REQUIREMENTS.] Child care grants for
facility improvements, interim financing, resource and referral,
and staff training and development require a 25 percent local
match by the grant applicant. A local match is not required for
a mini-grant.
Subd. 9. [CHILD CARE MINI-GRANTS.] Mini-grants for child
care service development must be used by the grantee for
facility improvements, including, but not limited to,
improvements to meet licensing requirements, improvements to
expand the facility, toys and equipment, start-up costs, interim
financing, or staff training and development. Priority for
child care mini-grants shall be given to grant applicants as
follows:
(1) family day care providers;
(2) public and private nonprofit agencies;
(3) employer-based child care centers; and
(4) for-profit child care centers.
Subd. 10. [ADVISORY TASK FORCE.] The commissioner shall
convene a statewide advisory task force which shall advise the
commissioner on grants and other child care issues. The
statewide advisory task force shall review and make
recommendations to the commissioner on child care resource and
referral grants and on statewide child care training grants.
Members of the advisory task force with a direct financial
interest in a resource and referral or a statewide training
proposal may not provide a recommendation or participate in the
ranking of that grant proposal. Each regional grant review
committee formed under subdivision 3, shall appoint a
representative to the advisory task force. The commissioner may
convene meetings of the task force as needed. Terms of office
and removal from office are governed by the appointing body.
The commissioner may compensate members for their expenses of
travel to meetings of the task force. The members of the child
care advisory task force shall also meet once with the
interagency advisory committee on child care under section
256H.25.
Subd. 11. [ADVISORY COMMITTEE COSTS.] The commissioner may
use money appropriated for services under this section for
administrative expenses associated with advisory committees and
task forces authorized by this section.
Sec. 156. [256H.23] [OTHER AUTHORIZATION TO MAKE GRANTS.]
Subdivision 1. [AUTHORITY.] In addition to the
commissioner's authority to make child care services grants, the
county board is authorized to provide child care services, or 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. The
county board is also authorized to contract for services with
any licensed day care facility, as the board deems necessary or
proper to carry out the purposes of this section.
The county board may also make grants to or contract with
any municipality, licensed child care facility, or resource and
referral program, or corporation or combination thereof, for any
of the following purposes:
(1) creating new licensed day care facilities and expanding
existing facilities including, but not limited to, supplies,
equipment, and facility renovation and remodeling;
(2) 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;
(3) supportive child development services, including, but
not limited to, in-service training, curriculum development,
consulting specialists, resource centers, and program and
resource materials;
(4) carrying out programs, including, but not limited to,
staff, supplies, equipment, facility renovation, and training;
(5) interim financing; and
(6) carrying out the resource and referral program services
identified in section 256H.20, subdivision 3.
Subd. 2. [DONATED MATERIALS AND SERVICES; MATCHING SHARE
OF COST.] For the purposes of this section, donated professional
and volunteer services, program materials, equipment, supplies,
and facilities may be approved as part of a matching share of
the cost, provided that total costs shall be reduced by the
costs charged to parents if a sliding fee scale has been used.
Subd. 3. [BIENNIAL PLAN.] The county board shall
biennially develop a plan for the distribution of money for
child care services as part of the community social services
plan described in section 256E.09. All licensed child care
programs shall be given written notice concerning the
availability of money and the application process.
Sec. 157. [256H.24] [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, the number of
children in various kinds of child care settings, staff wages,
rate of staff turnover, 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, low-income children, toddlers, and school-age children;
(3) administer the child care fund, including the sliding
fee program authorized under sections 256H.01 to 256H.19;
(4) monitor the child care resource and referral programs
established under section 256H.20; and
(5) encourage child care providers to participate in a
nationally recognized accreditation system for early childhood
programs. The commissioner shall reimburse licensed child care
providers for one-half of the direct cost of accreditation fees,
upon successful completion of accreditation.
Sec. 158. [256H.25] [INTERAGENCY ADVISORY COMMITTEE ON
CHILD CARE.]
Subdivision 1. [MEMBERSHIP.] By January 1, 1990, 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. The committee shall meet at
least once per year with the members of the child care advisory
task force.
Sec. 159. [256H.26] [CHILD CARE INFORMATION SERVICE.]
The commissioner shall establish, on a pilot project basis,
a toll-free information service for child care providers,
potential providers, and parents to assist callers to find
existing child care services at the state or local level and to
facilitate expansion and marketing of child care services. The
telephone must be staffed during regular business hours to
respond promptly to questions and during regular business hours
to respond promptly to questions and concerns. The information
and assistance must be made available free to all callers. The
commissioner shall report to the legislature by January 1, 1991
on the effectiveness of this service and shall recommend how and
by whom the operation should be administered. The commissioner
shall consult with local resource and referral agencies, both
public and private, in making its recommendations. The
commissioner may use money appropriated for child care resource
and referral grants for the administrative costs incurred under
this section.
Sec. 160. Minnesota Statutes 1988, section 257.071,
subdivision 7, is amended to read:
Subd. 7. [RULES.] By December 31, 1988 1989, the
commissioner shall revise Minnesota Rules, parts 9545.0010 to
9545.0269 9545.0260, 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. 161. Minnesota Statutes 1988, section 257.55,
subdivision 1, is amended to read:
Subdivision 1. [PRESUMPTION.] A man is presumed to be the
biological father of a child if:
(a) He and the child's biological mother are or have been
married to each other and the child is born during the marriage,
or within 280 days after the marriage is terminated by death,
annulment, declaration of invalidity, dissolution, or divorce,
or after a decree of legal separation is entered by a court;
(b) Before the child's birth, he and the child's biological
mother have attempted to marry each other by a marriage
solemnized in apparent compliance with law, although the
attempted marriage is or could be declared void, voidable, or
otherwise invalid, and,
(1) if the attempted marriage could be declared invalid
only by a court, the child is born during the attempted
marriage, or within 280 days after its termination by death,
annulment, declaration of invalidity, dissolution or divorce; or
(2) if the attempted marriage is invalid without a court
order, the child is born within 280 days after the termination
of cohabitation;
(c) After the child's birth, he and the child's biological
mother have married, or attempted to marry, each other by a
marriage solemnized in apparent compliance with law, although
the attempted marriage is or could be declared void, voidable,
or otherwise invalid, and,
(1) he has acknowledged his paternity of the child in
writing filed with the state registrar of vital statistics;
(2) with his consent, he is named as the child's father on
the child's birth certificate; or
(3) he is obligated to support the child under a written
voluntary promise or by court order;
(d) While the child is under the age of majority, he
receives the child into his home and openly holds out the child
as his biological child; or
(e) He and the child's biological mother acknowledge his
paternity of the child in a writing signed by both of them under
section 257.34 and filed with the state registrar of vital
statistics. If another man is presumed under this clause to be
the child's father, acknowledgment may be effected only with the
written consent of the presumed father or after the presumption
has been rebutted.
(f) Evidence of statistical probability of paternity based
on blood testing establishes that the likelihood that the man is
the father of the child, calculated with a prior probability of
no more than 0.5 (50 percent), is 99 percent or greater.
Sec. 162. Minnesota Statutes 1988, section 257.57,
subdivision 1, is amended to read:
Subdivision 1. A child, the child's biological mother, or
a man presumed to be the child's father under section 257.55,
subdivision 1, clause (a), (b), or (c) may bring an action:
(a) At any time for the purpose of declaring the existence
of the father and child relationship presumed under section
257.55, subdivision 1, clause (a), (b), or (c); or
(b) Within three years after the child's birth for the
purpose of declaring the nonexistence of the father and child
relationship presumed under section 257.55, subdivision 1,
clause (a), (b), or (c) only if the action is brought within a
reasonable time after the person bringing the action has
obtained knowledge of relevant facts, but in no event later than
three years after the child's birth. However, if the presumed
father was divorced from the child's mother after service by
publication, and, if, on or before the 280th day after the
judgment and decree of divorce or dissolution became final, he
did not know that the child was born during the marriage or
within 280 days after the marriage was terminated, the action is
not barred until one year after the child reaches the age of
majority. After the presumption has been rebutted, paternity of
the child by another man may be determined in the same action,
if he has been made a party.
Sec. 163. Minnesota Statutes 1988, section 257.62,
subdivision 5, is amended to read:
Subd. 5. [POSITIVE TEST RESULTS.] (a) If the results of
the blood tests completed in a laboratory accredited by the
American Association of Blood Banks indicate that the likelihood
of the alleged father's paternity, calculated with a prior
probability of no more than 0.5 (50 percent), is more than 92
percent or greater, upon motion the court shall order the
alleged father to pay temporary child support determined
according to chapter 518. The alleged father shall pay the
support money into court pursuant to the rules of civil
procedure to await the results of the paternity proceedings.
(b) If the results of blood tests completed in a laboratory
accredited by the American Association of Blood Banks indicate
that likelihood of the alleged father's paternity, calculated
with a prior probability of no more than 0.5 (50 percent), is 99
percent or greater, the alleged father is presumed to be the
parent and the party opposing the establishment of the alleged
father's paternity has the burden of proving by clear and
convincing evidence that the alleged father is not the father of
the child.
Sec. 164. [259.44] [REIMBURSEMENT OF NONRECURRING ADOPTION
EXPENSES.]
The commissioner of human services shall provide
reimbursement of up to $2,000 to the adoptive parent or parents
for costs incurred in adopting a child with special needs. The
commissioner shall determine the child's eligibility for
adoption expense reimbursement under title IV-E of the Social
Security Act, United States Code, title 42, sections 670 to 676.
Sec. 165. Minnesota Statutes 1988, section 259.47,
subdivision 5, is amended to read:
Subd. 5. [CHARGES.] Agencies The commissioner, the
commissioner's agents, and licensed child-placing agencies may
require a reasonable expense reimbursement for providing
services required in this section. Reimbursements received by
the commissioner according to this subdivision shall be
deposited in the general fund.
Sec. 166. [259.471] [POSTADOPTION SERVICE GRANTS PROGRAM.]
Subdivision 1. [PURPOSE.] The commissioner of human
services shall establish and supervise a postadoption service
grants program to be administered by local social service
agencies for the purpose of preserving and strengthening
adoptive families. The program will provide financial
assistance to adoptive parents to meet the special needs of an
adopted child that cannot be met by other resources available to
the family.
Subd. 2. [ELIGIBILITY CRITERIA.] A child may be certified
by the local social service agency as eligible for a
postadoption service grant after a final decree of adoption and
before the child's 18th birthday if:
(a) The child was a ward of the commissioner or a Minnesota
licensed child placing agency before adoption;
(b) The child had special needs at the time of adoption.
For the purposes of this section, "special needs" means a child
who had a physical, mental, emotional, or behavioral disability
at the time of an adoption or has a preadoption background to
which the current development of such disabilities can be
attributed; and
(c) The adoptive parents have exhausted all other available
resources. Available resources include public income support
programs, medical assistance, health insurance coverage,
services available through community resources, and any other
private or public benefits or resources available to the family
or to the child to meet the child's special needs.
Subd. 3. [CERTIFICATION STATEMENT.] The local social
service agency shall certify a child's eligibility for a
postadoption service grant in writing to the commissioner. The
certification statement shall include:
(1) a description and history of the special needs upon
which eligibility is based; and
(2) applicable supporting documentation including:
(i) the child's individual service plan;
(ii) medical, psychological, or special education
evaluations;
(iii) documentation that all other resources have been
exhausted; and
(iv) an estimate of the costs necessary to meet the special
needs of the child.
Subd. 4. [COMMISSIONER REVIEW.] The commissioner shall
review the facts upon which eligibility is based and shall award
postadoption service grants to eligible adoptive parents to the
extent funds are appropriated consistent with subdivision 5.
Subd. 5. [GRANT PAYMENTS.] The amount of the postadoption
service grant payment shall be based on the special needs of the
child and the determination that other resources to meet those
special needs are not available. The amount of any grant
payments shall be based on the severity of the child's
disability and the effect of the disability on the family and
must not exceed $10,000 annually.
Permissible expenses that may be paid from grants shall be
limited to:
(1) medical expenses not covered by the family's health
insurance or medical assistance;
(2) therapeutic expenses, including individual and family
therapy; and
(3) nonmedical services, items, or equipment required to
meet the special needs of the child.
The grants under this section shall not be used for
maintenance for out-of-home placement of the child in substitute
care.
Sec. 167. Minnesota Statutes 1988, section 259.49,
subdivision 2, is amended to read:
259.49 [ACCESS TO ADOPTION RECORDS ORIGINAL BIRTH
CERTIFICATE INFORMATION.]
Subd. 2. [SEARCH.] Within six months after receiving
notice of the request of the adopted person, the commissioner of
human services shall make complete and reasonable efforts to
notify each parent identified on the original birth certificate
of the adopted person. The commissioner, the commissioner's
agents, and licensed child-placing agencies may charge a
reasonable fee to the adopted person for the cost of making a
search pursuant to this subdivision. Every licensed child
placing agency in the state shall cooperate with the
commissioner of human services in efforts to notify an
identified parent. All communications under this subdivision
are confidential pursuant to section 13.02, subdivision 3.
For purposes of this subdivision, "notify" means a personal
and confidential contact with the genetic parents named on the
original birth certificate of the adopted person. The contact
shall not be by mail and shall be by an employee or agent of the
licensed child placing agency which processed the pertinent
adoption or some other licensed child placing agency designated
by the commissioner of human services. The contact shall be
evidenced by filing with the commissioner of health an affidavit
of notification executed by the person who notified each parent
certifying that each parent was given the following information:
(a) The nature of the information requested by the adopted
person;
(b) The date of the request of the adopted person;
(c) The right of the parent to file, within 120 days of
receipt of the notice, an affidavit with the commissioner of
health stating that the information on the original birth
certificate should not be disclosed;
(d) The right of the parent to file a consent to disclosure
with the commissioner of health at any time; and
(e) The effect of a failure of the parent to file either a
consent to disclosure or an affidavit stating that the
information on the original birth certificate should not be
disclosed.
Sec. 168. Minnesota Statutes 1988, section 260.251,
subdivision 1, is amended to read:
Subdivision 1. [CARE, EXAMINATION, OR TREATMENT.] (a)
Except where parental rights are terminated,
(1) whenever legal custody of a child is transferred by the
court to a county welfare board, or
(2) whenever legal custody is transferred to a person other
than the county welfare board, but under the supervision of the
county welfare board,
(3) whenever a child is given physical or mental
examinations or treatment under order of the court, and no
provision is otherwise made by law for payment for the care,
examination, or treatment of the child, these costs are a charge
upon the welfare funds of the county in which proceedings are
held upon certification of the judge of juvenile court.
(b) The court shall order, and the county welfare board
shall require, the parents or custodian of a child, while the
child is under the age of 18, to use the total income and
resources attributable to the child for the period of care,
examination, or treatment, except for clothing and personal
needs allowance as provided in section 256B.35, to reimburse the
county for the cost of care, examination, or treatment. Income
and resources attributable to the child include, but are not
limited to, social security benefits, supplemental security
income (SSI), veterans benefits, railroad retirement benefits
and child support. When the child is over the age of 18, and
continues to receive care, examination, or treatment, the court
shall order, and the county welfare board shall require,
reimbursement from the child to reimburse the county for the
cost of care, examination, or treatment from the income and
resources attributable to the child less the clothing and
personal needs allowance.
(c) If the income and resources attributable to the child
are not enough to reimburse the county for the full cost of the
care, examination, or treatment, the court shall inquire into
the ability of the parents to support the child and, after
giving the parents a reasonable opportunity to be heard, the
court shall order, and the county welfare board shall require,
the parents to reimburse the county, in the manner and to whom
the court may direct, such sums as will cover in whole or in
part contribute to the cost of care, examination, or treatment
of the child. When determining the amount to be contributed by
the parents, the court shall use a fee schedule based upon
ability to pay that is established by the county welfare board
and approved by the commissioner of human services. The income
of a stepparent who has not adopted a child shall be excluded in
calculating the parental contribution under this section.
(d) The court shall order the amount of reimbursement
attributable to the parents or custodian, or attributable to the
child, or attributable to both sources, withheld under chapter
518 from the income of the parents or the custodian of the
child. A parent or custodian or child over the age of 18 who
fails to pay this sum without good reason may be proceeded
against for contempt, or the court may inform the county
attorney, who shall proceed against any of them to collect the
unpaid sums, or both procedures may be used.
(e) If the court orders a physical or mental examination
for a child, the examination is a medically necessary service
for purposes of determining whether the service is covered by a
health insurance policy, health maintenance contract, or other
health coverage plan. Court-ordered treatment shall be subject
to policy, contract, or plan requirements for medical
necessity. Nothing in this paragraph changes or eliminates
benefit limits, conditions of coverage, copayments or
deductibles, provider restrictions, or other requirements in the
policy, contract, or plan that relate to coverage of other
medically necessary services.
Sec. 169. Minnesota Statutes 1988, section 268.08,
subdivision 1, is amended to read:
Subdivision 1. [ELIGIBILITY CONDITIONS.] An individual
shall be eligible to receive benefits with respect to any week
of unemployment only if the commissioner finds that the
individual:
(1) has registered for work at and thereafter has continued
to report to an employment office, or agent of the office, in
accordance with rules the commissioner may adopt; except that
the commissioner may by rule waive or alter either or both of
the requirements of this clause as to types of cases or
situations with respect to which the commissioner finds that
compliance with the requirements would be oppressive or would be
inconsistent with the purposes of sections 268.03 to 268.24;
(2) has made a claim for benefits in accordance with rules
as the commissioner may adopt;
(3) was able to work and was available for work, and was
actively seeking work. The individual's weekly benefit amount
shall be reduced one-fifth for each day the individual is unable
to work or is unavailable for work. Benefits shall not be
denied by application of this clause to an individual who is in
training with the approval of the commissioner, is a dislocated
worker as defined in section 268.975, subdivision 3, who is in
training approved by the commissioner, or in training approved
pursuant to section 236 of the Trade Act of 1974, as amended.
An individual is deemed unavailable for work with respect
to any week which occurs in a period when the individual is a
full-time student in attendance at, or on vacation from an
established school, college, or university unless a majority of
the wage credits earned in the base period were for services
performed during weeks in which the student was attending school
as a full-time student.
An individual serving as a juror shall be considered as
available for work and actively seeking work on each day the
individual is on jury duty; and
(4) has been unemployed for a waiting period of one week
during which the individual is otherwise eligible for benefits
under sections 268.03 to 268.24. However, payment for the
waiting week, not to exceed $20, shall be made to the individual
after the individual has qualified for and been paid benefits
for four weeks of unemployment in a benefit year which period of
unemployment is terminated because of the individual's return to
employment. No individual is required to serve a waiting period
of more than one week within the one-year period subsequent to
filing a valid claim and commencing with the week within which
the valid claim was filed.
Sec. 170. Minnesota Statutes 1988, section 268.31, is
amended to read:
268.31 [DEVELOPMENT OF YOUTH EMPLOYMENT OPPORTUNITIES.]
(a) To the extent of available funding, the commissioner of
jobs and training shall establish a program to employ
individuals from the ages of 14 years up to 22 years. Available
money may be used to operate this program on a full calendar
year basis, to provide transitional services, link basic skills
training and remedial education to job training and school
completion, and for support services. The amount spent on
support services in any one fiscal year may not exceed 15
percent of the total annual appropriation for this program.
Individuals employed in this program will be placed in service
with departments, agencies, and instrumentalities of the state,
county, local governments, school districts, with nonprofit
organizations, and private sector employers. The maximum number
of hours that an individual may be employed in a position
supported under this program is 480 hours. Program funds may
not be used for private sector placements. Program operators
must use the targeted jobs tax credit, other federal, state, and
local government resources, as well as private sector resources
to fund private sector placements. The commissioner shall
cooperate with the commissioner of human services in determining
and implementing the most effective means of disregarding a
youth's earnings from family income for purposes of the aid to
families with dependent children program, to the extent
permitted by the federal government.
(b) Upon request of the commissioner of the department of
natural resources, the commissioner will contract for or provide
available services for remedial skills, life skills, and career
counseling activities to youth in the Minnesota conservation
corps program.
(c) The commissioner shall evaluate the services provided
under this section. The evaluation shall include information on
the effectiveness of program services in promoting the
employability of young people. In order to measure the
long-term effectiveness of the program, the evaluation shall
include follow-up information on each participant.
Sec. 171. [268.912] [HEAD START PROGRAM.]
The department of jobs and training is the state agency
responsible for administering the head start program. The
commissioner of jobs and training may make grants to public or
private nonprofit agencies for the purpose of providing
supplemental funds for the federal head start program.
Sec. 172. [268.913] [DEFINITIONS.]
Subdivision 1. [SCOPE.] As used in sections 268.914 to
268.916, the terms defined in this section have the meanings
given them.
Subd. 2. [PROGRAM ACCOUNT 20.] "Program account 20" means
the federally designated and funded account limited to training
activities.
Subd. 3. [PROGRAM ACCOUNT 22.] "Program account 22" means
the federally designated and funded account for basic services.
Subd. 4. [PROGRAM ACCOUNT 26.] "Program account 26" means
the federally designated and funded account that can only be
used to provide special services to handicapped diagnosed
children.
Subd. 5. [PROGRAM ACCOUNT 23.] "Program account 23" means
the federally designated and funded account for all day services.
Subd. 6. [START-UP COSTS.] "Start-up costs" means one-time
costs incurred in expanding services to additional children.
Sec. 173. [268.914] [DISTRIBUTION OF APPROPRIATION.]
(a) The commissioner of jobs and training shall distribute
money appropriated for that purpose to head start program
grantees to expand services to additional low-income children.
Money must be allocated to each project head start grantee in
existence on the effective date of this act. Migrant and Indian
reservation grantees must be initially allocated money based on
the grantees' share of federal funds. The remaining money must
be initially allocated to the remaining local agencies based
equally on the agencies' share of federal funds and on the
proportion of eligible children in the agencies' service area
who are not currently being served. A head start grantee must
be funded at a per child rate equal to its contracted, federally
funded base level for program accounts 20 to 26 at the start of
the fiscal year. The commissioner may provide additional
funding to grantees for start-up costs incurred by grantees due
to the increased number of children to be served. Before paying
money to the grantees, the commissioner shall notify each
grantee of its initial allocation, how the money must be used,
and the number of low-income children that must be served with
the allocation. Each grantee must notify the commissioner of
the number of additional low-income children it will be able to
serve. For any grantee that cannot serve additional children to
its full allocation, the commissioner shall reduce the
allocation proportionately. Money available after the initial
allocations are reduced must be redistributed to eligible
grantees.
(b) Up to 11 percent of the funds appropriated annually may
be used to provide grants to local head start agencies to
provide funds for innovative programs designed either to target
head start resources to particular at-risk groups of children or
to provide services in addition to those currently allowable
under federal head start regulations. The commissioner shall
award funds for innovative programs under this paragraph on a
competitive basis.
Sec. 174. [268.915] [FEDERAL REQUIREMENTS.]
Grantees and the commissioner shall comply with federal
regulations governing the federal head start program, except for
innovative programs funded under section 268.914, paragraph (b),
which may operate differently than federal head start
regulations, and except that when a state statute or regulation
conflicts with a federal statute or regulation, the state
statute or regulation prevails.
Sec. 175. [268.916] [REPORTS.]
Each grantee shall submit an annual report to the
commissioner on the format designated by the commissioner,
including program information report data. By January 1 of each
year, the commissioner shall prepare an annual report to the
health and human services committees of the legislature
concerning the uses and impact of head start supplemental
funding, including a summary of innovative programs and the
results of innovative programs and an evaluation of the
coordination of head start programs with employment and training
services provided to AFDC recipients.
Sec. 176. [268.971] [HOSPITALITY HOST PROGRAM.]
Subdivision 1. [ESTABLISHMENT.] A hospitality host older
worker tourism program is established in the department of jobs
and training to assist economically disadvantaged older workers
to gain employment in the promotion of the tourism industry in
Minnesota and to become self-sufficient. The objectives of the
program are to:
(1) assist in the diversification of industry in rural
areas by stimulating and promoting tourism;
(2) create full-time and part-time employment for
low-income persons 55 years old or older;
(3) raise the income of older persons living in poverty;
and
(4) promote tourism in selected local areas throughout the
state, thereby improving local economies.
Subd. 2. [DEFINITIONS.] (a) [SCOPE.] As used in this
section, the terms defined in this section have the meanings
given them.
(b) [COMMISSIONER.] "Commissioner" means the commissioner
of the department of jobs and training.
(c) [OLDER WORKER.] "Older worker" means an economically
disadvantaged person 55 years or older.
(d) [ECONOMICALLY DISADVANTAGED.] "Economically
disadvantaged" means a person having an income of 125 percent or
less of the federal poverty income guidelines. In determining
income, the federal Job Training Partnership Act definition of
family and family income will prevail.
(e) [PROGRAM.] "Program" means the hospitality host older
worker program created in subdivision 1.
(f) [COORDINATING AGENCY.] "Coordinating agency" means the
Arrowhead economic opportunity agency.
Subd. 3. [DISTRIBUTION AND USE OF STATE MONEY.] Money
allocated to the coordinating agency by the commissioner must be
used for activities consistent with the objectives of the
program including, but not limited to: outreach, selection of
eligible participants, program sites, individual work sites,
classroom training, on-the-job training opportunities, and
program marketing. Program funds shall be used to provide
training-related costs to enrollees during orientation and
classroom training segments. Program funds shall be used to
subsidize up to 50 percent of enrollee wages during contracted
on-the-job training periods with the employer being responsible
for the remainder. Salaries upon employment shall be at least
the state or federal minimum wage, whichever is higher.
Subd. 4. [RESPONSIBILITIES OF COORDINATING AGENCY.] The
commissioner shall enter into written agreement with the
coordinating agency for the design, delivery, and general
administration of the program. The commissioner shall set
program goals and objectives, and monitor the program.
Subd. 5. [REPORTS.] The coordinating agency shall submit
an annual report to the commissioner one year from the effective
date of this act and annually thereafter. In addition, the
coordinating agency shall submit to the commissioner such other
reports as required to document the status and progress of the
program. The annual report must include: information on the
number and types of jobs created; status of program sites; wages
paid program participants; types of services provided by
programs; the retention of program participants; and other
information to assess the progress and status of the program.
Sec. 177. [268.975] [DEFINITIONS.]
Subdivision 1. [TERMS.] For the purposes of sections
268.975 to 268.98, the following terms have the meanings given
them.
Subd. 2. [COMMISSIONER.] "Commissioner" means the
commissioner of jobs and training.
Subd. 3. [DISLOCATED WORKER.] "Dislocated worker" means an
individual who:
(1) has been terminated or has received a notice of
termination of employment as a result of a plant closing or any
substantial layoff at a plant, facility, or enterprise located
in the state;
(2) was a resident of the state at the time of termination
of employment or at the time of receiving the notification of
termination of employment; and
(3) is eligible for or has exhausted unemployment
compensation and is unlikely to return to the previous industry
or occupation.
Subd. 4. [ELIGIBLE ORGANIZATION.] "Eligible organization"
means a local government unit, nonprofit organization, community
action agency, business organization or association, or labor
organization that has applied for a prefeasibility grant under
section 268.978.
Subd. 5. [LOCAL GOVERNMENT UNIT.] "Local government unit"
means a statutory or home rule charter city, county, or town.
Subd. 6. [PLANT CLOSING.] "Plant closing" means the
announced or actual permanent or temporary shutdown of a single
site of employment, or one or more facilities or operating units
within a single site of employment, if the shutdown results in
an employment loss at the single site of employment during any
30-day period for (a) 50 or more employees excluding employees
who work less than 20 hours per week; or (b) at least 500
employees who in the aggregate work at least 20,000 hours per
week, exclusive of hours of overtime.
Subd. 7. [PREFEASIBILITY STUDY GRANT; GRANT.]
"Prefeasibility study grant" or "grant" means the grant awarded
under section 268.978.
Subd. 8. [SUBSTANTIAL LAYOFF.] "Substantial layoff" means
a reduction in the work force, which is not a result of a plant
closing, and which results in an employment loss at a single
site of employment during any 30-day period for (a) at least 50
employees excluding those employees that work less than 20 hours
a week; or (b) at least 500 employees who in the aggregate work
at least 20,000 hours per week, exclusive of hours of overtime.
Sec. 178. [268.976] [EARLY WARNING SYSTEM.]
Subdivision 1. [EARLY WARNING INDICATORS.] The
commissioner, in cooperation with the commissioners of revenue
and trade and economic development, shall establish and oversee
an early warning system to identify industries and businesses
likely to experience large losses in employment including a
plant closing or a substantial layoff, by collecting and
analyzing information which may include, but not be limited to,
products and markets experiencing declining growth rates,
companies and industries subject to competition from production
in low wage counties, changes in ownership, layoff and
employment patterns, payments of unemployment compensation
contributions, and state tax payments. The commissioner may
request the assistance of businesses, business organizations,
and trade associations in identifying businesses, industries,
and specific establishments that are likely to experience large
losses in employment. The commissioner may request information
and other assistance from other state agencies for the purposes
of this subdivision.
Subd. 2. [NOTICE.] The commissioner shall encourage those
business establishments considering a decision to effect a plant
closing, substantial layoff or relocation of operations located
in this state to give notice of that decision as early as
possible to the commissioner, the employees of the affected
establishment, any employee organization representing the
employees, and the local government unit in which the affected
establishment is located. This notice shall be in addition to
any notice required under the Worker Adjustment and Retraining
Notification Act, United States Code, title 29, section 2101.
Subd. 3. [EMPLOYER RESPONSIBILITY.] An employer providing
notice of a plant closing, substantial layoff, or relocation of
operations under the Worker Adjustment and Retraining
Notification Act, United States Code, title 29, section 2101, or
under subdivision 2 must report to the commissioner the names,
addresses, and occupations of the employees who will be or have
been terminated.
Sec. 179. [268.977] [RAPID RESPONSE PROGRAM.]
Subdivision 1. [PROGRAM ESTABLISHMENT.] (a) The
commissioner shall establish a rapid response program to assist
employees, employers, business organizations or associations,
labor organizations, local government units, and community
organizations to quickly and effectively respond to announced or
actual plant closings and substantial layoffs.
(b) The program must include or address at least the
following:
(1) within five working days after becoming aware of an
announced or actual plant closing or substantial layoff,
establish on-site contact with the employer, employees, labor
organizations if there is one representing the employees, and
leaders of the local government units and community
organizations to provide coordination of efforts to formulate a
communitywide response to the plant closing or substantial
layoff, provide information on the public and private service
and programs that might be available, inform the affected
parties of the prefeasibility study grants under section
268.978, and collect any information required by the
commissioner to assist in responding to the plant closing or
substantial layoff;
(2) provide ongoing technical assistance to employers,
employees, business organizations or associations, labor
organizations, local government units, and community
organizations to assist them in reacting to or developing
responses to plant closings or substantial layoffs;
(3) establish and administer the prefeasibility study grant
program under section 268.978 to provide an initial assessment
of the feasibility of alternatives to plant closings or
substantial layoffs;
(4) work with employment and training service providers,
employers, business organizations or associations, labor
organizations, local government units, and community
organizations in providing training, education, community
support service, job search programs, job clubs, and other
services to address the needs of potential or actual dislocated
workers;
(5) coordinate with providers of economic development
related financial and technical assistance services so that
communities that are experiencing plant closings or substantial
layoffs have immediate access to economic development related
services; and
(6) collect and make available information on programs that
might assist dislocated workers and the communities affected by
plant closings or substantial layoffs.
Subd. 2. [APPLICABILITY.] Notwithstanding section 268.975,
subdivisions 6 and 8, the commissioner may waive the threshold
requirements for finding a plant closing or substantial layoff
in special cases where the governor's job training council
recommends waiver to the commissioner following a finding by the
council that the number of workers dislocated as a result of a
plant closing or substantial layoff would have a substantial
impact on the community or labor market where the closure or
layoff occurs and, in the absence of intervention through the
rapid response program, would overwhelm the capacity of other
programs to provide effective assistance.
Sec. 180. [268.978] [PREFEASIBILITY STUDIES.]
Subdivision 1. [PREFEASIBILITY STUDY GRANTS.] (a) The
commissioner may make grants for up to $10,000 to eligible
organizations to provide an initial assessment of the
feasibility of alternatives to plant closings or substantial
layoffs. The alternatives may include employee ownership, other
new ownership, new products or production processes, or public
financial or technical assistance to keep a plant open. Two or
more eligible organizations may jointly apply for a grant under
this section.
(b) Interested organizations shall apply to the
commissioner for the grants. As part of the application
process, applicants must provide a statement of need for a
grant, information relating to the workforce at the plant, the
area's unemployment rate, the community's and surrounding area's
labor market characteristics, information of efforts to
coordinate the community's response to the plant closing or
substantial layoff, a timetable of the prefeasibility study, a
description of the organization applying for the grant, a
description of the qualifications of persons conducting the
study, and other information required by the commissioner.
(c) The commissioner shall respond to the applicant within
five working days of receiving the organization's application.
The commissioner shall inform each organization that applied for
but did not receive a grant the reasons for the grant not being
awarded. The commissioner may request further information from
those organizations that did not receive a grant, and the
organization may reapply for the grant.
Subd. 2. [PREFEASIBILITY STUDY.] (a) The prefeasibility
study must explore the current and potential viability,
profitability, and productivity of the plant that may close or
experience a substantial layoff and alternative uses for the
plant. The study is not intended to be a major examination of
each possible alternative, but rather is meant to quickly
determine if further action or examination is feasible and
should be fully explored.
(b) The prefeasibility study must contain:
(1) a description of the plant's present products,
production techniques, management structure, and history;
(2) a brief discussion of the feasibility of the various
alternatives for ownership, production technique, and products;
(3) an estimate of the financing required to keep the plant
open and the potential sources of that financing;
(4) a description of the employer's, employees', and
community's efforts to maintain the operation of the plant; and
(5) other information the commissioner may require.
Subd. 3. [REPORTS.] (a) The commissioner shall report
monthly to the program subcommittee of the governor's job
training council on the grants made and studies completed during
the previous month.
(b) The commissioner shall provide an annual report to the
governor, legislature, and the governor's job training council
on the administration of the prefeasibility study grant
program. The report must also include details of actions taken
as a result of a grant.
Sec. 181. [268.979] [DISLOCATED WORKER COORDINATION.]
The commissioner shall coordinate the actions taken by
state agencies and public post-secondary educational
institutions to respond to or address the specific needs of
dislocated workers and to provide services to dislocated workers
including education and retraining. The commissioner shall also
assist local government units, community groups, business
associations or organizations, labor organizations, and others
in coordinating their efforts in providing services to
dislocated workers.
Sec. 182. [268.98] [PERFORMANCE STANDARDS.]
The commissioner shall establish performance standards for
the programs and activities administered or funded through the
rapid response program under section 268.977. The commissioner
may use existing federal performance standards or, if the
commissioner determines that the federal standards are
inadequate or not suitable, may formulate new performance
standards to ensure that the programs and activities of the
rapid response program are effectively administered.
Sec. 183. Minnesota Statutes 1988, section 326.78,
subdivision 2, is amended to read:
Subd. 2. [ISSUANCE OF LICENSES AND CERTIFICATES.] The
commissioner may issue licenses to employers and certificates to
employees who meet the criteria in sections 326.70 to 326.82 and
the commissioner's rules. Licenses and certificates shall be
valid for at least 12 months, except that the initial
certificate will be issued to expire one year after the
completion date on the approved training course diploma.
Sec. 184. Minnesota Statutes 1988, section 327C.02,
subdivision 2, is amended to read:
Subd. 2. [MODIFICATION OF RULES.] The park owner must give
the resident at least 60 days notice in writing of any rule
change. A rule adopted or amended after the resident initially
enters into a rental agreement may be enforced against that
resident only if the new or amended rule is reasonable and is
not a substantial modification of the original agreement. Any
security deposit increase is a substantial modification of the
rental agreement. A reasonable rent increase made in compliance
with section 327C.06 is not a substantial modification of the
rental agreement and is not considered to be a rule for purposes
of section 327C.01, subdivision 8. A rule change necessitated
by government action is not a substantial modification of the
rental agreement. A rule change requiring all residents to
maintain their homes, sheds and other appurtenances in good
repair and safe condition shall not be deemed a substantial
modification of a rental agreement. If a part of a resident's
home, shed or other appurtenance becomes so dilapidated that
repair is impractical and total replacement is necessary, the
park owner may require the resident to make the replacement in
conformity with a generally applicable rule adopted after the
resident initially entered into a rental agreement with the park
owner.
In any action in which a rule change is alleged to be a
substantial modification of the rental agreement, a court may
consider the following factors in limitation of the criteria set
forth in section 327C.01, subdivision 11:
(a) any significant changes in circumstances which have
occurred since the original rule was adopted and which
necessitate the rule change; and
(b) any compensating benefits which the rule change will
produce for the residents.
Sec. 185. Minnesota Statutes 1988, section 357.021,
subdivision 2, is amended to read:
Subd. 2. [FEE AMOUNTS.] The fees to be charged and
collected by the court administrator shall be as follows:
(1) In every civil action or proceeding in said court, the
plaintiff, petitioner, or other moving party shall pay, when the
first paper is filed for that party in said action, a fee of
$30, except that in an action for marriage dissolution, the fee
is $55 $75.
The defendant or other adverse or intervening party, or any
one or more of several defendants or other adverse or
intervening parties appearing separately from the others, shall
pay, when the first paper is filed for that party in said
action, a fee of $30.
The party requesting a trial by jury shall pay $30.
The fees above stated shall be the full trial fee
chargeable to said parties irrespective of whether trial be to
the court alone, to the court and jury, or disposed of without
trial, and shall include the entry of judgment in the action,
but does not include copies or certified copies of any papers so
filed or proceedings under sections 106A.005 to 106A.811, except
the provisions therein as to appeals.
(2) Certified copy of any instrument from a civil or
criminal proceeding $5, plus 25 cents per page after the first
page and $3.50, plus 25 cents per page after the first page for
an uncertified copy.
(3) Issuing a subpoena $3 for each name.
(4) Issuing an execution and filing the return thereof;
issuing a writ of attachment, injunction, habeas corpus,
mandamus, quo warranto, certiorari, or other writs not
specifically mentioned, $5.
(5) Issuing a transcript of judgment, or for filing and
docketing a transcript of judgment from another court, $5.
(6) Filing and entering a satisfaction of judgment, partial
satisfaction or assignment of judgment, $5.
(7) Certificate as to existence or nonexistence of
judgments docketed, $1 for each name certified to and $3 for
each judgment certified to.
(8) Filing and indexing trade name; or recording notary
commission; or recording basic science certificate; or recording
certificate of physicians, osteopaths, chiropractors,
veterinarians or optometrists, $5.
(9) For the filing of each partial, final, or annual
account in all trusteeships, $10.
(10) All other services required by law for which no fee is
provided such fee as compares favorably with those herein
provided, or such as may be fixed by rule or order of the court.
Sec. 186. Minnesota Statutes 1988, section 357.021,
subdivision 2a, is amended to read:
Subd. 2a. [CERTAIN FEE PURPOSES.] Of the marriage
dissolution fee collected pursuant to subdivision 1, the court
administrator shall pay $35 $55 to the state treasurer to be
deposited in the special revenue fund to be used as follows:
$15 $35 for the purposes of funding grant programs for emergency
shelter services and support services to battered women under
sections 611A.31 to 611A.36 and for administering displaced
homemaker programs established under section 268.96; and $20 is
appropriated to the commissioner of corrections for the purpose
of funding emergency shelter services and support services to
battered women, on a matching basis with local money for 20
percent of the costs and state money for 80 percent. Of
the $15 $35 for the purposes of funding grant programs for
emergency shelter services and support services to battered
women under sections 611A.31 to 611A.36 and for administering
displaced homemaker programs established under section
268.96, $6.75 $16.75 is appropriated to the commissioner of
corrections and $8.25 $18.25 is appropriated to the commissioner
of jobs and training. The commissioner of jobs and training may
use money appropriated in this subdivision for the
administration of a displaced homemaker program regardless of
the date on which the program was established.
Sec. 187. Minnesota Statutes 1988, section 517.08,
subdivision 1b, is amended to read:
Subd. 1b. [TERM OF LICENSE; FEE.] The court administrator
shall examine upon oath the party applying for a license
relative to the legality of the contemplated marriage. If at
the expiration of a five-day period, on being satisfied that
there is no legal impediment to it, the court administrator
shall issue the license, containing the full names of the
parties before and after marriage, and county and state of
residence, with the district court seal attached, and make a
record of the date of issuance. The license shall be valid for
a period of six months. In case of emergency or extraordinary
circumstances, a judge of the county court or a judge of the
district court of the county in which the application is made,
may authorize the license to be issued at any time before the
expiration of the five days. The court administrator shall
collect from the applicant a fee of $45 $65 for administering
the oath, issuing, recording, and filing all papers required,
and preparing and transmitting to the state registrar of vital
statistics the reports of marriage required by this section. If
the license should not be used within the period of six months
due to illness or other extenuating circumstances, it may be
surrendered to the court administrator for cancellation, and in
that case a new license shall issue upon request of the parties
of the original license without fee. A court administrator who
knowingly issues or signs a marriage license in any manner other
than as provided in this section shall pay to the parties
aggrieved an amount not to exceed $1,000.
Sec. 188. Minnesota Statutes 1988, section 517.08,
subdivision 1c, is amended to read:
Subd. 1c. [DISPOSITION OF LICENSE FEE.] Of the marriage
license fee collected pursuant to subdivision 1b, the court
administrator shall pay $30 $50 to the state treasurer to be
deposited in the special revenue fund to be used as follows:
$6.75 $16.75 is appropriated to the commissioner of corrections
for the purposes of funding grant programs for emergency shelter
services and support services to battered women under sections
611A.31 to 611A.36, and $23.25 $33.25 is appropriated to the
commissioner of jobs and training for displaced homemaker
programs under section 268.96. The commissioner of jobs and
training may use money appropriated in this subdivision for the
administration of a displaced homemaker program regardless of
the date on which the program was established.
Sec. 189. Minnesota Statutes 1988, section 518.54,
subdivision 6, is amended to read:
Subd. 6. [INCOME.] "Income" means any form of periodic
payment to an individual including, but not limited to, wages,
salaries, payments to an independent contractor, workers'
compensation, unemployment compensation, annuity, military and
naval retirement, pension and disability payments. Benefits
received under sections 256.72 to 256.87 and chapter 256D are
not income under this section.
Sec. 190. Minnesota Statutes 1988, section 518.551, is
amended by adding a subdivision to read:
Subd. 5a. [ORDER FOR COMMUNITY SERVICES.] If the court
finds that the obligor earns $400 or less per month and does not
have the ability to provide support based on the guidelines and
factors under subdivision 5, the court may order the obligor to
perform community services to fulfill the obligor's support
obligation. In ordering community services under this
subdivision, the court shall consider whether the obligor has
the physical capability of performing community services, and
shall order community services that are appropriate for the
obligor's abilities.
Sec. 191. Minnesota Statutes 1988, section 518.551,
subdivision 10, is amended to read:
Subd. 10. [ADMINISTRATIVE PROCESS FOR CHILD AND MEDICAL
SUPPORT PILOT PROJECT ORDERS.] A pilot project An administrative
process is established to obtain, modify, and enforce child and
medical support orders and maintenance through administrative
process, to evaluate the efficiency of the administrative
process. The pilot project shall begin when the procedures have
been established and end on June 30, 1989.
During the pilot project, The commissioner of human
services may designate counties to participate in the
administrative process established by this section. All
proceedings for obtaining, modifying, or enforcing child and
medical support orders and maintenance and adjudicating
uncontested parentage proceedings, required to be conducted
in Dakota county counties designated by the commissioner of
human services in which Dakota the county human services agency
is a party or represents a party to the action must be conducted
by an administrative law judge from the office of administrative
hearings, except for the following proceedings:
(1) adjudication of paternity contested parentage;
(2) motions to set aside a paternity adjudication or
declaration of parentage;
(3) evidentiary hearing on contempt motions; and
(4) motions to sentence or to revoke the stay of a jail
sentence in contempt proceedings.
An administrative law judge may hear a stipulation reached
on a contempt motion, but any stipulation that involves a
finding of contempt and a jail sentence, whether stayed or
imposed, shall require the review and signature of a county or
district judge.
For the purpose of this pilot project process, all powers,
duties, and responsibilities conferred on judges of the county
or district court to obtain and enforce child and medical
support obligations, subject to the limitation set forth herein,
are conferred on the administrative law judge conducting the
proceedings, including the power to issue orders to show cause
and to issue bench warrants for failure to appear.
During fiscal year 1988 Before implementing the process in
a county, the chief administrative law judge, the commissioner
of human services, the director of Dakota the county human
services agency, the Dakota county attorney, and the clerk of
the Dakota county court administrator shall jointly establish
procedures and the county shall provide hearing facilities for
the implementation of implementing this pilot project process in
a county.
Nonattorney employees of Dakota county human services the
public agency responsible for child support in the counties
designated by the commissioner, acting at the direction of the
county attorney, may prepare, sign, serve, and file complaints
and motions for obtaining, modifying, or enforcing child and
medical support orders and maintenance and related documents,
appear at prehearing conferences, and participate in proceedings
before an administrative law judge. This activity shall not be
considered to be the unauthorized practice of law.
For the purpose of this pilot project, The hearings shall
be conducted under the conference contested case rules adopted
by the chief administrative law judge. Any discovery required
in a proceeding shall be conducted under the rules of family
court and the rules of civil procedure. rules of the office of
administrative hearings, Minnesota Rules, parts 1400.7100 to
1400.7500, 1400.7700, and 1400.7800, as adopted by the chief
administrative law judge. All other aspects of the case,
including, but not limited to, pleadings, discovery, and
motions, shall be conducted under the rules of family court, the
rules of civil procedure and chapter 518. The administrative
law judge shall make findings of fact, conclusions, and a final
decision and issue an order. Orders issued by an administrative
law judge shall be are enforceable by the contempt powers of the
county or and district courts.
The administrative law judge shall make a report to the
chief administrative law judge or the chief administrative law
judge's designee, stating findings of fact and conclusions and
recommendations concerning the proposed action, in accordance
with sections 14.48 to 14.56. The chief administrative law
judge or a designee shall render the final decision and order in
accordance with sections 14.61 and 14.62. The decision and
order of the chief administrative law judge or a designee shall
be a final agency decision for purposes of sections 14.63 to
14.69.
Sec. 192. Minnesota Statutes 1988, section 518.611,
subdivision 4, is amended to read:
Subd. 4. [EFFECT OF ORDER.] Notwithstanding any law to the
contrary, the order is binding on the employer, trustee, or
other payor of the funds when service under subdivision 2 has
been made. Withholding must begin no later than the first pay
period that occurs after 14 days following the date of the
notice. An employer or other payor of funds in this state is
required to withhold income according to court orders for
withholding issued by other states or territories. The payor
shall withhold from the income payable to the obligor the amount
specified in the order and amounts required under subdivision 2,
paragraph (b) and section 518.613 and shall remit, within ten
days of the date the obligor is paid the remainder of the
income, the amounts withheld to the public authority. The payor
shall identify on the remittance information the date the
obligor is paid the remainder of the income. Employers may
combine all amounts withheld from one pay period into one
payment to each public authority, but shall separately identify
each obligor making payment. Amounts received by the public
authority which are in excess of public assistance expended for
the party or for a child shall be remitted to the party. An
employer shall not discharge, or refuse to hire, or otherwise
discipline an employee as a result of a wage or salary
withholding authorized by this section. The employer or other
payor of funds shall be liable to the obligee for any amounts
required to be withheld.
Sec. 193. Minnesota Statutes 1988, section 518.613,
subdivision 1, is amended to read:
Subdivision 1. [GENERAL.] Notwithstanding any provision of
section 518.611, subdivision 2 or 3, to the contrary, whenever
an obligation for child support or maintenance, enforced by the
public authority, is initially determined and ordered or
modified by the court in a county in which this section applies,
the amount of child support or maintenance ordered by the court
must be withheld from the income, regardless of source, of the
person obligated to pay the support.
Sec. 194. Minnesota Statutes 1988, section 518.613,
subdivision 2, is amended to read:
Subd. 2. [ORDER; COLLECTION SERVICES.] Every order for
child support must include the obligor's social security number
and the name and address of the obligor's employer or other
payor of funds. Upon entry of the order for support or
maintenance, the court shall mail a copy of the
court's automatic income withholding order and the provisions of
section 518.611 and this section to the obligor's employer or
other payor of funds and to the public agency authority
responsible for child support enforcement. An obligee who is
not a recipient of public assistance shall apply for the
collection services of the public authority when an order for
support is entered unless the requirements of this section have
been waived under subdivision 7. No later than January 1, 1990,
the supreme court shall develop a standard automatic income
withholding form to be used by all Minnesota courts. This form
shall be made a part of any order for support or decree by
reference.
Sec. 195. Minnesota Statutes 1988, section 518.613,
subdivision 4, is amended to read:
Subd. 4. [APPLICATION.] On and after August 1, 1987, and
prior to August 1, 1989, this section applies in a county
selected under Laws 1987, chapter 403, article 3, section 93 and
in a county that chooses to have this section apply by
resolution of a majority vote of its county board. On and after
November 1, 1990, this section applies to all child support and
maintenance obligations that are initially ordered or modified
on and after November 1, 1990, and that are being enforced by
the public authority.
Sec. 196. Minnesota Statutes 1988, section 518.613, is
amended by adding a subdivision to read:
Subd. 6. [NOTICE OF SERVICES.] The department of human
services shall prepare and make available to the courts a form
notice of child support and maintenance collection services
available through the public authority responsible for child
support enforcement, including automatic income withholding
under this section. Promptly upon the filing of a petition for
dissolution of marriage or legal separation by parties who have
a minor child, the court administrator shall send the form
notice to the petitioner and respondent at the addresses given
in the petition. The rulemaking provisions of chapter 14 shall
not apply to the preparation of the form notice.
Sec. 197. Minnesota Statutes 1988, section 518.613, is
amended by adding a subdivision to read:
Subd. 7. [WAIVER.] (a) The court may waive the
requirements of this section if the court finds that there is no
arrearage in child support or maintenance as of the date of the
hearing, that it would not be contrary to the best interests of
the child, and: (1) one party demonstrates and the court finds
that there is good cause to waive the requirements of this
section or to terminate automatic income withholding on an order
previously entered under this section; or (2) all parties reach
a written agreement that provides for an alternative payment
arrangement and the agreement is approved by the court after a
finding that the agreement is likely to result in regular and
timely payments. If the court waives the requirements of this
section:
(1) in all cases where the obligor is at least 30 days in
arrears, withholding must be carried out pursuant to section
518.611;
(2) the obligee may at any time and without cause request
the court to issue an order for automatic income withholding
under this section; and
(3) the obligor may at any time request the public
authority to begin withholding pursuant to this section, by
serving upon the public authority the request and a copy of the
order for child support or maintenance. Upon receipt of the
request, the public authority shall serve a copy of the court's
order and the provisions of section 518.611 and this section on
the obligor's employer or other payor of funds. The public
authority shall notify the court that withholding has begun at
the request of the obligor pursuant to this clause.
(b) For purposes of this subdivision, "parties" includes
the public authority in cases when it is a party pursuant to
section 518.551, subdivision 9.
Sec. 198. Minnesota Statutes 1988, section 540.08, is
amended to read:
540.08 [INJURY TO CHILD OR WARD; SUIT BY PARENT OR
GUARDIAN.]
A parent may maintain an action for the injury of a minor
son or daughter. A general guardian may maintain an action for
an injury to the ward. A guardian of a dependent, neglected, or
delinquent child, appointed by a court having jurisdiction, may
maintain an action for the injury of the child. If no action is
brought by the father or mother, an action for the injury may be
brought by a guardian ad litem, either before or after the death
of the parent. Before a parent receives property as a result of
the action, the parent shall file a bond as the court prescribes
and approves as security therefor. In lieu of this bond, upon
petition of the parent, the court may order that the property
received be invested in securities issued by the United States,
which shall be deposited pursuant to the order of the court, or
that the property be invested in a savings account, savings
certificate, or certificate of deposit, in a bank, savings and
loan association, or trust company, or an annuity or other form
of structured settlement, subject to the order of the court. A
copy of the court's order and the evidence of the deposit shall
be filed with the court administrator. Money or assets in an
account established by the court under this section are not
available to the minor child or the child's parent or guardian
until released by the court to the child or the child's parent
or guardian. No settlement or compromise of the action is valid
unless it is approved by a judge of the court in which the
action is pending.
Sec. 199. Minnesota Statutes 1988, section 609.378, is
amended to read:
609.378 [NEGLECT OR ENDANGERMENT OF A CHILD.]
Subdivision 1. [PERSONS GUILTY OF NEGLECT OR
ENDANGERMENT.] The following people are guilty of neglect or
endangerment of a child and may be sentenced to imprisonment for
not more than one year or to payment of a fine of not more than
$3,000, or both.
(a) [NEGLECT.] (1) A parent, legal guardian, or caretaker
who willfully deprives a child of necessary food, clothing,
shelter, health care, or supervision appropriate to the child's
age, when the parent, guardian, or caretaker is reasonably able
to make the necessary provisions and which the deprivation
substantially harms the child's physical or emotional health or
(b) is guilty of neglect of a child. If a parent, guardian, or
caretaker responsible for the child's care in good faith selects
and depends upon spiritual means or prayer for treatment or care
of disease or remedial care of the child, this treatment or care
is "health care," for purposes of this clause.
(2) A parent, legal guardian, or foster parent caretaker
who knowingly permits the continuing physical or sexual abuse of
a child, is guilty of neglect of a child and may be sentenced to
imprisonment for not more than one year or to payment of a fine
of not more than $3,000, or both.
(b) [ENDANGERMENT.] A parent, legal guardian, or caretaker
who endangers the child's person or health by intentionally
causing or permitting a child to be placed in a situation likely
to substantially harm the child's physical or mental health or
cause the child's death is guilty of child endangerment. This
paragraph does not prevent a parent, legal guardian, or
caretaker from causing or permitting a child to engage in
activities that are appropriate to the child's age, stage of
development, and experience, or from selecting health care as
defined in subdivision 1, paragraph (a).
Subd. 2. [DEFENSES.] It is a defense to a prosecution
under clause (b) subdivision 1, paragraph (a), clause (2), or
paragraph (b), that at the time of the neglect or endangerment
there was a reasonable apprehension in the mind of the defendant
that acting to stop or prevent the neglect or endangerment would
result in substantial bodily harm to the defendant or the child
in retaliation.
If a parent, guardian, or caretaker responsible for the
child's care in good faith selects and depends upon spiritual
means or prayer for treatment or care of disease or remedial
care of the child, this treatment shall constitute "health care"
as used in clause (a).
Sec. 200. Minnesota Statutes 1988, section 626.556,
subdivision 2, is amended to read:
Subd. 2. [DEFINITIONS.] As used in this section, the
following terms have the meanings given them unless the specific
content indicates otherwise:
(a) "Sexual abuse" means the subjection by a person
responsible for the child's care, or by a person in a position
of authority, as defined in section 609.341, subdivision 10, to
any act which constitutes a violation of section 609.342,
609.343, 609.344, or 609.345. Sexual abuse also includes any
act which involves a minor which constitutes a violation of
sections 609.321 to 609.324 or 617.246.
(b) "Person responsible for the child's care" means (1) an
individual functioning within the family unit and having
responsibilities for the care of the child such as a parent,
guardian, or other person having similar care responsibilities,
or (2) an individual functioning outside the family unit and
having responsibilities for the care of the child such as a
teacher, school administrator, or other lawful custodian of a
child having either full-time or short-term care
responsibilities including, but not limited to, day care,
babysitting whether paid or unpaid, counseling, teaching, and
coaching.
(c) "Neglect" means failure by a person responsible for a
child's care to supply a child with necessary food, clothing,
shelter or medical care when reasonably able to do so or failure
to protect a child from conditions or actions which imminently
and seriously endanger the child's physical or mental health
when reasonably able to do so. Nothing in this section shall be
construed to (1) mean that a child is neglected solely because
the child's parent, guardian, or other person responsible for
the child's care in good faith selects and depends upon
spiritual means or prayer for treatment or care of disease or
remedial care of the child, or (2) in lieu of medical care;
except that there is a duty to report if a lack of medical care
may cause imminent and serious danger to the child's health.
This section does not impose upon persons, not otherwise legally
responsible for providing a child with necessary food, clothing,
shelter, or medical care, a duty to provide that care. Neglect
also means "medical neglect" as defined in section 260.015,
subdivision 10 2a, clause (e) (5).
(d) "Physical abuse" means any physical injury inflicted by
a person responsible for the child's care on a child other than
by accidental means, or any physical injury that cannot
reasonably be explained by the child's history of injuries, or
any aversive and deprivation procedures that have not been
authorized under section 245.825.
(e) "Report" means any report received by the local welfare
agency, police department, or county sheriff pursuant to this
section.
(f) "Facility" means a day care facility, residential
facility, agency, hospital, sanitarium, or other facility or
institution required to be licensed pursuant to sections 144.50
to 144.58, 241.021, or 245.781 to 245.812.
(g) "Operator" means an operator or agency as defined in
section 245A.02.
(h) "Commissioner" means the commissioner of human services.
(i) "Assessment" includes authority to interview the child,
the person or persons responsible for the child's care, the
alleged perpetrator, and any other person with knowledge of the
abuse or neglect for the purpose of gathering the facts,
assessing the risk to the child, and formulating a plan.
(j) "Practice of social services," for the purposes of
subdivision 3, includes but is not limited to employee
assistance counseling and the provision of guardian ad litem
services.
Sec. 201. Minnesota Statutes 1988, section 626.556,
subdivision 10e, is amended to read:
Subd. 10e. [DETERMINATIONS.] Upon the conclusion of every
assessment or investigation it conducts, the local welfare
agency shall make two determinations: first, whether
maltreatment has occurred; and second, whether child protective
services are needed.
(a) For the purposes of this subdivision, "maltreatment"
means any of the following acts or omissions committed by a
person responsible for the child's care:
(1) an assault, as defined in section 609.02, subdivision
10, or any physical contact not exempted by section 609.379,
where the assault or physical contact is either severe or
recurring and causes either injury or significant risk of injury
to the child;
(2) neglect as defined in subdivision 2, paragraph (c); or
(3) sexual abuse as defined in subdivision 2, paragraph (a).
(b) For the purposes of this subdivision, a determination
that child protective services are needed means that the local
welfare agency has documented conditions during the assessment
or investigation sufficient to cause a child protection worker,
as defined in section 626.559, subdivision 1, to conclude that a
child is at significant risk of maltreatment if protective
intervention is not provided and that the individuals
responsible for the child's care have not taken or are not
likely to take actions to protect the child from maltreatment or
risk of maltreatment.
(c) This subdivision does not mean that maltreatment has
occurred solely because the child's parent, guardian, or other
person responsible for the child's care in good faith selects
and depends upon spiritual means or prayer for treatment or care
of disease or remedial care of the child, in lieu of medical
care. However, if lack of medical care may result in imminent
and serious danger to the child's health, the local welfare
agency may ensure that necessary medical services are provided
to the child.
Sec. 202. Minnesota Statutes 1988, section 626.558, is
amended to read:
626.558 [MULTIDISCIPLINARY CHILD PROTECTION TEAM.]
Subdivision 1. [ESTABLISHMENT OF THE TEAM.] A county may
establish a multidisciplinary child protection team comprised of
that may include, but not be limited to, the director of the
local welfare agency or designees, the county attorney or
designees, the county sheriff or designees, and representatives
of health and education. In addition, representatives of mental
health or other appropriate human service agencies, and parent
groups may be added to the child protection team.
Subd. 2. [DUTIES OF TEAM.] A multidisciplinary child
protection team may provide public and professional education,
develop resources for prevention, intervention, and treatment,
and provide case consultation to the local welfare agency to
better enable the agency to carry out its child protection
functions under section 626.556 and the community social
services act. As used in this section, "case consultation"
means a case review process in which recommendations are made
concerning services to be provided to the identified children
and family. Case consultation must may be performed by a
committee or subcommittee of the team composed of the team
members representing social human services, including mental
health and chemical dependency; law enforcement, including
probation and parole; the county attorney,; health care,;
education,; and other necessary agencies; and persons directly
involved in an individual case as determined designated by the
case consultation committee. Case consultation is a case review
process that results in recommendations about services to be
provided to the identified children and family other members
performing case consultation.
Subd. 2a. [JUVENILE PROSTITUTION OUTREACH PROGRAM.] A
multidisciplinary child protection team may assist the local
welfare agency, local law enforcement agency, or an appropriate
private organization in developing a program of outreach
services for juveniles who are engaging in prostitution. For
the purposes of this subdivision, at least one representative of
a youth intervention program or, where this type of program is
unavailable, one representative of a nonprofit agency serving
youth in crisis, shall be appointed to and serve on the
multidisciplinary child protection team in addition to the
standing members of the team. These services may include
counseling, medical care, short-term shelter, alternative living
arrangements, and drop-in centers. The county may finance these
services by means of the penalty assessment authorized by
section 609.3241. A juvenile's receipt of intervention services
under this subdivision may not be conditioned upon the juvenile
providing any evidence or testimony.
Subd. 3. [INFORMATION SHARING.] (a) The local welfare
agency may make available to the case consultation committee of
the team or subcommittee, all records collected and maintained
by the agency under section 626.556 and in connection with case
consultation. Any member of the A case consultation committee
or subcommittee member may share information acquired in the
member's professional capacity with the committee or
subcommittee to assist the committee in its function case
consultation.
(b) Case consultation committee or subcommittee members
must annually sign a data sharing agreement, approved by the
commissioner of human services, assuring compliance with chapter
13. Not public data, as defined by section 13.02, subdivision
8a, may be shared with members appointed to the committee or
subcommittee in connection with an individual case when the
members have signed the data sharing agreement.
(c) All data acquired by the case consultation committee or
subcommittee in exercising case consultation duties, are
confidential as defined in section 13.02, subdivision 3, and
shall not be disclosed except to the extent necessary to perform
case consultation, and shall not be subject to subpoena or
discovery.
(d) No members of a case consultation committee or
subcommittee meeting shall disclose what transpired at a case
consultation meeting, except to the extent necessary to carry
out the case consultation plan. The proceedings and records of
the case consultation meeting are not subject to discovery, and
may not be introduced into evidence in any civil or criminal
action against a professional or local welfare agency arising
out of the matter or matters which are the subject of
consideration of the case consultation meeting. Information,
documents, or records otherwise available from original sources
are not immune from discovery or use in any civil or criminal
action merely because they were presented during a case
consultation meeting. Any person who presented information
before the consultation committee or subcommittee or who is a
member shall not be prevented from testifying as to matters
within the person's knowledge. However, in a civil or criminal
proceeding a person shall not be questioned about the person's
presentation of information before the case consultation
committee or subcommittee or about opinions formed as a result
of the case consultation meetings.
A person who violates this subdivision is subject to the
civil remedies and penalties provided under chapter 13.
Sec. 203. [626.5593] [PEER REVIEW OF LOCAL AGENCY
RESPONSE.]
Subdivision 1. [ESTABLISHMENT.] By January 1, 1991, the
commissioner of human services shall establish a pilot program
for peer review of local agency responses to child maltreatment
reports made under section 626.556. The peer review program
shall examine agency assessments of maltreatment reports and
delivery of child protection services in at least two counties.
The commissioner shall designate the local agencies to be
reviewed, and shall appoint a peer review panel composed of
child protection workers, as defined in section 626.559, and law
enforcement personnel who are responsible for investigating
reports of child maltreatment under section 626.556, subdivision
10, within the designated counties.
Subd. 2. [DUTIES.] The peer review panel shall meet at
least quarterly to review case files representative of child
maltreatment reports that were investigated or assessed by the
local agency. These cases shall be selected randomly from local
welfare agency files by the commissioner. Not public data, as
defined in section 13.02, subdivision 8, may be shared with
panel members in connection with a case review.
The panel shall review each case for compliance with
relevant laws, rules, agency policies, appropriateness of agency
actions, and case determinations. The panel shall issue a
report to the designated agencies after each meeting which
includes findings regarding the agency's compliance with
relevant laws, rules, policies, case practice, and any
recommendations to be considered by the agency. The panel shall
also issue a semiannual report concerning its activities. This
semiannual report shall be available to the public, but may not
include any information that is classified as not public data.
Subd. 3. [REPORT TO LEGISLATURE.] By January 1, 1992, the
commissioner shall report to the legislature regarding the
activities of the peer review panel, compliance findings,
barriers to the effective delivery of child protection services,
and recommendations for the establishment of a permanent peer
review system for child protection services.
Subd. 4. [FUNDS.] The commissioner may use funds allocated
for child protection services, training, and grants to pay
administrative expenses associated with the peer review panel
pilot program created by this section.
Sec. 204. Laws 1984, chapter 654, article 5, section 57,
subdivision 1, as amended by Laws 1987, chapter 75, section 1,
and by Laws 1988, chapter 689, article 2, section 238, 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;
(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; or
(10) a project to replace a 130-bed or less hospital if:
(i) the new hospital site is located within five miles of the
current site; and (ii) the total licensed capacity of the
replacement hospital, either at the time of construction of the
initial building or as the result of future expansion, will not
exceed 70 licensed hospital beds.
Sec. 205. Laws 1988, chapter 689, article 2, section 248,
is amended to read:
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
eligible low-income households, including, but not limited to,
seniors, disabled persons, farmers, veterans, unemployed
workers, low-income working heads of households, battered women
residing in shelters, migrant workers, refugee 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. 206. Laws 1988, chapter 689, article 2, section 269,
subdivision 2, is amended to read:
Subd. 2. Section 248 is repealed effective July 1, 1990
1991.
Sec. 207. Laws 1988, chapter 719, article 8, section 32,
is amended to read:
Sec. 32. [TRANSFER OF COUNTY FOOD STAMP QUALITY CONTROL
SYSTEM EMPLOYEES.]
(a) All positions covered by the Minnesota merit system
located in Crow Wing county family social service center and in
the Redwood county welfare department classified as food stamp
corrective action specialist I and II and as financial assistant
supervisor I, if the positions supervise food stamp corrective
action specialists, are transferred to the department of human
services and become state civil service positions.
(b) All incumbent employees affected by this transfer, who
choose to transfer to state civil service positions in the
department of human services, must be transferred with no
reduction in salary. Salaries of individual employees who
transfer must be adjusted to the minimum salary or to the
nearest equal or higher step on the state compensation plan for
their class, whichever is greater.
(c) Existing sick leave and vacation accruals for an
employee who transfers must be transferred to the department of
human services and the employee shall accrue additional vacation
and sick leave under the provisions of the appropriate state
collective bargaining agreement based on the employee's years of
service in either Crow Wing county family service center or in
the Redwood county welfare department.
(d) If an employee who transfers chooses to retain the
county coverage for employee and dependent health, dental, and
life insurance, the department of human services shall reimburse
the employee for one month of continued enrollment in the
health, dental, and life insurance plans in an amount equal to
what their former county employer would have paid for the
coverage had the employee remained a county employee, until the
employee is eligible for coverage under the state insurance
plans.
(e) Classification seniority for an employee who transfers
must be calculated according to the provisions of the
appropriate state collective bargaining agreement based upon the
employee's years of service in the county merit system. The
state must negotiate with the exclusive representative for the
bargaining unit to which food stamp quality control employees
are transferring regarding their classification seniority. For
purposes of calculating classification seniority for employees
transferring into state service, a transferred employee must
retain the same seniority ranking the employee had within the
employee's current classification within the county relative to
the other employees with that classification within the county.
Classification seniority for classifications outside of the
bargaining unit into which the employee is transferring must be
calculated according to the provisions of the appropriate state
collective bargaining agreement based upon the employee's years
of service in the county merit system.
Sec. 208. [REPORT ON INHALANT ABUSE DEMONSTRATION
PROJECT.]
The commissioner shall prepare a report on the outcome of
the inhalant abuse demonstration project in Minnesota Statutes,
section 254A.145, to be presented to the legislature by February
1, 1991. In that report, the commissioner shall include
information on the effectiveness of the chemical dependency
treatment system for children under 14 years of age,
particularly children who are inhalant abusers, and shall issue
recommendations for the appropriate provision of services for
this population group.
Sec. 209. [PLANNING GRANT.]
The commissioner of human services is authorized to award,
for the biennium ending June 30, 1991, a planning grant to a
public or private agency or program experienced in working with
youth and inhalant/chemical abuse, in order to establish a
treatment program for children under age 12 identified as
inhalant abusers. This treatment program shall evaluate
clients, provide treatment and aftercare services, and
coordinate services provided with existing agencies. The agency
or program receiving the planning grant must report program
results and recommendations to the commissioner of human
services by February 15, 1991.
Sec. 210. [COMMUNITY ACTION PROGRAM LEGISLATIVE TASK
FORCE.]
Subdivision 1. [PURPOSE.] On this 25th anniversary of the
Economic Opportunity Act of 1964, the legislature recognizes the
need to evaluate how Minnesota can, through community action
programs, meet the needs of its low-income residents and provide
them with opportunities to escape poverty. With the population
of low-income residents increasing, and federal financial
support for community action programs decreasing, the
legislature must evaluate the ability of community action
programs to serve low-income residents. The purpose of the task
force is to chart a course for community action programs to
ensure that the needs of low-income residents are met.
Subd. 2. [MEMBERSHIP.] There is established a legislative
task force consisting of five members of the house of
representatives appointed by the speaker of the house and five
members of the senate appointed by the senate majority leader.
At least two members should be of the minority caucus.
Subd. 3. [CHAIR.] The members of the task force shall
elect one member to serve as chair of the task force.
Subd. 4. [STAFF.] The task force shall use legislative
staff to carry out its duties.
Subd. 5. [DUTIES.] The task force shall examine the role
and future of community action programs in Minnesota. At least
three hearings shall be held in the area of Minnesota outside
the metropolitan area as defined in Minnesota Statutes, section
473.121, subdivision 2. Community action programs shall
organize regional presentations as well as selected tours for
the task force. The task force shall examine and make
recommendations on how community action programs can better
address the needs of Minnesota's low-income residents. The task
force shall also examine programs, advocacy efforts, funding
trends, and local initiatives to reduce poverty, as well as the
state's role in supporting community action programs in
Minnesota. The task force shall submit a report on its findings
and recommendations to the legislature by January 15, 1990.
Sec. 211. [RULES FOR DROP-IN CARE.]
By April 1, 1990, the commissioner of human services must
adopt permanent rules to amend Minnesota Rules, part 9503.0075,
to bring that rule part into conformity with the requirements of
section 245A.14, subdivision 6.
Sec. 212. [RULES PROVIDING VARIANCES.]
The commissioner of human services is authorized to amend
Minnesota Rules, part 9503.0170, subpart 6, item D, to permit
variances from the staff distribution requirements of part
9503.0040, subpart 2, item D; to permit variances from the age
category grouping requirements of part 9503.0040, subpart 3,
item B, subitem (1); and to permit variances from the
transportation requirements of part 9503.0150, item E. Variance
requests submitted to the commissioner according to the
amendments authorized in this section must comply in all
respects with the provisions of part 9503.0170, subpart 6, items
A to C. The commissioner's authority to adopt rules under this
section expires on April 1, 1990.
Sec. 213. [SUPPORTIVE RESIDENTIAL PROGRAMS REPORT.]
Subdivision 1. [SUPPORTIVE RESIDENTIAL PROGRAM REGULATION
RECOMMENDATION.] By February 1, 1990, the commissioners of
health and human services shall jointly make a recommendation to
the legislature on the regulation and licensure of facilities
and programs that provide housing services and provide or
coordinate supportive services or health supervision services to
residents. The recommendations must address:
(1) the existing use of residential arrangements with a
lodging, hotel, or food service license under Minnesota
Statutes, chapter 157;
(2) existing county board and local human service agency
administrative or certification standards for board and lodging
houses or supportive living residences;
(3) county referral and placement practices for persons
who, in addition to food or lodging services, need assistance
with health or supportive services;
(4) the status of persons in these facilities with respect
to the vulnerable adults abuse reporting act and their need for
referral to protective services or social services for
assessment prior to placement by the county or referral to the
residence by the county;
(5) the applicability of laws governing the rights of
patients and residents specified in Minnesota Statutes, section
144.651, and the rights of tenants in housing;
(6) a determination as to the need for and degree of
regulation of these services;
(7) recommendations for repeal or revision of existing
facility and program statutes and regulations; and
(8) a fiscal analysis of the current costs associated with
the provision of supportive programs and facilities,
recommendations for methods for maximizing all funding sources
used for these services, and an analysis of the costs for
licensure and regulation.
Subd. 2. [CONSULTATION WITH AFFECTED PARTIES.] In
developing the recommendations, the commissioners may consult
other state departments and agencies, the interagency board for
quality assurance established under Minnesota Statutes, section
144A.31, counties and other affected political subdivisions,
advocacy groups, representatives or owners of facilities and
programs, lodging houses and assisted or supportive living
services, and service consumers.
Subd. 3. [COUNTY REPORTING.] No later than September 1,
1989, and annually after that date, the county board or human
services board in each county shall report to the commissioner
of human services the names and addresses of the owners and
operators of all facilities and programs with which the county
has a negotiated rate agreement and which are not licensed under
Minnesota Statutes, chapter 144, 144A, or 245A. The report must
identify the amount of the negotiated rate for each facility or
program, services other than the provision of lodging that the
owner or operator is responsible for coordinating or providing,
the number of persons receiving services, and the per unit cost
for the services. No later than September 1, 1989, the county
board or human services agency in each county shall also provide
the commissioner of human services with a copy of any
administrative standards or certification standards adopted by
or used by the county for board and lodging facilities and
supervised living residences that are in addition to or
different from those contained in Minnesota Rules, chapter 4625,
or that are for facilities and programs not licensed under
Minnesota Statutes, chapter 144, 144A, or 245A.
Sec. 214. [LICENSURE EXCLUSIONS.]
Until July 1, 1990, Minnesota Statutes, sections 245A.01 to
245A.16, do not apply to board and lodging establishments
licensed by the commissioner of health that provide services for
five or more persons whose primary diagnosis is mental illness
and who have refused an appropriate residential program offered
by a county agency.
Sec. 215. [STUDY; BOND REQUIREMENT FOR HEARING INSTRUMENT
SELLERS.]
The commissioner of health shall study issues relating to
the requirement in Minnesota Statutes, section 153A.16, that
hearing instruments obtain a surety bond. The study must
address the availability of bonds, the costs of obtaining the
bonds, and the underwriter financial requirements for obtaining
bonds. The commissioner of health shall report to the
legislature by January 1, 1990, with the results of the study
and the commissioner's recommendations, including findings and
recommendations on whether other mechanisms are available to
protect purchasers of hearing instrument products and services.
Sec. 216. [STUDY OF EXEMPTIONS TO REGISTRATION WITH THE
BOARD OF UNLICENSED MENTAL HEALTH SERVICE PROVIDERS.]
The commissioner of human services, in consultation with
the board of unlicensed mental health service providers, shall
study and report to the legislature by February 15, 1990, on
whether any of the persons exempted from registration by reason
of their employment in a program licensed by the commissioner of
human services should be required to register with the board.
Sec. 217. [IRIS COORDINATING COMMITTEE.]
Subdivision 1. [MEMBERSHIP.] The coordinating committee
for the inventory, referral, and intake system (IRIS) required
under Minnesota Statutes, section 268.86, subdivision 10,
consists of the commissioners or their designees of the
departments of human services, administration, and jobs and
training; a representative of the information policy office; two
members of the senate appointed under the rules of the senate;
and two members of the house of representatives appointed under
the rules of the house.
Subd. 2. [DUTIES.] The IRIS coordinating committee shall:
(1) monitor the implementation of IRIS;
(2) oversee a delivery system study to determine the scope
and nature of the current delivery system problems;
(3) oversee the development of a strategic plan for human
service delivery which must include, in addition to planned
improvements in delivery systems, information system objectives
and policy requirements accomplished through IRIS; and
(4) evaluate the IRIS prototype pilot project conducted
jointly by the department of human services and the department
of jobs and training.
Subd. 3. [REPORT.] The IRIS coordinating committee shall
report to the legislature every six months beginning July 1,
1989, on the activities of the committee.
Subd. 4. [EXPIRATION.] The IRIS coordinating committee
expires on July 1, 1991, or six months after full implementation
of IRIS, whichever occurs later.
Sec. 218. [INSTRUCTION TO REVISOR.]
In Minnesota Statutes 1989 Supplement and subsequent
editions of the statutes, the revisor of statutes shall change
the words "resident" and "patient," wherever they appear in
Minnesota Statutes, sections 246.50 to 246.55, to "client."
Sec. 219. [REPEALER.]
Subdivision 1. [HEALTH DEPARTMENT HOSPITAL
INFORMATION.] Minnesota Rules, parts 4650.0162 and 4650.0164,
are repealed.
Subd. 2. [HUMAN SERVICES LICENSING.] Laws 1987, chapter
403, article 5, section 1, is repealed.
Subd. 3. [CHEMICAL DEPENDENCY FUND.] Section 254B.09,
subdivision 3, is repealed effective the day following final
enactment. Section 254B.10 is repealed effective July 1, 1989.
Subd. 4. [PERMANENCY PLANNING.] Minnesota Statutes 1988,
section 256F.05, subdivision 1, is repealed.
Subd. 5. [CHILD SUPPORT.] Minnesota Statutes 1988, section
518.613, subdivision 5; and 256.87, subdivision 4, are
repealed. Laws 1988, chapter 719, article 8, section 34, is
repealed.
Subd. 6. [CHILD CARE.] Minnesota Statutes 1988, sections
245.83; 245.84; 245.85; 245.871; 245.872; 245.873; 256H.04;
256H.05, subdivision 4; 256H.06; 256H.07, subdivisions 2, 3, and
4; and 256H.13, are repealed.
Subd. 7. [STATE FACILITY COST OF CARE.] Minnesota
Statutes, section 246.50, subdivisions 3a, 4a, and 9, are
repealed.
Sec. 220. [EFFECTIVE DATE.]
Subdivision 1. [HEALTH DEPARTMENT
ADMINISTRATION.] Sections 3 to 6 are effective the day following
final enactment.
Subd. 2. [HUMAN SERVICES LICENSING.] Sections 62, 82, 83,
85, 210, and 211 are effective the day following final enactment.
Subd. 3. [CHEMICAL DEPENDENCY FUND.] Sections 105, 106,
and 108 to 110 are effective the day following final enactment.
Subd. 4. [HEAD START.] Sections 171 to 175 are effective
the day following final enactment.
Subd. 5. [HOSPITALITY HOST PROGRAM.] Section 176 is
effective the day following final enactment.
Subd. 6. [CHILD SUPPORT.] Section 162 is effective the day
following final enactment and applies to actions brought after
January 1, 1986. Section 197 is effective the day following
final enactment and applies to support and maintenance orders
entered or modified before, on, or after the effective date.
Subd. 7. [CHILD MORTALITY REVIEW PANELS.] Section 112 is
effective the day following final enactment.
Subd. 8. [LEAD ABATEMENT.] Section 19 is effective the day
following final enactment.
Subd. 9. [BOARD OF SOCIAL WORK.] Section 40 is effective
the day following final enactment.
Subd. 10. [MARRIAGE AND DISSOLUTION FEES.] Sections 185 to
188 are effective the day following final enactment.
Subd. 11. [MARRIAGE AND FAMILY THERAPISTS.] Section 42 is
effective retroactively to December 28, 1988.
Subd. 12. [COURT-SUPERVISED SETTLEMENT ACCOUNTS.] Section
198 is effective the day following final enactment and applies
to issues concerning the availability of funds that arise on and
after the effective date.
Subd. 13. [REPEALER SECTION.] Section 219, subdivisions 3
and 5, are effective the day following final enactment.
ARTICLE 3
HEALTH CARE AND MEDICAL ASSISTANCE
Section 1. Minnesota Statutes 1988, section 62A.045, is
amended to read:
62A.045 [PAYMENTS TO ON BEHALF OF WELFARE RECIPIENTS.]
No policy of accident and sickness insurance regulated
under this chapter; vendor of risk management services regulated
under section 60A.23; nonprofit health service plan corporation
regulated under chapter 62C; health maintenance organization
regulated under chapter 62D; or self-insured plan regulated
under chapter 62E shall contain any provision denying or
reducing benefits because services are rendered to an insured or
dependent a person who is eligible for or receiving medical
assistance benefits pursuant to chapter 256B or 256D or services
pursuant to section 252.27; 256.936; 260.251, subdivision 1a;
261.27; or 393.07, subdivision 1 or 2.
Notwithstanding any law to the contrary, when a person
covered under a policy of accident and sickness insurance, risk
management plan, nonprofit health service plan, health
maintenance organization, or self-insured plan receives medical
benefits according to any statute listed in this section,
payment for covered services or notice of denial for services
billed by the provider must be issued directly to the provider.
If a person was receiving medical benefits through the
department of human services at the time a service was provided,
the provider must indicate this benefit coverage on any claim
forms submitted by the provider to the insurer for those
services. If the commissioner of human services notifies the
insurer that the commissioner has made payments to the provider,
payment for benefits or notices of denials issued by the insurer
must be issued directly to the commissioner. Submission by the
department to the insurer of the claim on a department of human
services claim form is proper notice and shall be considered
proof of payment of the claim to the provider, and supersedes
any contract requirements of the insurer relating to the form of
submission. Liability to the insured for coverage is satisfied
to the extent that payments for those benefits are made by the
insurer to the provider or the commissioner.
Sec. 2. Minnesota Statutes 1988, section 62A.046, is
amended to read:
62A.046 [COORDINATION OF BENEFITS.]
(1) No group contract providing coverage for hospital and
medical treatment or expenses issued or renewed after August 1,
1984, which is responsible for secondary coverage for services
provided, may deny coverage or payment of the amount it owes as
a secondary payor solely on the basis of the failure of another
group contract, which is responsible for primary coverage, to
pay for those services.
(2) A group contract which provides coverage of a claimant
as a dependent of a parent who has legal responsibility for the
dependent's medical care pursuant to a court order under section
518.171 must make payments directly to the provider of care. In
such cases, liability to the insured is satisfied to the extent
of benefit payments made to the provider.
(3) This section applies to an insurer, a vendor of risk
management services regulated under section 60A.23, a nonprofit
health service plan corporation regulated under chapter 62C and
a health maintenance organization regulated under chapter 62D.
Nothing in this section shall require a secondary payor to pay
the obligations of the primary payor nor shall it prevent the
secondary payor from recovering from the primary payor the
amount of any obligation of the primary payor that the secondary
payor elects to pay.
(4) Payments made by an enrollee or by the commissioner on
behalf of an enrollee in the children's health plan under
section 256.936, or a person receiving benefits under chapter
256B or 256D, for services that are covered by the policy or
plan of health insurance shall, for purposes of the deductible,
be treated as if made by the insured.
(5) The commissioner of human services shall recover
payments made by the children's health plan from the responsible
insurer, for services provided by the children's health plan and
covered by the policy or plan of health insurance.
Sec. 3. [144.0723] [CLIENT REIMBURSEMENT CLASSIFICATIONS;
PROCEDURES FOR RECONSIDERATION.]
Subdivision 1. [CLIENT REIMBURSEMENT CLASSIFICATIONS.] The
commissioner of health shall establish reimbursement
classifications based upon the assessment of each client in
intermediate care facilities for the mentally retarded conducted
after December 31, 1988, under section 256B.501, subdivision 3g,
or under rules established by the commissioner of human services
under section 256B.501, subdivision 3j. The reimbursement
classifications established by the commissioner must conform to
the rules established by the commissioner of human services to
set payment rates for intermediate care facilities for the
mentally retarded beginning on or after October 1, 1990.
Subd. 2. [NOTICE OF CLIENT REIMBURSEMENT
CLASSIFICATION.] The commissioner of health shall notify each
client and intermediate care facility for the mentally retarded
in which the client resides of the reimbursement classification
established under subdivision 1. The notice must inform the
client of the classification that was assigned, the opportunity
to review the documentation supporting the classification, the
opportunity to obtain clarification from the commissioner, and
the opportunity to request a reconsideration of the
classification. The notice of classification must be sent by
first-class mail. The individual client notices may be sent to
the client's intermediate care facility for the mentally
retarded for distribution to the client. The facility must
distribute the notice to the client's case manager and to the
client or to the client's representative. This notice must be
distributed within three working days after the facility
receives the notices from the department. For the purposes of
this section, "representative" includes the client's legal
representative as defined in Minnesota Rules, part 9525.0015,
subpart 18, the person authorized to pay the client's facility
expenses, or any other individual designated by the client.
Subd. 3. [REQUEST FOR RECONSIDERATION.] The client,
client's representative, or the intermediate care facility for
the mentally retarded may request that the commissioner
reconsider the assigned classification. The request for
reconsideration must be submitted in writing to the commissioner
within 30 days after the receipt of the notice of client
classification. The request for reconsideration must include
the name of the client, the name and address of the facility in
which the client resides, the reasons for the reconsideration,
the requested classification changes, and documentation
supporting the requested classification. The documentation
accompanying the reconsideration request is limited to
documentation establishing that the needs of the client at the
time of the assessment resulting in the disputed classification
justify a change of classification.
Subd. 4. [ACCESS TO INFORMATION.] Upon written request,
the intermediate care facility for the mentally retarded must
give the client's case manager, the client, or the client's
representative a copy of the assessment form and the other
documentation that was given to the department to support the
assessment findings. The facility shall also provide access to
and a copy of other information from the client's record that
has been requested by or on behalf of the client to support a
client's reconsideration request. A copy of any requested
material must be provided within three working days after the
facility receives a written request for the information. If the
facility fails to provide the material within this time, it is
subject to the issuance of a correction order and penalty
assessment. Notwithstanding this section, any order issued by
the commissioner under this subdivision must require that the
facility immediately comply with the request for information and
that as of the date the order is issued, the facility shall
forfeit to the state a $100 fine the first day of noncompliance,
and an increase in the $100 fine by $50 increments for each day
the noncompliance continues.
Subd. 5. [FACILITY'S REQUEST FOR RECONSIDERATION.] (a) In
addition to the information required in subdivision 3, a
reconsideration request from an intermediate care facility for
the mentally retarded must contain the following information:
(1) the date the reimbursement classification notices were
received by the facility;
(2) the date the classification notices were distributed to
the client's case manager and to the client or to the client's
representative; and
(3) a copy of a notice sent to the client's case manager,
and to the client or client's representative that tells the
client or the client's representative (i) that a reconsideration
of the client's reimbursement classification is being requested;
(ii) the reason for the request; (iii) that the client's rate
may change if the request is approved by the department; (iv)
that copies of the facility's request and supporting
documentation are available for review; and (v) that the client
also has the right to request a reconsideration.
(b) If the facility fails to provide this information with
the reconsideration request, the request must be denied, and the
facility may not make further reconsideration requests on that
specific reimbursement classification.
Subd. 6. [RECONSIDERATION.] The commissioner's
reconsideration must be made by individuals not involved in
reviewing the assessment that established the disputed
classification. The reconsideration must be based upon the
initial assessment and upon the information provided to the
commissioner under subdivisions 3 and 5. If necessary for
evaluating the reconsideration request, the commissioner may
conduct on-site reviews. At the commissioner's discretion, the
commissioner may review the reimbursement classifications
assigned to all clients in the facility. Within 15 working days
after receiving the request for reconsideration, the
commissioner shall affirm or modify the original client
classification. The original classification must be modified if
the commissioner determines that the assessment resulting in the
classification did not accurately reflect the status of the
client at the time of the assessment. The client and the
intermediate care facility for the mentally retarded shall be
notified within five working days after the decision is made.
The commissioner's decision under this subdivision is the final
administrative decision of the agency.
Subd. 7. [AUDIT AUTHORITY.] The department of health may
audit assessments of clients in intermediate care facilities for
the mentally retarded. The audits may be conducted at the
facility, and the department may conduct the audits on an
unannounced basis.
Subd. 8. [RULEMAKING.] The commissioner of health shall
adopt rules necessary to implement these provisions.
Sec. 4. Minnesota Statutes 1988, section 144.50, is
amended by adding a subdivision to read:
Subd. 7. [RESIDENTS WITH AIDS OR HEPATITIS.] Boarding care
homes and supervised living facilities licensed by the
commissioner of health must accept as a resident a person who is
infected with the human immunodeficiency virus or the hepatitis
B virus unless the facility cannot meet the needs of the person
under Minnesota Rules, part 4665.0200, subpart 5, or part
4655.1500, subpart 2, or the person is otherwise not eligible
for admission to the facility under state laws or rules.
Sec. 5. Minnesota Statutes 1988, section 144.651,
subdivision 2, is amended to read:
Subd. 2. [DEFINITIONS.] For the purposes of this section,
"patient" means a person who is admitted to an acute care
inpatient facility for a continuous period longer than 24 hours,
for the purpose of diagnosis or treatment bearing on the
physical or mental health of that person. "Patient" also means
a minor who is admitted to a residential program as defined in
section 253C.01. For purposes of subdivisions 1, 3 to 16, 18,
20 and 30, "patient" also means any person who is receiving
mental health treatment on an outpatient basis or in a community
support program or other community-based program. "Resident"
means a person who is admitted to a nonacute care facility
including extended care facilities, nursing homes, and board and
boarding care homes for care required because of prolonged
mental or physical illness or disability, recovery from injury
or disease, or advancing age.
Sec. 6. Minnesota Statutes 1988, section 144A.01, is
amended by adding a subdivision to read:
Subd. 3a. "Certified" means certified for participation as
a provider in the Medicare or Medicaid programs under title
XVIII or XIX of the Social Security Act.
Sec. 7. Minnesota Statutes 1988, section 144A.01, is
amended by adding a subdivision to read:
Subd. 4a. "Emergency" means a situation or physical
condition that creates or probably will create an immediate and
serious threat to a resident's health or safety.
Sec. 8. Minnesota Statutes 1988, section 144A.04,
subdivision 7, is amended 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 certified 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.
(d) A nursing home that is issued a notice of noncompliance
under section 144A.10, subdivision 5, for a violation of this
subdivision, shall be assessed a civil fine of $300 for each day
of noncompliance, subject to section 144A.10, subdivisions 7 and
8.
Sec. 9. Minnesota Statutes 1988, section 144A.04, is
amended by adding a subdivision to read:
Subd. 8. [RESIDENTS WITH AIDS OR HEPATITIS.] A nursing
home must accept as a resident a person who is infected with the
human immunodeficiency virus or the hepatitis B virus unless the
facility cannot provide appropriate care for the person under
Minnesota Rules, part 4655.1500, subpart 2, or the person is
otherwise not eligible for admission under state laws and rules.
Sec. 10. Minnesota Statutes 1988, section 144A.04, is
amended by adding a subdivision to read:
Subd. 9. [CARDIOPULMONARY RESUSCITATION
TRAINING.] Effective October 1, 1989, a nursing home must have
on duty at all times at least one staff member who is trained in
single rescuer adult cardiopulmonary resuscitation and who has
completed the initial training or a refresher course within the
previous two years.
Sec. 11. Minnesota Statutes 1988, 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; and (2) the
relocation of nursing home beds under this clause should not
exceed a radius of six miles;
(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 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. 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;
(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; or
(r) to license and certify nursing home beds to replace
currently licensed and certified boarding care beds which may be
located either in a remodeled or renovated boarding care or
nursing home facility or in a remodeled, renovated, newly
constructed, or replacement nursing home facility within the
identifiable complex of health care facilities in which the
currently licensed boarding care beds are presently located,
provided that the number of boarding care beds in the facility
or complex are decreased by the number to be licensed as nursing
home beds and further provided that, if the total costs of new
construction, replacement, remodeling, or renovation exceed ten
percent of the appraised value of the facility or $200,000,
whichever is less, 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 new construction, replacement, remodeling, or
renovation. The provisions contained in section 144A.073
regarding the upgrading of facilities do not apply to facilities
that satisfy these requirements.
Sec. 12. Minnesota Statutes 1988, 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 or
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.
Sec. 13. Minnesota Statutes 1988, section 144A.10, is
amended by adding a subdivision to read:
Subd. 6b. [FINES FOR FEDERAL CERTIFICATION
DEFICIENCIES.] If the commissioner determines that a nursing
home or certified boarding care home does not meet a requirement
of section 1919(b), (c), or (d), of the Social Security Act, or
any regulation adopted under that section of the Social Security
Act, the nursing home or certified boarding care home may be
assessed a civil fine for each day of noncompliance and until a
notice of correction is received by the commissioner under
subdivision 7. Money collected because of these fines must be
applied to the protection of the health or property of residents
of nursing facilities the commissioner finds deficient. A fine
for a specific deficiency may not exceed $500 for each day of
noncompliance. The commissioner shall adopt rules establishing
a schedule of fines.
Sec. 14. Minnesota Statutes 1988, section 144A.10, is
amended by adding a subdivision to read:
Subd. 6c. [OVERLAP OF FINES.] If a nursing home is subject
to fines under both subdivisions 6 and 6b for the same
requirement, condition, situation, or practice, the commissioner
shall assess either the fine provided by subdivision 6 or the
fine provided by subdivision 6b.
Sec. 15. Minnesota Statutes 1988, section 144A.10, is
amended by adding a subdivision to read:
Subd. 6d. [SCHEDULE OF FINES.] (a) The schedule of fines
for noncompliance with correction orders issued to nursing homes
that was adopted under the provisions of section 144A.10,
subdivision 6, and in effect on May 1, 1989, is effective until
repealed, modified, or superseded by rule.
(b) By September 1, 1990, the commissioner shall amend the
schedule of fines to increase to $250 the fines for violations
of section 144.561, subdivisions 18, 20, 21, 22, 27, and 30, and
for repeated violations.
(c) The commissioner shall adopt rules establishing the
schedule of fines for deficiencies in the requirements of
section 1919(b), (c), and (d), of the Social Security Act, or
regulations adopted under that section of the Social Security
Act.
Sec. 16. Minnesota Statutes 1988, section 144A.10, is
amended by adding a subdivision to read:
Subd. 8a. [FINE FOR MISALLOCATION OF NURSING STAFF.] Upon
issuing a correction order to a nursing home under subdivision 4
for a violation of Minnesota Rules, part 4655.5600, because of
nursing staff performing duties such as washing wheelchairs or
beds of discharged residents, or other housekeeping or laundry
duties not related to the direct nursing care of residents, the
commissioner shall impose a civil fine of $500 per day. A fine
under this subdivision accrues in accordance with subdivision 6
and is subject to subdivision 8 for purposes of recovery and
hearings.
Sec. 17. Minnesota Statutes 1988, section 144A.10, is
amended by adding a subdivision to read:
Subd. 8b. [RESIDENT ADVISORY COUNCIL.] Each nursing home
or boarding care home shall establish a resident advisory
council and a family council, unless fewer than three persons
express an interest in participating. If one or both councils
do not function, the nursing home or boarding care home shall
document its attempts to establish the council or councils at
least once each calendar year. This subdivision does not alter
the rights of residents and families provided by section
144.651, subdivision 27. A nursing home or boarding care home
that is issued a notice of noncompliance with a correction order
for violation of this subdivision shall be assessed a civil fine
of $100 for each day of noncompliance.
Sec. 18. [144A.103] [PENALTY FOR DEATH OF A RESIDENT.]
Subdivision 1. [DEFINITIONS.] For purposes of this
section, "abuse" and "neglect" have the meanings given in
section 626.557, subdivision 2, paragraphs (d) and (e).
Subd. 2. [PENALTY.] Whenever the commissioner
substantiates that a situation existed that constituted abuse or
neglect by a nursing home and that could foreseeably result in
death or injury to a resident, and the abuse or neglect
contributed to the resident's death, the nursing home must be
assessed a civil fine of $1,000. The assessment of a fine under
this section does not preclude the use of any other remedy.
Subd. 3. [RECOVERY OF FINES; HEARING.] A nursing home that
is assessed a fine under this section must pay the fine no later
than 15 days after receipt of the notice of assessment. The
assessment shall be stayed if the nursing home makes a written
request for a hearing on the assessment within 15 days after
receipt of the notice of assessment. After submission of a
timely request, a hearing must be conducted as a contested case
hearing under chapter 14 no later than 30 days after the
request. If a nursing home does not pay the fine as required by
this section, the commissioner of health shall notify the
commissioner of human services, who shall deduct the amount of
the fine from reimbursement payments due or to be due the
nursing home under chapter 256B.
Sec. 19. [144A.105] [SUSPENSION OF ADMISSIONS.]
Subdivision 1. [CIRCUMSTANCES FOR SUSPENSIONS.] The
commissioner of health may suspend admissions to a nursing home
or certified boarding care home when:
(1) the commissioner has issued a penalty assessment or the
nursing home has a repeated violation for noncompliance with
section 144A.04, subdivision 7, or the portion of Minnesota
Rules, part 4655.5600, subpart 2, that establishes minimum
nursing personnel requirements;
(2) the commissioner has issued a penalty assessment or the
nursing home or certified boarding care home has repeated
violations for not maintaining a sufficient number or type of
nursing personnel to meet the needs of the residents, as
required by Minnesota Rules, parts 4655.5100 to 4655.6200;
(3) the commissioner has determined that an emergency
exists;
(4) the commissioner has initiated proceedings to suspend,
revoke, or not renew the license of the nursing home or
certified boarding care home; or
(5) the commissioner determines that the remedy of denial
of payment, as provided by subparagraph 1919(h)(2)(A)(i) of the
Social Security Act, is to be imposed under section 1919(h) of
the Social Security Act, or regulations adopted under that
section of the Social Security Act.
Subd. 2. [ORDER.] If the commissioner suspends admissions
under subdivision 1, the commissioner shall notify the nursing
home or certified boarding care home, by written order, that
admissions to the nursing home or certified boarding care home
will be suspended beginning at a time specified in the order.
The suspension is effective no earlier than 48 hours after the
nursing home or certified boarding care home receives the order,
unless the order is due to an emergency under subdivision 1,
clause (3). The order may be served on the administrator of the
nursing home or certified boarding care home, or the designated
agent in charge of the home, by personal service or by certified
or registered mail with a return receipt of delivery. The order
shall specify the reasons for the suspension, the corrective
action required to be taken by the nursing home or certified
boarding care home, and the length of time the suspension will
be in effect. The nursing home or certified boarding care home
shall not admit any residents after the effective time of the
order. In determining the length of time for the suspension,
the commissioner shall consider the reasons for the suspension,
the performance history of the nursing home, and the needs of
the residents.
Subd. 3. [CONFERENCE.] After receiving the order for
suspension, the nursing home or certified boarding care home may
request a conference with the commissioner to present reasons
why the suspension should be modified or should not go into
effect. The request need not be in writing. If a conference is
requested within 24 hours after receipt of the order, the
commissioner shall hold the conference before the effective time
of the suspension, unless the order for suspension is due to an
emergency under subdivision 1, clause (3). If a conference is
not requested within 24 hours after receipt of the order, the
nursing home or certified boarding care home may request a
conference and the commissioner shall schedule the conference as
soon as practicable. The conference may be held in person or by
telephone. After a conference, the commissioner may affirm,
rescind, or modify the order.
Subd. 4. [CORRECTION.] The nursing home or certified
boarding care home shall notify the commissioner, in writing,
when any required corrective action has been completed. The
commissioner may verify the corrective action by inspection
under section 144A.10. The commissioner may extend the initial
suspension period by written notice to the nursing home or
certified boarding care home.
Subd. 5. [NOTIFICATION OF COMMISSIONER OF HUMAN SERVICES.]
Whenever the commissioner suspends admissions to a nursing home
or certified boarding care home, the commissioner shall notify
the commissioner of human services of the order and of any
modifications to the order.
Subd. 6. [HEARING.] A nursing home or certified boarding
care home may appeal from an order for suspension of admissions
issued under subdivision 1. To appeal, the nursing home or
certified boarding care home shall file with the commissioner a
written notice of appeal. The appeal must be received by the
commissioner within ten days after the date of receipt of the
order for suspension by the nursing home or certified boarding
care home. Within 15 calendar days after receiving an appeal,
the commissioner shall request assignment of an administrative
law judge under sections 14.48 to 14.56 to conduct the hearing
as soon as possible or according to agreement of the parties.
Regardless of any appeal, the order for suspension of admissions
remains in effect until final resolution of the appeal.
Sec. 20. Minnesota Statutes 1988, section 144A.11, is
amended by adding a subdivision to read:
Subd. 2a. [NOTICE TO RESIDENTS.] Within five working days
after proceedings are initiated by the commissioner to revoke,
suspend, or not renew a nursing home license, the controlling
person of the nursing home or a designee must provide to the
commissioner and the ombudsman for older Minnesotans the names
of residents and the names and addresses of the residents'
guardians, representatives, and designated family contacts. The
controlling person or designees must provide updated information
each month until the proceeding is concluded. If the
controlling person or designee fails to provide the information
within this time, the nursing home is subject to the issuance of
a correction order and penalty assessment under sections 144.653
and 144A.10. Notwithstanding those sections, any correction
order issued under this subdivision must require that the
facility immediately comply with the request for information and
that as of the date of the issuance of the correction order, the
facility shall forfeit to the state a $100 fine the first day of
noncompliance, and an increase in the $100 fine by $50
increments for each day the noncompliance continues.
Information provided under this subdivision may be used by the
commissioner or the ombudsman only for the purpose of providing
affected consumers information about the status of the
proceedings. Within ten working days after the commissioner
initiates proceedings to revoke, suspend, or not renew a nursing
home license, the commissioner of health shall send a written
notice of the action and the process involved to each resident
of the nursing home and the resident's legal guardian,
representative, or designated family contact. The commissioner
shall provide the ombudsman with monthly information on the
department's actions and the status of the proceedings.
Sec. 21. Minnesota Statutes 1988, section 144A.11,
subdivision 3, is amended to read:
Subd. 3. [HEARING.] No nursing home license may be
suspended or revoked, and renewal may not be denied, without a
hearing held as a contested case in accordance with chapter 14.
The hearing must commence within 60 days after the proceedings
are initiated. If the controlling person designated under
section 144A.03, subdivision 2, as an agent to accept service on
behalf of all of the controlling persons of the nursing home has
been notified by the commissioner of health that the facility
will not receive an initial license or that a license renewal
has been denied, the controlling person or a legal
representative on behalf of the nursing home may request and
receive a hearing on the denial. This hearing shall be held as
a contested case in accordance with chapter 14.
Sec. 22. Minnesota Statutes 1988, section 144A.12,
subdivision 1, is amended to read:
Subdivision 1. [INJUNCTIVE RELIEF.] In addition to any
other remedy provided by law, the commissioner of health may
bring an action in the district court in Ramsey or Hennepin
county or in the district in which a nursing home is located to
enjoin a controlling person or an employee of the nursing home
from illegally engaging in activities regulated by sections
144A.01 to 144A.16. A temporary restraining order may be
granted by the court in the proceeding if continued activity by
the controlling person or employee would create an imminent risk
of harm to a resident of the facility.
Sec. 23. Minnesota Statutes 1988, section 144A.15,
subdivision 1, is amended to read:
Subdivision 1. [PETITION, NOTICE.] In addition to any
other remedy provided by law, the commissioner of health may
petition the district court in Ramsey or Hennepin county or in
the district in which a nursing home or certified boarding care
home is located for an order directing the controlling persons
of the nursing home or certified boarding care home to show
cause why the commissioner of health or a designee should not be
appointed receiver to operate the facility. The petition to the
district court shall contain proof by affidavit that the
commissioner of health has either commenced license suspension
or revocation proceedings, suspended or revoked a license, or
decided not to renew the nursing home license, or that
violations of section 1919(b), (c), or (d), of the Social
Security Act, or the regulations adopted under that section, or
violations of state law or rules, create an emergency. The
order to show cause shall be returnable not less than five days
after service is completed and shall provide for personal
service of a copy to the nursing home administrator and to the
persons designated as agents by the controlling persons to
accept service on their behalf pursuant to section 144A.03,
subdivision 2.
Sec. 24. Minnesota Statutes 1988, section 144A.15, is
amended by adding a subdivision to read:
Subd. 2a. [EMERGENCY PROCEDURE.] If it appears from the
petition filed under subdivision 1, or from an affidavit or
affidavits filed with the petition, or from testimony of
witnesses under oath when the court determines that this is
necessary, that there is probable cause to believe that an
emergency exists in a nursing home or certified boarding care
home, the court shall issue a temporary order for appointment of
a receiver within five days after receipt of the petition.
Notice of the petition shall be served personally on the nursing
home administrator and on the persons designated as agents by
the controlling persons to accept service on their behalf
according to section 144A.03, subdivision 2. A hearing on the
petition shall be held within five days after notice is served
unless the administrator or designated agent consents to a later
date. After the hearing, the court may continue, modify, or
terminate the temporary order.
Sec. 25. Minnesota Statutes 1988, section 144A.15, is
amended by adding a subdivision to read:
Subd. 6. [RATE RECOMMENDATION.] The commissioner may
recommend to the commissioner of human services a review of the
rates for a nursing home or boarding care home that participates
in the medical assistance program that is in involuntary
receivership, and that has needs or deficiencies documented by
the department of health. If the commissioner of health
determines that a review of the rate under section 256B.431 is
needed, the commissioner shall provide the commissioner of human
services with:
(1) a copy of the order or determination that cites the
deficiency or need; and
(2) the commissioner's recommendation for additional staff
and additional annual hours by type of employee and additional
consultants, services, supplies, equipment, or repairs necessary
to satisfy the need or deficiency.
Sec. 26. [144A.135] [TRANSFER AND DISCHARGE APPEALS.]
The commissioner shall establish a mechanism for hearing
appeals on transfers and discharges of residents by nursing
homes or boarding care homes licensed by the commissioner. The
commissioner may adopt permanent rules to implement this section.
Sec. 27. [144A.155] [PLACEMENT OF MONITOR.]
Subdivision 1. [AUTHORITY.] The commissioner may place a
person to act as a monitor in a nursing home or certified
boarding care home in any of the circumstances listed in clause
(1) or (2):
(1) in any situation for which a receiver may be appointed
under section 144A.15; or
(2) when the commissioner determines that violations of
sections 144.651, 144A.01 to 144A.16, 626.557, or section
1919(b), (c), or (d), of the Social Security Act, or rules or
regulations adopted under those provisions, require extended
surveillance to enforce compliance or protect the health,
safety, or welfare of the residents.
Subd. 2. [DUTIES OF MONITOR.] The monitor shall observe
the operation of the home, provide advice to the home on methods
of complying with state and federal rules and regulations, where
documented deficiencies from the regulations exist, and
periodically shall submit a written report to the commissioner
on the ways in which the home meets or fails to meet state and
federal rules and regulations.
Subd. 3. [SELECTION OF MONITOR.] The commissioner may
select as monitor an employee of the department or may contract
with any other individual to serve as a monitor. The
commissioner shall publish a notice in the State Register that
requests proposals from individuals who wish to be considered
for placement as monitors, and that sets forth the criteria for
selecting individuals as monitors. The commissioner shall
maintain a list of individuals who are not employees of the
department who are interested in serving as monitors. The
commissioner may contract with those individuals determined to
be qualified.
Subd. 4. [PAYMENT OF MONITOR.] A nursing home or certified
boarding care home in which a monitor is placed shall pay to the
department the actual costs associated with the placement,
unless payment would create an undue hardship for the home.
Sec. 28. Minnesota Statutes 1988, section 144A.61, is
amended to read:
144A.61 [NURSING ASSISTANT TRAINING.]
Subdivision 1. [PURPOSE AUTHORITY.] The purpose of this
section and section 144A.611 is to improve the quality of care
provided to patients of nursing homes by assuring that approved
programs for the training of nursing assistants are established
as necessary throughout the state. 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, testing, and the
establishment of a registry for nursing assistants in nursing
homes and boarding care homes certified for participation in the
medical assistance or Medicare programs. The commissioner of
health may adopt permanent rules that may be necessary to
implement Public Law Number 100-203 and provisions of this
section. The commissioner of health may contract with outside
parties for the purpose of implementing the provisions of this
section. At the request of the commissioner, the board of
nursing may establish training and competency evaluation
standards; review, evaluate, and approve curricula; review and
approve training programs; and establish a registry of nursing
assistants.
Subd. 2. [NURSING ASSISTANTS.] For the purposes of this
section and section 144A.611 "nursing assistant" means a nursing
home or certified boarding care home employee, including a
nurse's aide or an orderly, who is assigned by the director of
nursing to provide or assist in the provision of direct patient
care nursing or nursing-related services under the supervision
of a registered nurse. "Nursing assistant" includes nursing
assistants employed by nursing pool companies but does not
include a licensed health professional. The commissioner
of education health may, by rule, establish categories of
nursing assistants who are not required to comply with the
educational requirements of this section and section 144A.611.
Subd. 3. [CURRICULA; TEST.] The commissioner of state
director of vocational technical education shall develop
curricula and a test to be used for nursing assistant training
programs for employees of nursing homes and boarding care
homes. The curricula, as reviewed, approved, and evaluated by
the board of nursing, shall be utilized by all facilities,
institutions, or programs offering nursing assistant training
programs. The test may be given by any technical institute or
community college in accordance with instructions from the
commissioner of education. The commissioner of education may
prescribe a fee for the administration of the test not to exceed
$30.
Subd. 3a. [COMPETENCY EVALUATION PROGRAM.] The
commissioner of health shall approve the competency evaluation
program. A test must be administered to nursing assistants who
complete an approved training program and desire to be listed in
the nursing assistant registry. The tests may only be
administered by technical institutes and community colleges.
Subd. 4. [TECHNICAL ASSISTANCE.] The commissioner of state
director of vocational technical education shall, upon request,
provide necessary and appropriate technical assistance in the
development of nursing assistant training programs.
Subd. 6. [TRAINING PROGRAM.] Each nursing assistant hired
to work in a nursing home on or after January 1, 1979, shall but
before January 1, 1990, must have successfully completed an
approved nursing assistant training program or shall be enrolled
in the first available approved training program which is
scheduled to commence within 60 days of the date of the
assistant's employment. Approved training programs shall be
offered at the location most reasonably accessible to the
enrollees in each class.
Subd. 6a. [NURSING ASSISTANTS HIRED IN 1990 AND
AFTER.] Each nursing assistant hired to work in a nursing home
or in a certified boarding care home on or after January 1,
1990, must have successfully completed an approved nursing
assistant training program and competency evaluation within four
months from the date of employment.
Subd. 7. [VIOLATION, PENALTY.] Violation of this section
and section 144A.611 by a nursing home or certified boarding
care home shall be grounds for the issuance of a correction
order to the nursing home by the state commissioner of
health. Under the provisions of sections 144.653 or 144A.10,
the failure of the nursing home or certified boarding care home
to correct the deficiency or deficiencies specified in comply
with the correction order shall result in the assessment of a
fine in accordance with the schedule of fines promulgated by
rule of the state commissioner of health the amount of $300.
Subd. 8. [EXCEPTIONS.] Employees of nursing homes
conducted in accordance with the teachings of the body known as
the Church of Christ, Scientist, shall be exempt from the
requirements of this section and section 144A.611.
Sec. 29. Minnesota Statutes 1988, section 144A.611, is
amended to read:
144A.611 [REIMBURSABLE EXPENSES PAYABLE TO NURSING
ASSISTANTS.]
Subdivision 1. [NURSING HOMES AND CERTIFIED BOARDING CARE
HOMES.] The actual costs of tuition and reasonable expenses
for that approved program deemed by the commissioner of
education to be minimally necessary to protect the health and
welfare of nursing home residents the nursing assistant training
program approved under section 144A.61, which are paid to
nursing home assistants pursuant to subdivision 2, shall be are
a reimbursable expense for nursing homes and certified boarding
care homes under the provisions of chapter 256B and the rules
promulgated thereunder.
Subd. 2. [NURSING ASSISTANTS.] A nursing assistant who has
completed an approved training program shall be reimbursed by
the nursing home or certified boarding care home for actual
costs of tuition and reasonable expenses for the training
program 90 days after the date of employment, or upon completion
of the approved training program, whichever is later.
Subd. 3. [RULES.] The commissioner of human services shall
promulgate any rules necessary to implement the provisions of
this section. The rules shall include, but not be limited to:
(a) Provisions designed to prevent reimbursement by the
commissioner under this section and section 144A.61 to a nursing
home, certified boarding care home, or a nursing assistant for
the assistant's simultaneous training in more than one approved
program;
(b) Provisions designed to prevent reimbursement by the
commissioner under this section and section 144A.61 to more than
one nursing home or certified boarding care home for the
training of any individual nursing assistant; and
(c) Provisions permitting the reimbursement by the
commissioner to nursing homes, certified boarding care homes,
and nursing assistants for the retraining of a nursing assistant
after an absence from the labor market of not less than five
years 24 months.
Sec. 30. Minnesota Statutes 1988, section 145.61,
subdivision 5, is amended to read:
Subd. 5. "Review organization" means a nonprofit
organization acting according to clause (k) or a committee whose
membership is limited to professionals and administrative staff,
except where otherwise provided for by state or federal law, and
which is established by a hospital, by a clinic, by one or more
state or local associations of professionals, by an organization
of professionals from a particular area or medical institution,
by a health maintenance organization as defined in chapter 62D,
by a nonprofit health service plan corporation as defined in
chapter 62C or, by a professional standards review organization
established pursuant to United States Code, title 42, section
1320c-1 et seq., or by a medical review agent established to
meet the requirements of section 256B.04, subdivision 15, or
256D.03, subdivision 7, paragraph (b), or by the department of
human services, to gather and review information relating to the
care and treatment of patients for the purposes of:
(a) evaluating and improving the quality of health care
rendered in the area or medical institution;
(b) reducing morbidity or mortality;
(c) obtaining and disseminating statistics and information
relative to the treatment and prevention of diseases, illness
and injuries;
(d) developing and publishing guidelines showing the norms
of health care in the area or medical institution;
(e) developing and publishing guidelines designed to keep
within reasonable bounds the cost of health care;
(f) reviewing the quality or cost of health care services
provided to enrollees of health maintenance organizations;
(g) acting as a professional standards review organization
pursuant to United States Code, title 42, section 1320c-1 et
seq.;
(h) determining whether a professional shall be granted
staff privileges in a medical institution or whether a
professional's staff privileges should be limited, suspended or
revoked; or
(i) reviewing, ruling on, or advising on controversies,
disputes or questions between:
(1) health insurance carriers or health maintenance
organizations and their insureds or enrollees;
(2) professional licensing boards acting under their powers
including disciplinary, license revocation or suspension
procedures and health providers licensed by them when the matter
is referred to a review committee by the professional licensing
board;
(3) professionals and their patients concerning diagnosis,
treatment or care, or the charges or fees therefor;
(4) professionals and health insurance carriers or health
maintenance organizations concerning a charge or fee for health
care services provided to an insured or enrollee;
(5) professionals or their patients and the federal, state,
or local government, or agencies thereof; or
(j) providing underwriting assistance in connection with
professional liability insurance coverage applied for or
obtained by dentists, or providing assistance to underwriters in
evaluating claims against dentists.;
(k) acting as a medical review agent under section 256B.04,
subdivision 15, or 256D.03, subdivision 7, paragraph (b); or
(l) providing recommendations on the medical necessity of a
health service, or the relevant prevailing community standard
for a health service.
Sec. 31. Minnesota Statutes 1988, section 145.63, is
amended to read:
145.63 [LIMITATION ON LIABILITY FOR SPONSORING
ORGANIZATIONS, REVIEW ORGANIZATIONS, AND MEMBERS OF REVIEW
ORGANIZATIONS.]
Subdivision 1. [MEMBERS.] No review organization and no
person who is a member or employee of, who acts in an advisory
capacity to or who furnishes counsel or services to, a review
organization shall be liable for damages or other relief in any
action brought by a person or persons whose activities have been
or are being scrutinized or reviewed by a review organization,
by reason of the performance by the person of any duty,
function, or activity of such review organization, unless the
performance of such duty, function or activity was motivated by
malice toward the person affected thereby. No review
organization and no person shall be liable for damages or other
relief in any action by reason of the performance of the review
organization or person of any duty, function, or activity as
a review organization or a member of a review committee or by
reason of any recommendation or action of the review committee
when the person acts in the reasonable belief that the action or
recommendation is warranted by facts known to the person or the
review organization after reasonable efforts to ascertain the
facts upon which the review organization's action or
recommendation is made, except that any corporation designated
as a review organization under the Code of Federal Regulations,
title 42, section 466 (1983) shall be subject to actions for
damages or other relief by reason of any failure of a person,
whose care or treatment is required to be scrutinized or
reviewed by the review organization, to receive medical care or
treatment as a result of a determination by the review
organization that medical care was unnecessary or inappropriate.
Subd. 2. [ORGANIZATIONS.] No state or local association of
professionals or organization of professionals from a particular
area shall be liable for damages or other relief in any action
brought by a person whose activities have been or are being
scrutinized or reviewed by a review organization established by
the association or organization, unless the association or
organization was motivated by malice towards the person affected
by the review or scrutiny.
Sec. 32. Minnesota Statutes 1988, section 214.06,
subdivision 1, is amended to read:
Subdivision 1. Notwithstanding any law to the contrary,
the commissioner of health as authorized by section 214.13, all
health-related licensing boards and all non-health-related
licensing boards shall by rule, with the approval of the
commissioner of finance, adjust any fee which the commissioner
of health or the board is empowered to assess a sufficient
amount so that the total fees collected by each board will as
closely as possible equal anticipated expenditures during the
fiscal biennium, as provided in section 16A.128. For members of
an occupation registered after July 1, 1984 by the commissioner
of health under the provisions of section 214.13, the fee
established must include an amount necessary to recover, over a
five-year period, the commissioner's direct expenditures for
adoption of the rules providing for registration of members of
the occupation. All fees received shall be deposited in the
state treasury. Fees received by health-related licensing
boards must be credited to the special revenue fund. Any
balance remaining in the special revenue fund at the end of each
fiscal year, after payment of health-related licensing board
expenses including salaries, attorney general fees, and indirect
costs, must be credited to the public health fund.
Sec. 33. Minnesota Statutes 1988, section 256.936,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For purposes of this section
the following terms shall have the meanings given them:
(a) "Eligible persons" means children who are one year of
age or older but less than nine 18 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. 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 18 years old.
(b) "Covered services" means children's health services.
(c) "Children's health services" means the health services
reimbursed under chapter 256B, with the exception of inpatient
hospital services, special education 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.
(d) "Eligible providers" means those health care providers
who provide children's health services to medical assistance
clients recipients 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.
(e) "Commissioner" means the commissioner of human services.
(f) "Gross family income" for farm and nonfarm
self-employed means income calculated using as the baseline the
adjusted gross income reported on the applicant's federal income
tax form for the previous year and adding back in reported
depreciation, carryover loss, and net operating loss amounts
that apply to the business in which the family is currently
engaged. Applicants shall report the most recent financial
situation of the family if it has changed from the period of
time covered by the federal income tax form. The report may be
in the form of percentage increase or decrease.
Sec. 34. Minnesota Statutes 1988, section 256.936,
subdivision 2, is amended to read:
Subd. 2. [PLAN ADMINISTRATION.] The children's health plan
is established to promote access to appropriate primary health
care to assure healthy children. The commissioner shall
establish an office for the state administration of this plan.
The plan shall be used to provide children's health services for
eligible persons. Payment for these services shall be made to
all eligible providers. The commissioner may adopt rules to
administer this section. 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 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.
Sec. 35. Minnesota Statutes 1988, section 256.936,
subdivision 4, is amended to read:
Subd. 4. [ENROLLMENT FEE.] An annual enrollment fee of
$25, not to exceed $150 per family, is required from eligible
persons for children's health services. Enrollment fees must be
deposited in the public health fund and are appropriated
dedicated 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. 36. [256.9685] [ESTABLISHMENT OF INPATIENT HOSPITAL
PAYMENT SYSTEM.]
Subdivision 1. [AUTHORITY.] The commissioner shall
establish procedures for determining medical assistance and
general assistance medical care payment rates under a
prospective payment system for inpatient hospital services in
hospitals that qualify as vendors of medical assistance. The
commissioner shall establish, by rule, procedures for
implementing this section and sections 256.9686, 256.969, and
256.9695. The payment rates must 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 recipients
in efficiently and economically operated hospitals. Services
must meet the requirements of section 256B.04, subdivision 15,
or 256D.03, subdivision 7, paragraph (b), to be eligible for
payment.
Subd. 2. [FEDERAL REQUIREMENTS.] If it is determined that
a provision of this section or section 256.9686, 256.969, or
256.9695 conflicts with existing or future requirements of the
United States government with respect to federal financial
participation in medical assistance, the federal requirements
prevail. The commissioner may, in the aggregate, prospectively
reduce payment rates to avoid reduced federal financial
participation resulting from rates that are in excess of the
medicare limitations.
Sec. 37. [256.9686] [DEFINITIONS.]
Subdivision 1. [SCOPE.] For purposes of this section and
sections 256.9685, 256.969, and 256.9695, the following terms
and phrases have the meanings given.
Subd. 2. [BASE YEAR.] "Base year" means a hospital's
fiscal year that is recognized by the Medicare program or a
hospital's fiscal year specified by the commissioner if a
hospital is not required to file information by the Medicare
program from which cost and statistical data are used to
establish medical assistance and general assistance medical care
payment rates.
Subd. 3. [CASE MIX INDEX.] "Case mix index" means a
hospital's distribution of relative values among the diagnostic
categories.
Subd. 4. [CHARGES.] "Charges" means the usual and
customary payment requested of the general public.
Subd. 5. [COMMISSIONER.] "Commissioner" means the
commissioner of human services.
Subd. 6. [HOSPITAL.] "Hospital" means a facility licensed
under sections 144.50 to 144.58 or an out-of-state facility
licensed under the requirements of that state in which it is
located.
Subd. 7. [MEDICAL ASSISTANCE.] "Medical assistance" means
the program established under chapter 256B and Title XIX of the
Social Security Act. Medical assistance includes general
assistance medical care established under chapter 256D, unless
otherwise specifically stated.
Subd. 8. [RATE YEAR.] "Rate year" means a calendar year
from January 1 to December 31.
Subd. 9. [RELATIVE VALUE.] "Relative value" means the
average allowable cost of inpatient services provided within a
diagnostic category divided by the average allowable cost of
inpatient services provided in all diagnostic categories.
Sec. 38. Minnesota Statutes 1988, section 256.969, is
amended to read:
256.969 [INPATIENT HOSPITALS PAYMENT RATES.]
Subdivision 1. [ANNUAL HOSPITAL COST INDEX.] The
commissioner of human services shall develop a prospective
payment system for inpatient hospital service under the medical
assistance and general assistance medical care programs. Rates
established for licensed hospitals for rate years beginning
during the fiscal biennium ending June 30, 1987, shall not
exceed an annual hospital cost index for the final rate allowed
to the hospital for the preceding year not to exceed five
percent in any event. The annual hospital cost index shall be
obtained from an independent source representing and shall
represent a statewide weighted average of inflation historical
and projected cost change estimates determined for expense
categories to include wages and salaries, employee benefits,
medical and professional fees, raw food, medical supplies,
pharmaceuticals, utilities, repairs and maintenance, insurance
other than including malpractice insurance, and other applicable
expenses as determined by the commissioner. The index shall
reflect the regional differences within the state and include a
one percent increase to reflect changes in technology. The
annual hospital cost index shall be published 30 days before the
start of each calendar quarter and shall be applicable to all
hospitals whose fiscal years start on or during the calendar
quarter. Minnesota cost category weights. Individual indices
shall be specific to Minnesota if the commissioner determines
that sufficient accuracy of the hospital cost index is
achieved. The hospital cost index shall be used to adjust the
base year operating payment rate through the rate year on an
annually compounded basis.
Subd. 2. [RATES FOR INPATIENT HOSPITALS DIAGNOSTIC
CATEGORIES.] On July 1, 1984, The commissioner shall begin to
utilize use to the extent possible existing diagnostic
classification systems, including the system used by the
Medicare program to determine the relative values of inpatient
services and case mix indices. 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 commissioner may combine diagnostic
classifications into diagnostic categories and may establish
separate categories and numbers of categories based on program
eligibility or hospital peer group. Relative values shall be
recalculated when the base year is changed and shall not be
determined on a hospital specific basis. Relative value
determinations shall include paid claims for admissions during
each hospital's base year. The commissioner may extend the time
period forward to obtain sufficiently valid information to
establish relative values. Relative value determinations shall
not include property cost data, Medicare crossover data, and
data from the transferring hospital on transfer discharges,
except data on transfer discharges with a burn diagnostic
classification or data on transfer discharges for the patient's
convenience that have been reported by the hospital to the
commissioner by the October 1 preceding the rate year. 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 recognized in outlier payments 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 recategorize the
diagnostic categories classifications and recalculate relative
values and case mix indices 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
hospital cost index described in subdivision 1. When computing
budgeted pass-through cost payments, the commissioner shall use
the annual increase in the 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 hospital cost
index for the month in which the hospital's fiscal year ends
compared to the same month one year earlier.
Subd. 2a. [AUDIT ADJUSTMENTS TO INPATIENT HOSPITAL RATES.]
Inpatient hospital rates established under subdivision 2 using
1981 historical medicare cost-report data may be adjusted based
on the findings of audits of hospital billings and patient
records performed by the commissioner that identify billings for
services that were not delivered or never ordered. The audit
findings may be based on a statistically valid sample of
billings of the hospital. After the audits are complete, the
commissioner shall adjust rates paid in subsequent years to
reflect the audit findings and recover payments in excess of the
adjusted rates or reimburse hospitals when audit findings
indicate that underpayments were made to the hospital.
Subd. 2b. [OPERATING PAYMENT RATES.] In determining
operating payment rates for admissions occurring on or after the
rate year beginning January 1, 1991, and every two years after,
or more frequently as determined by the commissioner, the
commissioner shall obtain operating data from an updated base
year and establish operating payment rates per admission for
each hospital based on the cost-finding methods and allowable
costs of the Medicare program in effect during the base year.
The base year operating payment rate per admission is
standardized by the case mix index and adjusted by the hospital
cost index, relative values, and disproportionate population
adjustment. The cost and charge data used to establish
operating rates shall only reflect inpatient services covered by
medical assistance and shall not include property cost
information and costs recognized in outlier payments.
Subd. 2c. [PROPERTY PAYMENT RATES.] For each hospital's
first two consecutive fiscal years beginning on or after July 1,
1988, the commissioner shall limit the annual increase in
property payment rates for depreciation, rents and leases, and
interest expense to the annual growth in the hospital cost index
derived from the methodology in effect on the day before the
effective date of this section. When computing budgeted and
settlement property payment rates, the commissioner shall use
the annual increase in the hospital cost index forecasted by
Data Resources, Inc., consistent with the quarter of the
hospital's fiscal year end. For admissions occurring on or
after January 1, 1991, the commissioner shall obtain property
data from an updated base year and establish property payment
rates per admission for each hospital. Property payment rates
shall be derived from data from the same base year that is used
to establish operating payment rates. The property information
shall include cost categories not subject to the hospital cost
index and shall reflect the cost-finding methods and allowable
costs of the Medicare program in effect during the base year.
The property payment rate per admission shall be adjusted for
positive percentage change differences in the net book value of
hospital property and equipment by increasing the property
payment rate per admission 85 percent of the percentage change
from the base year through the most recent year ending prior to
the rate year for which required information is available. The
percentage change shall be derived from equivalent audited
information in both years and shall be adjusted to account for
changes in generally accepted accounting principles,
reclassification of assets, allocations to non-hospital areas,
and fiscal years. The cost, audit, and charge data used to
establish property rates shall only reflect inpatient services
covered by medical assistance and shall not include operating
cost information. To be eligible for the property payment rate
per admission adjustment, the hospital must provide the
necessary information to the commissioner, in a format specified
by the commissioner, by the October 1 preceding the rate year.
The commissioner shall adjust rates for the rate year beginning
January 1, 1991, to ensure that all hospitals are subject to the
hospital cost index limitation for two complete years.
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) The computation of each hospital's payment rate and the
relative values of the diagnostic categories are not subject to
the routine service cost limitation imposed under the Medicare
program.
(d) Indian health service facilities are exempt from the
rate establishment methods required by this section and section
256D.03, subdivision 4, and shall be reimbursed at the
facility's usual and customary charges to the general public.
(e) Out-of-state hospitals that are located within a
Minnesota local trade area shall have rates established using
the same procedures and methods that apply to Minnesota
hospitals. Hospitals that are not required by law to file
information in a format necessary to establish rates shall have
rates established based on the commissioner's estimates of the
information. Relative values of the diagnostic categories shall
not be redetermined under this paragraph until required by rule
and hospitals affected by this paragraph shall then be included
in determining relative values. However, hospitals that have
rates established based upon the commissioner's estimates of
information shall not be included in determining relative values.
This paragraph is effective for hospital fiscal years beginning
on or after July 1, 1988. A hospital shall provide the
information necessary to establish rates under this paragraph at
least 90 days before the start of the hospital's fiscal year.
(f) Hospitals that are not located within Minnesota or a
Minnesota local trade area shall have rates established as
provided in paragraph (e) or, at the commissioner's discretion,
at an amount negotiated by the commissioner. Relative values
shall not be affected by negotiated rates.
(g) 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.
Subd. 3a. [PAYMENTS.] Acute care hospital billings under
the medical assistance program must not be submitted until the
recipient is discharged. However, the commissioner shall
establish monthly interim payments for inpatient hospitals that
have individual patient lengths of stay over 30 days regardless
of diagnostic category. To establish interim rates, the
commissioner is exempt from the requirements of chapter 14.
Medical assistance reimbursement for treatment of mental illness
shall be reimbursed based on diagnostic classifications. The
commissioner may selectively contract with hospitals for
services within the diagnostic categories 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 use a hospital under contract with the commissioner,
as long as the physician meets credentialing standards of the
individual hospital. Individual hospital payments established
under this section and sections 256.9685, 256.9686, and
256.9695, in addition to third party liability, for admissions
occurring during the rate year shall not exceed, in aggregate,
the charges for the medical assistance covered inpatient
services paid for the same period of time to the hospital. This
payment limitation is not applicable and shall not be calculated
to include general assistance medical care services. Services
that have rates established under subdivision 6a, paragraph (a),
clause (5) or (6), must be limited separately from other
services. After consulting with the affected hospitals, the
commissioner may consider related hospitals one entity and may
merge the payment rates while maintaining separate provider
numbers. The operating and property base rates per admission or
per day shall be derived from the best Medicare and claims data
available when rates are established. The commissioner shall
determine the best Medicare and claims data, taking into
consideration variables of recency of the data, audit
disposition, settlement status, and the ability to set rates in
a timely manner. The commissioner shall notify hospitals of
payment rates by December 1 of the year preceding the rate
year. The rate setting data must reflect the admissions data
used to establish relative values. Base year changes from 1981
to the base year established for the rate year beginning January
1, 1991, and for subsequent rate years, shall not be limited to
the limits ending June 30, 1987, on the maximum rate of increase
under subdivision 1. The commissioner may adjust base year
cost, relative value, and case mix index data to exclude the
costs of services that have been discontinued by the October 1
of the year preceding the rate year or that are paid separately
from inpatient services. Inpatient stays that encompass
portions of two or more rate years shall have payments
established based on payment rates in effect at the time of
admission unless the date of admission preceded the rate year in
effect by six months or more. In this case, operating payment
rates for services rendered during the rate year in effect and
established based on the date of admission shall be adjusted to
the rate year in effect by the hospital cost index.
Subd. 4. [APPEALS BOARD.] An appeals board shall be
established for purposes of hearing reports for changes in the
rate per admission. The appeals board shall consist of two
public representatives, two representatives of the hospital
industry, and one representative of the business or consumer
community. The appeals board shall advise the commissioner on
adjustments to hospital rates under this section.
Subd. 4a. [REPORTS.] If, under this section or section
256.9685, 256.9686, or 256.9695, a hospital is required to
report information to the commissioner by a specified date, the
hospital must report the information on time. If the hospital
does not report the information on time, the commissioner may
determine the information that will be used and may disregard
the information that is reported late. If the Medicare program
does not require or does not audit information that is needed to
establish medical assistance rates, the commissioner may, after
consulting the affected hospitals, require reports to be
provided, in a format specified by the commissioner, that are
based on allowable costs and cost-finding methods of the
Medicare program in effect during the base year. The
commissioner may require any information that is necessary to
implement this section and sections 256.9685, 256.9686, and
256.9695 to be provided by a hospital within a reasonable time
period.
Subd. 5. [APPEAL RIGHTS.] Nothing in this section
supersedes the contested case provisions of chapter 14, the
administrative procedure act.
Subd. 5a. [AUDITS AND ADJUSTMENTS.] Inpatient hospital
rates and payments must be established under this section and
sections 256.9685, 256.9686, and 256.9695. The commissioner may
adjust rates and payments based on the findings of audits of
payments to hospitals, hospital billings, costs, statistical
information, charges, or patient records performed by the
commissioner or the Medicare program that identify billings,
costs, statistical information, or charges for services that
were not delivered, never ordered, in excess of limits, not
covered by the medical assistance program, paid separately from
rates established under this section and sections 256.9685,
256.9686, and 256.9695, or for charges that are not consistent
with other payor billings. Charges to the medical assistance
program must be less than or equal to charges to the general
public. Charges to the medical assistance program must not
exceed the lowest charge to any other payor. The audit findings
may be based on a statistically valid sample of hospital
information that is needed to complete the audit. If the
information the commissioner uses to establish rates or payments
is not audited by the Medicare program, the commissioner may
require an audit using Medicare principles and may adjust rates
and payments to reflect any subsequent audit.
Subd. 6. [RULES.] The commissioner of human services shall
promulgate emergency and permanent rules to implement a system
of prospective payment for inpatient hospital services pursuant
to chapter 14, the administrative procedure act.
Notwithstanding section 14.53, emergency rule authority
authorized by Laws 1983, chapter 312, article 5, section 9,
subdivision 6, shall extend to August 1, 1985.
Subd. 6a. [SPECIAL CONSIDERATIONS.] (a) In determining the
payment rates, the commissioner shall consider whether the
following circumstances exist:
(1) [MINIMAL MEDICAL ASSISTANCE USE.] Minnesota hospitals
with 30 or fewer annualized admissions of Minnesota medical
assistance recipients in the base year, excluding Medicare
crossover admissions, may have the base year operating rates, as
adjusted by the case mix index, and property payment rates
established at the 70th percentile of hospitals in the peer
group in effect during the base year as established by the
Minnesota department of health for use by the rate review
program. Rates within a peer group shall be adjusted for
differences in fiscal years and outlier percentage payments
before establishing the 70th percentile. The operating payment
rate portion of the 70th percentile shall be adjusted by the
hospital cost index. To have rates established under this
paragraph, the hospital must notify the commissioner in writing
by November 1 of the year preceding the rate year. This
paragraph shall be applied to all payment rates of the affected
hospital.
(2) [UNUSUAL COST OR LENGTH OF STAY EXPERIENCE.] The
commissioner shall establish day and cost outlier thresholds for
each diagnostic category established under subdivision 2 at two
standard deviations beyond the geometric mean length of stay or
allowable cost. Payment for the days and cost beyond the
outlier threshold shall be in addition to the operating and
property payment rates per admission established under
subdivisions 2, 2b and 2c. Payment for outliers shall be at 70
percent of the allowable operating cost calculated by dividing
the operating payment rate per admission, after adjustment by
the case mix index, hospital cost index, relative values and the
disproportionate population adjustment, by the arithmetic mean
length of stay for the diagnostic category. The outlier
threshold for neonatal and burn diagnostic categories shall be
established at one standard deviation beyond the geometric mean
length of stay or allowable cost, and payment shall be at 90
percent of allowable operating cost calculated in the same
manner as other outliers. A hospital may choose an alternative
percentage outlier payment to a minimum of 60 percent and a
maximum of 80 percent if the commissioner is notified in writing
of the request by October 1 of the year preceding the rate
year. The chosen percentage applies to all diagnostic
categories except burns and neonates. The percentage of
allowable cost that is unrecognized by the outlier payment shall
be added back to the base year operating payment rate per
admission. Cost outliers shall be calculated using hospital
specific allowable cost data. If a stay is both a day and a
cost outlier, outlier payments shall be based on the higher
outlier payment.
(3) [DISPROPORTIONATE NUMBERS OF LOW-INCOME PATIENTS
SERVED.] For admissions occurring on or after July 1, 1989, the
medical assistance disproportionate population adjustment shall
comply with federal law at fully implemented rates. The
commissioner may establish a separate disproportionate
population operating payment rate adjustment under the general
assistance medical care program. For admissions occurring on or
after January 1, 1991, the disproportionate population
adjustment shall be derived from base year Medicare cost report
data and may be adjusted by data reflecting actual claims paid
by the department.
(4) [SEPARATE BILLING BY CERTIFIED REGISTERED NURSE
ANESTHETISTS.] Hospitals may exclude certified registered nurse
anesthetist costs from the operating payment rate as allowed by
section 256B.0625, subdivision 11. To be eligible, a hospital
must notify the commissioner in writing by October 1 of the year
preceding the rate year of the request to exclude certified
registered nurse anesthetist costs. The hospital must agree
that all hospital claims for the cost and charges of certified
registered nurse anesthetist services will not be included as
part of the rates for inpatient services provided during the
rate year. In this case, the operating payment rate shall be
adjusted to exclude the cost of certified registered nurse
anesthetist services. Payments made through separate claims for
certified registered nurse anesthetist services shall not be
paid directly through the hospital provider number or indirectly
by the certified registered nurse anesthetist to the hospital or
related organizations.
(5) [SPECIAL RATES.] The commissioner may establish special
rate-setting methodologies, including a per day operating and
property payment system, for hospice, ventilator dependent, and
other services on a hospital and recipient specific basis taking
into consideration such variables as federal designation,
program size, and admission from a medical assistance waiver or
home care program. The data and rate calculation method shall
conform to the requirements of paragraph (7), except that
hospice rates shall not exceed the amount allowed under federal
law and payment shall be secondary to any other medical
assistance hospice program. Rates and payments established
under this paragraph must meet the requirements of section
256.9685, subdivisions 1 and 2, and must not exceed payments
that would otherwise be made to a hospital in total for rate
year admissions under subdivisions 2, 2b, 2c, 3, 4, 5, and 6.
The cost and charges used to establish rates shall only reflect
inpatient medical assistance covered services. Hospital and
claims data that are used to establish rates under this
paragraph shall not be used to establish payments or relative
values under subdivisions 2, 2b, 2c, 3, 4, 5, and 6.
(6) [REHABILITATION DISTINCT PARTS.] Units of hospitals
that are recognized as rehabilitation distinct parts by the
Medicare program shall have separate provider numbers under the
medical assistance program for rate establishment and billing
purposes only. These units shall also have operating and
property payment rates and the disproportionate population
adjustment established separately from other inpatient hospital
services, based on the methods of subdivisions 2, 2b, 2c, 3, 4,
5, and 6. The commissioner may establish separate relative
values under subdivision 2 for rehabilitation hospitals and
distinct parts as defined by the Medicare program. For
individual hospitals that did not have separate medical
assistance rehabilitation provider numbers or rehabilitation
distinct parts in the base year, hospitals shall provide the
information needed to separate rehabilitation distinct part cost
and claims data from other inpatient service data.
(7) [NEONATAL TRANSFERS.] For admissions occurring on or
after July 1, 1989, neonatal diagnostic category transfers shall
have operating and property payment rates established at
receiving hospitals which have neonatal intensive care units on
a per day payment system that is based on the cost finding
methods and allowable costs of the Medicare program during the
base year. Other neonatal diagnostic category transfers shall
have rates established according to paragraph (8). The rate per
day for the neonatal service setting within the hospital shall
be determined by dividing base year neonatal allowable costs by
neonatal patient days. The operating payment rate portion of
the rate shall be adjusted by the hospital cost index and the
disproportionate population adjustment. The cost and charges
used to establish rates shall only reflect inpatient services
covered by medical assistance. Hospital and claims data used to
establish rates under this paragraph shall not be used to
establish payments or relative values under subdivisions 2, 2b,
2c, 3, 4, 5, and 6.
(8) [TRANSFERS.] Except as provided in paragraphs (5) and
(7), operating and property payment rates for admissions that
result in transfers and transfers shall be established on a per
day payment system. The per day payment rate shall be the sum
of the adjusted operating and property payment rates determined
in subdivisions 2b and 2c, divided by the arithmetic mean length
of stay for the diagnostic category. Each admission that
results in a transfer and each transfer is considered a separate
admission to each hospital, and the total of the admission and
transfer payments to each hospital must not exceed the total per
admission payment that would otherwise be made to each hospital
under paragraph (2) and subdivisions 2b and 2c.
(b) The computation of each hospital's payment rate and the
relative values of the diagnostic categories are not subject to
the routine service cost limitation imposed under the Medicare
program.
(c) Indian health service facilities are exempt from the
rate establishment methods required by this section and shall be
reimbursed at the facility's usual and customary charges to the
general public. This exemption is not effective for payments
under general assistance medical care.
(d) Except as provided in paragraph (a), clauses (1) and
(3), out-of-state hospitals that are located within a Minnesota
local trade area shall have rates established using the same
procedures and methods that apply to Minnesota hospitals.
Hospitals that are not required by law to file information in a
format necessary to establish rates shall have rates established
based on the commissioner's estimates of the information.
Relative values of the diagnostic categories shall not be
redetermined under this paragraph until required by rule.
Hospitals affected by this paragraph shall then be included in
determining relative values. However, hospitals that have rates
established based upon the commissioner's estimates of
information shall not be included in determining relative values.
This paragraph is effective for hospital fiscal years beginning
on or after July 1, 1988. A hospital shall provide the
information necessary to establish rates under this paragraph at
least 90 days before the start of the hospital's fiscal year.
(e) Hospitals that are not located within Minnesota or a
Minnesota local trade area shall have operating and property
rates established at the average of statewide and local trade
area rates or, at the commissioner's discretion, at an amount
negotiated by the commissioner. Relative values shall not
include data from hospitals that have rates established under
this paragraph. Payments, including third party liability,
established under this paragraph may not exceed the charges on a
claim specific basis for inpatient services that are covered by
medical assistance.
(f) Medical assistance inpatient payment rates must include
the cost incurred by hospitals to pay the department of health
for metabolic disorder testing of newborns who are medical
assistance recipients, if the cost is not recognized by another
payment source.
(g) Medical assistance inpatient payments shall increase 20
percent for inpatient hospital originally paid admissions,
excluding Medicare crossovers, that occurred between July 1,
1988, and December 31, 1990, if: (i) the hospital had 100 or
fewer Minnesota medical assistance annualized paid admissions,
excluding Medicare crossovers, that were paid by March 1, 1988
for the period January 1, 1987, to June 30, 1987; (ii) the
hospital had 100 or fewer licensed beds on March 1, 1988; (iii)
the hospital is located in Minnesota; and (iv) the hospital is
not located in a city of the first class as defined in section
410.01. For this paragraph, medical assistance does not include
general assistance medical care.
(h) Medical assistance inpatient payments shall increase 15
percent for inpatient hospital originally paid admissions,
excluding Medicare crossovers, that occurred between July 1,
1988, and December 31, 1990, if: (i) the hospital had more than
100 but fewer than 250 Minnesota medical assistance annualized
paid admissions, excluding Medicare crossovers, that were paid
by March 1, 1988 for the period January 1, 1987, to June 30,
1987; (ii) the hospital had 100 or fewer licensed beds on March
1, 1988; (iii) the hospital is located in Minnesota; and (iv)
the hospital is not located in a city of the first class as
defined in section 410.01. For this paragraph, medical
assistance does not include general assistance medical care.
Sec. 39. [256.9695] [APPEALS OF RATES; PROHIBITED
PRACTICES FOR HOSPITALS; TRANSITION RATES.]
Subdivision 1. [APPEALS.] A hospital may appeal a decision
arising from the application of standards or methods under
section 256.9685, 256.9686, or 256.969, if an appeal would
result in a change to the hospital's payment rate or payments.
Both overpayments and underpayments that result from the
submission of appeals shall be implemented. Regardless of any
appeal outcome, relative values shall not be recalculated. The
appeal shall 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 office of administrative hearings. In any
proceeding under this section, the appealing party must
demonstrate by a preponderance of the evidence that the
commissioner's determination is incorrect or not according to
law.
(a) To appeal a payment rate or payment determination or a
determination made from base year information, the hospital
shall file a written appeal request to the commissioner within
60 days of the date the payment rate determination was mailed.
The appeal request shall specify: (i) the disputed items; (ii)
the authority in federal or state statute or rule upon which the
hospital relies for each disputed item; and (iii) the name and
address of the person to contact regarding the appeal. A change
to a payment rate or payments that results from a successful
appeal to the Medicare program of the base year information
establishing rates for the rate year beginning in 1991 and after
is a prospective adjustment to subsequent rate years. After
December 31, 1990, payment rates shall not be adjusted for
appeals of base year information that affect years prior to the
rate year beginning January 1, 1991. Facts to be considered in
any appeal of base year information are limited to those in
existence at the time the payment rates of the first rate year
were established from the base year information. In the case of
Medicare settled appeals, the 60-day appeal period shall begin
on the mailing date of the notice by the Medicare program or the
date the medical assistance payment rate determination notice is
mailed, whichever is later.
(b) To appeal a payment rate or payment change that results
from a difference in case mix between the base year and a rate
year, the procedures and requirements of paragraph (a) apply.
However, the appeal must be filed with the commissioner within
60 days after the end of a rate year. A case mix appeal must
apply to the cost of services to all medical assistance patients
that received inpatient services from the hospital during the
rate year appealed. For this paragraph, hospital means a
facility holding the provider number as an inpatient service
facility.
Subd. 2. [PROHIBITED PRACTICES.] (a) Hospitals that have a
provider agreement with the department may not limit medical
assistance admissions to percentages of certified capacity or to
quotas unless patients from all payors are limited in the same
manner. This requirement does not apply to certified capacity
that is unavailable due to contracts with payors for specific
occupancy levels.
(b) Hospitals may not transfer medical assistance patients
to or cause medical assistance patients to be admitted to other
hospitals without the explicit consent of the receiving hospital
when service needs of the patient are available and within the
scope of the transferring hospital. The transferring hospital
is liable to the receiving hospital for patient charges and
ambulance services without regard to medical assistance payments
plus the receiving hospital's reasonable attorney fees if found
in violation of this prohibition.
Subd. 3. [TRANSITION.] Except as provided in section
256.969, subdivision 6a, paragraph (a), clause (3), the
commissioner shall establish a transition period for the
calculation of payment rates from the effective date of this
section to December 31, 1990, as follows:
(a) Changes resulting from section 256.969, subdivision 6a,
paragraph (a), clauses (1), (2), (4), (5), (6), and (8), shall
not be implemented.
(b) Rates established for hospital fiscal years beginning
on or after July 1, 1989, shall not be adjusted for the one
percent technology factor included in the hospital cost index.
(c) Operating payment rates shall be indexed from the
hospital's most recent fiscal year ending prior to January 1,
1991, by prorating the hospital cost index methodology in effect
on January 1, 1989. Payments made for admissions occurring
after July 1, 1990, shall not include the one percent technology
factor.
(d) Property and pass-through payment rates shall be
maintained at the most recent payment rate effective for June 1,
1990. However, all hospitals are subject to the hospital cost
index limitation of subdivision 2c, for two complete fiscal
years. Property and pass-through costs shall be retroactively
settled through December 31, 1990. The laws in effect on the
day before the effective date of this section apply to the
retroactive settlement from the effective date of this section
to December 31, 1990.
Subd. 4. [STUDY.] The commissioner shall contract for an
evaluation of the inpatient and outpatient hospital payment
systems. The study shall include recommendations concerning:
(1) more effective methods of assigning operating and
property payment rates to specific services or diagnoses;
(2) effective methods of cost control and containment;
(3) fiscal impacts of alternative payment systems;
(4) the relationships of the use of and payment for
inpatient and outpatient hospital services;
(5) methods to relate reimbursement levels to the efficient
provision of services; and
(6) methods to adjust reimbursement levels to reflect cost
differences between geographic areas.
The commissioner shall report the findings to the
legislature by January 15, 1991, along with recommendations for
implementation.
Subd. 5. [RULES.] The commissioner of human services shall
adopt permanent rules to implement this section and sections
256.9685, 256.9686, and 256.969 under chapter 14, the
administrative procedure act.
Sec. 40. Minnesota Statutes 1988, 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 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 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) 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) The commissioner shall request a waiver from the
federal Health Care Financing Administration 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. 41. Minnesota Statutes 1988, section 256B.04,
subdivision 14, is amended to read:
Subd. 14. [COMPETITIVE BIDDING.] When determined to be
effective, economical, and feasible, the commissioner shall may
utilize volume purchase through competitive bidding and
negotiation under the provisions of chapter 16 16B, to
provide the following items under the medical assistance program
including but not limited to the following:
(1) eyeglasses;
(2) oxygen. The commissioner shall provide for oxygen
needed in an emergency situation on a short-term basis, until
the vendor can obtain the necessary supply from the contract
dealer;
(3) hearing aids and supplies; and
(4) durable medical equipment, including but not limited to:
(a) hospital beds;
(b) commodes;
(c) glide-about chairs;
(d) patient lift apparatus;
(e) wheelchairs and accessories;
(f) oxygen administration equipment;
(g) respiratory therapy equipment;
(h) electronic diagnostic, therapeutic and life support
systems;
(5) wheelchair special transportation services; and
(6) drugs.
Sec. 42. Minnesota Statutes 1988, section 256B.04, is
amended by adding a subdivision to read:
Subd. 17. [PRENATAL CARE OUTREACH.] (a) The commissioner
of human services shall award a grant to an eligible
organization to conduct a statewide media campaign promoting
early prenatal care. The goals of the campaign are to increase
public awareness of the importance of early and continuous
prenatal care and to inform the public about public and private
funds available for prenatal care.
(b) In order to receive a grant under this section, an
applicant must:
(1) have experience conducting prenatal care outreach;
(2) have an established statewide constituency or service
area; and
(3) demonstrate an ability to accomplish the purposes in
this subdivision.
(c) Money received under this subdivision may be used for
purchase of materials and supplies, staff fees and salaries,
consulting fees, and other goods and services necessary to
accomplish the goals of the campaign. Money may not be used for
capital expenditures.
Sec. 43. Minnesota Statutes 1988, section 256B.055,
subdivision 7, is amended to read:
Subd. 7. [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.
The methodology for calculating disregards and deductions from
income must be as specified in section 256D.37, subdivisions 6
to 14 the same methodology used for calculating income for the
supplemental security income program except as specified
otherwise by state or federal law, rule or regulation.
Effective February 1, 1989, and to the extent allowed by
federal law the commissioner shall deduct state and federal
income taxes and federal insurance contributions act payments
withheld from the individual's earned income in determining
eligibility under this subdivision.
Sec. 44. Minnesota Statutes 1988, section 256B.055,
subdivision 8, is amended to read:
Subd. 8. [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 subdivision 3, clause
(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.
Sec. 45. Minnesota Statutes 1988, section 256B.056,
subdivision 3, is amended to read:
Subd. 3. [ASSET LIMITATIONS.] To be eligible for medical
assistance, a person must not individually 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), 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: The value of the items in paragraphs (a)
to (i) are not considered in determining medical assistance
eligibility.
(a) The homestead, is not considered.
(b) Household goods and personal effects with a total
equity value of $2,000 or less, are not considered.
(c) Personal property used as a regular abode by the
applicant or recipient, is not considered.
(d) A lot in a burial plot for each member of the
household, is not considered.
(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, are not considered.
(f) For a period of six months, insurance settlements to
repair or replace damaged, destroyed, or stolen property, are
not considered.
(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 (h) other items which may be required by federal
law or statute is not considered.
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.
(h) Life insurance policies and assets designated as burial
expenses, according to the standards and restrictions of the
supplemental security income (SSI) program.
(i) Other items which may be excluded by federal law are
not considered.
Sec. 46. Minnesota Statutes 1988, section 256B.056,
subdivision 4, is amended to read:
Subd. 4. [INCOME.] To be eligible for medical assistance,
a person must not have, or anticipate receiving, semiannual
income in excess of 115 120 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.
Sec. 47. Minnesota Statutes 1988, section 256B.056,
subdivision 5, is amended to read:
Subd. 5. [EXCESS INCOME.] A person who has 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 by deducting incurred medical expenses
from the excess income to reduce the excess to the income
standard specified in subdivision 4. The person shall elect to
have the medical expenses deducted monthly at the beginning of a
one-month budget period or at the beginning of the a six-month
budget period; or who is a pregnant woman or infant up to one
year of age who meets the requirements of section 256B.055,
subdivisions 1 to 9, 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 185 percent of 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 subdivisions 2 and
4. 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. The commissioner shall seek applicable waivers from the
Secretary of Health and Human Services to allow persons eligible
for assistance on a spend-down basis under this subdivision to
elect to pay the monthly spend-down amount to the local agency
in order to maintain eligibility on a continuous basis for
medical assistance and to simplify payment to health care
providers. If the local agency has not received payment of the
spend-down amount by the 15th day of the month, the recipient is
ineligible for this option for the following month. The
commissioner may seek a waiver of the requirement of the Social
Security Act that all requirements be uniform statewide, to
phase in this option over a six-month period.
Sec. 48. [256B.057] [ELIGIBILITY; INCOME AND ASSET
LIMITATIONS FOR SPECIAL CATEGORIES.]
Subdivision 1. [PREGNANT WOMEN AND INFANTS.] An infant
less than one year of age or a pregnant woman, as certified in
writing by a physician or nurse midwife, is eligible for medical
assistance if countable family income is equal to or less than
185 percent of the federal poverty guideline for the same family
size. Eligibility for a pregnant woman or infant less than one
year of age under this subdivision must be determined without
regard to asset standards established in section 256B.056,
subdivision 3. Adjustments in the income limits due to annual
changes in the federal poverty guidelines shall be implemented
the first day of July following publication of the changes.
Subd. 2. [CHILDREN.] A child one through seven years of
age in a family whose countable income is less than 100 percent
of the federal poverty guidelines for the same family size is
eligible for medical assistance. Eligibility for children under
this subdivision must be determined without regard to asset
standards established in section 256B.056, subdivision 3.
Adjustments in the income limits due to annual changes in the
federal poverty guidelines shall be implemented the first day of
July following publication of the changes.
Subd. 3. [QUALIFIED MEDICARE BENEFICIARIES.] A person who
is entitled to Part A Medicare benefits, whose income is equal
to or less than 85 percent of the federal poverty guidelines,
and whose assets are no more than twice the asset limit used to
determine eligibility for the supplemental security income
program, is eligible for medical assistance reimbursement of
Part A and Part B premiums, Part A and Part B coinsurance and
deductibles, and cost-effective premiums for enrollment with a
health maintenance organization or a competitive medical plan
under section 1876 of the Social Security Act. The income limit
shall be increased to 90 percent of the federal poverty
guidelines on January 1, 1990; to 95 percent on January 1, 1991;
and to 100 percent on January 1, 1992. Reimbursement of the
Medicare coinsurance and deductibles, when added to the amount
paid by Medicare, must not exceed the total rate the provider
would have received for the same service or services if the
person were a medical assistance recipient with Medicare
coverage. Adjustments in the income limits due to annual
changes in the federal poverty guidelines shall be implemented
the first day of July following publication of the changes.
Sec. 49. [256B.0575] [AVAILABILITY OF INCOME FOR
INSTITUTIONALIZED PERSONS.]
When an institutionalized person is determined eligible for
medical assistance, the income that exceeds the deductions in
paragraphs (a) and (b) must be applied to the cost of
institutional care.
(a) The following amounts must be deducted from the
institutionalized person's income in the following order:
(1) the personal needs allowance under section 256B.35;
(2) the personal allowance for disabled individuals under
section 256B.36;
(3) if the institutionalized person has a legally-appointed
guardian or conservator, five percent of the recipient's gross
monthly income up to $100 as reimbursement for guardianship or
conservatorship services;
(4) a monthly income allowance determined under section
256B.058, subdivision 2, but only to the extent income of the
institutionalized spouse is made available to the community
spouse;
(5) a monthly family allowance for other family members,
equal to one-third of the difference between 122 percent of the
federal poverty guidelines and the monthly income for that
family member; and
(6) amounts for reasonable expenses incurred for necessary
medical or remedial care for the institutionalized spouse that
are not medical assistance covered expenses and that are not
subject to payment by a third party.
For purposes of clause (5), family member includes only
minor or dependent children, dependent parents, or dependent
siblings of the institutionalized or community spouse if the
sibling resides with the community spouse.
(b) Income shall be allocated to an institutionalized
person 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:
(1) a physician certifies that the person is expected to
reside in the long-term care facility for three calendar months
or less;
(2) if the person has expenses of maintaining a residence
in the community; and
(3) if one of the following circumstances apply:
(i) the person was not living together with a spouse or a
family member as defined in paragraph (a) when the person
entered a long-term care facility; or
(ii) the person and the person's spouse become
institutionalized on the same date, in which case the allocation
shall be applied to the income of one of the spouses.
For purposes of this paragraph, a person is determined to be
residing in a licensed nursing home, regional treatment center,
or medical institution if the person is expected to remain for a
period of one full calendar month or more.
Sec. 50. [256B.058] [TREATMENT OF INCOME OF
INSTITUTIONALIZED SPOUSE.]
Subdivision 1. [INCOME NOT AVAILABLE.] The income
described in subdivisions 2 and 3 shall be deducted from an
institutionalized spouse's monthly income and is not considered
available for payment of the monthly costs of an
institutionalized person in the institution after the person has
been determined eligible for medical assistance.
Subd. 2. [MONTHLY INCOME ALLOWANCE FOR COMMUNITY
SPOUSE.] (a) For an institutionalized spouse with a spouse
residing in the community, monthly income may be allocated to
the community spouse as a monthly income allowance for the
community spouse. Beginning with the first full calendar month
the institutionalized spouse is in the institution, the monthly
income allowance is not considered available to the
institutionalized spouse for monthly payment of costs of care in
the institution as long as the income is made available to the
community spouse.
(b) The monthly income allowance is the amount by which the
community spouse's monthly maintenance needs allowance under
paragraphs (c) and (d) exceeds the amount of monthly income
otherwise available to the community spouse.
(c) The community spouse's monthly maintenance needs
allowance is the lesser of $1,500 or 122 percent of the monthly
federal poverty guideline for a family of two plus an excess
shelter allowance. The excess shelter allowance is for the
amount of shelter expenses that exceed 30 percent of 122 percent
of the federal poverty guideline line for a family of two.
Shelter expenses are the community spouse's expenses for rent,
mortgage payments including principal and interest, taxes,
insurance, required maintenance charges for a cooperative or
condominium that is the community spouse's principal residence,
and the standard utility allowance under section 5(e) of the
federal Food Stamp Act of 1977. If the community spouse has a
required maintenance charge for a cooperative or condominium,
the standard utility allowance must be reduced by the amount of
utility expenses included in the required maintenance charge.
If the community or institutionalized spouse establishes
that the community spouse needs income greater than the monthly
maintenance needs allowance determined in this paragraph due to
exceptional circumstances resulting in significant financial
duress, the monthly maintenance needs allowance may be increased
to an amount that provides needed additional income.
(d) The percentage of the federal poverty guideline used to
determine the monthly maintenance needs allowance in paragraph
(c) is increased to 133 percent on July 1, 1991, and to 150
percent on July 1, 1992. Adjustments in the income limits due
to annual changes in the federal poverty guidelines shall be
implemented the first day of July following publication of the
annual changes. The $1,500 maximum must be adjusted January 1,
1990, and every January 1 after that by the same percentage
increase in the consumer price index for all urban consumers
(all items; United States city average) between the two previous
Septembers.
(e) If a court has entered an order against an
institutionalized spouse for monthly income for support of the
community spouse, the community spouse's monthly income
allowance under this subdivision shall not be less than the
amount of the monthly income ordered.
Subd. 3. [FAMILY ALLOWANCE.] (a) A family allowance
determined under paragraph (b) is not considered available to
the institutionalized spouse for monthly payment of costs of
care in the institution.
(b) The family allowance is equal to one-third of the
amount by which 122 percent of the monthly federal poverty
guideline for a family of two exceeds the monthly income for
that family member.
(c) For purposes of this subdivision, the term family
member only includes a minor or dependent child, dependent
parent, or dependent sibling of the institutionalized or
community spouse if the sibling resides with the community
spouse.
(d) The percentage of the federal poverty guideline used to
determine the family allowance in paragraph (b) is increased to
133 percent on July 1, 1991, and to 150 percent on July 1,
1992. Adjustments in the income limits due to annual changes in
the federal poverty guidelines shall be implemented the first
day of July following publication of the annual changes.
Subd. 4. [TREATMENT OF INCOME.] (a) No income of the
community spouse will be considered available to an eligible
institutionalized spouse, beginning the first full calendar
month of institutionalization, except as provided in this
subdivision.
(b) In determining the income of an institutionalized
spouse or community spouse, after the institutionalized spouse
has been determined eligible for medical assistance, the
following rules apply.
(1) For income that is not from a trust, availability is
determined according to items (i) to (v), unless the instrument
providing the income otherwise specifically provides:
(i) if payment is made solely in the name of one spouse,
the income is considered available only to that spouse;
(ii) if payment is made in the names of both spouses,
one-half of the income is considered available to each;
(iii) if payment is made in the names of one or both
spouses together with one or more other persons, the income is
considered available to each spouse according to the spouse's
interest, or one-half of the joint interest is considered
available to each spouse if each spouse's interest is not
specified;
(iv) if there is no instrument that establishes ownership,
one-half of the income is considered available to each spouse;
and
(v) either spouse may rebut the determination of
availability of income by showing by a preponderance of the
evidence that ownership interests are different than provided
above.
(2) For income from a trust, income is considered available
to each spouse as provided in the trust. If the trust does not
specify an amount available to either or both spouses,
availability will be determined according to items (i) to (iii):
(i) if payment of income is made only to one spouse, the
income is considered available only to that spouse;
(ii) if payment of income is made to both spouses, one-half
is considered available to each; and
(iii) if payment is made to either or both spouses and one
or more other persons, the income is considered available to
each spouse in proportion to each spouse's interest, or if no
such interest is specified, one-half of the joint interest is
considered available to each spouse.
Sec. 51. [256B.059] [TREATMENT OF ASSETS WHEN A SPOUSE IS
INSTITUTIONALIZED.]
Subdivision 1. [DEFINITIONS.] (a) For purposes of this
section, the terms defined in this subdivision have the meanings
given them.
(b) "Community spouse" means the spouse of an
institutionalized person.
(c) "Spousal share" means one-half of the total value of
all assets, to the extent that either the institutionalized
spouse or the community spouse had an ownership interest at the
time of institutionalization.
(d) "Assets otherwise available to the community spouse"
means assets individually or jointly owned by the community
spouse, other than assets excluded by subdivision 5, paragraph
(c).
(e) "Community spouse asset allowance" is the value of
assets that can be transferred under subdivision 3.
Subd. 2. [ASSESSMENT OF SPOUSAL SHARE.] At the beginning
of a continuous period of institutionalization of a person, at
the request of either the institutionalized spouse or the
community spouse, or upon application for medical assistance,
the total value of assets in which either the institutionalized
spouse or the community spouse had an interest at the time of
institutionalization shall be assessed and documented and the
spousal share shall be assessed and documented.
Subd. 3. [COMMUNITY SPOUSE ASSET ALLOWANCE.] (a) An
institutionalized spouse may transfer assets to the community
spouse solely for the benefit of the community spouse. Except
for increased amounts allowable under subdivision 4, the maximum
amount of assets allowed to be transferred is the amount which,
when added to the assets otherwise available to the community
spouse, is the greater of:
(1) $12,000;
(2) the lesser of the spousal share or $60,000; or
(3) the amount required by court order to be paid to the
community spouse.
If the assets available to the community spouse are already
at the limit permissible under this section, or the higher limit
attributable to increases under subdivision 4, no assets may be
transferred from the institutionalized spouse to the community
spouse. The transfer must be made as soon as practicable after
the date the institutionalized spouse is determined eligible for
medical assistance, or within the amount of time needed for any
court order required for the transfer. On January 1, 1990, and
every January 1 thereafter, the $12,000 and $60,000 limits shall
be adjusted by the same percentage change in the consumer price
index for all urban consumers (all items; United States city
average) between the two previous Septembers. These adjustments
shall also be applied to the $12,000 and $60,000 limits in
subdivision 5.
Subd. 4. [INCREASED COMMUNITY SPOUSE ASSET ALLOWANCE; WHEN
ALLOWED.] (a) If either the institutionalized spouse or
community spouse establishes that the community spouse asset
allowance under subdivision 3 (in relation to the amount of
income generated by such an allowance) is not sufficient to
raise the community spouse's income to the minimum monthly
maintenance needs allowance in section 256B.058, subdivision 2,
paragraph (c), there shall be substituted for the amount allowed
to be transferred an amount sufficient, when combined with the
monthly income otherwise available to the spouse, to provide the
minimum monthly maintenance needs allowance.
(b) The community spouse asset allowance under subdivision
3 can be increased by court order or hearing that complies with
the requirements of United States Code, title 42, section 1924.
Subd. 5. [ASSET AVAILABILITY.] (a) At the time of
application for medical assistance benefits, assets considered
available to the institutionalized spouse shall be the total
value of all assets in which either spouse has an ownership
interest, reduced by the greater of:
(1) $12,000; or
(2) the lesser of the spousal share or $60,000; or
(3) the amount required by court order to be paid to the
community spouse. If the community spouse asset allowance has
been increased under subdivision 4, then the assets considered
available to the institutionalized spouse under this subdivision
shall be further reduced by the value of additional amounts
allowed under subdivision 4.
(b) After the month in which the institutionalized spouse
is determined eligible for medical assistance, during the
continuous period of institutionalization, no assets of the
community spouse are considered available to the
institutionalized spouse.
(c) For purposes of this section, assets do not include
assets excluded under section 256B.056, without regard to the
limitations on total value in that section.
Sec. 52. [256B.0595] [PROHIBITIONS ON TRANSFER;
EXCEPTIONS.]
Subdivision 1. [PROHIBITED TRANSFERS.] If an
institutionalized person has given away, sold, or disposed of,
for less than fair market value, any asset or interest therein,
except assets other than the homestead that are excluded under
section 256B.056, subdivision 3, within 30 months of the date of
institutionalization if the person has been determined eligible
for medical assistance, or within 30 months of the date of the
first approved application for medical assistance if the person
has not yet been determined eligible for medical assistance, the
person is ineligible for long-term care services for the period
of time determined under subdivision 2. For purposes of this
section, long-term care services include nursing facility
services, and home and community-based services provided
pursuant to section 256B.491. For purposes of this subdivision
and subdivisions 2, 3, and 4, "institutionalized person"
includes a person who is an inpatient in a nursing facility, or
who is receiving home and community-based services under section
256B.491.
Subd. 2. [PERIOD OF INELIGIBILITY.] For any uncompensated
transfer, the number of months of ineligibility for long-term
care services shall be the lesser of 30 months, or the
uncompensated transfer amount divided by the average medical
assistance rate for nursing facility services in the state in
effect on the date of application. The amount used to calculate
the average medical assistance payment rate shall be adjusted
each July 1 to reflect payment rates for the previous calendar
year. The period of ineligibility begins with the month in
which the assets were transferred. The uncompensated transfer
amount is the fair market value of the asset at the time it was
given away, sold, or disposed of, less the amount of
compensation received.
Subd. 3. [HOMESTEAD EXCEPTION TO TRANSFER
PROHIBITION.] (a) An institutionalized person is not ineligible
for long-term care services due to a transfer of assets for less
than fair market value if the asset transferred was a homestead
and:
(1) title to the homestead was transferred to the
individual's
(i) spouse;
(ii) child who is under age 21;
(iii) blind or permanently and totally disabled child as
defined in the supplemental security income program;
(iv) sibling who has equity interest in the home and who
was residing in the home for a period of at least one year
immediately before the date of the individual's admission to the
facility; or
(v) son or daughter who was residing in the individual's
home for a period of at least two years immediately before the
date of the individual's admission to the facility, and who
provided care to the individual that permitted the individual to
reside at home rather than in an institution or facility;
(2) a satisfactory showing is made that the individual
intended to dispose of the homestead at fair market value or for
other valuable consideration; or
(3) the local agency grants a waiver of the excess
resources created by the uncompensated transfer because denial
of eligibility would cause undue hardship for the individual,
based on imminent threat to the individual's health and
well-being.
(b) When a waiver is granted under paragraph (a), clause
(3), a cause of action exists against the person to whom the
homestead was transferred for that portion of long-term care
services granted within 30 months of the transfer or the amount
of the uncompensated transfer, whichever is less, together with
the costs incurred due to the action. The action may be brought
by the state or the local agency responsible for providing
medical assistance under chapter 256G.
Subd. 4. [OTHER EXCEPTIONS TO TRANSFER PROHIBITION.] An
institutionalized person receiving medical assistance on the
date of institutionalization who has transferred assets for less
than fair market value within the 30 months immediately before
the date of institutionalization or an institutionalized person
who was not receiving medical assistance on the date of
institutionalization and who has transferred assets for less
than fair market value within 30 months immediately before the
month of application is not ineligible for long-term care
services if one of the following conditions apply:
(1) the assets were transferred to the community spouse, as
defined in section 256B.059; or
(2) the institutionalized spouse, prior to being
institutionalized, transferred assets to his or her spouse,
provided that the spouse to whom the assets were transferred
does not then transfer those assets to another person for less
than fair market value. (At the time when one spouse is
institutionalized, assets must be allocated between the spouses
as provided under section 256B.059); or
(3) the assets were transferred to the individual's child
who is blind or permanently and totally disabled as determined
in the supplemental security income program; or
(4) a satisfactory showing is made that the individual
intended to dispose of the assets either at fair market value or
for other valuable consideration; or
(5) the local agency determines that denial of eligibility
for long-term care services would work an undue hardship, and
grants a waiver of excess assets. When a waiver is granted, a
cause of action exists against the person to whom the assets
were transferred for that portion of long-term care services
granted within 30 months of the transfer, or the amount of the
uncompensated transfer, whichever is less, together with the
costs incurred due to the action. The action may be brought by
the state or the local agency responsible for providing medical
assistance under chapter 256B.
Sec. 53. Minnesota Statutes 1988, section 256B.062, is
amended to read:
256B.062 [CONTINUED ELIGIBILITY.]
Subdivision 1. Any family which was eligible for aid to
families with dependent children in at least three of the six
months immediately preceding the month in which the family
became ineligible for aid to families with dependent children
because of increased income from employment shall, while a
member of the family is employed, remain eligible for medical
assistance for four calendar months following the month in which
the family would otherwise be determined to be ineligible due to
the income and resources limitations of this chapter.
Subd. 2. A family whose eligibility for aid to families
with dependent children is terminated because of the loss of the
$30, or the $30 and one-third earned income disregard is
eligible for medical assistance for 12 calendar months following
the month in which the family loses medical assistance
eligibility as an aid to families with dependent children
recipient. Medical assistance may be paid for persons who
received aid to families with dependent children in at least
three of the six months preceding the month in which the person
became ineligible for aid to families with dependent children,
if the ineligibility was due to an increase in hours of
employment or employment income or due to the loss of an earned
income disregard. A person who is eligible for extended medical
assistance is entitled to six months of assistance without
reapplication, unless the assistance unit ceases to include a
dependent child. For a person under 21 years of age, medical
assistance may not be discontinued within the six-month period
of extended eligibility until it has been determined that the
person is not otherwise eligible for medical assistance.
Medical assistance may be continued for an additional six months
if the person meets all requirements for the additional six
months, according to Title XIX of the Social Security Act, as
amended by section 303 of the Family Support Act of 1988, Public
Law Number 100-485.
Sec. 54. Minnesota Statutes 1988, section 256B.0625,
subdivision 2, is amended to read:
Subd. 2. [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.
Sec. 55. Minnesota Statutes 1988, section 256B.0625,
subdivision 13, is amended to read:
Subd. 13. [DRUGS.] (a) Medical assistance covers drugs if
prescribed by a licensed practitioner. The commissioner shall
designate a formulary committee to advise the commissioner on
the names of drugs for which payment 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 and pregnant or nursing women; 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. Implementation of any change in the fixed
dispensing fee that has not been subject to the administrative
procedure act is limited to not more than 180 days, unless,
during that time, the commissioner initiates rulemaking through
the administrative procedure act.
Sec. 56. Minnesota Statutes 1988, section 256B.0625,
subdivision 17, is amended to read:
Subd. 17. [TRANSPORTATION COSTS.] (a) 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 subdivision, a person who is
incapable of transport by taxicab or bus shall be considered to
be nonambulatory.
(b) Special transportation, as defined in Minnesota Rules,
part 9505.0315, subpart 1, item F, provided to nonambulatory
persons who do not need a wheelchair lift van or
stretcher-equipped vehicle, may be reimbursed at a lower rate
than special transportation provided to persons who need a
wheelchair lift van or stretcher-equipped vehicle.
Sec. 57. Minnesota Statutes 1988, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 26. [SPECIAL EDUCATION SERVICES.] Medical assistance
covers medical services identified in a recipient's
individualized education plan and covered under the medical
assistance state plan. The services may be provided by a
Minnesota school district that is enrolled as a medical
assistance provider or its subcontractor, and only if the
services meet all the requirements otherwise applicable if the
service had been provided by a provider other than a school
district, in the following areas: medical necessity,
physician's orders, documentation, personnel qualifications, and
prior authorization requirements. Medical assistance coverage
for medically necessary services provided under other
subdivisions in this section may not be denied solely on the
basis that the same or similar services are covered under this
subdivision.
Sec. 58. Minnesota Statutes 1988, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 27. [ORGAN AND TISSUE TRANSPLANTS.] Medical
assistance coverage for organ and tissue transplant procedures
is limited to those procedures covered by the Medicare program,
provided those procedures comply with all applicable laws,
rules, and regulations governing (1) coverage by the Medicare
program, (2) federal financial participation by the Medicaid
program, and (3) coverage by the Minnesota medical assistance
program.
Sec. 59. [256B.0642] [FEDERAL FINANCIAL PARTICIPATION.]
The commissioner may, in the aggregate, prospectively
reduce payment rates for medical assistance providers receiving
federal funds to avoid reduced federal financial participation
resulting from rates that are in excess of the Medicare
limitations.
Sec. 60. Minnesota Statutes 1988, section 256B.091,
subdivision 3, is amended to read:
Subd. 3. [SCREENING TEAM; DUTIES.] Local screening teams
shall seek cooperation from other public and private agencies in
the community which offer services to the disabled and elderly.
The responsibilities of the agency responsible for screening
shall include:
(a) Provision of information and education to the general
public regarding availability of the screening program;
(b) Acceptance of referrals from individuals, families,
human service professionals and nursing home personnel of the
community agencies;
(c) Assessment of health and social needs of referred
individuals and identification of services needed to maintain
these persons in the least restrictive environments;
(d) Identification of available noninstitutional services
to meet the needs of individuals referred;
(e) Recommendations for individuals screened regarding:
(1) Nursing home or boarding care home admission; and
(2) Maintenance in the community with specific service
plans and referrals and designation of a lead agency to
implement each individual's plan of care;
(f) Assessment of active treatment needs:
(1) in cooperation with a qualified mental health
professional for persons with a primary or secondary diagnosis
of mental illness; and
(2) in cooperation with a qualified mental retardation
professional for persons with a primary or secondary diagnosis
of mental retardation or related conditions.
For purposes of this subdivision, a qualified mental
retardation professional must meet the standards for a qualified
mental retardation professional in Code of Federal Regulations,
title 42, section 483.430;
(g) Provision of follow up services as needed; and
(g) (h) Preparation of reports which may be required by the
commissioner of human services.
Sec. 61. Minnesota Statutes 1988, 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 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, and a qualified mental retardation professional, as
defined in the Code of Federal Regulations, title 42, section
442.401 483.430, as amended through December 31, 1987. June 3,
1988. The case manager may also act as the qualified mental
retardation professional if the case manager meets the federal
definition. County social service agencies may contract with a
public or private agency or individual who is not a service
provider for the person for the public guardianship
representation required by the screening or individual service
and habilitation planning process. The contract shall be
limited to public guardianship representation for the screening
and individual service and habilitation planning activities.
The contract shall require compliance with the commissioner's
instructions, and may be for paid or voluntary services. 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. 62. [256B.093] [SERVICES FOR PERSONS WITH BRAIN
INJURIES.]
Subdivision 1. [STATE COORDINATOR.] The commissioner of
human services shall designate a full-time position within the
long-term care management division of the department of human
services to supervise and coordinate services for persons with
brain injuries.
Subd. 2. [ELIGIBILITY.] The commissioner may contract with
qualified agencies or persons to provide case management
services to medical assistance recipients who are at risk of
institutionalization and meet one of the following criteria:
(a) The person has a brain injury.
(b) The person is receiving home care services or is in an
institution and has a discharge plan requiring the provision of
home care services and meets one of the following criteria:
(1) the person suffers from a brain abnormality or
degenerative brain disease resulting in significant destruction
of brain tissue and loss of brain function that requires
extensive services over an extended period of time;
(2) the person is unable to direct the person's own care;
(3) the person has medical home care costs that exceed
thresholds established by the commissioner under Minnesota
Rules, parts 9505.0170 to 9505.0475;
(4) the person is eligible for medical assistance under the
option for certain disabled children in section 134 of the Tax
Equity and Fiscal Responsibility Act of 1982 (TEFRA);
(5) the person receives home care from two or more
providers who are unable to effectively coordinate the services;
or
(6) the person has received or will receive home care
services for longer than six months.
Subd. 3. [CASE MANAGEMENT DUTIES.] The department shall
fund the case management contracts using medical assistance
administrative funds. The contractor must:
(1) assess the person's individual needs for services
required to prevent institutionalization;
(2) assure that a care plan that meets the person's needs
is developed by the appropriate agency or individual;
(3) assist the person in obtaining services necessary to
allow the person to remain in the community;
(4) coordinate home care services with other medical
assistance services under section 256B.0625;
(5) assure cost effectiveness of medical assistance
services;
(6) make recommendations to the commissioner on the
approval or denial of the use of medical assistance funds to pay
for home care services when home care services exceed thresholds
established by the commissioner under Minnesota Rules, parts
9505.0170 to 9505.0475;
(7) assist the person with problems related to the
provision of home care services;
(8) assure the quality of home care services; and
(9) reassess the person's need for and level of home care
services at a frequency determined by the commissioner.
Subd. 4. [DEFINITIONS.] For purposes of this section, the
following definitions apply:
(a) "Brain injury" means a sudden insult or damage to the
brain or its coverings, not of a degenerative nature. The
insult or damage may produce an altered state of consciousness
or a decrease in mental, cognitive, behavioral, or physical
functioning resulting in partial or total disability.
(b) "Home care services" means medical assistance home care
services defined under section 256B.0625, subdivisions 6, 7, and
19.
Sec. 63. Minnesota Statutes 1988, section 256B.14, is
amended to read:
256B.14 [RELATIVE'S RESPONSIBILITY.]
Subdivision 1. [IN GENERAL.] Subject to the provisions of
sections 256B.055, 256B.056, and 256B.06, responsible relative
means the spouse of a medical assistance recipient or parent of
a minor recipient of medical assistance.
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. No resource contribution is required of a spouse
at the time of the first approved medical assistance application.
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. 64. Minnesota Statutes 1988, section 256B.25, is
amended by adding a subdivision to read:
Subd. 4. [PAYMENT DURING SUSPENDED ADMISSIONS.] A nursing
home or boarding care home that has received a notice to suspend
admissions under section 144A.10, subdivision 4a, shall be
ineligible to receive payment for admissions that occur during
the effective dates of the suspension. Upon termination of the
suspension by the commissioner of health, payments may be made
for eligible persons, beginning with the day after the
suspension ends.
Sec. 65. Minnesota Statutes 1988, section 256B.421,
subdivision 14, is amended to read:
Subd. 14. [FRINGE BENEFITS.] "Fringe benefits" means
workers' compensation insurance, group health or dental
insurance, group life insurance, retirement benefits or
plans, except for public employee retirement act contributions,
and uniform allowances.
Sec. 66. Minnesota Statutes 1988, 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.
Allowable costs under this subdivision for payments made by a
nonprofit nursing home that are in lieu of real estate taxes
shall not exceed the amount which the nursing home would have
paid to a city or township and county for fire, police,
sanitation services, and road maintenance costs had real estate
taxes been levied on that property for those purposes. 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. For rate years beginning
on or after July 1, 1989, the commissioner shall include a
nursing home's reported public employee retirement act
contribution for the reporting year as apportioned to the
care-related operating cost categories and other operating cost
categories multiplied by the appropriate composite index or
indices established pursuant to paragraph (e) as costs under
this paragraph. Total adjusted real estate tax liability,
payments in lieu of real estate tax, actual special assessments
paid, the indexed public employee retirement act contribution,
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 care-related operating cost limits
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), unless otherwise
indicated in this paragraph.
(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. 67. Minnesota Statutes 1988, section 256B.431,
subdivision 2e, is amended to read:
Subd. 2e. [CONTRACTS FOR SERVICES FOR VENTILATOR DEPENDENT
PERSONS.] The commissioner may contract with a nursing home
eligible to receive medical assistance payments to provide
services to a ventilator dependent person identified by the
commissioner according to criteria developed by the
commissioner, including:
(1) nursing home care has been recommended for the person
by a preadmission screening team;
(2) the person has been assessed at case mix classification
K;
(3) the person has been hospitalized for at least six
months and no longer requires inpatient acute care hospital
services; and
(4) the commissioner has determined that necessary services
for the person cannot be provided under existing nursing home
rates.
The commissioner may issue a request for proposals to
provide services to a ventilator dependent person to nursing
homes eligible to receive medical assistance payments and shall
select nursing homes from among respondents according to
criteria developed by the commissioner, including:
(1) the cost effectiveness and appropriateness of services;
(2) the nursing home's compliance with federal and state
licensing and certification standards; and
(3) the proximity of the nursing home to a ventilator
dependent person identified by the commissioner who requires
nursing home placement.
The commissioner may negotiate an adjustment to the
operating cost payment rate for a nursing home selected by the
commissioner from among respondents to the request for
proposals. The negotiated adjustment must reflect only the
actual additional cost of meeting the specialized care needs of
a ventilator dependent person identified by the commissioner for
whom necessary services cannot be provided under existing
nursing home rates and which are not otherwise covered under
Minnesota Rules, parts 9549.0010 to 9549.0080 or 9505.0170 to
9505.0475. The negotiated payment rate must not exceed 200
percent of the highest multiple bedroom payment rate for a
Minnesota nursing home, as initially established by the
commissioner for the rate year for case mix classification K.
The negotiated adjustment shall not affect the payment rate
charged to private paying residents under the provisions of
section 256B.48, subdivision 1. The negotiated adjustment paid
pursuant to this paragraph is specifically exempt from the
definition of "rule" and the rulemaking procedures required by
chapter 14 and section 256B.502.
Sec. 68. Minnesota Statutes 1988, section 256B.431,
subdivision 2i, is amended 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, to 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. The commissioner shall establish new base years for both
the reporting year ending September 30, 1989, and the reporting
year ending September 30, 1990. In establishing new base years,
the commissioner must take into account:
(1) statutory changes made in geographic groups;
(2) redefinitions of cost categories; and
(3) reclassification, pass-through, or exemption of certain
costs such as public employee retirement act contributions.
Sec. 69. Minnesota Statutes 1988, section 256B.431, is
amended by adding a subdivision to read:
Subd. 2j. [HOSPITAL-ATTACHED NURSING HOME STATUS.] (a) For
the purpose of setting rates under Minnesota Rules, parts
9549.0010 to 9549.0080, for rate years beginning after June 30,
1989, a hospital-attached nursing home means a nursing home
recognized by the federal Medicare program to be a
hospital-based nursing facility for purposes of being subject to
higher cost limits accorded hospital-based nursing facilities
under the Medicare program, or, prior to June 30, 1983, was
classified as a hospital-attached nursing home under Minnesota
Rules, parts 9510.0010 to 9510.0480, provided that the nursing
home's cost report filed under Minnesota Rules, parts 9549.0010
to 9549.0080, shall use the same cost allocation principles and
methods used in the reports filed for the Medicare program.
(b) For rate years beginning after June 30, 1989, a nursing
home and hospital, which have applied for hospital-based nursing
facility status under the federal Medicare program during the
reporting year or the nine-month period following the nursing
home's reporting year, shall be considered a hospital-attached
nursing home for purposes of setting payment rates under
Minnesota Rules, parts 9549.0010 to 9549.0080, for the rate year
following the reporting year or the nine-month period in which
the facility made its Medicare application. The nursing home
must file its cost report or an amended cost report for that
reporting year before the following rate year using Medicare
principles and Medicare's recommended cost allocation methods
had the Medicare program's hospital-based nursing facility
status been granted to the nursing home. For each subsequent
rate year, the nursing home must meet the definition
requirements in paragraph (a). If the nursing home is denied
hospital-based nursing facility status under the Medicare
program, the nursing home's payment rates for the rate years the
nursing home was considered to be a hospital-attached nursing
home pursuant to this paragraph shall be recalculated treating
the nursing home as a non-hospital-attached nursing home.
Sec. 70. Minnesota Statutes 1988, section 256B.431, is
amended by adding a subdivision to read:
Subd. 2k. [OPERATING COSTS AFTER JULY 1, 1989.] For rate
years beginning on or after July 1, 1989, a nursing home that is
exempt under subdivision 2b, paragraph (d), clause (2); whose
total number of licensed beds are licensed under Minnesota
Rules, parts 9570.2000 to 9570.3600; and that maintains an
average length of stay of less than 365 days during each
reporting year, is limited to 140 percent of the
other-operating-cost limit for hospital-attached nursing homes
as established by Minnesota Rules, part 9549.0055, subpart 2,
item E, subitem (2), as modified by subdivision 2i, paragraph
(a). For purposes of this subdivision, the nursing home's
average length of stay must be computed by dividing the nursing
home's actual resident days for the reporting year by the
nursing home's total discharges for that reporting year.
Sec. 71. Minnesota Statutes 1988, section 256B.431,
subdivision 3a, is amended to read:
Subd. 3a. [PROPERTY-RELATED COSTS AFTER JULY 1, 1985.] (a)
For rate years beginning on or after July 1, 1985, the
commissioner, by permanent rule, shall reimburse nursing home
providers that are vendors in the medical assistance program for
the rental use of real estate and depreciable equipment. "Real
estate" means land improvements, buildings, and attached
fixtures used directly for resident care. "Depreciable
equipment" means the standard movable resident care equipment
and support service equipment generally used in long-term care
facilities.
(b) In developing the method for determining payment rates
for the rental use of nursing homes, the commissioner shall
consider factors designed to:
(1) simplify the administrative procedures for determining
payment rates for property-related costs;
(2) minimize discretionary or appealable decisions;
(3) eliminate any incentives to sell nursing homes;
(4) recognize legitimate costs of preserving and replacing
property;
(5) recognize the existing costs of outstanding
indebtedness allowable under the statutes and rules in effect on
May 1, 1983;
(6) address the current value of, if used directly for
patient care, land improvements, buildings, attached fixtures,
and equipment;
(7) establish an investment per bed limitation;
(8) reward efficient management of capital assets;
(9) provide equitable treatment of facilities;
(10) consider a variable rate; and
(11) phase-in implementation of the rental reimbursement
method.
(c) No later than January 1, 1984, the commissioner shall
report to the legislature on any further action necessary or
desirable in order to implement the purposes and provisions of
this subdivision.
(d) For rate years beginning on or after July 1, 1987, a
nursing home which has reduced licensed bed capacity after
January 1, 1986, shall be allowed to:
(1) aggregate the applicable investment per bed limits
based on the number of beds licensed prior to the reduction; and
(2) establish capacity days for each rate year following
the licensure reduction based on the number of beds licensed on
the previous April 1 if the commissioner is notified of the
change by April 4. The notification must include a copy of the
delicensure request that has been submitted to the commissioner
of health.
(e) Until the rental reimbursement method is fully phased
in, a nursing home whose final property-related payment rate is
the rental rate shall continue to have its property-related
payment rates established based on the rental reimbursement
method.
(f) For rate years beginning on or after July 1, 1989, the
interest expense that results from a refinancing of a nursing
home's demand call loan, when the loan that must be refinanced
was incurred before May 22, 1983, is an allowable interest
expense if:
(1) the demand call loan or any part of it was in the form
of a loan that was callable at the demand of the lender;
(2) the demand call loan or any part of it was called by
the lender through no fault of the nursing home;
(3) the demand call loan or any part of it was made by a
government agency operating under a statutory or regulatory loan
program;
(4) the refinanced debt does not exceed the sum of the
allowable remaining balance of the demand call loan at the time
of payment on the demand call loan and refinancing costs;
(5) the term of the refinanced debt does not exceed the
remaining term of the demand call loan, had the debt not been
subject to an on-call payment demand; and
(6) the refinanced debt is not a debt between related
organizations as defined in Minnesota Rules, part 9549.0020,
subpart 38.
Sec. 72. Minnesota Statutes 1988, section 256B.431,
subdivision 3f, is amended 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. For the rate year beginning July 1, 1989,
the replacement-cost-new per bed limit for a single bedroom must
be $49,907 adjusted according to Minnesota Rules, part
9549.0060, subpart 4, item A, subitem (1). Beginning January 1,
1989 1990, 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.
(e) [POST CHAPTER 199 RELATED-ORGANIZATION DEBTS AND
INTEREST EXPENSE.] For rate years beginning on or after July 1,
1990, Minnesota Rules, part 9549.0060, subpart 5, item E, shall
not apply to outstanding related organization debt incurred
prior to May 23, 1983, provided that the debt was an allowable
debt under Minnesota Rules, parts 9510.0010 to 9510.0480, the
debt is subject to repayment through annual principal payments,
and the nursing home demonstrates to the commissioner's
satisfaction that the interest rate on the debt was less than
market interest rates for similar arms-length transactions at
the time the debt was incurred. If the debt was incurred due to
a sale between family members, the nursing home must also
demonstrate that the seller no longer participates in the
management or operation of the nursing home. Debts meeting the
conditions of this paragraph are subject to all other provisions
of Minnesota Rules, parts 9549.0010 to 9549.0080.
(f) [BUILDING CAPITAL ALLOWANCE FOR NURSING HOMES WITH
OPERATING LEASES.] For rate years beginning on or after July 1,
1990, a nursing home with operating lease costs incurred for the
nursing home's buildings shall receive its building capital
allowance computed in accordance with Minnesota Rules, part
9549.0060, subpart 8.
Sec. 73. Minnesota Statutes 1988, section 256B.431,
subdivision 3g, is amended 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 January 1, 1987,
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 divided by their capacity
days as determined under Minnesota Rules, part 9549.0060,
subpart 11, as modified by subdivision 3f, paragraph (c), from
the preceding reporting year, 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. 74. Minnesota Statutes 1988, 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.
(d) A facility that meets the criteria of paragraph (c)
shall submit annual cost reports on forms prescribed by the
commissioner.
(e) 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.
(f) 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.
(g) 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.
Upon receiving a recommendation from the commissioner of health
for a review of rates under section 144A.15, subdivision 6, the
commissioner may grant an adjustment to the nursing home's
payment rate. The commissioner shall review the recommendation
of the commissioner of health, together with the nursing home's
cost report to determine whether or not the deficiency or need
can be corrected or met by reallocating nursing home staff,
costs, revenues, or other resources including any investments,
efficiency incentives, or allowances. If the commissioner
determines that the deficiency cannot be corrected or the need
cannot be met, the commissioner shall determine the payment rate
adjustment by dividing the additional annual costs established
during the commissioner's review by the nursing home's actual
resident days from the most recent desk-audited cost report.
The payment rate adjustment must meet the conditions in section
256B.47, subdivision 2, and shall remain in effect until the
receivership under section 144A.15 ends, or until another date
the commissioner sets.
Upon the subsequent sale or transfer of the nursing home,
the commissioner may recover amounts paid through payment rate
adjustments under this paragraph. The buyer or transferee shall
repay this amount to the commissioner within 60 days after the
commissioner notifies the buyer or transferee of the obligation
to repay. The buyer or transferee must also repay the
private-pay resident the amount the private-pay resident paid
through payment rate adjustment.
Sec. 75. Minnesota Statutes 1988, section 256B.431, is
amended by adding a subdivision to read:
Subd. 7. [ONE-TIME ADJUSTMENT TO NURSING HOME PAYMENT
RATES TO COMPLY WITH OMNIBUS BUDGET RECONCILIATION ACT.] The
commissioner shall determine a one-time nursing staff adjustment
to the payment rate to adjust payment rates to upgrade certain
nursing homes' professional nursing staff complement to meet the
minimum standards of 1987 Public Law Number 100-203. The
adjustments to the payment rates determined under this
subdivision cover cost increases to meet minimum standards for
professional nursing staff. For a nursing home to be eligible
for the payment rate adjustment, a nursing home must have all of
its current licensed beds certified solely for the intermediate
level of care. When the commissioner establishes that it is not
cost effective to upgrade an eligible nursing home to the new
minimum staff standards, the commissioner may exclude the
nursing home if it is either an institution for mental disease
or a nursing home that would have been determined to be an
institution for mental disease, but for the fact that it has 16
or fewer licensed beds.
(a) The increased cost of professional nursing for an
eligible nursing home shall be determined according to clauses
(1) to (4):
(1) subtract from the number 8760 the compensated hours for
professional nurses, both employed and contracted, and, if the
result is greater than zero, then multiply the result by $4.55;
(2) subtract from the number 2920 the compensated hours for
registered nurses, both employed and contracted, and, if the
result is greater than zero, then multiply the result by $9.30;
(3) if an eligible nursing home has less than 61 licensed
beds, the director of nurses' compensated hours must be included
in the compensated hours for professional nurses in clause (1).
If the director of nurses is also a registered nurse, the
director of nurses' hours must be included in the compensated
hours for registered nurses in clause (2); and
(4) the one-time nursing staff adjustment to the payment
rate shall be the sum of clauses (1) and (2) as adjusted by
clause (3), if appropriate, and then divided by the nursing
home's actual resident days for the reporting year ending
September 30, 1988.
(b) The one-time nursing staff adjustment to the payment
rate is effective from January 1, 1990, to June 30, 1991.
(c) If a nursing home is granted a waiver to the minimum
professional nursing staff standards under Public Law Number
100-203 for either the professional nurse adjustment referred to
in clause (1), or the registered nurse adjustment in clause (2),
the commissioner must recover the portion of the nursing home's
payment rate that relates to a one-time nursing staff adjustment
granted under this subdivision. The amount to be recovered
shall be based on the type and extent of the waiver granted.
Sec. 76. Minnesota Statutes 1988, section 256B.431, is
amended by adding a subdivision to read:
Subd. 8. [ONETIME PER DIEM RATE ADJUSTMENT FOR INCREASED
COSTS UNDER THE OMNIBUS BUDGET RECONCILIATION ACT.] For the rate
period January 1, 1990, through June 30, 1991, the commissioner
shall add 30 cents per resident per day to the nursing home's
payment rate. The adjustment must not be paid to freestanding
boarding care homes.
Sec. 77. Minnesota Statutes 1988, section 256B.431, is
amended by adding a subdivision to read:
Subd. 9. [ONETIME ADJUSTMENT FOR FREESTANDING BOARDING
CARE HOMES TO COVER INCREASED COSTS UNDER THE OMNIBUS BUDGET
RECONCILIATION ACT.] (a) The commissioner shall determine a
onetime adjustment to the payment rate of a freestanding
boarding care home necessary for that home to comply with the
provisions of Public Law Number 100-203 except those
requirements outlined in subdivision 7. The adjustment to the
payment rate determined under this subdivision covers increased
costs for a medical director, nurse aide training for newly
hired aides, ongoing in-service training for nurses aides, and
other requirements identified by the commissioner that are
required because of the Omnibus Budget Reconciliation Act of
1987. These costs will only be reimbursed if they are required
in the final regulations pertaining to Public Law Number 100-203.
(b) Each facility eligible for this adjustment shall submit
to the commissioner a detailed estimate of the cost increases
the facility will incur for these costs.
(c) The costs that are determined by the commissioner to be
reasonable and necessary for a freestanding boarding care home
to comply with Public Law Number 100-203, except those costs
outlined in subdivision 7, must be included in the calculation
of the adjustment.
(d) The maximum allowable annual adjustment per bed is $300.
(e) The onetime adjustment is the cost allowed in paragraph
(c), subject to the limits in paragraph (d), divided by the
nursing home's actual resident days for the reporting year that
ended September 30, 1988.
(f) The onetime adjustment determined is effective from
January 1, 1990, to June 30, 1991.
Sec. 78. Minnesota Statutes 1988, section 256B.431, is
amended by adding a subdivision to read:
Subd. 10. [APPRAISAL SAMPLE STABILIZATION AND SPECIAL
REAPPRAISALS.] (a) The percentage change in appraised values for
nursing homes in the sample used for routine updating of
appraised values under Minnesota Rules, part 9549.0060, subpart
2, shall be stabilized by eliminating from the sample of nursing
home those appraisals that represent the five highest and the
five lowest deviations from those nursing homes' previously
established appraised values.
(b) A special reappraisal request must be submitted to the
commissioner within 60 days after the project's completion date
to be considered eligible for a special reappraisal. If a
project has multiple completion dates or involves multiple
projects, only projects or parts of projects with completion
dates within one year of the completion date associated with a
special reappraisal request can be included for the purpose of
establishing the nursing home's eligibility for a special
reappraisal. A facility which is eligible to request, has
requested, or has received a special reappraisal during the
calendar year must not be included in the random sample process
used to determine the average percentage change in appraised
value of nursing homes in the sample.
Sec. 79. Minnesota Statutes 1988, section 256B.47,
subdivision 3, is amended to read:
Subd. 3. [ALLOCATION OF COSTS.] To ensure the avoidance of
double payments as required by section 256B.433, the direct and
indirect reporting year costs of providing residents of nursing
homes that are not hospital attached with therapy services that
are billed separately from the nursing home payment rate or
according to Minnesota Rules, parts 9500.0750 to 9500.1080, must
be determined and deducted from the appropriate cost categories
of the annual cost report as follows:
(a) The costs of wages and salaries for employees providing
or participating in providing and consultants providing services
shall be allocated to the therapy service based on direct
identification.
(b) The costs of fringe benefits and payroll taxes relating
to the costs in paragraph (a) must be allocated to the therapy
service based on direct identification or the ratio of total
costs in paragraph (a) to the sum of total allowable salaries
and the costs in paragraph (a).
(c) The costs of housekeeping, plant operations and
maintenance, real estate taxes, special assessments, property
and insurance, other than the amounts classified as a fringe
benefit, must be allocated to the therapy service based on the
ratio of service area square footage to total facility square
footage.
(d) The costs of bookkeeping and medical records must be
allocated to the therapy service either by the method in
paragraph (e) or based on direct identification. Direct
identification may be used if adequate documentation is provided
to, and accepted by, the commissioner.
(e) The costs of administrators, bookkeeping, and medical
records salaries, except as provided in paragraph (d), must be
allocated to the therapy service based on the ratio of the total
costs in paragraphs (a) to (d) to the sum of total allowable
nursing home costs and the costs in paragraphs (a) to (d).
(f) The cost of property must be allocated to the therapy
service and removed from the rental per diem, based on the ratio
of service area square footage to total facility square footage
multiplied by the building capital allowance.
Sec. 80. Minnesota Statutes 1988, section 256B.48,
subdivision 1, is amended to read:
Subdivision 1. [PROHIBITED PRACTICES.] A nursing home is
not eligible to receive medical assistance payments unless it
refrains from all of the following:
(a) Charging private paying residents rates for similar
services which exceed those which are approved by the state
agency for medical assistance recipients as determined by the
prospective desk audit rate, except under the following
circumstances: the nursing home may (1) charge private paying
residents a higher rate for a private room, and (2) charge for
special services which are not included in the daily rate if
medical assistance residents are charged separately at the same
rate for the same services in addition to the daily rate paid by
the commissioner. Services covered by the payment rate must be
the same regardless of payment source. Special services, if
offered, must be offered available to all residents in all areas
of the nursing home and charged separately at the same rate.
Residents are free to select or decline special services.
Special services must not include services which must be
provided by the nursing home in order to comply with licensure
or certification standards and that if not provided would result
in a deficiency or violation by the nursing home. Services
beyond those required to comply with licensure or certification
standards must not be charged separately as a special service if
they were included in the payment rate for the previous
reporting year. A nursing home that charges a private paying
resident a rate in violation of this clause is subject to an
action by the state of Minnesota or any of its subdivisions or
agencies for civil damages. A private paying resident or the
resident's legal representative has a cause of action for civil
damages against a nursing home that charges the resident rates
in violation of this clause. The damages awarded shall include
three times the payments that result from the violation,
together with costs and disbursements, including reasonable
attorneys' fees or their equivalent. A private paying resident
or the resident's legal representative, the state, subdivision
or agency, or a nursing home may request a hearing to determine
the allowed rate or rates at issue in the cause of action.
Within 15 calendar days after receiving a request for such a
hearing, the commissioner shall request assignment of an
administrative law judge under sections 14.48 to 14.56 to
conduct the hearing as soon as possible or according to
agreement by the parties. The administrative law judge shall
issue a report within 15 calendar days following the close of
the hearing. The prohibition set forth in this clause shall not
apply to facilities licensed as boarding care facilities which
are not certified as skilled or intermediate care facilities
level I or II for reimbursement through medical assistance.
(b) Requiring an applicant for admission to the home, or
the guardian or conservator of the applicant, as a condition of
admission, to pay any fee or deposit in excess of $100, loan any
money to the nursing home, or promise to leave all or part of
the applicant's estate to the home.
(c) Requiring any resident of the nursing home to utilize a
vendor of health care services who is a licensed physician or
pharmacist chosen by the nursing home.
(d) Providing differential treatment on the basis of status
with regard to public assistance.
(e) Discriminating in admissions, services offered, or room
assignment on the basis of status with regard to public
assistance or refusal to purchase special services. Admissions
discrimination shall include, but is not limited to:
(1) basing admissions decisions upon assurance by the
applicant to the nursing home, or the applicant's guardian or
conservator, that the applicant is neither eligible for nor will
seek public assistance for payment of nursing home care costs;
and
(2) engaging in preferential selection from waiting lists
based on an applicant's ability to pay privately or an
applicant's refusal to pay for a special service.
The collection and use by a nursing home of financial
information of any applicant pursuant to the preadmission
screening program established by section 256B.091 shall not
raise an inference that the nursing home is utilizing that
information for any purpose prohibited by this paragraph.
(f) Requiring any vendor of medical care as defined by
section 256B.02, subdivision 7, who is reimbursed by medical
assistance under a separate fee schedule, to pay any amount
based on utilization or service levels or any portion of the
vendor's fee to the nursing home except as payment for renting
or leasing space or equipment or purchasing support services
from the nursing home as limited by section 256B.433. All
agreements must be disclosed to the commissioner upon request of
the commissioner. Nursing homes and vendors of ancillary
services that are found to be in violation of this provision
shall each be subject to an action by the state of Minnesota or
any of its subdivisions or agencies for treble civil damages on
the portion of the fee in excess of that allowed by this
provision and section 256B.433. Damages awarded must include
three times the excess payments together with costs and
disbursements including reasonable attorney's fees or their
equivalent.
(g) Refusing, for more than 24 hours, to accept a resident
returning to the same bed or a bed certified for the same level
of care, in accordance with a physician's order authorizing
transfer, after receiving inpatient hospital services.
The prohibitions set forth in clause (b) shall not apply to
a retirement home with more than 325 beds including at least 150
licensed nursing home beds and which:
(1) is owned and operated by an organization tax-exempt
under section 290.05, subdivision 1, clause (i); and
(2) accounts for all of the applicant's assets which are
required to be assigned to the home so that only expenses for
the cost of care of the applicant may be charged against the
account; and
(3) agrees in writing at the time of admission to the home
to permit the applicant, or the applicant's guardian, or
conservator, to examine the records relating to the applicant's
account upon request, and to receive an audited statement of the
expenditures charged against the applicant's individual account
upon request; and
(4) agrees in writing at the time of admission to the home
to permit the applicant to withdraw from the home at any time
and to receive, upon withdrawal, the balance of the applicant's
individual account.
For a period not to exceed 180 days, the commissioner may
continue to make medical assistance payments to a nursing home
or boarding care home which is in violation of this section if
extreme hardship to the residents would result. In these cases
the commissioner shall issue an order requiring the nursing home
to correct the violation. The nursing home shall have 20 days
from its receipt of the order to correct the violation. If the
violation is not corrected within the 20-day period the
commissioner may reduce the payment rate to the nursing home by
up to 20 percent. The amount of the payment rate reduction
shall be related to the severity of the violation, and shall
remain in effect until the violation is corrected. The nursing
home or boarding care home may appeal the commissioner's action
pursuant to the provisions of chapter 14 pertaining to contested
cases. An appeal shall be considered timely if written notice
of appeal is received by the commissioner within 20 days of
notice of the commissioner's proposed action.
In the event that the commissioner determines that a
nursing home is not eligible for reimbursement for a resident
who is eligible for medical assistance, the commissioner may
authorize the nursing home to receive reimbursement on a
temporary basis until the resident can be relocated to a
participating nursing home.
Certified beds in facilities which do not allow medical
assistance intake on July 1, 1984, or after shall be deemed to
be decertified for purposes of section 144A.071 only.
Sec. 81. Minnesota Statutes 1988, section 256B.48,
subdivision 6, is amended to read:
Subd. 6. [MEDICARE CERTIFICATION.] (a) [DEFINITION.] For
purposes of this subdivision, "nursing facility" means a nursing
home that is certified as a skilled nursing facility or, after
September 30, 1990, a nursing home licensed under chapter 144A
that is certified as a nursing facility.
(b) [FULL MEDICARE PARTICIPATION REQUIRED.] All nursing
homes certified as skilled nursing facilities under the medical
assistance program shall fully participate in Medicare part A
and part B unless, after submitting an application, Medicare
certification is denied by the federal health care financing
administration. Medicare review shall be conducted at the time
of the annual medical assistance review. Charges for
medicare-covered services provided to residents who are
simultaneously eligible for medical assistance and Medicare must
be billed to Medicare part A or part B before billing medical
assistance. Medical assistance may be billed only for charges
not reimbursed by Medicare.
Until September 30, 1987, the commissioner of health may
grant exceptions from this requirement when a nursing home
submits a written request for exception and it is determined
that there is sufficient participation in the Medicare program
to meet the needs of Medicare beneficiaries in that region of
the state. For the purposes of this section, the relevant
region is the county in which the nursing home is located
together with contiguous Minnesota counties. There is
sufficient participation in the Medicare program in a particular
region when the proportion of skilled resident days paid by the
Medicare program is at least equal to the national average based
on the most recent figure that can be supplied by the federal
health care financing administration. A nursing home that is
granted an exception under this subdivision must give
appropriate notice to all applicants for admission that Medicare
coverage is not available in the nursing home and publish this
fact in all literature and advertisement related to the nursing
home.
(c) [UNTIL SEPTEMBER 30, 1990.] Until September 30, 1990, a
nursing facility satisfies the requirements of paragraph (b) if:
(1) at least 50 percent of the facility's beds that are licensed
under section 144A and certified as skilled nursing beds under
the medical assistance program are Medicare certified; or (2) if
a nursing facility's beds are licensed under section 144A, and
some are medical assistance certified as skilled nursing beds
and others are Medical assistance certified as intermediate care
facility I beds, at least 50 percent of the facility's total
skilled nursing beds and intermediate care facility I beds or
100 percent of its skilled nursing beds, whichever is less, are
Medicare certified.
(d) [OCTOBER 1, 1990, TO JUNE 30, 1991.] After September
30, 1990, and until June 30, 1991, a nursing facility satisfies
the requirements of paragraph (b) if at least 50 percent of the
facility's beds certified as nursing facility beds under the
medical assistance program are Medicare certified.
(e) [AFTER JUNE 30, 1991.] After June 30, 1991, a nursing
facility satisfies the requirements of paragraph (b) if 100
percent of the facility's beds that are certified as nursing
facility beds under the medical assistance program are Medicare
certified.
(f) [PROHIBITED TRANSFERS.] A resident in a skilled nursing
bed or, after September 30, 1990, a resident in any nursing
facility bed, who is eligible for medical assistance and who
becomes eligible for Medicare has the right to refuse an
intrafacility skilled nursing bed transfer if the commissioner
approves the exception request based on written documentation
submitted by a physician that the transfer would create or
contribute to a health problem for the resident. A resident who
is occupying a skilled nursing bed or, after September 30, 1990,
a nursing facility bed certified by the medical assistance and
Medicare programs, has the right to refuse a transfer if the
resident's bed is needed for a Medicare-eligible patient or
private-pay patient and if the commissioner approves the
exception based on written documentation submitted by a
physician that the transfer would create or contribute to a
health problem for the resident.
(g) [INSTITUTIONS FOR MENTAL DISEASE.] The commissioner may
grant exceptions to the requirements of paragraph (b) for
nursing facilities that are designated as institutions for
mental disease.
(h) [NOTICE OF RIGHTS.] The commissioner shall inform
recipients of their rights under this subdivision and section
144.651, subdivision 29.
Sec. 82. Minnesota Statutes 1988, section 256B.48,
subdivision 8, is amended to read:
Subd. 8. [NOTIFICATION TO A SPOUSE.] When a private pay
resident who has not yet been screened by the preadmission
screening team is admitted to a nursing home or boarding care
facility, the nursing home or boarding care facility must notify
the resident and the resident's spouse of the following:
(1) their right to retain certain resources under sections
256B.14, subdivision 2, and 256B.17; and
(2) that the federal Medicare hospital insurance benefits
program covers posthospital extended care services in a
qualified skilled nursing facility for up to 100 150 days and
that there are several limitations on this benefit. The
resident and the resident's family must be informed about all
mechanisms to appeal limitations imposed under this federal
benefit program.
This notice may be included in the nursing home's or
boarding care facility's admission agreement and must clearly
explain what resources the resident and spouse may retain if the
resident applies for medical assistance. The department of
human services must notify nursing homes and boarding care
facilities of changes in the determination of medical assistance
eligibility that relate to resources retained by a resident and
the resident's spouse.
The preadmission screening team has primary responsibility
for informing all private pay applicants to a nursing home or
boarding care facility of the resources the resident and spouse
may retain.
Sec. 83. [256B.495] [LONG-TERM CARE RECEIVERSHIP FEES.]
Subdivision 1. [PAYMENT OF RECEIVERSHIP FEES.] The
commissioner in consultation with the commissioner of health may
establish a receivership fee payment that exceeds a long-term
care facility payment rate when the commissioner of health
determines a long-term care facility is subject to the
receivership provisions under section 144A.14 or 144A.15 or the
commissioner of human services determines that a facility is
subject to the receivership under section 245A.12 or 245A.13.
In establishing the receivership fee payment, the commissioner
must reduce the receiver's requested receivership fee by amounts
that the commissioner determines are included in the long-term
care facility's payment rate and that can be used to cover part
or all of the receivership fee. Amounts that can be used to
reduce the receivership fee shall be determined by reallocating
facility staff or costs that were formerly paid by the long-term
care facility before the receivership and are no longer required
to be paid. The amounts may include any efficiency incentive,
allowance, and other amounts not specifically required to be
paid for expenditures of the long-term care facility.
If the receivership fee cannot be covered by amounts in the
long-term care facility's payment rate, a receivership fee
payment shall be set according to paragraphs (a) and (b) and
payment shall be according to paragraphs (c) to (e).
(a) The receivership fee per diem shall be determined by
dividing the annual receivership fee payment by the long-term
care facility's resident days from the most recent cost report
for which the commissioner has established a payment rate or the
estimated resident days in the projected receivership fee period.
(b) The receivership fee per diem shall be added to the
long-term care facility's payment rate.
(c) Notification of the payment rate increase must meet the
requirements of section 256B.47, subdivision 2.
(d) The payment rate in paragraph (b) for a nursing home
shall be effective the first day of the month following the
receiver's compliance with the notice conditions in paragraph
(c). The payment rate in paragraph (b) for an intermediate care
facility for the mentally retarded shall be effective on the
first day of the rate year in which the receivership fee per
diem is determined.
(e) The commissioner may elect to make a lump sum payment
of a portion of the receivership fee to the receiver. In this
case, the commissioner and the receiver shall agree to a
repayment plan. Regardless of whether the commissioner makes a
lump sum payment under this paragraph, the provisions of
paragraphs (a) to (d) and subdivision 2 also apply.
Subd. 2. [DEDUCTION OF RECEIVERSHIP FEE PAYMENTS UPON
TERMINATION OF RECEIVERSHIP.] If the commissioner has
established a receivership fee per diem for a long-term care
facility in receivership, the commissioner must deduct the
receivership fee payments according to paragraphs (a) to (c).
(a) The total receivership fee payments shall be the
receivership fee per diem multiplied by the number of resident
days for the period of the receivership fee payments. If actual
resident days for the receivership fee payment period are not
made available within two weeks of the commissioner's written
request, the commissioner shall compute the resident days by
prorating the facility's resident days based on the number of
calendar days from each portion of the long-term care facility's
reporting years covered by the receivership period.
(b) The amount determined in paragraph (a) must be divided
by the long-term care facility's resident days for the reporting
year in which the receivership period ends.
(c) The per diem amount in paragraph (b) shall be
subtracted from the long-term care facility's operating cost
payment rate for the rate year following the reporting year in
which the receivership period ends.
Subd. 3. [REESTABLISHMENT OF RECEIVERSHIP FEE
PAYMENT.] The commissioner of health may request the
commissioner to reestablish the receivership fee payment when
the original terms of the receivership fee payment have
significantly changed with regard to the cost or duration of the
receivership agreement. The commissioner, in consultation with
the commissioner of health, may reestablish the receivership fee
payment when the commissioner determines the cost or duration of
the receivership agreement has significantly changed. The
provisions of developing a receivership fee payment in
subdivisions 1 and 2 apply to the reestablishment process.
Sec. 84. Minnesota Statutes 1988, 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;
(e) a revaluation on sale between unrelated organizations
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. 85. Minnesota Statutes 1988, section 256B.501,
subdivision 3g, is amended 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. adjust the program
operating cost rates of facilities based on a comparison of
client service characteristics, resource needs, and costs. The
commissioner may adjust a facility's payment rate during the
rate year when accumulated changes in the facility's average
service units exceed the minimums established in the rules
required by subdivision 3j.
Sec. 86. Minnesota Statutes 1988, section 256B.501, is
amended by adding a subdivision to read:
Subd. 3k. [EXPERIMENTAL PROJECT.] The commissioner of
human services may conduct and administer experimental projects
to determine the effects of competency-based wage adjustments
for direct-care staff on the quality of care and active
treatment for persons with mental retardation or related
conditions. The commissioner shall authorize one project under
the following conditions:
(a) One service provider will participate in the project.
(b) The vendor must have an existing competency-based
training curriculum and a proposed salary schedule that is
coordinated with the training package.
(c) The University of Minnesota affiliated programs must
approve the content of the training package and assist the
vendor in studying the impact on service delivery and outcomes
for residents under a competency-based salary structure. The
study and its conclusions must be presented to the commissioner
at the conclusion of the project.
(d) The project will last no more than 21 months from its
inception.
(e) The project will be funded by Title XIX, medical
assistance and the costs incurred shall be allowable program
operating costs for future rate years under Minnesota Rules,
parts 9553.0010 to 9553.0080. The project's total annual cost
must not exceed $49,500. The commissioner shall establish an
adjustment to the selected facility's per diem by dividing the
$49,500 by the facility's actual resident days for the reporting
year ending December 31, 1988. The facility's experimental
training project per diem shall be effective on October 1, 1989,
and shall remain in effect for the 21-month period ending June
30, 1991.
(f) Only service vendors who have submitted a determination
of need pursuant to Minnesota Rules, parts 9525.0015 to
9525.0165, and Minnesota Statutes, section 252.28, requesting
the competency-based training program cost increase are eligible.
Furthermore, they are only eligible if their determination of
need was approved prior to January 1, 1989, and funds were not
available to implement the plan.
Sec. 87. Minnesota Statutes 1988, 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.055, subdivision 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; (3) recipients who
currently have private coverage through a health maintenance
organization; and (4) recipients who are eligible for medical
assistance by spending down excess income for medical expenses
other than the nursing facility per diem expense. 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. If a
demonstration provider ends participation in the project for any
reason, a recipient enrolled with that provider must select a
new provider but may change providers without cause once more
within the first 60 days after enrollment with the second
provider.
Sec. 88. Minnesota Statutes 1988, section 256B.69,
subdivision 5, is amended to read:
Subd. 5. [PROSPECTIVE PER CAPITA PAYMENT.] The project
advisory committees with the commissioner shall establish the
method and amount of payments for services. The commissioner
shall annually contract with demonstration providers to provide
services consistent with these established methods and amounts
for payment. Notwithstanding section 62D.02, subdivision 1,
payments for services rendered as part of the project may be
made to providers that are not licensed health maintenance
organizations on a risk-based, prepaid capitation basis.
If allowed by the commissioner, a demonstration provider
may contract with an insurer, health care provider, nonprofit
health service plan corporation, or the commissioner, to provide
insurance or similar protection against the cost of care
provided by the demonstration provider or to provide coverage
against the risks incurred by demonstration providers under this
section. The recipients enrolled with a demonstration provider
are a permissible group under group insurance laws and chapter
62C, the Nonprofit Health Service Plan Corporations Act. Under
this type of contract, the insurer or corporation may make
benefit payments to a demonstration provider for services
rendered or to be rendered to a recipient. Any insurer or
nonprofit health service plan corporation licensed to do
business in this state is authorized to provide this insurance
or similar protection.
Payments to providers participating in the project are
exempt from the requirements of sections 256.966 and 256B.03,
subdivision 2. The commissioner shall complete development of
capitation rates for payments before delivery of services under
this section is begun. For payments made during calendar year
1990 and later years, the commissioner shall contract with an
independent actuary to establish prepayment rates.
Sec. 89. Minnesota Statutes 1988, section 256B.69,
subdivision 11, is amended to read:
Subd. 11. [APPEALS.] A recipient may appeal to the
commissioner a demonstration provider's delay or refusal to
provide services, according to section 256.045. The
commissioner shall appoint a panel of health practitioners,
including social service practitioners, as necessary to
determine the necessity of services provided or refused to a
recipient. The deliberations and decisions of the panel replace
the administrative review process otherwise available under
chapter 256. The panel shall follow the time requirements and
other provisions of the Code of Federal Regulations, title 42,
sections 431.200 to 431.246. The time requirements shall be
expedited based on request by the individual who is appealing
for emergency services. If a service is determined to be
necessary and is included among the benefits for which a
recipient is enrolled, the service must be provided by the
demonstration provider as specified in subdivision 5. The
panel's decision is a final agency action.
Sec. 90. Minnesota Statutes 1988, section 256B.69, is
amended by adding a subdivision to read:
Subd. 17. [CONTINUATION OF PREPAID MEDICAL
ASSISTANCE.] The commissioner may continue the provisions of
this section after June 30, 1990, in any or all of the
participating counties if necessary federal authority is
granted. The commissioner may adopt permanent rules to continue
prepaid medical assistance in these areas.
Sec. 91. Minnesota Statutes 1988, 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) (i) 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 assets
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.; and
(ii) who has countable income not in excess of the
assistance standards established in section 256B.056,
subdivision 4, or whose excess income is spent down pursuant to
section 256B.056, subdivision 5. The method for calculating
earned income disregards and deductions for a person who resides
with a dependent child under age 21 shall be as specified in
section 256.74, subdivision 1. The earned income deductions for
a person who does not reside with a dependent child under age 21
shall be the same as the method used to determine eligibility
for a person under section 256D.06, subdivision 1, except for
the disregard of the first $50 of earned income; or
(3) who is over age 18 and who would be eligible for
medical assistance except that the person resides in a facility
that is determined by the commissioner or the federal health
care financing administration to be an institution for mental
diseases.
(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.
(e) In determining the amount of assets of an individual,
there shall be included any asset or interest in an asset,
including an asset excluded under paragraph (a), that was given
away, sold, or disposed of for less than fair market value
within the 30 months preceding application for general
assistance medical care or during the period of eligibility.
Any transfer described in this paragraph shall be presumed to
have been for the purpose of establishing eligibility for
general assistance medical care, unless the individual furnishes
convincing evidence to establish that the transaction was
exclusively for another purpose. For purposes of this
paragraph, the value of the asset or interest shall be the fair
market value at the time it was given away, sold, or disposed
of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility
shall be calculated by dividing the uncompensated transfer
amount by the average monthly per person payment made by the
medical assistance program to skilled nursing facilities for the
previous calendar year. The individual shall remain ineligible
until this fixed period has expired. The period of
ineligibility may exceed 30 months, and a reapplication for
benefits after 30 months from the date of the transfer shall not
result in eligibility unless and until the period of
ineligibility has expired.
Sec. 92. Minnesota Statutes 1988, section 256D.03,
subdivision 4, is amended to read:
Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a)
Reimbursement under the general assistance medical care program
shall be limited to the following categories of service:
inpatient hospital care, outpatient hospital care, services
provided by Medicare certified rehabilitation agencies,
prescription drugs, equipment necessary to administer insulin
and diagnostic supplies and equipment for diabetics to monitor
blood sugar level, eyeglasses and eye examinations provided by a
physician or optometrist, hearing aids, prosthetic devices,
laboratory and X-ray services, physician's services, medical
transportation, chiropractic services as covered under the
medical assistance program, podiatric services, and dental
care. In addition, payments of state aid shall be made for:
(1) outpatient services provided by a mental health center
or clinic that is under contract with the county board and is
certified under Minnesota Rules, parts 9520.0750 9520.0010 to
9520.0870 9520.0230;
(2) day treatment services for mental illness provided
under contract with the county board; and
(3) prescribed medications for persons who have been
diagnosed as mentally ill as necessary to prevent more
restrictive institutionalization.;
(4) case management services for a person with serious and
persistent mental illness who would be eligible for medical
assistance except that the person resides in an institution for
mental diseases;
(5) psychological services, medical supplies and equipment,
and Medicare premiums, coinsurance and deductible payments for a
person who would be eligible for medical assistance except that
the person resides in an institution for mental diseases; and
(6) equipment not specifically listed in this paragraph
when the use of the equipment will prevent the need for costlier
services that are reimbursable under this subdivision.
(b) In order to contain costs, the commissioner of human
services shall select vendors of medical care who can provide
the most economical care consistent with high medical standards
and shall where possible contract with organizations on a
prepaid capitation basis to provide these services. The
commissioner shall consider proposals by counties and vendors
for prepaid health plans, competitive bidding programs, block
grants, or other vendor payment mechanisms designed to provide
services in an economical manner or to control utilization, with
safeguards to ensure that necessary services are provided.
Before implementing prepaid programs in counties with a county
operated or affiliated public teaching hospital or a hospital or
clinic operated by the University of Minnesota, the commissioner
shall consider the risks the prepaid program creates for the
hospital and allow the county or hospital the opportunity to
participate in the program in a manner that reflects the risk of
adverse selection and the nature of the patients served by the
hospital, provided the terms of participation in the program are
competitive with the terms of other participants considering the
nature of the population served. Payment for services provided
pursuant to this subdivision shall be as provided to medical
assistance vendors of these services under sections 256B.02,
subdivision 8, and 256B.0625. The rates payable under this
section must be calculated according to section 256B.031,
subdivision 4 For payments made during fiscal year 1990 and
later years, the commissioner shall contract with an independent
actuary to establish prepayment rates.
(c) The commissioner of human services may reduce payments
provided under sections 256D.01 to 256D.21 and 261.23 in order
to remain within the amount appropriated for general assistance
medical care, within the following restrictions.
For the period July 1, 1985, to December 31, 1985,
reductions below the cost per service unit allowable under
section 256.966, are permitted only as follows: payments for
inpatient and outpatient hospital care provided in response to a
primary diagnosis of chemical dependency or mental illness may
be reduced no more than 30 percent; payments for all other
inpatient hospital care may be reduced no more than 20 percent.
Reductions below the payments allowable under general assistance
medical care for the remaining general assistance medical care
services allowable under this subdivision may be reduced no more
than ten percent.
For the period January 1, 1986 to December 31, 1986,
reductions below the cost per service unit allowable under
section 256.966 are permitted only as follows: payments for
inpatient and outpatient hospital care provided in response to a
primary diagnosis of chemical dependency or mental illness may
be reduced no more than 20 percent; payments for all other
inpatient hospital care may be reduced no more than 15 percent.
Reductions below the payments allowable under general assistance
medical care for the remaining general assistance medical care
services allowable under this subdivision may be reduced no more
than five percent.
For the period January 1, 1987 to June 30, 1987, reductions
below the cost per service unit allowable under section 256.966
are permitted only as follows: payments for inpatient and
outpatient hospital care provided in response to a primary
diagnosis of chemical dependency or mental illness may be
reduced no more than 15 percent; payments for all other
inpatient hospital care may be reduced no more than ten
percent. Reductions below the payments allowable under medical
assistance for the remaining general assistance medical care
services allowable under this subdivision may be reduced no more
than five percent.
For the period July 1, 1987, to June 30, 1988, reductions
below the cost per service unit allowable under section 256.966
are permitted only as follows: payments for inpatient and
outpatient hospital care provided in response to a primary
diagnosis of chemical dependency or mental illness may be
reduced no more than 15 percent; payments for all other
inpatient hospital care may be reduced no more than five percent.
Reductions below the payments allowable under medical assistance
for the remaining general assistance medical care services
allowable under this subdivision may be reduced no more than
five percent.
For the period July 1, 1988, to June 30, 1989, reductions
below the cost per service unit allowable under section 256.966
are permitted only as follows: payments for inpatient and
outpatient hospital care provided in response to a primary
diagnosis of chemical dependency or mental illness may be
reduced no more than 15 percent; payments for all other
inpatient hospital care may not be reduced. Reductions below
the payments allowable under medical assistance for the
remaining general assistance medical care services allowable
under this subdivision may be reduced no more than five percent.
There shall be no copayment required of any recipient of
benefits for any services provided under this subdivision. A
hospital receiving a reduced payment as a result of this section
may apply the unpaid balance toward satisfaction of the
hospital's bad debts.
(d) Any county may, from its own resources, provide medical
5 payments for which state payments are not made.
(e) Chemical dependency services that are reimbursed under
Laws 1986, chapter 394, sections 8 to 20, must not be reimbursed
under general assistance medical care.
(f) The maximum payment for new vendors enrolled in the
general assistance medical care program after the base year
shall be determined from the average usual and customary charge
of the same vendor type enrolled in the base year.
(g) The conditions of payment for services under this
subdivision are the same as the conditions specified in rules
adopted under chapter 256B governing the medical assistance
program, unless otherwise provided by statute or rule.
Sec. 93. Minnesota Statutes 1988, section 297.13,
subdivision 1, is amended to read:
Subdivision 1. [CIGARETTE TAX APPORTIONMENT.] Revenues
received from taxes, penalties, and interest under sections
297.01 to 297.13 and from license fees and miscellaneous sources
of revenue shall be deposited by the commissioner of revenue in
a separate and special fund, designated as the tobacco tax
revenue fund, in the state treasury and credited as follows:
(a) first to the general obligation special tax bond debt
service account in each fiscal year the amount required to
increase the balance on hand in the account on each December 1
to an amount equal to the full amount of principal and interest
to come due on all outstanding bonds whose debt service is
payable primarily from the proceeds of the tax to and including
the second following July 1; and
(b) after the requirements of paragraph (a) have been met:
(1) the revenue produced by one mill of the tax on
cigarettes weighing not more than three pounds a thousand and
two mills of the tax on cigarettes weighing more than three
pounds a thousand must be credited to the Minnesota future
resources account;
(2) the revenue produced by two mills of the tax on
cigarettes weighing not more than three pounds a thousand and
four mills of the tax on cigarettes weighing more than three
pounds a thousand must be credited to the Minnesota state water
pollution control fund created in section 116.16, provided that,
if the tax on cigarettes imposed by United States Code, title
26, section 5701, as amended, is reduced after June 1, 1985, an
additional one mill of the tax on cigarettes weighing not more
than three pounds a thousand and two mills of the tax on
cigarettes weighing more than three pounds a thousand must be
credited to the Minnesota state water pollution control fund
created in section 116.16 less any amount credited to the
general obligation special tax debt service account under
paragraph (a), with respect to bonds issued for the prevention,
control, and abatement of water pollution;
(3) the revenue produced by one mill of the tax on
cigarettes weighing not more than three pounds a thousand and
two mills of the tax on cigarettes weighing more than three
pounds a thousand must be credited to a public health fund,
provided that if the tax on cigarettes imposed by United States
Code, title 26, section 5701, as amended, is reduced after June
1, 1985, an additional two-tenths of one mill of the tax on
cigarettes weighing not more than three pounds a thousand and an
additional four-tenths of one mill of the tax on cigarettes
weighing more than three pounds a thousand must be credited to
the public health fund;
(4) the balance of the revenues derived from taxes,
penalties, and interest under sections 297.01 to 297.13 and from
license fees and miscellaneous sources of revenue shall be
credited to the general fund.
Sec. 94. [STUDY AND REPORT ON NURSING HOME PROPERTY
PAYMENTS VERSUS COSTS.] (a) If a nursing home has rental per
diem established by the commissioner under Minnesota Rules, part
9549.0060, for the rate year beginning July 1, 1989, that is
inadequate to minimally cover their annual principle and
interest payments, that nursing home must submit copies of their
amortization schedules to the commissioner by June 30, 1989, for
all debts except working capital debt. The term "inadequate to
minimally cover their annual principle and interest" means the
annual principle and interest payments on the nursing home's
debt for its land, land improvements, buildings, attached
fixtures, and depreciable equipment used directly for resident
care are more than the July 1, 1989, rental per diem multiplied
by the nursing home's resident days for the reporting year
ending September 30, 1988. The information regarding the
nursing home's amortization schedules which must be submitted to
the commissioner for each debt shall include:
(1) a monthly amortization schedule starting the later of
October 1, 1983, or the date the debt was incurred, through the
remaining term of the debt;
(2) the interest rate, if fixed;
(3) if the interest rate is variable, the current variable
interest rate and the method by which the interest rate may be
changed;
(4) the original amount borrowed;
(5) the assets or other collateral pledged as security for
the debt;
(6) the cost of the assets purchased or the amount of the
debt refinanced;
(7) a copy of the loan, bond, or mortgage agreement may be
supplied or made available for inspection by the commissioner;
(8) sinking fund requirements and balances, if any;
(9) the lender's name and relationship to the nursing
home's owners, if any; and
(10) other information that may be requested by the
commissioner regarding the nursing home's debt upon review of
the information provided in clauses (1) to (9).
(b) The commissioner shall contract with an independent
financial consultant to review and analyze the financial data in
paragraph (a) and to study the concept of a capital asset
replacement fund, and the consultant shall assist the
commissioner in the development of a report which must be
submitted to the legislative commission on long-term care by
January 1, 1990.
(c) The report shall identify the underlying reasons why
each nursing home in paragraph (a) is unable to meet its annual
debt obligations, possible actions or resources available to the
nursing home that could be used to address its debt obligations
such as the nursing home's efficiency incentive, investments, or
related organization transactions or investments. The report
shall include suggested solutions and recommendations for each
nursing home. The report must also address the need for a
capital asset replacement fund and the relative need for such a
fund given the provision for capital reimbursement under the
rental reimbursement system, the varying levels of property
reimbursement among nursing homes, the various debt and
financial structures of nursing homes, their actual property
costs in terms of their annual principal and interest
requirements, the cost of replacing or repairing capital assets
under the reimbursement system, and the adequacy of the
equipment allowance.
Sec. 95. [STUDY OF NURSING HOME WORKERS' COMPENSATION
COSTS.]
The commissioner of human services, in consultation with an
advisory committee, shall study workers' compensation costs of
nursing homes and make recommendations to the legislature by
January 1, 1990, regarding changes to the nursing home rate
system that will ensure adequate reimbursement to cover workers'
compensation costs without reducing incentives for nursing homes
to control costs by taking action to reduce the risk of
work-related injuries to employees.
Sec. 96. [STUDY.]
The commissioner of health shall review the provisions of
Minnesota Statutes, chapter 144A, regarding the revocation,
suspension, and nonrenewal of nursing home licenses and
provisions relating to controlling persons and managerial
employees. The results of the commissioner's review and any
recommendations for change must be submitted to the legislature
by February 15, 1990. The commissioner shall consult with
consumer and nursing home provider organizations during this
review.
Sec. 97. [TEMPORARY PROVISIONS RELATING TO INSTITUTIONS
FOR MENTAL DISEASES.]
Subdivision 1. [ELIGIBILITY FOR GENERAL ASSISTANCE MEDICAL
CARE AND MINNESOTA SUPPLEMENTAL AID.] For the period beginning
January 1, 1989 and ending June 30, 1989, general assistance
medical care and Minnesota supplemental aid may be paid for any
person who is over age 18 and would be eligible for medical
assistance except that the person resides in a facility that is
determined by the commissioner of human services or the federal
health care financing administration to be an institution for
mental diseases.
Subd. 2. [COVERED SERVICES.] For the period beginning
January 1, 1989 and ending June 30, 1989, reimbursement under
general assistance medical care includes, in addition to
services covered under Minnesota Statutes 1988, section 256D.03,
subdivision 4, the following services for a person who would be
eligible for medical assistance except that the person resides
in a facility that is determined by the commissioner of human
services or the federal health care financing administration to
be an institution for mental diseases:
(1) case management services for a person with serious and
persistent mental illness;
(2) medical supplies and equipment; and
(3) psychological services.
Subd. 3. [EXCEPTION TO RESIDENTIAL FACILITY LIMITS.] For
the period beginning January 1, 1989 and ending June 30, 1989, a
residential facility certified to participate in the medical
assistance program, licensed as a boarding care home or nursing
home, and determined by the commissioner of human services or
the federal health care financing administration to be an
institution for mental diseases is exempt from the maximum
negotiated rate in Minnesota Statutes, section 256D.37. The
rate for eligible individuals residing in these facilities is
the individual's medical assistance rate using the individual's
assigned case mix classification. Counties must be reimbursed
for payments made between January 1, 1989 and June 30, 1989, to
certified nursing homes and boarding care homes declared
institutions for mental diseases by January 1, 1989, on behalf
of persons otherwise eligible for medical assistance. The
reimbursement must not exceed the state share of supplemental
aid funds expended for each person at the appropriate medical
assistance rate.
Sec. 98. [REPEALER.]
Subdivision 1. [NURSING HOMES.] Minnesota Statutes 1988,
section 144A.10, subdivision 4a, is repealed. Laws 1988,
chapter 689, article 2, section 269, subdivision 4, is
repealed. Minnesota Statutes 1988, section 144A.61, subdivision
6, is repealed effective January 1, 1990.
Subd. 2. [BRAIN INJURIES.] Minnesota Statutes 1988,
section 256B.0625, subdivision 21, is repealed.
Subd. 3. [HEALTH CARE PROGRAMS.] Minnesota Statutes 1988,
sections 256.969, subdivisions 2a, 3, 4, 5, and 6; and 256B.69,
subdivisions 12, 13, 14, and 15, are repealed.
Subd. 4. Minnesota Statutes 1988, section 256B.17,
subdivisions 1, 2, 3, 4, 5, 6, and 8, are repealed.
Subd. 5. Minnesota Statutes 1988, section 256B.17,
subdivision 7, is repealed effective October 1, 1989.
Sec. 99. [EFFECTIVE DATE.]
Sections 33, 34, and 35 are effective the day after final
enactment, except that the amendment in section 33, to Minnesota
Statutes, section 256.936, subdivision 1, paragraph (a), is not
effective until January 1, 1991 and the amendment in section 33,
to Minnesota Statutes, section 256.936, subdivision 1, paragraph
(c), striking "mental health and" is effective July 1, 1990.
However, a child enrolled in the children's health plan who
reached or will reach age nine between the date of initial
implementation of the children's health plan and January 1,
1991, remains eligible for the plan after the child's ninth
birth date until January 1, 1991, if the child meets all other
program requirements.
Section 61 is effective the day after final enactment.
Section 46 is effective July 1, 1990.
Section 48, subdivision 2, is effective June 30, 1989.
Section 50 is effective October 1, 1989, for spousal income
calculations for anyone who resides in an institution on or
after that date.
Section 51 is effective October 1, 1989, for anyone who
enters an institution on or after that date.
Section 1 is effective for claims filed with the insurer
after June 30, 1989.
Section 52 is effective July 1, 1988, for all assets
transferred on or after that date except for interspousal
transfers under section 256B.17, subdivision 7.
Section 53 is effective April 1, 1990, for families who
become ineligible for AFDC on or after that date.
Section 57 is effective September 1, 1989.
Section 89 is effective for all appeals that are filed
after June 30, 1989.
Section 54 is effective July 1, 1990.
Section 81, except paragraph (f), is effective 30 days
following final enactment. Section 81, paragraph (f), is
effective the day following final enactment.
Section 89 is effective for all appeals that are filed
after June 30, 1989.
Section 13 is effective the day following final enactment.
ARTICLE 4
MENTAL HEALTH
Section 1. Minnesota Statutes 1988, section 245.461, is
amended to read:
245.461 [POLICY AND CITATION.]
Subdivision 1. [CITATION.] Sections 245.461 to 245.486 may
be cited as the "Minnesota comprehensive adult mental health
act."
Subd. 2. [MISSION STATEMENT.] The commissioner shall
create and ensure a unified, accountable, comprehensive adult
mental health service system that:
(1) recognizes the right of people adults with mental
illness to control their own lives as fully as possible;
(2) promotes the independence and safety of people adults
with mental illness;
(3) reduces chronicity of mental illness;
(4) reduces eliminates abuse of people adults with mental
illness;
(5) provides services designed to:
(i) increase the level of functioning of people adults with
mental illness or restore them to a previously held higher level
of functioning;
(ii) stabilize individuals adults with mental illness;
(iii) prevent the development and deepening of mental
illness;
(iv) support and assist individuals adults in
resolving emotional mental health problems that impede their
functioning;
(v) promote higher and more satisfying levels of emotional
functioning; and
(vi) promote sound mental health; and
(6) provides a quality of service that is effective,
efficient, appropriate, and consistent with contemporary
professional standards in the field of mental health.
Subd. 3. [REPORT.] By February 15, 1988, and annually
after that until February 15, 1990, the commissioner shall
report to the legislature on all steps taken and recommendations
for full implementation of sections 245.461 to 245.486 and on
additional resources needed to further implement those sections.
Subd. 4. [HOUSING MISSION STATEMENT.] The commissioner
shall ensure that the housing services provided as part of a
comprehensive mental health service system:
(1) allow all persons with mental illness to live in
stable, affordable housing, in settings that maximize community
integration and opportunities for acceptance;
(2) allow persons with mental illness to actively
participate in the selection of their housing from those living
environments available to the general public; and
(3) provide necessary support regardless of where persons
with mental illness choose to live.
Sec. 2. Minnesota Statutes 1988, section 245.462, is
amended to read:
245.462 [DEFINITIONS.]
Subdivision 1. [DEFINITIONS.] The definitions in this
section apply to sections 245.461 to 245.486.
Subd. 2. [ACUTE CARE HOSPITAL INPATIENT TREATMENT.] "Acute
care hospital inpatient treatment" means short-term medical,
nursing, and psychosocial services provided in an acute care
hospital licensed under chapter 144.
Subd. 3. [CASE MANAGEMENT ACTIVITIES SERVICES.] "Case
management activities services" means activities that are
coordinated with the community support services program as
defined in subdivision 6 and are designed to help people adults
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 services include developing a
functional assessment, an individual community support plan,
referring and assisting the person to obtain needed mental
health and other services, ensuring coordination of services,
and monitoring the delivery of services.
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
services specified in subdivision 3 and sections 245.471 and
245.475. A case manager must 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
adults 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 adults 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 adults 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.
Until June 30, 1991, a refugee who does not have the
qualifications specified in this subdivision may provide case
management services to adult refugees with serious and
persistent mental illness who are members of the same ethnic
group as the case manager if the person: (1) is actively
pursuing credits toward the completion of a bachelor's degree in
one of the behavioral sciences or a related field from an
accredited college or university; (2) completes 40 hours of
training as specified in this subdivision; and (3) receives
clinical supervision at least once a week until the requirements
of obtaining a bachelor's degree and 2,000 hours of supervised
experience are met.
Subd. 4a. [CLINICAL SUPERVISION.] "Clinical supervision"
means the oversight responsibility for individual treatment
plans and individual mental health service delivery, including
that provided by the case manager. Clinical supervision 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 by entries in the client's record
regarding supervisory activities.
Subd. 5. [COMMISSIONER.] "Commissioner" means the
commissioner of human services.
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 adults with
serious and persistent mental illness to function and remain in
the community. A community support services program includes:
(1) client outreach,
(2) medication management monitoring,
(3) assistance in independent living skills,
(4) development of employability and supportive work
related 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 services specified
in subdivision 3 and sections 245.471 and 245.475 section
245.4711.
Subd. 7. [COUNTY BOARD.] "County board" means the county
board of commissioners or board established pursuant to the
joint powers act, section 471.59, or the human services board
act, sections 402.01 to 402.10.
Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day
treatment services," means a structured program of intensive
therapeutic and rehabilitative services at least one day a week
for a minimum three-hour time block that is provided within a
group setting by a multidisciplinary staff under the clinical
supervision of a mental health professional. Day treatment
services are not a part of inpatient or residential treatment
services, but may be part of a community support services
program. or "day treatment program" means a structured program
of treatment and care provided to an adult in: (1) a hospital
accredited by the joint commission on accreditation of health
organizations and licensed under sections 144.50 to 144.55; (2)
a community mental health center under section 245.62; or (3) an
entity that is under contract with the county board to operate a
program that meets the requirements of section 245.4711,
subdivision 7, and Minnesota Rules, parts 9505.0170 to
9505.0475. Day treatment consists of group psychotherapy and
other intensive therapeutic services that are provided at least
one day a week for a minimum three-hour time block by a
multidisciplinary staff under the clinical supervision of a
mental health professional. The services are aimed at
stabilizing the adult's mental health status, providing mental
health services, and developing and improving the adult's
independent living and socialization skills. The goal of day
treatment is to reduce or relieve mental illness and to enable
the adult to live in the community. Day treatment services are
not a part of inpatient or residential treatment services. Day
treatment services are distinguished from day care by their
structured therapeutic program of psychotherapy services.
Subd. 9. [DIAGNOSTIC ASSESSMENT.] "Diagnostic assessment"
means a written summary of the history, diagnosis, strengths,
vulnerabilities, and general service needs of a person an adult
with a mental illness using diagnostic, interview, and other
relevant mental health techniques provided by a mental health
professional used in developing an individual treatment plan or
individual community support plan.
Subd. 10. [EDUCATION AND PREVENTION SERVICES.] "Education
and prevention services" means services designed to educate the
general public or special high-risk target populations about
mental illness, to increase the understanding and acceptance of
problems associated with mental illness, to increase people's
awareness of the availability of resources and services, and to
improve people's skills in dealing with high-risk situations
known to affect people's mental health and functioning. The
services include the distribution of information to individuals
and agencies identified by the county board and the local mental
health advisory council, on predictors and symptoms of mental
disorders, where mental health services are available in the
county, and how to access the services.
Subd. 11. [EMERGENCY SERVICES.] "Emergency services" means
an immediate response service available on a 24-hour,
seven-day-a-week basis for persons having a psychiatric crisis,
a mental health crisis, or emergency.
Subd. 11a. [FUNCTIONAL ASSESSMENT.] "Functional assessment"
means an assessment by the case manager of the adult's:
(1) mental health symptoms as presented in the adult's
diagnostic assessment;
(2) mental health needs as presented in the adult's
diagnostic assessment;
(3) use of drugs and alcohol;
(4) vocational and educational functioning;
(5) social functioning, including the use of leisure time;
(6) interpersonal functioning, including relationships with
the adult's family;
(7) self-care and independent living capacity;
(8) medical and dental health;
(9) financial assistance needs;
(10) housing and transportation needs; and
(11) other needs and problems.
Subd. 12. [INDIVIDUAL COMMUNITY SUPPORT PLAN.] "Individual
community support plan" means a written plan developed by a case
manager on the basis of a diagnostic assessment and functional
assessment. The plan identifies specific services needed by a
person an adult with serious and persistent mental illness to
develop independence or improved functioning in daily living,
health and medication management, social functioning,
interpersonal relationships, financial management, housing,
transportation, and employment.
Subd. 13. [INDIVIDUAL PLACEMENT AGREEMENT.] "Individual
placement agreement" means a written agreement or supplement to
a service contract entered into between the county board and a
service provider on behalf of an individual client adult to
provide residential treatment services.
Subd. 14. [INDIVIDUAL TREATMENT PLAN.] "Individual
treatment plan" means a written plan of intervention, treatment,
and services for a person an adult with mental illness that is
developed by a service provider under the clinical supervision
of a mental health professional on the basis of a diagnostic
assessment. The plan identifies goals and objectives of
treatment, treatment strategy, a schedule for accomplishing
treatment goals and objectives, and the individual responsible
for providing treatment to the person adult with mental illness.
Subd. 15. [LOCAL MENTAL HEALTH PROPOSAL.] "Local mental
health proposal" means the proposal developed by the county
board, reviewed by the commissioner, and described in section
245.463.
Subd. 16. [MENTAL HEALTH FUNDS.] "Mental health funds" are
funds expended under sections 245.73 and 256E.12, federal mental
health block grant funds, and funds expended under sections
256D.06 and 256D.37 to facilities licensed under Minnesota
Rules, parts 9520.0500 to 9520.0690.
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; 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 and has less than 4,000 hours post-master's
experience in the treatment of mental illness.
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 and who is certified as a clinical specialist by the
American nurses association;
(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.
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 adults with
mental illness and are described in sections 245.461 to 245.486.
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 An "adult with acute mental illness" means a
person an adult who has a mental illness that is serious enough
to require prompt intervention.
(c) For purposes of case management and community support
services, a "person with serious and persistent mental illness"
means a person an adult who has a mental illness and meets at
least one of the following criteria:
(1) the person adult has undergone two or more episodes of
inpatient care for a mental illness within the preceding 24
months;
(2) the person adult has experienced a continuous
psychiatric hospitalization or residential treatment exceeding
six months' duration within the preceding 12 months;
(3) the person adult:
(i) has 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 from a mental health
professional stating that the person adult 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 adult has been committed by a court as a
mentally ill person under chapter 253B, or the person's adult's
commitment has been stayed or continued.
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
adults with a mental illness who live outside a hospital.
Outpatient services include clinical activities such as
individual, group, and family therapy; individual treatment
planning; diagnostic assessments; medication management; and
psychological testing.
Subd. 22. [REGIONAL TREATMENT CENTER INPATIENT SERVICES.]
"Regional treatment center inpatient services" means the
24-hour-a-day comprehensive medical, nursing, or psychosocial
services provided in a regional treatment center operated by the
state.
Subd. 23. [RESIDENTIAL TREATMENT.] "Residential treatment"
means a 24-hour-a-day 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 inpatient unit, that must be licensed as a residential
treatment facility program for persons adults with mental
illness under Minnesota Rules, parts 9520.0500 to 9520.0690 for
adults, 9545.0900 to 9545.1090 for children, or other rule rules
adopted by the commissioner.
Subd. 24. [SERVICE PROVIDER.] "Service provider" means
either a county board or an individual or agency including a
regional treatment center under contract with the county board
that provides adult mental health services funded by sections
245.461 to 245.486.
Subd. 25. [CLINICAL SUPERVISION.] "Clinical supervision"
means the oversight responsibility for individual treatment
plans and individual service delivery, including that provided
by the case manager. Clinical supervision 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 by entries in the client's record regarding
supervisory activities.
Sec. 3. Minnesota Statutes 1988, section 245.463,
subdivision 2, is amended to read:
Subd. 2. [TECHNICAL ASSISTANCE.] The commissioner shall
provide ongoing technical assistance to county boards to develop
local mental health proposals as specified in section
245.479 245.478, to improve system capacity and quality. The
commissioner and county boards shall exchange information as
needed about the numbers of persons adults with mental illness
residing in the county and extent of existing treatment
components locally available to serve the needs of those
persons. County boards shall cooperate with the commissioner in
obtaining necessary planning information upon request.
Sec. 4. Minnesota Statutes 1988, section 245.463, is
amended by adding a subdivision to read:
Subd. 3. The commissioner of human services shall, in
cooperation with the commissioner of health, study and submit to
the legislature by February 15, 1991, a report and
recommendations regarding (1) plans and fiscal projections for
increasing the number of community-based beds, small
community-based residential programs, and support services for
persons with mental illness, including persons for whom nursing
home services are inappropriate, to serve all persons in need of
those programs; and (2) the projected fiscal impact of
maximizing the availability of medical assistance coverage for
persons with mental illness.
Sec. 5. Minnesota Statutes 1988, section 245.464, is
amended to read:
245.464 [COORDINATION OF MENTAL HEALTH SYSTEM.]
Subdivision 1. [SUPERVISION COORDINATION.] The
commissioner shall supervise the development and coordination of
locally available adult mental health services by the county
boards in a manner consistent with sections 245.461 to 245.486.
The commissioner shall coordinate locally available services
with those services available from the regional treatment center
serving the area. The commissioner shall review local mental
health service proposals developed by county boards as specified
in section 245.463 and provide technical assistance to county
boards in developing and maintaining locally available mental
health services. The commissioner shall monitor the county
board's progress in developing its full system capacity and
quality through ongoing review of the county board's adult
mental health proposals, quarterly reports, and other
information as required by sections 245.461 to 245.486.
Subd. 2. [PRIORITIES.] By January 1, 1990, the
commissioner shall require that each of the treatment services
and management activities described in sections 245.469 to
245.477 are developed for persons adults with mental illness
within available resources based on the following ranked
priorities:
(1) the provision of locally available emergency services;
(2) the provision of locally available services to all
persons adults with serious and persistent mental illness and
all persons adults with acute mental illness;
(3) the provision of specialized services regionally
available to meet the special needs of all persons adults with
serious and persistent mental illness and all persons adults
with acute mental illness;
(4) the provision of locally available services to persons
adults with other mental illness; and
(5) the provision of education and preventive mental health
services targeted at high-risk populations.
Sec. 6. Minnesota Statutes 1988, 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 adult mental health services in accordance
with sections 245.461 to 245.486;
(2) provide for case management services to persons adults
with serious and persistent mental illness in accordance with
sections 245.462, subdivisions 3 and 4; 245.471; 245.475
245.4711; and 245.486;
(3) provide for screening of persons adults 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;
and
(5) assure that mental health professionals, mental health
practitioners, and case managers employed by or under contract
with the county to provide mental health services have
experience and training in working with adults with mental
illness.
Sec. 7. Minnesota Statutes 1988, 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 adult 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. 8. Minnesota Statutes 1988, section 245.466,
subdivision 2, is amended to read:
Subd. 2. [ADULT MENTAL HEALTH SERVICES.] The adult mental
health service system developed by each county board must
include the following 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 section 245.4711;
(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;
(8) screening in accordance with section 245.476; and
(9) case management in accordance with sections 245.462,
subdivision 3; 245.471; and 245.475 245.4711.
Sec. 9. Minnesota Statutes 1988, 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 adult 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 an adult with mental illness, one mental
health professional, and one community support services program
representative. The local adult 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 adult mental health advisory council or
mental health subcommittee of an existing advisory council shall:
(1) arrange for input from the regional treatment center's
mental illness program unit regarding coordination of care
between the regional treatment center and community-based
services;
(2) identify for the county board the individuals,
providers, agencies, and associations as specified in section
245.462, subdivision 10; and
(3) coordinate its review, evaluation, and recommendations
regarding the local mental health system with the state advisory
council on mental health.
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. 10. Minnesota Statutes 1988, section 245.466,
subdivision 6, is amended to read:
Subd. 6. [OTHER LOCAL AUTHORITY.] The county board may
establish procedures and policies that are not contrary to those
of the commissioner or sections 245.461 to 245.486 regarding
local adult mental health services and facilities. The county
board shall perform other acts necessary to carry out sections
245.461 to 245.486.
Sec. 11. Minnesota Statutes 1988, section 245.467,
subdivision 3, is amended to read:
Subd. 3. [INDIVIDUAL TREATMENT PLANS.] All providers of
outpatient services, day treatment services, residential
treatment, acute care hospital inpatient treatment, and all
regional treatment centers must develop an individual treatment
plan for each of their adult clients. The individual treatment
plan must be based on a diagnostic assessment. To the extent
possible, the adult client shall be involved in all phases of
developing and implementing the individual treatment plan. The
individual treatment plan must be developed within ten days of
client intake and reviewed every 90 days thereafter.
Sec. 12. Minnesota Statutes 1988, section 245.467,
subdivision 4, is amended to read:
Subd. 4. [REFERRAL FOR CASE MANAGEMENT.] Each provider of
emergency services, day treatment 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. 13. Minnesota Statutes 1988, section 245.467,
subdivision 5, is amended to read:
Subd. 5. [INFORMATION FOR BILLING.] Each provider of
outpatient treatment, community support services, day treatment
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. 14. Minnesota Statutes 1988, section 245.468, is
amended to read:
245.468 [EDUCATION AND PREVENTION SERVICES.]
By July 1, 1988, county boards must provide or contract for
education and prevention services to persons adults residing in
the county. Education and prevention services must be designed
to:
(1) convey information regarding mental illness and
treatment resources to the general public or and special
high-risk target groups;
(2) increase understanding and acceptance of problems
associated with mental illness;
(3) improve people's skills in dealing with high-risk
situations known to have an impact on people's adults' mental
health functioning; and
(4) prevent development or deepening of mental illness; and
(5) refer adults with additional mental health needs to
appropriate mental health services.
Sec. 15. Minnesota Statutes 1988, section 245.469, is
amended to read:
245.469 [EMERGENCY SERVICES.]
Subdivision 1. [AVAILABILITY OF EMERGENCY SERVICES.] By
July 1, 1988, county boards must provide or contract for enough
emergency services within the county to meet the needs of
persons adults in the county who are experiencing an emotional
crisis or mental illness. Clients may be required to pay a
fee based on their ability to pay according to section 245.481.
Emergency services must include assessment, intervention, and
appropriate case disposition. Emergency services must:
(1) promote the safety and emotional stability of people
adults with mental illness or emotional crises;
(2) minimize further deterioration of people adults with
mental illness or emotional crises;
(3) help people adults with mental illness or emotional
crises to obtain ongoing care and treatment; and
(4) prevent placement in settings that are more intensive,
costly, or restrictive than necessary and appropriate to meet
client needs.
Subd. 2. [SPECIFIC REQUIREMENTS.] The county board shall
require that all service providers of emergency services to
adults with mental illness provide immediate direct access to a
mental health 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 until January 1, 1991, a
designated person with training in human services who receives
clinical supervision 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. 16. Minnesota Statutes 1988, section 245.470,
subdivision 1, is amended to read:
Subdivision 1. [AVAILABILITY OF OUTPATIENT SERVICES.] (a)
By July 1, 1988, county boards must provide or contract for
enough outpatient services within the county to meet the needs
of persons adults with mental illness residing in the county.
Clients may be required to pay a fee based on their ability to
pay according to section 245.481. Outpatient services include:
(1) conducting diagnostic assessments;
(2) conducting psychological testing;
(3) developing or modifying individual treatment plans;
(4) making referrals and recommending placements as
appropriate;
(5) treating a person's an adult's mental health needs
through therapy;
(6) prescribing and managing medication and evaluating the
effectiveness of prescribed medication; and
(7) preventing placement in settings that are more
intensive, costly, or restrictive than necessary and appropriate
to meet client needs.
(b) County boards may request a waiver allowing outpatient
services to be provided in a nearby trade area if it is
determined that the client can best be served outside the county.
Sec. 17. [245.4711] [CASE MANAGEMENT AND COMMUNITY SUPPORT
SERVICES.]
Subdivision 1. [AVAILABILITY OF CASE MANAGEMENT
SERVICES.] (a) By January 1, 1989, the county board shall
provide case management activities for all adults with serious
and persistent mental illness residing in the county who request
or consent to the services and to each adult for whom the court
appoints a case manager. Staffing ratios must be sufficient to
serve the needs of the clients. The case manager must meet the
requirements in section 245.462, subdivision 4.
(b) Case management services provided to adults with
serious and persistent mental illness eligible for medical
assistance must be billed to the medical assistance program
under sections 256B.02, subdivision 8, and 256B.0625.
Subd. 2. [NOTIFICATION OF CASE MANAGEMENT
ELIGIBILITY.] The county board shall notify the client of the
person's potential eligibility for case management services
within five working days after receiving 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 client and the client's representative, if any, that
identifies the designated case management providers.
Subd. 3. [DUTIES OF CASE MANAGER.] (a) The case manager
shall promptly arrange for a diagnostic assessment of the
applicant when one is not available as described in section
245.467, subdivision 2, to determine the applicant's eligibility
as an adult with serious and persistent mental illness for
community support services. The county board shall notify in
writing the applicant and the applicant's representative, if
any, if the applicant is determined ineligible for community
support services.
(b) Upon a determination of eligibility for community
support services, the case manager shall develop an individual
community support plan for an adult according to subdivision 4,
paragraph (a), review the client's progress, and monitor the
provision of services. If services are to be provided in a host
county that is not the county of financial responsibility, the
case manager shall consult with the host county and obtain a
letter demonstrating the concurrence of the host county
regarding the provision of services.
Subd. 4. [INDIVIDUAL COMMUNITY SUPPORT PLAN.] (a) The case
manager must develop an individual community support plan for
each adult 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 a functional assessment and for implementing and
monitoring the delivery of services according to the individual
community support plan. To the extent possible, the adult 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 or family community support plan.
(b) 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 individual community support plan.
Subd. 5. [COORDINATION BETWEEN CASE MANAGER AND COMMUNITY
SUPPORT SERVICES.] The county board must establish procedures
that ensure ongoing contact and coordination between the case
manager and the community support services program as well as
other mental health services.
Subd. 6. [AVAILABILITY OF COMMUNITY SUPPORT SERVICES.]
County boards must provide or contract for sufficient community
support services within the county to meet the needs of adults
with serious and persistent mental illness residing in the
county. Clients may be required to pay a fee according to
section 245.481. The community support services program must be
designed to improve the ability of adults with serious and
persistent mental illness to:
(1) work in a regular or supported work environment;
(2) handle basic activities of daily living;
(3) participate in leisure time activities;
(4) set goals and plans;
(5) obtain and maintain appropriate living arrangements;
and
(6) reduce the use of more intensive, costly, or
restrictive placements both in number of admissions and lengths
of stay as determined by client need.
Subd. 7. [DAY TREATMENT SERVICES PROVIDED.] (a) By July 1,
1989, day treatment services must be developed as a part of the
community support services available to adults with serious and
persistent mental illness residing in the county. Clients may
be required to pay a fee according to section 245.481. Day
treatment services must be designed to:
(1) provide a structured environment for treatment;
(2) provide community support;
(3) prevent placement in settings that are more intensive,
costly, or restrictive than necessary and appropriate to meet
client need;
(4) coordinate with or be offered in conjunction with a
local education agency's special education program; and
(5) operate on a continuous basis throughout the year.
(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 services for clients who would otherwise need
day treatment services;
(2) day treatment, if included, would be duplicative of
other components of the community support services; and
(3) county demographics and geography make the provision of
day treatment services cost ineffective and infeasible.
Subd. 8. [BENEFITS ASSISTANCE.] The county board must
offer help to adults with serious and persistent mental illness
in applying for federal benefits, including supplemental
security income, medical assistance, and Medicare. The help
must be offered as a part of the community support program
available to adults with serious and persistent mental illness
for whom the county is financially responsible and who may
qualify for these benefits.
Sec. 18. Minnesota Statutes 1988, section 245.472,
subdivision 1, is amended to read:
Subdivision 1. [AVAILABILITY OF RESIDENTIAL TREATMENT
SERVICES.] By July 1, 1988, county boards must provide or
contract for enough residential treatment services to meet the
needs of all persons adults with mental illness residing in the
county and needing this level of care. Residential treatment
services include both intensive and structured residential
treatment with length of stay based on client residential
treatment need. Services must be as close to the county as
possible. Residential treatment must be designed to:
(1) prevent placement in settings that are more intensive,
costly, or restrictive than necessary and appropriate to meet
client needs;
(2) help clients achieve the highest level of independent
living;
(3) help clients gain the necessary skills to be referred
to a community support services program or outpatient
services function in a less structured setting; and
(4) stabilize crisis admissions.
Sec. 19. Minnesota Statutes 1988, section 245.472, is
amended by adding a subdivision to read:
Subd. 3. [TRANSITION TO COMMUNITY.] Residential treatment
programs must plan for and assist clients in making a transition
from residential treatment facilities to other community-based
services. In coordination with the client's case manager, if
any, residential treatment facilities must also arrange for
appropriate follow-up care in the community during the
transition period. Before a client is discharged, the
residential treatment facility must notify the client's case
manager, so that the case manager can monitor and coordinate the
transition and arrangements for the client's appropriate
follow-up care in the community.
Sec. 20. Minnesota Statutes 1988, section 245.473,
subdivision 1, is amended to read:
Subdivision 1. [AVAILABILITY OF ACUTE CARE INPATIENT
SERVICES.] By July 1, 1988, county boards must make available
through contract or direct provision enough acute care hospital
inpatient treatment services as close to the county as possible
to meet the needs of persons for adults with mental illness
residing in the county. Acute care hospital inpatient treatment
services must be designed to:
(1) stabilize the medical and mental health condition of
people with acute or serious and persistent mental illness for
which admission is required;
(2) improve functioning to the point where discharge to
residential treatment or community-based mental health services
is possible; and
(3) facilitate appropriate referrals, for follow-up, and
placements mental health care in the community.
Sec. 21. Minnesota Statutes 1988, section 245.474, is
amended to read:
245.474 [REGIONAL TREATMENT CENTER INPATIENT SERVICES.]
Subdivision 1. [AVAILABILITY OF REGIONAL TREATMENT CENTER
INPATIENT SERVICES.] By July 1, 1987, the commissioner shall
make sufficient regional treatment center inpatient services
available to people adults with mental illness throughout the
state who need this level of care. Regional treatment centers
are responsible to:
(1) stabilize the medical and mental health condition of
the person with mental illness adult requiring the admission;
(2) improve functioning to the point where discharge to
community-based mental health services is possible;
(3) strengthen family and community support; and
(4) facilitate appropriate discharge, aftercare, and
referrals for follow-up placements mental health care in the
community.
Subd. 2. [QUALITY OF SERVICE.] The commissioner shall
biennially determine the needs of all mentally ill patients
adults with mental illness who are served by regional treatment
centers by administering a client-based evaluation system. The
client-based evaluation system must include at least the
following independent measurements: behavioral development
assessment; habilitation program assessment; medical needs
assessment; maladaptive behavioral assessment; and vocational
behavior assessment. The commissioner shall propose staff
ratios to the legislature for the mental health and support
units in regional treatment centers as indicated by the results
of the client-based evaluation system. The proposed staffing
ratios shall include professional, nursing, direct care,
medical, clerical, and support staff based on the client-based
evaluation system. The commissioner shall recompute staffing
ratios and recommendations on a biennial basis.
Subd. 3. [TRANSITION TO COMMUNITY.] Regional treatment
centers must plan for and assist clients in making a transition
from regional treatment centers to other community-based
services. In coordination with the client's case manager, if
any, regional treatment centers must also arrange for
appropriate follow-up care in the community during the
transition period. Before a client is discharged, the regional
treatment center must notify the client's case manager, so that
the case manager can monitor and coordinate the transition and
arrangements for the client's appropriate follow-up care in the
community.
Sec. 22. Minnesota Statutes 1988, section 245.476,
subdivision 1, is amended to read:
Subdivision 1. [SCREENING REQUIRED.] No later than January
1, 1991 1992, the county board shall screen all persons adults
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 an adult 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 Adults 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) the case manager, if assigned, is developing an
individual community support plan.
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. 23. Minnesota Statutes 1988, section 245.476,
subdivision 3, is amended to read:
Subd. 3. [INDIVIDUAL PLACEMENT AGREEMENT.] The county
board shall enter into an individual placement agreement with a
provider of residential treatment services to a person an adult
eligible for services under this section. The agreement must
specify the payment rate and terms and conditions of county
payment for the placement.
Sec. 24. Minnesota Statutes 1988, section 245.476, is
amended by adding a subdivision to read:
Subd. 4. [TASK FORCE ON RESIDENTIAL AND INPATIENT
TREATMENT SERVICES FOR ADULTS.] The commissioner of human
services shall appoint a task force on residential and inpatient
treatment services for adults. The task force must include
representatives from each of the mental health professional
categories defined in section 245.462, subdivision 18, the
Minnesota mental health association, the Minnesota alliance for
the mentally ill, the Minnesota mental health law project, the
Minnesota association of mental health residential facilities,
the Minnesota hospital association, department of human services
staff, the department of education, the department of
corrections, the ombudsman for mental health and mental
retardation, and counties. The task force shall examine and
evaluate existing mechanisms that have as their purpose review
of appropriate admission and need for continued care for clients
admitted to residential treatment, acute care hospital inpatient
treatment, and regional treatment center inpatient treatment.
These mechanisms shall include at least the following:
precommitment screening, licensure and reimbursement rules,
county monitoring, technical assistance, nursing home
preadmission screening, hospital preadmission certification, and
hospital retrospective reviews. The task force shall report to
the legislature by February 15, 1990, on how existing mechanisms
may be changed to accomplish the goals of screening as described
in subdivision 1.
Sec. 25. Minnesota Statutes 1988, section 245.477, is
amended to read:
245.477 [APPEALS.]
Any person adult who 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 the request and
each time the individual community service support plan or
individual treatment plan is reviewed. Any person adult whose
request for mental health services under sections 245.461 to
245.486 is denied, not acted upon with reasonable promptness, or
whose services are suspended, reduced, or terminated by action
or inaction for which the county board is responsible under
sections 245.461 to 245.486 may contest that action or inaction
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. 26. Minnesota Statutes 1988, section 245.478,
subdivision 2, is amended to read:
Subd. 2. [PROPOSAL CONTENT.] The local adult mental health
proposal must include:
(1) the local adult mental health advisory council's or
adult mental health subcommittee of an existing advisory
council's report on unmet needs of adults and any other needs
assessment used by the county board in preparing the local adult
mental health proposal;
(2) a description of the local adult mental health advisory
council's or the adult mental health subcommittee of an existing
advisory council's involvement in preparing the local adult
mental health proposal and methods used by the county board
to obtain ensure adequate and timely 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 for each mental health service and service waiting
lists; and
(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 mental health services 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 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 adult
mental health service listed in sections 245.468 245.461
to 245.476 245.486;
(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 adult
mental health services described in sections 245.468 245.461
to 245.476 245.486 or to provide over $10,000 of adult 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 adult mental health services
in the county will be unified and coordinated;
(iv) the estimated number of clients who will receive each
adult mental health service; and
(v) estimated expenditures for each adult mental health
service and revenues for the entire proposal.
Sec. 27. Minnesota Statutes 1988, section 245.478,
subdivision 3, is amended to read:
Subd. 3. [PROPOSAL FORMAT.] The local adult mental health
proposal must be made in a format prescribed by the commissioner.
Sec. 28. Minnesota Statutes 1988, section 245.479, is
amended to read:
245.479 [COUNTY OF FINANCIAL RESPONSIBILITY.]
For purposes of sections 245.461 to 245.486 and 245.487 to
245.4887, the county of financial responsibility is determined
under section 256G.02, subdivision 4. Disputes between counties
regarding financial responsibility must be resolved by the
commissioner in accordance with section 256G.09.
Sec. 29. Minnesota Statutes 1988, section 245.48, is
amended to read:
245.48 [MAINTENANCE OF EFFORT.]
Counties must continue to spend for mental health services
specified in sections 245.461 to 245.486 and 245.487 to
245.4887, 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 comparable
figure for Rule 5 facilities under target populations other than
mental illness in the approved 1987 CSSA plan.
Sec. 30. [245.481] [FEES FOR MENTAL HEALTH SERVICES.]
A client or, in the case of a child, the child or the
child's parent may be required to pay a fee for mental health
services provided under sections 245.461 to 245.486 and 245.487
to 245.4887. The fee must be based on the person's ability to
pay according to the fee schedule adopted by the county board.
In adopting the fee schedule for mental health services, the
county board may adopt the fee schedule provided by the
commissioner or adopt a fee schedule recommended by the county
board and approved by the commissioner. Agencies or individuals
under contract with a county board to provide mental health
services under sections 245.461 to 245.486 and 245.487 to
245.4887 must not charge clients whose mental health services
are paid wholly or in part from public funds fees which exceed
the county board's adopted fee schedule. This section does not
apply to regional treatment center fees, which are governed by
sections 246.50 to 246.55.
Sec. 31. Minnesota Statutes 1988, section 245.482, is
amended to read:
245.482 [REPORTING AND EVALUATION.]
Subdivision 1. [FISCAL REPORTS.] The commissioner shall
develop a unified format for quarterly fiscal reports that will
include information that the commissioner determines necessary
to carry out sections 245.461 to 245.486, 245.487 to 245.4887,
and section 256E.08. The county board shall submit a completed
fiscal report in the required format no later than 15 30 days
after the end of each quarter.
Subd. 2. [PROGRAM REPORTS.] The commissioner shall develop
a unified format formats for an annual program report
that reporting, which will include information that the
commissioner determines necessary to carry out sections 245.461
to 245.486, 245.487 to 245.4887, and section 256E.10. The
county board shall submit a completed program report reports in
the required format by March 15 of each year according to the
reporting schedule developed by the commissioner.
Subd. 3. [PROVIDER REPORTS.] The commissioner may
develop a format formats and procedures for direct reporting
from providers to the commissioner to include information that
the commissioner determines necessary to carry out sections
245.461 to 245.486 and 245.487 to 245.4887. In particular, the
provider reports must include aggregate information by county of
residence about mental health services paid for by funding
sources other than counties.
Subd. 4. [COMMISSIONER'S CONSOLIDATED REPORTING
RECOMMENDATIONS.] The commissioner's reports of February 15,
1990, required under sections 245.461, subdivision 3, and
245.487, subdivision 4, shall include recommended measures to
provide coordinated, interdepartmental efforts to ensure early
identification and intervention for children with, or at risk of
developing, emotional disturbance, to improve the efficiency of
the mental health funding mechanisms, and to standardize and
consolidate fiscal and program reporting. The recommended
measures must provide that client needs are met in an effective
and accountable manner and that state and county resources are
used as efficiently as possible. The commissioner shall
consider the advice of the state advisory council and the
children's subcommittee in developing these recommendations.
Subd. 4 5. [INACCURATE OR INCOMPLETE REPORTS.] The
commissioner shall promptly notify a county or provider if a
required report is clearly inaccurate or incomplete. The
commissioner may delay all or part of a mental health fund
payment if an appropriately completed report is not received as
required by this section.
Subd. 5 6. [STATEWIDE EVALUATION.] The commissioner shall
use the county and provider reports required by this section to
complete the statewide report required in section sections
245.461 and 245.487.
Sec. 32. Minnesota Statutes 1988, section 245.483, is
amended to read:
245.483 [TERMINATION OR RETURN OF AN ALLOCATION.]
Subdivision 1. [FUNDS NOT PROPERLY USED.] If the
commissioner determines that a county is not meeting the
requirements of sections 245.461 to 245.486 and 245.487 to
245.4887, or that funds are not being used according to the
approved local proposal, all or part of the mental health and
community social service act funds may be terminated upon 30
days notice to the county board. The commissioner may require
repayment of any funds not used according to the approved local
proposal. If the commissioner receives a written appeal from
the county board within the 30-day period, opportunity for a
hearing under the Minnesota administrative procedure act,
chapter 14, must be provided before the allocation is terminated
or is required to be repaid. The 30-day period begins when the
county board receives the commissioner's notice by certified
mail.
Subd. 2. [USE OF RETURNED FUNDS.] The commissioner may
reallocate the funds returned.
Subd. 3. [DELAYED PAYMENTS.] If the commissioner finds
that a county board or its contractors are not in compliance
with the approved local proposal or sections 245.461 to
245.486 and 245.487 to 245.4887, the commissioner may delay
payment of all or part of the quarterly mental health and
community social service act funds until the county board and
its contractors meet the requirements. The commissioner shall
not delay a payment longer than three months without first
issuing a notice under subdivision 2 that all or part of the
allocation will be terminated or required to be repaid. After
this notice is issued, the commissioner may continue to delay
the payment until completion of the hearing in subdivision 2.
Subd. 4. [STATE ASSUMPTION OF RESPONSIBILITY.] If the
commissioner determines that services required by sections
245.461 to 245.486 and 245.487 to 245.4887 will not be provided
by the county board in the manner or to the extent required by
sections 245.461 to 245.486 and 245.487 to 245.4887, the
commissioner shall contract directly with providers to ensure
that clients receive appropriate services. In this case, the
commissioner shall use the county's community social service act
and mental health funds to the extent necessary to carry out the
county's responsibilities under sections 245.461 to 245.486 and
245.487 to 245.4887. The commissioner shall work with the
county board to allow for a return of authority and
responsibility to the county board as soon as compliance with
sections 245.461 to 245.486 and 245.487 to 245.4887 can be
assured.
Sec. 33. Minnesota Statutes 1988, section 245.484, is
amended to read:
245.484 [RULES.]
The commissioner shall adopt permanent rules as necessary
to carry out Laws 1987, chapter 403 sections 245.461 to 245.486
and sections 1 to 53.
Sec. 34. Minnesota Statutes 1988, section 245.485, is
amended to read:
245.485 [NO RIGHT OF ACTION.]
Sections 245.461 to 245.484 and 245.487 to 245.4887 do not
independently establish a right of action on behalf of
recipients of services or service providers against a county
board or the commissioner. A claim for monetary damages must be
brought under section 3.736 or 3.751.
Sec. 35. Minnesota Statutes 1988, section 245.486, is
amended to read:
245.486 [LIMITED APPROPRIATIONS.]
Nothing in sections 245.461 to 245.485 and 245.487 to
245.4887 shall be construed to require the commissioner or
county boards to fund services beyond the limits of legislative
appropriations.
Sec. 36. [245.4861] [PUBLIC/ACADEMIC LIAISON INITIATIVE.]
Subdivision 1. [ESTABLISHMENT OF LIAISON INITIATIVE.] The
commissioner of human services, in consultation with the
appropriate post-secondary institutions, shall establish a
public/academic liaison initiative to coordinate and develop
brain research and education and training opportunities for
mental health professionals in order to improve the quality of
staffing and provide state-of-the-art services to residents in
regional treatment centers and other state facilities.
Subd. 2. [CONSULTATION.] The commissioner of human
services shall consult with the Minnesota department of health,
the regional treatment centers, the post-secondary educational
system, mental health professionals, and citizen and advisory
groups.
Subd. 3. [LIAISON INITIATIVE PROGRAMS.] The liaison
initiative, within the extent of available funding, shall plan,
implement, and administer programs which accomplish the
objectives of subdivision 1. These shall include but are not
limited to:
(1) encourage and coordinate joint research efforts between
academic research institutions throughout the state and regional
treatment centers, community mental health centers, and other
organizations conducting research on mental illness or working
with individuals who are mentally ill;
(2) sponsor and conduct basic research on mental illness
and applied research on existing treatment models and community
support programs;
(3) seek to obtain grants for research on mental illness
from the National Institute of Mental Health and other funding
sources;
(4) develop and provide grants for training, internship,
scholarship, and fellowship programs for mental health
professionals, in an effort to combine academic education with
practical experience obtained at regional treatment centers and
other state facilities, and to increase the number of mental
health professionals working in the state.
Subd. 4. [PRIVATE AND FEDERAL FUNDING.] The liaison
initiative shall seek private and federal funds to supplement
the appropriation provided by the state. Individuals,
businesses, and other organizations may contribute to the
liaison initiative. All money received shall be administered by
the commissioner of human services to implement and administer
the programs listed in subdivision 3.
Subd. 5. [REPORT.] By February 15 of each year, the
commissioner of human services shall submit to the legislature a
liaison initiative report. The annual report shall be part of
the commissioner's February 15 report to the legislature
required by section 245.487, subdivision 4.
Sec. 37. [245.487] [CITATION; DECLARATION OF POLICY;
MISSION.]
Subdivision 1. [CITATION.] Sections 245.487 to 245.4887
may be cited as the "Minnesota comprehensive children's mental
health act."
Subd. 2. [FINDINGS.] The legislature finds there is a need
for further development of existing clinical services for
emotionally disturbed children and their families and the
creation of new services for this population. Although the
services specified in sections 245.487 to 245.4887 are mental
health services, sections 245.487 to 245.4887 emphasize the need
for a child-oriented and family-oriented approach of therapeutic
programming and the need for continuity of care with other
community agencies. At the same time, sections 245.487 to
245.4887 emphasize the importance of developing special mental
health expertise in children's mental health services because of
the unique needs of this population.
Nothing in this act shall be construed to abridge the authority
of the court to make dispositions under chapter 260.
Subd. 3. [MISSION OF CHILDREN'S MENTAL HEALTH SERVICE
SYSTEM.] As part of the comprehensive children's mental health
system established under sections 245.487 to 245.4887, the
commissioner of human services shall create and ensure a
unified, accountable, comprehensive children's mental health
service system that is consistent with the provision of public
social services for children as specified in section 256F.01 and
that:
(1) identifies children who are eligible for mental health
services;
(2) makes preventive services available to all children;
(3) assures access to a continuum of services that:
(i) educate the community about the mental health needs of
children;
(ii) address the unique physical, emotional, social, and
educational needs of children;
(iii) are coordinated with the range of social and human
services provided to children and their families by the
departments of education, human services, health, and
corrections;
(iv) are appropriate to the developmental needs of
children; and
(v) are sensitive to cultural differences and special
needs;
(4) includes early screening and prompt intervention to:
(i) identify and treat the mental health needs of children
in the least restrictive setting appropriate to their needs; and
(ii) prevent further deterioration;
(5) provides mental health services to children and their
families in the context in which the children live and go to
school;
(6) addresses the unique problems of paying for mental
health services for children, including:
(i) access to private insurance coverage; and
(ii) public funding;
(7) includes the child and the child's family in planning
the child's program of mental health services, unless clinically
inappropriate to the child's needs; and
(8) when necessary, assures a smooth transition from mental
health services appropriate for a child to mental health
services needed by a person who is at least 18 years of age.
Subd. 4. [IMPLEMENTATION.] (a) The commissioner shall
begin implementing sections 245.487 to 245.4887 by February 15,
1990, and shall fully implement sections 245.487 to 245.4887 by
January 1, 1992.
(b) Annually until February 15, 1992, the commissioner
shall report to the legislature on all steps taken and
recommendations for full implementation of sections 245.487 to
245.4887 and on additional resources needed to further implement
those sections.
Subd. 5. [CONTINUATION OF EXISTING MENTAL HEALTH SERVICES
FOR CHILDREN.] Counties shall make available case management,
community support services, and day treatment to children
eligible to receive these services under Minnesota Statutes
1988, section 245.471. No later than August 1, 1989, the county
board shall notify providers in the local system of care of
their obligations to refer children eligible for case management
and community support services as of January 1, 1989. The
notice shall indicate which children are eligible, a description
of the services, and the name of the county employee designated
to coordinate case management activities.
Sec. 38. [245.4871] [DEFINITIONS.]
Subdivision 1. [DEFINITIONS.] The definitions in this
section apply to sections 245.487 to 245.4887.
Subd. 2. [ACUTE CARE HOSPITAL INPATIENT TREATMENT.] "Acute
care hospital inpatient treatment" means short-term medical,
nursing, and psychosocial services provided in an acute care
hospital licensed under chapter 144.
Subd. 3. [CASE MANAGEMENT SERVICES.] "Case management
services" means activities designed to help the child with
severe emotional disturbance and the child's family obtain
needed mental health services, social services, educational
services, health services, vocational services, recreational
services, and related services in the areas of volunteer
services, advocacy, transportation, and legal services. Case
management services include obtaining a comprehensive diagnostic
assessment, developing a functional assessment, developing an
individual family community support plan, and assisting the
child and the child's family in obtaining needed services by
coordination with other agencies and assuring continuity of
care. Case managers must assess and reassess the delivery,
appropriateness, and effectiveness of these services over time.
Subd. 4. [CASE MANAGER.] (a) "Case manager" means an
individual employed by the county or other entity authorized by
the county board to provide case management services specified
in subdivision 3 for the child with severe emotional disturbance
and the child's family. A case manager must have experience and
training in working with children.
(b) A case manager must:
(1) have at least a bachelor's degree in one of the
behavioral sciences or a related field from an accredited
college or university;
(2) have at least 2,000 hours of supervised experience in
the delivery of mental health services to children;
(3) have experience and training in identifying and
assessing a wide range of children's needs; and
(4) be knowledgeable about local community resources and
how to use those resources for the benefit of children and their
families.
(c) The case manager may be a member of any professional
discipline that is part of the local system of care for children
established by the county board.
(d) The case manager must meet in person with a mental
health professional at least once each month to obtain clinical
supervision.
(e) Case managers with a bachelor's degree but without
2,000 hours of supervised experience in the delivery of mental
health services to children with emotional disturbance must:
(1) begin 40 hours of training approved by the commissioner
of human services in case management skills and in the
characteristics and needs of children with severe emotional
disturbance before beginning to provide case management
services; and
(2) 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 experience is
met.
(f) Clinical supervision must be documented in the child's
record. When the case manager is not a mental health
professional, the county board must provide or contract for
needed clinical supervision.
(g) The county board must ensure that the case manager has
the freedom to access and coordinate the services within the
local system of care that are needed by the child.
(h) Until June 30, 1991, a refugee who does not have the
qualifications specified in this subdivision may provide case
management services to child refugees with severe emotional
disturbance of the same ethnic group as the refugee if the
person:
(1) is actively pursuing credits toward the completion of a
bachelor's degree in one of the behavioral sciences or related
fields at an accredited college or university;
(2) completes 40 hours of training as specified in this
subdivision; and
(3) receives clinical supervision at least once a week
until the requirements of obtaining a bachelor's degree and
2,000 hours of supervised experience are met.
Subd. 5. [CHILD.] "Child" means a person under 18 years of
age.
Subd. 6. [CHILD WITH SEVERE EMOTIONAL DISTURBANCE.] For
purposes of eligibility for case management and family community
support services, "child with severe emotional disturbance"
means a child who has an emotional disturbance and who meets one
of the following criteria:
(1) the child has been admitted within the last three years
or is at risk of being admitted to inpatient treatment or
residential treatment for an emotional disturbance; or
(2) the child is a Minnesota resident and is receiving
inpatient treatment or residential treatment for an emotional
disturbance through the interstate compact; or
(3) the child has one of the following as determined by a
mental health professional:
(i) psychosis or a clinical depression; or
(ii) risk of harming self or others as a result of an
emotional disturbance; or
(iii) psychopathological symptoms as a result of being a
victim of physical or sexual abuse or of psychic trauma within
the past year; or
(4) the child, as a result of an emotional disturbance, has
significantly impaired home, school, or community functioning
that has lasted at least one year or that, in the written
opinion of a mental health professional, presents substantial
risk of lasting at least one year.
The term "child with severe emotional disturbance" shall be
used only for purposes of county eligibility determinations. In
all other written and oral communications, case managers, mental
health professionals, mental health practitioners, and all other
providers of mental health services shall use the term "child
eligible for mental health case management" in place of "child
with severe emotional disturbance."
Subd. 7. [CLINICAL SUPERVISION.] "Clinical supervision"
means the oversight responsibility for individual treatment
plans and individual mental health service delivery, including
that provided by the case manager. Clinical supervision does
not include authority to make or terminate court-ordered
placements of the child. Clinical supervision must be
accomplished by full-time or part-time employment of or
contracts with mental health professionals. The mental health
professional must document the clinical supervision by cosigning
individual treatment plans and by making entries in the client's
record on supervisory activities.
Subd. 8. [COMMISSIONER.] "Commissioner" means the
commissioner of human services.
Subd. 9. [COUNTY BOARD.] "County board" means the county
board of commissioners or board established under the joint
powers act, section 471.59, or the human services board act,
sections 402.01 to 402.10.
Subd. 10. [DAY TREATMENT SERVICES.] "Day treatment," "day
treatment services," or "day treatment program" means a
structured program of treatment and care provided to a child in:
(1) an outpatient hospital accredited by the joint
commission on accreditation of health organizations and licensed
under sections 144.50 to 144.55;
(2) a community mental health center under section 245.62;
(3) an entity that is under contract with the county board
to operate a program that meets the requirements of section
245.4881, subdivision 7, and Minnesota Rules, parts 9505.0170 to
9505.0475; or
(4) an entity that operates a program that meets the
requirements of section 245.4881, subdivision 7, and Minnesota
Rules, parts 9505.0170 to 9505.0475, that is under contract with
an entity that is under contract with a county board.
Day treatment consists of group psychotherapy and other
intensive therapeutic services that are provided for a minimum
three-hour time block by a multidisciplinary staff under the
clinical supervision of a mental health professional. The
services are aimed at stabilizing the child's mental health
status, and developing and improving the child's daily
independent living and socialization skills. Day treatment
services are distinguished from day care by their structured
therapeutic program of psychotherapy services. Day treatment
services are not a part of inpatient hospital or residential
treatment services. Day treatment services for a child are an
integrated set of education, therapy, and family interventions.
A day treatment service must be available to a child at
least five days a week throughout the year and must be
coordinated with, integrated with, or part of an education
program offered by the child's school.
Subd. 11. [DIAGNOSTIC ASSESSMENT.] "Diagnostic assessment"
means a written evaluation by a mental health professional of:
(1) a child's current life situation and sources of stress,
including reasons for referral;
(2) the history of the child's current mental health
problem or problems, including important developmental
incidents, strengths, and vulnerabilities;
(3) the child's current functioning and symptoms;
(4) the child's diagnosis including a determination of
whether the child meets the criteria of severely emotionally
disturbed as specified in subdivision 6; and
(5) the mental health services needed by the child.
Subd. 12. [EARLY IDENTIFICATION AND INTERVENTION
SERVICES.] "Early identification and intervention services"
means services that are designed to identify children who are at
risk of needing or who need mental health services and that
arrange for intervention and treatment.
Subd. 13. [EDUCATION AND PREVENTION SERVICES.] (a)
"Education and prevention services" means services designed to:
(1) educate the general public and groups identified as at
risk of developing emotional disturbance under section 245.4872,
subdivision 3;
(2) increase the understanding and acceptance of problems
associated with emotional disturbances;
(3) improve people's skills in dealing with high-risk
situations known to affect children's mental health and
functioning; and
(4) refer specific children or their families with mental
health needs to mental health services.
(b) The services include distribution to individuals and
agencies identified by the county board and the local children's
mental health advisory council of information on predictors and
symptoms of emotional disturbances, where mental health services
are available in the county, and how to access the services.
Subd. 14. [EMERGENCY SERVICES.] "Emergency services" means
an immediate response service available on a 24-hour,
seven-day-a-week basis for each child having a psychiatric
crisis, a mental health crisis, or a mental health emergency.
Subd. 15. [EMOTIONAL DISTURBANCE.] "Emotional disturbance"
means an organic disorder of the brain or a clinically
significant disorder of thought, mood, perception, orientation,
memory, or behavior that:
(1) 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
(2) seriously limits a child's capacity to function in
primary aspects of daily living such as personal relations,
living arrangements, work, school, and recreation.
"Emotional disturbance" is a generic term and is intended
to reflect all categories of disorder described in DSM-MD,
current edition as "usually first evident in childhood or
adolescence."
Subd. 16. [FAMILY.] "Family" means a child and one or more
of the following persons whose participation is necessary to
accomplish the child's treatment goals: (1) a person related to
the child by blood, marriage, or adoption; (2) a person who is
the child's foster parent or significant other; (3) a person who
is the child's legal representative.
Subd. 17. [FAMILY COMMUNITY SUPPORT SERVICES.] "Family
community support services" means services provided under the
clinical supervision of a mental health professional and
designed to help each child with severe emotional disturbance to
function and remain with the child's family in the community.
Family community support services do not include acute care
hospital inpatient treatment, residential treatment services, or
regional treatment center services. Family community support
services include:
(1) client outreach to each child with severe emotional
disturbance and the child's family;
(2) medication monitoring where necessary;
(3) assistance in developing independent living skills;
(4) assistance in developing parenting skills necessary to
address the needs of the child with severe emotional
disturbance;
(5) assistance with leisure and recreational activities;
(6) crisis assistance, including crisis placement and
respite care;
(7) professional home-based family treatment;
(8) foster care with therapeutic supports;
(9) day treatment;
(10) assistance in locating respite care and special needs
day care; and
(11) assistance in obtaining potential financial resources,
including those benefits listed in section 245.4881, subdivision
10.
Subd. 18. [FUNCTIONAL ASSESSMENT.] "Functional assessment"
means an assessment by the case manager of the child's:
(1) mental health symptoms as presented in the child's
diagnostic assessment;
(2) mental health needs as presented in the child's
diagnostic assessment;
(3) use of drugs and alcohol;
(4) vocational and educational functioning;
(5) social functioning, including the use of leisure time;
(6) interpersonal functioning, including relationships with
the child's family;
(7) self-care and independent living capacity;
(8) medical and dental health;
(9) financial assistance needs;
(10) housing and transportation needs; and
(11) other needs and problems.
Subd. 19. [INDIVIDUAL FAMILY COMMUNITY SUPPORT
PLAN.] "Individual family community support plan" means a
written plan developed by a case manager in conjunction with the
family and the child with severe emotional disturbance on the
basis of a diagnostic assessment and a functional assessment.
The plan identifies specific services needed by a child and the
child's family to:
(1) treat the symptoms and dysfunctions determined in the
diagnostic assessment;
(2) relieve conditions leading to emotional disturbance and
improve the personal well-being of the child;
(3) improve family functioning;
(4) enhance daily living skills;
(5) improve functioning in education and recreation
settings;
(6) improve interpersonal and family relationships;
(7) enhance vocational development; and
(8) assist in obtaining transportation, housing, health
services, and employment.
Subd. 20. [INDIVIDUAL PLACEMENT AGREEMENT.] "Individual
placement agreement" means a written agreement or supplement to
a service contract entered into between the county board and a
service provider on behalf of a child to provide residential
treatment services.
Subd. 21. [INDIVIDUAL TREATMENT PLAN.] "Individual
treatment plan" means a written plan of intervention, treatment,
and services for a child with an emotional disturbance that is
developed by a service provider under the clinical supervision
of a mental health professional on the basis of a diagnostic
assessment. An individual treatment plan for a child must be
developed in conjunction with the family unless clinically
inappropriate. The plan identifies goals and objectives of
treatment, treatment strategy, a schedule for accomplishing
treatment goals and objectives, and the individuals responsible
for providing treatment to the child with an emotional
disturbance.
Subd. 22. [LEGAL REPRESENTATIVE.] "Legal representative"
means a guardian, conservator, or guardian ad litem of a child
with an emotional disturbance authorized by the court to make
decisions about mental health services for the child.
Subd. 23. [LOCAL MENTAL HEALTH PROPOSAL.] "Local mental
health proposal" means the proposal developed by the county
board, reviewed by the commissioner, and described in section
245.4872.
Subd. 24. [LOCAL SYSTEM OF CARE.] "Local system of care"
means services that are locally available to the child and the
child's family. The services are mental health, social
services, correctional services, education services, health
services, and vocational services.
Subd. 25. [MENTAL HEALTH FUNDS.] "Mental health funds" are
funds expended under sections 245.73 and 256E.12, federal mental
health block grant funds, and funds expended under sections
256D.06 and 256D.37 to facilities licensed under Minnesota
Rules, parts 9520.0500 to 9520.0690.
Subd. 26. [MENTAL HEALTH PRACTITIONER.] "Mental health
practitioner" means a person providing services to children with
emotional disturbances. A mental health practitioner must have
training and experience in working with children. A mental
health practitioner must be 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 mental health services to children with
emotional disturbances;
(2) has at least 6,000 hours of supervised experience in
the delivery of mental health services to children with
emotional disturbances;
(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; 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 and has less than 4,000 hours post-master's
experience in the treatment of emotional disturbance.
Subd. 27. [MENTAL HEALTH PROFESSIONAL.] "Mental health
professional" means a person providing clinical services in the
diagnosis and treatment of children's emotional disorders. A
mental health professional must have training and experience in
working with children consistent with the age group to which the
mental health professional is assigned. A mental health
professional must be qualified in at least one of the following
ways:
(1) in psychiatric nursing, the mental health professional
must be a registered nurse who is licensed under sections
148.171 to 148.285 and who is certified as a clinical specialist
in psychiatric or mental health nursing by the American nurses
association;
(2) in clinical social work, the mental health professional
must be 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 disorders;
(3) in psychology, the mental health professional must be 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 disorders;
(4) in psychiatry, the mental health professional must be 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, the mental health professional must
be 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
emotional disturbances.
Subd. 28. [MENTAL HEALTH SERVICES.] "Mental health
services" means at least all of the treatment services and case
management activities that are provided to children with
emotional disturbances and are described in sections 245.487 to
245.4887.
Subd. 29. [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 children
with emotional disturbances who live outside a hospital.
Outpatient services include clinical activities such as
individual, group, and family therapy; individual treatment
planning; diagnostic assessments; medication management; and
psychological testing.
Subd. 30. [PARENT.] "Parent" means the birth or adoptive
mother or father of a child. This definition does not apply to
a person whose parental rights have been terminated in relation
to the child.
Subd. 31. [PROFESSIONAL HOME-BASED FAMILY TREATMENT.]
"Professional home-based family treatment" means intensive
mental health services provided to children (1) who are at risk
of out-of-home placement; (2) who are in out-of-home placement;
or (3) who are returning from out-of-home placement because of
an emotional disturbance. Services are provided to the child
and the child's family primarily in the child's home environment
or other location appropriate to the child. Examples of
appropriate locations include, but are not limited to, the
child's school, day care center, home, and any other living
arrangement of the child. Services must be provided on an
individual family basis, must be child-oriented and
family-oriented, and must be designed to meet the specific
mental health needs of the child and the child's family.
Services include family and individual therapy and family living
skills training and must be coordinated with other service
providers.
Subd. 32. [RESIDENTIAL TREATMENT.] "Residential treatment"
means a 24-hour-a-day 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
inpatient unit, that must be licensed as a residential treatment
program for children with emotional disturbances under Minnesota
Rules, parts 9545.0900 to 9545.1090, or other rules adopted by
the commissioner.
Subd. 33. [SERVICE PROVIDER.] "Service provider" means
either a county board or an individual or agency including a
regional treatment center under contract with the county board
that provides children's mental health services funded under
sections 245.487 to 245.4887.
Subd. 34. [THERAPEUTIC SUPPORT OF FOSTER CARE.]
"Therapeutic support of foster care" means the mental health
training and mental health support services and clinical
supervision provided by a mental health professional to foster
families caring for children with severe emotional disturbance
to provide a therapeutic family environment and support for the
child's improved functioning.
Sec. 39. [245.4872] [PLANNING FOR A CHILDREN'S MENTAL
HEALTH SYSTEM.]
Subdivision 1. [PLANNING EFFORT.] Starting on the
effective date of sections 245.487 to 245.4887 and ending
January 1, 1992, the commissioner and the county agencies shall
plan for the development of a unified, accountable, and
comprehensive statewide children's mental health system. The
system must be planned and developed by stages until it is
operating at full capacity.
Subd. 2. [TECHNICAL ASSISTANCE.] The commissioner shall
provide ongoing technical assistance to county boards to develop
local mental health proposals as specified in section 245.4887,
to improve system capacity and quality. The commissioner and
county boards shall exchange information as needed about the
numbers of children with emotional disturbances residing in the
county and the extent of existing treatment components locally
available to serve the needs of those persons. County boards
shall cooperate with the commissioner in obtaining necessary
planning information upon request.
Subd. 3. [INFORMATION TO COUNTIES.] By January 1, 1990,
the commissioner shall provide each county with information
about the predictors and symptoms of children's emotional
disturbances and information about groups identified as at risk
of developing emotional disturbance.
Sec. 40. [245.4873] [COORDINATION OF CHILDREN'S MENTAL
HEALTH SYSTEM.]
Subdivision 1. [STATE AND LOCAL COORDINATION.]
Coordination of the development and delivery of mental health
services for children shall occur on the state and local levels
to assure the availability of services to meet the mental health
needs of children in a cost-effective manner.
Subd. 2. [STATE LEVEL; COORDINATION.] The commissioners or
designees of commissioners of the departments of human services,
health, education, state planning, and corrections, and a
representative of the Minnesota district judges association
juvenile committee, in conjunction with the commissioner of
commerce or a designee of the commissioner shall meet at least
quarterly through 1992 to:
(1) educate each agency about the policies, procedures,
funding, and services for children with emotional disturbances
of all agencies represented;
(2) develop mechanisms for interagency coordination on
behalf of children with emotional disturbances;
(3) identify barriers including policies and procedures
within all agencies represented that interfere with delivery of
mental health services for children;
(4) recommend policy and procedural changes needed to
improve development and delivery of mental health services for
children in the agency or agencies they represent;
(5) identify mechanisms for better use of federal and state
funding in the delivery of mental health services for children;
and
(6) prepare an annual report on the policy and procedural
changes needed to implement a coordinated, effective, and
cost-efficient children's mental health delivery system.
This report shall be submitted to the legislature and the
state mental health advisory council annually until February 15,
1992, as part of the report required under section 245.487,
subdivision 4. The report shall include information from each
department represented on:
(1) the number of children in each department's system who
require mental health services;
(2) the number of children in each system who receive
mental health services;
(3) how mental health services for children are funded
within each system;
(4) how mental health services for children could be
coordinated to provide more effectively appropriate mental
health services for children; and
(5) recommendations for the provision of early screening
and identification of mental illness in each system.
Subd. 3. [LOCAL LEVEL COORDINATION.] (a) Each agency
represented in the local system of care coordinating council,
including mental health, social services, education, health,
corrections, and vocational services as specified in section
245.4875, subdivision 6, is responsible for local coordination
and delivery of mental health services for children. The county
board shall establish a coordinating council that provides at
least:
(1) written interagency agreements with the providers of
the local system of care to coordinate the delivery of services
to children; and
(2) an annual report of the council to the local county
board and the children's mental health advisory council about
the unmet children's needs and service priorities.
(b) Each coordinating council shall collect information
about the local system of care and report annually to the
commissioner of human services on forms and in the manner
provided by the commissioner. The report must include a
description of the services provided through each of the service
systems represented on the council, the various sources of
funding for services and the amounts actually expended, a
description of the numbers and characteristics of the children
and families served during the previous year, and an estimate of
unmet needs. Each service system represented on the council
shall provide information to the council as necessary to compile
the report.
Subd. 4. [INDIVIDUAL CASE COORDINATION.] The case manager
designated under section 245.4881 is responsible for ongoing
coordination with any other person responsible for planning,
development, and delivery of social services, education,
corrections, health, or vocational services for the individual
child. The family community support plan developed by the case
manager shall reflect the coordination among the local service
system providers.
Subd. 5. [DUTIES OF THE COMMISSIONER.] The commissioner
shall supervise the development and coordination of locally
available children's mental health services by the county boards
in a manner consistent with sections 245.487 to 245.4887. The
commissioner shall review local mental health service proposals
developed by county boards as specified in section 245.4872 and
provide technical assistance to county boards in developing and
maintaining locally available and coordinated children's mental
health services. The commissioner shall monitor the county
board's progress in developing its full system capacity and
quality through ongoing review of the county board's children's
mental health proposals and other information as required by
sections 245.487 to 245.4887.
Subd. 6. [PRIORITIES.] By January 1, 1992, the
commissioner shall require that each of the treatment services
and management activities described in sections 245.487 to
245.4887 be developed for children with emotional disturbances
within available resources based on the following ranked
priorities:
(1) the provision of locally available mental health
emergency services;
(2) the provision of locally available mental health
services to all children with severe emotional disturbance;
(3) the provision of early identification and intervention
services to children who are at risk of needing or who need
mental health services;
(4) the provision of specialized mental health services
regionally available to meet the special needs of all children
with severe emotional disturbance, and all children with
emotional disturbances;
(5) the provision of locally available services to children
with emotional disturbances; and
(6) the provision of education and preventive mental health
services.
Sec. 41. [245.4874] [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 children's
mental health service proposal required under section 245.4887,
and approved by the commissioner. The county board must:
(1) develop a system of affordable and locally available
children's mental health services according to sections 245.487
to 245.4887;
(2) coordinate the delivery of children's mental health
services with services provided by social services, education,
corrections, health, and vocational agencies to improve the
availability of mental health services to children and the cost
effectiveness of their delivery;
(3) assure that mental health services delivered according
to sections 245.487 to 245.4887 are appropriate to the child's
diagnostic assessment and individual treatment plan;
(4) provide the community with information about predictors
and symptoms of emotional disturbances and how to access
children's mental health services according to sections 245.4877
and 245.4878;
(5) provide for case management services to each child with
severe emotional disturbance according to sections 245.486;
245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 1, 3,
and 5;
(6) provide for screening of each child under section
245.4885 upon admission to a residential treatment facility,
acute care hospital inpatient treatment, or informal admission
to a regional treatment center;
(7) prudently administer grants and purchase-of-service
contracts that the county board determines are necessary to
fulfill its responsibilities under sections 245.487 to 245.4887;
(8) assure that mental health professionals, mental health
practitioners, and case managers employed by or under contract
to the county to provide mental health services are qualified
under section 245.4871; and
(9) assure that children's mental health services are
coordinated with adult mental health services specified in
sections 245.461 to 245.486 so that a continuum of mental health
services is available to serve persons with mental illness,
regardless of the person's age.
Sec. 42. [245.4875] [LOCAL SERVICE DELIVERY SYSTEM.]
Subdivision 1. [DEVELOPMENT OF CHILDREN'S 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 children's mental health
services. The county board may provide some or all of the
children's 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 fully implementing sections
245.487 to 245.4887 during the period July 1, 1989, to January
1, 1992. County boards must develop fully each of the treatment
services prescribed by sections 245.487 to 245.4887 by January
1, 1992, according to the priorities established in section
245.4873 and the local children's mental health services
proposal approved by the commissioner under section 245.4887.
Subd. 2. [CHILDREN'S MENTAL HEALTH SERVICES.] The
children's mental health service system developed by each county
board must include the following services:
(1) education and prevention services according to section
245.4877;
(2) early identification and intervention services
according to section 245.4878;
(3) emergency services according to section 245.4879;
(4) outpatient services according to section 245.488;
(5) family community support services according to section
245.4881;
(6) day treatment services according to section 245.4881,
subdivision 7;
(7) residential treatment services according to section
245.4882;
(8) acute care hospital inpatient treatment services
according to section 245.4883;
(9) screening according to section 245.4885;
(10) case management according to section 245.4881;
(11) therapeutic support of foster care according to
section 245.4881, subdivision 9; and
(12) professional home-based family treatment according to
section 245.4881, subdivision 9.
Subd. 3. [LOCAL CONTRACTS.] The county board shall review
all proposed county agreements, grants, or other contracts
related to children's mental health services from any local,
state, or federal governmental sources. Contracts with service
providers must:
(1) name the commissioner as a third party beneficiary;
(2) identify monitoring and evaluation procedures not in
violation of the Minnesota government data practices act,
chapter 13, which are necessary to ensure effective delivery of
quality services;
(3) include a provision that makes payments conditional on
compliance by the contractor and all subcontractors with
sections 245.487 to 245.4887 and all other applicable laws,
rules, and standards; and
(4) require financial controls and auditing procedures.
Subd. 4. [JOINT COUNTY MENTAL HEALTH AGREEMENTS.] To
efficiently provide the children's mental health services
required by sections 245.487 to 245.4887, counties are
encouraged to join with one or more county boards to establish a
multicounty local children's mental health authority under the
joint powers act, section 471.59, the human service board act,
sections 402.01 to 402.10, community mental health center
provisions, section 245.62, or enter into multicounty mental
health agreements. Participating county boards shall establish
acceptable ways of apportioning the cost of the services.
Subd. 5. [LOCAL CHILDREN'S ADVISORY COUNCIL.] (a) By
October 1, 1989, the county board, individually or in
conjunction with other county boards, shall establish a local
children's mental health advisory council or children's mental
health subcommittee of the existing local mental health advisory
council or shall include persons on its existing mental health
advisory council who are representatives of children's mental
health interests. The following individuals must serve on the
local children's mental health advisory council, the children's
mental health subcommittee of an existing local mental health
advisory council, or be included on an existing mental health
advisory council: (1) at least one person who was in a mental
health program as a child or adolescent; (2) at least one parent
of a child or adolescent with severe emotional disturbance; (3)
one children's mental health professional; (4) representatives
of minority populations of significant size residing in the
county; (5) a representative of the children's mental health
local coordinating council; and (6) one family community support
services program representative.
(b) The local children's mental health advisory council or
children's mental health subcommittee of an existing advisory
council shall meet at least quarterly to review, evaluate, and
make recommendations regarding the local children's mental
health system. Annually, the local children's mental health
advisory council or children's mental health subcommittee of the
existing local mental health advisory council shall:
(1) arrange for input from the local system of care
providers regarding coordination of care between the services;
and
(2) identify for the county board the individuals,
providers, agencies, and associations as specified in section
245.4877, clause (2).
(c) The county board shall consider the advice of its local
children's mental health advisory council or children's mental
health subcommittee of the existing local mental health advisory
council in carrying out its authorities and responsibilities.
Subd. 6. [LOCAL SYSTEM OF CARE; COORDINATING COUNCIL.] The
county board shall establish, by January 1, 1990, a council
representing all members of the local system of care including
mental health services, social services, correctional services,
education services, health services, and vocational services.
The council shall include a representative of an Indian
reservation authority where a reservation exists within the
county. When possible, the council must also include a
representative of juvenile court or the court responsible for
juvenile issues and law enforcement. The members of the
coordinating council shall meet at least quarterly to develop
recommendations to improve coordination and funding of services
to children with severe emotional disturbances. A county may
use an existing child-focused interagency task force to fulfill
the requirements of this subdivision if the representatives and
duties of the existing task force are expanded to include those
specified in this subdivision and section 245.4873, subdivision
3.
Subd. 7. [OTHER LOCAL AUTHORITY.] The county board may
establish procedures and policies that are not contrary to those
of the commissioner or sections 245.487 to 245.4887 regarding
local children's mental health services and facilities. The
county board shall perform other acts necessary to carry out
sections 245.487 to 245.4887.
Sec. 43. [245.4876] [QUALITY OF SERVICES.]
Subdivision 1. [CRITERIA.] Children's mental health
services required by sections 245.487 to 245.4887 must be:
(1) based, when feasible, on research findings;
(2) based on individual clinical, cultural, and ethnic
needs, and other special needs of the children being served;
(3) delivered in a manner that improves family functioning
when clinically appropriate;
(4) provided in the most appropriate, least restrictive
setting available to the county board to meet the child's
treatment needs;
(5) accessible to all age groups of children;
(6) appropriate to the developmental age of the child being
served;
(7) delivered in a manner that provides accountability to
the child for the quality of service delivered and continuity of
services to the child during the years the child needs services
from the local system of care;
(8) provided by qualified individuals as required in
sections 245.487 to 245.4887;
(9) coordinated with children's mental health services
offered by other providers;
(10) provided under conditions that protect the rights and
dignity of the individuals being served; and
(11) provided in a manner and setting most likely to
facilitate progress toward treatment goals.
Subd. 2. [DIAGNOSTIC ASSESSMENT.] All residential
treatment facilities and acute care hospital inpatient treatment
services that provide mental health services for children must
complete a diagnostic assessment for each of their child clients
within five working days of admission. Providers of outpatient
and day treatment services for children must complete a
diagnostic assessment within ten working days of admission. In
cases where a diagnostic assessment is available and has been
completed within 90 days preceding admission, only updating is
necessary.
Subd. 3. [INDIVIDUAL TREATMENT PLANS.] All outpatient
services, day treatment services, family community support
services, professional home-based family treatment, residential
treatment facilities, acute care hospital inpatient treatment
facilities, and regional treatment centers that provide mental
health facilities for children must develop an individual
treatment plan for each child client. The individual treatment
plan must be based on a diagnostic assessment. To the extent
appropriate, the child shall be involved in all phases of
developing and implementing the individual treatment plan. The
individual treatment plan must be developed within ten working
days of client intake or admission and reviewed every 90 days
after that date, except that the administrative review of the
treatment plan of a child placed in a residential facility shall
be as specified in section 257.071, subdivisions 2 and 4.
Subd. 4. [REFERRAL FOR CASE MANAGEMENT.] Each provider of
emergency services, outpatient treatment, community support
services, family community support services, day treatment
services, screening under section 245.4885, professional
home-based family treatment services, residential treatment
facilities, acute care hospital inpatient treatment facilities,
or regional treatment center services must inform each child
with severe emotional disturbance, and the child's parent or
legal representative, of the availability and potential benefits
to the child of case management. The information shall be
provided as specified in subdivision 5. If consent is obtained
according to subdivision 5, the provider must refer the child by
notifying the county employee designated by the county board to
coordinate case management activities of the child's name and
address and by informing the child's family of whom to contact
to request case management. The provider must document
compliance with this subdivision in the child's record.
Subd. 5. [CONSENT FOR SERVICES OR FOR RELEASE OF
INFORMATION.] (a) Although sections 245.487 to 245.4887 require
each county board, within the limits of available resources, to
make the mental health services listed in those sections
available to each child residing in the county who needs them,
the county board shall not provide any services, either directly
or by contract, unless consent to the services is obtained under
this subdivision. The case manager assigned to a child with a
severe emotional disturbance shall not disclose to any person
other than the case manager's immediate supervisor and the
mental health professional providing clinical supervision of the
case manager information on the child, the child's family, or
services provided to the child or the child's family without
informed written consent unless required to do so by statute or
under the Minnesota government data practices act. Informed
written consent must comply with section 13.05, subdivision 4,
paragraph (d), and specify the purpose and use for which the
case manager may disclose the information.
(b) The consent or authorization must be obtained from the
child's parent unless: (1) the parental rights are terminated;
or (2) consent is otherwise provided under sections 144.341 to
144.347; 253B.04, subdivision 1; 260.133; 260.135; and 260.191,
subdivision 1, the terms of appointment of a court-appointed
guardian or conservator, or federal regulations governing
chemical dependency services.
Subd. 6. [INFORMATION FOR BILLING.] Each provider of
outpatient treatment, family community support services, day
treatment services, emergency services, professional home-based
family treatment services, residential treatment, or acute care
hospital inpatient treatment must include the name and home
address of each child for whom services are included on a bill
submitted to a county, if the release of that information under
subdivision 5 has been obtained and if the county requests the
information. Each provider must try to obtain the consent of
the child's family. Each provider must explain to the child's
family that the information can only be released with the
consent of the child's family and may be used only for purposes
of payment and maintaining provider accountability. The
provider shall document the attempt in the child's record.
Subd. 7. [RESTRICTED ACCESS TO DATA.] The county board
shall establish procedures to ensure that the names and
addresses of children receiving mental health services and their
families 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 subdivisions 5 and 6, to persons other than those
specified in this subdivision, or use of this data for purposes
other than those stated in subdivisions 5 and 6, results in
civil or criminal liability under section 13.08 or 13.09.
Sec. 44. [245.4877] [EDUCATION AND PREVENTION SERVICES.]
Education and prevention services must be available to all
children residing in the county. Education and prevention
services must be designed to:
(1) convey information regarding emotional disturbances,
mental health needs, and treatment resources to the general
public and groups identified as at high risk of developing
emotional disturbance under section 245.4872, subdivision 3;
(2) at least annually, distribute to individuals and
agencies identified by the county board and the local children's
mental health advisory council information on predictors and
symptoms of emotional disturbances, where mental health services
are available in the county, and how to access the services;
(3) increase understanding and acceptance of problems
associated with emotional disturbances;
(4) improve people's skills in dealing with high-risk
situations known to affect children's mental health and
functioning;
(5) prevent development or deepening of emotional
disturbances; and
(6) refer each child with emotional disturbance or the
child's family with additional mental health needs to
appropriate mental health services.
Sec. 45. [245.4878] [EARLY IDENTIFICATION AND
INTERVENTION.]
By January 1, 1991, early identification and intervention
services must be available to meet the needs of all children and
their families residing in the county, consistent with section
245.4873. Early identification and intervention services must
be designed to identify children who are at risk of needing or
who need mental health services. The county board must provide
intervention and offer treatment services to each child who is
identified as needing mental health services. The county board
must offer intervention services to each child who is identified
as being at risk of needing mental health services.
Sec. 46. [245.4879] [EMERGENCY SERVICES.]
Subdivision 1. [AVAILABILITY OF EMERGENCY SERVICES.]
County boards must provide or contract for enough mental health
emergency services within the county to meet the needs of
children in the county who are experiencing an emotional crisis
or emotional disturbance. A child or the child's parent may be
required to pay a fee according to section 245.481. Emergency
service providers shall not delay the timely provision of
emergency service because of delays in determining this fee or
because of the unwillingness or inability of the parent to pay
the fee. Emergency services must include assessment,
intervention, and appropriate case disposition. Emergency
services must:
(1) promote the safety and emotional stability of children
with emotional disturbances or emotional crises;
(2) minimize further deterioration of the child with
emotional disturbance or emotional crisis;
(3) help each child with an emotional disturbance or
emotional crisis to obtain ongoing care and treatment; and
(4) prevent placement in settings that are more intensive,
costly, or restrictive than necessary and appropriate to meet
the child's needs.
Subd. 2. [SPECIFIC REQUIREMENTS.] The county board shall
require that all service providers of emergency services to the
child with an emotional disturbance provide immediate direct
access to a mental health 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 until January 1,
1991, a designated person with training in human services who
receives clinical supervision from a mental health
professional. When 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. 47. [245.488] [OUTPATIENT SERVICES.]
Subdivision 1. [AVAILABILITY OF OUTPATIENT SERVICES.] (a)
County boards must provide or contract for enough outpatient
services within the county to meet the needs of each child with
emotional disturbance residing in the county and the child's
family. A child or a child's parent may be required to pay a
fee based in accordance with section 245.481. Outpatient
services include:
(1) conducting diagnostic assessments;
(2) conducting psychological testing;
(3) developing or modifying individual treatment plans;
(4) making referrals and recommending placements as
appropriate;
(5) treating the child's mental health needs through
therapy; and
(6) prescribing and managing medication and evaluating the
effectiveness of prescribed medication.
(b) County boards may request a waiver allowing outpatient
services to be provided in a nearby trade area if it is
determined that the child requires necessary and appropriate
services that are only available outside the county.
(c) Outpatient services offered by the county board to
prevent placement must be at the level of treatment appropriate
to the child's diagnostic assessment.
Subd. 2. [SPECIFIC REQUIREMENTS.] The county board shall
require that a service provider of outpatient services to
children:
(1) meets the professional qualifications contained in
sections 245.487 to 245.4887;
(2) uses a multidisciplinary mental health professional
staff including, at a minimum, arrangements for psychiatric
consultation, licensed consulting psychologist consultation, and
other necessary multidisciplinary mental health professionals;
(3) develops individual treatment plans; and
(4) provides initial appointments within three weeks,
except in emergencies where there must be immediate access as
described in section 245.4879.
Sec. 48. [245.4881] [CASE MANAGEMENT AND FAMILY COMMUNITY
SUPPORT SERVICES.]
Subdivision 1. [AVAILABILITY OF CASE MANAGEMENT
SERVICES.] (a) By July 1, 1991, the county board shall provide
case management activities for each child with severe emotional
disturbance residing in the county and the child's family who
request or consent to the services. Staffing ratios must be
sufficient to serve the needs of the clients. The case manager
must meet the requirements in section 245.4871, subdivision 4.
(b) Case management services provided to children with
severe emotional disturbance eligible for medical assistance
must be billed to the medical assistance program under sections
256B.02, subdivision 8, and 256B.0625.
Subd. 2. [NOTIFICATION OF CASE MANAGEMENT ELIGIBILITY.]
The county board shall notify, as appropriate, the child,
child's parent, or legal representative of the child's potential
eligibility for case management services within five working
days after receiving a request from an individual or a referral
from a provider under section 245.4876, subdivision 4.
The county board shall send a written notice that
identifies the designated case management providers. The county
board shall send the notice, as appropriate, to the child, the
child's parent, or the child's legal representative, if any.
Subd. 3. [DUTIES OF CASE MANAGER.] (a) The case manager
shall promptly arrange for a diagnostic assessment of the child
when one is not available as described in section 245.4876,
subdivision 2, to determine the child's eligibility as a child
with severe emotional disturbance for family community support
services. The county board shall notify in writing, as
appropriate, the child, the child's parent, or the child's legal
representative, if any, if the child is determined ineligible
for family community support services.
(b) Upon a determination of eligibility for family support
services, the case manager shall develop an individual family
community support plan for a child as specified in subdivision
4, review the child's progress, and monitor the provision of
services. If services are to be provided in a host county that
is not the county of financial responsibility, the case manager
shall consult with the host county and obtain a letter
demonstrating the concurrence of the host county regarding the
provision of services.
The case manager shall perform a functional assessment and
note in the client's record the services needed by the child and
the child's family, the services requested by the family,
services that are not available, and the child and family's
unmet needs. The information required under section 245.4886
shall be provided in writing to the child and the child's
family. The case manager shall note this provision in the
client record.
Subd. 4. [INDIVIDUAL FAMILY COMMUNITY SUPPORT PLAN.] (a)
For each child, the case manager must develop an individual
family community support plan that incorporates the child's
individual treatment plan. The individual treatment plan may
not be a substitute for the development of an individual family
community support plan. The case manager is responsible for
developing the individual family community support plan within
30 days of intake based on a diagnostic assessment and a
functional assessment and for implementing and monitoring the
delivery of services according to the individual family
community support plan. The case manager must review the plan
every 90 calendar days after it is developed. To the extent
appropriate, the child with severe emotional disturbance, the
child's family, advocates, service providers, and significant
others must be involved in all phases of development and
implementation of the individual family community support plan.
Notwithstanding the lack of a community support plan, the case
manager shall assist the child and family in accessing the
needed services listed in subdivision 6.
(b) The child's individual family community support plan
must state:
(1) the goals and expected outcomes of each service and
criteria for evaluating the effectiveness and appropriateness of
the 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 individual family community support plan.
Subd. 5. [COORDINATION BETWEEN CASE MANAGER AND FAMILY
COMMUNITY SUPPORT SERVICES.] The county board must establish
procedures that ensure ongoing contact and coordination between
the case manager and the family community support services as
well as other mental health services for each child.
Subd. 6. [AVAILABILITY OF FAMILY COMMUNITY SUPPORT
SERVICES.] By July 1, 1991, county boards must provide or
contract for sufficient family community support services within
the county to meet the needs of each child with severe emotional
disturbance who resides in the county and the child's family.
Children or their parents may be required to pay a fee in
accordance with section 245.481.
Family community support services must be designed to
improve the ability of children with severe emotional
disturbance to:
(1) handle basic activities of daily living;
(2) improve functioning in school settings;
(3) participate in leisure time or community youth
activities;
(4) set goals and plans;
(5) reside with the family in the community;
(6) participate in after school and summer activities;
(7) make a smooth transition between mental health services
provided to children; and
(8) make a smooth transition into the adult mental health
system as appropriate.
In addition, family community support services must be
designed to improve overall family functioning if clinically
appropriate to the child's needs, and to reduce the use of
placements more intensive, costly, or restrictive both in number
of admissions and lengths of stay than indicated by the child's
diagnostic assessment.
Subd. 7. [DAY TREATMENT SERVICES PROVIDED.] (a) Day
treatment services must be part of the family community support
services available to each child with severe emotional
disturbance residing in the county. A child or the child's
parent may be required to pay a fee according to section
245.481. 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
the child's need;
(4) coordinate with or be offered in conjunction with the
school's education program;
(5) provide therapy and family intervention for children
that are coordinated with education services provided and funded
by schools; and
(6) operate during all 12 months of the year.
(b) County boards may request a waiver from including day
treatment services if they can document that:
(1) alternative services exist through the county's family
community support services for each child who would otherwise
need day treatment services; and
(2) county demographics and geography make the provision of
day treatment services cost ineffective and unfeasible.
Subd. 8. [PROFESSIONAL HOME-BASED FAMILY TREATMENT
PROVIDED.] (a) By January 1, 1991, county boards must provide or
contract for sufficient professional home-based family treatment
within the county to meet the needs of each child with severe
emotional disturbance who is at risk of out-of-home placement
due to the child's emotional disturbance or who is returning to
the home from out-of-home placement. The child or the child's
parent may be required to pay a fee according to section
245.481. The county board shall require that all service
providers of professional home-based family treatment set fee
schedules approved by the county board that are based on the
child's or family's ability to pay. The professional home-based
family treatment must be designed to assist each child with
severe emotional disturbance who is at risk of or who is
returning from out-of-home placement and the child's family to:
(1) improve overall family functioning in all areas of
life;
(2) treat the child's symptoms of emotional disturbance
that contribute to a risk of out-of-home placement;
(3) provide a positive change in the emotional, behavioral,
and mental well-being of children and their families; and
(4) reduce risk of out-of-home placement for the identified
child with severe emotional disturbance and other siblings or
successfully reunify and reintegrate into the family a child
returning from out-of-home placement due to emotional
disturbance.
(b) Professional home-based family treatment must be
provided by a team consisting of a mental health professional
and others who are skilled in the delivery of mental health
services to children and families in conjunction with other
human service providers. The professional home-based family
treatment team must maintain flexible hours of service
availability and must provide or arrange for crisis services for
each family, 24 hours a day, seven days a week. Case loads for
each professional home-based family treatment team must be small
enough to permit the delivery of intensive services and to meet
the needs of the family. Professional home-based family
treatment providers shall coordinate services and service needs
with case managers assigned to children and their families.
Individual treatment plans must be developed that identify the
specific treatment objectives for both the child and the family.
Subd. 9. [THERAPEUTIC SUPPORT OF FOSTER CARE.] By January
1, 1992, county boards must provide or contract for foster care
with therapeutic support as defined in section 245.4871,
subdivision 34. Foster families caring for children with severe
emotional disturbance must receive training and supportive
services, as necessary, at no cost to the foster families within
the limits of available resources.
Subd. 10. [BENEFITS ASSISTANCE.] The county board must
offer help to a child with severe emotional disturbance and the
child's family in applying for federal benefits, including
supplemental security income, medical assistance, and Medicare.
Sec. 49. [245.4882] [RESIDENTIAL TREATMENT SERVICES.]
Subdivision 1. [AVAILABILITY OF RESIDENTIAL TREATMENT
SERVICES.] County boards must provide or contract for enough
residential treatment services to meet the needs of each child
with emotional disturbance residing in the county and needing
this level of care. Length of stay is based on the child's
residential treatment need and shall be subject to the six-month
review process established in section 257.071, subdivisions 2
and 4. Services must be made available as close to the county
as possible. Residential treatment must be designed to:
(1) prevent placement in settings that are more intensive,
costly, or restrictive than necessary and appropriate to meet
the child's needs;
(2) help the child improve family living and social
interaction skills;
(3) help the child gain the necessary skills to return to
the community;
(4) stabilize crisis admissions; and
(5) work with families throughout the placement to improve
the ability of the families to care for children with emotional
disturbance in the home.
Subd. 2. [SPECIFIC REQUIREMENTS.] A provider of
residential services to children must be licensed under
applicable rules adopted by the commissioner and must be
clinically supervised by a mental health professional.
Subd. 3. [TRANSITION TO COMMUNITY.] Residential treatment
facilities and regional treatment centers serving children must
plan for and assist those children and their families in making
a transition to less restrictive community-based services.
Residential treatment facilities must also arrange for
appropriate follow-up care in the community. Before a child is
discharged, the residential treatment facility or regional
treatment center shall provide notification to the child's case
manager, if any, so that the case manager can monitor and
coordinate the transition and make timely arrangements for the
child's appropriate follow-up care in the community.
Sec. 50. [245.4883] [ACUTE CARE HOSPITAL INPATIENT
SERVICES.]
Subdivision 1. [AVAILABILITY OF ACUTE CARE HOSPITAL
INPATIENT SERVICES.] County boards must make available through
contract or direct provision enough acute care hospital
inpatient treatment services as close to the county as possible
for children with emotional disturbances residing in the county
needing this level of care. Acute care hospital inpatient
treatment services must be designed to:
(1) stabilize the medical and mental health condition for
which admission is required;
(2) improve functioning to the point where discharge to
residential treatment or community-based mental health services
is possible;
(3) facilitate appropriate referrals for follow-up mental
health care in the community;
(4) work with families to improve the ability of the
families to care for those children with emotional disturbances
at home; and
(5) assist families and children in the transition from
inpatient services to community-based services or home setting,
and provide notification to the child's case manager, if any, so
that the case manager can monitor the transition and make timely
arrangements for the child's appropriate follow-up care in the
community.
Subd. 2. [SPECIFIC REQUIREMENTS.] Providers of acute care
hospital inpatient services for children must meet applicable
standards established by the commissioners of health and human
services.
Sec. 51. [245.4885] [SCREENING FOR INPATIENT AND
RESIDENTIAL TREATMENT.]
Subdivision 1. [SCREENING REQUIRED.] The county board
shall ensure that all children are screened upon admission for
treatment of emotional disturbance 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. If a child is admitted to a residential treatment
facility or acute care hospital for emergency treatment of
emotional disturbance or held for emergency care by a regional
treatment center under section 253B.05, subdivision 1, screening
must occur within five working days of admission. Screening
shall determine whether the proposed treatment:
(1) is necessary;
(2) is appropriate to the child's individual treatment
needs;
(3) cannot be effectively provided in the child's home;
(4) the length of stay is as short as possible consistent
with the individual child's need; and
(5) the case manager, if assigned, is developing an
individual family community support plan.
Screening shall be in compliance with section 256F.07 or
257.071, whichever applies. Wherever possible, the parent shall
be consulted in the screening process, unless clinically
inappropriate.
The screening process and placement decision must be
documented in the child'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 in clauses (1) to (3).
Subd. 2. [QUALIFICATIONS.] No later than January 1, 1992,
screening of children for residential and inpatient services
must be conducted by a mental health professional. Mental
health professionals providing screening for inpatient and
residential services must not be financially affiliated with any
acute care inpatient hospital, residential treatment facility,
or regional treatment center. The commissioner may waive this
requirement for mental health professional participation in
sparsely populated areas.
Subd. 3. [INDIVIDUAL PLACEMENT AGREEMENT.] The county
board shall enter into an individual placement agreement with a
provider of residential treatment services to a child eligible
for county-paid services under this section. The agreement must
specify the payment rate and terms and conditions of county
payment for the placement.
Subd. 4. [TASK FORCE ON RESIDENTIAL AND INPATIENT
TREATMENT SERVICES FOR CHILDREN.] The commissioner of human
services shall appoint a task force on residential and inpatient
treatment services for children that includes representatives
from each of the mental health professional categories defined
in section 245.4871, subdivision 27, the Minnesota mental health
association, the Minnesota alliance for the mentally ill, the
children's mental health initiative, the Minnesota mental health
law project, the Minnesota district judges association juvenile
committee, department of human services staff, the department of
education, local community-based corrections, the department of
corrections, the ombudsman for mental health and mental
retardation, residential treatment facilities for children,
inpatient hospital facilities for children, and counties. The
task force shall examine and evaluate existing and available
mechanisms that have as their purpose determination of and
review of appropriate admission and need for continued care for
all children with emotional disturbances who are admitted to
residential treatment facilities or acute care hospital
inpatient treatment. These mechanisms shall include at least
the following: precommitment screening, preplacement screening
for children, licensure and reimbursement rules, county
monitoring, technical assistance, hospital preadmission
certification, and hospital retrospective reviews. The task
force shall report to the legislature by February 15, 1990, on
how existing mechanisms may be changed to accomplish the goals
of screening as described in section 245.4885, subdivision 1.
Sec. 52. [245.4886] [APPEALS.]
A child or a child's family, as appropriate, who requests
mental health services under sections 245.487 to 245.4887 must
be advised of services available and the right to appeal as
described in this section at the time of the request and each
time the individual family community support plan or individual
treatment plan is reviewed. A child whose request for mental
health services under sections 245.487 to 245.4887 is denied,
not acted upon with reasonable promptness, or whose services are
suspended, reduced, or terminated by action or inaction for
which the county board is responsible under sections 245.487 to
245.4887 may contest that action or inaction before the state
agency according to section 256.045. The commissioner shall
monitor the nature and frequency of administrative appeals under
this section.
Sec. 53. [245.4887] [CHILDREN'S SECTION OF LOCAL MENTAL
HEALTH PROPOSAL.]
Subdivision 1. [TIME PERIOD.] The county board shall
submit its first complete children's section of its local mental
health proposal to the commissioner by November 15, 1989.
Subsequent proposals must be on the same two-year cycle as
community social service plans. If a proposal complies with
sections 245.487 to 245.4887, it satisfies the requirement of
the community social service plan for the emotionally disturbed
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.
Subd. 2. [PROPOSAL CONTENT.] The children's section of the
local mental health proposal must include:
(1) a report of the local children's mental health advisory
council or children's mental health subcommittee of the existing
local mental health advisory council on unmet needs of children
and any other needs assessment used by the county board in
preparing the local mental health proposal, including the report
of the local coordinating council or local interagency task
force specified in section 245.4875, subdivision 6;
(2) a description of the involvement of the local
children's mental health advisory council or the children's
mental health subcommittee of the existing local mental health
advisory council in preparing the local mental health proposal
and methods used by the county board to ensure adequate and
timely 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 children who received each of the mental health
services listed in sections 245.487 to 245.4887, and actual
expenditures for each mental health service and service waiting
lists; and
(4) the following information describing how the county
board intends to meet the requirements of sections 245.487 to
245.4887 during the proposal period:
(i) specific objectives and outcome goals for each mental
health service listed in sections 245.487 to 245.4887;
(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 mental
health services described in sections 245.487 to 245.4887 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, including the
mechanism established by the county board providing for
interagency coordination as specified in section 245.4875,
subdivision 6;
(iv) the estimated number of children who will receive each
mental health service; and
(v) estimated expenditures for each mental health service
and revenues for the entire proposal.
Subd. 3. [PROPOSAL FORMAT.] The children's section of the
local mental health proposal must be made in a format prescribed
by the commissioner.
Subd. 4. [PROVIDER APPROVAL.] The commissioner's review of
the children's section of the local mental health proposal must
include a review of the qualifications of each service provider
required to be identified in the children's section of the local
mental health proposal under subdivision 2. The commissioner
may reject a county board's proposal for a particular provider
if:
(1) the provider does not meet the professional
qualifications contained in sections 245.487 to 245.4887;
(2) the provider does not have adequate fiscal stability or
controls to provide the proposed services as determined by the
commissioner; or
(3) the provider is not in compliance with other applicable
state laws or rules.
Subd. 5. [SERVICE APPROVAL.] The commissioner's review of
the children's section of the local mental health proposal must
include a review of the appropriateness of the amounts and types
of children's mental health services in the children's section
of the local mental health proposal. The commissioner may
reject the county board's proposal if the commissioner
determines that the amount and types of services proposed are
not cost effective, do not meet the child's needs, or do not
comply with sections 245.487 to 245.4887.
Subd. 6. [PROPOSAL APPROVAL.] The commissioner shall
review each children's section of the local mental health
proposal within 90 days and work with the county board to make
any necessary modifications to comply with sections 245.487 to
245.4887. After the commissioner has approved the proposal, the
county board is eligible to receive an allocation of mental
health and community social service act funds.
Subd. 7. [PARTIAL OR CONDITIONAL APPROVAL.] If the
children's section of the local mental health proposal is in
substantial compliance, but not in full compliance with sections
245.487 to 245.4887, and necessary modifications cannot be made
before the proposal period begins, the commissioner may grant
partial or conditional approval and withhold a proportional
share of the county board's mental health and community social
service act funds until full compliance is achieved.
Subd. 8. [AWARD NOTICE.] Upon approval of the county board
proposal, the commissioner shall send a notice of approval for
funding. The notice must specify any conditions of funding and
is binding on the county board. Failure of the county board to
comply with the approved proposal and funding conditions may
result in withholding or repayment of funds according to section
245.483.
Subd. 9. [PLAN AMENDMENT.] If the county board finds it
necessary to make significant changes in the approved children's
section of the local mental health proposal, it must present the
proposed changes to the commissioner for approval at least 30
days before the changes take effect. "Significant changes"
means:
(1) the county board proposes to provide a children's
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 children's 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 children's mental health service to exceed more
than ten percent of the total children's 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 children's mental health proposal.
Sec. 54. Minnesota Statutes 1988, section 245.62,
subdivision 3, is amended to read:
Subd. 3. [CLINICAL DIRECTOR SUPERVISOR.] All community
mental health center services shall be provided under the
clinical direction supervision of a licensed consulting
psychologist licensed under sections 148.88 to 148.98, or a
physician who is board certified or eligible for board
certification in psychiatry, and who is licensed under section
147.02.
Sec. 55. Minnesota Statutes 1988, 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) (5) cooperate with the commissioners of health and jobs
and training to coordinate services and programs for people with
mental illness;
(7) (6) 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) (7) 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;
(9) (8) provide data and other information, as requested,
to the advisory council on mental health;
(10) (9) 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;
(11) (10) apply for grants and develop pilot programs to
test and demonstrate new methods of assessing mental health
needs and delivering mental health services;
(12) (11) study alternative reimbursement systems and make
waiver requests that are deemed necessary by the commissioner;
(13) (12) 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;
(14) (13) 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;
(15) (14) 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
(16) (15) enter into contracts and promulgate rules the
commissioner deems necessary to carry out the purposes of this
chapter.
Sec. 56. Minnesota Statutes 1988, section 245.697,
subdivision 1, is amended to read:
Subdivision 1. [CREATION.] A state advisory council on
mental health is created. The council must have 25 30 members
appointed by the governor in accordance with federal
requirements. The council must be composed of:
(1) the assistant commissioner of mental health for the
department of human services;
(2) a representative of the department of human services
responsible for the medical assistance program;
(3) one member of each of the four core mental health
professional disciplines (psychiatry, psychology, social work,
nursing);
(4) one representative from each of the following advocacy
groups: mental health association of Minnesota, Minnesota
alliance for the mentally ill, and Minnesota mental health law
project;
(5) providers of mental health services;
(6) consumers of mental health services;
(7) family members of persons with mental illnesses;
(8) legislators;
(9) social service agency directors;
(10) county commissioners; and
(11) other members reflecting a broad range of community
interests, as the United States Secretary of Health and Human
Services may prescribe by regulation or as may be selected by
the governor.
Terms, compensation, and removal of members and filling of
vacancies are governed by section 15.059, except that members
shall not receive a per diem. The council expires does not
expire as provided in section 15.059.
Sec. 57. Minnesota Statutes 1988, 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
(7) review and comment on all grants dealing with mental
health and on the development and implementation of state and
local mental health plans; and
(8) coordinate the work of local children's and adult
mental health advisory councils and subcommittees.
Sec. 58. Minnesota Statutes 1988, section 245.697,
subdivision 2a, is amended 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, state
planning, 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 emotional disturbances;
(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 disturbances;
(6) a present or former consumer of adolescent mental
health services;
(7) educators experienced in currently 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) one person from the local corrections department and
one representative of the Minnesota district judges association
juvenile committee; and
(12) county commissioners and social services agency
representatives.
The chair of the advisory council shall appoint
subcommittee members described in clauses (3) to (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. 59. Minnesota Statutes 1988, section 245.713,
subdivision 2, is amended to read:
Subd. 2. [TOTAL FUNDS AVAILABLE; ALLOCATION.] Funds
granted to the state by the federal government under United
States Code, title 42, sections 300X to 300X-9 each federal
fiscal year for mental health services must be allocated as
follows:
(a) Any amount set aside by the commissioner of human
services for American Indian organizations within the state,
which funds shall not duplicate any direct federal funding of
American Indian organizations and which funds shall be at least
25 percent of the total federal allocation to the state for
mental health services; provided that sufficient applications
for funding are received by the commissioner which meet the
specifications contained in requests for proposals. Money from
this source may be used for special committees to advise the
commissioner on mental health programs and services for American
Indians and other minorities or underserved groups. For
purposes of this subdivision, "American Indian organization"
means an American Indian tribe or band or an organization
providing mental health services that is legally incorporated as
a nonprofit organization registered with the secretary of state
and governed by a board of directors having at least a majority
of American Indian directors.
(b) An amount not to exceed ten five percent of the federal
block grant allocation for mental health services to be retained
by the commissioner for administration.
(c) Any amount permitted under federal law which the
commissioner approves for demonstration or research projects for
severely disturbed children and adolescents, the underserved,
special populations or multiply disabled mentally ill persons.
The groups to be served, the extent and nature of services to be
provided, the amount and duration of any grant awards are to be
based on criteria set forth in the Alcohol, Drug Abuse and
Mental Health Block Grant Law, United States Code, title 42,
sections 300X to 300X-9, and on state policies and procedures
determined necessary by the commissioner. Grant recipients must
comply with applicable state and federal requirements and
demonstrate fiscal and program management capabilities that will
result in provision of quality, cost-effective services.
(d) The amount required under federal law, for federally
mandated expenditures.
(e) An amount not to exceed ten 15 percent of the federal
block grant allocation for mental health services to be retained
by the commissioner for planning and evaluation.
Sec. 60. Minnesota Statutes 1988, section 245.73,
subdivision 4, is amended to read:
Subd. 4. [RULES; REPORTS.] The commissioner shall
promulgate an emergency and permanent rule to govern grant
applications, approval of applications, allocation of grants,
and maintenance of service and financial records by grant
recipients. The commissioner shall require collection of data
for compliance, monitoring and evaluation purposes and shall
require periodic reports to demonstrate the effectiveness of the
services in helping adult mentally ill persons remain and
function in their own communities. As a part of the report
required by section 245.461, the commissioner shall report to
the legislature no later than December 31 of each even-numbered
year as to the effectiveness of this program and recommendations
regarding continued funding.
Sec. 61. Minnesota Statutes 1988, section 245A.095, is
amended to read:
245A.095 [REVIEW OF RULES FOR PROGRAMS SERVING PERSONS WITH
MENTAL ILLNESSES.]
Subdivision 1. [LICENSE REQUIRED.] Residential programs
for with five or more persons with a mental illness must be
licensed under sections 245A.01 to 245A.16. To assure that this
requirement is met, the commissioner of health, in cooperation
with the commissioner of human services, shall monitor licensed
boarding care homes, board and lodging houses, and supervised
living facilities.
By January 1, 1989, the commissioner of health shall
recommend to the legislature an appropriate method for enforcing
this requirement.
Subd. 1a. [RULES.] In developing rules for serving persons
with mental illness, the commissioner of human services shall
assure that persons with mental illness are provided with needed
treatment or support in the least restrictive, most appropriate
environment, that supportive residential care in small homelike
settings is available for persons needing that care, and that a
mechanism is developed to ensure that no person is placed in a
care or treatment setting inappropriate for meeting the person's
needs. To the maximum extent possible, the rule shall assure
that length of stay is governed solely by client need and shall
allow for a variety of innovative and flexible approaches in
meeting residential and support needs of persons with mental
illness.
Subd. 2. [SPECIFIC REVIEW OF RULES.] The commissioner
shall:
(1) provide in rule for various levels of care additional
types of programs and services, including but not limited to
supportive small group residential care, semi-independent and
apartment living services, and crisis and respite services, to
address the residential treatment and support needs of persons
with mental illness;
(2) review category I and II programs established in
Minnesota Rules, parts 9520.0500 to 9520.0690 to ensure that the
categories of programs provide a continuum of residential
service programs for persons with mental illness, including but
not limited to programs meeting needs for intensive treatment,
crisis and respite care, and rehabilitation and training;
(3) provide in rule for a definition of the term
"treatment" as used in relation to persons with mental illness;
(4) adjust funding mechanisms by rule as needed to reflect
the requirements established by rule for services being
provided;
(5) review and recommend staff educational requirements and
staff training as needed; and
(6) review and make changes in rules relating to
residential care and service programs for persons with mental
illness as the commissioner may determine necessary; and
(7) the commissioner shall report to the legislature by
February 15, 1990, on the status of rulemaking with respect to
clauses (1) to (6).
Subd. 3. [HOUSING SERVICES FOR PERSONS WITH MENTAL
ILLNESS.] The commissioner of human services shall study the
housing needs of people with mental illness and shall articulate
a continuum of services from residential treatment as the most
intensive service through housing programs as the least
intensive. The commissioner shall develop recommendations for
implementing the continuum of services and shall present the
recommendations to the legislature by January 31, 1988.
Sec. 62. [246.018] [OFFICE OF MEDICAL DIRECTOR.]
Subdivision 1. [ESTABLISHED.] The office of medical
director within the department of human services is established.
Subd. 2. [MEDICAL DIRECTOR.] The commissioner of human
services shall appoint a medical director. The medical director
must be a psychiatrist certified by the board of psychiatry.
Subd. 3. [DUTIES.] The medical director shall:
(1) oversee the clinical provision of inpatient mental
health services provided in the state's regional treatment
centers;
(2) recruit and retain psychiatrists to serve on the state
medical staff established in subdivision 4;
(3) consult with the commissioner of human services, the
assistant commissioner of mental health, community mental health
center directors, and the regional treatment center governing
bodies to develop standards for treatment and care of patients
in regional treatment centers and outpatient programs;
(4) develop and oversee a continuing education program for
members of the regional treatment center medical staff;
(5) consult with the commissioner on the appointment of the
chief executive officers for regional treatment centers; and
(6) participate and cooperate in the development and
maintenance of a quality assurance program for regional
treatment centers that assures that residents receive quality
inpatient care and continuous quality care once they are
discharged or transferred to an outpatient setting.
Subd. 4. [REGIONAL TREATMENT CENTER MEDICAL STAFF.] (a)
The commissioner of human services shall establish a regional
treatment center medical staff which shall be under the clinical
direction of the office of medical director.
(b) The medical director, in conjunction with the regional
treatment center medical staff, shall:
(1) establish standards and define qualifications for
physicians who care for residents in regional treatment centers;
(2) monitor the performance of physicians who care for
residents in regional treatment centers; and
(3) recommend to the commissioner changes in procedures for
operating regional treatment centers that are needed to improve
the provision of medical care in those facilities.
Sec. 63. [STUDY.]
The commissioner of human services shall, in cooperation
with the commissioner of health, study and submit to the
legislature by February 15, 1991, a report and recommendations
regarding: (1) plans and fiscal projections for increasing the
number of community-based beds, small community-based
residential programs, and support services for persons with
mental illness, including persons for whom nursing home services
are inappropriate, to serve all persons in need of those
programs; and (2) the projected fiscal impact of maximizing the
availability of medical assistance coverage for persons with
mental illness.
Sec. 64. [REPEALER.]
Minnesota Statutes 1988, sections 245.462, subdivision 25;
245.471; 245.475; 245.64; 245.698; and 245A.095, subdivision 3,
are repealed.
Sec. 65. [EFFECTIVE DATE.]
Section 37, subdivision 5, is effective the day following
final enactment.
ARTICLE 5
INCOME MAINTENANCE AND WELFARE REFORM
Section 1. Minnesota Statutes 1988, section 13.46,
subdivision 2, is amended to read:
Subd. 2. [GENERAL.] (a) Unless the data is summary data or
a statute specifically provides a different classification, data
on individuals collected, maintained, used, or disseminated by
the welfare system is private data on individuals, and shall not
be disclosed except:
(1) pursuant to section 13.05;
(2) pursuant to court order;
(3) pursuant to a statute specifically authorizing access
to the private data;
(4) to an agent of the welfare system, including a law
enforcement person, attorney, or investigator acting for it in
the investigation, prosecution, criminal or civil proceeding
relating to the administration of a program;
(5) to personnel of the welfare system who require the data
to determine eligibility, amount of assistance, and the need to
provide services of additional programs to the individual;
(6) to administer federal funds or programs;
(7) between personnel of the welfare system working in the
same program;
(8) the amounts of cash public assistance and relief paid
to welfare recipients in this state, including their names and
social security numbers, upon request by the department of
revenue to administer the property tax refund law, supplemental
housing allowance, and the income tax;
(9) to the Minnesota department of jobs and training for
the purpose of monitoring the eligibility of the data subject
for unemployment compensation, for any employment or training
program administered, supervised, or certified by that agency,
or for the purpose of administering any rehabilitation program,
whether alone or in conjunction with the welfare system;, and to
verify receipt of energy assistance for the telephone assistance
plan;
(10) to appropriate parties in connection with an emergency
if knowledge of the information is necessary to protect the
health or safety of the individual or other individuals or
persons; or
(11) data maintained by residential facilities as defined
in section 245A.02, subdivision 6, may be disclosed to the
protection and advocacy system established in this state
pursuant to Part C of Public Law Number 98-527 to protect the
legal and human rights of persons with mental retardation or
other related conditions who live in residential facilities for
these persons if the protection and advocacy system receives a
complaint by or on behalf of that person and the person does not
have a legal guardian or the state or a designee of the state is
the legal guardian of the person.
(b) Mental health data shall be treated as provided in
subdivisions 7, 8, and 9, but is not subject to the access
provisions of subdivision 10, paragraph (b).
Sec. 2. Minnesota Statutes 1988, section 237.70,
subdivision 7, is amended to read:
Subd. 7. [ADMINISTRATION.] The telephone assistance plan
must be administered jointly by the commission, the department
of human services, and the telephone companies in accordance
with the following guidelines:
(a) The commission and the department of human services
shall develop an application form that must be completed by the
subscriber for the purpose of certifying eligibility for
telephone assistance plan credits to the telephone companies.
The application must contain the applicant's social security
number. Applications without a social security number will be
denied. Each telephone company shall annually mail a notice of
the availability of the telephone assistance plan to each
residential subscriber in a regular billing and shall mail the
application form to customers when requested.
The notice must state the following:
YOU MAY BE ELIGIBLE FOR ASSISTANCE IN PAYING YOUR TELEPHONE
BILL IF YOU MEET CERTAIN HOUSEHOLD INCOME LIMITS, AND YOU ARE 65
YEARS OF AGE OR OLDER OR ARE DISABLED. FOR MORE INFORMATION OR
AN APPLICATION FORM PLEASE CONTACT .........
(b) The department of human services shall determine the
eligibility for telephone assistance plan credits at least
annually according to the criteria contained in subdivision 4a.
(c) Each telephone company shall provide telephone
assistance plan credits against monthly charges in the earliest
possible month following receipt of an application form and
shall continue to provide credits unless notified that the
subscriber is ineligible. The company shall cease granting
credits at the earliest possible billing cycle when notified by
the department of human services that the subscriber is
ineligible.
(d) The commission shall serve as the coordinator of the
telephone assistance plan and be reimbursed for its
administrative expenses from the surcharge revenue pool. As the
coordinator, the commission shall:
(1) establish a uniform statewide surcharge in accordance
with subdivision 6;
(2) establish a uniform statewide level of telephone
assistance plan credit that each telephone company shall extend
to each eligible household in its service area;
(3) require each telephone company to account to the
commission on a periodic basis for surcharge revenues collected
by the company, expenses incurred by the company, not to include
expenses of collecting surcharges, and credits extended by the
company under the telephone assistance plan;
(4) require each telephone company to remit surcharge
revenues to the department of administration for deposit in the
fund; and
(5) remit to each telephone company from the surcharge
revenue pool the amount necessary to compensate the company for
expenses, not including expenses of collecting the surcharges,
and telephone assistance plan credits. When it appears that the
revenue generated by the maximum surcharge permitted under
subdivision 6 will be inadequate to fund any particular
established level of telephone assistance plan credits, the
commission shall reduce the credits to a level that can be
adequately funded by the maximum surcharge. Similarly, the
commission may increase the level of the telephone assistance
plan credit that is available or reduce the surcharge to a level
and for a period of time that will prevent an unreasonable
overcollection of surcharge revenues.
(e) Each telephone company shall maintain adequate records
of surcharge revenues, expenses, and credits related to the
telephone assistance plan and shall, as part of its annual
report or separately, provide the commission and the department
of public service with a financial report of its experience
under the telephone assistance plan for the previous year. That
report must also be adequate to satisfy the reporting
requirements of the federal matching plan.
(f) The department of public service shall investigate
complaints against telephone companies with regard to the
telephone assistance plan and shall report the results of its
investigation to the commission.
Sec. 3. Minnesota Statutes 1988, section 237.701,
subdivision 1, is amended to read:
Subdivision 1. [TELEPHONE ASSISTANCE FUND.] The telephone
assistance fund is created as a separate account in the state
treasury to consist of amounts received by the department of
administration representing the surcharge authorized by section
237.70, subdivision 6, and amounts earned on the fund assets.
Money in the fund may be used only for:
(1) reimbursement to telephone companies for expenses and
credits allowed in section 237.70, subdivision 7, paragraph (d),
clause (5);
(2) reimbursement of the administrative expenses of the
department of human services from January 1, 1988, to June 30,
1989, to implement sections 237.69 to 237.71, not to
exceed $90,000 $180,000 annually; and
(3) reimbursement of the administrative expenses of the
commission not to exceed $25,000 annually.
Sec. 4. Minnesota Statutes 1988, section 245.771,
subdivision 3, is amended to read:
Subd. 3. [EMPLOYMENT AND TRAINING PROGRAMS.] The
commissioner of human services, in consultation with the
commissioner of jobs and training, is authorized to implement
and allocate money to food stamp employment and training
programs in as many counties as is necessary to meet federal
participation requirements and comply with federal laws and
regulations. 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. 5. Minnesota Statutes 1988, section 256.014,
subdivision 1, is amended to read:
Subdivision 1. [ESTABLISHMENT OF SYSTEMS.] The
commissioner of human services shall establish and enhance
computer systems necessary for the efficient operation of the
programs the commissioner supervises, including:
(1) management and administration of the food stamp and
income maintenance programs;
(2) the central clearinghouse project for management and
administration of the child support enforcement program; and
(3) administration of medical assistance and general
assistance medical care.
The commissioner shall distribute the nonfederal share of
the costs of operating and maintaining the systems to the
commissioner and to the counties participating in the system in
a manner that reflects actual system usage, except that the
nonfederal share of the costs of the MAXIS computer system and
child support enforcement systems shall be born entirely by the
commissioner. Development costs must not be assessed against
local agencies.
Sec. 6. [256.031] [MINNESOTA FAMILY INVESTMENT PLAN.]
Subdivision 1. [CITATION.] Sections 256.031 to 256.036 may
be cited as the Minnesota family investment plan.
Subd. 2. [LEGISLATIVE FINDINGS.] The legislature
recognizes the need to fundamentally change the way government
supports families. The legislature finds that many features of
the current system of public assistance do not help families
carry out their two basic functions: the economic support of
the family unit and the care and nurturing of children. The
legislature recognizes that the Minnesota family investment plan
is an investment strategy that will support and strengthen the
family's social and financial functions. This investment in
families will provide long-term benefits through stronger and
more independent families.
Subd. 3. [AUTHORIZATION FOR THE DEMONSTRATION.] The
commissioner of human services, in consultation with the
commissioners of education, finance, jobs and training, health,
and planning, and the directors of the higher education
coordinating board and the office of jobs policy, is authorized
to proceed with the planning and designing of the Minnesota
family investment plan and test policies, methods, and cost
impact on an experimental basis by using field trials. Sections
256.031 to 256.033 describe the basic principles of the program.
Sections 256.034 to 256.036 provide a basis for congressional
action. Using sections 256.031 to 256.036, the commissioner
shall seek congressional authority to implement the program in
field trials. After obtaining congressional authority to
implement the Minnesota family investment plan in field trials,
the commissioner shall request specific appropriations from the
legislature to implement field trials. The field trials must be
conducted for as many years as necessary, and in different
geographical settings, to provide reliable instruction about the
desirability of expanding the program statewide.
Subd. 4. [GOALS OF THE MINNESOTA FAMILY INVESTMENT PLAN.]
The commissioner shall design the program to meet the following
goals:
(1) to support families' transition to financial
independence by emphasizing options, removing barriers to work
and education, providing necessary support services, and
building a supportive network of education, employment and
training, health, social, counseling, and family-based services;
(2) to allow resources to be more effectively and
efficiently focused on investing in families by removing the
complexity of current rules and procedures and consolidating
public assistance programs;
(3) to prevent long-term dependence on public assistance
through paternity establishment, child support enforcement,
emphasis on education and training, and early intervention with
minor parents; and
(4) to provide families with an opportunity to increase
their living standard by rewarding efforts aimed at transition
to employment and by allowing families to keep a greater portion
of earnings when they become employed.
Subd. 5. [FEDERAL WAIVERS.] The commissioner of human
services shall seek authority from Congress to implement the
Minnesota family investment plan on a demonstration basis. If
necessary, the commissioner shall seek waivers of compliance
with requirements for: aid to families with dependent children
under United States Code, title 42, sections 601 to 679a, as
amended; medical assistance under United States Code, title 42,
sections 1396 to 1396s, as amended; food stamps under United
States Code, title 7, sections 2011 to 2030, as amended; and
other federal requirements that would inhibit implementation of
the Minnesota family investment plan. The commissioner shall
seek terms from the federal government that are consistent with
the goals of the Minnesota family investment plan. The
commissioner shall also seek terms from the federal government
that will maximize federal financial participation so that the
extra costs to the state of implementing the program are
minimized, to the extent that those terms are consistent with
the goals of the Minnesota family investment plan. An agreement
with the federal government under this section shall provide
that the agreements may be canceled by the state or federal
government upon six months' notice or immediately upon mutual
agreement. If the agreements are canceled, families receiving
assistance under the Minnesota family investment plan who are
eligible for the aid to families with dependent children,
general assistance, medical assistance, general assistance
medical care, and the food stamp programs must be placed on
those programs.
Sec. 7. [256.032] [DEFINITIONS.]
Subdivision 1. [SCOPE OF DEFINITIONS.] The terms used in
sections 256.031 to 256.036 have the meanings given them unless
otherwise provided or indicated by the context.
Subd. 2. [CAREGIVER.] "Caregiver" means a minor child's
natural or adoptive parent or parents who live in the home with
the minor child. For purposes of determining eligibility for
this program, "caregiver" also means any of the following
individuals who live with and provide care and support to a
minor child when the minor child's natural or adoptive parent or
parents do not reside in the same home: grandfather,
grandmother, brother, sister, stepfather, stepmother,
stepbrother, stepsister, uncle, aunt, first cousin, nephew,
niece, persons of preceding generations as denoted by prefixes
of "great" or "great-great," or a spouse of any person named in
the above groups even after the marriage ends by death or
divorce.
Subd. 3. [CASE MANAGEMENT.] "Case management" means the
assessment of family needs and coordination of services
necessary to support the family in its social and economic
roles, in addition to the services described in section 256.736,
subdivision 11.
Subd. 4. [COMMISSIONER.] "Commissioner" means the
commissioner of human services or a designee.
Subd. 5. [CONTRACT.] "Contract" means a family
self-sufficiency plan, described in section 256.035, subdivision
7, based on the case manager's assessment of the family's needs
and abilities and developed, together with a parental caregiver,
by a county agency or its designee.
Subd. 6. [DEPARTMENT.] "Department" means the department
of human services.
Subd. 7. [FAMILY.] For purposes of determining eligibility
for this program, "family" includes the following individuals
who live together: a minor child or a group of minor children
related to each other as siblings, half siblings, stepsiblings,
or adopted siblings, together with their natural or adoptive
parents, or their caregiver as defined in subdivision 2.
"Family" also includes a pregnant woman in the third trimester
of pregnancy with no children.
Subd. 8. [FAMILY WAGE LEVEL.] "Family wage level" means
120 percent of the transitional standard, as defined in
subdivision 13.
Subd. 9. [ORIENTATION.] "Orientation" means a presentation
that meets the requirements of section 256.736, subdivision 10a,
provides information to caregivers about the Minnesota family
investment plan, and encourages parental caregivers to engage in
activities that will stabilize the family and lead to
self-sufficiency.
Subd. 10. [PROGRAM.] "Program" means the Minnesota family
investment plan.
Subd. 11. [SIGNIFICANT CHANGE.] "Significant change" means
a change of ten percent or $50, whichever is less, in monthly
gross family earned income, or a change in family composition.
Subd. 12. [TRANSITIONAL STATUS.] "Transitional status"
means the status of caregivers who are independently pursuing
self-sufficiency or caregivers who are complying with the terms
of a contract with a county agency or its designee.
Subd. 13. [TRANSITIONAL STANDARD.] "Transitional standard"
means the sum of the AFDC standard of assistance and the full
cash value of food stamps for a family of the same size and
composition in effect when implementation of the Minnesota
family investment plan begins. This standard applies to
families in which the parental caregiver is in transitional
status and to families in which the caregiver is exempt from
having a contract or is exempt from complying with the terms of
the contract. Full cash value of food stamps is the amount of
the cash value of food stamps to which a family of a given size
would be entitled for a month, determined by assuming unearned
income equal to the AFDC standard for a family of that size and
composition and subtracting the standard deduction and maximum
shelter deduction from gross family income, as allowed under the
Food Stamp Act of 1977, as amended, and Public Law Number
100-435. The assistance standard for a family consisting of a
pregnant woman in the third trimester of pregnancy with no
children must equal the assistance standard for one adult and
one child.
Sec. 8. [256.033] [ELIGIBILITY FOR THE MINNESOTA FAMILY
INVESTMENT PLAN.]
Subdivision 1. [ELIGIBILITY CONDITIONS.] A family is
eligible for and entitled to assistance under the Minnesota
family investment plan if:
(1) the family's net income, after deducting an amount to
cover taxes and actual dependent care costs up to the maximum
disregarded under United States Code, title 42, section
602(a)(8)(A)(iii), does not exceed the applicable standard of
assistance for that family as defined under section 256.032,
subdivision 13; and
(2) the family's nonexcluded resources do not exceed $2,000.
Subd. 2. [DETERMINATION OF FAMILY INCOME.] The aid to
families with dependent children income exclusions listed in
Code of Federal Regulations, title 45, sections 233.20(a)(3) and
233.20(a)(4), must be used when determining a family's available
income, except that:
(1) the disregard of the first $75 of gross earned income
is replaced with a single disregard described in section
256.035, subdivision 4, paragraph (a);
(2) all earned income of a minor child receiving assistance
through the Minnesota family investment plan is excluded when
the child is attending school at least half-time;
(3) all earned income tax credit payments received by the
family as a refund of federal income taxes or made as advance
payments are excluded in accordance with 42 United States Code,
section 602(a)(8)(A)(viii);
(4) educational grants and loans as provided in section
256.74, subdivision 1, clause (2), are excluded; and
(5) all other income listed in Minnesota Rules, part
9500.2380, subpart 2, is excluded.
Subd. 3. [DETERMINATION OF FAMILY RESOURCES.] When
determining a family's resources, the following are excluded:
(1) the family's home, together with the surrounding
property not separated from the home by intervening property
owned by others;
(2) one burial plot for each family member;
(3) one prepaid burial contract with an equity value of no
more than $1,500 for each member of the family;
(4) licensed automobiles, trucks, or vans up to a total
equity value of $4,500;
(5) the value of personal property needed to produce earned
income, including tools, implements, farm animals, and
inventory;
(6) the entire equity value of a motor vehicle determined
to be necessary for the operation of a self-employment business;
and
(7) clothing, necessary household furniture, equipment, and
other basic maintenance items essential for daily living.
Subd. 4. [TREATMENT OF SSI AND MSA.] The monthly benefits
and any other income received through the supplemental security
income or Minnesota supplemental aid programs and any real or
personal property of a person receiving supplemental security
income or Minnesota supplemental aid must be excluded in
determining the family's eligibility for the Minnesota family
investment plan and the amount of assistance. In determining
the amount of assistance to be paid to the family, the needs of
the person receiving supplemental security income or Minnesota
supplemental aid must not be taken into account.
Subd. 5. [ABILITY TO APPLY FOR FOOD STAMPS.] A family that
is ineligible for assistance through the Minnesota family
investment plan due to income or resources may apply for, and if
eligible receive, benefits under the food stamp program.
Sec. 9. [256.034] [PROGRAM SIMPLIFICATION.]
Subdivision 1. [CONSOLIDATION OF TYPES OF ASSISTANCE.]
Under the Minnesota family investment plan, assistance
previously provided to families through the AFDC, food stamp,
and general assistance programs must be combined into a single
cash assistance program. If authorized by Congress, families
receiving assistance through the Minnesota family investment
plan are automatically eligible for and entitled to medical
assistance under chapter 256B. Federal, state, and local funds
that would otherwise be allocated for assistance to families
under the AFDC, food stamp, and general assistance programs must
be transferred to the Minnesota family investment plan. The
provisions of the Minnesota family investment plan prevail over
any provisions of sections 256.72 to 256.87 or 256D.01 to
256D.21 with which they are irreconcilable. The food stamp,
general assistance, and work readiness programs for single
persons and couples who are not responsible for the care of
children are not replaced by the Minnesota family investment
plan.
Subd. 2. [COUPON OPTION.] Families have the option to
receive a portion of their assistance, designated by the
commissioner, in the form of food coupons or vendor payments.
Subd. 3. [MODIFICATION OF ELIGIBILITY TESTS.] (a) A needy
family is eligible and entitled to receive assistance under the
program even if its children are not found to be deprived of
parental support or care by reason of death, continued absence
from the home, physical or mental incapacity of a parent, or
unemployment of a parent, provided the family's income and
resources do not exceed the eligibility requirements in section
256.033. In addition, a family member who is physically and
mentally fit, who is between the ages of 18 and 60 years, who is
enrolled at least half time in an institution of higher
education, and whose family income and resources do not exceed
the eligibility requirements in section 256.033, is eligible for
assistance under the Minnesota family investment plan even if
the conditions for eligibility as prescribed under the federal
Food Stamp Act of 1977, as amended, are not met.
(b) An applicant for, or a person receiving, assistance
under the Minnesota family investment plan is considered to have
assigned to the public agency responsible for child support
enforcement at the time of application all rights to child
support and maintenance from any other person the applicant may
have in the applicant's own behalf or on behalf of any other
family member for whom application is made under the Minnesota
family investment plan. The provisions of section 256.74,
subdivision 5, govern the assignment. An applicant for, or a
person receiving, assistance under the Minnesota family
investment plan shall cooperate with the efforts of the county
agency to collect child and spousal support. The county agency
is entitled to any child support and maintenance received by or
on behalf of the person receiving assistance or another member
of the family for which the person receiving assistance is
responsible. Failure by an applicant or a person receiving
assistance to cooperate with the efforts of the county agency to
collect child and spousal support without good cause must be
sanctioned according to section 256.035, subdivision 3.
(c) An applicant for, or a person receiving, assistance
under the Minnesota family investment plan is not required to
comply with the employment and training requirements prescribed
under sections 256.736, subdivisions 3, 3a, and 14; and 256D.05,
subdivision 1; section 402(a)(19) of the Social Security Act;
the federal Food Stamp Act of 1977, as amended; Public Law
Number 100-485; or any other state or federal employment and
training program, unless compliance is specifically required in
a contract with the county agency.
Subd. 4. [SIMPLIFICATION OF BUDGETING PROCEDURES.] The
monthly amount of assistance provided by the Minnesota family
investment plan must be calculated on a prospective basis taking
into account actual income or circumstances that existed in a
previous month and other relevant information to predict income
and circumstances for the next month or months. When a family
has a significant change in circumstances, the budgeting cycle
must be interrupted and the amount of assistance for the payment
month must be based on the county agency's best estimate of the
family's income and circumstances for that month. Families may
be required to report their income monthly, but income may be
averaged over a period of more than one month.
Subd. 5. [SIMPLIFICATION OF VERIFICATION PROCEDURES.]
Verification procedures must be reduced to the minimum that is
workable and consistent with the goals and requirements of the
Minnesota family investment plan.
Sec. 10. [256.035] [INCOME SUPPORT AND TRANSITION.]
Subdivision 1. [EXPECTATIONS.] All families eligible for
assistance under the family investment plan are expected to be
in transitional status as defined in section 256.032,
subdivision 12. To be considered in transitional status,
families must meet the following expectations:
(a) For a family headed by a single adult parent, the
expectation is that the parent will independently pursue
self-sufficiency until the family has received assistance for 24
months within the preceding 36 months. Beginning with the 25th
month of assistance, the parent must be developing or have a
contract and comply with the terms of the contract with the
county agency or its designee.
(b) For a family with a minor parent, the expectation is
that, concurrent with the receipt of assistance, the minor
parent must be developing or have a contract with the county
agency. The terms of the contract must include compliance with
section 256.736, subdivision 3b.
(c) For a family with two adult parents, the expectation is
that one or both parents will independently pursue
self-sufficiency until the family has received assistance for
six months within the preceding 12 months. Beginning with the
seventh month of assistance, one parent must be developing or
have a contract and comply with the terms of the contract with
the county agency or its designee.
Subd. 2. [EXEMPTIONS.] A caregiver is exempt from the
requirement of developing a contract and complying with the
terms of the contract developed with the county agency, or
engaging in transitional activities, if:
(1) the caregiver is not the natural or adoptive parent of
a minor child; or
(2) in the case of a parental caregiver, the county agency
determines that:
(i) individual circumstances prevent compliance;
(ii) support services necessary to enable compliance are
not available;
(iii) activities identified in the contract are not
available; or
(iv) a parental caregiver is willing to accept suitable
employment but employment is not available.
Subd. 3. [SANCTIONS.] A family whose parental caregiver is
not exempt from the expectations in subdivision 1 and who is not
complying with those expectations must have assistance reduced
by a value equal to ten percent of the transitional standard as
defined in section 256.032, subdivision 13. This reduction
continues until the failure to comply ceases. The county agency
must notify the parental caregiver of its intent to implement
this sanction and the opportunity to have a conciliation
conference, upon request, before the sanctions are implemented.
Subd. 4. [TREATMENT OF INCOME.] To help families during
their transition from the Minnesota family investment plan to
self-sufficiency, the following income supports are available:
(a) The $30 and one-third and $75 disregards allowed under
section 256.74, subdivision 1, and the 20 percent earned income
deduction allowed under the federal Food Stamp Act of 1977, as
amended, are replaced with a single disregard of not less than
35 percent of gross earned income to cover taxes and other
work-related expenses and to reward the earning of income. This
single disregard is available for the entire time a family
receives assistance through the Minnesota family investment plan.
(b) The dependent care deduction, as prescribed under
section 256.74, subdivision 1, and United States Code, title 7,
section 2014(e), is replaced for families with earned income who
need assistance with dependent care with an entitlement to a
dependent care subsidy from money earmarked for the Minnesota
family investment plan.
(c) The family wage level, as defined in section 256.032,
subdivision 8, allows families to supplement earned income with
assistance received through the Minnesota family investment
plan. If, after earnings are adjusted according to the
disregard described in paragraph (a), earnings have raised
family income to a level equal to or greater than the family
wage level, the amount of assistance received through the
Minnesota family investment plan must be reduced.
(d) The first $50 of any timely support payment for a month
received by the public agency responsible for child support
enforcement shall be paid to the family and disregarded in
determining eligibility and the amount of assistance in
accordance with United States Code, title 42, sections
602(a)(8)(A)(vi) and 657(b)(1). This paragraph applies
regardless of whether the caregiver is in transitional status,
is exempt from having or complying with the terms of a contract,
or has had a sanction imposed under subdivision 3.
Subd. 5. [ORIENTATION.] All caregivers receiving
assistance through the Minnesota family investment plan must
attend orientation.
Subd. 6. [CONTRACT.] (a) To receive the transitional
standard of assistance, a single adult parent who is a member of
a family that has received assistance through the Minnesota
family investment plan for 24 months within the preceding 36
months, a minor parent receiving assistance through the
Minnesota family investment plan, and one parent in a two-parent
family that has received assistance through the Minnesota family
investment plan for six months within the preceding 12 months,
must comply with the terms of a contract with the county agency
or its designee unless exempt under subdivision 2. Case
management must be provided to a caregiver who is a parent to
assist the caregiver in meeting established goals and to monitor
the caregiver's progress toward achieving those goals. The
parental caregiver and the county agency must finalize the
contract as soon as possible, but in any event within a
reasonable period of time after the deadline specified in
subdivision 1, paragraph (a), (b), or (c), whichever applies.
(b) A contract must identify the parental caregiver's
employment goal and explain what steps the family must take to
pursue self-sufficiency. Activities may include:
(1) orientation;
(2) employment;
(3) employment and training services as defined under
section 256.736, subdivision 1a, paragraph (d);
(4) preemployment activities;
(5) participation in an educational program leading to a
high school or general equivalency diploma and post-secondary
education programs, excluding postbaccalaureate degrees as
provided in section 256.736, subdivision 1a, paragraph (d);
(6) case management;
(7) social services; or
(8) other programs or services leading to self-sufficiency.
The contract must also identify the services that the county
agency will provide to the family that the family needs to
enable the parental caregiver to comply with the contract,
including support services such as transportation and child care.
Subd. 7. [EMPLOYMENT BONUS.] A family leaving the program
as a result of increased earnings through employment is entitled
to an employment bonus. This bonus is a one-time cash
incentive, not more than the family's monthly payment standard,
to cover initial expenses incurred by the family leaving the
Minnesota family investment plan.
Subd. 8. [CHILD CARE.] The commissioner shall ensure that
each Minnesota family investment plan caregiver who is a parent
in transitional status and who needs assistance with child care
costs to independently pursue self-sufficiency or comply with
the terms of a contract with the county agency receives a child
care subsidy through child care money earmarked for the
Minnesota family investment plan. The subsidy must cover all
actual child care costs for eligible hours up to the maximum
rate allowed under sections 256H.15 and 256H.16. A caregiver
who is a parent who leaves the program as a result of increased
earnings from employment and who needs child care assistance to
remain employed is entitled to extended child care assistance as
provided under United States Code, title 42, section
602(g)(1)(A)(ii).
Subd. 9. [HEALTH CARE.] A family leaving the program as a
result of increased earnings from employment is eligible for
extended medical assistance as provided under Public Law Number
100-485, section 303, as amended.
Sec. 11. [256.036] [PROTECTIONS.]
Subdivision 1. [SUPPORT SERVICES.] If assistance with
child care or transportation is necessary to enable a caregiver
who is a parent to work, obtain training or education, attend
orientation, or comply with the terms of a contract with the
county agency, and the county determines that child care or
transportation is not available, the family's applicable
standard of assistance continues to be the transitional standard.
Subd. 2. [VOLUNTEERS.] For caregivers receiving assistance
under the Minnesota family investment plan who are independently
pursuing self-sufficiency, case management and support services
other than child care are available to the extent that resources
permit.
Subd. 3. [NOTIFICATION REQUIREMENT.] The county agency
shall contact a family headed by a single adult parent when the
family has received assistance through the Minnesota family
investment plan for 18 months within the preceding 36 months.
The county agency shall remind the family that beginning with
the 24th month of assistance, receipt of the transitional
standard is contingent upon transitional status. The county
agency shall encourage the family to begin preparing for the
change in expectations.
Subd. 4. [TIMELY ASSISTANCE.] Applications must be
processed in a timely manner according to the processing
standards of the federal Food Stamp Act of 1977, as amended, and
no later than 30 days following the date of application, unless
the county agency has requested information that the applicant
has not yet supplied. Financial assistance must be provided on
no less than a monthly basis to eligible families.
Subd. 5. [DUE PROCESS.] Any family that applies for or
receives assistance under the Minnesota family investment plan
whose application for assistance is denied or not acted upon
with reasonable promptness, or whose assistance is suspended,
reduced, terminated, or claimed to have been incorrectly paid,
is entitled, upon request, to a hearing under section 256.045.
A parental caregiver may request a conciliation conference,
under section 256.736, subdivisions 4a and 11, when the
caregiver disputes the contents of a contract developed under
the Minnesota family investment plan or disputes a decision
regarding failure or refusal to cooperate with the terms of a
contract. The disputes are not subject to administrative review
under section 256.045, unless they result in a denial,
suspension, reduction, or termination, and the parental
caregiver complies with section 256.045. A caregiver need not
request a conciliation conference to request a hearing according
to section 256.045.
Subd. 6. [TREATMENT OF FOOD ASSISTANCE.] The portion of
cash assistance provided under the Minnesota family investment
plan that the commissioner designates as representing food
assistance must be disregarded for other local, state, or
federal programs.
Subd. 7. [ADJUSTMENT OF FOOD ASSISTANCE AMOUNT.] The
commissioner shall assure that increases in the federal food
stamp allotments and deductions are reflected in the food
assistance portion of the assistance provided under the
Minnesota family investment plan.
Subd. 8. [EXPEDITED BENEFITS.] Provisions for expedited
benefits under the Minnesota family investment plan may not be
less restrictive than provisions for expedited benefits under
the Food Stamp Act of 1977, as amended, and state food stamp
policy and include either expediting issuance of a predesignated
portion of assistance provided through the Minnesota family
investment plan or through the existing food stamp program.
Subd. 9. [SPECIAL RIGHTS OF MIGRANT AND SEASONAL FARM
WORKERS AND HOMELESS PEOPLE.] Federally prescribed procedures,
means of applying for and obtaining assistance, reporting and
verification requirements, and other similar provisions
specifically for migrant and seasonal farmworkers or homeless
people under the Food Stamp Act of 1977, as amended, continue to
be available to eligible migrant, seasonal farmworker, or
homeless families. The commissioner shall comply with the
bilingual requirements of United States Code, title 7, section
2020(e)(1)(B).
Subd. 10. [ASSESSMENT OF FAMILY IMPACT.] The evaluation
design of the field trials must include an assessment of the
financial condition of a sample of families in the Minnesota
family investment plan relative to what their financial
condition would have been in the absence of the Minnesota family
investment plan.
Sec. 12. Minnesota Statutes 1988, section 256.045,
subdivision 1, is amended to read:
Subdivision 1. [POWERS OF THE STATE AGENCY.] The
commissioner of human services may appoint one or more state
human services referees to conduct hearings and recommend orders
in accordance with subdivisions 3, 3a, 4a, and 5. Human
services referees designated pursuant to this section may
administer oaths and shall be under the control and supervision
of the commissioner of human services and shall not be a part of
the office of administrative hearings established pursuant to
sections 14.48 to 14.56.
Sec. 13. Minnesota Statutes 1988, section 256.045,
subdivision 3, is amended to read:
Subd. 3. [STATE AGENCY HEARINGS.] (a) Any person applying
for, receiving or having received public assistance or a program
of social services granted by the state agency or a local agency
under sections 252.32, 256.031 to 256.036, and 256.72 to
256.879, chapters 256B, 256D, 256E, 261, or the federal Food
Stamp Act whose application for assistance is denied, not acted
upon with reasonable promptness, or whose assistance is
suspended, reduced, terminated, or claimed to have been
incorrectly paid, or any patient or relative aggrieved by an
order of the commissioner under section 252.27, or a party
aggrieved by a ruling of a prepaid health plan, may contest that
action or decision before the state agency by submitting a
written request for a hearing to the state agency within 30 days
after receiving written notice of the action or decision, or
within 90 days of such written notice if the applicant,
recipient, patient, or relative shows good cause why the request
was not submitted within the 30-day time limit.
(b) All prepaid health plans under contract to the
commissioner pursuant to chapter 256B or 256D must provide for a
complaint system according to section 62D.11. The prepaid
health plan must notify the ombudsman within three working days
of any formal complaint made under section 62D.11 by persons
enrolled in a prepaid health plan under chapter 256B or 256D.
At the time a complaint is made, the prepaid health plan must
notify the recipient of the name and telephone number of the
ombudsman. Recipients may request the assistance of the
ombudsman in the complaint system process. The prepaid health
plan shall issue a written resolution within 30 days of filing
with the prepaid health plan. The ombudsman may waive the
requirement that the complaint system procedures be exhausted
prior to an appeal if the ombudsman determines that the
complaint must be resolved expeditiously in order to provide
care in an urgent situation.
(c) A state human services referee shall conduct a hearing
on the matter and shall recommend an order to the commissioner
of human services. The commissioner need not grant a hearing if
the sole issue raised by an appellant is the commissioner's
authority to require mandatory enrollment in a prepaid health
plan in a county where prepaid health plans are under contract
with the commissioner.
(d) In a notice of appeal from a ruling of a prepaid health
plan, a recipient may request an expedited hearing. The
ombudsman, after discussing with the recipient his or her
condition and in consultation with a health practitioner who
practices in the specialty area of the recipient's primary
diagnosis, shall investigate and determine whether an expedited
appeal is warranted. In making the determination, the ombudsman
shall evaluate whether the medical condition of the recipient,
if not expeditiously diagnosed and treated, could cause physical
or mental disability, substantial deterioration of physical or
mental health, continuation of severe pain, or death. The
ombudsman may order a second medical opinion from the prepaid
health plan or order a second medical opinion from a nonprepaid
health plan provider at prepaid health plan expense. If the
ombudsman determines that an expedited appeal is warranted, the
state welfare referee shall hear the appeal and render a
decision within a time commensurate with the level of urgency
involved, based on the individual circumstances of the case. In
urgent or emergency situations in which a prepaid health plan
provider has prescribed treatment, and the prepaid health plan
has denied authorization for that treatment, the referee may
order the health plan to authorize treatment pending the outcome
of the appeal. Except for a prepaid health plan, a vendor of
medical care as defined in section 256B.02, subdivision 7, or a
vendor under contract with a local agency to provide social
services under section 256E.08, subdivision 4, is not a party
and may not request a hearing under this section.
Sec. 14. Minnesota Statutes 1988, section 256.045, is
amended by adding a subdivision to read:
Subd. 3a. [PREPAID HEALTH PLAN APPEALS.] (a) All prepaid
health plans under contract to the commissioner under chapter
256B or 256D must provide for a complaint system according to
section 62D.11. When a prepaid health plan denies, reduces, or
terminates a health service, the prepaid health plan must notify
the recipient of the right to file a complaint or an appeal.
The notice must include the name and telephone number of the
ombudsman and notice of the recipient's right to request a
hearing under paragraph (b). When a complaint is filed, the
prepaid health plan must notify the ombudsman within three
working days. Recipients may request the assistance of the
ombudsman in the complaint system process. The prepaid health
plan must issue a written resolution of the complaint to the
recipient within 30 days after the complaint is filed with the
prepaid health plan. A recipient is not required to exhaust the
complaint system procedures in order to request a hearing under
paragraph (b).
(b) Recipients enrolled in a prepaid health plan under
chapter 256B or 256D may contest a prepaid health plan's denial,
reduction, or termination of health services or the prepaid
health plan's written resolution of a complaint by submitting a
written request for a hearing according to subdivision 3. A
state human services referee shall conduct a hearing on the
matter and shall recommend an order to the commissioner of human
services. The commissioner need not grant a hearing if the sole
issue raised by a recipient is the commissioner's authority to
require mandatory enrollment in a prepaid health plan in a
county where prepaid health plans are under contract with the
commissioner. The state human services referee may order a
second medical opinion from the prepaid health plan or may order
a second medical opinion from a nonprepaid health plan provider
at the expense of the prepaid health plan. Recipients may
request the assistance of the ombudsman in the appeal process.
(c) In the written request for a hearing to appeal from a
prepaid health plan's denial, reduction, or termination of a
health service or the prepaid health plan's written resolution
to a complaint, a recipient may request an expedited hearing.
If an expedited appeal is warranted, the state human services
referee shall hear the appeal and render a decision within a
time commensurate with the level of urgency involved, based on
the individual circumstances of the case.
Sec. 15. Minnesota Statutes 1988, section 256.045,
subdivision 4, is amended to read:
Subd. 4. [CONDUCT OF HEARINGS.] All hearings held pursuant
to subdivision 3, 3a, or 4a shall be conducted according to the
provisions of the federal Social Security Act and the
regulations implemented in accordance with that act to enable
this state to qualify for federal grants-in-aid, and according
to the rules and written policies of the commissioner of human
services. Local agencies shall install equipment necessary to
conduct telephone hearings. A state human services referee may
schedule a telephone conference hearing when the distance or
time required to travel to the local agency offices will cause a
delay in the issuance of an order, or to promote efficiency, or
at the mutual request of the parties. Hearings may be conducted
by telephone conferences unless the applicant, recipient, or
former recipient objects. The hearing shall not be held earlier
than five days after filing of the required notice with the
local or state agency. The state human services referee shall
notify all interested persons of the time, date, and location of
the hearing at least five days before the date of the hearing.
Interested persons may be represented by legal counsel or other
representative of their choice at the hearing and may appear
personally, testify and offer evidence, and examine and
cross-examine witnesses. The applicant, recipient, or former
recipient shall have the opportunity to examine the contents of
the case file and all documents and records to be used by the
local agency at the hearing at a reasonable time before the date
of the hearing and during the hearing. Upon request, the local
agency shall provide reimbursement for transportation, child
care, photocopying, medical assessment, witness fee, and other
necessary and reasonable costs incurred by the applicant,
recipient, or former recipient in connection with the appeal.
All evidence, except that privileged by law, commonly accepted
by reasonable people in the conduct of their affairs as having
probative value with respect to the issues shall be submitted at
the hearing and such hearing shall not be "a contested case"
within the meaning of section 14.02, subdivision 3.
Sec. 16. Minnesota Statutes 1988, section 256.045,
subdivision 4a, is amended to read:
Subd. 4a. [CASE MANAGEMENT APPEALS.] Any recipient of case
management services pursuant to section 256B.092, subdivisions 1
to 1b who contests the local agency's action or failure to act
in the provision of those services, other than a failure to act
with reasonable promptness or a suspension, reduction, denial,
or termination of services, must submit a written request for
review to the local agency. The local agency shall inform the
commissioner of the receipt of a request for review when it is
submitted and shall schedule a conciliation conference. The
local agency shall notify the recipient, the commissioner, and
all interested persons of the time, date, and location of the
conciliation conference. The commissioner shall designate a
representative to be present at the conciliation conference to
assist in the resolution of the dispute without the need for a
hearing. Within 30 days, the local agency shall conduct the
conciliation conference and inform the recipient in writing of
the action the local agency is going to take and when that
action will be taken and notify the recipient of the right to a
hearing under this subdivision. The conciliation conference
shall be conducted in a manner consistent with the procedures
for reconsideration of an individual service plan or an
individual habilitation plan pursuant to Minnesota Rules, parts
9525.0075, subpart 5 and 9525.0105, subpart 6. If the county
fails to conduct the conciliation conference and issue its
report within 30 days, or, at any time up to 90 days after the
conciliation conference is held, a recipient may submit to the
commissioner a written request for a hearing before a state
human services referee to determine whether case management
services have been provided in accordance with applicable laws
and rules or whether the local agency has assured that the
services identified in the recipient's individual service plan
have been delivered in accordance with the laws and rules
governing the provision of those services. The state human
services referee shall recommend an order to the commissioner,
who shall, in accordance with the procedure in subdivision 5,
issue a final order within 60 days of the receipt of the request
for a hearing, unless the commissioner refuses to accept the
recommended order, in which event a final order shall issue
within 90 days of the receipt of that request. The order may
direct the local agency to take those actions necessary to
comply with applicable laws or rules. The commissioner may
issue a temporary order prohibiting the demission of a recipient
of case management services from a residential or day
habilitation program licensed under chapter 245A, while a local
agency review process or an appeal brought by a recipient under
this subdivision is pending, or for the period of time necessary
for the local agency to implement the commissioner's order. The
commissioner shall not issue a final order staying the demission
of a recipient of case management services from a residential or
day habilitation program licensed under chapter 245A.
Sec. 17. Minnesota Statutes 1988, section 256.045,
subdivision 5, is amended to read:
Subd. 5. [ORDERS OF THE COMMISSIONER OF HUMAN SERVICES.] A
state human services referee shall conduct a hearing on the
appeal and shall recommend an order to the commissioner of human
services. The recommended order must be based on all relevant
evidence and must not be limited to a review of the propriety of
the state or local agency's action. A referee may take official
notice of adjudicative facts. The commissioner of human
services may accept the recommended order of a state human
services referee and issue the order to the local agency and the
applicant, recipient, or former recipient, or prepaid health
plan. The commissioner on refusing to accept the recommended
order of the state human services referee, shall notify the
local agency and the applicant, recipient, or former recipient,
or prepaid health plan of that fact and shall state reasons
therefor and shall allow each party ten days' time to submit
additional written argument on the matter. After the expiration
of the ten-day period, the commissioner shall issue an order on
the matter to the local agency and the applicant, recipient, or
former recipient, or prepaid health plan.
A party aggrieved by an order of the commissioner may
appeal under subdivision 7, or request reconsideration by the
commissioner within 30 days after the date the commissioner
issues the order. The commissioner may reconsider an order upon
request of any party or on the commissioner's own motion. A
request for reconsideration does not stay implementation of the
commissioner's order. Upon reconsideration, the commissioner
may issue an amended order or an order affirming the original
order.
Any order of the commissioner issued in accordance with
under this subdivision shall be conclusive upon the parties
unless appeal is taken in the manner provided by subdivision 7.
Any order of the commissioner is binding on the parties and must
be implemented by the state agency or a local agency until the
order is reversed by the district court, or unless the
commissioner or a district court orders monthly assistance or
aid or services paid or provided under subdivision 10.
Except for a prepaid health plan, a vendor of medical care
as defined in section 256B.02, subdivision 7, or a vendor under
contract with a local agency to provide social services under
section 256E.08, subdivision 4, is not a party and may not
request a hearing or seek judicial review of an order issued
under this section.
Sec. 18. Minnesota Statutes 1988, section 256.045,
subdivision 6, is amended to read:
Subd. 6. [ADDITIONAL POWERS OF THE COMMISSIONER;
SUBPOENAS.] (a) The commissioner of human services may initiate
a review of any action or decision of a local agency and direct
that the matter be presented to a state human services referee
for a hearing held pursuant to under subdivision 3, 3a, or 4a.
In all matters dealing with human services committed by law to
the discretion of the local agency, the commissioner's judgment
may be substituted for that of the local agency. The
commissioner may order an independent examination when
appropriate.
(b) Any party to a hearing held pursuant to subdivision 3,
3a, or 4a may request that the commissioner issue a subpoena to
compel the attendance of witnesses at the hearing. The
issuance, service, and enforcement of subpoenas under this
subdivision is governed by section 357.22 and the Minnesota
Rules of Civil Procedure.
(c) The commissioner may issue a temporary order staying a
proposed demission by a residential facility licensed under
chapter 245A while an appeal by a recipient under subdivision 3
is pending, or for the period of time necessary for the local
agency to implement the commissioner's order.
Sec. 19. Minnesota Statutes 1988, section 256.045,
subdivision 7, is amended to read:
Subd. 7. [JUDICIAL REVIEW.] Any party who is aggrieved by
an order of the commissioner of human services may appeal the
order to the district court of the county responsible for
furnishing assistance by serving a written copy of a notice of
appeal upon the commissioner and any adverse party of record
within 30 days after the date the commissioner issued the order,
the amended order, or order affirming the original order, and by
filing the original notice and proof of service with the court
administrator of the district court. Service may be made
personally or by mail; service by mail is complete upon mailing;
no filing fee shall be required by the court administrator in
appeals taken pursuant to this subdivision. The commissioner
may elect to become a party to the proceedings in the district
court. Any party may demand that the commissioner furnish all
parties to the proceedings with a copy of the decision, and a
transcript of any testimony, evidence, or other supporting
papers from the hearing held before the human services referee,
by serving a written demand upon the commissioner within 30 days
after service of the notice of appeal. Any party aggrieved by
the failure of an adverse party to obey an order issued by the
commissioner under subdivision 5 may compel performance
according to the order in the manner prescribed in sections
586.01 to 586.12.
Sec. 20. Minnesota Statutes 1988, section 256.045,
subdivision 10, is amended to read:
Subd. 10. [PAYMENTS PENDING APPEAL.] If the commissioner
of human services or district court orders monthly assistance or
aid or services paid or provided in any proceeding under this
section, it shall be paid or provided pending appeal to the
commissioner of human services, district court, court of
appeals, or supreme court. The state or local agency has a
claim for food stamps and cash payments made to a recipient or
former recipient while an appeal is pending if the recipient or
former recipient is determined ineligible for the food stamps
and cash payments as a result of the appeal.
Sec. 21. Minnesota Statutes 1988, section 256.12,
subdivision 14, is amended to read:
Subd. 14. [DEPENDENT CHILD.] (a) "Dependent child," as
used in sections 256.72 to 256.87, means a child under the age
of 18 years, or a child under the age of 19 years who is
regularly attending as a full-time student, and is expected to
complete before reaching age 19, a high school or a secondary
level course of vocational or technical training designed to fit
students for gainful employment, who is found to be deprived of
parental support or care by reason of the death, continued
absence from the home, physical or mental incapacity of a
parent, or who is a child of an unemployed parent as that term
is defined by the commissioner of human services, such
definition to be consistent with and not to exceed minimum
standards established by the Congress of the United States and
the Secretary of Health and Human Services, and whose relatives,.
When defining "unemployed parent," the commissioner shall count
up to four calendar quarters of full-time attendance in any of
the following toward the requirement that a principal earner
have six or more quarters of work in any 13 calendar quarter
period ending within one year before application for aid to
families with dependent children:
(1) an elementary or secondary school;
(2) a federally approved vocational or technical training
course designed to prepare the parent for gainful employment; or
(3) full-time participation in an education or training
program established under the job training partnership act.
(b) Dependent child also means a child:
(1) whose relatives are liable under the law for the
child's support and are not able to provide adequate care and
support of the child,; and
(2) who is living with father, mother, grandfather,
grandmother, brother, sister, stepfather, stepmother,
stepbrother, stepsister, uncle, aunt, first cousin, nephew, or
niece in a place of residence maintained by one or more of these
relatives as a home.
The term " (c) Dependent child" also means a child who has
been removed from the home of a relative after a judicial
determination that continuance in the home would be contrary to
the welfare and best interests of the child and whose care and
placement in a foster home or a private licensed child care
institution is, in accordance with the rules of the
commissioner, the responsibility of the state or county agency
under sections 256.72 to 256.87. This child is eligible for
benefits only through the foster care and adoption assistance
program contained in Title IV-E of the Social Security Act,
United States Code, title 42, sections 670 to 676, and is not
entitled to benefits under sections 256.72 to 256.87.
Sec. 22. [256.484] [SOCIAL ADJUSTMENT SERVICES TO
REFUGEES.]
Subdivision 1. [SPECIAL PROJECTS.] The commissioner of
human services shall establish a grant program to provide social
adjustment services to refugees residing in Minnesota who
experience depression, emotional stress, and personal crises
resulting from past trauma and refugee camp experiences.
Subd. 2. [DEFINITIONS.] For purposes of this section, the
following terms have the meanings given them:
(a) "Refugee" means a refugee or asylee status granted by
the United States Immigration and Naturalization Service.
(b) "Social adjustment services" means treatment or
services, including psychiatric assessment, chemical therapy,
individual or family counseling, support group participation,
after care or follow-up, information and referral, and crisis
intervention.
Subd. 3. [PROJECT SELECTION.] The commissioner shall
select projects for funding under this section. Projects
selected must be administered by service providers who have
experience in providing bilingual social adjustment services to
refugees. Project administrators must present evidence that the
service provider's social adjustment services for targeted
refugees has historically resolved major problems identified at
the time of intake.
Subd. 4. [PROJECT DESIGN.] Project proposals selected
under this section must:
(1) use existing resources when possible;
(2) clearly specify program goals and timetables for
project operation;
(3) identify available support services, social services,
and referral procedures to be used in serving the targeted
refugees;
(4) provide bilingual services; and
(5) identify the training and experience that enable
project staff to provide services to targeted refugees, and
identify the number of staff with bilingual service expertise.
Subd. 5. [ANNUAL REPORT.] Selected service providers must
report to the commissioner by June 30 of each year on the number
of refugees served, the average cost per refugee served, the
number and percentage of refugees who are successfully assisted
through social adjustment services, and recommendations for
modifications in service delivery for the upcoming year.
Sec. 23. [256.485] [CHILD WELFARE SERVICES TO MINOR
REFUGEES.]
Subdivision 1. [SPECIAL PROJECTS.] The commissioner of
human services shall establish a grant program to provide
specialized child welfare services to Asian and Amerasian
refugees under the age of 18 who reside in Minnesota.
Subd. 2. [DEFINITIONS.] For the purpose of this section,
the following terms have the meanings given them:
(a) "Refugee" means refugee or asylee status granted by the
United States Immigration and Naturalization Service.
(b) "Child welfare services" means treatment or services,
including workshops or training regarding independent living
skills, coping skills, and responsible parenting, and family or
individual counseling regarding career planning,
intergenerational relationships and communications, and
emotional or psychological stress.
Subd. 3. [PROJECT SELECTION.] The commissioner shall
select projects for funding under this section. Projects
selected must be administered by service providers who have
experience in providing child welfare services to minor Asian
and Amerasian refugees.
Subd. 4. [PROJECT DESIGN.] Project proposals selected
under this section must:
(1) use existing resources when possible;
(2) provide bilingual services;
(3) clearly specify program goals and timetables for
project operation;
(4) identify support services, social services, and
referral procedures to be used; and
(5) identify the training and experience that enable
project staff to provide services to targeted refugees, as well
as the number of staff with bilingual service expertise.
Subd. 5. [ANNUAL REPORT.] Selected service providers must
report to the commissioner by June 30 of each year on the number
of refugees served, the average cost per refugee served, the
number and percentage of refugees who are successfully assisted
through child welfare services, and recommendations for
modifications in service delivery for the upcoming year.
Sec. 24. Minnesota Statutes 1988, section 256.73,
subdivision 3a, is amended to read:
Subd. 3a. [PERSONS INELIGIBLE.] No assistance shall be
given under sections 256.72 to 256.87:
(1) on behalf of any person who is receiving supplemental
security income under title XVI of the Social Security Act
unless permitted by federal regulations;
(2) for any month in which the assistance unit's gross
income, without application of deductions or disregards, exceeds
185 percent of the standard of need for a family of the same
size and composition; except that the earnings of a dependent
child who is a full-time student may be disregarded for six
calendar months per year and the earnings of a dependent child
who is a full-time student that are derived from the jobs
training and partnership act may be disregarded for six calendar
months per year. If a stepparent's income is taken into account
in determining need, the disregards specified in section 256.74,
subdivision 1a shall be applied to determine income available to
the assistance unit before calculating the unit's gross income
for purposes of this paragraph;
(3) to any assistance unit for any month in which any
caretaker relative with whom the child is living is, on the last
day of that month, participating in a strike;
(4) on behalf of any other individual in the assistance
unit, nor shall the individual's needs be taken into account for
any month in which, on the last day of the month, the individual
is participating in a strike;
(5) to an assistance unit if its eligibility is based on a
parent's unemployment and the parent on behalf of any individual
who is the principal earner in an assistance unit whose
eligibility is based on the unemployment of a parent when the
principal earner, without good cause, fails or refuses to seek
work, to participate in the work incentive job search program
under section 256.736, or a community work experience program
under section 256.737 if this program is available and
participation is mandatory in the county, to accept employment,
or to register with a public employment office, unless the
principal earner is exempt from these work requirements.
Sec. 25. Minnesota Statutes 1988, section 256.736,
subdivision 3, is amended to read:
Subd. 3. [REGISTRATION.] (a) To the extent permissible
under federal law, every caretaker or child is required to
register for employment and training services, as a condition of
receiving AFDC, unless the caretaker or child is:
(1) a child who is under age 16, a child age 16 or 17 who
is attending elementary or secondary school or a secondary level
vocational or technical school full time, or a full-time student
age 18 who is attending a secondary school or a secondary level
vocational or technical program and who is expected to complete
the school or program before reaching age 19;
(2) a caretaker who is ill, incapacitated or age 55 60 or
older;
(3) a caretaker person for whom participation in an
employment and training service would require a round trip
commuting time by available transportation of more than two
hours;
(4) a caretaker person whose presence in the home is
required because of illness or incapacity of another member of
the household;
(5) a caretaker or other caretaker relative of a child
under the age of six three who personally provides full-time
care for the child;
(6) a caretaker or other caretaker relative personally
providing care for a child under six years of age, except that
when child care is arranged for or provided, the caretaker or
caretaker relative may be required to register and participate
in employment and training services up to a maximum of 20 hours
per week;
(7) a caretaker if another adult relative in the assistance
unit is registered and has not, without good cause, failed or
refused to participate or accept employment;
(7) a pregnant woman in the last trimester of pregnancy (8)
a pregnant woman, if it has been medically verified that the
child is expected to be born in the current month or within the
next six months;
(9) employed at least 30 hours per week; or
(8) (10) a parent who is not the principal earner if the
parent who is the principal earner is not exempt under clauses
(1) to (7).
Any individual in clauses (3) and (5) to (8) must be
advised of any available employment and training services and
must be informed of any available child care and other support
services required to register.
(b) To the extent permissible by federal law, applicants
for benefits under the AFDC program are registered for
employment and training services by signing the application
form. Applicants must be informed that they are registering for
employment and training services by signing the form. Persons
receiving benefits on or after July 1, 1987, shall register for
employment and training services to the extent permissible by
federal law. The caretaker has a right to a fair hearing under
section 256.045 with respect to the appropriateness of the
registration.
Sec. 26. Minnesota Statutes 1988, section 256.736,
subdivision 3b, is amended to read:
Subd. 3b. [MANDATORY ASSESSMENT AND SCHOOL ATTENDANCE
FOR MINOR CERTAIN CUSTODIAL PARENTS.] This subdivision applies
to the extent permitted under federal law and regulation.
(a) [DEFINITIONS.] The definitions in this paragraph apply
to this subdivision.
(1) "Minor Custodial 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 custodial 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) [ASSESSMENT AND PLAN; REQUIREMENT; CONTENT.] The county
agency must examine the educational level of each custodial
parent under the age of 20 to determine if the recipient has
completed a high school education or its equivalent. If the
custodial parent has not completed a high school education or
its equivalent and is not exempt from the requirement to attend
school under paragraph (c), the county agency must complete an
individual assessment for the custodial parent. The assessment
must be performed as soon as possible but within 60 days of
determining AFDC eligibility for the custodial parent. The
assessment must provide an initial examination of the custodial
parent's educational progress and needs, literacy level, child
care and supportive service needs, family circumstances, skills,
and work experience. In the case of a custodial parent under
the age of 18, the assessment must also consider the results of
the early and periodic screening, diagnosis and treatment (EPSDT)
screening, if available, and the effect of a child's development
and educational needs on the parent's ability to participate in
the program. The county agency must advise the parent that the
parent's first goal must be to complete an appropriate
educational option if one is identified for the parent through
the assessment and, in consultation with educational agencies,
must review the various school completion options with the
parent and assist the parent in selecting the most appropriate
option.
(c) [RESPONSIBILITY FOR ASSESSMENT AND PLAN.] For custodial
parents who are under age 18, the assessment and the
employability plan must be completed by the county social
services agency, as specified in section 257.33. For custodial
parents who are age 18 or 19, the assessment and employability
plan must be completed by the case manager. The social services
agency or the case manager shall consult with representatives of
educational agencies required to assist in developing
educational plans under section 126.235.
(d) [EDUCATION DETERMINED TO BE APPROPRIATE.] If the case
manager or county social services agency identifies an
appropriate educational option, it must develop an employability
plan in consultation with the custodial parent which reflects
the assessment. The plan must specify that participation in an
educational activity is required, what school or educational
program is most appropriate, the services that will be provided,
the activities the parent will take part in including child care
and supportive services, the consequences to the custodial
parent for failing to participate or comply with the specified
requirements, and the right to appeal any adverse action. The
employability plan must, to the extent possible, reflect the
preferences of the participant.
(e) [EDUCATION DETERMINED TO BE NOT APPROPRIATE.] If the
case manager determines that there is no appropriate educational
option for a custodial parent who is age 18 or 19, the case
manager shall indicate the reasons for the determination. The
case manager shall then notify the county agency which must
refer the custodial parent to case management services under
subdivision 11 for completion of an employability plan and
services. If the custodial parent fails to participate or
cooperate with case management services and does not have good
cause for the failure, the county agency shall apply the
sanctions listed in subdivision 4, beginning with the first
payment month after issuance of notice. If the county social
services agency determines that school attendance is not
appropriate for a custodial parent under age 18, the county
agency shall refer the custodial parent to social services for
services as provided in section 257.33.
(f) [SCHOOL ATTENDANCE REQUIRED.] Notwithstanding
subdivision 3, a minor custodial 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 the custodial parent is
less than 20 years of age;
(2) transportation services needed to enable the minor
custodial parent to attend school are available;
(3) licensed or legal nonlicensed child care services
needed to enable the minor custodial parent to attend school are
available;
(4) the minor custodial parent has not already graduated
from high school and has not received a general educational
development (GED) diploma received a high school diploma or its
equivalent; and
(5) the minor custodial parent does not have good cause for
failing to attend school, as provided in paragraph (d) is not
exempt because the custodial parent:
(i) is ill or incapacitated seriously enough to prevent him
or her from attending school;
(ii) is needed in the home because of the illness or
incapacity of another member of the household; this includes a
custodial parent of a child who is younger than six weeks of
age;
(iii) works 30 or more hours a week; or
(iv) is pregnant if it has been medically verified that the
child's birth is expected in the current month or within the
next six months.
(c) (g) [ENROLLMENT AND ATTENDANCE.] The minor custodial
parent must be enrolled in school and meeting the school's
attendance requirements. The minor custodial parent is
considered to be attending when the minor parent he or she is
enrolled but the school is not in regular session, including
during holiday and summer breaks.
(d) (h) [GOOD CAUSE FOR NOT ATTENDING SCHOOL.] The local
agency shall not impose the sanctions in subdivision 4 if it
determines that a custodial parent has good cause for not being
enrolled or for not meeting the school's attendance
requirements. 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 custodial 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) (2) Good cause exists when the minor custodial parent
has indicated a desire to attend school, but the public school
system is not providing for the minor parent's his or her
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 12
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) (i) [FAILURE TO COMPLY.] The case manager and social
services agency shall establish ongoing contact with appropriate
school staff to monitor problems that custodial parents may have
in pursuing their educational plan, and shall jointly seek
solutions to prevent parents from failing to complete
education. If the school notifies the local agency that
the minor custodial parent is not enrolled or is not meeting the
school's attendance requirements, and the local agency or
appears to be facing barriers to completing education, the
information must be conveyed to the case manager for a custodial
parent age 18 or 19, or to the social services agency for a
custodial parent under age 18. The case manager or social
services agency shall reassess the appropriateness of school
attendance as specified in paragraph (f). If after
consultation, school attendance is still appropriate and the
case manager or social services agency determines that the minor
custodial parent has failed to enroll or is not meeting the
school's attendance requirements and the custodial parent does
not have good cause, the local agency case manager or social
services agency shall inform the custodial parent's financial
worker who shall apply the sanctions listed in subdivision 4
beginning with the first payment month after issuance of notice.
(f) (j) [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) (k) [SOCIAL SERVICES.] When a minor custodial parent
under the age of 18 has failed to attend school, is not exempt,
and does not have good cause, the local agency shall refer
the minor custodial parent to the social services agency for
services, as provided in section 257.33.
(h) (l) [VERIFICATION.] No less often than quarterly, the
local agency financial worker must verify that the minor
custodial parent is meeting the requirements of this
subdivision. Notwithstanding section 13.32, subdivision 3, when
the local agency notifies the school that a minor custodial
parent is subject to this subdivision, the school must furnish
verification of school enrollment and, attendance, and progress
to the local agency. The county agency must not impose the
sanctions in paragraph (i) if the school fails to cooperate in
providing verification of the minor parent's education,
attendance, or progress.
Sec. 27. Minnesota Statutes 1988, 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 ten 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) (3) Provide that the county board shall impose the
sanctions in clause (5) or (6) (4) 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 custodial parent under the age
of 16 who is required to attend school under subdivision 3b has,
without good cause, failed to attend school;
(c) (b) 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) (c) determines that a caretaker has, without good
cause, failed to attend orientation.
(5) (4) To the extent permissible by federal law, impose
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 (5) Provide that the county board
shall impose the sanctions in clause (6) when the county board:
(a) determines 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, through the job search program described in subdivision
14, or the community work experience program described in
section 256.737, a bona fide offer of public or other
employment; or
(b) determines that a custodial parent aged 16 to 19 who is
required to attend school under subdivision 3b has, without good
cause, failed to enroll or attend school.
(6) To the extent required by federal law, the following
sanctions must be imposed for a recipient's failure to
participate in required employment and training services, to
accept a bona fide offer of public or other employment, or to
enroll or attend school under subdivision 3b.
(a) If the caretaker fails to participate, the caretaker's
For the first failure, the needs of the noncompliant individual
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 until the individual complies with the
requirements.
(b) For the second failure, the needs of the noncompliant
individual shall not be taken into account in making the grant
determination until the individual complies with the requirement
or for three consecutive months, whichever is longer.
(c) For subsequent failures, the needs of the noncompliant
individual shall not be taken into account in making the grant
determination until the individual complies with the requirement
or for six consecutive months, whichever is longer.
(d) Aid with respect to a dependent child will be denied if
a child who 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 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 without good cause to participate or to accept
employment, the entire assistance unit is ineligible for
benefits under sections 256.72 to 256.87.
(e) If the noncompliant individual is a parent or other
relative caretaker, payments of aid for any dependent child in
the family must be made in the form of protective or vendor
payments. When protective payments are required, the county
agency may continue payments to the caretaker if a protective
payee cannot reasonably be found. When protective payments are
imposed on assistance units whose basis of eligibility is
unemployed parent or incapacitated parent, cash payments may
continue to the nonsanctioned caretaker in the assistance unit,
subject to clause (f). After removing a caretaker's needs from
the grant, the standard of assistance applicable to 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.
(f) If the noncompliant individual is a parent or other
caretaker of a family whose basis of eligibility is the
unemployment of a parent and the noncompliant individual's
spouse is not participating in an approved employment and
training service, the needs of the spouse must not be taken into
account in making the grant determination;
(7) Request approval from the secretary of health and human
services to use vendor payment sanctions for persons listed in
paragraph (5), clause (b). If approval is granted, the
commissioner must begin using vendor payment sanctions as soon
as changes to the state plan are approved.
Sec. 28. Minnesota Statutes 1988, section 256.736,
subdivision 10, is amended to read:
Subd. 10. [COUNTY DUTIES.] (a) To the extent of available
state appropriations, county boards shall:
(1) refer all priority caretakers required to register
under subdivision 3 to an employment and training service
provider for participation in employment and training services;
(2) identify to the employment and training service
provider caretakers who fall into the priority groups;
(3) provide all caretakers with an orientation which (a)
gives information on available employment and training services
and support services, and (b) encourages clients to view AFDC as
a temporary program providing grants and services to clients who
set goals and develop strategies for supporting their families
without AFDC assistance meets the requirements in subdivisions
10a and 10b;
(4) work with the employment and training service provider
to encourage voluntary participation by caretakers in the
priority groups;
(5) work with the employment and training service provider
to collect data as required by the commissioner;
(6) to the extent permissible under federal law, require
all caretakers coming into the AFDC program to attend
orientation;
(7) encourage nonpriority caretakers to develop a plan to
obtain self-sufficiency;
(8) notify the commissioner of the caretakers required to
participate in employment and training services;
(9) inform appropriate caretakers of opportunities
available through the head start program and encourage
caretakers to have their children screened for enrollment in the
program where appropriate;
(10) provide transportation assistance using the employment
special needs fund or other available funds to caretakers who
participate in employment and training programs, with priority
for services to caretakers in priority groups;
(11) ensure that orientation, employment search, and case
management services are made available to appropriate caretakers
under this section, except that payment for case management
services is governed by subdivision 13; and
(12) explain in its local service unit plan under section
268.88 how it will ensure that priority caretakers determined to
be in need of social services are provided with such social
services. The plan must specify how the case manager and the
county social service workers will ensure delivery of needed
services.;
(13) to the extent allowed by federal laws and regulations,
provide a job search program as defined in subdivision 14 and at
least one of the following employment and training services:
community work experience program (CWEP) as defined in section
256.737, grant diversion as defined in section 268.86,
on-the-job training as defined in section 256.738, or another
work and training program approved by the commissioner and the
secretary of the United States Department of Health and Human
Services. Planning and approval for employment and training
services listed in this clause must be obtained through
submission of the local service unit plan as specified under
section 268.88. Each county is urged to adopt grant diversion
as the second program required under this clause;
(14) provide an assessment of each AFDC recipient who is
required or volunteers to participate in one of the employment
and training services specified in clause (13), including job
search, and to recipients who volunteer for participation in
case management under subdivision 11. The assessment must
include an evaluation of the participant's (i) educational,
child care, and other supportive service needs; (ii) skills and
prior work experience; and (iii) ability to secure and retain a
job which, when wages are added to child support, will support
the participant's family. The assessment must also include a
review of the results of the early and periodic screening,
diagnosis and treatment (EPSDT) screening and preschool
screening under chapter 123, if available; the participant's
family circumstances; and, in the case of a custodial parent
under the age of 18, a review of the effect of a child's
development and educational needs on the parent's ability to
participate in the program;
(15) develop an employability development plan for each
recipient for whom an assessment is required under clause (14)
which: (i) reflects the assessment required by clause 14; (ii)
takes into consideration the recipient's physical capacity,
skills, experience, health and safety, family responsibilities,
place of residence, proficiency, child care and other supportive
service needs; (iii) is based on available resources and local
employment opportunities; (iv) specifies the services to be
provided by the employment and training service provider; (v)
specifies the activities the recipient will participate in; (vi)
specifies necessary supportive services such as child care;
(vii) to the extent possible, reflects the preferences of the
participant; and (viii) specifies the recipient's employment
goal; and
(16) assure that no work assignment under this section or
sections 256.737 and 256.738 results in: (i) termination,
layoff, or reduction of the work hours of an employee for the
purpose of hiring an individual under this section or sections
256.737 and 256.738; (ii) the hiring of an individual if any
other person is on layoff from the same or a substantially
equivalent job; (iii) any infringement of the promotional
opportunities of any currently employed individual; (iv) the
impairment of existing contracts for services or collective
bargaining agreements; or (v) a participant filling an
established unfilled position vacancy.
(b) Funds available under this subdivision may not be used
to assist, promote, or deter union organizing.
(c) A county board may provide other employment and
training services that it considers necessary to help caretakers
obtain self-sufficiency.
(d) Notwithstanding section 256G.07, when a priority
caretaker relocates to another county to implement the
provisions of the caretaker's case management contract or other
written employability development plan approved by the county
human service agency or its case manager, the county that
approved the plan is responsible for the costs of case
management, child care, and other services required to carry out
the plan. The county agency's responsibility for the costs ends
when all plan obligations have been met, when the caretaker
loses AFDC eligibility for at least 30 days, or when approval of
the plan is withdrawn for a reason stated in the plan, whichever
occurs first. A county human service agency may pay for the
costs of case management, child care, and other services
required in an approved employability development plan when the
nonpriority caretaker relocates to another county or when a
priority caretaker again becomes eligible for AFDC after having
been ineligible for at least 30 days.
Sec. 29. Minnesota Statutes 1988, section 256.736, is
amended by adding a subdivision to read:
Subd. 10a. [ORIENTATION.] (a) Each county agency must
provide an orientation to all caretakers within its jurisdiction
who are determined eligible for AFDC on or after July 1, 1989,
and who are required to attend an orientation. The county
agency shall require attendance at orientation of all caretakers
except those who are:
(1) physically disabled, mentally ill, or developmentally
disabled and whose condition has or is expected to continue for
at least 90 days and will prevent participation in educational
programs or employment and training services;
(2) aged 60 or older;
(3) currently employed in unsubsidized employment that is
expected to continue at least 30 days and that provides an
average of at least 30 hours of employment per week; or
(4) currently employed in subsidized employment that is
expected to continue at least 30 days and that provides an
average of at least 30 hours of employment per week and is
expected to result in full-time permanent employment.
(b) The orientation must consist of a presentation that
informs caretakers of:
(1) the identity, location, and phone numbers of employment
and training and support services available in the county;
(2) the types and locations of child care services
available through the county agency that are accessible to
enable a caretaker to participate in educational programs or
employment and training services;
(3) the availability of assistance for participants to help
select appropriate child care services and that, on request,
assistance will be provided to select appropriate child care
services;
(4) the obligations of the county agency and service
providers under contract to the county agency;
(5) the rights, responsibilities, and obligations of
participants;
(6) the grounds for exemption from mandatory employment and
training services or educational requirements;
(7) the consequences for failure to participate in
mandatory services or requirements;
(8) the method of entering educational programs or
employment and training services available through the county;
and
(9) the availability and the benefits of the early and
periodic, screening, diagnosis and treatment (EPSDT) program and
preschool screening under chapter 123.
(c) Orientation must encourage recipients to view AFDC as a
temporary program providing grants and services to individuals
who set goals and develop strategies for supporting their
families without AFDC assistance. The content of the
orientation must not imply that a recipient's eligibility for
AFDC is time limited. Orientation may be provided through
audio-visual methods, but the caretaker must be given an
opportunity for face-to-face interaction with staff of the
county agency or the entity providing the orientation, and an
opportunity to express the desire to participate in educational
programs and employment and training services offered through
the county agency.
(d) County agencies shall not require caretakers to attend
orientation for more than three hours during any period of 12
continuous months. The local agency shall also arrange for or
provide needed transportation and child care to enable
caretakers to attend.
Sec. 30. Minnesota Statutes 1988, section 256.736, is
amended by adding a subdivision to read:
Subd. 10b. [INFORMING.] Each county agency must provide
written information concerning the topics identified in
subdivision 10a, paragraph (b), to all AFDC caretakers within
the county agency's jurisdiction who are exempt from the
requirement to attend orientation, except those under age 16,
and to recipients who have good cause for failing to attend
orientation as specified in rules adopted by the commissioner.
The written materials must tell the individual how the
individual may indicate the desire to participate in educational
programs and employment and training services offered through
the county. The written materials must be mailed or hand
delivered to the recipient at the time the recipient is
determined to be exempt or have good cause for failing to attend
an orientation.
Sec. 31. Minnesota Statutes 1988, 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. Provide an
assessment as described in subdivision 10, paragraph (a), clause
(14). As part of the assessment, the case manager shall inform
caretakers of the screenings available through the early
periodic screening, diagnosis and treatment (EPSDT) program
under chapter 256B and pre-school screening under chapter 123,
and encourage caretakers to have their children screened. 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. Develop an employability
development plan as described in subdivision 10, paragraph (a),
clause (15). 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 should be to complete literacy training or a
general education equivalency 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). The case manager
shall refer caretakers to resource and referral services, if
available, and shall assist caretakers in securing appropriate
child care services. 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 equivalency
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 be based upon
the employability development plan described in subdivision 10,
paragraph (a), clause (15), and 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;
(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 their
need for training in parenting and independent living skills and
when appropriate shall refer 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. 32. Minnesota Statutes 1988, section 256.736,
subdivision 14, is amended to read:
Subd. 14. [EMPLOYMENT JOB SEARCH.] (a) The commissioner of
human services shall establish an employment a job search
program under United States Code, title 42, section
602(a)(35) Public Law 100-485. The principal wage earner in an
AFDC-UP assistance unit must participate be referred to and must
begin participation in the employment job search program within
four months of being determined eligible for AFDC-UP unless:
(1) the caretaker is already participating in another
approved employment and training service;
(2) the caretaker's employability plan specifies other
activities; or
(3) the caretaker is exempt from registration under
subdivision 3; or
(4) the caretaker is unable to secure employment due to
inability to communicate in the English language, is
participating in an English as a second language course, and is
making satisfactory progress towards completion of the course.
If an English as a second language course is not available to
the caretaker, the caretaker is exempt from participation until
a course becomes available.
The employment and training service provider shall refer
caretakers unable to communicate in the English language to
English as a second language courses.
(b) The employment job search program must provide the
following services:
(1) an initial period of up to four weeks of job search
activities for not more than 32 hours per week. The employment
and training service provider shall specify for each
participating caretaker the number of weeks and hours of job
search to be conducted and shall report to the county board if
the caretaker fails to cooperate with the employment search
requirement; and
(2) an additional period of job search following the first
period at the discretion of the employment and training service
provider. The total of these two periods of job search may not
exceed eight weeks for any 12 consecutive month period beginning
with the month of application.
(c) The employment search program may provide services to
non-AFDC-UP caretakers.
Sec. 33. Minnesota Statutes 1988, section 256.736,
subdivision 16, is amended to read:
Subd. 16. [ALLOCATION AND USE OF MONEY.] (a) State money
appropriated for employment and training services under this
section must be allocated to counties as follows:
(1) Forty percent of the state money must be allocated
based on the average monthly number of caretakers receiving AFDC
in the county who are under age 21 and the average monthly
number of AFDC cases open in the county for 24 or more
consecutive months and residing in the county for the 12-month
period ending March December 31 of the previous fiscal year.
(2) Twenty percent of the state money must be allocated
based on the average monthly number of nonpriority caretakers
receiving AFDC in the county for the period ending March
December 31 of the previous fiscal year. Funds may be used to
develop employability plans for nonpriority caretakers if
resources allow.
(3) Twenty-five percent of the state money must be
allocated based on the average monthly number of assistance
units in the county receiving AFDC-UP for the period ending
March December 31 of the previous fiscal year.
(4) Fifteen percent of the state money must be allocated at
the discretion of the commissioner based on participation levels
for priority group members in each county.
(b) No more than 15 percent of the money allocated under
paragraph (a) may be used for administrative activities.
(c) Except as provided in paragraph (d), at least 70
percent of the money allocated to counties must be used for case
management services and employment and training services for
caretakers in the priority groups. Up to 30 percent of the
money may be used for employment search activities and
employment and training services for nonpriority caretakers.
(d) A county whose proportion of the statewide average
monthly AFDC-UP caseload exceeds its proportion of the statewide
AFDC caseload having a high proportion of nonpriority caretakers
that interferes with the county's ability to meet the 70 percent
spending requirement of paragraph (c) may, with the approval of
the commissioner of human services, use up to 40 percent of the
money allocated under this section for employment search
activities orientation and employment and training services for
nonpriority caretakers.
(e) Money appropriated to cover the nonfederal share of
costs for bilingual case management services to refugees for the
employment and training programs under this section are
allocated to counties based on each county's proportion of the
total statewide number of AFDC refugee cases. However, counties
with less than one percent of the statewide number of AFDC
refugee cases do not receive an allocation.
(f) Counties and the department of jobs and training shall
bill the commissioner of human services for any expenditures
incurred by the county, the county's employment and training
service provider, or the department of jobs and training that
may be reimbursed by federal money. The commissioner of human
services shall bill the United States Department of Health and
Human Services and the United States Department of Agriculture
for the reimbursement and appropriate the reimbursed money to
the county or employment and training service provider that
submitted the original bill. The reimbursed money must be used
to expand employment and training services.
(g) The commissioner of human services shall review county
expenditures of case management and employment and training
block grant money at the end of the fourth quarter of the
biennium and each quarter after that, and may reallocate
unencumbered or unexpended money allocated under this section to
those counties that can demonstrate a need for additional
money. Reallocation of funds must be based on the formula set
forth in paragraph (a), excluding the counties that have not
demonstrated a need for additional funds.
Sec. 34. Minnesota Statutes 1988, section 256.736, is
amended by adding a subdivision to read:
Subd. 18. [PROGRAM OPERATION BY INDIAN TRIBES.] (a) The
commissioner may enter into agreements with any federally
recognized Indian tribe with a reservation in the state to
provide employment and training programs under this section to
members of the Indian tribe receiving AFDC. For purposes of
this section, "Indian tribe" means a tribe, band, nation, or
other organized group or community of Indians that is recognized
as eligible for the special programs and services provided by
the United States to Indians because of their status as Indians;
and for which a reservation exists as is consistent with Public
Law Number 100-485, as amended.
(b) Agreements entered into under this subdivision must
require the governing body of the Indian tribe to fulfill all
county responsibilities required under this section in operation
of the employment and training services covered by the contract,
excluding the county share of costs in subdivision 13 and any
county function related to AFDC eligibility determination or
grant payment. The commissioner may enter into an agreement
with a consortium of Indian tribes providing the governing body
of each Indian tribe in the consortium agrees to these
conditions.
(c) Agreements entered into under this subdivision must
require the Indian tribe to operate the employment and training
services within a geographic service area not to exceed the
counties within which a border of the reservation falls. Indian
tribes may also operate services in Hennepin and Ramsey counties
or other geographic areas as approved by the commissioner of
human services in consultation with the commissioner of jobs and
training.
(d) Agreements entered into under this section must require
the Indian tribe to operate a federal jobs program under Public
Law Number 100-485, section 482(i).
(e) Agreements entered into under this section must require
conformity with section 13.46 and any applicable federal
regulations in the use of data about AFDC recipients.
(f) Agreements entered into under this section must require
financial and program participant activity record keeping and
reporting in the manner and using the forms and procedures
specified by the commissioner and that federal reimbursement
received must be used to expand operation of the employment and
training services.
(g) Agreements entered into under this section must require
that the Indian tribe coordinate operation of the programs with
county employment and training programs, Indian Job Training
Partnership Act programs, and educational programs in the
counties in which the tribal unit's program operates.
(h) Agreements entered into under this section must require
the Indian tribe to allow inspection of program operations and
records by representatives of the department.
(i) Agreements entered into under this subdivision must
require the Indian tribe to contract with an employment and
training service provider certified by the commissioner of jobs
and training for operation of the programs, or become certified
itself.
(j) Agreements entered into under this subdivision must
require the Indian tribe to specify a starting date for each
program with a procedure to enable tribal members participating
in county-operated employment and training services to make the
transition to the program operated by the tribal unit. Programs
must begin on the first day of a month specified by the
agreement.
(k) If the commissioner and Indian tribe enter into an
agreement, the commissioner may immediately reallocate county
case management and employment and training block grant money
from the counties in the Indian tribe's service area to the
Indian tribe, prorating each county's annual allocations
according to that percentage of the number of tribal unit
members receiving AFDC residing in the county compared to the
total number of AFDC recipients residing in the county and also
prorating the annual allocation according to the month in which
the Indian tribe program starts. If the Indian tribe cancels
the agreement or fails, in the commissioner's judgment, to
fulfill any requirement of the agreement, the commissioner shall
reallocate money back to the counties in the Indian tribe's
service area.
(l) Indian tribe members receiving AFDC and residing in the
service area of an Indian tribe operating employment and
training services under an agreement with the commissioner must
be referred by county agencies in the service area to the Indian
tribe for employment and training services.
(m) The Indian tribe shall bill the commissioner of human
services for services performed under the contract. The
commissioner shall bill the United States Department of Health
and Human Services for reimbursement. Federal receipts are
appropriated to the commissioner to be provided to the Indian
tribe that submitted the original bill.
Sec. 35. Minnesota Statutes 1988, section 256.737, is
amended to read:
256.737 [COMMUNITY WORK EXPERIENCE PROGRAM.]
Subdivision 1. [PILOT PROGRAMS ESTABLISHMENT AND PURPOSE.]
In order that persons receiving aid under this chapter may be
assisted in achieving self-sufficiency by enhancing their
employability through meaningful work experience and training
and the development of job search skills, the commissioner of
human services may shall continue the pilot community work
experience demonstration programs that were approved by January
1, 1984. No new pilot community work experience demonstration
programs may be established under this subdivision The
commissioner may establish additional community work experience
programs in as many counties as necessary to comply with the
participation requirements of the family support act of 1988,
Public Law Number 100-485. Programs established on or after
July 1, 1989, must be operated on a volunteer basis.
Subd. 1a. [COMMISSIONER'S DUTIES.] The commissioner shall:
(a) assist counties in the design, and implementation, and
evaluation of these demonstration programs; (b) promulgate, in
accordance with chapter 14, emergency rules necessary for the
implementation of this section, except that the time
restrictions of section 14.35 shall not apply and the rules may
be in effect until the termination of the demonstration programs
June 30, 1990 unless superseded by permanent rules; and (c) seek
any federal waivers necessary for proper implementation of this
section in accordance with federal law. The commissioner shall;
and (d) prohibit the use of participants in the programs to do
work that was part or all of the duties or responsibilities of
an authorized public employee position established as of January
1, 1985 1989. The exclusive bargaining representative shall be
notified no less than 14 days in advance of any placement by the
community work experience program. Concurrence with respect to
job duties of persons placed under the community work experience
program shall be obtained from the appropriate exclusive
bargaining representative. The appropriate oversight committee
shall be given monthly lists of all job placements under a
community work experience program.
As the commissioner phases in case management and other
employment and training services under section 256.736, and no
later than June 30, 1989, the commissioner may phase out
projects under this section.
Subd. 2. [ADDITIONAL PROGRAMS PROGRAM REQUIREMENTS.] In
addition to the pilot programs established in subdivision 1, the
commissioner may approve the application of up to eight
additional counties to enter into a community work experience
program. The programs under this subdivision are governed by
subdivision 1 except as in paragraphs (a) and (b). (a) Programs
under this section are limited to projects that serve a useful
public service such as: health, social service, environmental
protection, education, urban and rural development and
redevelopment, welfare, recreation, public facilities, public
safety and child care. To the extent possible, the prior
training, skills, and experience of a recipient must be used in
making appropriate work experience assignments.
(a) (b) As a condition to placing a person receiving aid to
families with dependent children in a program under this
subdivision, the county agency shall first provide the recipient
the opportunity to participate in the following services:
(1) placement in suitable subsidized or unsubsidized
employment through participation in job search under section
256.736, subdivision 14; or
(2) basic educational or vocational or occupational
training for an identifiable job opportunity.
(b) (c) If the recipient refuses suitable employment and a
training program, the county agency may, subject to subdivision
1, require the recipient to participate in a community work
experience program as a condition of eligibility.
(d) The county agency shall limit the maximum number of
hours any participant under this section may be required to work
in any month to a number equal to the amount of the aid to
families with dependent children payable to the family divided
by the greater of the federal minimum wage or the applicable
state minimum wage.
(e) After a participant has been assigned to a position
under this section for nine months, the participant may not be
required to continue in that assignment unless the maximum
number of hours a participant is required to work is no greater
than the amount of the aid to families with dependent children
payable with respect to the family divided by the higher of (1)
the federal minimum wage or the applicable state minimum wage,
whichever is greater, or (2) the rate of pay for individuals
employed in the same or similar occupations by the same employer
at the same site.
(f) After each six months of a recipient's participation in
an assignment, and at the conclusion of each assignment under
this section. The county agency shall reassess and revise, as
appropriate, each participant's employability development plan.
(g) The county agency shall apply the grant reduction
sanctions specified in section 256.736, subdivision 4, clause
(6), when it is determined that a mandatory participant has
failed, without good cause, to participate in the program.
Sec. 36. [256.738] [ON-THE-JOB TRAINING.]
(a) County agencies may, in accordance with section
256.736, subdivision 10, develop on-the-job training programs
that permit voluntary participation by AFDC recipients. A
county agency that chooses to provide on-the-job training as one
of its optional employment and training services may make
payments to employers for on-the-job training costs that, during
the period of the training, must not exceed 50 percent of the
wages paid by the employer to the participant. The payments are
deemed to be in compensation for the extraordinary costs
associated with training participants under this section and in
compensation for the costs associated with the lower
productivity of the participants during training.
(b) County agencies shall limit the length of training
based on the complexity of the job and the recipient's previous
experience and training. Placement in an on-the-job training
position with an employer is for the purpose of training and
employment with the same employer, who has agreed to retain the
person upon satisfactory completion of training.
(c) Placement of any recipient in an on-the-job training
position must be compatible with the assessment and
employability development plan established for the recipient
under section 256.736, subdivision 10, paragraph (a), clauses
(14) and (15).
(d) Provision of an on-the-job training program under the
job training partnership act, in and of itself, does not qualify
as an on-the-job training program under section 256.736,
subdivision 10, paragraph (a), clause (13).
Sec. 37. Minnesota Statutes 1988, section 256.74,
subdivision 1, is amended to read:
Subdivision 1. [AMOUNT.] The amount of assistance which
shall be granted to or on behalf of any dependent child and
mother or other needy eligible relative caring for the dependent
child shall be determined by the county agency in accordance
with rules promulgated by the commissioner and shall be
sufficient, when added to all other income and support available
to the child, to provide the child with a reasonable subsistence
compatible with decency and health. The amount shall be based
on the method of budgeting required in Public Law Number 97-35,
section 2315, United States Code, title 42, section 602, as
amended and federal regulations at Code of Federal Regulations,
title 45, section 233. Nonrecurring lump sum income received by
an assistance unit must be budgeted in the normal retrospective
cycle. The number of months of ineligibility is determined by
dividing the amount of the lump sum income and all other income,
after application of the applicable disregards, by the standard
of need for the assistance unit. An amount remaining after this
calculation is income in the first month of eligibility. If the
total monthly income including the lump sum income is larger
than the standard of need for a single month the first month of
ineligibility is the payment month that corresponds with the
budget month in which the lump sum income was received. In
making its determination the county agency shall disregard the
following from family income:
(1) all of the earned income of each dependent child
receiving aid to families with dependent children who is a
full-time student or part-time student, and not a full-time
employee, attending a school, college, or university, or a
course of vocational or technical training designed to fit
students for gainful employment as well as all the earned income
derived from the job training and partnership act (JTPA) for a
dependent child for six calendar months per year, together with
unearned income derived from the job training and partnership
act;
(2) all educational grants and loans;
(3) the first $75 $90 of each individual's earned income.
For self-employed persons, the expenses directly related to
producing goods and services and without which the goods and
services could not be produced shall be disregarded pursuant to
rules promulgated by the commissioner;
(4) an amount equal to the actual expenditures but not to
exceed $160 for the care of each dependent child or
incapacitated individual living in the same home and receiving
aid. In the case of a person not engaged in full-time
employment or not employed throughout the month, the
commissioner shall prescribe by rule a lesser amount to be
disregarded;
(5) thirty dollars plus one-third of the remainder of each
individual's earned income not already disregarded for
individuals found otherwise eligible to receive aid or who have
received aid in one of the four months before the month of
application. With respect to any month, the county welfare
agency shall not disregard under this clause any earned income
of any person who has: (a) reduced earned income without good
cause within 30 days preceding any month in which an assistance
payment is made; or (b) refused without good cause to accept an
offer of suitable employment; or (c) left employment or reduced
earnings without good cause and applied for assistance so as to
be able later to return to employment with the advantage of the
income disregard; or (d) failed without good cause to make a
timely report of earned income in accordance with rules
promulgated by the commissioner of human services. Persons who
are already employed and who apply for assistance shall have
their needs computed with full account taken of their earned and
other income. If earned and other income of the family is less
than need, as determined on the basis of public assistance
standards, the county agency shall determine the amount of the
grant by applying the disregard of income provisions. The
county agency shall not disregard earned income for persons in a
family if the total monthly earned and other income exceeds
their needs, unless for any one of the four preceding months
their needs were met in whole or in part by a grant payment.
The disregard of $30 and one-third of the remainder of earned
income described in this clause (5) shall be applied to the
individual's income for a period not to exceed four consecutive
months. Any month in which the individual loses this disregard
because of the provisions of sub clauses (5) (a) to (5) (d)
shall be considered as one of the four months. An additional
$30 work incentive must be available for an eight-month period
beginning in the month following the last month of the combined
$30 and one-third work incentive. This period must be in effect
whether or not the person has earned income or is eligible for
AFDC. To again qualify for the earned income disregards
under this clause (d), the individual must not be a recipient of
aid for a period of 12 consecutive months. When an assistance
unit becomes ineligible for aid due to the fact that these
disregards are no longer applied to income, the assistance unit
shall be eligible for medical assistance benefits for a 12-month
period beginning with the first month of AFDC ineligibility;
(5) an amount equal to the actual expenditures for the care
of each dependent child or incapacitated individual living in
the same home and receiving aid, not to exceed: (a) $175 for
each individual age two and older, and $200 for each individual
under the age of two, when the family member whose needs are
included in the eligibility determination is employed for 30 or
more hours per week; or (b) $174 for each individual age two or
older, and $199 for each individual under the age of two, when
the family member whose needs are included in the eligibility
determination is not employed throughout the month or when
employment is less than 30 hours per week. The dependent care
disregard must be applied after all other disregards under this
subdivision have been applied;
(6) the first $50 per assistance unit of the monthly
support obligation collected by the support and recovery (IV-D)
unit; and. The first $50 of periodic support payments collected
by the public authority responsible for child support
enforcement from a person with a legal obligation to pay support
for a member of the assistance unit must be paid to the
assistance unit within 15 days after the end of the month in
which the collection of the periodic support payments occurred
and must be disregarded when determining the amount of
assistance;
(7) that portion of an insurance settlement earmarked and
used to pay medical expenses, funeral and burial costs, or to
repair or replace insured property; and
(8) all earned income tax credit payments received by the
family as a refund of federal income taxes or made as advance
payments by an employer.
The first $50 of periodic support payments collected by the
public authority responsible for child support enforcement from
a person with a legal obligation to pay support for a member of
the assistance unit shall be paid to the assistance unit within
15 days after the end of the month in which the collection of
such periodic support payments occurred and shall be disregarded
in determining the amount of assistance.
Sec. 38. Minnesota Statutes 1988, section 256.74,
subdivision 1a, is amended to read:
Subd. 1a. [STEPPARENT'S INCOME.] In determining income
available, the county agency shall take into account the
remaining income of the dependent child's stepparent who lives
in the same household after disregarding:
(1) the first $75 of the stepparent's gross earned income.
The commissioner shall prescribe by rule lesser amounts to be
disregarded for stepparents who are not engaged in full-time
employment or not employed throughout the month;
(2) an amount for support of the stepparent and any other
individuals whom the stepparent claims as dependents
for determining federal personal income tax purposes liability
and who live in the same household but whose needs are not
considered in determining eligibility for assistance under
sections 256.72 to 256.87. The amount equals the standard of
need for a family of the same composition as the stepparent and
these other individuals;
(3) amounts the stepparent actually paid to individuals not
living in the same household but whom the stepparent claims as
dependents for determining federal personal income tax purposes
liability; and
(4) alimony or child support, or both, paid by the
stepparent for individuals not living in the same household.
Sec. 39. Minnesota Statutes 1988, section 256.74, is
amended by adding a subdivision to read:
Subd. 1b. [REVIEW OF STANDARD OF NEED.] The commissioner
of human services shall develop a household budget sufficient to
maintain a family in Minnesota. The budget must be based on a
market survey of the cost of items needed by families raising
children to the extent these factors are consistent with the
requirements of federal regulations. The commissioner shall
develop recommendations for an AFDC standard of need and level
of payment that are based on the budget. The commissioner shall
submit to the legislature by January 1, 1990, a report
identifying the methods proposed for the conduct of the market
survey, the funds required for the survey, and a timetable for
completion of the survey, establishment of a family budget, and
recommendation of an AFDC standard of need.
Sec. 40. Minnesota Statutes 1988, section 256.85, is
amended to read:
256.85 [LIBERAL CONSTRUCTION.]
Sections 256.031 to 256.036 and 256.72 to 256.87 shall be
liberally construed with a view to accomplishing their purpose,
which is to enable the state and its several counties to
cooperate with responsible primary caretakers of children in
rearing future citizens, when the cooperation is necessary on
account of relatively permanent conditions, in order to keep the
family together in the same household, reasonably safeguard the
health of the children's primary caretaker and secure personal
care and training to the children during their tender years.
Sec. 41. [256.983] [FRAUD PREVENTION INVESTIGATIONS.]
(a) Within the limits of available appropriations, and to
the extent either required or authorized by applicable federal
regulations, the commissioner of human services shall select and
fund not less than four pilot projects for a two-year period to
test the effectiveness of fraud prevention investigations
conducted at the point of application for assistance. County
agencies must be selected to be involved in the pilot projects
based on their response to requests for proposals issued by the
commissioner. One of the county agencies selected must be
located in either Hennepin or Ramsey county, one must be from a
county in the seven-county metropolitan area other than Hennepin
and Ramsey counties, and two must be located outside the
metropolitan area.
(b) If proposals are not submitted, the commissioner may
select the county agencies to be involved. The county agencies
must be selected from the locations described in paragraph (a).
Sec. 42. Minnesota Statutes 1988, section 256D.01,
subdivision 1, is amended to read:
Subdivision 1. [POLICY.] The objectives of sections
256D.01 to 256D.21 are to provide a sound administrative
structure for public assistance programs; to maximize the use of
federal money for public assistance purposes; and to provide an
integrated public assistance program for all persons in the
state without adequate income or resources to maintain a
subsistence reasonably compatible with decency and health; and
to provide work readiness services to help employable and
potentially employable persons prepare for and attain
self-sufficiency and obtain permanent work.
It is declared to be the policy of this state that persons
unable to provide for themselves and not otherwise provided for
by law and who meet the eligibility requirements of sections
256D.01 to 256D.21 are entitled to receive grants of general
assistance necessary to maintain a subsistence reasonably
compatible with decency and health. Providing this assistance
is a matter of public concern and a necessity in promoting the
public health and welfare.
Sec. 43. Minnesota Statutes 1988, section 256D.01,
subdivision 1a, is amended to read:
Subd. 1a. [STANDARDS.] (1) (a) 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) (b) 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 must
also be increased by the same percentage.
(3) (c) For an assistance unit consisting of a single adult
who lives with a parent or parents, the general assistance
standard of assistance shall be equal to is 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 except
that the standard shall may 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 may not
be counted in the determination of eligibility or benefit level
for the assistance unit. Except as provided below, the
assistance unit is ineligible for general assistance if the
available resources or the countable income of the assistance
unit and the parent or parents with whom the assistance unit
lives are such that a family consisting of the assistance unit's
parent or parents, the parent or parents' other family members
and the 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 must be
used.
(4) (d) For an assistance unit consisting of a childless
couple, the standards of assistance shall be equal to are the
same as 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 is 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) (e) For an assistance unit consisting of all members of
a family, the standards of assistance shall be are the same as
the standards of assistance applicable that apply 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 are the same as the standards of assistance applicable that
apply to an assistance unit composed of the entire family, less
the standards of assistance applicable to for 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 However, 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 is the same as the special child standard of the aid to
families with dependent children program. A child shall may 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. The income
of a child who is excluded from the assistance unit shall may
not be counted in the determination of eligibility or benefit
level for the assistance unit.
Sec. 44. Minnesota Statutes 1988, section 256D.01,
subdivision 1b, is amended to read:
Subd. 1b. [RULES.] The commissioner may adopt emergency
rules and shall adopt permanent rules to set standards of
assistance and methods of calculating payment to conform with
subdivision 1a. The minimum standards of assistance shall
authorize the payment of rates negotiated by local county
agencies for recipients living in a room and board
arrangement according to sections 256I.01 to 256I.07. Except
for payments made to a secure crisis shelter under section
256D.05, subdivision 3, monthly general assistance payments for
rates negotiated by a local agency on behalf of recipients
living in a room and board, boarding care, supervised living, or
adult foster care arrangement must not exceed the limits
established under the Minnesota supplemental aid program. In
order to maximize the use of federal funds, the commissioner
shall adopt rules, to the extent permitted by federal law for
eligibility for the emergency assistance program under aid to
families with dependent children, and under the terms of
sections 256D.01 to 256D.21 for general assistance, to require
use of the emergency program under aid to families with
dependent children as the primary financial resource when
available. The commissioner shall provide by rule for
eligibility for general assistance of persons with seasonal
income, and may attribute seasonal income to other periods not
in excess of one year from receipt by an applicant or recipient.
When a recipient is a resident of a regional treatment center,
or a residence with a negotiated rate, the recipient is not
eligible for a full general assistance standard. The state
standard of assistance for those recipients is the personal
needs allowance authorized for medical assistance recipients
under section 256B.35.
Sec. 45. Minnesota Statutes 1988, section 256D.01,
subdivision 1c, is amended to read:
Subd. 1c. [GENERAL ASSISTANCE PAYMENTS TO FACILITIES.] (a)
The commissioner shall make authorize the payment of rates
negotiated by local agencies for recipients living in a room and
board arrangement. Except for payments made to a secure crisis
shelter under section 256D.05, subdivision 3, monthly general
assistance payments for rates negotiated by a local agency on
behalf of recipients living in a room and board, boarding care,
supervised living, or adult foster care arrangement may not
exceed the limits established under the Minnesota supplemental
aid program. No payments under subdivision 1b this paragraph
may be made to facilities a facility licensed after August 1,
1987, which have that has more than four residents with a
diagnosis of mental illness except for facilities unless the
facility is specifically licensed to serve persons with mental
illness. The commissioner of health shall monitor
newly-licensed facilities and shall report to the commissioner
of human services facilities that are not in compliance with
this section.
(b) In order to maximize the use of federal funds, the
commissioner shall adopt rules, to the extent permitted by
federal law, for eligibility for the emergency assistance
program under aid to families with dependent children, and under
the terms of sections 256D.01 to 256D.21 for general assistance,
to require use of the emergency program under aid to families
with dependent children as the primary financial resource when
available.
(c) The commissioner shall adopt rules for eligibility for
general assistance of persons with seasonal income, and may
attribute seasonal income to other periods not in excess of one
year from receipt by an applicant or recipient.
(d) General assistance payments may not be made for foster
care, child welfare services, or other social services.
(e) Vendor payments and vouchers may be issued only as
authorized in sections 256D.05, subdivision 6, and 256D.09.
Sec. 46. Minnesota Statutes 1988, section 256D.02,
subdivision 1, is amended to read:
Subdivision 1. [SCOPE.] For purposes of sections 256D.01
to 256D.21, the terms defined in this section shall have the
meanings given them unless otherwise provided or indicated by
the context.
Sec. 47. Minnesota Statutes 1988, section 256D.02,
subdivision 4, is amended to read:
Subd. 4. [GENERAL ASSISTANCE.] "General assistance" means
cash payments to persons unable to provide themselves with a
reasonable subsistence compatible with decency and health and
who are not otherwise provided for under the laws of this state
or the United States. General assistance shall not include
payments for foster care, child welfare services, or other
social services. Vendor payments and vouchers may be issued
only as provided for in section 256D.09.
Sec. 48. Minnesota Statutes 1988, section 256D.02, is
amended by adding a subdivision to read:
Subd. 12a. [RESIDENT.] For purposes of eligibility for
general assistance under section 256D.05, and work readiness
payments under section 256D.051, a "resident" is a person living
in the state with the intention of making his or her home here
and not for any temporary purpose. All applicants for these
programs are required to demonstrate the requisite intent and
can do so in any of the following ways:
(1) by showing that the applicant maintains a residence at
a verified address, other than a place of public accommodation.
An applicant may verify a residence address by presenting a
valid state driver's license, a state identification card, a
voter registration card, a rent receipt, a statement by the
landlord, apartment manager, or homeowner verifying that the
individual is residing at the address, or other form of
verification approved by the commissioner;
(2) by providing written documentation that the applicant
came to the state in response to an offer of employment;
(3) by providing verification that the applicant has been a
long-time resident of the state or was formerly a resident of
the state for at least 365 days and is returning to the state
from a temporary absence, as those terms are defined in rules to
be adopted by the commissioner; or
(4) by providing other persuasive evidence to show that the
applicant is a resident of the state, according to rules adopted
by the commissioner.
Sec. 49. Minnesota Statutes 1988, section 256D.03,
subdivision 2, is amended to read:
Subd. 2. For the period from January 1 to June 30, state
aid shall be paid to local agencies for 75 percent of all
general assistance and work readiness grants up to the standards
of sections 256D.01, subdivision 1a, and 256D.051, and according
to procedures established by the commissioner, except as
provided for under section 256.017. Subsequent to July 1 of
each year, the state agency shall reimburse the county agency
for the funds expended during the January 1 to June 30 period,
except as provided for in section 256.017.
For the period from July 1 to December 31, state aid shall
be paid to local agencies for 100 percent of all general
assistance and work readiness grants up to the standards of
sections 256D.01, subdivision 1a, and 256D.051, and according to
procedures established by the commissioner, except as provided
for under section 256.017 and except that, after December 31,
1988, state aid is reduced to 65 percent of all general
assistance grants work readiness assistance if the local agency
does not make occupational or vocational literacy training
available and accessible to recipients who are eligible for
assistance under section 256D.05, subdivision 1, paragraph (a),
clause (15) 256D.051.
After December 31, 1988, state aid must be paid to local
agencies for 65 percent of work readiness assistance paid under
section 256D.051 if the county does not have an approved and
operating community investment program.
Any local agency may, from its own resources, make payments
of general assistance and work readiness assistance: (a) at a
standard higher than that established by the commissioner
without reference to the standards of section 256D.01,
subdivision 1; or, (b) to persons not meeting the eligibility
standards set forth in section 256D.05, subdivision 1, or
256D.051 but for whom the aid would further the purposes
established in the general assistance or work readiness program
in accordance with rules promulgated adopted by the commissioner
pursuant to the administrative procedure act.
Sec. 50. Minnesota Statutes 1988, section 256D.05,
subdivision 1, is amended to read:
Subdivision 1. [ELIGIBILITY.] (a) Each person or family
whose income and resources are less than the standard of
assistance established by the commissioner and who is a resident
of the state shall be eligible for and entitled to general
assistance if the person or family is:
(1) a person who is suffering from a medically certified
permanent or temporary illness, injury, or incapacity which
is medically certified expected to continue for more than 30
days and which prevents the person from obtaining or retaining
employment;
(2) a person whose presence in the home on a substantially
continuous basis is required because of the medically certified
illness, injury, incapacity, or the age of another member of the
household;
(3) a person who has been placed in, and is residing in, a
licensed or certified facility for purposes of physical or
mental health or rehabilitation, or in an approved chemical
dependency domiciliary facility, if the placement is based on
illness or incapacity and is pursuant to a plan developed or
approved by the local agency through its director or designated
representative;
(4) a person who resides in a shelter facility described in
subdivision 3;
(5) a person who is or may be eligible for displaced
homemaker services, programs, or assistance under section
268.96, but only if that person is enrolled as a full-time
student;
(6) a person who is unable to secure suitable employment
due to inability to communicate in the English language,
provided that the person is not an illegal alien, and who, if
assigned to a language skills program by the local agency, is
participating in that program;
(7) a person not described in clause (1) or (3) who is
diagnosed by a licensed physician or, licensed consulting
psychologist, or other qualified professional, as mentally
retarded or mentally ill, and that condition prevents the person
from obtaining or retaining employment;
(8) (6) a person who has an application pending for the
social security disability program or the program of
supplemental security income for the aged, blind, and
disabled, provided that within 60 days of the initial denial of
the application by the social security administration, the
person produces medical evidence in support of the person's
application; or a person who has been terminated from either
program and has an appeal from that termination pending;. A
person whose benefits are terminated for failure to produce any
medical evidence within 60 days of the denial of the
application, is eligible as soon as medical evidence in support
of the application for the social security disability program or
the program of supplemental security income for the aged, blind,
and disabled is produced. Except for a person whose application
is based in whole or in part on mental illness or chemical
dependency, a person whose application for either program is
denied and who does not pursue an appeal is eligible under this
paragraph based on a new application only if the new application
concerns a different disability or alleges new or aggravated
symptoms of the original disability;
(9) (7) a person who is unable to obtain or retain
employment because advanced age significantly affects the
person's ability to seek or engage in substantial work;
(10) a person completing a secondary education program;
(11) a family with one or more minor children; provided
that, if all the children are six years of age or older, all the
adult members of the family register for and cooperate in the
work readiness program under section 256D.051; and provided
further that, if one or more of the children are under the age
of six and if the family contains more than one adult member,
all the adult members except one adult member register for and
cooperate in the work readiness program under section 256D.051.
The adult members required to register for and cooperate with
the work readiness program are not eligible for financial
assistance under section 256D.051, except as provided in section
256D.051, subdivision 6, and shall be included in the general
assistance grant. If an adult member fails to cooperate with
requirements of section 256D.051, the local agency shall not
take that member's needs into account in making the grant
determination. The time limits of section 256D.051,
subdivisions 4 and 5, do not apply to people eligible under this
clause;
(12) a person who has substantial barriers to employment,
including but not limited to factors relating to work or
training history, as determined by the local agency in
accordance with permanent or emergency rules adopted by the
commissioner after consultation with the commissioner of jobs
and training;
(13) a person who is certified by the commissioner of jobs
and training before August 1, 1985, as lacking work skills or
training or as being unable to obtain work skills or training
necessary to secure employment, as defined in a permanent or
emergency rule adopted by the commissioner of jobs and training
in consultation with the commissioner;
(8) a person who has been assessed by a qualified
professional or a vocational specialist as not being likely to
obtain permanent employment. The assessment must consider the
recipient's age, physical and mental health, education,
trainability, prior work experience, and the local labor market;
(14) (9) a person who is determined by the local agency, in
accordance with emergency and permanent rules adopted by the
commissioner, to be learning disabled;
(15) a person who is determined by the local agency, in
accordance with emergency and permanent rules adopted by the
commissioner, to be functionally illiterate, provided that the
person complies with literacy training requirements set by the
local agency under section 256D.052. A person who is terminated
for failure to comply with literacy training requirements may
not reapply for assistance under this clause for 60 days. The
local agency must provide an oral explanation to the person of
the person's responsibilities under this clause, the penalties
for failure to comply, the agency's duties under section
256D.0505, subdivision 2, and the person's right to appeal (1)
at the time an application is approved based on this clause, and
(2) at the time the person is referred to literacy training; or
(16) (10) a child under the age of 18 who is not living
with a parent, stepparent, or legal custodian, but only if: the
child is legally emancipated or living with an adult with the
consent of an agency acting as a legal custodian; the child is
at least 16 years of age and the general assistance grant is
approved by the director of the local agency or a designated
representative as a component of a social services case plan for
the child; or the child is living with an adult with the consent
of the child's legal custodian and the local agency.;
(b) The following persons or families with income and
resources that are less than the standard of assistance
established by the commissioner are eligible for and entitled to
a maximum of six months of general assistance during any
consecutive 12-month period, after registering with and
completing six months in a work readiness program under section
256D.051:
(1) a person who has borderline mental retardation; and
(2) a person who exhibits perceptible symptoms of mental
illness as certified by a qualified professional but who is not
eligible for general assistance under paragraph (a), because the
mental illness interferes with the medical certification
process; provided that the person cooperates with social
services, treatment, or other plans developed by the local
agency to address the illness.
In order to retain eligibility under this paragraph, a
recipient must continue to cooperate with work and training
requirements as determined by the local agency.
(11) a woman in the last trimester of pregnancy who does
not qualify for aid to families with dependent children. A
woman who is in the last trimester of pregnancy who is currently
receiving aid to families with dependent children may be granted
emergency general assistance to meet emergency needs;
(12) a person whose need for general assistance will not
exceed 30 days;
(13) a person who lives more than two hours round-trip
traveling time from any potential suitable employment; and
(14) a person who is involved with protective or
court-ordered services that prevent the applicant or recipient
from working at least four hours per day.
(b) Persons or families who are not state residents but who
are otherwise eligible for general assistance may receive
emergency general assistance to meet emergency needs.
Sec. 51. Minnesota Statutes 1988, section 256D.05, is
amended by adding a subdivision to read:
Subd. 6. [ASSISTANCE FOR PERSONS WITHOUT A VERIFIED
RESIDENCE.] (a) For applicants or recipients of general
assistance, emergency general assistance, or work readiness
assistance who do not have a verified residence address, the
local agency may provide assistance using one or more of the
following methods:
(1) the local agency may provide assistance in the form of
vouchers or vendor payments and provide separate vouchers or
vendor payments for food, shelter, and other needs;
(2) the local agency may divide the monthly assistance
standard into weekly payments, whether in cash or by voucher or
vendor payment; or, if actual need is greater than the standards
of assistance established under section 256D.01, subdivision 1a,
issue assistance based on actual need. Nothing in this clause
prevents the local agency from issuing voucher or vendor
payments for emergency general assistance in an amount less than
the standards of assistance; and
(3) the local agency may determine eligibility and provide
assistance on a weekly basis. Weekly assistance can be issued
in cash or by voucher or vendor payment and can be determined
either on the basis of actual need or by prorating the monthly
assistance standard.
(b) An individual may verify a residence address by
providing a driver's license; a state identification card; a
statement by the landlord, apartment manager, or homeowner
verifying that the individual is residing at the address; or
other written documentation approved by the commissioner.
(c) If the local agency elects to provide assistance on a
weekly basis, the agency may not provide assistance for a period
during which no need is claimed by the individual. The
individual must be notified, each time weekly assistance is
provided, that subsequent weekly assistance will not be issued
unless the individual claims need. The advance notice required
under section 256D.10 does not apply to weekly assistance issued
under this paragraph.
(d) The local agency may not issue assistance on a weekly
basis to an applicant or recipient who has medically certified
mental illness or mental retardation or a related condition, or
to an assistance unit that includes minor children, unless
requested by the assistance unit.
Sec. 52. Minnesota Statutes 1988, section 256D.051,
subdivision 1, is amended to read:
Subdivision 1. [WORK REGISTRATION.] (a) A person, family,
or married couple who are residents of the state and whose
income and resources are less than the standard of assistance
established by the commissioner, but who are not eligible to
receive general assistance under section 256D.05, subdivision 1,
are eligible for a the work readiness program. Upon
registration, a registrant is eligible to receive assistance in
an amount equal to general assistance under section 256D.05,
subdivision 1, for a maximum of six months during any
consecutive 12-month period, subject to subdivision 3. The
local agency shall pay work readiness assistance in monthly
payments beginning at the time of registration.
(b) Persons, families, and married couples who are not
state residents but who are otherwise eligible for work
readiness assistance may receive emergency assistance to meet
emergency needs.
Sec. 53. Minnesota Statutes 1988, section 256D.051, is
amended by adding a subdivision to read:
Subd. 1a. [WORK READINESS PAYMENTS.] Grants of work
readiness shall be determined using the standards of assistance,
exclusions, disregards, and procedures which are used in the
general assistance program. Work readiness shall be granted in
an amount that, when added to the nonexempt income actually
available to the assistance unit, the total amount equals the
applicable standard of assistance.
Work readiness payments must be provided to persons
determined eligible for the work readiness program as provided
in this subdivision except when the special payment provisions
in subdivision 1b are utilized. The initial payment must be
prorated to provide assistance for the period beginning with the
date the completed application is received by the county agency
or the date the assistance unit meets all work readiness
eligibility factors, whichever is later, and ending on the final
day of that month. The amount of the first payment must be
determined by dividing the number of days to be covered under
the payment by the number of days in the month, to determine the
percentage of days in the month that are covered by the payment,
and multiplying the monthly payment amount by this percentage.
Subsequent payments must be paid monthly on the first day of
each month.
There shall be an initial certification period which shall
begin on the date the completed application is received by the
county agency or the date that the assistance unit meets all
work readiness eligibility factors, whichever is later, and
ending on the date that mandatory registrants in the assistance
unit must attend a work readiness orientation. This initial
certification period may not cover a period in excess of 30
calendar days. All mandatory registrants in the assistance unit
must be informed of the period of certification, the requirement
to attend orientation, and that work readiness eligibility will
end at the end of the certification period unless the
registrants attend orientation. A registrant who fails to
comply with requirements during the certification period,
including attendance at orientation, will lose work readiness
eligibility without notice under section 256D.101, subdivision
1, paragraph (b).
Sec. 54. Minnesota Statutes 1988, section 256D.051, is
amended by adding a subdivision to read:
Subd. 1b. [SPECIAL PAYMENT PROVISIONS.] A county agency
may, at its option, provide work readiness payments as provided
under section 256D.05, subdivision 6, during the initial
certification period. The initial certification period shall
cover the time from the date the completed application is
received by the county agency or the date that the assistance
unit meets all work readiness eligibility factors, whichever is
later, and ending on the date that mandatory registrants in the
assistance unit must attend a work readiness orientation. This
initial certification period may not cover a period in excess of
30 calendar days. All mandatory registrants in the assistance
unit must be informed of the period of certification, the
requirement to attend orientation, and that work readiness
eligibility will end at the end of the certification period
unless the registrants attend orientation. A registrant who
fails to comply with requirements during the certification
period, including attendance at orientation, will lose work
readiness eligibility without notice under section 256D.101,
subdivision 1, paragraph (b). If all mandatory registrants
attend orientation, an additional grant of work readiness
assistance must be issued to cover the period beginning the day
after the scheduled orientation and ending on the final day of
that month. Subsequent payments of work readiness shall be
governed by subdivision 1a or section 256D.05, subdivision 6.
If one or more mandatory registrants from the assistance unit
fail to attend the orientation, those who failed to attend
orientation will be removed from the assistance unit without
further notice and shall be ineligible for additional
assistance. Subsequent assistance to such persons shall be
dependent upon the person completing application for assistance
and being determined eligible.
A local agency that utilizes the provisions in this
subdivision must implement the provisions consistently for all
applicants or recipients in the county. A local agency must pay
emergency general assistance to a registrant whose prorated work
readiness payment does not meet emergency needs. A local agency
which elects to pay work readiness assistance on a prorated
basis under this subdivision may not provide payments under
section 256D.05, subdivision 6, for the same time period.
Sec. 55. Minnesota Statutes 1988, section 256D.051,
subdivision 2, is amended to read:
Subd. 2. [LOCAL AGENCY DUTIES.] (a) The local agency shall
provide to registrants under subdivision 1 a work readiness
program. The work readiness program must include:
(1) orientation to the work readiness program;
(2) an individualized employability assessment and
development plan in which the local agency that includes
assessment of literacy, ability to communicate in the English
language, eligibility for displaced homemaker services under
section 268.96, educational history, and that estimates the
length of time it will take the registrant to obtain
employment. The employability assessment and development plan
must assess the registrant's assets, barriers, and strengths,
and must identify steps necessary to overcome barriers to
employment;
(3) referral to available accredited remedial or skills
training programs designed to address registrant's barriers to
employment;
(2) (4) referral to available employment assistance
programs including the Minnesota employment and economic
development program;
(3) (5) a job search program, including job seeking skills
training; and
(4) (6) other activities, including public employment
experience programs to the extent of available resources
designed by the local agency to prepare the registrant for
permanent employment.
In order to allow time for job search, the local agency
shall may not require an individual to participate in the work
readiness program for more than 32 hours a week. The local
agency shall require an individual to spend at least eight hours
a week in job search or other work readiness program activities.
(b) The local agency may provide a work readiness program
to recipients under section 256D.05, subdivision 1, paragraph
(b) and shall provide a work readiness program to recipients
referred under section 256D.052, subdivision 5, paragraph
(b). The local agency shall prepare an annual plan for the
operation of its work readiness program. The plan must be
submitted to and approved by the commissioner of jobs and
training. The plan must include:
(1) a description of the services to be offered by the
local agency;
(2) a plan to coordinate the activities of all public
entities providing employment-related services in order to avoid
duplication of effort and to provide services more efficiently;
(3) a description of the factors that will be taken into
account when determining a client's employability development
plan; and
(4) provisions to assure that applicants and recipients are
evaluated for eligibility for general assistance prior to
termination from the work readiness program.
Sec. 56. Minnesota Statutes 1988, section 256D.051,
subdivision 3, is amended to read:
Subd. 3. [REGISTRANT DUTIES.] In order to receive work
readiness assistance, a registrant shall: (1) cooperate with
the local agency in all aspects of the work readiness
program and shall; (2) accept any suitable employment, including
employment offered through the job training partnership act,
Minnesota employment and economic development act, and other
employment and training options; and (3) participate in work
readiness activities assigned by the local agency. The local
agency may terminate assistance to a registrant who fails to
cooperate in the work readiness program, as provided in
subdivision 3b. A registrant who is terminated for failure to
cooperate is not eligible, for a period of two months, for any
remaining or additional work readiness assistance for which the
registrant would otherwise be eligible.
Sec. 57. Minnesota Statutes 1988, section 256D.051, is
amended by adding a subdivision to read:
Subd. 3a. [PERSONS REQUIRED TO REGISTER FOR AND
PARTICIPATE IN THE WORK READINESS PROGRAM.] Each person in a
work readiness assistance unit who is 18 years old or older must
register for and participate in the work readiness program. A
child in the assistance unit who is at least 16 years old but
less than 19 years old and who is not a full-time secondary
school student is required to register and participate. A
student who was enrolled as a full-time student during the last
school term must be considered a full-time student during
summers and school holidays. If an assistance unit includes
children under age six and suitable child care is not available
at no cost to the family, one adult member of the assistance
unit is exempt from registration for and participation in the
work readiness program. The local agency shall designate the
adult who must register. The registrant must be the adult who
is the principal wage earner, having earned the greater of the
incomes, except for income received in-kind, during the 24
months immediately preceding the month of application for
assistance. When there are no earnings or when earnings are
identical for each parent, the applicant must designate the
principal wage earner, and that designation must not be
transferred after program eligibility is determined as long as
assistance continues without interruption.
Sec. 58. Minnesota Statutes 1988, section 256D.051, is
amended by adding a subdivision to read:
Subd. 3b. [WORK READINESS PARTICIPATION REQUIREMENTS.] A
work readiness registrant meets the work readiness participation
requirements if the registrant:
(1) completes the specific tasks or assigned duties that
were identified by the county agency in the notice required
under section 256D.101, subdivision 1, paragraph (a); and
(2) meets the requirements in subdivisions 3 and 8.
Sec. 59. Minnesota Statutes 1988, section 256D.051, is
amended by adding a subdivision to read:
Subd. 3c. [WORK READINESS DISQUALIFICATION PERIOD.]
Mandatory registrants who fail without good cause to meet the
work readiness participation requirements will be terminated and
disqualified from work readiness. If after the initial
certification period the county agency determines that a
registrant has failed without good cause to meet the work
readiness participation requirements, the agency will notify the
registrant of its determination according to section 256D.101,
subdivision 1, paragraph (b). For the first time in a six-month
period after the initial certification period that the
registrant has failed without good cause to comply with program
requirements, the notification shall inform the registrant of
the particular actions that must be taken by the registrant by a
date certain to achieve compliance. Failure to take the
required action by the specified date will result in termination
and disqualification from work readiness. Failure to comply a
second or subsequent time during a six-month period shall result
in termination and disqualification without opportunity for
corrective action. The first time in a six-month period that a
registrant is terminated from work readiness for failure to
comply with participation requirements, that person is
disqualified from receiving work readiness for one month. If
less than six months have passed since the end of a
disqualification period and the registrant is terminated from
work readiness for failure to comply with participation
requirements, the person is disqualified from receiving work
readiness for two months. If an assistance unit includes more
than one mandatory work readiness participant and it is
determined that one or more, but not all, of the mandatory
participants have failed to comply with work readiness
requirements, those who failed to comply shall be removed from
the assistance unit for the appropriate time period, subject to
the notice and appeal rights in section 256D.101. If an
assistance unit includes persons who are exempt from
participation in work readiness activities and all of the
mandatory registrants have been terminated for failure to
participate, the county agency shall remove the terminated
registrants from the assistance unit after notice and an
opportunity to be heard, and provide assistance to the remaining
persons using vendor or protective payments.
Sec. 60. Minnesota Statutes 1988, section 256D.051,
subdivision 6, is amended to read:
Subd. 6. [LOCAL AGENCY OPTIONS SERVICE COSTS.] The local
agency may, at its option, provide up to $200 The commissioner
shall reimburse 92 percent of local agency expenditures for
providing work readiness services including direct participation
expenses and administrative costs. Reimbursement must not
exceed an average of $260 each year for each registrant who has
completed an employment development plan for direct expenses
incurred by the registrant for transportation, clothes, and
tools necessary for employment. After paying direct expenses as
needed by individual registrants, the local agency may use any
remaining money to provide additional services as needed by any
registrant including employability assessments and employability
development plans, education, orientation, employment search
assistance, placement, other work experience, on-the-job
training, and other appropriate activities and the
administrative costs incurred providing these services.
Sec. 61. Minnesota Statutes 1988, section 256D.051, is
amended by adding a subdivision to read:
Subd. 6b. [FEDERAL REIMBURSEMENT.] Federal financial
participation from the United States Department of Agriculture
for work readiness expenditures that are eligible for
reimbursement through the food stamp employment and training
program are dedicated funds and are annually appropriated to the
commissioner of human services for the operation of the work
readiness program. Federal financial participation for the
nonstate portion of work readiness costs must be paid to the
county agency that incurred the costs.
Sec. 62. Minnesota Statutes 1988, section 256D.051,
subdivision 8, is amended to read:
Subd. 8. [VOLUNTARY QUIT.] A person is not eligible for
work readiness payments or services if, without good cause, the
person refuses a legitimate offer of suitable employment within
60 days before the date of application. A person who, without
good cause, voluntarily quits suitable employment or refuses a
legitimate offer of suitable employment while receiving work
readiness payments or services shall be terminated from the work
readiness program and disqualified for two months according to
rules adopted by the commissioner.
Sec. 63. Minnesota Statutes 1988, section 256D.051,
subdivision 13, is amended to read:
Subd. 13. [RIGHT TO NOTICE AND HEARING.] (a) The local
agency shall provide notice and opportunity for hearings for
adverse actions as required under this section according to
sections 256D.10 and section 256D.101, for adverse actions based
on a determination that a recipient has failed to participate in
work readiness activities, or 256D.10 for all other adverse
actions. A determination made under subdivision 1, that a
person is not eligible for general assistance is a denial of
general assistance for purposes of notice, appeal, and hearing
requirements. The local agency must notify the person that this
determination will result in a limit on the number of months of
assistance for which the person will be eligible requirement
that the person participate in the work readiness program as a
condition of receiving assistance.
Sec. 64. Minnesota Statutes 1988, section 256D.051, is
amended by adding a subdivision to read:
Subd. 15. [GENERAL ASSISTANCE REQUIREMENTS APPLY.] The
laws and rules that apply to general assistance also apply to
the work readiness program, unless superseded by a specific
inconsistent provision in this section or section 256D.101.
Sec. 65. Minnesota Statutes 1988, section 256D.051, is
amended by adding a subdivision to read:
Subd. 16. [START WORK GRANTS.] Within the limit of
available appropriations, the local agency may make grants
necessary to enable work readiness recipients to accept bona
fide offers of employment. The grants may be made for costs
directly related to starting employment, including
transportation costs, clothing, tools and equipment, license or
other fees, and relocation. Start work grants are available
once in any 12-month period to a recipient. The commissioner
shall allocate money appropriated for start work grants to
counties based on each county's work readiness caseload in the
12 months ending in March for each following state fiscal year
and may reallocate any unspent amounts.
Sec. 66. Minnesota Statutes 1988, section 256D.052,
subdivision 1, is amended to read:
Subdivision 1. [OCCUPATIONAL AND VOCATIONAL PROGRAMS.] The
local agency must work with local educational institutions and
job training programs in the identification, development, and
utilization of occupational and vocational literacy programs for
general assistance recipients work readiness registrants who are
functionally illiterate. Occupational and vocational literacy
programs are programs which provide literacy training to adults
who lack formal education or job skills. The programs emphasize
particular language and reading skills needed for successful job
performance.
Sec. 67. Minnesota Statutes 1988, section 256D.052,
subdivision 2, is amended to read:
Subd. 2. [ASSESSMENT AND ASSIGNMENT.] The local agency
must:
(1) assess existing reading level, learning disabilities,
reading potential, and vocational or occupational interests of
people eligible under section 256D.05, subdivision 1, paragraph
(a), clause (15) work readiness registrants who are functionally
illiterate;
(2) assign suitable recipients to openings in occupational
and vocational literacy programs;
(3) if no openings are available in accessible occupational
or vocational literacy programs, assign suitable recipients to
openings in other accessible literacy training programs; and
(4) reassign to another accessible literacy program any
recipient who does not complete an assigned program and who
wishes to try another program.; and
(5) within the limits of funds available contract with
technical institutes or other groups who have literacy
instructors trained in occupational literacy methods, to provide
literacy training sessions so that county registrants eligible
for literacy training will have the opportunity to attend
training.
Sec. 68. Minnesota Statutes 1988, section 256D.052,
subdivision 3, is amended to read:
Subd. 3. [SERVICES PROVIDED.] The local agency must
provide child care and transportation to enable people to
participate in literacy training under this section. The state
shall reimburse local agencies for the costs of providing
transportation under this section. Counties must make every
effort to ensure that child care is available as needed by
recipients who are pursuing literacy training.
Sec. 69. Minnesota Statutes 1988, section 256D.052,
subdivision 4, is amended to read:
Subd. 4. [PAYMENT OF GENERAL ASSISTANCE WORK READINESS.]
The local agency must provide assistance under section 256D.05,
subdivision 1, paragraph (a), clause (15) 256D.051 to people
persons who:
(1) participate in a literacy program assigned under
subdivision 2. To "participate" means to attend regular
classes, complete assignments, and make progress toward literacy
goals; or
(2) despite participation for a period of six months or
more, fail to progress in assigned literacy programs;
(3) are not assigned to literacy training because there is
no program available or accessible to them; or
(4) have failed for good cause to complete an assigned
literacy program.
Work readiness payments may be terminated for persons who
fail to attend the orientation and participate in the assessment
and development of the employment development plan.
Sec. 70. Minnesota Statutes 1988, section 256D.101, is
amended to read:
256D.101 [FAILURE TO COMPLY WITH WORK REQUIREMENTS;
NOTICE.]
Subdivision 1. [DISQUALIFICATION NOTICE REQUIREMENTS.] (a)
At the time a registrant is registered for the work readiness
program, and at least every 30 days after that, the local agency
shall provide, in advance, a clear, written description of the
specific tasks and assigned duties the registrant must complete
to receive work readiness pay. The notice must explain that the
registrant will be terminated from the work readiness program
unless the registrant has completed the specific tasks and
assigned duties. The notice must inform the registrant that if
the registrant fails without good cause to comply with work
readiness requirements more than once every six months, the
registrant will be terminated from the work readiness program
and disqualified from receiving assistance for one month if it
is the registrant's first disqualification within the preceding
six months, or for two months if the registrant has been
previously disqualified within the preceding six months.
(b) If after the initial certification period the local
agency determines that a registrant has failed to comply
with the work readiness requirements of section 256D.051, the
local agency shall notify the registrant of the
determination. Notice must be hand delivered or mailed to the
registrant within three days after the agency makes the
determination but no later than the date work readiness pay was
scheduled to be paid. For a recipient who has failed to provide
the local agency with a mailing address, the recipient must be
assigned a schedule by which a recipient is to visit the agency
to pick up any notices. For a recipient without a mailing
address, notices must be deemed delivered on the date of the
registrant's next scheduled visit with the local agency. The
notification shall be in writing and shall state the facts that
support the local agency's determination. For the first two
times time in a six-month period that the registrant has failed
without good cause to comply with program requirements, the
notification shall inform the registrant that the registrant may
lose eligibility for work readiness pay and must specify the
particular actions that must be taken by the registrant to
achieve compliance; shall and reinstate work readiness
payments. The notice must state that the recipient must take
the specified actions by a date certain, which must be at
least ten five working days following the date the notification
is mailed or delivered to the registrant; shall must explain the
ramifications of the registrant's failure to take the required
actions by the specified date; and shall must advise the
registrant that the registrant may request and have a conference
with the local agency to discuss the notification. A registrant
who fails without good cause to comply with requirements of the
program more than two times once in a six-month period must be
notified of termination.
Subd. 2. [NOTICE OF GRANT REDUCTION, SUSPENSION, OR
TERMINATION.] The notice of grant reduction, suspension, or
termination on the ground that a registrant has failed to comply
with section 256D.051 work readiness requirements shall be
mailed or hand delivered by the local agency concurrently with
the notification required by subdivision 1, paragraph (b).
Prior to giving the notification, the local agency must assess
the registrant's eligibility for general assistance under
section 256D.05 to the extent possible using information
contained in the case file, and determine that the registrant is
not eligible under that section. The determination that the
registrant is not eligible shall must be stated in the notice of
grant reduction, suspension, or termination. The notice of
termination shall indicate the applicable disqualification
period.
Subd. 3. [BENEFITS AFTER NOTIFICATION.] Assistance
payments otherwise due to the registrant under section 256D.051
shall may not be paid after the notification required in
subdivision 1 has been provided to the registrant unless, before
the date stated in the notification, the registrant takes the
specified action necessary to achieve compliance or, within five
days after the effective date stated in the notice, files an
appeal of the grant reduction, suspension, or termination. If,
by the required date, the registrant does take the specified
action necessary to achieve compliance, both the notification
required by subdivision 1 and the notice required by subdivision
2 shall be canceled and all benefits due to the registrant shall
be paid promptly. If, by the required date, the registrant
files an appeal of the grant reduction, suspension, or
termination, benefits otherwise due to the registrant shall be
continued pending the outcome of the appeal. An appeal of a
proposed termination shall be brought under section 256.045,
except that the timelines specified in this section shall apply,
notwithstanding the requirements of section 256.045, subdivision
3. Appeals of proposed terminations from the work readiness
program shall be heard within 30 days of the date that the
appeal was filed.
Sec. 71. Minnesota Statutes 1988, section 256D.111,
subdivision 5, is amended to read:
Subd. 5. [RULEMAKING.] The commissioner shall adopt rules
and is authorized to adopt emergency rules:
(a) providing for the disqualification from the receipt of
general assistance or work readiness assistance for a recipient
who has been finally determined to have failed to comply with
work requirements or the requirements of the work readiness
program;
(b) providing for the use of vouchers or vendor payments
with respect to the family of a recipient described in clause
(a) or section 256D.09, subdivision 4 disqualified recipient;
and
(c) providing that at the time of the approval of an
application for assistance, the local agency gives to the
recipient a written notice in plain and easily understood
language describing the recipient's job registration, search,
and acceptance obligations, and the disqualification that will
be imposed for a failure to comply with those obligations.
Sec. 72. [256D.33] [CITATION.]
Sections 256D.33 to 256D.54 may be cited as the Minnesota
supplemental aid act.
Sec. 73. [256D.34] [POLICY.]
The purpose of sections 256D.33 to 256D.54 is to (1)
provide a sound administrative structure for public assistance
programs; (2) maximize the use of federal funds for public
assistance purposes; and (3) provide an integrated public
assistance program for all Minnesota residents who are
recipients of supplemental security income or who, except for
excess income, would be receiving supplemental security income
and who are found to have maintenance needs as determined by
application of state standards of assistance according to
section 256D.44.
Sec. 74. Minnesota Statutes 1988, section 256D.35,
subdivision 1, is amended to read:
Subdivision 1. [SCOPE.] For the purposes of Laws 1974,
chapter 487, The terms defined in this section shall have the
meanings given them. The definitions in this section apply to
sections 256D.33 to 256D.54.
Sec. 75. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 2a. [AGED.] "Aged" means having reached age 65 or
reaching the age of 65 during the month of application.
Sec. 76. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 3a. [ASSISTANCE UNIT.] "Assistance unit" means the
individual applicant or recipient.
Sec. 77. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 4a. [BLIND.] "Blind" means the condition of a person
whose central visual acuity does not exceed 20/200 in the better
eye with correcting lenses, or, if visual acuity is greater than
20/200, the condition is accompanied by limitation in the fields
of vision such that the widest diameter of the visual field
subtends an angle no greater than 20 degrees. A person who
receives supplemental security income based on other visual
disabilities may also be eligible for the Minnesota supplemental
aid program.
Sec. 78. Minnesota Statutes 1988, section 256D.35,
subdivision 7, is amended to read:
Subd. 7. "Local County agency" means the county welfare
boards in the several counties of the state except that it may
also include any multicounty welfare boards or departments where
those have been established in accordance with law.
Sec. 79. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 8a. [DISABILITY.] "Disability" means disability as
determined under the criteria used by the Title II program of
the Social Security Act.
Sec. 80. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 8b. [EMERGENCY.] "Emergency" means circumstances
that demand immediate action to safeguard against threats to
health or safety of an individual.
Sec. 81. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 8c. [FINANCIALLY RESPONSIBLE RELATIVE.] "Financially
responsible relative" means a spouse or a parent of a minor
child.
Sec. 82. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 8d. [GOOD CAUSE.] "Good cause" means a reason for
taking an action or failing to take an action that is reasonable
and justified when viewed in the context of surrounding
circumstances.
Sec. 83. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 10. [GROSS INCOME.] "Gross income" means the total
amount of earned and unearned money received in a month before
any deductions or disregards are applied.
Sec. 84. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 11. [IN-KIND INCOME.] "In-kind income" means income,
benefits, or payments that are provided in a form other than
money or liquid asset. In-kind income includes goods, produce,
services, privileges, or payments on behalf of a person by a
third party.
Sec. 85. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 12. [LUMP SUM.] "Lump sum" means money received on
an irregular or unexpected basis.
Sec. 86. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 13. [MAINTENANCE BENEFIT.] "Maintenance benefit"
means cash payments, other than Minnesota supplemental aid,
provided under law or rule. Maintenance benefit includes
workers' compensation, unemployment compensation, railroad
retirement, veterans benefits, supplemental security income,
social security disability insurance, or other benefits
identified by the county agency that provide periodic benefits
that can be used to meet the basic needs of the assistance unit.
Sec. 87. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 14. [NEGOTIATED RATE.] "Negotiated rate" means a
monthly rate for payment for room and board for an individual
living in a group living arrangement according to sections
256I.01 to 256I.07. This rate may be fully or partially paid
from the Minnesota supplemental aid program depending on the net
income of the assistance unit.
Sec. 88. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 15. [NET INCOME.] "Net income" means monthly income
remaining after allowable deductions and disregards are
subtracted from gross income.
Sec. 89. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 16. [OVERPAYMENT.] "Overpayment" means an amount of
Minnesota supplemental aid paid to a recipient that exceeds the
amount to which the recipient is entitled for that month.
Sec. 90. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 17. [POTENTIAL ELIGIBILITY.] "Potential eligibility"
means a determination by a county agency that an assistance unit
or a financially responsible relative appears to meet the
eligibility requirements of another maintenance benefit program.
Sec. 91. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 18. [RETIREMENT, SURVIVORS, AND DISABILITY
INSURANCE.] "Retirement, survivors, and disability insurance"
means benefits paid under the federal program for retired,
disabled, and surviving spouses of retired or disabled
individuals under Title II of the Social Security Act.
Sec. 92. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 19. [SHELTER COSTS.] "Shelter costs" means monthly
costs for rent, mortgage payments, contract for deed payments,
property taxes, and insurance on real or personal property, and
utilities, for the home in which the recipient lives and for
which the recipient is legally responsible.
Sec. 93. Minnesota Statutes 1988, section 256D.35, is
amended by adding a subdivision to read:
Subd. 20. [SUPPLEMENTAL SECURITY INCOME.] "Supplemental
security income" means benefits paid under the federal program
of supplemental security income for the aged, blind, and
disabled under Title XVI of the Social Security Act.
Sec. 94. Minnesota Statutes 1988, section 256D.36,
subdivision 1, is amended to read:
Subdivision 1. [STATE PARTICIPATION.] Commencing January
1, 1974, the commissioner shall certify to each local agency the
names of all county residents who were eligible for and did
receive aid during December, 1973, pursuant to a categorical aid
program of old age assistance, aid to the blind, or aid to the
disabled. Each year for the period from January 1 to June 30,
the state shall pay 85 percent and the county shall pay 15
percent of the supplemental aid calculated for each county
resident certified under this section who is an applicant for or
recipient of supplemental security income, except as provided
for in section 256.017. Subsequent to July 1 After June 30 of
each year, the state agency shall reimburse the county agency
for the funds expended during the January 1 to June 30 period,
except as provided for in section 256.017. For the period from
July 1 to December 31, the state agency shall pay 100 percent of
the supplemental aid calculated for each county resident
certified under this section who is an applicant for or
recipient of supplemental security income, except as provided
for in section 256.017. The amount of supplemental aid for each
individual eligible under this section shall be
calculated pursuant according to the formula prescribed in title
II, section 212 (a) (3) of Public Law Number 93-66, as amended.
Sec. 95. Minnesota Statutes 1988, section 256D.36, is
amended by adding a subdivision to read:
Subd. 1a. A negotiated rate payment made according to
sections 256I.01 to 256I.07, for a person who is eligible for
Minnesota supplemental aid, under sections 256D.33 to 256D.54,
is a Minnesota supplemental aid payment for purposes of meeting
the total expenditures test under the supplemental security
income program state supplement program.
Sec. 96. Minnesota Statutes 1988, 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 nursing home, regional
treatment center, or a dwelling residence 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
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. 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. 97. [256D.385] [RESIDENCE.]
To be eligible for Minnesota supplemental aid, a person
must be a resident of Minnesota and (1) a citizen of the United
States, (2) an alien lawfully admitted to the United States for
permanent residence, or (3) otherwise permanently residing in
the United States under color of law as defined by the
supplemental security income program.
Sec. 98. [256D.395] [APPLICATION PROCEDURES.]
Subdivision 1. [INFORMATION.] The county agency shall
provide information about the program and application procedures
to a person who inquires about Minnesota supplemental aid.
Subd. 2. [FILING OF APPLICATION.] The county agency must
immediately provide an application form to any person requesting
Minnesota supplemental aid. Application for Minnesota
supplemental aid must be in writing on a form prescribed by the
commissioner. The county agency must determine an applicant's
eligibility for Minnesota supplemental aid as soon as the
required verifications are received by the county agency and
within 30 days after a signed application is received by the
county agency for the aged or blind or within 60 days for the
disabled. The amount of the first grant of Minnesota
supplemental aid awarded to an applicant must be computed to
cover the time period starting with the first day of the month
in which the county agency received the signed and dated
application or the first day of the month in which all
eligibility factors were met, whichever is later.
Sec. 99. [256D.405] [VERIFICATION AND REPORTING
REQUIREMENTS.]
Subdivision 1. [VERIFICATION.] The county agency shall
request, and applicants and recipients shall provide and verify,
all information necessary to determine initial and continuing
eligibility and assistance payment amounts. If necessary, the
county agency shall assist the applicant or recipient in
obtaining verifications. If the applicant or recipient refuses
or fails without good cause to provide the information or
verification, the county agency shall deny or terminate
assistance.
Subd. 2. [REDETERMINATION OF ELIGIBILITY.] The eligibility
of each recipient must be redetermined at least once every 12
months.
Subd. 3. [REPORTS.] Recipients must report changes in
circumstances that affect eligibility or assistance payment
amounts within ten days of the change. Recipients with earned
income, and recipients who have income allocated to them from a
financially responsible relative with whom the recipient
resides, must complete a monthly household report form. If the
report form is not received before the end of the month in which
it is due, the county agency must terminate assistance. The
termination shall be effective on the first day of the month
following the month in which the report was due. If a complete
report is received within the month the assistance was
terminated, the assistance unit is considered to have continued
its application for assistance, effective the first day of the
month the assistance was terminated.
Sec. 100. [256D.415] [RESIDENCE; COUNTY OF FINANCIAL
RESPONSIBILITY.]
The county of financial responsibility is the county
specified in section 256G.02, subdivision 4.
Sec. 101. [256D.425] [ELIGIBILITY CRITERIA.]
Subdivision 1. [PERSONS ENTITLED TO RECEIVE AID.] A person
who is aged, blind, or 18 years of age or older and disabled,
whose income is less than the standards of assistance in section
256D.44 and whose resources are less than the limits in
subdivision 2 is eligible for and entitled to Minnesota
supplemental aid. A person found eligible by the Social
Security Administration for supplemental security income under
Title XVI on the basis of age, blindness, or disability meets
these requirements. A person who would be eligible for the
supplemental security income program except for income that
exceeds the limit of that program but that is within the limits
of the Minnesota supplemental aid program, must have blindness
or disability determined by the state medical review team.
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.
Subd. 3. [TRANSFERS.] The transfer policies and procedures
of the Minnesota supplemental aid program are those used by the
medical assistance program under section 256B.17.
Sec. 102. [256D.435] [INCOME.]
Subdivision 1. [EXCLUSIONS.] The following is excluded
from income in determining eligibility for Minnesota
supplemental aid:
(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;
(16) any other type of funds excluded as income by state
law;
(17) student financial aid, as allowed for the supplemental
security income program; and
(18) other income excluded by the supplemental security
income program.
Subd. 2. [SELF-SUPPORT PLANS.] The county agency shall,
for up to 36 months, disregard amounts of an individual's income
and resources that are needed to fulfill a plan of self-support
approved by the county agency, but only for the period during
substantially all of which the individual is actually undergoing
vocational rehabilitation. If an individual has a plan for
self-support approved by the Social Security Administration, the
county agency shall disregard income and resources in the amount
and for the time approved in that plan.
Subd. 3. [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 AFDC and other federally funded benefits. If
the persons are determined potentially eligible for AFDC by the
county agency, the applicant or recipient may not allocate
earned or unearned income to those persons while an AFDC
application is pending, or after the persons are determined
eligible for AFDC. If the persons are determined potentially
eligible for other federal benefits, the applicant or recipient
may only allocate income to those persons until they are
determined eligible for those other benefits unless the amount
of those benefits is less than the amount in subdivision 4.
Subd. 4. [ALLOCATION OF INCOME.] The rate of allocation to
relatives for whom the applicant or recipient is financially
responsible is one-half the individual supplemental security
income standard of assistance, except as restricted in
subdivision 3.
If the applicant or recipient shares a residence with
another person who has financial responsibility for the
applicant or recipient, the income of that person is considered
available to the applicant or recipient after allowing: (1) the
deductions in subdivisions 7 and 8; and (2) a deduction for the
needs of the financially responsible relative and others in the
household for whom that relative is financially responsible.
The rate allowed to meet the needs of each of these people is
one-half the individual supplemental security income standard.
Subd. 5. [GENERAL INCOME DISREGARD.] The local agency
shall disregard the first $20 of the assistance unit's unearned
or earned income from the assistance unit's gross earned income.
Subd. 6. [EARNED INCOME DISREGARDS.] From the assistance
unit's gross earned income, the local agency shall disregard $65
plus one-half of the remaining income.
Subd. 7. [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.
Subd. 8. [SELF-EMPLOYMENT EARNINGS.] A local agency must
determine gross earned income from self-employment by
subtracting business costs from gross receipts.
Subd. 9. [RENTAL PROPERTY.] Income from rental property is
considered self-employment income for each month that the owner
of the property who is the assistance unit or a responsible
relative of the assistance unit does an average of at least ten
hours a week of labor. When no labor is expended, income from
rental property is considered unearned income and an additional
deduction is allowed for actual, reasonable, and necessary labor
costs for upkeep and repair.
Subd. 10. [LUMP SUMS.] Lump sum payments are considered
income in the month received.
Sec. 103. [256D.44] [STANDARDS OF ASSISTANCE.]
Subdivision 1. [USE OF STANDARDS; INCREASES.] The state
standards of assistance for shelter, basic needs, and special
need items that establish the total amount of maintenance need
for an applicant for or recipient of Minnesota supplemental aid,
are used to determine the assistance unit's eligibility for
Minnesota supplemental aid. The state standards of assistance
for basic needs must increase by an amount equal to the dollar
value, rounded up to the nearest dollar, of any cost of living
increases in the supplemental security income program.
Subd. 2. [STANDARD OF ASSISTANCE FOR SHELTER.] The state
standard of assistance for shelter provides for the recipient's
shelter costs. The monthly state standard of assistance for
shelter must be determined according to paragraphs (a) to (c).
(a) If the recipient does not reside with another person,
the state standard of assistance is the actual cost for shelter
items or $124, whichever is less.
(b) If the recipient resides with another person, the state
standard of assistance is the actual costs for shelter items or
$93, whichever is less.
(c) Actual shelter costs for applicants or recipients are
determined by dividing the total monthly shelter costs by the
number of persons who share the residence.
Subd. 3. [STANDARD OF ASSISTANCE FOR BASIC NEEDS.] The
state standard of assistance for basic needs provides for the
applicant's or recipient's maintenance needs, other than actual
shelter costs. Except as provided in subdivision 4, the monthly
state standard of assistance for basic needs is as follows:
(a) For an applicant or recipient who does not reside with
another person, the state standard of assistance is $305.
(b) For an individual who resides with another person or
persons, the state standard of assistance is $242.
Subd. 4. [TEMPORARY ABSENCE DUE TO ILLNESS.] For the
purposes of this subdivision, "home" means a residence owned or
rented by a recipient or the recipient's spouse. Home does not
include a negotiated rate facility. Assistance payments for
recipients who are temporarily absent from their home due to
hospitalization for illness must continue at the same level of
payment during their absence if the following criteria are met:
(1) a physician certifies that the absence is not expected
to continue for more than three months;
(2) a physician certifies that the recipient will be able
to return to independent living; and
(3) the recipient has expenses associated with maintaining
a residence in the community.
Subd. 5. [SPECIAL NEEDS.] Notwithstanding subdivisions 1
to 4, payments are allowed for the following special needs of
recipients of Minnesota supplemental aid:
(a) The local agency shall pay a monthly allowance for
medically prescribed diets payable under the AFDC program if the
cost of those additional dietary needs cannot be met through
some other maintenance benefit.
(b) Payment for nonrecurring special needs must be allowed
for necessary home repairs or necessary repairs or replacement
of household furniture and appliances using the payment standard
of the AFDC program for these expenses, as long as other funding
sources are not available.
(c) A fee for guardian or conservator service is allowed at
a reasonable rate negotiated by the county or approved by the
court. This rate shall not exceed five percent of the
assistance unit's gross monthly income up to a maximum of $100
per month. If the guardian or conservator is a member of the
county agency staff, no fee is allowed.
(d) The county agency shall continue to pay a monthly
allowance of $68 for restaurant meals for a person who was
receiving a restaurant meal allowance on June 1, 1990, and who
eats two or more meals in a restaurant daily. The allowance
must continue until the person has not received Minnesota
supplemental aid for one full calendar month or until the
person's living arrangement changes and the person no longer
meets the criteria for the restaurant meal allowance, whichever
occurs first.
Subd. 6. [COUNTY AGENCY STANDARDS OF ASSISTANCE.] The
county agency may establish standards of assistance for shelter,
basic needs, special needs, clothing and personal needs, and
negotiated rates that exceed the corresponding state standards
of assistance. State aid is not available for costs above state
standards.
Sec. 104. [256D.45] [PAYMENT PERIOD.]
Subdivision 1. [PROSPECTIVE BUDGETING.] A calendar month
is the payment period for Minnesota supplemental aid. The
monthly payment to a recipient must be determined prospectively.
Subd. 2. [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 an
individual.
Subd. 3. [AMOUNT OF ASSISTANCE.] The amount of assistance
is the difference between the recipient's net income and the
applicable standards of assistance in section 256D.44,
subdivisions 2 to 4, for persons living independently.
Sec. 105. [256D.46] [EMERGENCY MINNESOTA SUPPLEMENTAL
AID.]
Subdivision 1. [ELIGIBILITY.] Emergency Minnesota
supplemental aid must be granted if the recipient is without
adequate resources to resolve an emergency that, if unresolved,
will threaten the health or safety of the recipient.
Subd. 2. [INCOME AND RESOURCE TEST.] All income and
resources available to the recipient during the month in which
the need for emergency Minnesota supplemental aid arises must be
considered in determining the recipient's ability to meet the
emergency need. Property that can be liquidated in time to
resolve the emergency and income that is normally disregarded or
excluded under the Minnesota supplemental aid program must be
considered available to meet the emergency need.
Subd. 3. [PAYMENT AMOUNT.] The amount of assistance
granted under emergency Minnesota supplemental aid is limited to
the amount necessary to resolve the emergency.
Sec. 106. [256D.47] [PAYMENT METHODS.]
Minnesota supplemental aid payments must be issued to the
recipient, a protective payee, or a conservator or guardian of
the recipient's estate in the form of county warrants
immediately redeemable in cash, electronic benefits transfer, or
by direct deposit into the recipient's account in a financial
institution. Minnesota supplemental aid payments must be issued
regularly on the first day of the month. The supplemental aid
warrants must be mailed only to the address at which the
recipient resides, unless another address has been approved in
advance by the local agency. Vendor payments must not be issued
by the local agency except for nonrecurring emergency need
payments; at the request of the recipient; for special needs,
other than special diets; or when the agency determines the need
for protective payments exist.
Sec. 107. [256D.48] [PROTECTIVE PAYMENTS.]
Subdivision 1. [NEED FOR PROTECTIVE PAYEE.] The county
agency shall determine whether a recipient needs a protective
payee when a physical or mental condition renders the recipient
unable to manage funds and when payments to the recipient would
be contrary to the recipient's welfare. Protective payments
must be issued when there is evidence of: (1) repeated
inability to plan the use of income to meet necessary
expenditures; (2) repeated observation that the recipient is not
properly fed or clothed; (3) repeated failure to meet
obligations for rent, utilities, food, and other essentials; (4)
evictions or a repeated incurrence of debts; or (5) lost or
stolen checks. The determination of representative payment by
the Social Security Administration for the recipient is
sufficient reason for protective payment of Minnesota
supplemental aid payments.
Subd. 2. [ESTABLISHING PROTECTIVE PAYMENT.] When the
county agency determines that a recipient needs a protective
payee, the county agency shall appoint a payee according to the
procedures in paragraphs (a) and (b).
(a) The county agency shall consider the recipient's
preference of protective payee. The protective payee must have
an interest in or concern for the welfare of the recipient. The
protective payee must be capable of and willing to provide the
required assistance. A vendor of goods or services, including
the recipient's landlord, shall not serve as protective payee.
(b) The county agency shall reconsider the need for a
protective payee at least annually. The criteria used to
determine a person's continuing need for a protective payee are
the criteria used in the supplemental security income program to
determine if a person is incapable of managing or directing the
management of the person's money. If the need for protective
payment is likely to continue beyond two years, the county
agency shall seek judicial appointment of a guardian or other
legal representative.
Subd. 3. [PROTECTIVE PAYEE FOR PAYMENTS MADE BY THE SOCIAL
SECURITY ADMINISTRATION.] If the assistance unit receives
benefits from the social security administration, the county
agency shall also petition the social security administration to
establish a representative payee for those benefits.
Sec. 108. [256D.49] [PAYMENT CORRECTION.]
Subdivision 1. [WHEN.] When the county agency finds that
the recipient has received less than or more than the correct
payment of Minnesota supplemental aid benefits, the county
agency shall issue a corrective payment or initiate recovery
under subdivision 3, as appropriate.
Subd. 2. [UNDERPAYMENT OF MONTHLY GRANTS.] When the county
agency determines that an underpayment of the recipient's
monthly payment has occurred, it shall, during that same month,
issue a corrective payment. Corrective payments must be
excluded when determining the applicant's or recipient's income
and resources for the month of payment.
Subd. 3. [OVERPAYMENT OF MONTHLY GRANTS.] When the county
agency determines that an overpayment of the recipient's monthly
payment of Minnesota supplemental aid has occurred, it shall
issue a notice of overpayment to the recipient. If the person
is no longer receiving Minnesota supplemental aid, the county
agency may request voluntary repayment or pursue civil
recovery. If the person is receiving Minnesota supplemental
aid, the county agency shall recover the overpayment by
withholding an amount equal to three percent of the standard of
assistance for the recipient or the total amount of the monthly
grant, whichever is less. Residents of nursing homes, regional
treatment centers, and facilities with negotiated rates shall
not have overpayments recovered from their personal needs
allowance.
Sec. 109. [256D.50] [NOTICE.]
Subdivision 1. [TEN-DAY NOTICE.] The county agency shall
give recipients ten days' advance notice when the agency intends
to terminate, suspend, or reduce a grant. The ten-day notice
must be in writing on a form prescribed by the commissioner.
The notice must be mailed or given to the recipient not later
than ten days before the effective date of the action. The
notice must clearly state the action the county agency intends
to take, the reasons for the action, the right to appeal the
action, and the conditions under which assistance can be
continued while an appeal is pending.
Subd. 2. [FIVE-DAY NOTICE.] Five days' advance notice is
sufficient when the county agency has verified and documented
that the case facts require termination, suspension, or
reduction of the grant for probable fraud by a recipient. If
the last day of the five-day period falls on a weekend or
holiday, the effective date of the action is the next working
day.
Subd. 3. [ADEQUATE NOTICE.] Notice must be given no later
than the effective date of the action when: (1) the county
agency has factual information confirming the death of a person
included in the grant; (2) the county agency receives a clear
written statement, signed by a recipient, that the recipient no
longer wishes assistance; (3) the county agency receives a clear
statement, signed by a recipient, reporting information that the
recipient acknowledges will require termination of or a
reduction in the grant; (4) a recipient has been placed in a
skilled nursing home, intermediate care, or a long-term
hospitalization facility; (5) a recipient has been admitted to
or committed to an institution; or (6) a recipient's whereabouts
are unknown and the county agency mail to the recipient has been
returned by the post office showing no forwarding address.
Sec. 110. [256D.51] [APPEALS.]
Subdivision 1. [RIGHT TO APPEAL.] Applicants and
recipients may appeal under section 256.045 if they are
aggrieved by an action or by inaction of the county agency.
Subd. 2. [CONTINUATION OF PAYMENT PENDING APPEAL
DECISION.] When assistance is reduced, suspended, or terminated,
the client has the right to choose to have the grant continued
while an appeal is pending if the appellant files the appeal
within ten days after the date the notice is mailed or before
the effective date of the proposed action, whichever is later.
Sec. 111. [256D.52] [FRAUD.]
A person who obtains or tries to obtain, or aids or abets
any person in obtaining assistance to which the person is not
entitled by a willfully false statement or representation, or by
the intentional withholding or concealment of a material fact,
or by impersonation, or other fraudulent device, violates
section 256.98 and is subject to both the criminal and civil
penalties in that section.
Sec. 112. [256D.53] [DUTIES OF THE COMMISSIONER.]
In addition to other duties imposed by law, the
commissioner shall:
(1) supervise the administration of Minnesota supplemental
aid by county agencies as provided in sections 256D.33 to
256D.54;
(2) adopt permanent rules consistent with law for carrying
out and enforcing the provisions of sections 256D.33 to 256D.54,
so that Minnesota supplemental aid may be administered as
uniformly as possible throughout the state;
(3) immediately upon adoption, give rules to all county
agencies and other interested persons;
(4) establish necessary administrative and fiscal
procedures; and
(5) allocate money appropriated for Minnesota supplemental
aid to county agencies.
Sec. 113. [256D.54] [APPLICATION FOR OTHER BENEFITS.]
Subdivision 1. [POTENTIAL ELIGIBILITY.] An applicant or
recipient who is otherwise eligible for supplemental aid and who
is potentially eligible for maintenance benefits from any other
source shall (1) apply for those benefits within 30 days of the
county's determination of potential eligibility for those
benefits; and (2) execute an interim assistance authorization
agreement on a form as directed by the commissioner.
Subd. 2. [RECOVERY OF SUPPLEMENTAL AID UNDER AN INTERIM
ASSISTANCE AGREEMENT.] If a recipient is eligible for benefits
from other sources, and receives a payment from another source
for a period during which supplemental aid was also issued, the
recipient shall reimburse the county agency for the interim
assistance paid. Reimbursement shall not exceed the amount of
supplemental aid paid during the time period to which the other
maintenance benefits apply. Reimbursement shall not exceed the
state standard that applies to that time period. Reimbursement
may be sought directly from the other source of maintenance
income but remains the primary obligation of the recipient when
an interim assistance agreement has been executed.
Subd. 3. [INTERIM ASSISTANCE ADVOCACY INCENTIVE
PROGRAM.] From the amount recovered under an interim assistance
agreement, county agencies may retain 25 percent plus actual
reasonable fees, costs, and disbursements of appeals,
litigation, and advocacy assistance given to the recipient for
the recipient's claim for supplemental security income. The
money kept under this section is from the state share of the
recovery. The county agency may contract with qualified persons
to provide the special assistance. The methods by which a
county agency identifies, refers, and assists recipients who may
be eligible for benefits under federal programs for the aged,
blind, or disabled are those methods used by the general
assistance interim assistance advocacy incentive program.
Sec. 114. Minnesota Statutes 1988, section 256G.03,
subdivision 1, is amended to read:
Subdivision 1. [STATE RESIDENCE.] For purposes of this
chapter, "state residence" is coincidental with residence in a
Minnesota county. The establishment of county residence serves
as proof of residence in Minnesota a resident of any Minnesota
county is considered a state resident. For purposes of
eligibility for general assistance or work readiness, residency
must be substantiated according to section 256D.02, subdivision
12a.
Sec. 115. [256I.01] [CITATION.]
Sections 256I.01 to 256I.06 shall be cited as the
"negotiated rate act."
Sec. 116. [256I.02] [PURPOSE.]
The negotiated rate act establishes a comprehensive system
of rates and payments for persons who reside in a negotiated
rate residence and who meet the eligibility criteria of the
general assistance program under sections 256D.01 to 256D.21, or
the Minnesota supplemental aid program under sections 256D.33 to
256D.54.
Sec. 117. [256I.03] [DEFINITIONS.]
Subdivision 1. [SCOPE.] For the purposes of sections
256I.01 to 256I.06, the terms defined in this section have the
meanings given them.
Subd. 2. [NEGOTIATED RATE.] "Negotiated rate" means a
monthly rate set for shelter, fuel, food, utilities, household
supplies, and other costs necessary to provide room and board
for individuals eligible for general assistance under sections
256D.01 to 256D.21 or supplemental aid under sections 256D.33 to
256D.54. Negotiated rate does not include payments for foster
care for children who are not blind, child welfare services,
medical care, dental care, hospitalization, nursing care, drugs
or medical supplies, program costs, or other social services.
However, the negotiated rate for recipients living in residences
in section 256I.05, subdivision 2, paragraph (c), clause (2),
includes all items covered by that residence's medical
assistance per diem rate. The rate is negotiated by the county
agency or the state according to the provisions of sections
256I.01 to 256I.06.
Subd. 3. [NEGOTIATED RATE RESIDENCE.] "Negotiated rate
residence" means a group living situation that provides at a
minimum room and board to unrelated persons who meet the
eligibility requirements of section 256I.04. To receive payment
for a negotiated rate, the residence must comply with applicable
laws and rules establishing standards for health, safety, and
licensure. Secure crisis shelters for battered women and their
children are not negotiated rate residences.
Subd. 4. [REPRESENTATIVE PAYEE.] "Representative payee"
means a person selected to receive and manage general assistance
or Minnesota supplemental aid benefits provided by the county
agency on behalf of a general assistance or Minnesota
supplemental aid recipient.
Sec. 118. [256I.04] [ELIGIBILITY FOR NEGOTIATED RATE
PAYMENT.]
Subdivision 1. [ELIGIBILITY REQUIREMENTS.] To be eligible
for a negotiated rate payment, the individual must be eligible
for general assistance under sections 256D.01 to 256D.21, or
supplemental aid under sections 256D.33 to 256D.54. If the
individual is in the negotiated rate residence due to illness or
incapacity, the individual must be in the residence under a plan
developed or approved by the county agency. Residence in other
negotiated rate residences must be approved by the county agency.
Subd. 2. [DATE OF ELIGIBILITY.] For a person living in a
negotiated rate residence who is eligible for general assistance
under sections 256D.01 to 256D.21, payment shall be made from
the date a signed application form is received by the county
agency or the date the applicant meets all eligibility factors,
whichever is later. For a person living in a negotiated rate
residence who is eligible for supplemental aid under sections
256D.33 to 256D.54, payment shall be made from the first of the
month in which an approved application is received by a county
agency.
Sec. 119. [256I.05] [PAYMENT RATES.]
Subdivision 1. [MONTHLY RATES.] Monthly payments for rates
negotiated by a county agency on behalf of a recipient living in
a negotiated rate residence may be paid at the rates in effect
on March 1, 1985, not to exceed $919.80 in 1989. These rates
must be increased annually according to subdivision 7.
Subd. 2. [MONTHLY RATES; EXEMPTIONS.] (a) The maximum
negotiated rate does not apply to a residence 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. For residences in this clause that have less than
five percent of their licensed boarding care capacity reimbursed
by the medical assistance program, rate increases shall be
provided according to section 256B.431, subdivision 4, paragraph
(c).
(b) The maximum negotiated rate does not apply to a
residence 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 negotiated rate
residence under general assistance or Minnesota supplemental aid.
Rate increases for these residences are subject to the
provisions of subdivision 7.
(c) The following residences 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 residence that is not certified to participate in the
medical assistance program, that was licensed as a boarding care
facility by March 1, 1985, and does not receive supplemental
program funding under Minnesota Rules, parts 9535.2000 to
9535.3000 or 9553.0010 to 9553.0080;
(2) a residence certified to participate in the medical
assistance program, licensed as a boarding care facility or a
nursing home, and declared to be an institution for mental
disease by January 1, 1989. Effective January 1, 1989, the
actual documented cost for these residences is the individual's
appropriate medical assistance case mix rate until the
commissioner develops a comprehensive system of rates and
payments for persons in all negotiated rate residences. The
exclusion from the rate limit for residences under this clause
expires July 1, 1991. The commissioner of human services, in
consultation with the counties in which these residences are
located, shall review the status of each certified nursing home
and board and care facility declared to be an institution for
mental disease. This review shall include the cost
effectiveness of continued payment for residents through general
assistance or Minnesota supplemental aid; the appropriateness of
placement of general assistance or supplemental aid clients in
these facilities; the effects of Public Law Number 100-203 on
these facilities; and the role of these facilities in the mental
health service delivery system. The commissioner shall make
recommendations to the legislature by January 1, 1990, regarding
the need to continue the exclusion of these facilities from the
negotiated rate maximum and the future role of these facilities
in serving persons with mental illness.
Subd. 3. [LIMITS ON RATES.] When a negotiated rate is used
to pay for an individual's room and board, the rate payable to
the residence must not exceed the rate paid by an individual not
receiving a negotiated rate under this chapter.
Subd. 4. [CERTAIN RESIDENCES NOT ELIGIBLE.] The
commissioner shall make no payments under this section to
residences licensed after August 1, 1987, that have more than
four residents with a diagnosis of mental illness, except for
residences specifically licensed to serve persons with mental
illness or residences excluded from licensure under chapter
245A. The commissioner of health shall monitor newly licensed
residences and shall report to the commissioner of human
services residences that do not comply with this section.
Subd. 5. [ADULT FOSTER CARE RATES.] The commissioner shall
annually establish statewide maintenance and difficulty of care
rates for adults in foster care. The commissioner shall adopt
rules to implement statewide rates. In adopting rules, the
commissioner shall consider existing maintenance and difficulty
of care rates so that, to the extent possible, an adult for whom
a maintenance or difficulty of care rate is established will not
be adversely affected.
Subd. 6. [STATEWIDE RATE SETTING SYSTEM.] The commissioner
shall establish a comprehensive statewide system of rates and
payments for recipients who reside in residences with negotiated
rates to be effective January 1, 1992, or as soon as possible
after that date. The commissioner may adopt rules to establish
this rate setting system.
Subd. 7. [RATE INCREASES.] 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.
Subd. 8. [STATE PARTICIPATION.] For a resident of a
negotiated rate residence who is eligible for general assistance
under sections 256D.01 to 256D.21, state participation in the
negotiated rate is determined according to section 256D.03,
subdivision 2. For a resident of a negotiated rate facility who
is eligible under sections 256D.33 to 256D.54, state
participation in the negotiated rate is determined according to
section 256D.36.
Subd. 9. [PERSONAL NEEDS ALLOWANCE.] In addition to the
negotiated rate paid for the room and board costs, a person
residing in a negotiated rate residence shall receive an
allowance for clothing and personal needs. The allowance shall
not be less than that authorized for a medical assistance
recipient in section 256B.35.
Sec. 120. [256I.06] [PAYMENT METHODS.]
When a negotiated rate is used to pay the room and board
costs of a person eligible under sections 256D.01 to 256D.21,
the monthly payment may be issued as a voucher or vendor
payment. When a negotiated rate is used to pay the room and
board costs of a person eligible under sections 256D.33 to
256D.54, payments must be made to the recipient. If a recipient
is not able to manage the recipient's finances, a representative
payee must be appointed.
Sec. 121. Minnesota Statutes 1988, section 268.0111,
subdivision 4, is amended to read:
Subd. 4. [EMPLOYMENT AND TRAINING SERVICES.] "Employment
and training services" means programs, activities, and services
related to job training, job placement, and job creation
including job service programs, job training partnership act
programs, wage subsidies, work incentive programs, work
readiness programs, employment job search, counseling, case
management, community work experience programs, displaced
homemaker programs, disadvantaged job training programs, grant
diversion, employment experience programs, youth employment
programs, conservation corps, apprenticeship programs, community
investment programs, supported work programs, community
development corporations, economic development programs, and
opportunities industrialization centers.
Sec. 122. Minnesota Statutes 1988, section 268.0111, is
amended by adding a subdivision to read:
Subd. 5a. [INDIAN TRIBE.] For purposes of employment and
training services, "Indian tribe" means a tribe, band, nation,
or other organized group or community of Indians that is
recognized as eligible for the special programs and services
provided by the United States to Indians because of their status
as Indians, and for which a reservation exists as is consistent
with Public Law Number 100-485, as amended.
Sec. 123. Minnesota Statutes 1988, section 268.0122,
subdivision 2, is amended to read:
Subd. 2. [SPECIFIC POWERS.] The commissioner of jobs and
training shall:
(1) administer and supervise all forms of unemployment
insurance provided for under federal and state laws that are
vested in the commissioner;
(2) administer and supervise all employment and training
services assigned to the department of jobs and training under
federal or state law;
(3) review and comment on local service unit plans and
community investment program plans and approve or disapprove the
plans;
(4) establish and maintain administrative units necessary
to perform administrative functions common to all divisions of
the department;
(5) supervise the county boards of commissioners, local
service units, and any other units of government designated in
federal or state law as responsible for employment and training
programs;
(6) establish administrative standards and payment
conditions for providers of employment and training services;
(7) act as the agent of, and cooperate with, the federal
government in matters of mutual concern, including the
administration of any federal funds granted to the state to aid
in the performance of functions of the commissioner; and
(8) obtain reports from local service units and service
providers for the purpose of evaluating the performance of
employment and training services; and
(9) review and comment on plans for Indian tribe employment
and training services and approve or disapprove the plans.
Sec. 124. Minnesota Statutes 1988, section 268.0122,
subdivision 3, is amended to read:
Subd. 3. [DUTIES AS A STATE AGENCY.] The commissioner
shall:
(1) administer the unemployment insurance laws and related
programs;
(2) administer the aspects of aid to families with
dependent children, general assistance, work readiness, and food
stamps that relate to employment and training services, subject
to the contract under section 268.86, subdivision 2;
(3) administer wage subsidies and the discretionary
employment and training fund;
(4) administer a national system of public employment
offices as prescribed by United States Code, title 29, chapter
4B, the Wagner-Peyser Act, and other federal employment and
training programs;
(5) cooperate with the federal government and its
employment and training agencies in any reasonable manner as
necessary to qualify for federal aid for employment and training
services and money;
(6) enter into agreements with other departments of the
state and local units of government as necessary;
(7) certify employment and training service providers and
decertify service providers that fail to comply with performance
criteria according to standards established by the commissioner;
(8) provide consistent, integrated employment and training
services across the state;
(9) establish the standards for all employment and training
services administered under this chapter;
(10) develop standards for the contents and structure of
the local service unit plans and plans for Indian tribe
employment and training services;
(11) provide current state and substate labor market
information and forecasts, in cooperation with other agencies;
(12) identify underserved populations, unmet service needs,
and funding requirements;
(13) consult with the council for the blind on matters
pertaining to programs and services for the blind and visually
impaired; and
(14) submit to the governor, the commissioners of human
services and finance, and the chairs of the senate finance and
house appropriations committees a semiannual report that:
(a) reports, by client classification, an unduplicated
count of the kinds and number of services furnished through each
program administered or supervised by the department or
coordinated with it;
(b) reports on the number of job openings listed,
developed, available, and obtained by clients;
(c) identifies the number of cooperative agreements in
place, the number of individuals being served, and the kinds of
service provided them;
(d) evaluates the performance of services, such as wage
subsidies, community investments, work readiness, and grant
diversions; and
(e) explains the effects of current employment levels,
unemployment rates, and program performance on the unemployment
insurance fund and general assistance, work readiness, and aid
to families with dependent children caseloads and program
expenditures; and
(15) enter into agreements with Indian tribes as necessary
to provide employment and training services as funds become
available.
Sec. 125. Minnesota Statutes 1988, section 268.86,
subdivision 2, is amended to read:
Subd. 2. [INTERAGENCY AGREEMENTS.] By October 1, 1987, the
commissioner and the commissioner of human services shall enter
into a written contract for the design, delivery, and
administration of employment and training services for
applicants for or recipients of food stamps or aid to families
with dependent children and work readiness, including AFDC
employment and training programs, grant diversion, and supported
work. The contract must be approved by the coordinator and must
address:
(1) specific roles and responsibilities of each department;
(2) assignment and supervision of staff for interagency
activities including any necessary interagency employee mobility
agreements under the administrative procedures of the department
of employee relations;
(3) mechanisms for determining the conditions under which
individuals participate in services, their rights and
responsibilities while participating, and the standards by which
the services must be administered;
(4) procedures for providing technical assistance to local
service units, Indian tribes, and employment and training
service providers;
(5) access to appropriate staff for ongoing development and
interpretation of policy, rules, and program standards;
(6) procedures for reimbursing appropriate agencies for
administrative expenses; and
(7) procedures for accessing available federal funds.
Sec. 126. Minnesota Statutes 1988, section 268.871,
subdivision 5, is amended to read:
Subd. 5. [REPORTS.] Each employment and training service
provider under contract with a local service unit or an Indian
tribe to deliver employment and training services must submit an
annual report by March 1 to the local service unit or the Indian
tribe. The report must specify:
(1) the types of services provided;
(2) the number of priority and nonpriority AFDC recipients
served, the number of work readiness assistance recipients
served, and the number of other clients served;
(3) how resources will be prioritized to serve priority and
nonpriority public assistance recipients and other clients; and
(4) the manner in which state employment and training funds
and programs are being coordinated with federal and local
employment and training funds and programs.
Sec. 127. Minnesota Statutes 1988, section 268.88, is
amended to read:
268.88 [LOCAL SERVICE UNIT PLANS.]
(a) Local service units shall prepare and submit to the
commissioner by April 15 of each year an annual plan for the
subsequent calendar fiscal year. The commissioner shall notify
each local service unit by May 1 of each year if within 60 days
of receipt of its plan that the plan has been approved or
disapproved. The plan must include:
(1) a statement of objectives for the employment and
training services the local service unit administers;
(2) the establishment of public assistance caseload
reduction goals and the strategies and programs that will be
used to achieve these goals;
(3) a statement of whether the goals from the preceding
year were met and an explanation if the local service unit
failed to meet the goals;
(4) the amount proposed to be allocated to each employment
and training service;
(5) the proposed types of employment and training services
the local service unit plans to utilize;
(6) a description of how the local service unit will use
funds provided under section 256.736 to meet the requirements of
that section. The description must include the two work
programs required by section 256.736, subdivision 10, paragraph
(a), clause (13), what services will be provided, number of
clients served, per service expenditures, type of clients
served, and projected outcomes;
(7) a report on the use of wage subsidies, grant
diversions, community investment programs, sliding fee day care,
and other services administered under this chapter;
(8) an annual update of the community investment program
plan according to standards established by the commissioner;
(9) a performance review of the employment and training
service providers delivering employment and training services
for the local service unit; and
(10) a copy of any contract between the local service unit
and an employment and training service provider including
expected outcomes and service levels for public assistance
clients; and
(11) a copy of any other agreements between educational
institutions, family support services, and child care providers.
(b) In counties with a city of the first class, the county
and the city shall develop and submit a joint plan. The plan
may not be submitted until agreed to by both the city and the
county. The plan must provide for the direct allocation of
employment and training money to the city and the county unless
waived by either. If the county and the city cannot concur on a
plan, the commissioner shall resolve their dispute. In counties
in which a federally recognized Indian tribe is operating an
employment and training program under an agreement with the
commissioner of human services, the plan must provide that the
county will coordinate its employment and training programs,
including developing a system for referrals, sanctions, and the
provision of supporting services such as access to child care
funds and transportation with programs operated by the Indian
tribe. The plan may not be given final approval by the
commissioner until the tribal unit and county have submitted
written agreement on these provisions in the plan. If the
county and Indian tribe cannot agree on these provisions, the
local service unit shall notify the commissioner of jobs and
training and the commissioners of jobs and training and human
services shall resolve the dispute.
(c) The commissioner may withhold the distribution of
employment and training money from a local service unit that
does not submit a plan to the commissioner by the date set by
this section, and shall withhold the distribution of employment
and training money from a local service unit whose plan has been
disapproved by the commissioner until an acceptable amended plan
has been submitted.
(d) For 1987, local service unit plans must be submitted by
October 1, 1987. The plan must include the implementation plan
for aid to families with dependent children employment and
training services as required under Laws 1987, chapter 403,
article 3, section 91. Notwithstanding Minnesota Statutes 1988,
section 268.88, local service units shall prepare and submit to
the commissioner by June 1, 1989, an annual plan for fiscal year
1990. The commissioner shall notify each local service unit
within 30 days of receipt of its plan if its plan has been
approved or disapproved.
Sec. 128. [268.881] [INDIAN TRIBE PLANS.]
The commissioner, in consultation with the commissioner of
human services, shall review and comment on Indian tribe plans
submitted to the commissioner for provision of employment and
training services. The plan must be submitted by April 15 for
the state fiscal year ending June 30, 1990. For subsequent
years, the plan must be submitted at least 60 days before the
program commences. The commissioner shall approve or disapprove
the plan for the state fiscal year ending June 30, 1990, within
30 days of receipt. The commissioner shall notify the Indian
tribe of approval or disapproval of plans for subsequent years
within 60 days of submission of the plans. The grant proposal
must contain information that has been established by the
commissioner and the commissioner of human services for the
employment and training services grant program for Indian tribes.
Sec. 129. Laws 1987, chapter 403, article 3, section 98,
is amended to read:
Sec. 98. [REPEALER.]
Minnesota Statutes 1986, sections 257.34, subdivision 2;
and section 268.86, subdivisions 1, 3, 4, and 5, are repealed.
Section 95 is repealed effective June 30, 1989 October 1, 1990.
Sec. 130. [IMPLEMENTATION.]
The commissioner is authorized to proceed with the planning
and designing of the Minnesota family investment plan, according
to the requirements of Minnesota Statutes, sections 256.031 to
256.036. Sections 256.031 to 256.036 may not be implemented or
enforced until the legislature authorizes a specific date for
implementation either statewide or on a field trial basis. The
definition of family in section 256.032, subdivision 7, shall
not be construed to define what an assistance unit or filing
unit is in the Minnesota family investment plan on and after the
effective date of sections 256.031 to 256.036, this section, and
amendments to section 256.045, subdivision 3, in section 13.
The commissioner shall study the relevance of these concepts for
the Minnesota family investment plan and include recommendations
in the Minnesota family investment plan and funding request.
The commissioner shall include in the Minnesota family
investment plan a mechanism to empower the parental caregiver in
a dispute regarding the contents of a contract. This mechanism
shall be available before the caregiver is given a notice of
intent to implement sanctions as required under section 256.035,
subdivision 3. This mechanism may be a hearing under section
256.045.
Sec. 131. [MIGRANT ISSUES TASK FORCE.]
The department of human services, in coordination with the
Minnesota housing finance agency, shall convene a task force to
consider issues relating to public assistance and housing for
migrant farm workers. The task force shall include migrant
workers, representatives of communities in which migrant workers
reside, employers of migrant workers, particularly agricultural
employers, representatives of housing agencies, and
representatives of advocacy groups. The task force shall report
back to the legislature by February 1, 1990, with
recommendations.
Sec. 132. [PLAN AND FUNDING REQUEST.]
After securing federal approval to implement the Minnesota
family investment plan on a field trial basis, the commissioner
shall submit a plan and funding request to the legislature for
specific appropriations for the implementation of field trials.
Sec. 133. [REPEALER.]
Subdivision 1. [WELFARE REFORM.] Minnesota Statutes 1988,
sections 256D.051, subdivision 6a, and 268.86, subdivision 7,
are repealed.
Subd. 2. [AFDC AND MSA SIMPLIFICATION.] (a) Sections
256D.01, subdivision 1c; and 256D.06, subdivisions 3, 4, and 6,
are repealed.
(b) Sections 256D.35, subdivisions 2, 3, 4, and 8; 256D.36,
subdivision 2; 256D.37, subdivisions 2, 4, 6, 7, 8, 9, 10, 11,
12, 13, and 14; 256D.38; 256D.39; 256D.41; 256D.42; and 256D.43,
are repealed.
Subd. 3. [GENERAL ASSISTANCE AND WORK READINESS.]
Minnesota Statutes 1988, sections 256D.06, subdivisions 3, 4, 6,
and 6a; and 256D.052, subdivisions 5, 6, and 7, are repealed
effective October 1, 1990.
Sec. 134. [EFFECTIVE DATES.]
Sections 21; 42; 43; the changes in section 44 relating to
the general assistance and work readiness programs; 45,
subdivision 1c, paragraphs (b), (c), (d), and (e); 46 to 61; and
63 to 71, are effective October 1, 1990. Section 37 is
effective October 1, 1989. Sections 92; 103, subdivisions 1, 2,
3, and 5; and 104, subdivision 3, are effective July 1, 1990.
Section 129 is effective the day following final enactment.
ARTICLE 6
REGIONAL TREATMENT CENTERS
Section 1. [FINDING.]
The legislature finds that it is beneficial to encourage
the placement of persons requiring residential, health care, and
treatment services in community-based facilities and in the
regional treatment centers. It is the policy of the state to:
(1) carry out measures that encourage the delivery of these
services in a manner that ensures fair and equitable
arrangements to protect the interests of the affected residents,
family members, employees, providers, and communities; and
(2) provide adequate staff and funding at regional
treatment centers and all state facilities to ensure that
existing programs and new programs that may be developed meet
all licensing and certification standards and contemporary
standards of care.
Sec. 2. [245.073] [TECHNICAL TRAINING ASSISTANCE TO
COMMUNITY-BASED PROGRAMS.]
In conjunction with the discharge of persons from regional
treatment centers and their admission to state-operated and
privately operated community-based programs, the commissioner
may provide technical training assistance to the community-based
programs. The commissioner may apply for and accept money from
any source including reimbursement charges from the
community-based programs for reasonable costs of training.
Money received must be deposited in the general fund and is
appropriated annually to the commissioner of human services for
training under this section.
Sec. 3. Minnesota Statutes 1988, section 245.463, is
amended by adding a subdivision to read:
Subd. 4. [REVIEW OF FUNDING.] The commissioner shall
complete a review of funding for mental health services and make
recommendations for any changes needed. The commissioner shall
submit a report on the review and recommendations to the
legislature by January 31, 1991.
Sec. 4. Minnesota Statutes 1988, section 245.476, is
amended by adding a subdivision to read:
Subd. 5. [REPORT ON PREADMISSION SCREENING.] The
commissioner shall review the statutory preadmission screening
requirements for psychiatric hospitalization, both in the
regional treatment centers and other hospitals, to determine if
changes in preadmission screening are needed. The commissioner
shall deliver a report of the review to the legislature by
January 31, 1990.
Sec. 5. [245.652] [CHEMICAL DEPENDENCY SERVICES FOR
REGIONAL TREATMENT CENTERS.]
Subdivision 1. [PURPOSE.] The regional treatment centers
shall provide services designed to end a person's reliance on
chemical use or a person's chemical abuse and increase effective
and chemical-free functioning. Clinically effective programs
must be provided in accordance with section 246.64.
Subd. 2. [SERVICES OFFERED.] Services provided must
include, but are not limited to, the following:
(1) primary and extended residential care, including
residential treatment programs of varied duration intended to
deal with a person's chemical dependency or chemical abuse
problems;
(2) follow-up care to persons discharged from regional
treatment center programs;
(3) outpatient treatment programs; and
(4) other treatment services, as appropriate and as
provided under contract or shared service agreements.
Subd. 3. [PERSONS SERVED.] The regional treatment centers
shall provide services primarily to adolescent and adult
residents of the state.
Subd. 4. [SYSTEM LOCATIONS.] Programs shall be located in
Anoka, Brainerd, Fergus Falls, Moose Lake, St. Peter, and
Willmar.
Sec. 6. Minnesota Statutes 1988, section 246.18, is
amended by adding a subdivision to read:
Subd. 3a. [CONTINGENCY FUND.] A separate interest-bearing
account must be established in accordance with subdivision 3 for
use by the commissioner of human services in contingency
situations related to chemical dependency programs operated by
the regional treatment centers or state nursing homes. Within
the limits of appropriations made available for this purpose,
money must be provided to each regional treatment center to
enable each center to continue to provide chemical dependency
services.
Sec. 7. Minnesota Statutes 1988, section 246.18,
subdivision 4, is amended to read:
Subd. 4. [COLLECTIONS DEPOSITED IN MEDICAL ASSISTANCE
ACCOUNT.] Except as provided in subdivision 2, all receipts from
collection efforts for the regional treatment centers and, state
nursing homes, and other state facilities as defined in section
246.50, subdivision 3, must be deposited in the medical
assistance account and are appropriated for that purpose. The
commissioner shall ensure that the departmental financial
reporting systems and internal accounting procedures comply with
federal standards for reimbursement for program and
administrative expenditures and fulfill the purpose of this
paragraph.
Sec. 8. Minnesota Statutes 1988, section 246.36, is
amended to read:
246.36 [ACCEPTANCE OF VOLUNTARY, UNCOMPENSATED SERVICES.]
For the purpose of carrying out a duty, the commissioner of
human services shall have authority to accept uncompensated and
voluntary services and to enter into contracts or agreements
with private or public agencies, or persons, for uncompensated
and voluntary services, as the commissioner may deem
practicable. Uncompensated and voluntary services do not
include services mandated by licensure and certification
requirements for health care facilities. The volunteer
agencies, organizations, or persons who provide services to
residents of state hospitals shall facilities operated under the
authority of the commissioner are not be subject to the
procurement requirements of chapters 16A and 16B. The agencies,
organizations, or persons may purchase supplies, services, and
equipment to be used in providing services to residents of state
hospitals facilities through the department of administration.
Sec. 9. Minnesota Statutes 1988, section 246.57,
subdivision 1, is amended to read:
Subdivision 1. [AUTHORIZED.] The commissioner of human
services may authorize any regional center or state operated
nursing home state facility operated under the authority of the
commissioner to enter into agreement with other governmental
entities and both nonprofit and profit health service for-profit
organizations for participation in shared service agreements
that would be of mutual benefit to the state, other governmental
entities and health service organizations involved, and the
public. Notwithstanding section 16B.06, subdivision 2, the
commissioner of human services may delegate the execution of
shared services contracts to the chief executive officers of the
regional centers or state operated nursing homes. No additional
employees shall be added to the legislatively approved
complement for any regional center or state nursing home as a
result of entering into any shared service agreement. However,
positions funded by a shared service agreement may be authorized
by the commissioner of finance for the duration of the shared
service agreement. The charges for the services shall be on an
actual cost basis and. All receipts shall be deposited in the
general fund. The receipts are appropriated to the commissioner
of human services for the duration of the shared service
agreement to make expenditures under the agreement that are not
covered by other appropriations for shared services may be
retained by the regional treatment center or state-operated
nursing home that provided the services, in addition to other
funding the regional treatment center or state-operated nursing
home receives.
Sec. 10. [246.70] [SERVICES TO FAMILIES.]
(a) The commissioner shall publicize the planned changes to
the facilities operated by the commissioner. A parent, other
involved family member, or private guardian of a resident of a
facility must be notified of the changes planned for each
facility. When new services developed for a person require the
person to move, the commissioner shall provide each parent,
family member, and guardian of that person with the following:
(1) names and telephone numbers of the state and county
contacts;
(2) information on types of services to be developed;
(3) information on how the individual planning process
works, including how alternative placements will be determined,
and how family members can be involved;
(4) information on the process to be followed when a
parent, other family member, or guardian disagrees with the
proposed services; and
(5) a list of additional resources such as advocates, local
volunteer coordinators, and family groups.
(b) At least one staff person in each facility must be
available to provide information about:
(1) community placements;
(2) the opportunity for interested family members and
guardians to participate in program planning; and
(3) family support groups.
Sec. 11. Minnesota Statutes 1988, section 251.011,
subdivision 4, is amended to read:
Subd. 4. [OAK TERRACE NURSING HOME.] Any portion or unit
of Glen Lake Sanitarium not used for the treatment of
tuberculosis patients may be used by the commissioner of human
services for the care of geriatric patients, under the name of
Oak Terrace Nursing Home.
The commissioner of administration may lease any portion or
unit of Oak Terrace Nursing Home for the purpose of providing
food and shelter for the homeless.
The facility at Oak Terrace must be closed as soon as a
reasonable plan for relocation of its residents can be safely
implemented and employee mitigation measures completed, but no
later than July 1, 1992. Relocation of persons must be
carefully planned and take into account any remaining ties the
person has to family or community, available capacity in private
and state-operated nursing homes, and personal choices and needs
of the resident. Relocation must be implemented according to
Minnesota Rules, parts 4655.6810 to 4655.6830 and 9546.0010 to
9546.0060.
Sec. 12. Minnesota Statutes 1988, section 251.011, is
amended by adding a subdivision to read:
Subd. 4a. [NURSING HOME BEDS AT REGIONAL TREATMENT
CENTERS.] The commissioner shall operate the following number of
nursing home beds at regional treatment centers in addition to
current capacity: at Brainerd, 105 beds; at Cambridge, 70 beds;
and at Fergus Falls, 85 beds. The commissioner may operate
nursing home beds at other regional treatment centers as
necessary to provide an appropriate level of care for persons
served at those centers.
Sec. 13. [251.012] [PROVISION OF NURSING HOME SERVICES.]
Subdivision 1. [NURSING HOME CARE.] (a) The commissioner
shall provide nursing home care to a person requiring and
eligible for that level of care when the person:
(1) is medically fragile or clinically challenging;
(2) exhibits severe or challenging behaviors; or
(3) requires treatment for an underlying mental illness.
(b) A person may be accepted for admission only after
nursing home preadmission screening by the county.
Subd. 2. [TECHNICAL ASSISTANCE.] Within the limits of
appropriations, the commissioner may expand the provision of
technical assistance to community providers in handling the
behavior problems of their residents, and with community
placements for younger persons who have heavy nursing needs and
behavior problems. Technical assistance may include site
visits, consultation with providers, or provider training.
Subd. 3. [AUXILIARY SERVICES.] The nursing homes may enter
into agreements according to section 246.57 to provide other
services needed in the region that build on the services
provided by the regional nursing homes and that are offered in
conjunction with a community or community group.
Subd. 4. [RESPITE CARE.] Respite care may be offered when
space is available if payment for the cost of care is guaranteed
by the person, the person's family or legal representative, or a
source other than a direct state appropriation to the nursing
home, and if the individual meets the facility's admission
criteria.
Sec. 14. Minnesota Statutes 1988, section 252.025, is
amended by adding a subdivision to read:
Subd. 4. [STATE-PROVIDED SERVICES.] (a) It is the policy
of the state to capitalize and recapitalize the regional
treatment centers as necessary to prevent depreciation and
obsolescence of physical facilities and to ensure they retain
the physical capability to provide residential programs.
Consistent with that policy and with section 252.50, and within
the limits of appropriations made available for this purpose,
the commissioner may establish, by June 30, 1991, the following
state-operated, community-based programs for the least
vulnerable regional treatment center residents: at Brainerd
regional services center, two residential programs and two day
programs; at Cambridge regional treatment center, four
residential programs and two day programs; at Faribault regional
treatment center, ten residential programs and six day programs;
at Fergus Falls regional treatment center, two residential
programs and one day program; at Moose Lake regional treatment
center, four residential programs and two day programs; and at
Willmar regional treatment center, two residential programs and
one day program.
(b) By January 15, 1991, the commissioner shall report to
the legislature a plan to provide continued regional treatment
center capacity and state-operated, community-based residential
and day programs for persons with developmental disabilities at
Brainerd, Cambridge, Faribault, Fergus Falls, Moose Lake, St.
Peter, and Willmar, as follows:
(1) by July 1, 1998, continued regional treatment center
capacity to serve 350 persons with developmental disabilities as
follows: at Brainerd, 80 persons; at Cambridge, 12 persons; at
Faribault, 110 persons; at Fergus Falls, 60 persons; at Moose
Lake, 12 persons; at St. Peter, 35 persons; at Willmar, 25
persons; and up to 16 crisis beds in the Twin Cities
metropolitan area; and
(2) by July 1, 1999, continued regional treatment center
capacity to serve 254 persons with developmental disabilities as
follows: at Brainerd, 57 persons; at Cambridge, 12 persons; at
Faribault, 80 persons; at Fergus Falls, 35 persons; at Moose
Lake, 12 persons; at St. Peter, 30 persons; at Willmar, 12
persons, and up to 16 crisis beds in the Twin Cities
metropolitan area. In addition, the plan shall provide for the
capacity to provide residential services to 570 persons with
developmental disabilities in 95 state-operated, community-based
residential programs.
Sec. 15. [252.032] [ADMINISTRATIVE STRUCTURE.]
Subdivision 1. [REGIONAL STRUCTURE.] The administrative
structure of the state-operated system must be regional in
character.
Subd. 2. [STAFF; LOCATION OF FACILITIES.] The
administrative and professional staffs of the regional treatment
centers must be based on campus. Community-based facilities and
services must be located and operated so they facilitate the
delivery of professional and administrative staff services from
the regional treatment center campus. The regional treatment
center professional staff and all other staff may deliver
services that they deliver on campus throughout the catchment
area.
Sec. 16. [252.035] [REGIONAL TREATMENT CENTER CATCHMENT
AREAS.]
The commissioner may administratively designate catchment
areas for regional treatment centers and state nursing homes.
Catchment areas may vary by client group served. Catchment
areas in effect on January 1, 1989, may not be modified until
the commissioner has consulted with the regional planning
committees of the affected regional treatment centers and with
the chairs of the senate health and human services finance
division and the house of representatives health and human
services appropriation division.
Sec. 17. [252.038] [PROVISION OF RESIDENTIAL SERVICES.]
Subdivision 1. [RESIDENTIAL CARE.] The commissioner of
human services may continue to provide residential care in
regional treatment centers.
Subd. 2. [TECHNICAL ASSISTANCE.] To the extent of
available money, the commissioner of human services may expand
the capacity to provide technical assistance to community
providers in handling the behavior problems of their patients.
Technical assistance may include site visits, consultation with
providers, or provider training.
Subd. 3. [RESPITE CARE.] Respite care may be provided in a
regional treatment center when space is available if (1) payment
for 20 percent of the prevailing facility per diem is guaranteed
by the person, the person's family or legal representative, or a
source other than a direct state appropriation to the regional
treatment center and (2) provision of respite care to the
individual meets the facility's admission criteria and licensing
standards. The parent or guardian must consent to admission and
sign a waiver of liability. Respite care is limited to 30 days
within a calendar year. No preadmission screening process is
required for a respite care stay under this subdivision.
Sec. 18. Minnesota Statutes 1988, section 252.291,
subdivision 2, is amended to read:
Subd. 2. [EXCEPTIONS.] (a) The commissioner of human
services in coordination with the commissioner of health may
approve a newly constructed or newly established publicly or
privately operated community intermediate care facility for six
or fewer persons with mental retardation or related conditions
only when the following circumstances exist:
(a) when (1) the facility is developed in accordance with a
request for proposal approved by the commissioner of human
services;
(b) when (2) the facility is necessary to serve the needs
of identified persons with mental retardation or related
conditions who are seriously behaviorally disordered or who are
seriously physically or sensorily impaired. At least 50 No more
than 40 percent of the capacity of the facility specified in the
proposal submitted to the commissioner must be used for persons
coming being discharged from regional treatment centers; and
(c) when (3) the commissioner determines that the need for
increased service capacity cannot be met by the use of
alternative resources or the modification of existing facilities.
(b) The percentage limitation in paragraph (a), clause (2),
does not apply to state-operated, community-based facilities.
Sec. 19. Minnesota Statutes 1988, section 252.31, is
amended to read:
252.31 [ADVISORY TASK FORCE.]
The commissioner of human services may appoint an advisory
task force for services to persons with mental retardation,
related conditions, or physical handicaps. The task force shall
advise the commissioner relative to those laws for which the
commissioner is responsible to administer and enforce relating
to mental retardation or related conditions and physical
disabilities. The commissioner also may request the task force
for advice on implementing a comprehensive plan of services
necessary to provide for the transition of persons with mental
retardation or related conditions from regional treatment
centers services to community-based programs. The task force
shall consist of persons who are providers or consumers of
service for persons with mental retardation, related conditions,
or physical handicaps, or who are interested citizens. The task
force shall expire and the terms, compensation and removal of
members shall be as provided in section 15.059.
Sec. 20. Minnesota Statutes 1988, section 252.41,
subdivision 9, is amended to read:
Subd. 9. [VENDOR.] "Vendor" means a nonprofit legal entity
that:
(1) is licensed under sections 245.781 245A.01 to 245.812
245A.16 and 252.28, subdivision 2, to provide day training and
habilitation services to adults with mental retardation and
related conditions; and
(2) does not have a financial interest in the legal entity
that provides residential services to the same person or persons
to whom it provides day training and habilitation services.
This clause does not apply to regional treatment centers,
state-operated, community-based programs operating according to
section 252.50 until July 1, 2000, or vendors licensed prior to
April 15, 1983.
Sec. 21. Minnesota Statutes 1988, section 252.50, is
amended to read:
252.50 [STATE-OPERATED, COMMUNITY-BASED RESIDENTIAL
PROGRAMS.]
Subdivision 1. [RESIDENTIAL COMMUNITY-BASED PROGRAMS
ESTABLISHED.] The commissioner may shall establish a system of
noninstitutional, state-operated, community-based residential
services programs for persons with mental retardation or related
conditions. For purposes of this section, "state-operated,
community-based residential facility program" 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 programs must be state
employees under chapters 43A and 179A. The establishment of
state-operated, community-based residential facilities programs
must be within the context of a comprehensive definition of the
role of state-operated services in the state. The role of
state-operated services must be defined within the context of a
comprehensive system of services for persons with mental
retardation or related conditions. Services State-operated,
community-based programs may include, but are not limited to,
community group homes, foster care, supportive
living arrangements services, day training and habilitation
programs, and respite care arrangements. The commissioner may
operate the pilot projects established under Laws 1985, First
Special Session chapter 9, article 1, section 2, subdivision 6,
and may shall, within the limits of available appropriations,
establish additional state-operated, community-based services
programs for regional treatment center residents persons 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. State-operated, community-based programs may accept
admissions from regional treatment centers, from the person's
own home, or from community programs. State-operated,
community-based programs offering day program services may be
provided for persons with mental retardation or related
conditions who are living in state-operated, community-based
residential programs until July 1, 2000. No later than 1994,
the commissioner, together with family members, counties,
advocates, employee representatives, and other interested
parties, shall begin planning so that by July 1, 2000,
state-operated, community-based residential facilities will be
in compliance with section 252.41, subdivision 9.
Subd. 2. [AUTHORIZATION TO BUILD OR PURCHASE.] Within the
limits of available appropriations, the commissioner may build,
purchase, or lease suitable buildings for state-operated,
community-based residential facilities programs. Facilities
Programs must be homelike and adaptable to the needs of persons
with mental retardation or related conditions and residential
programs must be homelike.
Subd. 3. [ALTERNATIVE FUNDING MECHANISMS.] To the extent
possible, the commissioner may amend the medical assistance home
and community-based waiver and, as appropriate, develop special
waiver procedures for targeting services to persons currently in
state regional treatment centers.
Subd. 4. [COUNTIES.] State-operated, community-based
residential facilities programs may be developed in conjunction
with existing county responsibilities and authorities for
persons with mental retardation or related conditions.
Assessment, placement, screening, case management
responsibilities, and determination of need procedures must be
consistent with county responsibilities established under law
and rule. Counties may enter into shared service agreements
with state-operated programs.
Subd. 5. [LOCATION OF PROGRAMS.] (a) In determining the
location of state-operated, community-based programs, the needs
of the individual client shall be paramount. The commissioner
shall also take into account:
(1) the personal preferences of the persons being served
and their families as determined by Minnesota Rules, parts
9525.0015 to 9525.0165;
(2) location of the support services established by the
individual service plans of the persons being served;
(3) the appropriate grouping of the persons served;
(4) the availability of qualified staff;
(5) the need for state-operated, community-based programs
in the geographical region of the state; and
(6) a reasonable commuting distance from a regional
treatment center or the residences of the program staff.
(b) State-operated, community-based programs must be
located according to section 252.28.
Subd. 6. [RATES FOR STATE-OPERATED, COMMUNITY-BASED
PROGRAMS FOR PERSONS WITH MENTAL RETARDATION.] State-operated,
community-based programs that meet the definition of a facility
in Minnesota Rules, part 9553.0020, subpart 19, must be
reimbursed consistent with Minnesota Rules, parts 9553.0010 to
9553.0080. State-operated, community-based programs that meet
the definition of vendor in section 252.41, subdivision 9, must
be reimbursed consistent with the rate setting procedures in
sections 252.41 to 252.47 and Minnesota Rules, parts 9525.1200
to 9525.1330. This subdivision does not operate to abridge the
statutorily created pension rights of state employees or
collective bargaining agreements reached pursuant to chapter
179A.
Subd. 7. [CRISIS SERVICES.] Within the limits of
appropriations, state-operated regional technical assistance
must be available in each region to assist counties, residential
and day programming staff, and families to prevent or resolve
crises that could lead to a change in placement. Crisis
capacity must be provided on all regional treatment center
campuses serving persons with developmental disabilities. In
addition, crisis capacity may be developed to serve 16 persons
in the Twin Cities metropolitan area. Technical assistance and
consultation must also be available in each region to providers
and counties. Staff must be available to provide:
(1) individual assessments;
(2) program plan development and implementation assistance;
(3) analysis of service delivery problems; and
(4) assistance with transition planning, including
technical assistance to counties and providers to develop new
services, site the new services, and assist with community
acceptance.
Subd. 8. [SPIRITUAL CARE SERVICES.] An organized means for
providing spiritual care services and follow-up may be
established as part of the comprehensive health care, congruent
with the operational philosophy of the department of human
services, to residents of state-operated residential facilities
and former residents discharged to private facilities, by
persons certified for ministry in specialized settings.
Subd. 9. [EVALUATION OF COMMUNITY-BASED SERVICES
DEVELOPMENT.] The commissioner shall develop an integrated
approach to assessing and improving the quality of
community-based services, including state-operated programs for
persons with developmental disabilities.
The commissioner shall evaluate the progress of the
development and quality of community-based services to determine
if further development can proceed. The commissioner shall
report results of the evaluation to the legislature by January
31, 1991, and January 31, 1993.
Subd. 10. [RULES AND LICENSURE.] Each state-operated
residential and day habilitation service site shall be
separately licensed and movement of residents between them shall
be governed by applicable rules adopted by the commissioner.
Subd. 11. [AGREEMENT AUTHORIZED.] The agreement between
the commissioner of human services, the state negotiator, and
the bargaining representatives of state employees, dated March
10, 1989, concerning the department of human services plan to
restructure the regional treatment centers, is ratified, subject
to approval by the legislative commission on employee relations.
Sec. 22. [252.51] [COMMUNITY PLANNING.]
Each community where there is a regional treatment center
shall establish a group to work with and advise the commissioner
and the counties to:
(1) ensure community input in the development of community
services for persons with developmental disabilities;
(2) assure consideration of family concern about choice of
service settings;
(3) assist counties in recruiting new providers,
capitalizing, and siting new day services and residential
programs;
(4) work with the surrounding counties to coordinate
development of services for persons with developmental
disabilities;
(5) facilitate community education concerning services to
persons with developmental disabilities;
(6) assist in recruiting potential supported employment
opportunities;
(7) assist in developing shared services agreements among
providers of service;
(8) coordinate with the development of state-operated
services; and
(9) seek to resolve local transportation issues for people
with developmental disabilities.
Funds appropriated to the department of human services for
this purpose shall be transferred to the city in which the
regional treatment center is located upon receipt of evidence
from the city that such a group has been constituted and
designated. The funds shall be used to defray the expenses of
the group.
The membership of each community group must reflect a broad
range of community interests, including, at a minimum, families
of persons with developmental disabilities, state employee
unions, providers, advocates, and counties.
Sec. 23. Minnesota Statutes 1988, section 252A.03, is
amended by adding a subdivision to read:
Subd. 4. [ALTERNATIVES.] Public guardianship or
conservatorship may be imposed only when no acceptable, less
restrictive form of guardianship or conservatorship is
available. The commissioner shall seek parents, near relatives,
and other interested persons to assume private guardianship for
persons with developmental disabilities who are currently under
public guardianship. If a person seeks to become a private
guardian or conservator, costs to the person may be reimbursed
under section 525.703, subdivision 3, paragraph (b). The
commissioner must provide technical assistance to parents, near
relatives, and interested persons seeking to become private
guardians or conservators.
Sec. 24. Minnesota Statutes 1988, section 253.015, is
amended to read:
253.015 [LOCATION; MANAGEMENT; COMMITMENT; CHIEF EXECUTIVE
OFFICER.]
Subdivision 1. [STATE HOSPITALS FOR PERSONS WITH MENTAL
ILLNESS.] The state hospitals located at Anoka, Brainerd, Fergus
Falls, Hastings, Moose Lake, Rochester, St. Peter, and Willmar
shall constitute the state hospitals for mentally ill persons
with mental illness, and shall be maintained under the general
management of the commissioner of human services. The
commissioner of human services shall determine to what state
hospital persons with mental illness shall be committed from
each county and notify the probate judge thereof, and of changes
made from time to time. The chief executive officer of each
hospital for persons with mental illness shall be known as the
chief executive officer.
Subd. 2. [PLAN FOR NEEDED REGIONAL TREATMENT CENTER
SERVICES.] (a) By January 30, 1990, the commissioner shall
develop and submit to the legislature a plan to implement a
program for persons in southeastern Minnesota who are mentally
ill.
(b) By January 1, 1990, the commissioner shall develop a
plan to establish a comprehensive brain injury treatment program
at the Faribault regional center site to meet the needs of
people with brain injuries in Minnesota. The program shall
provide post-acute, community integration and family support
services for people with brain injuries which have resulted in
behavior, cognitive, emotional, communicative and mobility
impairments or deficits. The plan shall include development of
a brain injury residential unit, a functional evaluation
outpatient clinic and an adaptive equipment center within the
outpatient clinic. Health care services already available at
the regional center or from the Faribault community must be
utilized, and the plan shall include provisions and cost
estimates for capital improvements, staff retraining, and
program start-up costs.
(c) By January 1, 1990, the commissioner shall develop a
plan to establish 35 auxiliary beds at Brainerd regional
treatment center for the Minnesota security hospital.
Sec. 25. [253.016] [PURPOSE OF REGIONAL TREATMENT
CENTERS.]
The primary mission of the regional treatment centers for
persons with major mental illness is to provide inpatient
psychiatric hospital services. The regional treatment centers
are part of a comprehensive mental health system. Regional
treatment center services must be integrated into an array of
services based on assessment of individual needs.
Sec. 26. [253.017] [TREATMENT PROVIDED BY REGIONAL
TREATMENT CENTERS.]
Subdivision 1. [ACTIVE PSYCHIATRIC TREATMENT.] The
regional treatment centers shall provide active psychiatric
treatment according to contemporary professional standards.
Treatment must be designed to:
(1) stabilize the individual and the symptoms that required
hospital admission;
(2) restore individual functioning to a level permitting
return to the community;
(3) strengthen family and community support; and
(4) facilitate discharge, after care, and follow-up as
patients return to the community.
Subd. 2. [NEED FOR SERVICES.] The commissioner shall
determine the need for the psychiatric services provided by the
department based upon individual needs assessments of persons in
the regional treatment centers as required by section 245.474,
subdivision 2, and an evaluation of: (1) regional treatment
center programs, (2) programs needed in the region for persons
who require hospitalization, and (3) available epidemiologic
data. Throughout its planning and implementation, the
assessment process must be discussed with the state advisory
council on mental health in accordance with its duties under
section 245.697. Continuing assessment of this information must
be considered in planning for and implementing changes in
state-operated programs and facilities for persons with mental
illness. By January 31, 1990, the commissioner shall submit a
proposal for renovation or new construction of the facilities at
Anoka, Brainerd, Moose Lake, and Fergus Falls. Expansion may be
considered only after a thorough analysis of need and in
conjunction with a comprehensive mental health plan.
Subd. 3. [DISSEMINATION OF ADMISSION AND STAY
CRITERIA.] The commissioner shall periodically disseminate
criteria for admission and continued stay in a regional
treatment center and security hospital. The commissioner shall
disseminate the criteria to the courts of the state and counties.
Sec. 27. [253.018] [PERSONS SERVED.]
The regional treatment centers shall primarily serve adults.
Programs treating children and adolescents who require the
clinical support available in a psychiatric hospital may be
maintained on present campuses until adequate state-operated
alternatives are developed off campus according to the criteria
of section 253.28, subdivision 2.
Sec. 28. [253.28] [STATE-OPERATED, COMMUNITY-BASED
PROGRAMS FOR PERSONS WITH MENTAL ILLNESS.]
Subdivision 1. [PROGRAMS FOR PERSONS WITH MENTAL ILLNESS.]
Beginning July 1, 1991, the commissioner may establish a system
of state-operated, community-based programs for persons with
mental illness. For purposes of this section, "state-operated,
community-based program" means a program administered by the
state to provide treatment and habilitation in community
settings to persons with mental illness. Employees of the
programs must be state employees under chapters 43A and 179A.
The role of state-operated services must be defined within the
context of a comprehensive system of services for persons with
mental illness. Services may include, but are not limited to,
community residential treatment facilities for children and
adults.
Subd. 2. [LOCATION OF PROGRAMS FOR PERSONS WITH MENTAL
ILLNESS.] In determining the location of state-operated,
community-based programs, the needs of the individual clients
shall be paramount. The commissioner shall take into account:
(1) the personal preferences of the persons being served
and their families;
(2) location of the support services needed by the persons
being served as established by an individual service plan;
(3) the appropriate grouping of the persons served;
(4) the availability of qualified staff;
(5) the need for state-operated, community-based programs
in the geographical region of the state; and
(6) a reasonable commuting distance from a regional
treatment center or the residences of the program staff.
Subd. 3. [EVALUATION OF COMMUNITY-BASED SERVICES
DEVELOPMENT.] The commissioner shall develop an integrated
approach to assessing and improving the quality of
community-based services including state-operated programs to
persons with mental illness. The commissioner shall evaluate
the progress of the development and quality of the
community-based services to determine if further development can
proceed. The commissioner shall report results of the
evaluation to the legislature by January 31, 1993.
Sec. 29. Minnesota Statutes 1988, section 256B.092,
subdivision 7, is amended to read:
Subd. 7. [SCREENING TEAMS ESTABLISHED.] (a) 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 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, 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.
(b) In addition to the requirements of paragraph (a), the
following conditions apply to the discharge of persons with
mental retardation or a related condition from a regional
treatment center:
(1) For a person under public guardianship, at least two
weeks prior to each screening team meeting the case manager must
notify in writing parents, near relatives, and the ombudsman
established under section 245.92 or a designee, and invite them
to attend. The notice to parents and near relatives must
include: (i) notice of the provisions of section 252A.03,
subdivision 4, regarding assistance to persons interested in
assuming private guardianship; (ii) notice of the rights of
parents and near relatives to object to a proposed discharge by
requesting a review as provided in clause (7); and (iii)
information about advocacy services available to assist parents
and near relatives of persons with mental retardation or related
conditions. In the case of an emergency screening meeting, the
notice must be provided as far in advance as practicable.
(2) Prior to the discharge, a screening must be conducted
under subdivision 8 and a plan developed under subdivision 1a.
For a person under public guardianship, the county shall
encourage parents and near relatives to participate in the
screening team meeting. The screening team shall consider the
opinions of parents and near relatives in making its
recommendations. The screening team shall determine that the
services outlined in the plan are available in the community
before recommending a discharge. The case manager shall provide
a copy of the plan to the person, legal representative, parents,
near relatives, the ombudsman established under section 245.92,
and the protection and advocacy system established under United
States Code, title 42, section 6042, at least 30 days prior to
the date the proposed discharge is to occur. The information
provided to parents and near relatives must include notice of
the rights of parents and near relatives to object to a proposed
discharge by requesting a review as provided in clause (7). If
a discharge occurs, the case manager and a staff person from the
regional treatment center from which the person was discharged
must conduct a monitoring visit as required in Minnesota Rules,
part 9525.0115, within 90 days of discharge and provide an
evaluation within 15 days of the visit to the person, legal
representative, parents, near relatives, ombudsman, and the
protection and advocacy system established under United States
Code, title 42, section 6042.
(3) In order for a discharge or transfer from a regional
treatment center to be approved, the concurrence of a majority
of the screening team members is required. The screening team
shall determine that the services outlined in the discharge plan
are available and accessible in the community before the person
is discharged. The recommendation of the screening team cannot
be changed except by subsequent action of the team and is
binding on the county and on the commissioner. If the
commissioner or the county determines that the decision of the
screening team is not in the best interests of the person, the
commissioner or the county may seek judicial review of the
screening team recommendation. A person or legal representative
may appeal under section 256.045, subdivision 3 or 4a.
(4) For persons who have overriding health care needs or
behaviors that cause injury to self or others, or cause damage
to property that is an immediate threat to the physical safety
of the person or others, the following additional conditions
must be met:
(i) For a person with overriding health care needs, either
a registered nurse or a licensed physician shall review the
proposed community services to assure that the medical needs of
the person have been planned for adequately. For purposes of
this paragraph, "overriding health care needs" means a medical
condition that requires daily clinical monitoring by a licensed
registered nurse.
(ii) For a person with behaviors that cause injury to self
or others, or cause damage to property that is an immediate
threat to the physical safety of the person or others, a
qualified mental retardation professional, as defined in
paragraph (a), shall review the proposed community services to
assure that the behavioral needs of the person have been planned
for adequately. The qualified mental retardation professional
must have at least one year of experience in the areas of
assessment, planning, implementation, and monitoring of
individual habilitation plans that have used behavior
intervention techniques.
(5) No person with mental retardation or a related
condition may be discharged from a regional treatment center
before an appropriate community placement is available to
receive the person.
(6) A resident of a regional treatment center may not be
discharged to a community intermediate care facility with a
licensed capacity of more than 15 beds. Effective July 1, 1993,
a resident of a regional treatment center may not be discharged
to a community intermediate care facility with a licensed
capacity of more than ten beds.
(7) If the person, legal representative, parent, or near
relative of the person proposed to be discharged from a regional
treatment center objects to the proposed discharge, the
individual who objects to the discharge may request a review
under section 256.045, subdivision 4a, and may request
reimbursement as allowed under section 256.045. The person must
not be transferred from a regional treatment center while a
review or appeal is pending. Within 30 days of the request for
a review, the local agency shall conduct a conciliation
conference and inform the individual who requested the review in
writing of the action the local agency plans to take. The
conciliation conference must be conducted in a manner consistent
with section 256.045, subdivision 4a. A person, legal
representative, parent, or near relative of the person proposed
to be discharged who is not satisfied with the results of the
conciliation conference may submit to the commissioner a written
request for a hearing before a state human services referee
under section 256.045, subdivision 4a. The person, legal
representative, parent, or near relative of the person proposed
to be discharged may appeal the order to the district court of
the county responsible for furnishing assistance by serving a
written copy of a notice of appeal on the commissioner and any
adverse party of record within 30 days after the day the
commissioner issued the order and by filing the original notice
and proof of service with the court administrator of the
district court. Judicial review must proceed under section
256.045, subdivisions 7 to 10. For a person under public
guardianship, the ombudsman established under section 245.92 may
object to a proposed discharge by requesting a review or hearing
or by appealing to district court as provided in this clause.
The person must not be transferred from a regional treatment
center while a conciliation conference or appeal of the
discharge is pending.
Sec. 30. Minnesota Statutes 1988, section 256B.092,
subdivision 8, is amended to read:
Subd. 8. [SCREENING TEAM DUTIES.] The screening team shall:
(a) review diagnostic data;
(b) review health, social, and developmental assessment
data using a uniform screening tool specified by the
commissioner;
(c) identify the level of services needed appropriate to
maintain the person in the most normal and least restrictive
setting that is consistent with the person's treatment needs;
(d) identify other noninstitutional public assistance or
social service that may prevent or delay long-term residential
placement;
(e) assess whether a client is in serious need of long-term
residential care;
(f) make recommendations regarding placement and payment
for: (1) social service or public assistance support to
maintain a client in the client's own home or other place of
residence; (2) training and habilitation service, vocational
rehabilitation, and employment training activities; (3)
community residential placement; (4) state hospital regional
treatment center placement; or (5) a home and community-based
alternative to community residential placement or state hospital
placement;
(g) evaluate the availability, location, and quality of the
services listed in paragraph (f), including the impact of
placement alternatives on the client's ability to maintain or
improve existing patterns of contact and involvement with
parents and other family members;
(h) identify the cost implications of recommendations
in paragraph (f), above;
(h) (i) make recommendations to a court as may be needed to
assist the court in making commitments of mentally retarded
persons; and
(i) (j) inform clients that appeal may be made to the
commissioner pursuant to section 256.045.
Sec. 31. [256E.14] [GRANTS FOR CASE MANAGEMENT FOR PERSONS
WITH MENTAL RETARDATION OR RELATED CONDITIONS.]
For the biennium ending June 30, 1991, the commissioner
shall distribute to counties the appropriation made available
under this section for case management services for persons with
mental retardation or related conditions as follows:
(1) one-half of the appropriation must be distributed to
the counties according to the formula in section 256E.06,
subdivision 1; and
(2) one-half of the appropriation must be distributed to
the counties on the basis of the number of persons with mental
retardation or a related condition that were receiving case
management services from the county on the January 1 preceding
the start of the fiscal year in which the funds are distributed.
Sec. 32. [STUDY OF PARENTAL INVOLVEMENT.]
The commissioner of human services shall determine the
number of persons transferred from public to private
guardianship, and the increased involvement of parents and near
relatives in the activities of screening teams established under
Minnesota Statutes, section 256B.092, subdivision 7, as a result
of the adoption of sections 23, 29, and 30, and report the
results of the study to the legislature by December 15, 1990.
Sec. 33. [STUDY OF REGIONAL TREATMENT CENTER DISCHARGES.]
The commissioner shall contract for a study of the progress
of selected citizens who have been discharged from regional
treatment centers since 1985 and shall report to the legislature
on or before July 1, 1990. The study must be supervised and
directed by the commissioner of human services.
Presented to the governor May 30, 1989
Signed by the governor June 1, 1989, 11:05 p.m.
Official Publication of the State of Minnesota
Revisor of Statutes