Minnesota Session Laws - 1993, 1st Special Session

 
    Laws of Minnesota, 1993 First Special Session 

                          CHAPTER 6-S.F.No. 5 
           An act relating to legislative enactments; providing 
          for the correction of miscellaneous oversights, 
          inconsistencies, ambiguities, unintended results, and 
          technical errors of a noncontroversial nature; 
          amending Minnesota Statutes 1992, sections 16B.42, 
          subdivision 1; 115C.02, subdivision 14, as amended; 
          116.76, subdivision 1, as amended; 116.77, as amended; 
          116.82, subdivision 3, as amended; 124.914, 
          subdivision 4, as added; 256.969, by adding 
          subdivisions, as amended; 256B.057, subdivision 1, as 
          amended; 256B.0625, by adding a subdivision, as 
          amended; 256B.0913, subdivision 5, as amended; 
          256B.0915, subdivision 3; 256B.0915, subdivision 3, as 
          amended; 256D.02, subdivision 5, as amended; 256D.051, 
          subdivision 6, as amended; 257.071, subdivision 1, as 
          amended; 260.191, subdivisions 3a and 3b, as added; 
          295.50, subdivisions 3 and 4, as amended, and by 
          adding subdivisions; 295.51, subdivision 1, as 
          amended; 295.52, by adding a subdivision; 295.53, 
          subdivision 3, as amended, and by adding a 
          subdivision; 295.54, as amended; 298.28, subdivision 
          4, as amended; 477A.013, subdivision 1; Laws 1992, 
          chapter 549, article 9, section 19, as amended; Laws 
          1993, chapter 206, sections 8, subdivision 1; 25; 
          chapter 340, section 60; chapter 345, article 1, 
          sections 2, subdivision 2; and 8, subdivision 1; 
          article 2, section 5, subdivision 2; chapter 372, 
          section 8; 1993 Special Session H.F. No. 1, article 3, 
          section 29, subdivision 1; article 4, sections 4, 
          subdivision 5; 6, subdivision 6; repealing Laws 1993, 
          chapter 224, article 1, section 31; and chapter 337, 
          section 16. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
    Section 1.  Minnesota Statutes 1992, section 16B.42, 
subdivision 1, is amended to read: 
    Subdivision 1.  [COMPOSITION.] The commissioner of 
administration shall appoint an intergovernmental information 
systems advisory council, to serve at the pleasure of the 
commissioner of administration, consisting of 25 members.  
Fourteen members shall be appointed or elected officials of 
local governments, seven shall be representatives of state 
agencies, and four shall be selected from the community at 
large.  Further, the council shall be composed of (1) two 
members from each of the following groups:  counties outside of 
the seven county metropolitan area, cities of the second and 
third class outside the metropolitan area, cities of the second 
and third class within the metropolitan area, and cities of the 
fourth class; (2) one member from each of the following groups: 
the metropolitan council, an outstate regional body, counties 
within the metropolitan area, cities of the first class, school 
districts in the metropolitan area, and school districts outside 
the metropolitan area; (3) one member each from the state 
departments of administration, education, human services, 
revenue, planning and the legislative auditor; (4) one member 
from the office of the state auditor; and (5) four members from 
the state community at large.  To the extent permitted by 
resources the commissioner shall furnish staff and other 
assistance as requested by the council.  The terms, 
compensation, and removal of members of the advisory council 
shall be as provided in section 15.059, but the council does not 
expire until June 30, 1993 1995. 
    Sec. 2.  Minnesota Statutes 1992, section 115C.02, 
subdivision 14, as amended by Laws 1993, chapter 341, section 3, 
is amended to read: 
    Subd. 14.  [TANK.] "Tank" means any one or a combination of 
containers, vessels, and enclosures, including structures and 
appurtenances connected to them, that is, or has been, used to 
contain or dispense petroleum.  
    "Tank" does not include: 
    (1) a mobile storage tank with a capacity of 500 gallons or 
less used to transport petroleum only on the person's private 
property and which is used only for home heating fuel from one 
location to another, except a mobile storage tank with a 
capacity of 500 gallons or less used only to transport home 
heating fuel on private property; or 
    (2) pipeline facilities, including gathering lines, 
regulated under the Natural Gas Pipeline Safety Act of 1968, 
United States Code, title 49, chapter 24, or the Hazardous 
Liquid Pipeline Safety Act of 1979, United States Code, title 
49, chapter 29. 
    Sec. 3.  Minnesota Statutes 1992, section 116.76, 
subdivision 1, as amended by Laws 1993, chapter 206, section 3, 
is amended to read: 
    Subdivision 1.  [APPLICABILITY.] The definitions in this 
section apply to sections 116.76 to 116.82 116.83. 
    Sec. 4.  Minnesota Statutes 1992, section 116.77, as 
amended by Laws 1993, chapter 206, section 4, is amended to read:
    116.77 [COVERAGE.] 
    Sections 116.75 to 116.82 116.83 and 609.671, subdivision 
10, cover any person, including a veterinarian, who generates, 
treats, stores, transports, or disposes of infectious or 
pathological waste but not including infectious or pathological 
waste generated by households, farm operations, or agricultural 
businesses.  Except as specifically provided, sections 116.75 to 
116.83 do not limit or alter treatment or disposal methods for 
infectious or pathological waste. 
    Sec. 5.  Minnesota Statutes 1992, section 116.82, 
subdivision 3, as amended by Laws 1993, chapter 206, section 5, 
is amended to read: 
    Subd. 3.  [LOCAL ENFORCEMENT.] Sections 116.76 to 116.81 
may be enforced by a county by delegation of enforcement 
authority granted to the commissioner of health and the agency 
in section 144.99 116.83.  Separate enforcement actions may not 
be brought by a state agency and a county for the same 
violations.  The state or county may not bring an action that is 
being enforced by the federal Office of Safety and Health 
Administration.  
    Sec. 6.  Minnesota Statutes 1992, section 124.914, 
subdivision 4, as added by Laws 1993, chapter 224, article 6, 
section 17, is amended to read: 
    Subd. 4.  [1992 OPERATING DEBT.] (a) Each year, a district 
that has filed a plan pursuant to section 121.917, subdivision 
4, may levy, with the approval of the commissioner, to eliminate 
a deficit in the net unappropriated balance in the operating 
funds of the district, determined as of June 30, 1992, and 
certified and adjusted by the commissioner.  Each year this levy 
may be an amount not to exceed the greater lesser of: 
    (1) an amount raised by a levy of a net tax rate of one 
percent times the adjusted net tax capacity; or 
    (2) $100,000. 
This amount shall be reduced by referendum revenue authorized 
under section 124A.03 pursuant to the plan filed under section 
121.917.  However, the total amount of this levy for all years 
it is made shall not exceed the amount of the deficit in the net 
unappropriated balance in the operating funds of the district as 
of June 30, 1992.  When the cumulative levies made pursuant to 
this subdivision equal the total amount permitted by this 
subdivision, the levy shall be discontinued.  
    (b) A district, if eligible, may levy under this 
subdivision or subdivision 2 or 3, or under section 122.531, 
subdivision 4a, or Laws 1992, chapter 499, article 7, sections 
16 or 17, but not under more than one. 
    (c) The proceeds of this levy shall be used only for cash 
flow requirements and shall not be used to supplement district 
revenues or income for the purposes of increasing the district's 
expenditures or budgets.  
    (d) Any district that levies pursuant to this subdivision 
shall certify the maximum levy allowable under section 124A.23, 
subdivision 2, in that same year. 
    Sec. 7.  Minnesota Statutes 1992, section 256.969, 
subdivision 9a, as amended by Laws 1993, chapter 20, section 2, 
and amended by 1993 Special Session H.F. No. 1, article 5, 
section 21, is amended to read:  
    Subd. 9a.  [DISPROPORTIONATE POPULATION ADJUSTMENTS UNTIL 
JULY 1, 1993.] (a) For admissions occurring between January 1, 
1993, and June 30, 1993, the adjustment under this subdivision 
shall be paid to a hospital, excluding regional treatment 
centers and facilities of the federal Indian Health Service, 
with a medical assistance inpatient utilization rate in excess 
of one standard deviation above the arithmetic mean.  The 
adjustment must be determined by multiplying the total of the 
operating and property payment rates by the difference between 
the hospital's actual medical assistance inpatient utilization 
rate and the arithmetic mean for all hospitals excluding 
regional treatment centers and facilities of the federal Indian 
Health Service, and the result must be multiplied by 1.1.  The 
provisions of this paragraph are effective only if federal 
matching funds are not available for all adjustments under this 
subdivision and it is necessary to implement ratable reductions 
under subdivision 9b 9. 
    Sec. 8.  Minnesota Statutes 1992, section 256.969, 
subdivision 22, as added by Laws 1993, chapter 20, section 5, 
and amended by 1993 Special Session H.F. No. 1, article 5, 
section 23, is amended to read: 
    Subd. 22.  [HOSPITAL PAYMENT ADJUSTMENT.] For admissions 
occurring from January 1, 1993, until June 30, 1993, the 
commissioner shall adjust the medical assistance payment paid to 
a hospital, excluding regional treatment centers and facilities 
of the federal Indian Health Service, with a medical assistance 
inpatient utilization rate in excess of the arithmetic mean.  
The adjustment must be determined as follows: 
    (1) for a hospital with a medical assistance inpatient 
utilization rate above the arithmetic mean for all hospitals 
excluding regional treatment centers and facilities of the 
federal Indian Health Service, the adjustment must be determined 
by multiplying the total of the operating and property payment 
rates by the difference between the hospital's actual medical 
assistance inpatient utilization rate and the arithmetic mean 
for all hospitals excluding regional treatment centers and 
facilities of the federal Indian Health Service; and 
    (2) for a hospital with a medical assistance inpatient 
utilization rate above one standard deviation above the mean, 
the adjustment must be determined by multiplying the adjustment 
under clause (1) for that hospital by 1.1.  Any payment under 
this clause must be reduced by the amount of any payment 
received under subdivision 9a.  For purposes of this 
subdivision, medical assistance does not include general 
assistance medical care. 
    This subdivision is effective only if federal matching 
funds are not available for all adjustments under this 
subdivision and it is necessary to implement ratable reductions 
under subdivision 9b 9. 
    Sec. 9.  Minnesota Statutes 1992, section 256B.057, 
subdivision 1, as amended by Laws 1993, chapter 345, article 9, 
section 11, is amended to read: 
    Subdivision 1.  [PREGNANT WOMEN AND INFANTS.] An infant 
less than one year of age or a pregnant woman who has written 
verification of a positive pregnancy test from a physician or 
licensed registered nurse, is eligible for medical assistance if 
countable family income is equal to or less than 275 percent of 
the federal poverty guideline for the same family size.  For 
purposes of this subdivision, "countable family income" means 
the amount of income considered available using the methodology 
of the AFDC program, except for the earned income disregard and 
employment deductions.  An amount equal to the amount of earned 
income exceeding 275 percent of the federal poverty guideline, 
up to a maximum of the amount by which the combined total of 185 
percent of the federal poverty guideline plus the earned income 
disregards and deductions of the AFDC program exceeds 275 
percent of the federal poverty guideline will be deducted for 
pregnant women and infants less than one year of age.  
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.  
    An infant born on or after January 1, 1991, to a woman who 
was eligible for and receiving medical assistance on the date of 
the child's birth shall continue to be eligible for medical 
assistance without redetermination until the child's first 
birthday, as long as the child remains in the woman's household. 
    Sec. 10.  [CHILD WELFARE TARGETED CASE MANAGEMENT.] 
Minnesota Statutes 1992, section 256B.0625, subdivision 32, as 
added to section 256B.0625 by 1993 Special Session H.F. No. 1, 
article 3, section 23, is amended to read: 
    Subd. 32.  [CHILD WELFARE TARGETED CASE MANAGEMENT.] 
Medical assistance, subject to federal approval, covers child 
welfare targeted case management services as defined in section 
256B.094 to children under age 21 who have been assessed and 
determined in accordance with section 256F.10 256F.095 to be:  
    (1) at risk of placement or in placement as defined in 
section 257.071, subdivision 1; 
    (2) at risk of maltreatment or experiencing maltreatment as 
defined in section 626.556, subdivision 10e; or 
    (3) in need of protection or services as defined in section 
260.015, subdivision 2a. 
    Sec. 11.  The repeal of Minnesota Statutes, section 
256B.0629 by Laws 1993, chapter 339 is of no effect and the 
section is reenacted.  
    Sec. 12.  [STATUTORY REFERENCE.] Minnesota Statutes 1992, 
section 256B.0913, subdivision 5, as amended by 1993 Special 
Session H.F. No. 1, article 5, section 63, is amended to read: 
    Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
Alternative care funding may be used for payment of costs of: 
    (1) adult foster care; 
    (2) adult day care; 
    (3) home health aide; 
    (4) homemaker services; 
    (5) personal care; 
    (6) case management; 
    (7) respite care; 
    (8) assisted living; 
    (9) residential care services; 
    (10) care-related supplies and equipment; 
    (11) meals delivered to the home; 
    (12) transportation; 
    (13) skilled nursing; 
    (14) chore services; 
    (15) companion services; 
    (16) nutrition services; and 
    (17) training for direct informal caregivers. 
    (b) The county agency must ensure that the funds are used 
only to supplement and not supplant services available through 
other public assistance or services programs. (c) Unless 
specified in statute, the service standards for alternative care 
services shall be the same as the service standards defined in 
the elderly waiver.  Persons or agencies must be employed by or 
under a contract with the county agency or the public health 
nursing agency of the local board of health in order to receive 
funding under the alternative care program. 
    (d) The adult foster care rate shall be considered a 
difficulty of care payment and shall not include room and 
board.  The adult foster care daily rate shall be negotiated 
between the county agency and the foster care provider.  The 
rate established under this section shall not exceed 75 percent 
of the state average monthly nursing home payment for the case 
mix classification to which the individual receiving foster care 
is assigned, and it must allow for other alternative care 
services to be authorized by the case manager. 
    (e) Personal care services may be provided by a personal 
care provider organization.  A county agency may contract with a 
relative of the client to provide personal care services, but 
must ensure nursing supervision.  Covered personal care services 
defined in section 256B.0627, subdivision 4, must meet 
applicable standards in Minnesota Rules, part 9505.0335. 
    (f) Costs for supplies and equipment that exceed $150 per 
item per month must have prior approval from the commissioner.  
A county may use alternative care funds to purchase supplies and 
equipment from a non-Medicaid certified vendor if the cost for 
the items is less than that of a Medicaid vendor. 
    (g) For purposes of this section, residential care services 
are services which are provided to individuals living in 
residential care homes.  Residential care homes are currently 
licensed as board and lodging establishments and are registered 
with the department of health as providing special services.  
Residential care services are defined as "supportive services" 
and "health-related services."  "Supportive services" means the 
provision of up to 24-hour supervision and oversight.  
Supportive services includes:  (1) transportation, when provided 
by the residential care center only; (2) socialization, when 
socialization is part of the plan of care, has specific goals 
and outcomes established, and is not diversional or recreational 
in nature; (3) assisting clients in setting up meetings and 
appointments; (4) assisting clients in setting up medical and 
social services; (5) providing assistance with personal laundry, 
such as carrying the client's laundry to the laundry room.  
Assistance with personal laundry does not include any laundry, 
such as bed linen, that is included in the room and board rate.  
Health-related services are limited to minimal assistance with 
dressing, grooming, and bathing and providing reminders to 
residents to take medications that are self-administered or 
providing storage for medications, if requested.  Individuals 
receiving residential care services cannot receive both personal 
care services and residential care services.  
    (h) For the purposes of this section, "assisted living" 
refers to supportive services provided by a single vendor to 
clients who reside in the same apartment building of three or 
more units.  Assisted living services are defined as up to 
24-hour supervision, and oversight, supportive services as 
defined in clause (1), individualized home care aide tasks as 
defined in clause (2), and individualized home management tasks 
as defined in clause (3) provided to residents of a residential 
center living in their units or apartments with a full kitchen 
and bathroom.  A full kitchen includes a stove, oven, 
refrigerator, food preparation counter space, and a kitchen 
utensil storage compartment.  Assisted living services must be 
provided by the management of the residential center or by 
providers under contract with the management or with the county. 
    (1) Supportive services include:  
    (i) socialization, when socialization is part of the plan 
of care, has specific goals and outcomes established, and is not 
diversional or recreational in nature; 
    (ii) assisting clients in setting up meetings and 
appointments; and 
    (iii) providing transportation, when provided by the 
residential center only.  
    Individuals receiving assisted living services will not 
receive both assisted living services and homemaking or personal 
care services.  Individualized means services are chosen and 
designed specifically for each resident's needs, rather than 
provided or offered to all residents regardless of their 
illnesses, disabilities, or physical conditions.  
    (2) Home care aide tasks means:  
    (i) preparing modified diets, such as diabetic or low 
sodium diets; 
    (ii) reminding residents to take regularly scheduled 
medications or to perform exercises; 
    (iii) household chores in the presence of technically 
sophisticated medical equipment or episodes of acute illness or 
infectious disease; 
    (iv) household chores when the resident's care requires the 
prevention of exposure to infectious disease or containment of 
infectious disease; and 
    (v) assisting with dressing, oral hygiene, hair care, 
grooming, and bathing, if the resident is ambulatory, and if the 
resident has no serious acute illness or infectious disease.  
Oral hygiene means care of teeth, gums, and oral prosthetic 
devices.  
    (3) Home management tasks means:  
    (i) housekeeping; 
    (ii) laundry; 
    (iii) preparation of regular snacks and meals; and 
    (iv) shopping.  
    A person's eligibility to reside in the building must not 
be contingent on the person's acceptance or use of the assisted 
living services.  Assisted living services as defined in this 
section shall not be authorized in boarding and lodging 
establishments licensed according to sections 157.01 to 157.031. 
    Reimbursement for assisted living services and residential 
care services shall be made by the lead agency to the vendor as 
a monthly rate negotiated with the county agency.  The rate 
shall not exceed the nonfederal share of the greater of either 
the statewide or any of the geographic groups' weighted average 
monthly medical assistance nursing facility payment rate of the 
case mix resident class to which the 180-day eligible client 
would be assigned under Minnesota Rules, parts 9549.0050 to 
9549.0059, except for alternative care assisted living projects 
established under chapter Laws 1988, chapter 689, article 2, 
section 256, whose rates may not exceed 65 percent of either the 
statewide or any of the geographic groups' weighted average 
monthly medical assistance nursing facility payment rate of the 
case mix resident class to which the 180-day eligible client 
would be assigned under Minnesota Rules, parts 9549.0050 to 
9549.0059.  The rate may not cover rent and direct food costs. 
    (i) For purposes of this section, companion services are 
defined as nonmedical care, supervision and oversight, provided 
to a functionally impaired adult.  Companions may assist the 
individual with such tasks as meal preparation, laundry and 
shopping, but do not perform these activities as discrete 
services.  The provision of companion services does not entail 
hands-on medical care.  Providers may also perform light 
housekeeping tasks which are incidental to the care and 
supervision of the recipient.  This service must be approved by 
the case manager as part of the care plan.  Companion services 
must be provided by individuals or nonprofit organizations who 
are under contract with the local agency to provide the 
service.  Any person related to the waiver recipient by blood, 
marriage or adoption cannot be reimbursed under this service.  
Persons providing companion services will be monitored by the 
case manager. 
    (j) For purposes of this section, training for direct 
informal caregivers is defined as a classroom or home course of 
instruction which may include:  transfer and lifting skills, 
nutrition, personal and physical cares, home safety in a home 
environment, stress reduction and management, behavioral 
management, long-term care decision making, care coordination 
and family dynamics.  The training is provided to an informal 
unpaid caregiver of a 180-day eligible client which enables the 
caregiver to deliver care in a home setting with high levels of 
quality.  The training must be approved by the case manager as 
part of the individual care plan.  Individuals, agencies, and 
educational facilities which provide caregiver training and 
education will be monitored by the case manager. 
    Sec. 13.  Minnesota Statutes 1992, section 256B.0915, 
subdivision 3, as amended by 1993 Special Session H.F. No. 1, 
article 5, subdivision 72, is amended to read: 
    Subd. 3.  [LIMITS OF CASES, RATES, REIMBURSEMENT, AND 
FORECASTING.] (a) The number of medical assistance waiver 
recipients that a county may serve must be allocated according 
to the number of medical assistance waiver cases open on July 1 
of each fiscal year.  Additional recipients may be served with 
the approval of the commissioner. 
    (b) The monthly limit for the cost of waivered services to 
an individual waiver client shall be the statewide average 
payment rate of the case mix resident class to which the waiver 
client would be assigned under medical assistance case mix 
reimbursement system.  The statewide average payment rate is 
calculated by determining the statewide average monthly nursing 
home rate effective July 1 of the fiscal year in which the cost 
is incurred, less the statewide average monthly income of 
nursing home residents who are age 65 or older, and who are 
medical assistance recipients in the month of March of the 
previous state fiscal year.  The following costs must be 
included in determining the total monthly costs for the waiver 
client: 
     (1) cost of all waivered services, including extended 
medical supplies and equipment; and 
     (2) cost of skilled nursing, home health aide, and personal 
care services reimbursable by medical assistance.  
     (c) Medical assistance funding for skilled nursing 
services, home health aide, and personal care services for 
waiver recipients must be approved by the case manager and 
included in the individual care plan. 
    (d) Expenditures for extended medical supplies and 
equipment that cost over $150 per month for both the elderly 
waiver and the disabled waiver must have the commissioner's 
prior approval. 
    (e) For the fiscal year beginning on July 1, 1993, and for 
subsequent fiscal years, the commissioner of human services 
shall not provide automatic annual inflation adjustments for 
home- and community-based waivered services.  The commissioner 
of finance shall include as a budget change request in each 
biennial detailed expenditure budget submitted to the 
legislature under section 16A.11 annual adjustments in 
reimbursement rates for home- and community-based waivered 
services, based on the forecasted percentage change in the Home 
Health Agency Market Basket of Operating Costs, for the fiscal 
year beginning July 1, compared to the previous fiscal year, 
unless otherwise adjusted by statute.  The Home Health Agency 
Market Basket of Operating Costs is published by Data Resources, 
Inc.  The forecast to be used is the one published for the 
calendar quarter beginning January 1, six months prior to the 
beginning of the fiscal year for which rates are set.  The adult 
foster care rate shall be considered a difficulty of care 
payment and shall not include room and board. 
    (f) The adult foster care daily rate for the elderly and 
disabled waivers shall be negotiated between the county agency 
and the foster care provider.  The rate established under this 
section shall not exceed the state average monthly nursing home 
payment for the case mix classification to which the individual 
receiving foster care is assigned, and it must allow for other 
waiver and medical assistance home care services to be 
authorized by the case manager. 
    (g) The assisted living and residential care service rates 
for elderly and disabled waivers shall be made to the vendor as 
a monthly rate negotiated with the county agency.  The rate 
shall not exceed the nonfederal share of the greater of either 
the statewide or any of the geographic groups' weighted average 
monthly medical assistance nursing facility payment rate of the 
case mix resident class to which the elderly or disabled client 
would be assigned under Minnesota Rules, parts 9549.0050 to 
9549.0059, except for alternative care assisted living projects 
established under Laws 1988, chapter 689, article 2, section 
256, whose rates may not exceed 65 percent of the greater of 
either the statewide or any of the geographic groups' weighted 
average monthly medical assistance nursing facility payment rate 
for the case mix resident class to which the elderly or disabled 
client would be assigned under Minnesota Rules, parts 9549.0050 
to 9549.0059.  The rate may not cover direct rent or food costs. 
    (h) The county shall negotiate individual rates with 
vendors and may be reimbursed for actual costs up to the greater 
of the county's current approved rate or 60 percent of the 
maximum rate in fiscal year 1994 and 65 percent of the maximum 
rate in fiscal year 1995 for each service within each program. 
    (i) On July 1, 1993, the commissioner shall increase the 
maximum rate for home-delivered meals to $4.50 per meal. 
    (j) Reimbursement for the medical assistance recipients 
under the approved waiver shall be made from the medical 
assistance account through the invoice processing procedures of 
the department's Medicaid Management Information System (MMIS), 
only with the approval of the client's case manager.  The budget 
for the state share of the Medicaid expenditures shall be 
forecasted with the medical assistance budget, and shall be 
consistent with the approved waiver.  
    (k) Beginning July 1, 1991, the state shall reimburse 
counties according to the payment schedule in section 256.025 
for the county share of costs incurred under this subdivision on 
or after January 1, 1991, for individuals who are receiving 
medical assistance. 
    Sec. 14.  [DEFINITION OF FAMILIES: RESIDENTIAL LEAD PAINT 
DISPOSAL EFFECTIVE DATE.] Minnesota Statutes 1992, section 
256D.02, subdivision 5, as amended by 1993 Special Session H.F. 
No. 1, article 6, section 27, is amended to read: 
    Subd. 5.  "Family" means the applicant or recipient and the 
following persons who reside with the applicant or recipient:  
    (1) the applicant's spouse; 
    (2) any minor child of whom the applicant is a parent, 
stepparent, or legal custodian, and that child's minor siblings, 
including half-siblings and stepsiblings; 
    (3) the other parent of the applicant's minor child or 
children together with that parent's minor children, and, if 
that parent is a minor, his or her parents, stepparents, legal 
guardians, and minor siblings; and 
    (4) if the applicant or recipient is a minor, the minor's 
parents, stepparents, or legal guardians, and any other minor 
children for whom those parents, stepparents, or legal guardians 
are financially responsible.  
    For the period July 1, 1993, to June 30, 1995, a minor 
child who is temporarily absent from the applicant's or 
recipient's home due to placement in foster care paid for from 
state or local funds, but who is expected to return within six 
months of the month of departure, is considered to be residing 
with the applicant or recipient. 
    A "family" must contain at least one minor child and at 
least one of that child's natural or adoptive parents, 
stepparents, or legal custodians. 
    Sec. 15.  [STATUTORY REFERENCES.] Minnesota Statutes 1992, 
section 256D.051, subdivision 6, as amended by 1993 Special 
Session H.F. No. 1, article 6, section 32, is amended to read: 
    Subd. 6.  [SERVICE COSTS.] The commissioner shall reimburse 
92 percent of county agency expenditures for providing work 
readiness services including direct participation expenses and 
administrative costs, except as provided in section 256.017. 
State work readiness funds shall be used only to pay the county 
agency's and work readiness service provider's actual costs of 
providing participant support services, direct program services, 
and program administrative costs for persons who participate in 
work readiness services.  Beginning July 1, 1991, the average 
annual reimbursable cost for providing work readiness services 
to a recipient for whom an individualized employability 
development plan is not completed must not exceed $60 for the 
work readiness services, and $223 for necessary recipient 
support services such as transportation or child care needed to 
participate in work readiness services.  If an individualized 
employability development plan has been completed, the average 
annual reimbursable cost for providing work readiness services 
must not exceed $283, except that the total annual average 
reimbursable cost shall not exceed $804 for recipients who 
participate in a pilot project work experience program under 
section 56 55, for all services and costs necessary to implement 
the plan, including the costs of training, employment search 
assistance, placement, work experience, on-the-job training, 
other appropriate activities, the administrative and program 
costs incurred in providing these services, and necessary 
recipient support services such as tools, clothing, and 
transportation needed to participate in work readiness 
services.  Beginning July 1, 1991, the state will reimburse 
counties, up to the limit of state appropriations, according to 
the payment schedule in section 256.025 for the county share of 
costs incurred under this subdivision on or after January 1, 
1991.  Payment to counties under this subdivision is subject to 
the provisions of section 256.017.  
    Sec. 16.  Minnesota Statutes 1992, section 257.071, 
subdivision 1, as amended by Laws 1993, chapter 291, section 2, 
is amended to read: 
    Subdivision 1.  [PLACEMENT; PLAN.] A case plan shall be 
prepared within 30 days after any child is placed in a 
residential facility by court order or by the voluntary release 
of the child by the parent or parents.  
    For purposes of this section, a residential facility means 
any group home, family foster home or other publicly supported 
out-of-home residential facility, including any out-of-home 
residential facility under contract with the state, county or 
other political subdivision, or any agency thereof, to provide 
those services or family foster care as defined in section 
260.015, subdivision 7.  
    For the purposes of this section, a case plan means a 
written document which is ordered by the court or which is 
prepared by the social service agency responsible for the 
residential facility placement and is signed by the parent or 
parents, or other custodian, of the child, the child's legal 
guardian, the social service agency responsible for the 
residential facility placement, and, if possible, the child.  
The document shall be explained to all persons involved in its 
implementation, including the child who has signed the document, 
and shall set forth: 
    (1) The specific reasons for the placement of the child in 
a residential facility, including a description of the problems 
or conditions in the home of the parent or parents which 
necessitated removal of the child from home; 
    (2) The specific actions to be taken by the parent or 
parents of the child to eliminate or correct the problems or 
conditions identified in clause (1), and the time period during 
which the actions are to be taken; 
    (3) The financial responsibilities and obligations, if any, 
of the parents for the support of the child during the period 
the child is in the residential facility; 
    (4) The visitation rights and obligations of the parent or 
parents or other relatives as defined in section 260.181, if 
such visitation is consistent with the best interest of the 
child, during the period the child is in the residential 
facility; 
    (5) The social and other supportive services to be provided 
to the parent or parents of the child, the child, and the 
residential facility during the period the child is in the 
residential facility; 
    (6) The date on which the child is expected to be returned 
to the home of the parent or parents; 
    (7) The nature of the effort to be made by the social 
service agency responsible for the placement to reunite the 
family; and 
    (8) Notice to the parent or parents that placement of the 
child in foster care may result in termination of parental 
rights but only after notice and a hearing as provided in 
chapter 260. 
    The parent or parents and the child each shall have the 
right to legal counsel in the preparation of the case plan and 
shall be informed of the right at the time of placement of the 
child.  The child shall also have the right to a guardian ad 
litem.  If unable to employ counsel from their own resources, 
the court shall appoint counsel upon the request of the parent 
or parents or the child or the child's legal guardian.  The 
parent or parents may also receive assistance from any person or 
social service agency in preparation of the case plan. 
    After the plan has been agreed upon by the parties 
involved, the foster parents shall be fully informed of the 
provisions of the case plan. 
    When an agency accepts a child for placement, the agency 
shall determine whether the child has had a physical examination 
by or under the direction of a licensed physician within the 12 
months immediately preceding the date when the child came into 
the agency's care.  If there is documentation that the child has 
had such an examination within the last 12 months, the agency is 
responsible for seeing that the child has another physical 
examination within one year of the documented examination and 
annually in subsequent years.  If the agency determines that the 
child has not had a physical examination within the 12 months 
immediately preceding placement, the agency shall ensure that 
the child has the examination within 30 days of coming into the 
agency's care and once a year in subsequent years. 
    Sec. 17.  Minnesota Statutes 1992, section 260.191, 
subdivision 3a, as added by Laws 1993, chapter 291, section 20, 
is amended to read: 
    Subd. 3a.  [COURT REVIEW OF OUT-OF-HOME PLACEMENTS.] If the 
court places a child in a residential facility, as defined in 
section 257.071, subdivision 1, the court shall review the 
out-of-home placement at least every six months to determine 
whether continued out-of-home placement is necessary and 
appropriate or whether the child should be returned home.  The 
court shall review agency efforts pursuant to section 257.072, 
subdivision 1, and order that the efforts continue if the agency 
has failed to perform the duties under that section.  The court 
shall review the case plan and may modify the case plan as 
provided under subdivisions 1e and 2.  If the court orders 
continued out-of-home placement, the court shall notify the 
parents of the provisions of subdivision 3b. 
    Sec. 18.  Minnesota Statutes 1992, section 260.191, 
subdivision 3b, as added by Laws 1993, chapter 291, section 21, 
is amended to read: 
    Subd. 3b.  [REVIEW OF COURT ORDERED PLACEMENTS; PERMANENT 
PLACEMENT DETERMINATION.] (a) If the court places a child in a 
residential facility, as defined in section 257.071, subdivision 
1, the court shall conduct a hearing to determine the permanent 
status of the child not later than 12 months after the child was 
placed out of the home of the parent.  Not later than 30 days 
prior to this hearing the responsible social service agency 
shall file pleadings to establish the basis for the permanent 
placement determination.  Notice of the hearing and copies of 
the pleadings must be provided pursuant to sections 260.135 and 
260.141.  If a termination of parental rights petition is filed 
before the date required for the permanency planning 
determination, no hearing need be conducted under this section.  
The court shall determine whether the child is to be returned 
home or, if not, what permanent placement is consistent with the 
child's best interests.  The "best interests of the child" means 
all relevant factors to be considered and evaluated. 
    If the child is not returned to the home, the dispositions 
available for permanent placement determination are permanent 
legal and physical custody to a relative, adoption, or permanent 
foster care.  The court may order a child into permanent foster 
care only if it finds that neither an award of legal and 
physical custody to a relative, termination of parental rights, 
nor adoption is in the child's best interests.  
    (b) The court may extend the time period for determination 
of permanent placement to 18 months after the child was placed 
in a residential facility if: 
    (1) there is a substantial probability that the child will 
be returned home within the next six months; 
    (2) the agency has not made reasonable, or, in the case of 
an Indian child, active efforts, to correct the conditions that 
form the basis of the out-of-home placement; or 
    (3) extraordinary circumstances exist precluding a 
permanent placement determination, in which case the court shall 
make written findings documenting the extraordinary 
circumstances and order one subsequent review after six months 
to determine permanent placement. 
    (c) If the court determines that an adoptive placement is 
in the best interests of the child, the social service agency 
shall file a petition for termination of parental rights under 
section 260.231.  Nothing in this subdivision waives the 
requirements of sections 260.221 to 260.245 with respect to 
termination of parental rights. 
    (d) In ordering a permanent placement of a child, the court 
must be governed by the best interests of the child, including a 
review of the relationship between the child and relatives and 
the child and other important persons with whom the child has 
resided or had significant contact. 
    (e) Once a permanent placement determination has been made 
and permanent placement has been established, further reviews 
are only necessary if otherwise required by federal law, an 
adoption has not yet been finalized, or there is a disruption of 
the permanent placement.  These reviews must take place no less 
frequently than every six months. 
    (f) An order under this subdivision must include the 
following detailed findings: 
    (1) how the child's best interests are served by the order; 
    (2) the nature and extent of the responsible social service 
agency's reasonable efforts, or, in the case of an Indian child, 
active efforts, to reunify the child with the parent or parents; 
    (3) the parent's or parents' efforts and ability to use 
services to correct the conditions which led to the out-of-home 
placement; 
    (4) whether the conditions which led to the out-of-home 
placement have been corrected so that the child can return home; 
and 
    (5) if the child cannot be returned home, whether there is 
a substantial probability of the child being able to return home 
in the next six months.  
    If the court orders the child placed in permanent foster 
care, the court shall make findings that neither an award of 
legal and physical custody to a relative, termination of 
parental rights, nor adoption is in the child's best interests. 
    A court finding that extraordinary circumstances exist 
precluding a permanent placement determination must be supported 
by detailed factual findings regarding those circumstances. 
    Sec. 19.  Minnesota Statutes 1992, section 295.50, 
subdivision 3, as amended by Laws 1993, chapter 345, article 13, 
section 3, is amended to read: 
    Subd. 3.  [GROSS REVENUES.] "Gross revenues" are total 
amounts received in money or otherwise by: 
    (1) a resident hospital for patient services; 
    (2) a resident surgical center for patient services; 
    (3) a nonresident hospital for patient services provided to 
patients domiciled in Minnesota; 
    (4) a nonresident surgical center for patient services 
provided to patients domiciled in Minnesota; 
    (5) a resident health care provider, other than a staff 
model health carrier, for patient services; 
    (6) a nonresident health care provider for patient services 
provided to an individual domiciled in Minnesota; 
    (7) a wholesale drug distributor for sale or distribution 
of prescription drugs that are delivered:  (i) to a Minnesota 
resident by a wholesale drug distributor who is a nonresident 
pharmacy directly, by common carrier, or by mail; or (ii) in 
Minnesota by the wholesale drug distributor, by common carrier, 
or by mail, unless the prescription drugs are delivered to 
another wholesale drug distributor.  Prescription drugs do not 
include nutritional products as defined in Minnesota Rules, part 
9505.0325; and 
    (8) a staff model health carrier as gross premiums for 
enrollees, copayments, deductibles, coinsurance, and fees for 
patient services covered under its contracts with groups and 
enrollees; 
    (9) a resident pharmacy for medical supplies, appliances, 
and equipment; and 
    (10) a nonresident pharmacy for medical supplies, 
appliances, and equipment. 
    Sec. 20.  Minnesota Statutes 1992, section 295.50, 
subdivision 4, as amended by Laws 1993, chapter 345, article 13, 
section 4, is amended to read: 
    Subd. 4.  [HEALTH CARE PROVIDER.] (a) "Health care provider"
means: 
    (1) a person furnishing any or all of the following goods 
or services directly to a patient or consumer:  medical, 
surgical, optical, visual, dental, hearing, nursing services, 
drugs, medical supplies, medical appliances, laboratory, 
diagnostic or therapeutic services, or any goods and services 
not listed above that qualifies for reimbursement under the 
medical assistance program provided under chapter 256B; 
    (2) a staff model health carrier; or 
    (3) a licensed ambulance service; or 
    (4) a pharmacy as defined in section 151.01. 
    (b) Health care provider does not include hospitals, 
nursing homes licensed under chapter 144A, pharmacies, and 
surgical centers. 
    Sec. 21.  Minnesota Statutes 1992, section 295.50, is 
amended by adding a subdivision to read: 
    Subd. 9a.  [NONRESIDENT PHARMACY.] "Nonresident pharmacy" 
means a pharmacy that is physically located outside Minnesota. 
    Sec. 22.  Minnesota Statutes 1992, section 295.50, is 
amended by adding a subdivision to read: 
    Subd. 10a.  [PHARMACY.] "Pharmacy" means a pharmacy, as 
defined in section 151.01. 
    Sec. 23.  Minnesota Statutes 1992, section 295.50, is 
amended by adding a subdivision to read: 
    Subd. 12a.  [RESIDENT PHARMACY.] "Resident pharmacy" means 
a pharmacy that is physically located inside Minnesota. 
    Sec. 24.  Minnesota Statutes 1992, section 295.51, 
subdivision 1, as amended by Laws 1993, chapter 345, article 13, 
section 11, is amended to read: 
    Subdivision 1.  [BUSINESS TRANSACTIONS IN MINNESOTA.] A 
hospital, surgical center, pharmacy, or health care provider is 
subject to tax under sections 295.50 to 295.58 if it is 
"transacting business in Minnesota."  A hospital, surgical 
center, pharmacy, or health care provider is transacting 
business in Minnesota only if it: 
    (1) maintains an office in Minnesota used in the trade or 
business of providing patient services or medical supplies, 
appliances, or equipment; 
    (2) has employees, representatives, or independent 
contractors conducting business in Minnesota related to the 
trade or business of providing patient services or medical 
supplies, appliances, or equipment; 
    (3) regularly provides patient services or medical 
supplies, appliances, or equipment to customers that receive the 
services in Minnesota; 
    (4) regularly solicits business from potential customers in 
Minnesota.  A hospital, surgical center, pharmacy, or health 
care provider is presumed to regularly solicit business within 
Minnesota if it receives gross receipts for patient services or 
medical supplies, appliances, or equipment from 20 or more 
patients domiciled in Minnesota in a calendar year; 
    (5) regularly performs services outside Minnesota the 
benefits of which are consumed in Minnesota; 
    (6) owns or leases tangible personal or real property 
physically located in Minnesota and used in the trade or 
business of providing patient services or medical supplies, 
appliances, or equipment; or 
    (7) receives medical assistance payments from the state of 
Minnesota. 
    Sec. 25.  Minnesota Statutes 1992, section 295.52, is 
amended by adding a subdivision to read: 
    Subd. 1b.  [PHARMACY TAX.] A tax is imposed on each 
pharmacy equal to two percent of its gross revenues. 
    Sec. 26.  Minnesota Statutes 1992, section 295.53, 
subdivision 3, as amended by Laws 1993, chapter 345, article 13, 
section 16, is amended to read: 
    Subd. 3.  [RESTRICTION ON ITEMIZATION.] A hospital, 
surgical center, pharmacy, or health care provider must not 
separately state the tax obligation under section 295.52 on 
bills provided to individual patients. 
    Sec. 27.  Minnesota Statutes 1992, section 295.53, is 
amended by adding a subdivision to read: 
    Subd. 5.  [DEDUCTIONS FOR PHARMACIES.] Pharmacies may 
deduct from their gross revenues subject to tax payments for 
medical supplies, appliances, and devices that are exempt under 
subdivision 1, except payments under subdivision 1, clauses (3), 
(6), (9), (11), and (14). 
    Sec. 28.  Minnesota Statutes 1992, section 295.54, as 
amended by Laws 1993, chapter 345, article 13, section 18, is 
amended to read: 
    295.54 [CREDIT FOR TAXES PAID TO ANOTHER STATE.] 
    A resident hospital, resident surgical center, pharmacy, or 
resident health care provider who is liable for taxes payable to 
another state or province or territory of Canada measured by 
gross receipts and is subject to tax under section 295.52 is 
entitled to a credit for the tax paid to another state or 
province or territory of Canada to the extent of the lesser of 
(1) the tax actually paid to the other state or province or 
territory of Canada, or (2) the amount of tax imposed by 
Minnesota on the gross receipts subject to tax in the other 
taxing jurisdictions. 
    Sec. 29.  Laws 1992, chapter 549, article 9, section 19, as 
amended by Laws 1993, chapter 345, article 13, section 22, is 
amended to read: 
    Sec. 19.  [295.582] [AUTHORITY.] 
    A hospital, surgical center, pharmacy, or health care 
provider that is subject to a tax under section 295.52 may 
transfer additional expense generated by section 295.52 
obligations on to all third-party contracts for the purchase of 
health care services on behalf of a patient or consumer.  The 
expense must not exceed two percent of the gross revenues 
received under the third-party contract, including copayments 
and deductibles paid by the individual patient or consumer.  The 
expense must not be generated on revenues derived from payments 
that are excluded from the tax under section 295.53.  All 
third-party purchasers of health care services including, but 
not limited to, third-party purchasers regulated under chapters 
60A, 62A, 62C, 62D, 64B, or 62H, must pay the transferred 
expense in addition to any payments due under existing or future 
contracts with the hospital, surgical center, pharmacy, or 
health care provider, to the extent allowed under federal law.  
Nothing in this subdivision limits the ability of a hospital, 
surgical center, pharmacy, or health care provider to recover 
all or part of the section 295.52 obligation by other methods, 
including increasing fees or charges. 
    Sec. 30.  [EFFECTIVE DATE] 
    Sections 19 to 29 are effective for services performed and 
goods sold after December 31, 1993. 
    Sec. 31.  Subdivision 1.  [CORRECTION.] Minnesota Statutes 
1993, section 298.28, subdivision 4, as amended by Laws 1993, 
chapter 375, article 16, section 2, is amended to read: 
    Subd. 4.  [SCHOOL DISTRICTS.] (a) 27.5 cents per taxable 
ton plus the increase provided in paragraph (d) must be 
allocated to qualifying school districts to be distributed, 
based upon the certification of the commissioner of revenue, 
under paragraphs (b) and (c). 
    (b) 5.5 cents per taxable ton must be distributed to the 
school districts in which the lands from which taconite was 
mined or quarried were located or within which the concentrate 
was produced.  The distribution must be based on the 
apportionment formula prescribed in subdivision 2. 
    (c)(i) 22 cents per taxable ton, less any amount 
distributed under paragraph (e), shall be distributed to a group 
of school districts comprised of those school districts in which 
the taconite was mined or quarried or the concentrate produced 
or in which there is a qualifying municipality as defined by 
section 273.134 in direct proportion to school district indexes 
as follows:  for each school district, its pupil units 
determined under section 124.17 for the prior school year shall 
be multiplied by the ratio of the average adjusted net tax 
capacity per pupil unit for school districts receiving aid under 
this clause as calculated pursuant to chapter 124A for the 
school year ending prior to distribution to the adjusted net tax 
capacity per pupil unit of the district.  Each district shall 
receive that portion of the distribution which its index bears 
to the sum of the indices for all school districts that receive 
the distributions.  
    (ii) Notwithstanding clause (i), each school district that 
receives a distribution under sections 298.018; 298.23 to 
298.28, exclusive of any amount received under this clause; 
298.34 to 298.39; 298.391 to 298.396; 298.405; or any law 
imposing a tax on severed mineral values that is less than the 
amount of its levy reduction under section 124.918, subdivision 
8, for the second year prior to the year of the distribution 
shall receive a distribution equal to the difference; the amount 
necessary to make this payment shall be derived from 
proportionate reductions in the initial distribution to other 
school districts under clause (i).  
    (d) On July 15, in years prior to 1988, an amount equal to 
the increase derived by increasing the amount determined by 
paragraph (c) in the same proportion as the increase in the 
steel mill products index over the base year of 1977 as provided 
in section 298.24, subdivision 1, clause (a), shall be 
distributed to Any school district described in paragraph (c) 
where a levy increase pursuant to section 124A.03, subdivision 
2, is authorized by referendum, shall receive a distribution 
according to the following formula.  On July 15, 1988, the 
increase over the amount established for 1987 shall be 
determined as if there had been an increase in the tax rate 
under section 298.24, subdivision 1, paragraph (b), according to 
the increase in the implicit price deflator.  On July 15, 1989, 
1990, and 1991, the increase over the amount established for the 
prior year shall be determined according to the increase in the 
implicit price deflator as provided in section 298.24, 
subdivision 1, paragraph (a).  In 1992 and 1993, the amount 
distributed per ton shall be the same as that determined for 
distribution in 1991.  In 1994, the amount distributed per ton 
shall be equal to the amount per ton distributed in 1991 under 
this paragraph increased in the same proportion as the increase 
between the fourth quarter of 1989 and the fourth quarter of 
1992 in the implicit price deflator as defined in section 
298.24, subdivision 1.  On July 15, 1995, and subsequent years, 
the increase over the amount established for the prior year 
shall be determined according to the increase in the implicit 
price deflator as provided in section 298.24, subdivision 1.  
Each district shall receive the product of: 
    (i) $175 times the pupil units identified in section 
124.17, subdivision 1, enrolled in the second previous year or 
the 1983-1984 school year, whichever is greater, less the 
product of 1.8 percent times the district's taxable net tax 
capacity in the second previous year; times 
    (ii) the lesser of: 
    (A) one, or 
    (B) the ratio of the sum of the amount certified pursuant 
to section 124A.03, subdivision 1g, in the previous year, plus 
the amount certified pursuant to section 124A.03, subdivision 
1i, in the previous year, plus the referendum aid according to 
section 124A.03, subdivision 1h, for the current year, plus an 
amount equal to the reduction under section 124A.03, subdivision 
3b, to the product of 1.8 percent times the district's taxable 
net tax capacity in the second previous year. 
     If the total amount provided by paragraph (d) is 
insufficient to make the payments herein required then the 
entitlement of $175 per pupil unit shall be reduced uniformly so 
as not to exceed the funds available.  Any amounts received by a 
qualifying school district in any fiscal year pursuant to 
paragraph (d) shall not be applied to reduce general education 
aid which the district receives pursuant to section 124A.23 or 
the permissible levies of the district.  Any amount remaining 
after the payments provided in this paragraph shall be paid to 
the commissioner of iron range resources and rehabilitation who 
shall deposit the same in the taconite environmental protection 
fund and the northeast Minnesota economic protection trust fund 
as provided in subdivision 11. 
    Each district receiving money according to this paragraph 
shall reserve $25 times the number of pupil units in the 
district.  It may use the money for early childhood programs or 
for outcome-based learning programs that enhance the academic 
quality of the district's curriculum.  The outcome-based 
learning programs must be approved by the commissioner of 
education.  
    (e) There shall be distributed to any school district the 
amount which the school district was entitled to receive under 
section 298.32 in 1975. 
    Subd. 2.  [REPEALER.] Laws 1993, chapter 224, article 1, 
section 31, is repealed. 
    Subd. 3.  [EFFECTIVE DATE.] Subdivisions 1 and 2 are 
effective for production year 1993, and thereafter. 
    Sec. 32.  Minnesota Statutes 1992, section 477A.013, 
subdivision 1, is amended to read: 
    Subdivision 1.  [TOWNS.] In calendar year 1990, each town 
that had levied for taxes payable in the prior year a local tax 
rate of at least .008 shall receive a distribution equal to 106 
percent of the amount received in 1989 under this subdivision.  
In calendar years 1991 and 1992, each town that had levied for 
taxes payable in the prior year a local tax rate of at least 
.008 shall receive a distribution equal to the amount it 
received in the previous year under this subdivision less any 
permanent reductions made under section 477A.0132.  In 1993 and 
thereafter, each town that had levied for taxes payable in the 
prior year a local tax rate of at least .008 shall receive a 
distribution equal to the amount it received in 1992 before any 
nonpermanent reductions made under section 477A.0132 plus $1 per 
capita based on the town's population.  In 1994 and thereafter 
each town that had levied for taxes payable in the prior year a 
local tax rate of at least .008 shall receive a distribution 
equal to the amount it received in 1993 under this section 
before any nonpermanent reductions made under section 477A.0132. 
    Sec. 33.  Laws 1993, chapter 206, section 8, subdivision 1, 
is amended to read: 
    Subdivision 1.  [REMEDIES AVAILABLE.] The provisions of 
chapters 103I and 157 and sections 115.71 to 115.82; 116.76 to 
116.81; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), 
(10), (12), (13), (14), and (15); 144.121; 144.35; 144.381 to 
144.385; 144.411 to 144.417; 144.491; 144.495; 144.71 to 144.76; 
144.871 to 144.878; 144.992; 326.37 to 326.45; 326.57 to 
326.785; 327.10 to 327.131; and 327.14 to 327.28 and all rules, 
orders, stipulation agreements, settlements, compliance 
agreements, licenses, registrations, certificates, and permits 
adopted or issued by the department or under any other law now 
in force or later enacted for the preservation of public health 
may, in addition to provisions in other statutes, be enforced 
under this section. 
    Sec. 34.  Laws 1993, chapter 206, section 25, is amended to 
read: 
     Sec. 25.  [REPEALER.] 
    Minnesota Statutes 1992, sections 103I.701; 103I.705; 
116.83; 144.1211; 144.386, subdivision 4; 144.73, subdivisions 
2, 3, and 4; 144.76; 148.95; 157.081; 326.43; 326.53, 
subdivision 2; 326.63; 326.78, subdivisions 4, 6, 7, and 8; 
326.79; 326.80; 327.18; and 327.24, subdivisions 1 and 2, are 
repealed. 
     Sec. 35.  Laws 1993, chapter 340, section 60, is amended to 
read: 
    Sec. 60.  [REPEALER.] 
    (a) Minnesota Statutes 1992, section 256.979, is 
subdivisions 1, 2, 3, and 4, are repealed. 
    (b) Minnesota Statutes 1992, section 609.37, is repealed. 
    Sec. 36.  Laws 1993, chapter 345, article 1, section 2, 
subdivision 2, is amended to read: 
    Subd. 2.  [PURPOSE.] Sections 62N.01 to 62N.24 allow the 
creation of integrated service networks that will be responsible 
for arranging for or delivering a full array of health care 
services, from routine primary and preventive care through acute 
inpatient hospital care, to a defined population for a fixed 
price from a purchaser.  
    Each integrated service network is accountable to keep its 
total revenues within the limit of growth set by the 
commissioner of health under section 62N.05, subdivision 2, 
clause (1).  Integrated service networks can be formed by health 
care providers, health maintenance organizations, insurance 
companies, employers, or other organizations.  Competition 
between integrated service networks on the quality and price of 
health care services is encouraged. 
    Sec. 37.  Laws 1993, chapter 345, article 1, section 8, 
subdivision 1, is amended to read: 
    Subdivision 1.  [UNREASONABLE EXPENSES.] No integrated 
service network shall incur or pay for any expense of any nature 
which is unreasonably high in relation to the value of the 
service or goods provided.  The commissioner shall implement and 
enforce this section by rules adopted under this section. 
    In an effort to achieve the stated purposes of sections 
62N.01 to 62N.22 62N.24; in order to safeguard the underlying 
nonprofit status of integrated service networks; and to ensure 
that payment of integrated service network money to any person 
or organization results in a corresponding benefit to the 
integrated service network and its enrollees; when determining 
whether an integrated service network has incurred an 
unreasonable expense in relation to payments made to a person or 
organization, due consideration shall be given to, in addition 
to any other appropriate factors, whether the officers and 
trustees of the integrated service network have acted with good 
faith and in the best interests of the integrated service 
network in entering into, and performing under, a contract under 
which the integrated service network has incurred an expense.  
In addition to the compliance powers under subdivision 3, the 
commissioner has standing to sue, on behalf of an integrated 
service network, officers or trustees of the integrated service 
network who have breached their fiduciary duty in entering into 
and performing such contracts. 
    Sec. 38.  Laws 1993, chapter 345, article 2, section 5, 
subdivision 2, is amended to read:  
    Subd. 2.  [ESTABLISHMENT.] The commissioner of health shall 
establish limits on the increase in revenue for each health care 
provider, for calendar years 1994 and 1995.  The limits must be 
the same as the annual rate of growth in health care spending 
established under section 62J.04, subdivision 1, paragraph (b).  
The commissioner may adjust final revenue figures for case mix 
complexity, inpatient to outpatient conversion, payer mix, 
out-of-period settlements, taxes, donations, grants, and 
legislative initiatives that materially change health care 
costs, as long as these adjustments are consistent with the 
methodology submitted by the health care provider to the 
commissioner, and approved by the commissioner as actuarially 
justified.  The methodology to be used for adjustments must be 
submitted to the commissioner by September 1, 1993.  A health 
care provider's revenues for purposes of these growth limits are 
net of the contributions, surcharges, taxes, and assessments 
listed in section 62P.04, subdivision 2 1, that the health care 
provider pays. 
    Sec. 39.  Laws 1993, chapter 372, section 8, is amended to 
read: 
    Sec. 8.  [EFFECTIVE DATE.] 
    Sections 1 and 2 apply to all franchise contracts or 
franchise transfer agreements entered into or renewed on or 
after the effective date August 1, 1993, and apply as of July 1, 
1993, that date to franchise contracts in effect on the 
effective date August 1, 1993 that have no expiration date. 
    Sections 4 to 7 apply to all agreements for private label 
purchases entered into or renewed on or after July 1, 1993, and 
to all private label purchases occurring on or after that date. 
    Sec. 40.  1993 Special Session H.F. No. 1, article 3, 
section 29, subdivision 1, is amended to read: 
    Subdivision 1.  [FEDERAL REVENUE ENHANCEMENT.] (a) [DUTIES 
OF THE COMMISSIONER OF HUMAN SERVICES.] The commissioner of 
human services may enter into an agreement with one or more 
family services collaboratives to enhance federal reimbursement 
under Title IV-E of the Social Security Act and federal 
administrative reimbursement under Title XIX of the Social 
Security Act.  The commissioner shall have the following 
authority and responsibilities regarding family services 
collaboratives: 
    (1) the commissioner shall submit amendments to state plans 
and seek waivers as necessary to implement the provisions of 
this section; 
    (2) the commissioner shall pay the federal reimbursement 
earned under this subdivision to each collaborative based on 
their earnings.  Notwithstanding section 256.025, subdivision 2, 
payments to collaboratives for expenditures under this 
subdivision will only be made of federal earnings from services 
provided by the collaborative; 
    (3) the commissioner shall review expenditures of family 
services collaboratives using reports specified in the agreement 
with the collaborative to ensure that the base level of 
expenditures is continued and new federal reimbursement is used 
to expand education, social, health, or health-related services 
to young children and their families; 
    (4) the commissioner may reduce, suspend, or eliminate a 
family services collaborative's obligations to continue the base 
level of expenditures or expansion of services if the 
commissioner determines that one or more of the following 
conditions apply: 
    (i) imposition of levy limits that significantly reduce 
available funds for social, health, or health-related services 
to families and children; 
    (ii) reduction in the net tax capacity of the taxable 
property eligible to be taxed by the lead county or 
subcontractor that significantly reduces available funds for 
education, social, health, or health-related services to 
families and children; 
    (iii) reduction in the number of children under age 19 in 
the county, collaborative service delivery area, subcontractor's 
district, or catchment area when compared to the number in the 
base year using the most recent data provided by the state 
demographer's office; or 
    (iv) termination of the federal revenue earned under the 
family services collaborative agreement; 
    (5) the commissioner shall not use the federal 
reimbursement earned under this subdivision in determining the 
allocation or distribution of other funds to counties or 
collaboratives; 
    (6) the commissioner may suspend, reduce, or terminate the 
federal reimbursement to a provider that does not meet the 
reporting or other requirements of this subdivision; 
    (7) the commissioner shall recover from the family services 
collaborative any federal fiscal disallowances or sanctions for 
audit exceptions directly attributable to the family services 
collaborative's actions in the integrated fund, or the 
proportional share if federal fiscal disallowances or sanctions 
are based on a statewide random sample; and 
    (8) the commissioner shall establish criteria for the 
family services collaborative for the accounting and financial 
management system that will support claims for federal 
reimbursement. 
    (b) [FAMILY SERVICES COLLABORATIVE RESPONSIBILITIES.] The 
family services collaborative shall have the following authority 
and responsibilities regarding federal revenue enhancement: 
    (1) the family services collaborative shall be the party 
with which the commissioner contracts.  A lead county shall be 
designated as the fiscal agency for reporting, claiming, and 
receiving payments; 
    (2) the family services collaboratives may enter into 
subcontracts with other counties, school districts, special 
education cooperatives, municipalities, and other public and 
nonprofit entities for purposes of identifying and claiming 
eligible expenditures to enhance federal reimbursement, or to 
expand education, social, health, or health-related services to 
families and children; 
    (3) the family services collaborative must continue the 
base level of expenditures for education, social, health, or 
health-related services to families and children from any state, 
county, federal, or other public or private funding source 
which, in the absence of the new federal reimbursement earned 
under this subdivision, would have been available for those 
services, except as provided in subdivision 1, paragraph (a), 
clause (4).  The base year for purposes of this subdivision 
shall be the four-quarter calendar year ending at least two 
calendar quarters before the first calendar quarter in which the 
new federal reimbursement is earned; 
    (4) the family services collaborative must use all new 
federal reimbursement resulting from federal revenue enhancement 
to expand expenditures for education, social, health, or 
health-related services to families and children beyond the base 
level, except as provided in subdivision 1, paragraph (a), 
clause (4); 
    (5) the family services collaborative must ensure that 
expenditures submitted for federal reimbursement are not made 
from federal funds or funds used to match other federal funds.  
Notwithstanding section 256B.19, subdivision 1, for the purposes 
of family services collaborative expenditures under agreement 
with the department, the nonfederal share of costs shall be 
provided by the family services collaborative from sources other 
than federal funds or funds used to match other federal funds; 
    (6) the family services collaborative must develop and 
maintain an accounting and financial management system adequate 
to support all claims for federal reimbursement, including a 
clear audit trail and any provisions specified in the agreement; 
and 
    (7) the family services collaborative shall submit an 
annual report to the commissioner as specified in the agreement. 
    Sec. 41.  1993 Special Session H.F. No. 1, article 4, 
section 4, subdivision 5, is amended to read: 
    Subd. 5.  [VENDOR PAYMENT.] (a) For purposes of this 
section, the vendor shall bill and the commissioner shall 
reimburse for full-day or partial-day services that would 
otherwise have been paid to the vendor for providing direct 
services provided that: 
    (1) the vendor provides services and payments to the 
business that enable the business to perform services for the 
client that the vendor would otherwise need to perform; and 
    (2) any client for whom a rate will be billed was receiving 
full-time services from the vendor on or before July 1, 1993, 
and a the rate will allow the client to work with support in a 
community business instead of receiving any other service from 
the vendor. 
    (b) Medical assistance reimbursement of services provided 
to persons receiving day training and habilitation services 
under this section is subject to the limitations on 
reimbursement for vocational services under federal law and 
regulation. 
    Sec. 42.  1993 Special Session H.F. No. 1, article 4, 
section 6, subdivision 6, is amended to read: 
    Subd. 6.  [VARIANCES.] (a) A variance from the minimum or 
maximum payment rates in subdivisions 2 and 3 may be granted by 
the commissioner when the vendor requests and the county board 
submits to the commissioner a written variance request on forms 
supplied by the commissioner with the recommended payment rates. 
A variance to the rate maximum may be utilized for costs 
associated with compliance with state administrative rules, 
compliance with court orders, capital costs required for 
continued licensure, increased insurance costs, start-up and 
conversion costs for supported employment, direct service staff 
salaries and benefits, transportation, and other program related 
costs when any of the criteria in clauses (1) to (3) is also met:
    (1) change is necessary to comply with licensing citations; 
    (2) a significant change is approved by the commissioner 
under section 252.28 that is necessary to provide authorized 
services to new clients with very severe self-injurious or 
assaultive behavior, or medical conditions requiring delivery of 
physician-prescribed medical interventions requiring one-to-one 
staffing for at least 15 minutes each time they are performed, 
or to new clients directly discharged to the vendor's program 
from a regional treatment center; or 
    (3) a significant increase in the average level of staffing 
is needed to provide authorized services approved by the 
commissioner under section 252.28, that is necessitated by a 
decrease in licensed capacity or loss of clientele when counties 
choose alternative services under Laws 1992, chapter 513, 
article 9, section 41. 
    A variance under this paragraph may be approved only if the 
costs to the medical assistance program do not exceed the 
medical assistance costs for all clients served by the 
alternatives and all clients remaining in the existing services. 
    (b) A variance to the rate minimum may be granted when (1) 
the county board contracts for increased services from a 
vendor and for some or all individuals receiving services from 
the vendor lower per unit fixed costs result or (2) when the 
actual costs of delivering authorized service over a 12-month 
contract period have decreased. 
    (c) The written variance request under this subdivision 
must include documentation that all the following criteria have 
been met: 
    (1) The commissioner and the county board have both 
conducted a review and have identified a need for a change in 
the payment rates and recommended an effective date for the 
change in the rate. 
    (2) The vendor documents efforts to reallocate current 
staff and any additional staffing needs cannot be met by using 
temporary special needs rate exceptions under Minnesota Rules, 
parts 9510.1020 to 9510.1140. 
    (3) The vendor documents that financial resources have been 
reallocated before applying for a variance.  No variance may be 
granted for equipment, supplies, or other capital expenditures 
when depreciation expense for repair and replacement of such 
items is part of the current rate. 
    (4) For variances related to loss of clientele, the vendor 
documents the other program and administrative expenses, if any, 
that have been reduced. 
    (5) The county board submits verification of the conditions 
for which the variance is requested, a description of the nature 
and cost of the proposed changes, and how the county will 
monitor the use of money by the vendor to make necessary changes 
in services.  
    (6) The county board's recommended payment rates do not 
exceed 95 percent of the greater of 125 percent of the current 
statewide median or 125 percent of the regional average payment 
rates, whichever is higher, for each of the regional commission 
districts under sections 462.381 to 462.396 in which the vendor 
is located except for the following:  when a variance is 
recommended to allow authorized service delivery to new clients 
with severe self-injurious or assaultive behaviors or with 
medical conditions requiring delivery of physician prescribed 
medical interventions, or to persons being directly discharged 
from a regional treatment center to the vendor's program, those 
persons must be assigned a payment rate of 200 percent of the 
current statewide average rates.  All other clients receiving 
services from the vendor must be assigned a payment rate equal 
to the vendor's current rate unless the vendor's current rate 
exceeds 95 percent of 125 percent of the statewide median or 125 
percent of the regional average payment rates, whichever is 
higher.  When the vendor's rates exceed 95 percent of 125 
percent of the statewide median or 125 percent of the regional 
average rates, the maximum rates assigned to all other clients 
must be equal to the greater of 95 percent of 125 percent of the 
statewide median or 125 percent of the regional average rates.  
The maximum payment rate that may be recommended for the vendor 
under these conditions is determined by multiplying the number 
of clients at each limit by the rate corresponding to that limit 
and then dividing the sum by the total number of clients. 
    (7) The vendor has not received a variance under this 
subdivision in the past 12 months.  
    (d) 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. 43.  [EFFECTIVE DATE.] 
    Laws 1993, chapter 224, article 1, section 3, is effective 
June 1, 1993. 
     Sec. 44.  [EFFECTIVE DATE.] 
     If not otherwise provided, the sections of this act that 
amend provisions of law passed during 1993 take effect at the 
same time that the provisions that they amend take effect. 
    Presented to the governor May 27, 1993 
    Signed by the governor May 27, 1993, 4:25 p.m.