1.1                          A bill for an act 
  1.2             relating to state government; making changes to public 
  1.3             assistance programs, health care programs, long-term 
  1.4             care, continuing care for persons with disabilities, 
  1.5             human services licensing, county initiatives, and 
  1.6             children's services; establishing the Community 
  1.7             Services Act; changing estate recovery provisions for 
  1.8             medical assistance; changing health department 
  1.9             provisions; modifying local public health grants; 
  1.10            changing child care provisions; making forecast 
  1.11            adjustments; appropriating money; amending Minnesota 
  1.12            Statutes 2002, sections 16A.724; 61A.072, subdivision 
  1.13            6; 62A.315; 62A.48, by adding a subdivision; 62A.49, 
  1.14            by adding a subdivision; 62A.65, subdivision 7; 
  1.15            62D.095, subdivision 2, by adding a subdivision; 
  1.16            62J.692, subdivision 4, by adding a subdivision; 
  1.17            62Q.19, subdivision 1; 62S.22, subdivision 1; 69.021, 
  1.18            subdivision 11; 119B.011, subdivisions 5, 6, 15, 19, 
  1.19            21, by adding subdivisions; 119B.02, subdivision 1; 
  1.20            119B.03, subdivision 9; 119B.05, subdivision 1; 
  1.21            119B.08, subdivision 3; 119B.09, subdivisions 1, 2, 7, 
  1.22            by adding subdivisions; 119B.11, subdivision 2a; 
  1.23            119B.12, subdivision 2; 119B.13, subdivisions 1, 2, 6, 
  1.24            by adding subdivisions; 119B.16, subdivision 2, by 
  1.25            adding subdivisions; 119B.19, subdivision 7; 119B.21, 
  1.26            subdivision 11; 119B.23, subdivision 3; 124D.23, 
  1.27            subdivision 2; 144.1222, by adding a subdivision; 
  1.28            144.125; 144.128; 144.1483; 144.1488, subdivision 4; 
  1.29            144.1491, subdivision 1; 144.1502, subdivision 4; 
  1.30            144.551, subdivision 1; 144A.04, subdivision 3, by 
  1.31            adding a subdivision; 144A.071, subdivision 4a; 
  1.32            144A.10, by adding a subdivision; 144A.4605, 
  1.33            subdivision 4; 144E.11, subdivision 6; 145.88; 
  1.34            145.881, subdivision 2; 145.882, subdivisions 1, 2, 3, 
  1.35            7, by adding a subdivision; 145.883, subdivisions 1, 
  1.36            9; 145A.02, subdivisions 5, 6, 7; 145A.06, subdivision 
  1.37            1; 145A.09, subdivisions 2, 4, 7; 145A.10, 
  1.38            subdivisions 2, 10, by adding a subdivision; 145A.11, 
  1.39            subdivisions 2, 4; 145A.12, subdivisions 1, 2, by 
  1.40            adding a subdivision; 145A.13, by adding a 
  1.41            subdivision; 145A.14, subdivision 2, by adding a 
  1.42            subdivision; 147A.08; 148.5194, subdivisions 1, 2, 3, 
  1.43            by adding a subdivision; 148.6445, subdivision 7; 
  1.44            153A.17; 174.30, subdivision 1; 179A.03, subdivision 
  1.45            7; 245.4932, subdivision 1; 245A.035, subdivision 3; 
  1.46            245A.04, subdivisions 3, 3b, 3d; 245A.09, subdivision 
  2.1             7; 245A.10; 245A.11, subdivisions 2a, 2b, by adding a 
  2.2             subdivision; 245B.03, subdivision 2, by adding a 
  2.3             subdivision; 245B.04, subdivision 2; 245B.06, 
  2.4             subdivisions 2, 5, 8; 245B.07, subdivisions 6, 9, 11; 
  2.5             245B.08, subdivision 1; 246.54; 252.27, subdivision 
  2.6             2a; 252.32, subdivisions 1, 1a, 3, 3c; 252.41, 
  2.7             subdivision 3; 252.46, subdivision 1; 253B.04, 
  2.8             subdivision 1; 253B.05, subdivision 3; 256.01, 
  2.9             subdivision 2; 256.012; 256.046, subdivision 1; 
  2.10            256.0471, subdivision 1; 256.476, subdivisions 3, 4, 
  2.11            5; 256.482, subdivision 8; 256.935, subdivision 1; 
  2.12            256.955, subdivisions 2a, 3, by adding subdivisions; 
  2.13            256.9657, subdivisions 1, 4, by adding a subdivision; 
  2.14            256.969, subdivisions 2b, 3a; 256.975, by adding a 
  2.15            subdivision; 256.9754, subdivisions 2, 3, 4, 5; 
  2.16            256.98, subdivisions 3, 4, 8; 256.984, subdivision 1; 
  2.17            256B.055, by adding a subdivision; 256B.056, 
  2.18            subdivisions 1a, 1c, 6; 256B.057, subdivisions 1, 2, 
  2.19            3b, 9, 10; 256B.0595, subdivisions 1, 2, by adding 
  2.20            subdivisions; 256B.06, subdivision 4; 256B.061; 
  2.21            256B.0621, subdivision 4; 256B.0623, subdivisions 2, 
  2.22            4, 5, 6, 8; 256B.0625, subdivisions 5a, 9, 13, 17, 
  2.23            18a, 19c, 20, 23, by adding subdivisions; 256B.0627, 
  2.24            subdivisions 1, 4, 9; 256B.0635, subdivisions 1, 2; 
  2.25            256B.064, subdivision 2; 256B.0911, subdivisions 3, 
  2.26            4d; 256B.0913, subdivisions 2, 4, 5, 6, 7, 8, 10, 12; 
  2.27            256B.0915, subdivision 3, by adding a subdivision; 
  2.28            256B.092, subdivisions 1a, 5; 256B.0945, subdivisions 
  2.29            2, 4; 256B.095; 256B.0951, subdivisions 1, 2, 3, 5, 7, 
  2.30            9; 256B.0952, subdivision 1; 256B.0953, subdivision 2; 
  2.31            256B.0955; 256B.15, subdivisions 1, 1a, 2, 3, 4, by 
  2.32            adding subdivisions; 256B.19, subdivision 1; 256B.195, 
  2.33            subdivisions 4, 5; 256B.31; 256B.32, subdivision 1; 
  2.34            256B.431, subdivisions 2r, 32, 36, by adding 
  2.35            subdivisions; 256B.434, subdivisions 4, 10; 256B.47, 
  2.36            subdivision 2; 256B.48, subdivision 1; 256B.501, 
  2.37            subdivision 1, by adding a subdivision; 256B.5012, by 
  2.38            adding a subdivision; 256B.5013, subdivision 4; 
  2.39            256B.5015; 256B.69, subdivisions 2, 4, 5a, 5c, by 
  2.40            adding subdivisions; 256B.75; 256B.76; 256B.761; 
  2.41            256B.82; 256D.03, subdivisions 3, 3a, 4; 256D.06, 
  2.42            subdivision 2; 256D.44, subdivision 5; 256D.46, 
  2.43            subdivisions 1, 3; 256D.48, subdivision 1; 256F.10, 
  2.44            subdivision 6; 256F.13, subdivisions 1, 2; 256G.05, 
  2.45            subdivision 2; 256I.02; 256I.04, subdivision 3; 
  2.46            256I.05, subdivisions 1, 1a, 7c; 256J.01, subdivision 
  2.47            5; 256J.02, subdivision 2; 256J.021; 256J.08, 
  2.48            subdivisions 35, 65, 82, 85, by adding subdivisions; 
  2.49            256J.09, subdivisions 2, 3, 3a, 3b, 8, 10; 256J.14; 
  2.50            256J.20, subdivision 3; 256J.21, subdivisions 1, 2; 
  2.51            256J.24, subdivisions 3, 5, 6, 7, 10; 256J.30, 
  2.52            subdivision 9; 256J.31, subdivision 4; 256J.32, 
  2.53            subdivisions 2, 4, 5a, by adding a subdivision; 
  2.54            256J.37, subdivision 9, by adding subdivisions; 
  2.55            256J.38, subdivisions 3, 4; 256J.40; 256J.42, 
  2.56            subdivisions 4, 5, 6; 256J.425, subdivisions 1, 1a, 2, 
  2.57            3, 4, 6, 7; 256J.45, subdivision 2; 256J.46, 
  2.58            subdivisions 1, 2, 2a; 256J.49, subdivisions 4, 5, 9, 
  2.59            13, by adding subdivisions; 256J.50, subdivisions 1, 
  2.60            8, 9, 10; 256J.51, subdivisions 1, 2, 3, 4; 256J.53, 
  2.61            subdivisions 1, 2, 5; 256J.54, subdivisions 1, 2, 3, 
  2.62            5; 256J.55, subdivisions 1, 2; 256J.56; 256J.57; 
  2.63            256J.62, subdivision 9; 256J.645, subdivision 3; 
  2.64            256J.66, subdivision 2; 256J.67, subdivisions 1, 3; 
  2.65            256J.69, subdivision 2; 256J.75, subdivision 3; 
  2.66            256J.751, subdivisions 1, 2, 5; 256L.02, by adding a 
  2.67            subdivision; 256L.03, subdivisions 1, 3, 5; 256L.04, 
  2.68            subdivision 1; 256L.05, subdivisions 1, 3, 3a, 3c, 4; 
  2.69            256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3; 
  2.70            256L.09, subdivision 4; 256L.12, subdivisions 6, 9, by 
  2.71            adding subdivisions; 256L.15, subdivisions 1, 2, 3; 
  3.1             256L.17, subdivision 2; 257.05; 259.67, subdivision 4; 
  3.2             260C.141, subdivision 2; 261.035; 261.063; 295.55, 
  3.3             subdivision 2; 326.42; 393.07, subdivisions 1, 5, 10; 
  3.4             466.03, subdivision 6d; 514.981, subdivision 6; 
  3.5             518.167, subdivision 1; 518.551, subdivision 7; 
  3.6             518.6111, subdivisions 2, 3, 4, 16; 524.3-805; 
  3.7             626.559, subdivision 5; 641.15, subdivision 2; Laws 
  3.8             1997, chapter 203, article 9, section 21, as amended; 
  3.9             proposing coding for new law as Minnesota Statutes, 
  3.10            chapter 256M; proposing coding for new law in 
  3.11            Minnesota Statutes, chapters 62S; 119B; 144; 144A; 
  3.12            145; 145A; 148C; 256; 256B; 256D; 256I; 256J; 514; 
  3.13            repealing Minnesota Statutes 2002, sections 16A.151, 
  3.14            subdivision 5; 16A.87; 62J.17; 62J.66; 62J.68; 
  3.15            62J.694; 119B.061; 144.126; 144.1484; 144.1494; 
  3.16            144.1495; 144.1496; 144.1497; 144.395; 144.396; 
  3.17            144.401; 144.9507, subdivision 3; 144A.071, 
  3.18            subdivision 5; 144A.35; 144A.36; 144A.38; 145.56, 
  3.19            subdivision 2; 145.882, subdivisions 4, 5, 6, 8; 
  3.20            145.883, subdivisions 4, 7; 145.884; 145.885; 145.886; 
  3.21            145.888; 145.889; 145.890; 145.9266, subdivisions 2, 
  3.22            4, 5, 6, 7; 145.928, subdivision 9; 145A.02, 
  3.23            subdivisions 9, 10, 11, 12, 13, 14; 145A.09, 
  3.24            subdivision 6; 145A.10, subdivisions 5, 6, 8; 145A.11, 
  3.25            subdivision 3; 145A.12, subdivisions 3, 4, 5; 145A.14, 
  3.26            subdivisions 3, 4; 145A.17, subdivisions 2, 9; 
  3.27            148.5194, subdivision 3a; 148.6445, subdivision 9; 
  3.28            245.4712, subdivision 2; 245.478; 245.4886; 245.4888; 
  3.29            245.496; 245.714; 252.32, subdivision 2; 254A.17; 
  3.30            256.955, subdivision 8; 256.973; 256.9772; 256B.055, 
  3.31            subdivision 10a; 256B.056, subdivision 3c; 256B.057, 
  3.32            subdivision 1b; 256B.0625, subdivisions 35, 36; 
  3.33            256B.0928; 256B.0945, subdivisions 6, 7, 8, 9, 10; 
  3.34            256B.195, subdivision 5; 256B.437, subdivision 2; 
  3.35            256B.83; 256E.01; 256E.02; 256E.03; 256E.04; 256E.05; 
  3.36            256E.06; 256E.07; 256E.08; 256E.081; 256E.09; 256E.10; 
  3.37            256E.11; 256E.115; 256E.13; 256E.14; 256E.15; 256F.01; 
  3.38            256F.02; 256F.03; 256F.04; 256F.05; 256F.06; 256F.07; 
  3.39            256F.08; 256F.10, subdivision 7; 256F.11; 256F.12; 
  3.40            256F.14; 256J.02, subdivision 3; 256J.08, subdivisions 
  3.41            28, 70; 256J.24, subdivision 8; 256J.30, subdivision 
  3.42            10; 256J.462; 256J.47; 256J.48; 256J.49, subdivisions 
  3.43            1a, 2, 6, 7; 256J.50, subdivisions 2, 3, 3a, 5, 7; 
  3.44            256J.52; 256J.62, subdivisions 1, 2a, 4, 6, 7, 8; 
  3.45            256J.625; 256J.655; 256J.74, subdivision 3; 256J.751, 
  3.46            subdivisions 3, 4; 256J.76; 256K.30; 256L.02, 
  3.47            subdivision 3; 256L.04, subdivision 9; 257.075; 
  3.48            257.81; 260.152; 626.562; Laws 1998, chapter 407, 
  3.49            article 4, section 63; Laws 2000, chapter 488, article 
  3.50            10, section 29; Laws 2001, First Special Session 
  3.51            chapter 3, article 1, section 16; Laws 2001, First 
  3.52            Special Session chapter 9, article 13, section 24; 
  3.53            Laws 2002, chapter 374, article 9, section 8; 
  3.54            Minnesota Rules, parts 4705.0100; 4705.0200; 
  3.55            4705.0300; 4705.0400; 4705.0500; 4705.0600; 4705.0700; 
  3.56            4705.0800; 4705.0900; 4705.1000; 4705.1100; 4705.1200; 
  3.57            4705.1300; 4705.1400; 4705.1500; 4705.1600; 4736.0010; 
  3.58            4736.0020; 4736.0030; 4736.0040; 4736.0050; 4736.0060; 
  3.59            4736.0070; 4736.0080; 4736.0090; 4736.0120; 4736.0130; 
  3.60            4763.0100; 4763.0110; 4763.0125; 4763.0135; 4763.0140; 
  3.61            4763.0150; 4763.0160; 4763.0170; 4763.0180; 4763.0190; 
  3.62            4763.0205; 4763.0215; 4763.0220; 4763.0230; 4763.0240; 
  3.63            4763.0250; 4763.0260; 4763.0270; 4763.0285; 4763.0295; 
  3.64            4763.0300; 9505.0324; 9505.0326; 9505.0327; 9505.3045; 
  3.65            9505.3050; 9505.3055; 9505.3060; 9505.3068; 9505.3070; 
  3.66            9505.3075; 9505.3080; 9505.3090; 9505.3095; 9505.3100; 
  3.67            9505.3105; 9505.3107; 9505.3110; 9505.3115; 9505.3120; 
  3.68            9505.3125; 9505.3130; 9505.3138; 9505.3139; 9505.3140; 
  3.69            9505.3680; 9505.3690; 9505.3700; 9545.2000; 9545.2010; 
  3.70            9545.2020; 9545.2030; 9545.2040; 9550.0010; 9550.0020; 
  3.71            9550.0030; 9550.0040; 9550.0050; 9550.0060; 9550.0070; 
  4.1             9550.0080; 9550.0090; 9550.0091; 9550.0092; 9550.0093. 
  4.2   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  4.3                              ARTICLE 1 
  4.4           WELFARE REFORM; PUBLIC ASSISTANCE MODIFICATIONS 
  4.5      Section 1.  Minnesota Statutes 2002, section 256.984, 
  4.6   subdivision 1, is amended to read: 
  4.7      Subdivision 1.  [DECLARATION.] Every application for public 
  4.8   assistance under this chapter and/or or chapters 256B, 256D, 
  4.9   256K, MFIP program 256J, and food stamps or food support under 
  4.10  chapter 393 shall be in writing or reduced to writing as 
  4.11  prescribed by the state agency and shall contain the following 
  4.12  declaration which shall be signed by the applicant: 
  4.13     "I declare under the penalties of perjury that this 
  4.14     application has been examined by me and to the best of my 
  4.15     knowledge is a true and correct statement of every material 
  4.16     point.  I understand that a person convicted of perjury may 
  4.17     be sentenced to imprisonment of not more than five years or 
  4.18     to payment of a fine of not more than $10,000, or both." 
  4.19     Sec. 2.  Minnesota Statutes 2002, section 256D.06, 
  4.20  subdivision 2, is amended to read: 
  4.21     Subd. 2.  [EMERGENCY NEED.] Notwithstanding the provisions 
  4.22  of subdivision 1, a grant of emergency general assistance shall, 
  4.23  to the extent funds are available, be made to an eligible single 
  4.24  adult, married couple, or family for an emergency need, as 
  4.25  defined in rules promulgated by the commissioner, where the 
  4.26  recipient requests temporary assistance not exceeding 30 days if 
  4.27  an emergency situation appears to exist and (a) until March 31, 
  4.28  1998, the individual is ineligible for the program of emergency 
  4.29  assistance under aid to families with dependent children and is 
  4.30  not a recipient of aid to families with dependent children at 
  4.31  the time of application; or (b) the individual or family is (i) 
  4.32  ineligible for MFIP or is not a participant of MFIP; and (ii) is 
  4.33  ineligible for emergency assistance under section 256J.48.  If 
  4.34  an applicant or recipient relates facts to the county agency 
  4.35  which may be sufficient to constitute an emergency situation, 
  4.36  the county agency shall, to the extent funds are available, 
  5.1   advise the person of the procedure for applying for assistance 
  5.2   according to this subdivision.  An emergency general assistance 
  5.3   grant is available to a recipient not more than once in any 
  5.4   12-month period.  Funding for an emergency general assistance 
  5.5   program is limited to the appropriation.  Each fiscal year, the 
  5.6   commissioner shall allocate to counties the money appropriated 
  5.7   for emergency general assistance grants based on each county 
  5.8   agency's average share of state's emergency general expenditures 
  5.9   for the immediate past three fiscal years as determined by the 
  5.10  commissioner, and may reallocate any unspent amounts to other 
  5.11  counties.  Any emergency general assistance expenditures by a 
  5.12  county above the amount of the commissioner's allocation to the 
  5.13  county must be made from county funds. 
  5.14     Sec. 3.  Minnesota Statutes 2002, section 256D.44, 
  5.15  subdivision 5, is amended to read: 
  5.16     Subd. 5.  [SPECIAL NEEDS.] In addition to the state 
  5.17  standards of assistance established in subdivisions 1 to 4, 
  5.18  payments are allowed for the following special needs of 
  5.19  recipients of Minnesota supplemental aid who are not residents 
  5.20  of a nursing home, a regional treatment center, or a group 
  5.21  residential housing facility. 
  5.22     (a) The county agency shall pay a monthly allowance for 
  5.23  medically prescribed diets payable under the Minnesota family 
  5.24  investment program if the cost of those additional dietary needs 
  5.25  cannot be met through some other maintenance benefit.  The need 
  5.26  for special diets or dietary items must be prescribed by a 
  5.27  licensed physician.  Costs for special diets shall be determined 
  5.28  as percentages of the allotment for a one-person household under 
  5.29  the thrifty food plan as defined by the United States Department 
  5.30  of Agriculture.  The types of diets and the percentages of the 
  5.31  thrifty food plan that are covered are as follows: 
  5.32     (1) high protein diet, at least 80 grams daily, 25 percent 
  5.33  of thrifty food plan; 
  5.34     (2) controlled protein diet, 40 to 60 grams and requires 
  5.35  special products, 100 percent of thrifty food plan; 
  5.36     (3) controlled protein diet, less than 40 grams and 
  6.1   requires special products, 125 percent of thrifty food plan; 
  6.2      (4) low cholesterol diet, 25 percent of thrifty food plan; 
  6.3      (5) high residue diet, 20 percent of thrifty food plan; 
  6.4      (6) pregnancy and lactation diet, 35 percent of thrifty 
  6.5   food plan; 
  6.6      (7) gluten-free diet, 25 percent of thrifty food plan; 
  6.7      (8) lactose-free diet, 25 percent of thrifty food plan; 
  6.8      (9) antidumping diet, 15 percent of thrifty food plan; 
  6.9      (10) hypoglycemic diet, 15 percent of thrifty food plan; or 
  6.10     (11) ketogenic diet, 25 percent of thrifty food plan. 
  6.11     (b) Payment for nonrecurring special needs must be allowed 
  6.12  for necessary home repairs or necessary repairs or replacement 
  6.13  of household furniture and appliances using the payment standard 
  6.14  of the AFDC program in effect on July 16, 1996, for these 
  6.15  expenses, as long as other funding sources are not available.  
  6.16     (c) A fee for guardian or conservator service is allowed at 
  6.17  a reasonable rate negotiated by the county or approved by the 
  6.18  court.  This rate shall not exceed five percent of the 
  6.19  assistance unit's gross monthly income up to a maximum of $100 
  6.20  per month.  If the guardian or conservator is a member of the 
  6.21  county agency staff, no fee is allowed. 
  6.22     (d) The county agency shall continue to pay a monthly 
  6.23  allowance of $68 for restaurant meals for a person who was 
  6.24  receiving a restaurant meal allowance on June 1, 1990, and who 
  6.25  eats two or more meals in a restaurant daily.  The allowance 
  6.26  must continue until the person has not received Minnesota 
  6.27  supplemental aid for one full calendar month or until the 
  6.28  person's living arrangement changes and the person no longer 
  6.29  meets the criteria for the restaurant meal allowance, whichever 
  6.30  occurs first. 
  6.31     (e) A fee of ten percent of the recipient's gross income or 
  6.32  $25, whichever is less, is allowed for representative payee 
  6.33  services provided by an agency that meets the requirements under 
  6.34  SSI regulations to charge a fee for representative payee 
  6.35  services.  This special need is available to all recipients of 
  6.36  Minnesota supplemental aid regardless of their living 
  7.1   arrangement.  
  7.2      (f) Notwithstanding the language in this subdivision, an 
  7.3   amount equal to the maximum allotment authorized by the federal 
  7.4   Food Stamp Program for a single individual which is in effect on 
  7.5   the first day of January of the previous year will be added to 
  7.6   the standards of assistance established in subdivisions 1 to 4 
  7.7   for individuals under the age of 65 who are relocating from an 
  7.8   institution and who are shelter needy.  An eligible individual 
  7.9   who receives this benefit prior to age 65 may continue to 
  7.10  receive the benefit after the age of 65. 
  7.11     "Shelter needy" means that the assistance unit incurs 
  7.12  monthly shelter costs that exceed 40 percent of the assistance 
  7.13  unit's gross income before the application of this special needs 
  7.14  standard.  "Gross income" for the purposes of this section is 
  7.15  the applicant's or recipient's income as defined in section 
  7.16  256D.35, subdivision 10, or the standard specified in 
  7.17  subdivision 3, whichever is greater.  A recipient of a federal 
  7.18  or state housing subsidy, that limits shelter costs to a 
  7.19  percentage of gross income, shall not be considered shelter 
  7.20  needy for purposes of this paragraph. 
  7.21     Sec. 4.  Minnesota Statutes 2002, section 256D.46, 
  7.22  subdivision 1, is amended to read: 
  7.23     Subdivision 1.  [ELIGIBILITY.] A county agency must grant 
  7.24  emergency Minnesota supplemental aid must be granted, to the 
  7.25  extent funds are available, if the recipient is without adequate 
  7.26  resources to resolve an emergency that, if unresolved, will 
  7.27  threaten the health or safety of the recipient.  For the 
  7.28  purposes of this section, the term "recipient" includes persons 
  7.29  for whom a group residential housing benefit is being paid under 
  7.30  sections 256I.01 to 256I.06. 
  7.31     Sec. 5.  Minnesota Statutes 2002, section 256D.46, 
  7.32  subdivision 3, is amended to read: 
  7.33     Subd. 3.  [PAYMENT AMOUNT.] The amount of assistance 
  7.34  granted under emergency Minnesota supplemental aid is limited to 
  7.35  the amount necessary to resolve the emergency.  An emergency 
  7.36  Minnesota supplemental aid grant is available to a recipient no 
  8.1   more than once in any 12-month period.  Funding for emergency 
  8.2   Minnesota supplemental aid is limited to the appropriation.  
  8.3   Each fiscal year, the commissioner shall allocate to counties 
  8.4   the money appropriated for emergency Minnesota supplemental aid 
  8.5   grants based on each county agency's average share of state's 
  8.6   emergency Minnesota supplemental aid expenditures for the 
  8.7   immediate past three fiscal years as determined by the 
  8.8   commissioner, and may reallocate any unspent amounts to other 
  8.9   counties.  Any emergency Minnesota supplemental aid expenditures 
  8.10  by a county above the amount of the commissioner's allocation to 
  8.11  the county must be made from county funds. 
  8.12     Sec. 6.  Minnesota Statutes 2002, section 256D.48, 
  8.13  subdivision 1, is amended to read: 
  8.14     Subdivision 1.  [NEED FOR PROTECTIVE PAYEE.] The county 
  8.15  agency shall determine whether a recipient needs a protective 
  8.16  payee when a physical or mental condition renders the recipient 
  8.17  unable to manage funds and when payments to the recipient would 
  8.18  be contrary to the recipient's welfare.  Protective payments 
  8.19  must be issued when there is evidence of:  (1) repeated 
  8.20  inability to plan the use of income to meet necessary 
  8.21  expenditures; (2) repeated observation that the recipient is not 
  8.22  properly fed or clothed; (3) repeated failure to meet 
  8.23  obligations for rent, utilities, food, and other essentials; (4) 
  8.24  evictions or a repeated incurrence of debts; or (5) lost or 
  8.25  stolen checks; or (6) use of emergency Minnesota supplemental 
  8.26  aid more than twice in a calendar year.  The determination of 
  8.27  representative payment by the Social Security Administration for 
  8.28  the recipient is sufficient reason for protective payment of 
  8.29  Minnesota supplemental aid payments.  
  8.30     Sec. 7.  Minnesota Statutes 2002, section 256J.01, 
  8.31  subdivision 5, is amended to read: 
  8.32     Subd. 5.  [COMPLIANCE SYSTEM.] The commissioner shall 
  8.33  administer a compliance system for the state's temporary 
  8.34  assistance for needy families (TANF) program, the food stamp 
  8.35  program, emergency assistance, general assistance, medical 
  8.36  assistance, general assistance medical care, emergency general 
  9.1   assistance, Minnesota supplemental aid, preadmission screening, 
  9.2   child support program, and alternative care grants under the 
  9.3   powers and authorities named in section 256.01, subdivision 2.  
  9.4   The purpose of the compliance system is to permit the 
  9.5   commissioner to supervise the administration of public 
  9.6   assistance programs and to enforce timely and accurate 
  9.7   distribution of benefits, completeness of service and efficient 
  9.8   and effective program management and operations, to increase 
  9.9   uniformity and consistency in the administration and delivery of 
  9.10  public assistance programs throughout the state, and to reduce 
  9.11  the possibility of sanction and fiscal disallowances for 
  9.12  noncompliance with federal regulations and state statutes. 
  9.13     Sec. 8.  Minnesota Statutes 2002, section 256J.02, 
  9.14  subdivision 2, is amended to read: 
  9.15     Subd. 2.  [USE OF MONEY.] State money appropriated for 
  9.16  purposes of this section and TANF block grant money must be used 
  9.17  for: 
  9.18     (1) financial assistance to or on behalf of any minor child 
  9.19  who is a resident of this state under section 256J.12; 
  9.20     (2) employment and training services under this chapter or 
  9.21  chapter 256K; 
  9.22     (3) emergency financial assistance and services under 
  9.23  section 256J.48; 
  9.24     (4) diversionary assistance under section 256J.47; 
  9.25     (5) the health care and human services training and 
  9.26  retention program under chapter 116L, for costs associated with 
  9.27  families with children with incomes below 200 percent of the 
  9.28  federal poverty guidelines; 
  9.29     (6) (3) the pathways program under section 116L.04, 
  9.30  subdivision 1a; 
  9.31     (7) welfare-to-work extended employment services for MFIP 
  9.32  participants with severe impairment to employment as defined in 
  9.33  section 268A.15, subdivision 1a; 
  9.34     (8) the family homeless prevention and assistance program 
  9.35  under section 462A.204; 
  9.36     (9) the rent assistance for family stabilization 
 10.1   demonstration project under section 462A.205; 
 10.2      (10) (4) welfare to work transportation authorized under 
 10.3   Public Law Number 105-178; 
 10.4      (11) (5) reimbursements for the federal share of child 
 10.5   support collections passed through to the custodial parent; 
 10.6      (12) (6) reimbursements for the working family credit under 
 10.7   section 290.0671; 
 10.8      (13) intensive ESL grants under Laws 2000, chapter 489, 
 10.9   article 1; 
 10.10     (14) transitional housing programs under section 119A.43; 
 10.11     (15) programs and pilot projects under chapter 256K; and 
 10.12     (16) (7) program administration under this chapter; 
 10.13     (8) the diversionary work program under section 256J.95; 
 10.14     (9) the MFIP consolidated fund under section 256J.626; and 
 10.15     (10) the Minnesota department of health consolidated fund 
 10.16  under Laws 2001, First Special Session chapter 9, article 17, 
 10.17  section 3, subdivision 2. 
 10.18     Sec. 9.  Minnesota Statutes 2002, section 256J.021, is 
 10.19  amended to read: 
 10.20     256J.021 [SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.] 
 10.21     Beginning October 1, 2001, and each year thereafter, the 
 10.22  commissioner of human services must treat financial assistance 
 10.23  MFIP expenditures made to or on behalf of any minor child under 
 10.24  section 256J.02, subdivision 2, clause (1), who is a resident of 
 10.25  this state under section 256J.12, and who is part of a 
 10.26  two-parent eligible household as expenditures under a separately 
 10.27  funded state program and report those expenditures to the 
 10.28  federal Department of Health and Human Services as separate 
 10.29  state program expenditures under Code of Federal Regulations, 
 10.30  title 45, section 263.5. 
 10.31     Sec. 10.  Minnesota Statutes 2002, section 256J.08, is 
 10.32  amended by adding a subdivision to read: 
 10.33     Subd. 11a.  [CHILD ONLY CASE.] "Child only case" means a 
 10.34  case that would be part of the child only TANF program under 
 10.35  section 256J.88. 
 10.36     Sec. 11.  Minnesota Statutes 2002, section 256J.08, is 
 11.1   amended by adding a subdivision to read: 
 11.2      Subd. 24b.  [DIVERSIONARY WORK PROGRAM OR DWP.] 
 11.3   "Diversionary work program" or "DWP" has the meaning given in 
 11.4   section 256J.95. 
 11.5      Sec. 12.  Minnesota Statutes 2002, section 256J.08, is 
 11.6   amended by adding a subdivision to read: 
 11.7      Subd. 28b.  [EMPLOYABLE.] "Employable" means a person is 
 11.8   capable of performing existing positions in the local labor 
 11.9   market, regardless of the current availability of openings for 
 11.10  those positions. 
 11.11     Sec. 13.  Minnesota Statutes 2002, section 256J.08, is 
 11.12  amended by adding a subdivision to read: 
 11.13     Subd. 34a.  [FAMILY VIOLENCE.] (a) "Family violence" means 
 11.14  the following, if committed against a family or household member 
 11.15  by a family or household member: 
 11.16     (1) physical harm, bodily injury, or assault; 
 11.17     (2) the infliction of fear of imminent physical harm, 
 11.18  bodily injury, or assault; or 
 11.19     (3) terroristic threats, within the meaning of section 
 11.20  609.713, subdivision 1; criminal sexual conduct, within the 
 11.21  meaning of section 609.342, 609.343, 609.344, 609.345, or 
 11.22  609.3451; or interference with an emergency call within the 
 11.23  meaning of section 609.78, subdivision 2. 
 11.24     (b) For the purposes of family violence, "family or 
 11.25  household member" means:  
 11.26     (1) spouses and former spouses; 
 11.27     (2) parents and children; 
 11.28     (3) persons related by blood; 
 11.29     (4) persons who are residing together or who have resided 
 11.30  together in the past; 
 11.31     (5) persons who have a child in common regardless of 
 11.32  whether they have been married or have lived together at any 
 11.33  time; 
 11.34     (6) a man and woman if the woman is pregnant and the man is 
 11.35  alleged to be the father, regardless of whether they have been 
 11.36  married or have lived together at anytime; and 
 12.1      (7) persons involved in a current or past significant 
 12.2   romantic or sexual relationship. 
 12.3      Sec. 14.  Minnesota Statutes, section 256J.08, is amended 
 12.4   by adding a subdivision to read: 
 12.5      Subd. 34b.  [FAMILY VIOLENCE WAIVER.] "Family violence 
 12.6   waiver" means a waiver of the 60-month time limit for victims of 
 12.7   family violence who meet the criteria in section 256J.545 and 
 12.8   are complying with an employment plan in section 256J.521, 
 12.9   subdivision 3. 
 12.10     Sec. 15.  Minnesota Statutes 2002, section 256J.08, 
 12.11  subdivision 35, is amended to read: 
 12.12     Subd. 35.  [FAMILY WAGE LEVEL.] "Family wage level" means 
 12.13  110 percent of the transitional standard as specified in section 
 12.14  256J.24, subdivision 7. 
 12.15     Sec. 16.  Minnesota Statutes 2002, section 256J.08, is 
 12.16  amended by adding a subdivision to read: 
 12.17     Subd. 51b.  [LEARNING DISABLED.] "Learning disabled," for 
 12.18  purposes of an extension to the 60-month time limit under 
 12.19  section 256J.425, subdivision 3, clause (3), means the person 
 12.20  has a disorder in one or more of the psychological processes 
 12.21  involved in perceiving, understanding, or using concepts through 
 12.22  verbal language or nonverbal means.  Learning disabled does not 
 12.23  include learning problems that are primarily the result of 
 12.24  visual, hearing, or motor handicaps, mental retardation, 
 12.25  emotional disturbance, or due to environmental, cultural, or 
 12.26  economic disadvantage. 
 12.27     Sec. 17.  Minnesota Statutes 2002, section 256J.08, 
 12.28  subdivision 65, is amended to read: 
 12.29     Subd. 65.  [PARTICIPANT.] "Participant" means a person who 
 12.30  is currently receiving cash assistance or the food portion 
 12.31  available through MFIP as funded by TANF and the food stamp 
 12.32  program.  A person who fails to withdraw or access 
 12.33  electronically any portion of the person's cash and food 
 12.34  assistance payment by the end of the payment month, who makes a 
 12.35  written request for closure before the first of a payment month 
 12.36  and repays cash and food assistance electronically issued for 
 13.1   that payment month within that payment month, or who returns any 
 13.2   uncashed assistance check and food coupons and withdraws from 
 13.3   the program is not a participant.  A person who withdraws a cash 
 13.4   or food assistance payment by electronic transfer or receives 
 13.5   and cashes an MFIP assistance check or food coupons and is 
 13.6   subsequently determined to be ineligible for assistance for that 
 13.7   period of time is a participant, regardless whether that 
 13.8   assistance is repaid.  The term "participant" includes the 
 13.9   caregiver relative and the minor child whose needs are included 
 13.10  in the assistance payment.  A person in an assistance unit who 
 13.11  does not receive a cash and food assistance payment because the 
 13.12  person case has been suspended from MFIP is a participant.  A 
 13.13  person who receives cash payments under the diversionary work 
 13.14  program under section 256J.95 is a participant. 
 13.15     Sec. 18.  Minnesota Statutes 2002, section 256J.08, is 
 13.16  amended by adding a subdivision to read: 
 13.17     Subd. 65a.  [PARTICIPATION REQUIREMENTS OF 
 13.18  TANF.] "Participation requirements of TANF" means activities and 
 13.19  hourly requirements allowed under title IV-A of the federal 
 13.20  Social Security Act. 
 13.21     Sec. 19.  Minnesota Statutes 2002, section 256J.08, is 
 13.22  amended by adding a subdivision to read: 
 13.23     Subd. 73a.  [QUALIFIED PROFESSIONAL.] (a) For physical 
 13.24  illness, injury, or incapacity, a "qualified professional" means 
 13.25  a licensed physician, a physician's assistant, a nurse 
 13.26  practitioner, or in the case of spinal subluxation, a licensed 
 13.27  chiropractor. 
 13.28     (b) For mental retardation and intelligence testing, a 
 13.29  "qualified professional" means an individual qualified by 
 13.30  training and experience to administer the tests necessary to 
 13.31  make determinations, such as tests of intellectual functioning, 
 13.32  assessments of adaptive behavior, adaptive skills, and 
 13.33  developmental functioning.  These professionals include licensed 
 13.34  psychologists, certified school psychologists, or certified 
 13.35  psychometrists working under the supervision of a licensed 
 13.36  psychologist. 
 14.1      (c) For learning disabilities, a "qualified professional" 
 14.2   means a licensed psychologist or school psychologist with 
 14.3   experience determining learning disabilities.  
 14.4      (d) For mental health, a "qualified professional" means a 
 14.5   licensed physician or a qualified mental health professional.  A 
 14.6   "qualified mental health professional" means: 
 14.7      (1) for children, in psychiatric nursing, a registered 
 14.8   nurse who is licensed under sections 148.171 to 148.285, and who 
 14.9   is certified as a clinical specialist in child and adolescent 
 14.10  psychiatric or mental health nursing by a national nurse 
 14.11  certification organization or who has a master's degree in 
 14.12  nursing or one of the behavioral sciences or related fields from 
 14.13  an accredited college or university or its equivalent, with at 
 14.14  least 4,000 hours of post-master's supervised experience in the 
 14.15  delivery of clinical services in the treatment of mental 
 14.16  illness; 
 14.17     (2) for adults, in psychiatric nursing, a registered nurse 
 14.18  who is licensed under sections 148.171 to 148.285, and who is 
 14.19  certified as a clinical specialist in adult psychiatric and 
 14.20  mental health nursing by a national nurse certification 
 14.21  organization or who has a master's degree in nursing or one of 
 14.22  the behavioral sciences or related fields from an accredited 
 14.23  college or university or its equivalent, with at least 4,000 
 14.24  hours of post-master's supervised experience in the delivery of 
 14.25  clinical services in the treatment of mental illness; 
 14.26     (3) in clinical social work, a person licensed as an 
 14.27  independent clinical social worker under section 148B.21, 
 14.28  subdivision 6, or a person with a master's degree in social work 
 14.29  from an accredited college or university, with at least 4,000 
 14.30  hours of post-master's supervised experience in the delivery of 
 14.31  clinical services in the treatment of mental illness; 
 14.32     (4) in psychology, an individual licensed by the board of 
 14.33  psychology under sections 148.88 to 148.98, who has stated to 
 14.34  the board of psychology competencies in the diagnosis and 
 14.35  treatment of mental illness; 
 14.36     (5) in psychiatry, a physician licensed under chapter 147 
 15.1   and certified by the American Board of Psychiatry and Neurology 
 15.2   or eligible for board certification in psychiatry; and 
 15.3      (6) in marriage and family therapy, the mental health 
 15.4   professional must be a marriage and family therapist licensed 
 15.5   under sections 148B.29 to 148B.39, with at least two years of 
 15.6   post-master's supervised experience in the delivery of clinical 
 15.7   services in the treatment of mental illness. 
 15.8      Sec. 20.  Minnesota Statutes 2002, section 256J.08, 
 15.9   subdivision 82, is amended to read: 
 15.10     Subd. 82.  [SANCTION.] "Sanction" means the reduction of a 
 15.11  family's assistance payment by a specified percentage of the 
 15.12  MFIP standard of need because:  a nonexempt participant fails to 
 15.13  comply with the requirements of sections 256J.52 256J.515 to 
 15.14  256J.55 256J.57; a parental caregiver fails without good cause 
 15.15  to cooperate with the child support enforcement requirements; or 
 15.16  a participant fails to comply with the insurance, tort 
 15.17  liability, or other requirements of this chapter. 
 15.18     Sec. 21.  Minnesota Statutes 2002, section 256J.08, is 
 15.19  amended by adding a subdivision to read: 
 15.20     Subd. 84a.  [SSI RECIPIENT.] "SSI recipient" means a person 
 15.21  who receives at least $1 in SSI benefits, or who is not 
 15.22  receiving an SSI benefit due to recoupment or a one month 
 15.23  suspension by the Social Security Administration due to excess 
 15.24  income. 
 15.25     Sec. 22.  Minnesota Statutes 2002, section 256J.08, 
 15.26  subdivision 85, is amended to read: 
 15.27     Subd. 85.  [TRANSITIONAL STANDARD.] "Transitional standard" 
 15.28  means the basic standard for a family with no other income or a 
 15.29  nonworking family without earned income and is a combination of 
 15.30  the cash assistance needs portion and food assistance needs for 
 15.31  a family of that size portion as specified in section 256J.24, 
 15.32  subdivision 5. 
 15.33     Sec. 23.  Minnesota Statutes 2002, section 256J.08, is 
 15.34  amended by adding a subdivision to read: 
 15.35     Subd. 90.  [SEVERE FORMS OF TRAFFICKING IN 
 15.36  PERSONS.] "Severe forms of trafficking in persons" means:  (1) 
 16.1   sex trafficking in which a commercial sex act is induced by 
 16.2   force, fraud, or coercion, or in which the person induced to 
 16.3   perform the act has not attained 18 years of age; or (2) the 
 16.4   recruitment, harboring, transportation, provision, or obtaining 
 16.5   of a person for labor or services through the use of force, 
 16.6   fraud, or coercion for the purposes of subjection to involuntary 
 16.7   servitude, peonage, debt bondage, or slavery. 
 16.8      Sec. 24.  Minnesota Statutes 2002, section 256J.09, 
 16.9   subdivision 2, is amended to read: 
 16.10     Subd. 2.  [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 
 16.11  INFORMATION.] When a person inquires about assistance, a county 
 16.12  agency must: 
 16.13     (1) explain the eligibility requirements of, and how to 
 16.14  apply for, diversionary assistance as provided in section 
 16.15  256J.47; emergency assistance as provided in section 256J.48; 
 16.16  MFIP as provided in section 256J.10; or any other assistance for 
 16.17  which the person may be eligible; and 
 16.18     (2) offer the person brochures developed or approved by the 
 16.19  commissioner that describe how to apply for assistance. 
 16.20     Sec. 25.  Minnesota Statutes 2002, section 256J.09, 
 16.21  subdivision 3, is amended to read: 
 16.22     Subd. 3.  [SUBMITTING THE APPLICATION FORM.] (a) A county 
 16.23  agency must offer, in person or by mail, the application forms 
 16.24  prescribed by the commissioner as soon as a person makes a 
 16.25  written or oral inquiry.  At that time, the county agency must: 
 16.26     (1) inform the person that assistance begins with the date 
 16.27  the signed application is received by the county agency or the 
 16.28  date all eligibility criteria are met, whichever is later; 
 16.29     (2) inform the person that any delay in submitting the 
 16.30  application will reduce the amount of assistance paid for the 
 16.31  month of application; 
 16.32     (3) inform a person that the person may submit the 
 16.33  application before an interview; 
 16.34     (4) explain the information that will be verified during 
 16.35  the application process by the county agency as provided in 
 16.36  section 256J.32; 
 17.1      (5) inform a person about the county agency's average 
 17.2   application processing time and explain how the application will 
 17.3   be processed under subdivision 5; 
 17.4      (6) explain how to contact the county agency if a person's 
 17.5   application information changes and how to withdraw the 
 17.6   application; 
 17.7      (7) inform a person that the next step in the application 
 17.8   process is an interview and what a person must do if the 
 17.9   application is approved including, but not limited to, attending 
 17.10  orientation under section 256J.45 and complying with employment 
 17.11  and training services requirements in sections 256J.52 256J.515 
 17.12  to 256J.55 256J.57; 
 17.13     (8) explain the child care and transportation services that 
 17.14  are available under paragraph (c) to enable caregivers to attend 
 17.15  the interview, screening, and orientation; and 
 17.16     (9) identify any language barriers and arrange for 
 17.17  translation assistance during appointments, including, but not 
 17.18  limited to, screening under subdivision 3a, orientation under 
 17.19  section 256J.45, and the initial assessment under section 
 17.20  256J.52 256J.521.  
 17.21     (b) Upon receipt of a signed application, the county agency 
 17.22  must stamp the date of receipt on the face of the application.  
 17.23  The county agency must process the application within the time 
 17.24  period required under subdivision 5.  An applicant may withdraw 
 17.25  the application at any time by giving written or oral notice to 
 17.26  the county agency.  The county agency must issue a written 
 17.27  notice confirming the withdrawal.  The notice must inform the 
 17.28  applicant of the county agency's understanding that the 
 17.29  applicant has withdrawn the application and no longer wants to 
 17.30  pursue it.  When, within ten days of the date of the agency's 
 17.31  notice, an applicant informs a county agency, in writing, that 
 17.32  the applicant does not wish to withdraw the application, the 
 17.33  county agency must reinstate the application and finish 
 17.34  processing the application. 
 17.35     (c) Upon a participant's request, the county agency must 
 17.36  arrange for transportation and child care or reimburse the 
 18.1   participant for transportation and child care expenses necessary 
 18.2   to enable participants to attend the screening under subdivision 
 18.3   3a and orientation under section 256J.45.  
 18.4      Sec. 26.  Minnesota Statutes 2002, section 256J.09, 
 18.5   subdivision 3a, is amended to read: 
 18.6      Subd. 3a.  [SCREENING.] The county agency, or at county 
 18.7   option, the county's employment and training service provider as 
 18.8   defined in section 256J.49, must screen each applicant to 
 18.9   determine immediate needs and to determine if the applicant may 
 18.10  be eligible for: 
 18.11     (1) another program that is not partially funded through 
 18.12  the federal temporary assistance to needy families block grant 
 18.13  under Title I of Public Law Number 104-193, including the 
 18.14  expedited issuance of food stamps under section 256J.28, 
 18.15  subdivision 1.  If the applicant may be eligible for another 
 18.16  program, a county caseworker must provide the appropriate 
 18.17  referral to the program; 
 18.18     (2) the diversionary assistance program under section 
 18.19  256J.47; or 
 18.20     (3) the emergency assistance program under section 
 18.21  256J.48.  If the applicant appears eligible for another program, 
 18.22  including any program funded by the MFIP consolidated fund, the 
 18.23  county must make a referral to the appropriate program. 
 18.24     Sec. 27.  Minnesota Statutes 2002, section 256J.09, 
 18.25  subdivision 3b, is amended to read: 
 18.26     Subd. 3b.  [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 
 18.27  If the applicant is not diverted from applying for MFIP, and if 
 18.28  the applicant meets the MFIP eligibility requirements, then a 
 18.29  county agency must: 
 18.30     (1) identify an applicant who is under the age of 
 18.31  20 without a high school diploma or its equivalent and explain 
 18.32  to the applicant the assessment procedures and employment plan 
 18.33  requirements for minor parents under section 256J.54; 
 18.34     (2) explain to the applicant the eligibility criteria in 
 18.35  section 256J.545 for an exemption under the family violence 
 18.36  provisions in section 256J.52, subdivision 6 waiver, and explain 
 19.1   what an applicant should do to develop an alternative employment 
 19.2   plan; 
 19.3      (3) determine if an applicant qualifies for an exemption 
 19.4   under section 256J.56 from employment and training services 
 19.5   requirements, explain how a person should report to the county 
 19.6   agency any status changes, and explain that an applicant who is 
 19.7   exempt may volunteer to participate in employment and training 
 19.8   services; 
 19.9      (4) for applicants who are not exempt from the requirement 
 19.10  to attend orientation, arrange for an orientation under section 
 19.11  256J.45 and an initial assessment under section 256J.52 
 19.12  256J.521; 
 19.13     (5) inform an applicant who is not exempt from the 
 19.14  requirement to attend orientation that failure to attend the 
 19.15  orientation is considered an occurrence of noncompliance with 
 19.16  program requirements and will result in an imposition of a 
 19.17  sanction under section 256J.46; and 
 19.18     (6) explain how to contact the county agency if an 
 19.19  applicant has questions about compliance with program 
 19.20  requirements. 
 19.21     Sec. 28.  Minnesota Statutes 2002, section 256J.09, 
 19.22  subdivision 8, is amended to read: 
 19.23     Subd. 8.  [ADDITIONAL APPLICATIONS.] Until a county agency 
 19.24  issues notice of approval or denial, additional applications 
 19.25  submitted by an applicant are void.  However, an application for 
 19.26  monthly assistance or other benefits funded under section 
 19.27  256J.626 and an application for emergency assistance or 
 19.28  emergency general assistance may exist concurrently.  More than 
 19.29  one application for monthly assistance, emergency assistance, or 
 19.30  emergency general assistance may exist concurrently when the 
 19.31  county agency decisions on one or more earlier applications have 
 19.32  been appealed to the commissioner, and the applicant asserts 
 19.33  that a change in circumstances has occurred that would allow 
 19.34  eligibility.  A county agency must require additional 
 19.35  application forms or supplemental forms as prescribed by the 
 19.36  commissioner when a payee's name changes, or when a caregiver 
 20.1   requests the addition of another person to the assistance unit.  
 20.2      Sec. 29.  Minnesota Statutes 2002, section 256J.09, 
 20.3   subdivision 10, is amended to read: 
 20.4      Subd. 10.  [APPLICANTS WHO DO NOT MEET ELIGIBILITY 
 20.5   REQUIREMENTS FOR MFIP OR THE DIVERSIONARY WORK PROGRAM.] When an 
 20.6   applicant is not eligible for MFIP or the diversionary work 
 20.7   program under section 256J.95 because the applicant does not 
 20.8   meet eligibility requirements, the county agency must determine 
 20.9   whether the applicant is eligible for food stamps, medical 
 20.10  assistance, diversionary assistance, or has a need for emergency 
 20.11  assistance when the applicant meets the eligibility requirements 
 20.12  for those programs or health care programs.  The county must 
 20.13  also inform applicants about resources available through the 
 20.14  county or other agencies to meet short-term emergency needs. 
 20.15     Sec. 30.  Minnesota Statutes 2002, section 256J.14, is 
 20.16  amended to read: 
 20.17     256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 
 20.18     (a) The definitions in this paragraph only apply to this 
 20.19  subdivision. 
 20.20     (1) "Household of a parent, legal guardian, or other adult 
 20.21  relative" means the place of residence of: 
 20.22     (i) a natural or adoptive parent; 
 20.23     (ii) a legal guardian according to appointment or 
 20.24  acceptance under section 260C.325, 525.615, or 525.6165, and 
 20.25  related laws; 
 20.26     (iii) a caregiver as defined in section 256J.08, 
 20.27  subdivision 11; or 
 20.28     (iv) an appropriate adult relative designated by a county 
 20.29  agency. 
 20.30     (2) "Adult-supervised supportive living arrangement" means 
 20.31  a private family setting which assumes responsibility for the 
 20.32  care and control of the minor parent and minor child, or other 
 20.33  living arrangement, not including a public institution, licensed 
 20.34  by the commissioner of human services which ensures that the 
 20.35  minor parent receives adult supervision and supportive services, 
 20.36  such as counseling, guidance, independent living skills 
 21.1   training, or supervision. 
 21.2      (b) A minor parent and the minor child who is in the care 
 21.3   of the minor parent must reside in the household of a parent, 
 21.4   legal guardian, other adult relative, or in an adult-supervised 
 21.5   supportive living arrangement in order to receive MFIP unless: 
 21.6      (1) the minor parent has no living parent, other adult 
 21.7   relative, or legal guardian whose whereabouts is known; 
 21.8      (2) no living parent, other adult relative, or legal 
 21.9   guardian of the minor parent allows the minor parent to live in 
 21.10  the parent's, other adult relative's, or legal guardian's home; 
 21.11     (3) the minor parent lived apart from the minor parent's 
 21.12  own parent or legal guardian for a period of at least one year 
 21.13  before either the birth of the minor child or the minor parent's 
 21.14  application for MFIP; 
 21.15     (4) the physical or emotional health or safety of the minor 
 21.16  parent or minor child would be jeopardized if the minor parent 
 21.17  and the minor child resided in the same residence with the minor 
 21.18  parent's parent, other adult relative, or legal guardian; or 
 21.19     (5) an adult supervised supportive living arrangement is 
 21.20  not available for the minor parent and child in the county in 
 21.21  which the minor parent and child currently reside.  If an adult 
 21.22  supervised supportive living arrangement becomes available 
 21.23  within the county, the minor parent and child must reside in 
 21.24  that arrangement. 
 21.25     (c) The county agency shall inform minor applicants both 
 21.26  orally and in writing about the eligibility requirements, their 
 21.27  rights and obligations under the MFIP program, and any other 
 21.28  applicable orientation information.  The county must advise the 
 21.29  minor of the possible exemptions under section 256J.54, 
 21.30  subdivision 5, and specifically ask whether one or more of these 
 21.31  exemptions is applicable.  If the minor alleges one or more of 
 21.32  these exemptions, then the county must assist the minor in 
 21.33  obtaining the necessary verifications to determine whether or 
 21.34  not these exemptions apply. 
 21.35     (d) If the county worker has reason to suspect that the 
 21.36  physical or emotional health or safety of the minor parent or 
 22.1   minor child would be jeopardized if they resided with the minor 
 22.2   parent's parent, other adult relative, or legal guardian, then 
 22.3   the county worker must make a referral to child protective 
 22.4   services to determine if paragraph (b), clause (4), applies.  A 
 22.5   new determination by the county worker is not necessary if one 
 22.6   has been made within the last six months, unless there has been 
 22.7   a significant change in circumstances which justifies a new 
 22.8   referral and determination. 
 22.9      (e) If a minor parent is not living with a parent, legal 
 22.10  guardian, or other adult relative due to paragraph (b), clause 
 22.11  (1), (2), or (4), the minor parent must reside, when possible, 
 22.12  in a living arrangement that meets the standards of paragraph 
 22.13  (a), clause (2). 
 22.14     (f) Regardless of living arrangement, MFIP must be paid, 
 22.15  when possible, in the form of a protective payment on behalf of 
 22.16  the minor parent and minor child according to section 256J.39, 
 22.17  subdivisions 2 to 4. 
 22.18     Sec. 31.  Minnesota Statutes 2002, section 256J.20, 
 22.19  subdivision 3, is amended to read: 
 22.20     Subd. 3.  [OTHER PROPERTY LIMITATIONS.] To be eligible for 
 22.21  MFIP, the equity value of all nonexcluded real and personal 
 22.22  property of the assistance unit must not exceed $2,000 for 
 22.23  applicants and $5,000 for ongoing participants.  The value of 
 22.24  assets in clauses (1) to (19) must be excluded when determining 
 22.25  the equity value of real and personal property: 
 22.26     (1) a licensed vehicle up to a loan value of less than or 
 22.27  equal to $7,500.  The county agency shall apply any excess loan 
 22.28  value as if it were equity value to the asset limit described in 
 22.29  this section.  If the assistance unit owns more than one 
 22.30  licensed vehicle, the county agency shall determine the vehicle 
 22.31  with the highest loan value and count only the loan value over 
 22.32  $7,500, excluding:  (i) the value of one vehicle per physically 
 22.33  disabled person when the vehicle is needed to transport the 
 22.34  disabled unit member; this exclusion does not apply to mentally 
 22.35  disabled people; (ii) the value of special equipment for a 
 22.36  handicapped member of the assistance unit; and (iii) any vehicle 
 23.1   used for long-distance travel, other than daily commuting, for 
 23.2   the employment of a unit member. 
 23.3      The county agency shall count the loan value of all other 
 23.4   vehicles and apply this amount as if it were equity value to the 
 23.5   asset limit described in this section.  To establish the loan 
 23.6   value of vehicles, a county agency must use the N.A.D.A. 
 23.7   Official Used Car Guide, Midwest Edition, for newer model cars.  
 23.8   When a vehicle is not listed in the guidebook, or when the 
 23.9   applicant or participant disputes the loan value listed in the 
 23.10  guidebook as unreasonable given the condition of the particular 
 23.11  vehicle, the county agency may require the applicant or 
 23.12  participant document the loan value by securing a written 
 23.13  statement from a motor vehicle dealer licensed under section 
 23.14  168.27, stating the amount that the dealer would pay to purchase 
 23.15  the vehicle.  The county agency shall reimburse the applicant or 
 23.16  participant for the cost of a written statement that documents a 
 23.17  lower loan value; 
 23.18     (2) the value of life insurance policies for members of the 
 23.19  assistance unit; 
 23.20     (3) one burial plot per member of an assistance unit; 
 23.21     (4) the value of personal property needed to produce earned 
 23.22  income, including tools, implements, farm animals, inventory, 
 23.23  business loans, business checking and savings accounts used at 
 23.24  least annually and used exclusively for the operation of a 
 23.25  self-employment business, and any motor vehicles if at least 50 
 23.26  percent of the vehicle's use is to produce income and if the 
 23.27  vehicles are essential for the self-employment business; 
 23.28     (5) the value of personal property not otherwise specified 
 23.29  which is commonly used by household members in day-to-day living 
 23.30  such as clothing, necessary household furniture, equipment, and 
 23.31  other basic maintenance items essential for daily living; 
 23.32     (6) the value of real and personal property owned by a 
 23.33  recipient of Supplemental Security Income or Minnesota 
 23.34  supplemental aid; 
 23.35     (7) the value of corrective payments, but only for the 
 23.36  month in which the payment is received and for the following 
 24.1   month; 
 24.2      (8) a mobile home or other vehicle used by an applicant or 
 24.3   participant as the applicant's or participant's home; 
 24.4      (9) money in a separate escrow account that is needed to 
 24.5   pay real estate taxes or insurance and that is used for this 
 24.6   purpose; 
 24.7      (10) money held in escrow to cover employee FICA, employee 
 24.8   tax withholding, sales tax withholding, employee worker 
 24.9   compensation, business insurance, property rental, property 
 24.10  taxes, and other costs that are paid at least annually, but less 
 24.11  often than monthly; 
 24.12     (11) monthly assistance, emergency assistance, and 
 24.13  diversionary payments for the current month's needs or 
 24.14  short-term emergency needs under section 256J.626, subdivision 
 24.15  2; 
 24.16     (12) the value of school loans, grants, or scholarships for 
 24.17  the period they are intended to cover; 
 24.18     (13) payments listed in section 256J.21, subdivision 2, 
 24.19  clause (9), which are held in escrow for a period not to exceed 
 24.20  three months to replace or repair personal or real property; 
 24.21     (14) income received in a budget month through the end of 
 24.22  the payment month; 
 24.23     (15) savings from earned income of a minor child or a minor 
 24.24  parent that are set aside in a separate account designated 
 24.25  specifically for future education or employment costs; 
 24.26     (16) the federal earned income credit, Minnesota working 
 24.27  family credit, state and federal income tax refunds, state 
 24.28  homeowners and renters credits under chapter 290A, property tax 
 24.29  rebates and other federal or state tax rebates in the month 
 24.30  received and the following month; 
 24.31     (17) payments excluded under federal law as long as those 
 24.32  payments are held in a separate account from any nonexcluded 
 24.33  funds; 
 24.34     (18) the assets of children ineligible to receive MFIP 
 24.35  benefits because foster care or adoption assistance payments are 
 24.36  made on their behalf; and 
 25.1      (19) the assets of persons whose income is excluded under 
 25.2   section 256J.21, subdivision 2, clause (43). 
 25.3      Sec. 32.  Minnesota Statutes 2002, section 256J.21, 
 25.4   subdivision 1, is amended to read: 
 25.5      Subdivision 1.  [INCOME INCLUSIONS.] To determine MFIP 
 25.6   eligibility, the county agency must evaluate income received by 
 25.7   members of an assistance unit, or by other persons whose income 
 25.8   is considered available to the assistance unit, and only count 
 25.9   income that is available to the member of the assistance unit.  
 25.10  Income is available if the individual has legal access to the 
 25.11  income.  All payments, unless specifically excluded in 
 25.12  subdivision 2, must be counted as income.  The county agency 
 25.13  shall verify the income of all MFIP recipients and applicants. 
 25.14     Sec. 33.  Minnesota Statutes 2002, section 256J.21, 
 25.15  subdivision 2, is amended to read: 
 25.16     Subd. 2.  [INCOME EXCLUSIONS.] The following must be 
 25.17  excluded in determining a family's available income: 
 25.18     (1) payments for basic care, difficulty of care, and 
 25.19  clothing allowances received for providing family foster care to 
 25.20  children or adults under Minnesota Rules, parts 9545.0010 to 
 25.21  9545.0260 and 9555.5050 to 9555.6265, and payments received and 
 25.22  used for care and maintenance of a third-party beneficiary who 
 25.23  is not a household member; 
 25.24     (2) reimbursements for employment training received through 
 25.25  the Job Training Partnership Workforce Investment Act 1998, 
 25.26  United States Code, title 29 20, chapter 19 73, sections 1501 
 25.27  to 1792b section 9201; 
 25.28     (3) reimbursement for out-of-pocket expenses incurred while 
 25.29  performing volunteer services, jury duty, employment, or 
 25.30  informal carpooling arrangements directly related to employment; 
 25.31     (4) all educational assistance, except the county agency 
 25.32  must count graduate student teaching assistantships, 
 25.33  fellowships, and other similar paid work as earned income and, 
 25.34  after allowing deductions for any unmet and necessary 
 25.35  educational expenses, shall count scholarships or grants awarded 
 25.36  to graduate students that do not require teaching or research as 
 26.1   unearned income; 
 26.2      (5) loans, regardless of purpose, from public or private 
 26.3   lending institutions, governmental lending institutions, or 
 26.4   governmental agencies; 
 26.5      (6) loans from private individuals, regardless of purpose, 
 26.6   provided an applicant or participant documents that the lender 
 26.7   expects repayment; 
 26.8      (7)(i) state income tax refunds; and 
 26.9      (ii) federal income tax refunds; 
 26.10     (8)(i) federal earned income credits; 
 26.11     (ii) Minnesota working family credits; 
 26.12     (iii) state homeowners and renters credits under chapter 
 26.13  290A; and 
 26.14     (iv) federal or state tax rebates; 
 26.15     (9) funds received for reimbursement, replacement, or 
 26.16  rebate of personal or real property when these payments are made 
 26.17  by public agencies, awarded by a court, solicited through public 
 26.18  appeal, or made as a grant by a federal agency, state or local 
 26.19  government, or disaster assistance organizations, subsequent to 
 26.20  a presidential declaration of disaster; 
 26.21     (10) the portion of an insurance settlement that is used to 
 26.22  pay medical, funeral, and burial expenses, or to repair or 
 26.23  replace insured property; 
 26.24     (11) reimbursements for medical expenses that cannot be 
 26.25  paid by medical assistance; 
 26.26     (12) payments by a vocational rehabilitation program 
 26.27  administered by the state under chapter 268A, except those 
 26.28  payments that are for current living expenses; 
 26.29     (13) in-kind income, including any payments directly made 
 26.30  by a third party to a provider of goods and services; 
 26.31     (14) assistance payments to correct underpayments, but only 
 26.32  for the month in which the payment is received; 
 26.33     (15) emergency assistance payments for short-term emergency 
 26.34  needs under section 256J.626, subdivision 2; 
 26.35     (16) funeral and cemetery payments as provided by section 
 26.36  256.935; 
 27.1      (17) nonrecurring cash gifts of $30 or less, not exceeding 
 27.2   $30 per participant in a calendar month; 
 27.3      (18) any form of energy assistance payment made through 
 27.4   Public Law Number 97-35, Low-Income Home Energy Assistance Act 
 27.5   of 1981, payments made directly to energy providers by other 
 27.6   public and private agencies, and any form of credit or rebate 
 27.7   payment issued by energy providers; 
 27.8      (19) Supplemental Security Income (SSI), including 
 27.9   retroactive SSI payments and other income of an SSI recipient, 
 27.10  except as described in section 256J.37, subdivision 3b; 
 27.11     (20) Minnesota supplemental aid, including retroactive 
 27.12  payments; 
 27.13     (21) proceeds from the sale of real or personal property; 
 27.14     (22) adoption assistance payments under section 259.67; 
 27.15     (23) state-funded family subsidy program payments made 
 27.16  under section 252.32 to help families care for children with 
 27.17  mental retardation or related conditions, consumer support grant 
 27.18  funds under section 256.476, and resources and services for a 
 27.19  disabled household member under one of the home and 
 27.20  community-based waiver services programs under chapter 256B; 
 27.21     (24) interest payments and dividends from property that is 
 27.22  not excluded from and that does not exceed the asset limit; 
 27.23     (25) rent rebates; 
 27.24     (26) income earned by a minor caregiver, minor child 
 27.25  through age 6, or a minor child who is at least a half-time 
 27.26  student in an approved elementary or secondary education 
 27.27  program; 
 27.28     (27) income earned by a caregiver under age 20 who is at 
 27.29  least a half-time student in an approved elementary or secondary 
 27.30  education program; 
 27.31     (28) MFIP child care payments under section 119B.05; 
 27.32     (29) all other payments made through MFIP to support a 
 27.33  caregiver's pursuit of greater self-support economic stability; 
 27.34     (30) income a participant receives related to shared living 
 27.35  expenses; 
 27.36     (31) reverse mortgages; 
 28.1      (32) benefits provided by the Child Nutrition Act of 1966, 
 28.2   United States Code, title 42, chapter 13A, sections 1771 to 
 28.3   1790; 
 28.4      (33) benefits provided by the women, infants, and children 
 28.5   (WIC) nutrition program, United States Code, title 42, chapter 
 28.6   13A, section 1786; 
 28.7      (34) benefits from the National School Lunch Act, United 
 28.8   States Code, title 42, chapter 13, sections 1751 to 1769e; 
 28.9      (35) relocation assistance for displaced persons under the 
 28.10  Uniform Relocation Assistance and Real Property Acquisition 
 28.11  Policies Act of 1970, United States Code, title 42, chapter 61, 
 28.12  subchapter II, section 4636, or the National Housing Act, United 
 28.13  States Code, title 12, chapter 13, sections 1701 to 1750jj; 
 28.14     (36) benefits from the Trade Act of 1974, United States 
 28.15  Code, title 19, chapter 12, part 2, sections 2271 to 2322; 
 28.16     (37) war reparations payments to Japanese Americans and 
 28.17  Aleuts under United States Code, title 50, sections 1989 to 
 28.18  1989d; 
 28.19     (38) payments to veterans or their dependents as a result 
 28.20  of legal settlements regarding Agent Orange or other chemical 
 28.21  exposure under Public Law Number 101-239, section 10405, 
 28.22  paragraph (a)(2)(E); 
 28.23     (39) income that is otherwise specifically excluded from 
 28.24  MFIP consideration in federal law, state law, or federal 
 28.25  regulation; 
 28.26     (40) security and utility deposit refunds; 
 28.27     (41) American Indian tribal land settlements excluded under 
 28.28  Public Law Numbers Laws 98-123, 98-124, and 99-377 to the 
 28.29  Mississippi Band Chippewa Indians of White Earth, Leech Lake, 
 28.30  and Mille Lacs reservations and payments to members of the White 
 28.31  Earth Band, under United States Code, title 25, chapter 9, 
 28.32  section 331, and chapter 16, section 1407; 
 28.33     (42) all income of the minor parent's parents and 
 28.34  stepparents when determining the grant for the minor parent in 
 28.35  households that include a minor parent living with parents or 
 28.36  stepparents on MFIP with other children; 
 29.1      (43) income of the minor parent's parents and stepparents 
 29.2   equal to 200 percent of the federal poverty guideline for a 
 29.3   family size not including the minor parent and the minor 
 29.4   parent's child in households that include a minor parent living 
 29.5   with parents or stepparents not on MFIP when determining the 
 29.6   grant for the minor parent.  The remainder of income is deemed 
 29.7   as specified in section 256J.37, subdivision 1b; 
 29.8      (44) payments made to children eligible for relative 
 29.9   custody assistance under section 257.85; 
 29.10     (45) vendor payments for goods and services made on behalf 
 29.11  of a client unless the client has the option of receiving the 
 29.12  payment in cash; and 
 29.13     (46) the principal portion of a contract for deed payment. 
 29.14     Sec. 34.  Minnesota Statutes 2002, section 256J.24, 
 29.15  subdivision 3, is amended to read: 
 29.16     Subd. 3.  [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 
 29.17  ASSISTANCE UNIT.] (a) The following individuals who are part of 
 29.18  the assistance unit determined under subdivision 2 are 
 29.19  ineligible to receive MFIP: 
 29.20     (1) individuals receiving who are recipients of 
 29.21  Supplemental Security Income or Minnesota supplemental aid; 
 29.22     (2) individuals disqualified from the food stamp program or 
 29.23  MFIP, until the disqualification ends; 
 29.24     (3) children on whose behalf federal, state or local foster 
 29.25  care payments are made, except as provided in sections 256J.13, 
 29.26  subdivision 2, and 256J.74, subdivision 2; and 
 29.27     (4) children receiving ongoing monthly adoption assistance 
 29.28  payments under section 259.67.  
 29.29     (b) The exclusion of a person under this subdivision does 
 29.30  not alter the mandatory assistance unit composition. 
 29.31     Sec. 35.  Minnesota Statutes 2002, section 256J.24, 
 29.32  subdivision 5, is amended to read: 
 29.33     Subd. 5.  [MFIP TRANSITIONAL STANDARD.] The following table 
 29.34  represents the MFIP transitional standard table when all members 
 29.35  of is based on the number of persons in the assistance unit are 
 29.36  eligible for both food and cash assistance unless the 
 30.1   restrictions in subdivision 6 on the birth of a child apply.  
 30.2   The following table represents the transitional standards 
 30.3   effective October 1, 2002. 
 30.4       Number of       Transitional         Cash       Food
 30.5    Eligible People     Standard           Portion    Portion
 30.6         1                $351   $370:      $250       $120
 30.7         2                $609   $658:      $437       $221
 30.8         3                $763   $844:      $532       $312
 30.9         4                $903   $998:      $621       $377
 30.10        5              $1,025 $1,135:      $697       $438
 30.11        6              $1,165 $1,296:      $773       $523
 30.12        7              $1,273 $1,414:      $850       $564
 30.13        8              $1,403 $1,558:      $916       $642
 30.14        9              $1,530 $1,700:      $980       $720
 30.15       10              $1,653 $1,836:    $1,035       $801
 30.16  over 10            add $121   $136:       $53        $83
 30.17  per additional member.
 30.18     The commissioner shall annually publish in the State 
 30.19  Register the transitional standard for an assistance unit sizes 
 30.20  1 to 10 including a breakdown of the cash and food portions. 
 30.21     Sec. 36.  Minnesota Statutes 2002, section 256J.24, 
 30.22  subdivision 6, is amended to read: 
 30.23     Subd. 6.  [APPLICATION OF ASSISTANCE STANDARDS FAMILY CAP.] 
 30.24  The standards apply to the number of eligible persons in the 
 30.25  assistance unit.  (a) MFIP assistance units shall not receive an 
 30.26  increase in the cash portion of the transitional standard as a 
 30.27  result of the birth of a child, unless one of the conditions 
 30.28  under paragraph (b) is met.  The child shall be considered a 
 30.29  member of the assistance unit according to subdivisions 1 to 3, 
 30.30  but shall be excluded in determining family size for purposes of 
 30.31  determining the amount of the cash portion of the transitional 
 30.32  standard under subdivision 5.  The child shall be included in 
 30.33  determining family size for purposes of determining the food 
 30.34  portion of the transitional standard.  The transitional standard 
 30.35  under this subdivision shall be the total of the cash and food 
 30.36  portions as specified in this paragraph.  The family wage level 
 31.1   under this subdivision shall be based on the family size used to 
 31.2   determine the food portion of the transitional standard. 
 31.3      (b) A child shall be included in determining family size 
 31.4   for purposes of determining the amount of the cash portion of 
 31.5   the MFIP transitional standard when at least one of the 
 31.6   following conditions is met: 
 31.7      (1) for families receiving MFIP assistance on July 1, 2003, 
 31.8   the child is born to the adult parent before May 1, 2004; 
 31.9      (2) for families who apply for the diversionary work 
 31.10  program under section 256J.95 or MFIP assistance on or after 
 31.11  July 1, 2003, the child is born to the adult parent within ten 
 31.12  months of the date the family is eligible for assistance; 
 31.13     (3) the child was conceived as a result of a sexual assault 
 31.14  or incest, provided that: 
 31.15     (i) the incident has been reported to a law enforcement 
 31.16  agency which determines that there is probable cause to believe 
 31.17  the crime occurred; and 
 31.18     (ii) a physician verifies that there is reason to believe 
 31.19  the pregnancy or birth resulted from the reported incident; 
 31.20     (4) the child's mother is a minor caregiver as defined in 
 31.21  section 256J.08, subdivision 59, and the child, or multiple 
 31.22  children, are the mother's first birth; or 
 31.23     (5) any child previously excluded in determining family 
 31.24  size under paragraph (a) shall be included if the adult parent 
 31.25  or parents have not received benefits from the diversionary work 
 31.26  program under section 256J.95 or MFIP assistance in the previous 
 31.27  ten months.  An adult parent or parents who reapply and have 
 31.28  received benefits from the diversionary work program or MFIP 
 31.29  assistance in the past ten months shall be under the ten-month 
 31.30  grace period of their previous application under clause (2). 
 31.31     (c) Income and resources of a child excluded under this 
 31.32  subdivision must be considered using the same policies as for 
 31.33  other children when determining the grant amount of the 
 31.34  assistance unit. 
 31.35     (d) The caregiver must assign support and cooperate with 
 31.36  the child support enforcement agency to establish paternity and 
 32.1   collect child support on behalf of the excluded child.  Failure 
 32.2   to cooperate results in the sanction specified in section 
 32.3   256J.46, subdivisions 2 and 2a.  Current support paid on behalf 
 32.4   of the excluded child shall be distributed according to section 
 32.5   256.741, subdivision 15, and counted to determine the grant 
 32.6   amount of the assistance unit. 
 32.7      (e) County agencies must inform applicants of the 
 32.8   provisions under this subdivision at the time of each 
 32.9   application and at recertification.  
 32.10     (f) Children excluded under this provision shall be deemed 
 32.11  MFIP recipients for purposes of child care under chapter 119B. 
 32.12     Sec. 37.  Minnesota Statutes 2002, section 256J.24, 
 32.13  subdivision 7, is amended to read: 
 32.14     Subd. 7.  [FAMILY WAGE LEVEL STANDARD.] The family wage 
 32.15  level standard is 110 percent of the transitional standard under 
 32.16  subdivision 5 or 6, when applicable, and is the standard used 
 32.17  when there is earned income in the assistance unit.  As 
 32.18  specified in section 256J.21, earned income is subtracted from 
 32.19  the family wage level to determine the amount of the assistance 
 32.20  payment.  Not including The family wage level standard, 
 32.21  assistance payments payment may not exceed the MFIP standard of 
 32.22  need transitional standard under subdivision 5 or 6, or the 
 32.23  shared household standard under subdivision 9, whichever is 
 32.24  applicable, for the assistance unit. 
 32.25     Sec. 38.  Minnesota Statutes 2002, section 256J.24, 
 32.26  subdivision 10, is amended to read: 
 32.27     Subd. 10.  [MFIP EXIT LEVEL.] The commissioner shall adjust 
 32.28  the MFIP earned income disregard to ensure that most 
 32.29  participants do not lose eligibility for MFIP until their income 
 32.30  reaches at least 120 115 percent of the federal poverty 
 32.31  guidelines in effect in October of each fiscal year.  The 
 32.32  adjustment to the disregard shall be based on a household size 
 32.33  of three, and the resulting earned income disregard percentage 
 32.34  must be applied to all household sizes.  The adjustment under 
 32.35  this subdivision must be implemented at the same time as the 
 32.36  October food stamp cost-of-living adjustment is reflected in the 
 33.1   food portion of MFIP transitional standard as required under 
 33.2   subdivision 5a. 
 33.3      Sec. 39.  Minnesota Statutes 2002, section 256J.30, 
 33.4   subdivision 9, is amended to read: 
 33.5      Subd. 9.  [CHANGES THAT MUST BE REPORTED.] A caregiver must 
 33.6   report the changes or anticipated changes specified in clauses 
 33.7   (1) to (17) (16) within ten days of the date they occur, at the 
 33.8   time of the periodic recertification of eligibility under 
 33.9   section 256J.32, subdivision 6, or within eight calendar days of 
 33.10  a reporting period as in subdivision 5 or 6, whichever occurs 
 33.11  first.  A caregiver must report other changes at the time of the 
 33.12  periodic recertification of eligibility under section 256J.32, 
 33.13  subdivision 6, or at the end of a reporting period under 
 33.14  subdivision 5 or 6, as applicable.  A caregiver must make these 
 33.15  reports in writing to the county agency.  When a county agency 
 33.16  could have reduced or terminated assistance for one or more 
 33.17  payment months if a delay in reporting a change specified under 
 33.18  clauses (1) to (16) (15) had not occurred, the county agency 
 33.19  must determine whether a timely notice under section 256J.31, 
 33.20  subdivision 4, could have been issued on the day that the change 
 33.21  occurred.  When a timely notice could have been issued, each 
 33.22  month's overpayment subsequent to that notice must be considered 
 33.23  a client error overpayment under section 256J.38.  Calculation 
 33.24  of overpayments for late reporting under clause (17) (16) is 
 33.25  specified in section 256J.09, subdivision 9.  Changes in 
 33.26  circumstances which must be reported within ten days must also 
 33.27  be reported on the MFIP household report form for the reporting 
 33.28  period in which those changes occurred.  Within ten days, a 
 33.29  caregiver must report: 
 33.30     (1) a change in initial employment; 
 33.31     (2) a change in initial receipt of unearned income; 
 33.32     (3) a recurring change in unearned income; 
 33.33     (4) a nonrecurring change of unearned income that exceeds 
 33.34  $30; 
 33.35     (5) the receipt of a lump sum; 
 33.36     (6) an increase in assets that may cause the assistance 
 34.1   unit to exceed asset limits; 
 34.2      (7) a change in the physical or mental status of an 
 34.3   incapacitated member of the assistance unit if the physical or 
 34.4   mental status is the basis of exemption from an MFIP employment 
 34.5   services program under section 256J.56, or as the basis for 
 34.6   reducing the hourly participation requirements under section 
 34.7   256J.55, subdivision 1, or the type of activities included in an 
 34.8   employment plan under section 256J.521, subdivision 2; 
 34.9      (8) a change in employment status; 
 34.10     (9) information affecting an exception under section 
 34.11  256J.24, subdivision 9; 
 34.12     (10) a change in health insurance coverage; 
 34.13     (11) the marriage or divorce of an assistance unit member; 
 34.14     (12) (11) the death of a parent, minor child, or 
 34.15  financially responsible person; 
 34.16     (13) (12) a change in address or living quarters of the 
 34.17  assistance unit; 
 34.18     (14) (13) the sale, purchase, or other transfer of 
 34.19  property; 
 34.20     (15) (14) a change in school attendance of a custodial 
 34.21  parent caregiver under age 20 or an employed child; 
 34.22     (16) (15) filing a lawsuit, a workers' compensation claim, 
 34.23  or a monetary claim against a third party; and 
 34.24     (17) (16) a change in household composition, including 
 34.25  births, returns to and departures from the home of assistance 
 34.26  unit members and financially responsible persons, or a change in 
 34.27  the custody of a minor child. 
 34.28     Sec. 40.  Minnesota Statutes 2002, section 256J.31, 
 34.29  subdivision 4, is amended to read: 
 34.30     Subd. 4.  [PARTICIPANT'S RIGHT TO NOTICE.] A county agency 
 34.31  must give a participant written notice of all adverse actions 
 34.32  affecting the participant including payment reductions, 
 34.33  suspensions, terminations, and use of protective, vendor, or 
 34.34  two-party payments.  The notice of adverse action must be on a 
 34.35  form prescribed or approved by the commissioner, must be 
 34.36  understandable at a seventh grade reading level, and must be 
 35.1   mailed to the last known mailing address provided by the 
 35.2   participant.  A notice written in English must include the 
 35.3   department of human services language block and must be sent to 
 35.4   every applicable participant.  The county agency must state on 
 35.5   the notice of adverse action the action it intends to take, the 
 35.6   reasons for the action, the participant's right to appeal the 
 35.7   action, the conditions under which assistance can be continued 
 35.8   pending an appeal decision, and the related consequences of the 
 35.9   action.  A county agency shall combine the information required 
 35.10  in this notice with the information required in a notice of 
 35.11  intent to sanction under section 256J.57, subdivision 2. 
 35.12     Sec. 41.  Minnesota Statutes 2002, section 256J.32, 
 35.13  subdivision 2, is amended to read: 
 35.14     Subd. 2.  [DOCUMENTATION.] The applicant or participant 
 35.15  must document the information required under subdivisions 4 to 6 
 35.16  or authorize the county agency to verify the information.  The 
 35.17  applicant or participant has the burden of providing documentary 
 35.18  evidence to verify eligibility.  The county agency shall assist 
 35.19  the applicant or participant in obtaining required documents 
 35.20  when the applicant or participant is unable to do so.  When an 
 35.21  applicant or participant and the county agency are unable to 
 35.22  obtain documents needed to verify information, the county agency 
 35.23  may accept an affidavit from an applicant or participant as 
 35.24  sufficient documentation.  The county agency may accept an 
 35.25  affidavit only for factors specified under subdivision 8.  
 35.26     Sec. 42.  Minnesota Statutes 2002, section 256J.32, 
 35.27  subdivision 4, is amended to read: 
 35.28     Subd. 4.  [FACTORS TO BE VERIFIED.] The county agency shall 
 35.29  verify the following at application: 
 35.30     (1) identity of adults; 
 35.31     (2) presence of the minor child in the home, if 
 35.32  questionable; 
 35.33     (3) relationship of a minor child to caregivers in the 
 35.34  assistance unit; 
 35.35     (4) age, if necessary to determine MFIP eligibility; 
 35.36     (5) immigration status; 
 36.1      (6) social security number according to the requirements of 
 36.2   section 256J.30, subdivision 12; 
 36.3      (7) income; 
 36.4      (8) self-employment expenses used as a deduction; 
 36.5      (9) source and purpose of deposits and withdrawals from 
 36.6   business accounts; 
 36.7      (10) spousal support and child support payments made to 
 36.8   persons outside the household; 
 36.9      (11) real property; 
 36.10     (12) vehicles; 
 36.11     (13) checking and savings accounts; 
 36.12     (14) savings certificates, savings bonds, stocks, and 
 36.13  individual retirement accounts; 
 36.14     (15) pregnancy, if related to eligibility; 
 36.15     (16) inconsistent information, if related to eligibility; 
 36.16     (17) medical insurance; 
 36.17     (18) burial accounts; 
 36.18     (19) (18) school attendance, if related to eligibility; 
 36.19     (20) (19) residence; 
 36.20     (21) (20) a claim of family violence if used as a basis for 
 36.21  a to qualify for the family violence waiver from the 60-month 
 36.22  time limit in section 256J.42 and regular employment and 
 36.23  training services requirements in section 256J.56; 
 36.24     (22) (21) disability if used as the basis for an exemption 
 36.25  from employment and training services requirements under section 
 36.26  256J.56 or as the basis for reducing the hourly participation 
 36.27  requirements under section 256J.55, subdivision 1, or the type 
 36.28  of activity included in an employment plan under section 
 36.29  256J.521, subdivision 2; and 
 36.30     (23) (22) information needed to establish an exception 
 36.31  under section 256J.24, subdivision 9. 
 36.32     Sec. 43.  Minnesota Statutes 2002, section 256J.32, 
 36.33  subdivision 5a, is amended to read: 
 36.34     Subd. 5a.  [INCONSISTENT INFORMATION.] When the county 
 36.35  agency verifies inconsistent information under subdivision 4, 
 36.36  clause (16), or 6, clause (4) (5), the reason for verifying the 
 37.1   information must be documented in the financial case record. 
 37.2      Sec. 44.  Minnesota Statutes 2002, section 256J.32, is 
 37.3   amended by adding a subdivision to read: 
 37.4      Subd. 8.  [AFFIDAVIT.] The county agency may accept an 
 37.5   affidavit from the applicant or recipient as sufficient 
 37.6   documentation at the time of application or recertification only 
 37.7   for the following factors: 
 37.8      (1) a claim of family violence if used as a basis to 
 37.9   qualify for the family violence waiver; 
 37.10     (2) information needed to establish an exception under 
 37.11  section 256J.24, subdivision 9; 
 37.12     (3) relationship of a minor child to caregivers in the 
 37.13  assistance unit; and 
 37.14     (4) citizenship status from a noncitizen who reports to be, 
 37.15  or is identified as, a victim of severe forms of trafficking in 
 37.16  persons, if the noncitizen reports that the noncitizen's 
 37.17  immigration documents are being held by an individual or group 
 37.18  of individuals against the noncitizen's will.  The noncitizen 
 37.19  must follow up with the Office of Refugee Resettlement (ORR) to 
 37.20  pursue certification.  If verification that certification is 
 37.21  being pursued is not received within 30 days, the MFIP case must 
 37.22  be closed and the agency shall pursue overpayments.  The ORR 
 37.23  documents certifying the noncitizen's status as a victim of 
 37.24  severe forms of trafficking in persons, or the reason for the 
 37.25  delay in processing, must be received within 90 days, or the 
 37.26  MFIP case must be closed and the agency shall pursue 
 37.27  overpayments. 
 37.28     Sec. 45.  Minnesota Statutes 2002, section 256J.37, is 
 37.29  amended by adding a subdivision to read: 
 37.30     Subd. 3a.  [RENTAL SUBSIDIES; UNEARNED INCOME.] (a) 
 37.31  Effective July 1, 2003, the county agency shall count $100 of 
 37.32  the value of public and assisted rental subsidies provided 
 37.33  through the Department of Housing and Urban Development (HUD) as 
 37.34  unearned income to the cash portion of the MFIP grant.  The full 
 37.35  amount of the subsidy must be counted as unearned income when 
 37.36  the subsidy is less than $100.  For the purposes of initial 
 38.1   implementation of this subdivision, the county shall budget the 
 38.2   income from the subsidy prospectively in the months of July and 
 38.3   August 2003.  This shall be done regardless of whether the case 
 38.4   is in the retrospective or prospective budgeting cycle.  
 38.5   Thereafter, the income from this subsidy shall be budgeted 
 38.6   according to section 256J.34. 
 38.7      (b) The provisions of this subdivision shall not apply to 
 38.8   an MFIP assistance unit which includes a participant who is: 
 38.9      (1) age 60 or older; 
 38.10     (2) a caregiver who is suffering from an illness, injury, 
 38.11  or incapacity that has been certified by a qualified 
 38.12  professional when the illness, injury, or incapacity is expected 
 38.13  to continue for more than 30 days and prevents the person from 
 38.14  obtaining or retaining employment; or 
 38.15     (3) a caregiver whose presence in the home is required due 
 38.16  to the illness or incapacity of another member in the assistance 
 38.17  unit, a relative in the household, or a foster child in the 
 38.18  household when the illness or incapacity and the need for the 
 38.19  participant's presence in the home has been certified by a 
 38.20  qualified professional and is expected to continue for more than 
 38.21  30 days. 
 38.22     (c) The provisions of this subdivision shall not apply to 
 38.23  an MFIP assistance unit where the parental caregiver is an SSI 
 38.24  recipient. 
 38.25     Sec. 46.  Minnesota Statutes 2002, section 256J.37, is 
 38.26  amended by adding a subdivision to read: 
 38.27     Subd. 3b.  [TREATMENT OF SUPPLEMENTAL SECURITY 
 38.28  INCOME.] Effective July 1, 2003, the county shall reduce the 
 38.29  cash portion of the MFIP grant by $175 per SSI recipient who 
 38.30  resides in the household, and who would otherwise be included in 
 38.31  the MFIP assistance unit under section 256J.24, subdivision 2, 
 38.32  but is excluded solely due to the SSI recipient status under 
 38.33  section 256J.24, subdivision 3, paragraph (a), clause (1).  If 
 38.34  the SSI recipient receives less than $175 of SSI, only the 
 38.35  amount received shall be used in calculating the MFIP cash 
 38.36  assistance payment.  This provision does not apply to relative 
 39.1   caregivers who could elect to be included in the MFIP assistance 
 39.2   unit under section 256J.24, subdivision 4, unless the 
 39.3   caregiver's children or stepchildren are included in the MFIP 
 39.4   assistance unit. 
 39.5      Sec. 47.  Minnesota Statutes 2002, section 256J.37, 
 39.6   subdivision 9, is amended to read: 
 39.7      Subd. 9.  [UNEARNED INCOME.] (a) The county agency must 
 39.8   apply unearned income to the MFIP standard of need.  When 
 39.9   determining the amount of unearned income, the county agency 
 39.10  must deduct the costs necessary to secure payments of unearned 
 39.11  income.  These costs include legal fees, medical fees, and 
 39.12  mandatory deductions such as federal and state income taxes. 
 39.13     (b) Effective July 1, 2003, the county agency shall count 
 39.14  $100 of the value of public and assisted rental subsidies 
 39.15  provided through the Department of Housing and Urban Development 
 39.16  (HUD) as unearned income.  The full amount of the subsidy must 
 39.17  be counted as unearned income when the subsidy is less than $100.
 39.18     (c) The provisions of paragraph (b) shall not apply to MFIP 
 39.19  participants who are exempt from the employment and training 
 39.20  services component because they are: 
 39.21     (i) individuals who are age 60 or older; 
 39.22     (ii) individuals who are suffering from a professionally 
 39.23  certified permanent or temporary illness, injury, or incapacity 
 39.24  which is expected to continue for more than 30 days and which 
 39.25  prevents the person from obtaining or retaining employment; or 
 39.26     (iii) caregivers whose presence in the home is required 
 39.27  because of the professionally certified illness or incapacity of 
 39.28  another member in the assistance unit, a relative in the 
 39.29  household, or a foster child in the household. 
 39.30     (d) The provisions of paragraph (b) shall not apply to an 
 39.31  MFIP assistance unit where the parental caregiver receives 
 39.32  supplemental security income. 
 39.33     Sec. 48.  Minnesota Statutes 2002, section 256J.38, 
 39.34  subdivision 3, is amended to read: 
 39.35     Subd. 3.  [RECOVERING OVERPAYMENTS FROM FORMER 
 39.36  PARTICIPANTS.] A county agency must initiate efforts to recover 
 40.1   overpayments paid to a former participant or caregiver.  Adults 
 40.2   Caregivers, both parental and nonparental, and minor caregivers 
 40.3   of an assistance unit at the time an overpayment occurs, whether 
 40.4   receiving assistance or not, are jointly and individually liable 
 40.5   for repayment of the overpayment.  The county agency must 
 40.6   request repayment from the former participants and caregivers.  
 40.7   When an agreement for repayment is not completed within six 
 40.8   months of the date of discovery or when there is a default on an 
 40.9   agreement for repayment after six months, the county agency must 
 40.10  initiate recovery consistent with chapter 270A, or section 
 40.11  541.05.  When a person has been convicted of fraud under section 
 40.12  256.98, recovery must be sought regardless of the amount of 
 40.13  overpayment.  When an overpayment is less than $35, and is not 
 40.14  the result of a fraud conviction under section 256.98, the 
 40.15  county agency must not seek recovery under this subdivision.  
 40.16  The county agency must retain information about all overpayments 
 40.17  regardless of the amount.  When an adult, adult caregiver, or 
 40.18  minor caregiver reapplies for assistance, the overpayment must 
 40.19  be recouped under subdivision 4. 
 40.20     Sec. 49.  Minnesota Statutes 2002, section 256J.38, 
 40.21  subdivision 4, is amended to read: 
 40.22     Subd. 4.  [RECOUPING OVERPAYMENTS FROM PARTICIPANTS.] A 
 40.23  participant may voluntarily repay, in part or in full, an 
 40.24  overpayment even if assistance is reduced under this 
 40.25  subdivision, until the total amount of the overpayment is 
 40.26  repaid.  When an overpayment occurs due to fraud, the county 
 40.27  agency must recover from the overpaid assistance unit, including 
 40.28  child only cases, ten percent of the applicable standard or the 
 40.29  amount of the monthly assistance payment, whichever is less.  
 40.30  When a nonfraud overpayment occurs, the county agency must 
 40.31  recover from the overpaid assistance unit, including child only 
 40.32  cases, three percent of the MFIP standard of need or the amount 
 40.33  of the monthly assistance payment, whichever is less.  
 40.34     Sec. 50.  Minnesota Statutes 2002, section 256J.40, is 
 40.35  amended to read: 
 40.36     256J.40 [FAIR HEARINGS.] 
 41.1      Caregivers receiving a notice of intent to sanction or a 
 41.2   notice of adverse action that includes a sanction, reduction in 
 41.3   benefits, suspension of benefits, denial of benefits, or 
 41.4   termination of benefits may request a fair hearing.  A request 
 41.5   for a fair hearing must be submitted in writing to the county 
 41.6   agency or to the commissioner and must be mailed within 30 days 
 41.7   after a participant or former participant receives written 
 41.8   notice of the agency's action or within 90 days when a 
 41.9   participant or former participant shows good cause for not 
 41.10  submitting the request within 30 days.  A former participant who 
 41.11  receives a notice of adverse action due to an overpayment may 
 41.12  appeal the adverse action according to the requirements in this 
 41.13  section.  Issues that may be appealed are: 
 41.14     (1) the amount of the assistance payment; 
 41.15     (2) a suspension, reduction, denial, or termination of 
 41.16  assistance; 
 41.17     (3) the basis for an overpayment, the calculated amount of 
 41.18  an overpayment, and the level of recoupment; 
 41.19     (4) the eligibility for an assistance payment; and 
 41.20     (5) the use of protective or vendor payments under section 
 41.21  256J.39, subdivision 2, clauses (1) to (3). 
 41.22     Except for benefits issued under section 256J.95, a county 
 41.23  agency must not reduce, suspend, or terminate payment when an 
 41.24  aggrieved participant requests a fair hearing prior to the 
 41.25  effective date of the adverse action or within ten days of the 
 41.26  mailing of the notice of adverse action, whichever is later, 
 41.27  unless the participant requests in writing not to receive 
 41.28  continued assistance pending a hearing decision.  An appeal 
 41.29  request cannot extend benefits for the diversionary work program 
 41.30  under section 256J.95 beyond the four-month time limit.  
 41.31  Assistance issued pending a fair hearing is subject to recovery 
 41.32  under section 256J.38 when as a result of the fair hearing 
 41.33  decision the participant is determined ineligible for assistance 
 41.34  or the amount of the assistance received.  A county agency may 
 41.35  increase or reduce an assistance payment while an appeal is 
 41.36  pending when the circumstances of the participant change and are 
 42.1   not related to the issue on appeal.  The commissioner's order is 
 42.2   binding on a county agency.  No additional notice is required to 
 42.3   enforce the commissioner's order. 
 42.4      A county agency shall reimburse appellants for reasonable 
 42.5   and necessary expenses of attendance at the hearing, such as 
 42.6   child care and transportation costs and for the transportation 
 42.7   expenses of the appellant's witnesses and representatives to and 
 42.8   from the hearing.  Reasonable and necessary expenses do not 
 42.9   include legal fees.  Fair hearings must be conducted at a 
 42.10  reasonable time and date by an impartial referee employed by the 
 42.11  department.  The hearing may be conducted by telephone or at a 
 42.12  site that is readily accessible to persons with disabilities. 
 42.13     The appellant may introduce new or additional evidence 
 42.14  relevant to the issues on appeal.  Recommendations of the 
 42.15  appeals referee and decisions of the commissioner must be based 
 42.16  on evidence in the hearing record and are not limited to a 
 42.17  review of the county agency action. 
 42.18     Sec. 51.  Minnesota Statutes 2002, section 256J.42, 
 42.19  subdivision 4, is amended to read: 
 42.20     Subd. 4.  [VICTIMS OF FAMILY VIOLENCE.] Any cash assistance 
 42.21  received by an assistance unit in a month when a caregiver 
 42.22  complied with a safety plan, an alternative employment plan, or 
 42.23  an employment plan or after October 1, 2001, complied or is 
 42.24  complying with an alternative employment plan under section 
 42.25  256J.49 256J.521, subdivision 1a 3, does not count toward the 
 42.26  60-month limitation on assistance. 
 42.27     Sec. 52.  Minnesota Statutes 2002, section 256J.42, 
 42.28  subdivision 5, is amended to read: 
 42.29     Subd. 5.  [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 
 42.30  assistance received by an assistance unit does not count toward 
 42.31  the 60-month limit on assistance during a month in which the 
 42.32  caregiver is in the category in age 60 or older, including 
 42.33  months during which the caregiver was exempt under section 
 42.34  256J.56, paragraph (a), clause (1). 
 42.35     (b) From July 1, 1997, until the date MFIP is operative in 
 42.36  the caregiver's county of financial responsibility, any cash 
 43.1   assistance received by a caregiver who is complying with 
 43.2   Minnesota Statutes 1996, section 256.73, subdivision 5a, and 
 43.3   Minnesota Statutes 1998, section 256.736, if applicable, does 
 43.4   not count toward the 60-month limit on assistance.  Thereafter, 
 43.5   any cash assistance received by a minor caregiver who is 
 43.6   complying with the requirements of sections 256J.14 and 256J.54, 
 43.7   if applicable, does not count towards the 60-month limit on 
 43.8   assistance. 
 43.9      (c) Any diversionary assistance or emergency assistance 
 43.10  received prior to July 1, 2003, does not count toward the 
 43.11  60-month limit. 
 43.12     (d) Any cash assistance received by an 18- or 19-year-old 
 43.13  caregiver who is complying with the requirements of an 
 43.14  employment plan that includes an education option under section 
 43.15  256J.54 does not count toward the 60-month limit. 
 43.16     (e) Payments provided to meet short-term emergency needs 
 43.17  under section 256J.626 and diversionary work program benefits 
 43.18  provided under section 256J.95 do not count toward the 60-month 
 43.19  time limit. 
 43.20     Sec. 53.  Minnesota Statutes 2002, section 256J.42, 
 43.21  subdivision 6, is amended to read: 
 43.22     Subd. 6.  [CASE REVIEW.] (a) Within 180 days, but not less 
 43.23  than 60 days, before the end of the participant's 60th month on 
 43.24  assistance, the county agency or job counselor must review the 
 43.25  participant's case to determine if the employment plan is still 
 43.26  appropriate or if the participant is exempt under section 
 43.27  256J.56 from the employment and training services component, and 
 43.28  attempt to meet with the participant face-to-face. 
 43.29     (b) During the face-to-face meeting, a county agency or the 
 43.30  job counselor must: 
 43.31     (1) inform the participant how many months of counted 
 43.32  assistance the participant has accrued and when the participant 
 43.33  is expected to reach the 60th month; 
 43.34     (2) explain the hardship extension criteria under section 
 43.35  256J.425 and what the participant should do if the participant 
 43.36  thinks a hardship extension applies; 
 44.1      (3) identify other resources that may be available to the 
 44.2   participant to meet the needs of the family; and 
 44.3      (4) inform the participant of the right to appeal the case 
 44.4   closure under section 256J.40. 
 44.5      (c) If a face-to-face meeting is not possible, the county 
 44.6   agency must send the participant a notice of adverse action as 
 44.7   provided in section 256J.31, subdivisions 4 and 5. 
 44.8      (d) Before a participant's case is closed under this 
 44.9   section, the county must ensure that: 
 44.10     (1) the case has been reviewed by the job counselor's 
 44.11  supervisor or the review team designated in by the county's 
 44.12  approved local service unit plan county to determine if the 
 44.13  criteria for a hardship extension, if requested, were applied 
 44.14  appropriately; and 
 44.15     (2) the county agency or the job counselor attempted to 
 44.16  meet with the participant face-to-face. 
 44.17     Sec. 54.  Minnesota Statutes 2002, section 256J.425, 
 44.18  subdivision 1, is amended to read: 
 44.19     Subdivision 1.  [ELIGIBILITY.] (a) To be eligible for a 
 44.20  hardship extension, a participant in an assistance unit subject 
 44.21  to the time limit under section 256J.42, subdivision 1, in which 
 44.22  any participant has received 60 counted months of assistance, 
 44.23  must be in compliance in the participant's 60th counted month 
 44.24  the participant is applying for the extension.  For purposes of 
 44.25  determining eligibility for a hardship extension, a participant 
 44.26  is in compliance in any month that the participant has not been 
 44.27  sanctioned. 
 44.28     (b) If one participant in a two-parent assistance unit is 
 44.29  determined to be ineligible for a hardship extension, the county 
 44.30  shall give the assistance unit the option of disqualifying the 
 44.31  ineligible participant from MFIP.  In that case, the assistance 
 44.32  unit shall be treated as a one-parent assistance unit and the 
 44.33  assistance unit's MFIP grant shall be calculated using the 
 44.34  shared household standard under section 256J.08, subdivision 82a.
 44.35     Sec. 55.  Minnesota Statutes 2002, section 256J.425, 
 44.36  subdivision 1a, is amended to read: 
 45.1      Subd. 1a.  [REVIEW.] If a county grants a hardship 
 45.2   extension under this section, a county agency shall review the 
 45.3   case every six or 12 months, whichever is appropriate based on 
 45.4   the participant's circumstances and the extension 
 45.5   category.  More frequent reviews shall be required if 
 45.6   eligibility for an extension is based on a condition that is 
 45.7   subject to change in less than six months. 
 45.8      Sec. 56.  Minnesota Statutes 2002, section 256J.425, 
 45.9   subdivision 2, is amended to read: 
 45.10     Subd. 2.  [ILL OR INCAPACITATED.] (a) An assistance unit 
 45.11  subject to the time limit in section 256J.42, subdivision 1, in 
 45.12  which any participant has received 60 counted months of 
 45.13  assistance, is eligible to receive months of assistance under a 
 45.14  hardship extension if the participant who reached the time limit 
 45.15  belongs to any of the following groups: 
 45.16     (1) participants who are suffering from a professionally 
 45.17  certified an illness, injury, or incapacity which has been 
 45.18  certified by a qualified professional when the illness, injury, 
 45.19  or incapacity is expected to continue for more than 30 days 
 45.20  and which prevents the person from obtaining or retaining 
 45.21  employment and who are following.  These participants must 
 45.22  follow the treatment recommendations of the health care provider 
 45.23  qualified professional certifying the illness, injury, or 
 45.24  incapacity; 
 45.25     (2) participants whose presence in the home is required as 
 45.26  a caregiver because of a professionally certified the illness or 
 45.27  incapacity of another member in the assistance unit, a relative 
 45.28  in the household, or a foster child in the household and when 
 45.29  the illness or incapacity and the need for the participant's 
 45.30  presence in the home has been certified by a qualified 
 45.31  professional and is expected to continue for more than 30 days; 
 45.32  or 
 45.33     (3) caregivers with a child or an adult in the household 
 45.34  who meets the disability or medical criteria for home care 
 45.35  services under section 256B.0627, subdivision 1, paragraph 
 45.36  (c) (f), or a home and community-based waiver services program 
 46.1   under chapter 256B, or meets the criteria for severe emotional 
 46.2   disturbance under section 245.4871, subdivision 6, or for 
 46.3   serious and persistent mental illness under section 245.462, 
 46.4   subdivision 20, paragraph (c).  Caregivers in this category are 
 46.5   presumed to be prevented from obtaining or retaining employment. 
 46.6      (b) An assistance unit receiving assistance under a 
 46.7   hardship extension under this subdivision may continue to 
 46.8   receive assistance as long as the participant meets the criteria 
 46.9   in paragraph (a), clause (1), (2), or (3). 
 46.10     Sec. 57.  Minnesota Statutes 2002, section 256J.425, 
 46.11  subdivision 3, is amended to read: 
 46.12     Subd. 3.  [HARD-TO-EMPLOY PARTICIPANTS.] An assistance unit 
 46.13  subject to the time limit in section 256J.42, subdivision 1, in 
 46.14  which any participant has received 60 counted months of 
 46.15  assistance, is eligible to receive months of assistance under a 
 46.16  hardship extension if the participant who reached the time limit 
 46.17  belongs to any of the following groups: 
 46.18     (1) a person who is diagnosed by a licensed physician, 
 46.19  psychological practitioner, or other qualified professional, as 
 46.20  mentally retarded or mentally ill, and that condition prevents 
 46.21  the person from obtaining or retaining unsubsidized employment; 
 46.22     (2) a person who: 
 46.23     (i) has been assessed by a vocational specialist or the 
 46.24  county agency to be unemployable for purposes of this 
 46.25  subdivision; or 
 46.26     (ii) has an IQ below 80 who has been assessed by a 
 46.27  vocational specialist or a county agency to be employable, but 
 46.28  not at a level that makes the participant eligible for an 
 46.29  extension under subdivision 4 or,.  The determination of IQ 
 46.30  level must be made by a qualified professional.  In the case of 
 46.31  a non-English-speaking person for whom it is not possible to 
 46.32  provide a determination due to language barriers or absence of 
 46.33  culturally appropriate assessment tools, is determined by a 
 46.34  qualified professional to have an IQ below 80.  A person is 
 46.35  considered employable if positions of employment in the local 
 46.36  labor market exist, regardless of the current availability of 
 47.1   openings for those positions, that the person is capable of 
 47.2   performing:  (A) the determination must be made by a qualified 
 47.3   professional with experience conducting culturally appropriate 
 47.4   assessments, whenever possible; (B) the county may accept 
 47.5   reports that identify an IQ range as opposed to a specific 
 47.6   score; (C) these reports must include a statement of confidence 
 47.7   in the results; 
 47.8      (3) a person who is determined by the county agency a 
 47.9   qualified professional to be learning disabled or, and the 
 47.10  disability severely limits the person's ability to obtain, 
 47.11  perform, or maintain suitable employment.  For purposes of the 
 47.12  initial approval of a learning disability extension, the 
 47.13  determination must have been made or confirmed within the 
 47.14  previous 12 months.  In the case of a non-English-speaking 
 47.15  person for whom it is not possible to provide a medical 
 47.16  diagnosis due to language barriers or absence of culturally 
 47.17  appropriate assessment tools, is determined by a qualified 
 47.18  professional to have a learning disability.  If a rehabilitation 
 47.19  plan for the person is developed or approved by the county 
 47.20  agency, the plan must be incorporated into the employment plan.  
 47.21  However, a rehabilitation plan does not replace the requirement 
 47.22  to develop and comply with an employment plan under section 
 47.23  256J.52.  For purposes of this section, "learning disabled" 
 47.24  means the applicant or recipient has a disorder in one or more 
 47.25  of the psychological processes involved in perceiving, 
 47.26  understanding, or using concepts through verbal language or 
 47.27  nonverbal means.  The disability must severely limit the 
 47.28  applicant or recipient in obtaining, performing, or maintaining 
 47.29  suitable employment.  Learning disabled does not include 
 47.30  learning problems that are primarily the result of visual, 
 47.31  hearing, or motor handicaps; mental retardation; emotional 
 47.32  disturbance; or due to environmental, cultural, or economic 
 47.33  disadvantage:  (i) the determination must be made by a qualified 
 47.34  professional with experience conducting culturally appropriate 
 47.35  assessments, whenever possible; and (ii) these reports must 
 47.36  include a statement of confidence in the results.  If a 
 48.1   rehabilitation plan for a participant extended as learning 
 48.2   disabled is developed or approved by the county agency, the plan 
 48.3   must be incorporated into the employment plan.  However, a 
 48.4   rehabilitation plan does not replace the requirement to develop 
 48.5   and comply with an employment plan under section 256J.521; or 
 48.6      (4) a person who is a victim of has been granted a family 
 48.7   violence as defined in section 256J.49, subdivision 2 waiver, 
 48.8   and who is participating in complying with an alternative 
 48.9   employment plan under section 256J.49 256J.521, subdivision 1a 
 48.10  3.  
 48.11     Sec. 58.  Minnesota Statutes 2002, section 256J.425, 
 48.12  subdivision 4, is amended to read: 
 48.13     Subd. 4.  [EMPLOYED PARTICIPANTS.] (a) An assistance unit 
 48.14  subject to the time limit under section 256J.42, subdivision 1, 
 48.15  in which any participant has received 60 months of assistance, 
 48.16  is eligible to receive assistance under a hardship extension if 
 48.17  the participant who reached the time limit belongs to: 
 48.18     (1) a one-parent assistance unit in which the participant 
 48.19  is participating in work activities for at least 30 hours per 
 48.20  week, of which an average of at least 25 hours per week every 
 48.21  month are spent participating in employment; 
 48.22     (2) a two-parent assistance unit in which the participants 
 48.23  are participating in work activities for at least 55 hours per 
 48.24  week, of which an average of at least 45 hours per week every 
 48.25  month are spent participating in employment; or 
 48.26     (3) an assistance unit in which a participant is 
 48.27  participating in employment for fewer hours than those specified 
 48.28  in clause (1), and the participant submits verification from a 
 48.29  health care provider qualified professional, in a form 
 48.30  acceptable to the commissioner, stating that the number of hours 
 48.31  the participant may work is limited due to illness or 
 48.32  disability, as long as the participant is participating in 
 48.33  employment for at least the number of hours specified by 
 48.34  the health care provider qualified professional.  The 
 48.35  participant must be following the treatment recommendations of 
 48.36  the health care provider qualified professional providing the 
 49.1   verification.  The commissioner shall develop a form to be 
 49.2   completed and signed by the health care provider qualified 
 49.3   professional, documenting the diagnosis and any additional 
 49.4   information necessary to document the functional limitations of 
 49.5   the participant that limit work hours.  If the participant is 
 49.6   part of a two-parent assistance unit, the other parent must be 
 49.7   treated as a one-parent assistance unit for purposes of meeting 
 49.8   the work requirements under this subdivision. 
 49.9      (b) For purposes of this section, employment means: 
 49.10     (1) unsubsidized employment under section 256J.49, 
 49.11  subdivision 13, clause (1); 
 49.12     (2) subsidized employment under section 256J.49, 
 49.13  subdivision 13, clause (2); 
 49.14     (3) on-the-job training under section 256J.49, subdivision 
 49.15  13, clause (4) (2); 
 49.16     (4) an apprenticeship under section 256J.49, subdivision 
 49.17  13, clause (19) (1); 
 49.18     (5) supported work.  For purposes of this section, 
 49.19  "supported work" means services supporting a participant on the 
 49.20  job which include, but are not limited to, supervision, job 
 49.21  coaching, and subsidized wages under section 256J.49, 
 49.22  subdivision 13, clause (2); 
 49.23     (6) a combination of clauses (1) to (5); or 
 49.24     (7) child care under section 256J.49, subdivision 13, 
 49.25  clause (25) (7), if it is in combination with paid employment. 
 49.26     (c) If a participant is complying with a child protection 
 49.27  plan under chapter 260C, the number of hours required under the 
 49.28  child protection plan count toward the number of hours required 
 49.29  under this subdivision.  
 49.30     (d) The county shall provide the opportunity for subsidized 
 49.31  employment to participants needing that type of employment 
 49.32  within available appropriations. 
 49.33     (e) To be eligible for a hardship extension for employed 
 49.34  participants under this subdivision, a participant in a 
 49.35  one-parent assistance unit or both parents in a two-parent 
 49.36  assistance unit must be in compliance for at least ten out of 
 50.1   the 12 months immediately preceding the participant's 61st month 
 50.2   on assistance.  If only one parent in a two-parent assistance 
 50.3   unit fails to be in compliance ten out of the 12 months 
 50.4   immediately preceding the participant's 61st month, the county 
 50.5   shall give the assistance unit the option of disqualifying the 
 50.6   noncompliant parent.  If the noncompliant participant is 
 50.7   disqualified, the assistance unit must be treated as a 
 50.8   one-parent assistance unit for the purposes of meeting the work 
 50.9   requirements under this subdivision and the assistance unit's 
 50.10  MFIP grant shall be calculated using the shared household 
 50.11  standard under section 256J.08, subdivision 82a. 
 50.12     (f) The employment plan developed under section 256J.52 
 50.13  256J.521, subdivision 5 2, for participants under this 
 50.14  subdivision must contain the number of hours specified in 
 50.15  paragraph (a) related to employment and work activities.  The 
 50.16  job counselor and the participant must sign the employment plan 
 50.17  to indicate agreement between the job counselor and the 
 50.18  participant on the contents of the plan. 
 50.19     (g) Participants who fail to meet the requirements in 
 50.20  paragraph (a), without good cause under section 256J.57, shall 
 50.21  be sanctioned or permanently disqualified under subdivision 6.  
 50.22  Good cause may only be granted for that portion of the month for 
 50.23  which the good cause reason applies.  Participants must meet all 
 50.24  remaining requirements in the approved employment plan or be 
 50.25  subject to sanction or permanent disqualification.  
 50.26     (h) If the noncompliance with an employment plan is due to 
 50.27  the involuntary loss of employment, the participant is exempt 
 50.28  from the hourly employment requirement under this subdivision 
 50.29  for one month.  Participants must meet all remaining 
 50.30  requirements in the approved employment plan or be subject to 
 50.31  sanction or permanent disqualification.  This exemption is 
 50.32  available to one-parent assistance units a participant two times 
 50.33  in a 12-month period, and two-parent assistance units, two times 
 50.34  per parent in a 12-month period. 
 50.35     (i) This subdivision expires on June 30, 2004. 
 50.36     Sec. 59.  Minnesota Statutes 2002, section 256J.425, 
 51.1   subdivision 6, is amended to read: 
 51.2      Subd. 6.  [SANCTIONS FOR EXTENDED CASES.] (a) If one or 
 51.3   both participants in an assistance unit receiving assistance 
 51.4   under subdivision 3 or 4 are not in compliance with the 
 51.5   employment and training service requirements in sections 256J.52 
 51.6   256J.521 to 256J.55 256J.57, the sanctions under this 
 51.7   subdivision apply.  For a first occurrence of noncompliance, an 
 51.8   assistance unit must be sanctioned under section 256J.46, 
 51.9   subdivision 1, paragraph (d) (c), clause (1).  For a second or 
 51.10  third occurrence of noncompliance, the assistance unit must be 
 51.11  sanctioned under section 256J.46, subdivision 1, 
 51.12  paragraph (d) (c), clause (2).  For a fourth occurrence of 
 51.13  noncompliance, the assistance unit is disqualified from MFIP.  
 51.14  If a participant is determined to be out of compliance, the 
 51.15  participant may claim a good cause exception under section 
 51.16  256J.57, however, the participant may not claim an exemption 
 51.17  under section 256J.56.  
 51.18     (b) If both participants in a two-parent assistance unit 
 51.19  are out of compliance at the same time, it is considered one 
 51.20  occurrence of noncompliance.  
 51.21     Sec. 60.  Minnesota Statutes 2002, section 256J.425, 
 51.22  subdivision 7, is amended to read: 
 51.23     Subd. 7.  [STATUS OF DISQUALIFIED PARTICIPANTS.] (a) An 
 51.24  assistance unit that is disqualified under subdivision 6, 
 51.25  paragraph (a), may be approved for MFIP if the participant 
 51.26  complies with MFIP program requirements and demonstrates 
 51.27  compliance for up to one month.  No assistance shall be paid 
 51.28  during this period. 
 51.29     (b) An assistance unit that is disqualified under 
 51.30  subdivision 6, paragraph (a), and that reapplies under paragraph 
 51.31  (a) is subject to sanction under section 256J.46, subdivision 1, 
 51.32  paragraph (d) (c), clause (1), for a first occurrence of 
 51.33  noncompliance.  A subsequent occurrence of noncompliance results 
 51.34  in a permanent disqualification. 
 51.35     (c) If one participant in a two-parent assistance unit 
 51.36  receiving assistance under a hardship extension under 
 52.1   subdivision 3 or 4 is determined to be out of compliance with 
 52.2   the employment and training services requirements under sections 
 52.3   256J.52 256J.521 to 256J.55 256J.57, the county shall give the 
 52.4   assistance unit the option of disqualifying the noncompliant 
 52.5   participant from MFIP.  In that case, the assistance unit shall 
 52.6   be treated as a one-parent assistance unit for the purposes of 
 52.7   meeting the work requirements under subdivision 4 and the 
 52.8   assistance unit's MFIP grant shall be calculated using the 
 52.9   shared household standard under section 256J.08, subdivision 
 52.10  82a.  An applicant who is disqualified from receiving assistance 
 52.11  under this paragraph may reapply under paragraph (a).  If a 
 52.12  participant is disqualified from MFIP under this subdivision a 
 52.13  second time, the participant is permanently disqualified from 
 52.14  MFIP. 
 52.15     (d) Prior to a disqualification under this subdivision, a 
 52.16  county agency must review the participant's case to determine if 
 52.17  the employment plan is still appropriate and attempt to meet 
 52.18  with the participant face-to-face.  If a face-to-face meeting is 
 52.19  not conducted, the county agency must send the participant a 
 52.20  notice of adverse action as provided in section 256J.31.  During 
 52.21  the face-to-face meeting, the county agency must: 
 52.22     (1) determine whether the continued noncompliance can be 
 52.23  explained and mitigated by providing a needed preemployment 
 52.24  activity, as defined in section 256J.49, subdivision 13, clause 
 52.25  (16), or services under a local intervention grant for 
 52.26  self-sufficiency under section 256J.625 (9); 
 52.27     (2) determine whether the participant qualifies for a good 
 52.28  cause exception under section 256J.57; 
 52.29     (3) inform the participant of the family violence waiver 
 52.30  criteria and make appropriate referrals if the waiver is 
 52.31  requested; 
 52.32     (4) inform the participant of the participant's sanction 
 52.33  status and explain the consequences of continuing noncompliance; 
 52.34     (4) (5) identify other resources that may be available to 
 52.35  the participant to meet the needs of the family; and 
 52.36     (5) (6) inform the participant of the right to appeal under 
 53.1   section 256J.40. 
 53.2      Sec. 61.  Minnesota Statutes 2002, section 256J.45, 
 53.3   subdivision 2, is amended to read: 
 53.4      Subd. 2.  [GENERAL INFORMATION.] The MFIP orientation must 
 53.5   consist of a presentation that informs caregivers of: 
 53.6      (1) the necessity to obtain immediate employment; 
 53.7      (2) the work incentives under MFIP, including the 
 53.8   availability of the federal earned income tax credit and the 
 53.9   Minnesota working family tax credit; 
 53.10     (3) the requirement to comply with the employment plan and 
 53.11  other requirements of the employment and training services 
 53.12  component of MFIP, including a description of the range of work 
 53.13  and training activities that are allowable under MFIP to meet 
 53.14  the individual needs of participants; 
 53.15     (4) the consequences for failing to comply with the 
 53.16  employment plan and other program requirements, and that the 
 53.17  county agency may not impose a sanction when failure to comply 
 53.18  is due to the unavailability of child care or other 
 53.19  circumstances where the participant has good cause under 
 53.20  subdivision 3; 
 53.21     (5) the rights, responsibilities, and obligations of 
 53.22  participants; 
 53.23     (6) the types and locations of child care services 
 53.24  available through the county agency; 
 53.25     (7) the availability and the benefits of the early 
 53.26  childhood health and developmental screening under sections 
 53.27  121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10; 
 53.28     (8) the caregiver's eligibility for transition year child 
 53.29  care assistance under section 119B.05; 
 53.30     (9) the caregiver's eligibility for extended medical 
 53.31  assistance when the caregiver loses eligibility for MFIP due to 
 53.32  increased earnings or increased child or spousal support the 
 53.33  availability of all health care programs, including transitional 
 53.34  medical assistance; 
 53.35     (10) the caregiver's option to choose an employment and 
 53.36  training provider and information about each provider, including 
 54.1   but not limited to, services offered, program components, job 
 54.2   placement rates, job placement wages, and job retention rates; 
 54.3      (11) the caregiver's option to request approval of an 
 54.4   education and training plan according to section 256J.52 
 54.5   256J.53; 
 54.6      (12) the work study programs available under the higher 
 54.7   education system; and 
 54.8      (13) effective October 1, 2001, information about the 
 54.9   60-month time limit exemption and waivers of regular employment 
 54.10  and training requirements for family violence victims exemptions 
 54.11  under the family violence waiver and referral information about 
 54.12  shelters and programs for victims of family violence. 
 54.13     Sec. 62.  Minnesota Statutes 2002, section 256J.46, 
 54.14  subdivision 1, is amended to read: 
 54.15     Subdivision 1.  [PARTICIPANTS NOT COMPLYING WITH PROGRAM 
 54.16  REQUIREMENTS.] (a) A participant who fails without good 
 54.17  cause under section 256J.57 to comply with the requirements of 
 54.18  this chapter, and who is not subject to a sanction under 
 54.19  subdivision 2, shall be subject to a sanction as provided in 
 54.20  this subdivision.  Prior to the imposition of a sanction, a 
 54.21  county agency shall provide a notice of intent to sanction under 
 54.22  section 256J.57, subdivision 2, and, when applicable, a notice 
 54.23  of adverse action as provided in section 256J.31. 
 54.24     (b) A participant who fails to comply with an alternative 
 54.25  employment plan must have the plan reviewed by a person trained 
 54.26  in domestic violence and a job counselor or the county agency to 
 54.27  determine if components of the alternative employment plan are 
 54.28  still appropriate.  If the activities are no longer appropriate, 
 54.29  the plan must be revised with a person trained in domestic 
 54.30  violence and approved by a job counselor or the county agency.  
 54.31  A participant who fails to comply with a plan that is determined 
 54.32  not to need revision will lose their exemption and be required 
 54.33  to comply with regular employment services activities.  
 54.34     (c) A sanction under this subdivision becomes effective the 
 54.35  month following the month in which a required notice is given.  
 54.36  A sanction must not be imposed when a participant comes into 
 55.1   compliance with the requirements for orientation under section 
 55.2   256J.45 or third-party liability for medical services under 
 55.3   section 256J.30, subdivision 10, prior to the effective date of 
 55.4   the sanction.  A sanction must not be imposed when a participant 
 55.5   comes into compliance with the requirements for employment and 
 55.6   training services under sections 256J.49 256J.515 to 
 55.7   256J.55 256J.57 ten days prior to the effective date of the 
 55.8   sanction.  For purposes of this subdivision, each month that a 
 55.9   participant fails to comply with a requirement of this chapter 
 55.10  shall be considered a separate occurrence of noncompliance.  A 
 55.11  participant who has had one or more sanctions imposed must 
 55.12  remain in compliance with the provisions of this chapter for six 
 55.13  months in order for a subsequent occurrence of noncompliance to 
 55.14  be considered a first occurrence.  If both participants in a 
 55.15  two-parent assistance unit are out of compliance at the same 
 55.16  time, it is considered one occurrence of noncompliance.  
 55.17     (d) (c) Sanctions for noncompliance shall be imposed as 
 55.18  follows: 
 55.19     (1) For the first occurrence of noncompliance by a 
 55.20  participant in an assistance unit, the assistance unit's grant 
 55.21  shall be reduced by ten percent of the MFIP standard of need for 
 55.22  an assistance unit of the same size with the residual grant paid 
 55.23  to the participant.  The reduction in the grant amount must be 
 55.24  in effect for a minimum of one month and shall be removed in the 
 55.25  month following the month that the participant returns to 
 55.26  compliance.  
 55.27     (2) For a second or subsequent, third, fourth, fifth, or 
 55.28  sixth occurrence of noncompliance by a participant in an 
 55.29  assistance unit, or when each of the participants in a 
 55.30  two-parent assistance unit have a first occurrence of 
 55.31  noncompliance at the same time, the assistance unit's shelter 
 55.32  costs shall be vendor paid up to the amount of the cash portion 
 55.33  of the MFIP grant for which the assistance unit is eligible.  At 
 55.34  county option, the assistance unit's utilities may also be 
 55.35  vendor paid up to the amount of the cash portion of the MFIP 
 55.36  grant remaining after vendor payment of the assistance unit's 
 56.1   shelter costs.  The residual amount of the grant after vendor 
 56.2   payment, if any, must be reduced by an amount equal to 30 
 56.3   percent of the MFIP standard of need for an assistance unit of 
 56.4   the same size before the residual grant is paid to the 
 56.5   assistance unit.  The reduction in the grant amount must be in 
 56.6   effect for a minimum of one month and shall be removed in the 
 56.7   month following the month that the participant in a one-parent 
 56.8   assistance unit returns to compliance.  In a two-parent 
 56.9   assistance unit, the grant reduction must be in effect for a 
 56.10  minimum of one month and shall be removed in the month following 
 56.11  the month both participants return to compliance.  The vendor 
 56.12  payment of shelter costs and, if applicable, utilities shall be 
 56.13  removed six months after the month in which the participant or 
 56.14  participants return to compliance.  If an assistance unit is 
 56.15  sanctioned under this clause, the participant's case file must 
 56.16  be reviewed as required under paragraph (e) to determine if the 
 56.17  employment plan is still appropriate. 
 56.18     (e) When a sanction under paragraph (d), clause (2), is in 
 56.19  effect (d) For a seventh occurrence of noncompliance by a 
 56.20  participant in an assistance unit, or when the participants in a 
 56.21  two-parent assistance unit have a total of seven occurrences of 
 56.22  noncompliance, the county agency shall close the MFIP assistance 
 56.23  unit's financial assistance case, both the cash and food 
 56.24  portions.  The case must remain closed for a minimum of one full 
 56.25  month.  Closure under this paragraph does not make a participant 
 56.26  automatically ineligible for food support, if otherwise eligible.
 56.27  Before the case is closed, the county agency must review the 
 56.28  participant's case to determine if the employment plan is still 
 56.29  appropriate and attempt to meet with the participant 
 56.30  face-to-face.  The participant may bring an advocate to the 
 56.31  face-to-face meeting.  If a face-to-face meeting is not 
 56.32  conducted, the county agency must send the participant a written 
 56.33  notice that includes the information required under clause (1). 
 56.34     (1) During the face-to-face meeting, the county agency must:
 56.35     (i) determine whether the continued noncompliance can be 
 56.36  explained and mitigated by providing a needed preemployment 
 57.1   activity, as defined in section 256J.49, subdivision 13, clause 
 57.2   (16), or services under a local intervention grant for 
 57.3   self-sufficiency under section 256J.625 (9); 
 57.4      (ii) determine whether the participant qualifies for a good 
 57.5   cause exception under section 256J.57, or if the sanction is for 
 57.6   noncooperation with child support requirements, determine if the 
 57.7   participant qualifies for a good cause exemption under section 
 57.8   256.741, subdivision 10; 
 57.9      (iii) determine whether the participant qualifies for an 
 57.10  exemption under section 256J.56 or the work activities in the 
 57.11  employment plan are appropriate based on the criteria in section 
 57.12  256J.521, subdivision 2 or 3; 
 57.13     (iv) determine whether the participant qualifies for an 
 57.14  exemption from regular employment services requirements for 
 57.15  victims of family violence under section 256J.52, subdivision 
 57.16  6 determine whether the participant qualifies for the family 
 57.17  violence waiver; 
 57.18     (v) inform the participant of the participant's sanction 
 57.19  status and explain the consequences of continuing noncompliance; 
 57.20     (vi) identify other resources that may be available to the 
 57.21  participant to meet the needs of the family; and 
 57.22     (vii) inform the participant of the right to appeal under 
 57.23  section 256J.40. 
 57.24     (2) If the lack of an identified activity or service can 
 57.25  explain the noncompliance, the county must work with the 
 57.26  participant to provide the identified activity, and the county 
 57.27  must restore the participant's grant amount to the full amount 
 57.28  for which the assistance unit is eligible.  The grant must be 
 57.29  restored retroactively to the first day of the month in which 
 57.30  the participant was found to lack preemployment activities or to 
 57.31  qualify for an exemption under section 256J.56, a good cause 
 57.32  exception under section 256J.57, or an exemption for victims of 
 57.33  family violence under section 256J.52, subdivision 6. 
 57.34     (3) If the participant is found to qualify for a good cause 
 57.35  exception or an exemption, the county must restore the 
 57.36  participant's grant to the full amount for which the assistance 
 58.1   unit is eligible.  The grant must be restored to the full amount 
 58.2   for which the assistance unit is eligible retroactively to the 
 58.3   first day of the month in which the participant was found to 
 58.4   lack preemployment activities or to qualify for an exemption 
 58.5   under section 256J.56, a family violence waiver, or for a good 
 58.6   cause exemption under section 256.741, subdivision 10, or 
 58.7   256J.57. 
 58.8      (e) For the purpose of applying sanctions under this 
 58.9   section, only occurrences of noncompliance that occur after the 
 58.10  effective date of this section shall be considered.  If the 
 58.11  participant is in 30 percent sanction in the month this section 
 58.12  takes effect, that month counts as the first occurrence for 
 58.13  purposes of applying the sanctions under this section, but the 
 58.14  sanction shall remain at 30 percent for that month. 
 58.15     (f) An assistance unit whose case is closed under paragraph 
 58.16  (d) or (g), or under an approved county option sanction plan 
 58.17  under section 256J.462 in effect June 30, 2003, or a county 
 58.18  pilot project under Laws 2000, chapter 488, article 10, section 
 58.19  29, in effect June 30, 2003, may reapply for MFIP and shall be 
 58.20  eligible if the participant complies with MFIP program 
 58.21  requirements and demonstrates compliance for up to one month.  
 58.22  No assistance shall be paid during this period. 
 58.23     (g) An assistance unit whose case has been closed for 
 58.24  noncompliance, that reapplies under paragraph (f) is subject to 
 58.25  sanction under paragraph (c), clause (2), for a first occurrence 
 58.26  of noncompliance.  Any subsequent occurrence of noncompliance 
 58.27  shall result in case closure under paragraph (d). 
 58.28     Sec. 63.  Minnesota Statutes 2002, section 256J.46, 
 58.29  subdivision 2, is amended to read: 
 58.30     Subd. 2.  [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 
 58.31  REQUIREMENTS.] The grant of an MFIP caregiver who refuses to 
 58.32  cooperate, as determined by the child support enforcement 
 58.33  agency, with support requirements under section 256.741, shall 
 58.34  be subject to sanction as specified in this subdivision and 
 58.35  subdivision 1.  For a first occurrence of noncooperation, the 
 58.36  assistance unit's grant must be reduced by 25 30 percent of the 
 59.1   applicable MFIP standard of need.  Subsequent occurrences of 
 59.2   noncooperation shall be subject to sanction under subdivision 1, 
 59.3   paragraphs (c), clause (2), and (d).  The residual amount of the 
 59.4   grant, if any, must be paid to the caregiver.  A sanction under 
 59.5   this subdivision becomes effective the first month following the 
 59.6   month in which a required notice is given.  A sanction must not 
 59.7   be imposed when a caregiver comes into compliance with the 
 59.8   requirements under section 256.741 prior to the effective date 
 59.9   of the sanction.  The sanction shall be removed in the month 
 59.10  following the month that the caregiver cooperates with the 
 59.11  support requirements.  Each month that an MFIP caregiver fails 
 59.12  to comply with the requirements of section 256.741 must be 
 59.13  considered a separate occurrence of noncompliance for the 
 59.14  purpose of applying sanctions under subdivision 1, paragraphs 
 59.15  (c), clause (2), and (d).  An MFIP caregiver who has had one or 
 59.16  more sanctions imposed must remain in compliance with the 
 59.17  requirements of section 256.741 for six months in order for a 
 59.18  subsequent sanction to be considered a first occurrence. 
 59.19     Sec. 64.  Minnesota Statutes 2002, section 256J.46, 
 59.20  subdivision 2a, is amended to read: 
 59.21     Subd. 2a.  [DUAL SANCTIONS.] (a) Notwithstanding the 
 59.22  provisions of subdivisions 1 and 2, for a participant subject to 
 59.23  a sanction for refusal to comply with child support requirements 
 59.24  under subdivision 2 and subject to a concurrent sanction for 
 59.25  refusal to cooperate with other program requirements under 
 59.26  subdivision 1, sanctions shall be imposed in the manner 
 59.27  prescribed in this subdivision. 
 59.28     A participant who has had one or more sanctions imposed 
 59.29  under this subdivision must remain in compliance with the 
 59.30  provisions of this chapter for six months in order for a 
 59.31  subsequent occurrence of noncompliance to be considered a first 
 59.32  occurrence.  Any vendor payment of shelter costs or utilities 
 59.33  under this subdivision must remain in effect for six months 
 59.34  after the month in which the participant is no longer subject to 
 59.35  sanction under subdivision 1. 
 59.36     (b) If the participant was subject to sanction for: 
 60.1      (i) noncompliance under subdivision 1 before being subject 
 60.2   to sanction for noncooperation under subdivision 2; or 
 60.3      (ii) noncooperation under subdivision 2 before being 
 60.4   subject to sanction for noncompliance under subdivision 1, the 
 60.5   participant is considered to have a second occurrence of 
 60.6   noncompliance and shall be sanctioned as provided in subdivision 
 60.7   1, paragraph (d) (c), clause (2).  Each subsequent occurrence of 
 60.8   noncompliance shall be considered one additional occurrence and 
 60.9   shall be subject to the applicable level of sanction under 
 60.10  subdivision 1, paragraph (d), or section 256J.462.  The 
 60.11  requirement that the county conduct a review as specified in 
 60.12  subdivision 1, paragraph (e) (d), remains in effect. 
 60.13     (c) A participant who first becomes subject to sanction 
 60.14  under both subdivisions 1 and 2 in the same month is subject to 
 60.15  sanction as follows: 
 60.16     (i) in the first month of noncompliance and noncooperation, 
 60.17  the participant's grant must be reduced by 25 30 percent of the 
 60.18  applicable MFIP standard of need, with any residual amount paid 
 60.19  to the participant; 
 60.20     (ii) in the second and subsequent months of noncompliance 
 60.21  and noncooperation, the participant shall be subject to the 
 60.22  applicable level of sanction under subdivision 1, paragraph (d), 
 60.23  or section 256J.462. 
 60.24     The requirement that the county conduct a review as 
 60.25  specified in subdivision 1, paragraph (e) (d), remains in effect.
 60.26     (d) A participant remains subject to sanction under 
 60.27  subdivision 2 if the participant: 
 60.28     (i) returns to compliance and is no longer subject to 
 60.29  sanction under subdivision 1 or section 256J.462 for 
 60.30  noncompliance with section 256J.45 or sections 256J.515 to 
 60.31  256J.57; or 
 60.32     (ii) has the sanction under subdivision 1, paragraph (d), 
 60.33  or section 256J.462 for noncompliance with section 256J.45 or 
 60.34  sections 256J.515 to 256J.57 removed upon completion of the 
 60.35  review under subdivision 1, paragraph (e). 
 60.36     A participant remains subject to the applicable level of 
 61.1   sanction under subdivision 1, paragraph (d), or section 256J.462 
 61.2   if the participant cooperates and is no longer subject to 
 61.3   sanction under subdivision 2. 
 61.4      Sec. 65.  Minnesota Statutes 2002, section 256J.49, 
 61.5   subdivision 4, is amended to read: 
 61.6      Subd. 4.  [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 
 61.7   "Employment and training service provider" means: 
 61.8      (1) a public, private, or nonprofit employment and training 
 61.9   agency certified by the commissioner of economic security under 
 61.10  sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 
 61.11  is approved under section 256J.51 and is included in the county 
 61.12  plan service agreement submitted under section 256J.50 256J.626, 
 61.13  subdivision 7 4; 
 61.14     (2) a public, private, or nonprofit agency that is not 
 61.15  certified by the commissioner under clause (1), but with which a 
 61.16  county has contracted to provide employment and training 
 61.17  services and which is included in the county's plan service 
 61.18  agreement submitted under section 256J.50 256J.626, 
 61.19  subdivision 7 4; or 
 61.20     (3) a county agency, if the county has opted to provide 
 61.21  employment and training services and the county has indicated 
 61.22  that fact in the plan service agreement submitted under section 
 61.23  256J.50 256J.626, subdivision 7 4. 
 61.24     Notwithstanding section 268.871, an employment and training 
 61.25  services provider meeting this definition may deliver employment 
 61.26  and training services under this chapter. 
 61.27     Sec. 66.  Minnesota Statutes 2002, section 256J.49, 
 61.28  subdivision 5, is amended to read: 
 61.29     Subd. 5.  [EMPLOYMENT PLAN.] "Employment plan" means a plan 
 61.30  developed by the job counselor and the participant which 
 61.31  identifies the participant's most direct path to unsubsidized 
 61.32  employment, lists the specific steps that the caregiver will 
 61.33  take on that path, and includes a timetable for the completion 
 61.34  of each step.  The plan should also identify any subsequent 
 61.35  steps that support long-term economic stability.  For 
 61.36  participants who request and qualify for a family violence 
 62.1   waiver, an employment plan must be developed by the job 
 62.2   counselor, the participant, and a person trained in domestic 
 62.3   violence and follow the employment plan provisions in section 
 62.4   256J.521, subdivision 3. 
 62.5      Sec. 67.  Minnesota Statutes 2002, section 256J.49, is 
 62.6   amended by adding a subdivision to read: 
 62.7      Subd. 6a.  [FUNCTIONAL WORK LITERACY.] "Functional work 
 62.8   literacy" means an intensive English as a second language 
 62.9   program that is work focused and offers at least 20 hours of 
 62.10  class time per week. 
 62.11     Sec. 68.  Minnesota Statutes 2002, section 256J.49, 
 62.12  subdivision 9, is amended to read: 
 62.13     Subd. 9.  [PARTICIPANT.] "Participant" means a recipient of 
 62.14  MFIP assistance who participates or is required to participate 
 62.15  in employment and training services under sections 256J.515 to 
 62.16  256J.57 and 256J.95. 
 62.17     Sec. 69.  Minnesota Statutes 2002, section 256J.49, is 
 62.18  amended by adding a subdivision to read: 
 62.19     Subd. 12a.  [SUPPORTED WORK.] "Supported work" means a 
 62.20  subsidized or unsubsidized work experience placement with a 
 62.21  public or private sector employer, which may include services 
 62.22  such as individualized supervision and job coaching to support 
 62.23  the participant on the job. 
 62.24     Sec. 70.  Minnesota Statutes 2002, section 256J.49, 
 62.25  subdivision 13, is amended to read: 
 62.26     Subd. 13.  [WORK ACTIVITY.] "Work activity" means any 
 62.27  activity in a participant's approved employment plan that is 
 62.28  tied to the participant's leads to employment goal.  For 
 62.29  purposes of the MFIP program, any activity that is included in a 
 62.30  participant's approved employment plan meets this includes 
 62.31  activities that meet the definition of work activity as counted 
 62.32  under the federal participation standards requirements of TANF.  
 62.33  Work activity includes, but is not limited to: 
 62.34     (1) unsubsidized employment, including work study and paid 
 62.35  apprenticeships or internships; 
 62.36     (2) subsidized private sector or public sector employment, 
 63.1   including grant diversion as specified in section 256J.69, 
 63.2   on-the-job training as specified in section 256J.66, the 
 63.3   self-employment investment demonstration program (SEID) as 
 63.4   specified in section 256J.65, paid work experience, and 
 63.5   supported work when a wage subsidy is provided; 
 63.6      (3) unpaid work experience, including CWEP community 
 63.7   service, volunteer work, the community work experience program 
 63.8   as specified in section 256J.67, unpaid apprenticeships or 
 63.9   internships, and including work associated with the refurbishing 
 63.10  of publicly assisted housing if sufficient private sector 
 63.11  employment is not available supported work when a wage subsidy 
 63.12  is not provided; 
 63.13     (4) on-the-job training as specified in section 256J.66 job 
 63.14  search including job readiness assistance, job clubs, job 
 63.15  placement, job-related counseling, and job retention services; 
 63.16     (5) job search, either supervised or unsupervised; 
 63.17     (6) job readiness assistance; 
 63.18     (7) job clubs, including job search workshops; 
 63.19     (8) job placement; 
 63.20     (9) job development; 
 63.21     (10) job-related counseling; 
 63.22     (11) job coaching; 
 63.23     (12) job retention services; 
 63.24     (13) job-specific training or education; 
 63.25     (14) job skills training directly related to employment; 
 63.26     (15) the self-employment investment demonstration (SEID), 
 63.27  as specified in section 256J.65; 
 63.28     (16) preemployment activities, based on availability and 
 63.29  resources, such as volunteer work, literacy programs and related 
 63.30  activities, citizenship classes, English as a second language 
 63.31  (ESL) classes as limited by the provisions of section 256J.52, 
 63.32  subdivisions 3, paragraph (d), and 5, paragraph (c), or 
 63.33  participation in dislocated worker services, chemical dependency 
 63.34  treatment, mental health services, peer group networks, 
 63.35  displaced homemaker programs, strength-based resiliency 
 63.36  training, parenting education, or other programs designed to 
 64.1   help families reach their employment goals and enhance their 
 64.2   ability to care for their children; 
 64.3      (17) community service programs; 
 64.4      (18) vocational educational training or educational 
 64.5   programs that can reasonably be expected to lead to employment, 
 64.6   as limited by the provisions of section 256J.53; 
 64.7      (19) apprenticeships; 
 64.8      (20) satisfactory attendance in general educational 
 64.9   development diploma classes or an adult diploma program; 
 64.10     (21) satisfactory attendance at secondary school, if the 
 64.11  participant has not received a high school diploma; 
 64.12     (22) adult basic education classes; 
 64.13     (23) internships; 
 64.14     (24) bilingual employment and training services; 
 64.15     (25) providing child care services to a participant who is 
 64.16  working in a community service program; and 
 64.17     (26) activities included in an alternative employment plan 
 64.18  that is developed under section 256J.52, subdivision 6. 
 64.19     (5) job readiness education, including English as a second 
 64.20  language (ESL) or functional work literacy classes as limited by 
 64.21  the provisions of section 256J.531, subdivision 2, general 
 64.22  educational development (GED) course work, high school 
 64.23  completion, and adult basic education as limited by the 
 64.24  provisions of section 256J.531, subdivision 1; 
 64.25     (6) job skills training directly related to employment, 
 64.26  including education and training that can reasonably be expected 
 64.27  to lead to employment, as limited by the provisions of section 
 64.28  256J.53; 
 64.29     (7) providing child care services to a participant who is 
 64.30  working in a community service program; 
 64.31     (8) activities included in the employment plan that is 
 64.32  developed under section 256J.521, subdivision 3; and 
 64.33     (9) preemployment activities including chemical and mental 
 64.34  health assessments, treatment, and services; learning 
 64.35  disabilities services; child protective services; family 
 64.36  stabilization services; or other programs designed to enhance 
 65.1   employability. 
 65.2      Sec. 71.  Minnesota Statutes 2002, section 256J.50, 
 65.3   subdivision 1, is amended to read: 
 65.4      Subdivision 1.  [EMPLOYMENT AND TRAINING SERVICES COMPONENT 
 65.5   OF MFIP.] (a) By January 1, 1998, Each county must develop and 
 65.6   implement provide an employment and training services component 
 65.7   of MFIP which is designed to put participants on the most direct 
 65.8   path to unsubsidized employment.  Participation in these 
 65.9   services is mandatory for all MFIP caregivers, unless the 
 65.10  caregiver is exempt under section 256J.56. 
 65.11     (b) A county must provide employment and training services 
 65.12  under sections 256J.515 to 256J.74 within 30 days after 
 65.13  the caregiver's participation becomes mandatory under 
 65.14  subdivision 5 or within 30 days of receipt of a request for 
 65.15  services from a caregiver who under section 256J.42 is no longer 
 65.16  eligible to receive MFIP but whose income is below 120 percent 
 65.17  of the federal poverty guidelines for a family of the same 
 65.18  size.  The request must be made within 12 months of the date the 
 65.19  caregivers' MFIP case was closed caregiver is determined 
 65.20  eligible for MFIP, or within five days when the caregiver 
 65.21  participated in the diversionary work program under section 
 65.22  256J.95 within the past 12 months. 
 65.23     Sec. 72.  Minnesota Statutes 2002, section 256J.50, 
 65.24  subdivision 8, is amended to read: 
 65.25     Subd. 8.  [COUNTY DUTY TO ENSURE EMPLOYMENT AND TRAINING 
 65.26  CHOICES FOR PARTICIPANTS.] Each county, or group of counties 
 65.27  working cooperatively, shall make available to participants the 
 65.28  choice of at least two employment and training service providers 
 65.29  as defined under section 256J.49, subdivision 4, except in 
 65.30  counties utilizing workforce centers that use multiple 
 65.31  employment and training services, offer multiple services 
 65.32  options under a collaborative effort and can document that 
 65.33  participants have choice among employment and training services 
 65.34  designed to meet specialized needs.  The requirements of this 
 65.35  subdivision do not apply to the diversionary work program under 
 65.36  section 256J.95. 
 66.1      Sec. 73.  Minnesota Statutes 2002, section 256J.50, 
 66.2   subdivision 9, is amended to read: 
 66.3      Subd. 9.  [EXCEPTION; FINANCIAL HARDSHIP.] Notwithstanding 
 66.4   subdivision 8, a county that explains in the plan service 
 66.5   agreement required under section 256J.626, subdivision 7 4, that 
 66.6   the provision of alternative employment and training service 
 66.7   providers would result in financial hardship for the county is 
 66.8   not required to make available more than one employment and 
 66.9   training provider. 
 66.10     Sec. 74.  Minnesota Statutes 2002, section 256J.50, 
 66.11  subdivision 10, is amended to read: 
 66.12     Subd. 10.  [REQUIRED NOTIFICATION TO VICTIMS OF FAMILY 
 66.13  VIOLENCE.] (a) County agencies and their contractors must 
 66.14  provide universal notification to all applicants and recipients 
 66.15  of MFIP that: 
 66.16     (1) referrals to counseling and supportive services are 
 66.17  available for victims of family violence; 
 66.18     (2) nonpermanent resident battered individuals married to 
 66.19  United States citizens or permanent residents may be eligible to 
 66.20  petition for permanent residency under the federal Violence 
 66.21  Against Women Act, and that referrals to appropriate legal 
 66.22  services are available; 
 66.23     (3) victims of family violence are exempt from the 60-month 
 66.24  limit on assistance while the individual is if they are 
 66.25  complying with an approved safety plan or, after October 1, 
 66.26  2001, an alternative employment plan, as defined in under 
 66.27  section 256J.49 256J.521, subdivision 1a 3; and 
 66.28     (4) victims of family violence may choose to have regular 
 66.29  work requirements waived while the individual is complying with 
 66.30  an alternative employment plan as defined in under section 
 66.31  256J.49 256J.521, subdivision 1a 3.  
 66.32     (b) If an alternative employment plan under section 
 66.33  256J.521, subdivision 3, is denied, the county or a job 
 66.34  counselor must provide reasons why the plan is not approved and 
 66.35  document how the denial of the plan does not interfere with the 
 66.36  safety of the participant or children. 
 67.1      Notification must be in writing and orally at the time of 
 67.2   application and recertification, when the individual is referred 
 67.3   to the title IV-D child support agency, and at the beginning of 
 67.4   any job training or work placement assistance program. 
 67.5      Sec. 75.  Minnesota Statutes 2002, section 256J.51, 
 67.6   subdivision 1, is amended to read: 
 67.7      Subdivision 1.  [PROVIDER APPLICATION.] An employment and 
 67.8   training service provider that is not included in a county's 
 67.9   plan service agreement under section 256J.50 256J.626, 
 67.10  subdivision 7 4, because the county has demonstrated financial 
 67.11  hardship under section 256J.50, subdivision 9 of that section, 
 67.12  may appeal its exclusion to the commissioner of economic 
 67.13  security under this section. 
 67.14     Sec. 76.  Minnesota Statutes 2002, section 256J.51, 
 67.15  subdivision 2, is amended to read: 
 67.16     Subd. 2.  [APPEAL; ALTERNATE APPROVAL.] (a) An employment 
 67.17  and training service provider that is not included by a county 
 67.18  agency in the plan service agreement under section 
 67.19  256J.50 256J.626, subdivision 7 4, and that meets the criteria 
 67.20  in paragraph (b), may appeal its exclusion to the commissioner 
 67.21  of economic security, and may request alternative approval by 
 67.22  the commissioner of economic security to provide services in the 
 67.23  county.  
 67.24     (b) An employment and training services provider that is 
 67.25  requesting alternative approval must demonstrate to the 
 67.26  commissioner that the provider meets the standards specified in 
 67.27  section 268.871, subdivision 1, paragraph (b), except that the 
 67.28  provider's past experience may be in services and programs 
 67.29  similar to those specified in section 268.871, subdivision 1, 
 67.30  paragraph (b). 
 67.31     Sec. 77.  Minnesota Statutes 2002, section 256J.51, 
 67.32  subdivision 3, is amended to read: 
 67.33     Subd. 3.  [COMMISSIONER'S REVIEW.] (a) The commissioner 
 67.34  must act on a request for alternative approval under this 
 67.35  section within 30 days of the receipt of the request.  If after 
 67.36  reviewing the provider's request, and the county's plan service 
 68.1   agreement submitted under section 256J.50 256J.626, 
 68.2   subdivision 7 4, the commissioner determines that the provider 
 68.3   meets the criteria under subdivision 2, paragraph (b), and that 
 68.4   approval of the provider would not cause financial hardship to 
 68.5   the county, the county must submit a revised plan service 
 68.6   agreement under subdivision 4 that includes the approved 
 68.7   provider.  
 68.8      (b) If the commissioner determines that the approval of the 
 68.9   provider would cause financial hardship to the county, the 
 68.10  commissioner must notify the provider and the county of this 
 68.11  determination.  The alternate approval process under this 
 68.12  section shall be closed to other requests for alternate approval 
 68.13  to provide employment and training services in the county for up 
 68.14  to 12 months from the date that the commissioner makes a 
 68.15  determination under this paragraph. 
 68.16     Sec. 78.  Minnesota Statutes 2002, section 256J.51, 
 68.17  subdivision 4, is amended to read: 
 68.18     Subd. 4.  [REVISED PLAN SERVICE AGREEMENT REQUIRED.] The 
 68.19  commissioner of economic security must notify the county agency 
 68.20  when the commissioner grants an alternative approval to an 
 68.21  employment and training service provider under subdivision 2.  
 68.22  Upon receipt of the notice, the county agency must submit a 
 68.23  revised plan service agreement under section 256J.50 256J.626, 
 68.24  subdivision 7 4, that includes the approved provider.  The 
 68.25  county has 90 days from the receipt of the commissioner's notice 
 68.26  to submit the revised plan service agreement. 
 68.27     Sec. 79.  [256J.521] [ASSESSMENT; EMPLOYMENT PLANS.] 
 68.28     Subdivision 1.  [ASSESSMENTS.] (a) For purposes of MFIP 
 68.29  employment services, assessment is a continuing process of 
 68.30  gathering information related to employability for the purpose 
 68.31  of identifying both participant's strengths and strategies for 
 68.32  coping with issues that interfere with employment.  The job 
 68.33  counselor must use information from the assessment process to 
 68.34  develop and update the employment plan under subdivision 2. 
 68.35     (b) The scope of assessment must cover at least the 
 68.36  following areas: 
 69.1      (1) basic information about the participant's ability to 
 69.2   obtain and retain employment, including:  a review of the 
 69.3   participant's education level; interests, skills, and abilities; 
 69.4   prior employment or work experience; transferable work skills; 
 69.5   child care and transportation needs; 
 69.6      (2) identification of personal and family circumstances 
 69.7   that impact the participant's ability to obtain and retain 
 69.8   employment, including:  any special needs of the children, the 
 69.9   level of English proficiency, family violence issues, and any 
 69.10  involvement with social services or the legal system; 
 69.11     (3) the results of a mental and chemical health screening 
 69.12  tool designed by the commissioner and results of the brief 
 69.13  screening tool for special learning needs.  Screening for mental 
 69.14  and chemical health and special learning needs must be completed 
 69.15  by participants who are unable to find suitable employment after 
 69.16  six weeks of job search under subdivision 2, paragraph (b), and 
 69.17  participants who are determined to have barriers to employment 
 69.18  under subdivision 2, paragraph (d).  Failure to complete the 
 69.19  screens will result in sanction under section 256J.46; and 
 69.20     (4) a comprehensive review of participation and progress 
 69.21  for participants who have received MFIP assistance and have not 
 69.22  worked in unsubsidized employment during the past 12 months.  
 69.23  The purpose of the review is to determine the need for 
 69.24  additional services and supports, including placement in 
 69.25  subsidized employment or unpaid work experience under section 
 69.26  256J.49, subdivision 13. 
 69.27     (c) Information gathered during a caregiver's participation 
 69.28  in the diversionary work program under section 256J.95 must be 
 69.29  incorporated into the assessment process. 
 69.30     (d) The job counselor may require the participant to 
 69.31  complete a professional chemical use assessment to be performed 
 69.32  according to the rules adopted under section 254A.03, 
 69.33  subdivision 3, including provisions in the administrative rules 
 69.34  which recognize the cultural background of the participant, or a 
 69.35  professional psychological assessment as a component of the 
 69.36  assessment process, when the job counselor has a reasonable 
 70.1   belief, based on objective evidence, that a participant's 
 70.2   ability to obtain and retain suitable employment is impaired by 
 70.3   a medical condition.  The job counselor may assist the 
 70.4   participant with arranging services, including child care 
 70.5   assistance and transportation, necessary to meet needs 
 70.6   identified by the assessment.  Data gathered as part of a 
 70.7   professional assessment must be classified and disclosed 
 70.8   according to the provisions in section 13.46. 
 70.9      Subd. 2.  [EMPLOYMENT PLAN; CONTENTS.] (a) Based on the 
 70.10  assessment under subdivision 1, the job counselor and the 
 70.11  participant must develop an employment plan that includes 
 70.12  participation in activities and hours that meet the requirements 
 70.13  of section 256J.55, subdivision 1.  The purpose of the 
 70.14  employment plan is to identify for each participant the most 
 70.15  direct path to unsubsidized employment and any subsequent steps 
 70.16  that support long-term economic stability.  The employment plan 
 70.17  should be developed using the highest level of activity 
 70.18  appropriate for the participant.  Activities must be chosen from 
 70.19  clauses (1) to (6), which are listed in order of preference.  
 70.20  The employment plan must also list the specific steps the 
 70.21  participant will take to obtain employment, including steps 
 70.22  necessary for the participant to progress from one level of 
 70.23  activity to another, and a timetable for completion of each 
 70.24  step.  Levels of activity include: 
 70.25     (1) unsubsidized employment; 
 70.26     (2) job search; 
 70.27     (3) subsidized employment or unpaid work experience; 
 70.28     (4) unsubsidized employment and job readiness education or 
 70.29  job skills training; 
 70.30     (5) unsubsidized employment or unpaid work experience, and 
 70.31  activities related to a family violence waiver or preemployment 
 70.32  needs; and 
 70.33     (6) activities related to a family violence waiver or 
 70.34  preemployment needs. 
 70.35     (b) Participants who are determined able to work in 
 70.36  unsubsidized employment must job search at least 30 hours per 
 71.1   week for up to six weeks, and accept any offer of suitable 
 71.2   employment.  The remaining hours necessary to meet the 
 71.3   requirements of section 256J.55, subdivision 1, may be met 
 71.4   through participation in other work activities under section 
 71.5   256J.49, subdivision 13.  The participant's employment plan must 
 71.6   specify, at a minimum:  (1) whether the job search is supervised 
 71.7   or unsupervised; (2) support services that will be provided; and 
 71.8   (3) how frequently the participant must report to the job 
 71.9   counselor.  Participants who are unable to find suitable 
 71.10  employment after six weeks must meet with the job counselor to 
 71.11  determine whether other activities in paragraph (a) should be 
 71.12  incorporated into the employment plan.  Job search activities 
 71.13  which are continued after six weeks must be structured and 
 71.14  supervised. 
 71.15     (c) Beginning July 1, 2004, activities and hourly 
 71.16  requirements in the employment plan may be adjusted as necessary 
 71.17  to accommodate the personal and family circumstances of 
 71.18  participants identified under section 256J.561, subdivision 2, 
 71.19  paragraph (d).  Participants who no longer meet the provisions 
 71.20  of section 256J.561, subdivision 2, paragraph (d), must meet 
 71.21  with the job counselor within ten days of the determination to 
 71.22  revise the employment plan. 
 71.23     (d) Participants who are determined to have barriers to 
 71.24  obtaining or retaining employment that will not be overcome 
 71.25  during six weeks of job search under paragraph (b) must work 
 71.26  with the job counselor to develop an employment plan that 
 71.27  addresses those barriers by incorporating appropriate activities 
 71.28  from paragraph (a), clauses (1) to (6).  The employment plan 
 71.29  must include enough hours to meet the participation requirements 
 71.30  in section 256J.55, subdivision 1, unless a compelling reason to 
 71.31  require fewer hours is noted in the participant's file. 
 71.32     (e) The job counselor and the participant must sign the 
 71.33  employment plan to indicate agreement on the contents.  Failure 
 71.34  to develop or comply with activities in the plan, or voluntarily 
 71.35  quitting suitable employment without good cause, will result in 
 71.36  the imposition of a sanction under section 256J.46. 
 72.1      (f) Employment plans must be reviewed at least every three 
 72.2   months to determine whether activities and hourly requirements 
 72.3   should be revised. 
 72.4      Subd. 3.  [EMPLOYMENT PLAN; FAMILY VIOLENCE WAIVER.] (a) A 
 72.5   participant who requests and qualifies for a family violence 
 72.6   waiver shall develop or revise the employment plan as specified 
 72.7   in this subdivision with a job counselor or county, and a person 
 72.8   trained in domestic violence.  The revised or new employment 
 72.9   plan must be approved by the county or the job counselor.  The 
 72.10  plan may address safety, legal, or emotional issues, and other 
 72.11  demands on the family as a result of the family violence.  
 72.12  Information in section 256J.515, clauses (1) to (8), must be 
 72.13  included as part of the development of the plan. 
 72.14     (b) The primary goal of an employment plan developed under 
 72.15  this subdivision is to ensure the safety of the caregiver and 
 72.16  children.  To the extent it is consistent with ensuring safety, 
 72.17  the plan shall also include activities that are designed to lead 
 72.18  to economic stability.  An activity is inconsistent with 
 72.19  ensuring safety if, in the opinion of a person trained in 
 72.20  domestic violence, the activity would endanger the safety of the 
 72.21  participant or children.  A plan under this subdivision may not 
 72.22  automatically include a provision that requires a participant to 
 72.23  obtain an order for protection or to attend counseling. 
 72.24     (c) If at any time there is a disagreement over whether the 
 72.25  activities in the plan are appropriate or the participant is not 
 72.26  complying with activities in the plan under this subdivision, 
 72.27  the participant must receive the assistance of a person trained 
 72.28  in domestic violence to help resolve the disagreement or 
 72.29  noncompliance with the county or job counselor.  If the person 
 72.30  trained in domestic violence recommends that the activities are 
 72.31  still appropriate, the county or a job counselor must approve 
 72.32  the activities in the plan or provide written reasons why 
 72.33  activities in the plan are not approved and document how denial 
 72.34  of the activities do not endanger the safety of the participant 
 72.35  or children. 
 72.36     Subd. 4.  [SELF-EMPLOYMENT.] (a) Self-employment activities 
 73.1   may be included in an employment plan contingent on the 
 73.2   development of a business plan which establishes a timetable and 
 73.3   earning goals that will result in the participant exiting MFIP 
 73.4   assistance.  Business plans must be developed with assistance 
 73.5   from an individual or organization with expertise in small 
 73.6   business as approved by the job counselor. 
 73.7      (b) Participants with an approved plan that includes 
 73.8   self-employment must meet the participation requirements in 
 73.9   section 256J.55, subdivision 1.  Only hours where the 
 73.10  participant earns at least minimum wage shall be counted toward 
 73.11  the requirement.  Additional activities and hours necessary to 
 73.12  meet the participation requirements in section 256J.55, 
 73.13  subdivision 1, must be included in the employment plan. 
 73.14     (c) Employment plans which include self-employment 
 73.15  activities must be reviewed every three months.  Participants 
 73.16  who fail, without good cause, to make satisfactory progress as 
 73.17  established in the business plan must revise the employment plan 
 73.18  to replace the self-employment with other approved work 
 73.19  activities. 
 73.20     (d) The requirements of this subdivision may be waived for 
 73.21  participants who are enrolled in the self-employment investment 
 73.22  demonstration program (SEID) under section 256J.65, and who make 
 73.23  satisfactory progress as determined by the job counselor and the 
 73.24  SEID provider. 
 73.25     Subd. 5.  [TRANSITION FROM THE DIVERSIONARY WORK 
 73.26  PROGRAM.] Participants who become eligible for MFIP assistance 
 73.27  after completing the diversionary work program under section 
 73.28  256J.95 must comply with all requirements of subdivisions 1 and 
 73.29  2.  Participants who become eligible for MFIP assistance after 
 73.30  being determined unable to benefit from the diversionary work 
 73.31  program must comply with the requirements of subdivisions 1 and 
 73.32  2, with the exception of subdivision 2, paragraph (b). 
 73.33     Subd. 6.  [LOSS OF EMPLOYMENT.] Participants who are laid 
 73.34  off, quit with good cause, or are terminated from employment 
 73.35  through no fault of their own must meet with the job counselor 
 73.36  within ten working days to ascertain the reason for the job loss 
 74.1   and to revise the employment plan as necessary to address the 
 74.2   problem. 
 74.3      Sec. 80.  Minnesota Statutes 2002, section 256J.53, 
 74.4   subdivision 1, is amended to read: 
 74.5      Subdivision 1.  [LENGTH OF PROGRAM.] (a) In order for a 
 74.6   post-secondary education or training program to be an approved 
 74.7   work activity as defined in section 256J.49, subdivision 13, 
 74.8   clause (18) (6), it must be a program lasting 24 12 months or 
 74.9   less, and the participant must meet the requirements of 
 74.10  subdivisions 2 and, 3, and 5.  
 74.11     (b) The 12 months of allowable postsecondary education or 
 74.12  training may be used to complete the final 12 months of a longer 
 74.13  program, provided the program does not exceed the undergraduate 
 74.14  level. 
 74.15     (c) All course work must be completed within 18 months of 
 74.16  enrollment in the program. 
 74.17     Sec. 81.  Minnesota Statutes 2002, section 256J.53, 
 74.18  subdivision 2, is amended to read: 
 74.19     Subd. 2.  [DOCUMENTATION SUPPORTING PROGRAM APPROVAL OF 
 74.20  POSTSECONDARY EDUCATION OR TRAINING.] (a) In order for a 
 74.21  post-secondary education or training program to be an approved 
 74.22  activity in a participant's an employment plan, the participant 
 74.23  or the employment and training service provider must provide 
 74.24  documentation that: be working in unsubsidized employment at 
 74.25  least 25 hours per week. 
 74.26     (b) Participants seeking approval of a postsecondary 
 74.27  education or training plan must provide documentation that: 
 74.28     (1) the participant's employment plan identifies specific 
 74.29  goals that goal can only be met with the additional education or 
 74.30  training; 
 74.31     (2) there are suitable employment opportunities that 
 74.32  require the specific education or training in the area in which 
 74.33  the participant resides or is willing to reside; 
 74.34     (3) the education or training will result in significantly 
 74.35  higher wages for the participant than the participant could earn 
 74.36  without the education or training; 
 75.1      (4) the participant can meet the requirements for admission 
 75.2   into the program; and 
 75.3      (5) there is a reasonable expectation that the participant 
 75.4   will complete the training program based on such factors as the 
 75.5   participant's MFIP assessment, previous education, training, and 
 75.6   work history; current motivation; and changes in previous 
 75.7   circumstances. 
 75.8      (c) The hourly unsubsidized employment requirement may be 
 75.9   reduced for intensive education or training programs lasting 12 
 75.10  weeks or less when full-time attendance is required. 
 75.11     (d) Participants with an approved employment plan in place 
 75.12  on July 1, 2003, which includes more than 12 months of 
 75.13  postsecondary education or training shall be allowed to complete 
 75.14  that plan provided that hourly requirements in section 256J.55, 
 75.15  subdivision 1, and conditions specified in paragraph (b), and 
 75.16  subdivisions 3 and 5 are met. 
 75.17     Sec. 82.  Minnesota Statutes 2002, section 256J.53, 
 75.18  subdivision 5, is amended to read: 
 75.19     Subd. 5.  [JOB SEARCH AFTER COMPLETION OF WORK ACTIVITY 
 75.20  REQUIREMENTS AFTER POSTSECONDARY EDUCATION OR TRAINING.] If a 
 75.21  participant's employment plan includes a post-secondary 
 75.22  educational or training program, the plan must include an 
 75.23  anticipated completion date for those activities.  At the time 
 75.24  the education or training is completed, the participant must 
 75.25  participate in job search.  If, after three months of job 
 75.26  search, the participant does not find a job that is consistent 
 75.27  with the participant's employment goal, the participant must 
 75.28  accept any offer of suitable employment.  Upon completion of an 
 75.29  approved education or training program, a participant who does 
 75.30  not meet the participation requirements in section 256J.55, 
 75.31  subdivision 1, through unsubsidized employment must participate 
 75.32  in job search.  If, after six weeks of job search, the 
 75.33  participant does not find a full-time job consistent with the 
 75.34  employment goal, the participant must accept any offer of 
 75.35  full-time suitable employment, or meet with the job counselor to 
 75.36  revise the employment plan to include additional work activities 
 76.1   necessary to meet hourly requirements. 
 76.2      Sec. 83.  [256J.531] [BASIC EDUCATION; ENGLISH AS A SECOND 
 76.3   LANGUAGE.] 
 76.4      Subdivision 1.  [APPROVAL OF ADULT BASIC EDUCATION.] With 
 76.5   the exception of classes related to obtaining a general 
 76.6   educational development credential (GED), a participant must 
 76.7   have reading or mathematics proficiency below a ninth grade 
 76.8   level in order for adult basic education classes to be an 
 76.9   approved work activity.  The employment plan must also specify 
 76.10  that the participant fulfill no more than one-half of the 
 76.11  participation requirements in section 256J.55, subdivision 1, 
 76.12  through attending adult basic education or general educational 
 76.13  development classes. 
 76.14     Subd. 2.  [APPROVAL OF ENGLISH AS A SECOND LANGUAGE.] In 
 76.15  order for English as a second language (ESL) classes to be an 
 76.16  approved work activity in an employment plan, a participant must 
 76.17  be below a spoken language proficiency level of SPL6 or its 
 76.18  equivalent, as measured by a nationally recognized test.  In 
 76.19  approving ESL as a work activity, the job counselor must give 
 76.20  preference to enrollment in a functional work literacy program, 
 76.21  if one is available, over a regular ESL program.  A participant 
 76.22  may not be approved for more than a combined total of 24 months 
 76.23  of ESL classes while participating in the diversionary work 
 76.24  program and the employment and training services component of 
 76.25  MFIP.  The employment plan must also specify that the 
 76.26  participant fulfill no more than one-half of the participation 
 76.27  requirements in section 256J.55, subdivision 1, through 
 76.28  attending ESL classes. 
 76.29     Sec. 84.  Minnesota Statutes 2002, section 256J.54, 
 76.30  subdivision 1, is amended to read: 
 76.31     Subdivision 1.  [ASSESSMENT OF EDUCATIONAL PROGRESS AND 
 76.32  NEEDS.] (a) The county agency must document the educational 
 76.33  level of each MFIP caregiver who is under the age of 20 and 
 76.34  determine if the caregiver has obtained a high school diploma or 
 76.35  its equivalent.  If the caregiver has not obtained a high school 
 76.36  diploma or its equivalent, and is not exempt from the 
 77.1   requirement to attend school under subdivision 5, the county 
 77.2   agency must complete an individual assessment for the 
 77.3   caregiver unless the caregiver is exempt from the requirement to 
 77.4   attend school under subdivision 5 or has chosen to have an 
 77.5   employment plan under section 256J.521, subdivision 2, as 
 77.6   allowed in paragraph (b).  The assessment must be performed as 
 77.7   soon as possible but within 30 days of determining MFIP 
 77.8   eligibility for the caregiver.  The assessment must provide an 
 77.9   initial examination of the caregiver's educational progress and 
 77.10  needs, literacy level, child care and supportive service needs, 
 77.11  family circumstances, skills, and work experience.  In the case 
 77.12  of a caregiver under the age of 18, the assessment must also 
 77.13  consider the results of either the caregiver's or the 
 77.14  caregiver's minor child's child and teen checkup under Minnesota 
 77.15  Rules, parts 9505.0275 and 9505.1693 to 9505.1748, if available, 
 77.16  and the effect of a child's development and educational needs on 
 77.17  the caregiver's ability to participate in the program.  The 
 77.18  county agency must advise the caregiver that the caregiver's 
 77.19  first goal must be to complete an appropriate educational 
 77.20  education option if one is identified for the caregiver through 
 77.21  the assessment and, in consultation with educational agencies, 
 77.22  must review the various school completion options with the 
 77.23  caregiver and assist in selecting the most appropriate option.  
 77.24     (b) The county agency must give a caregiver, who is age 18 
 77.25  or 19 and has not obtained a high school diploma or its 
 77.26  equivalent, the option to choose an employment plan with an 
 77.27  education option under subdivision 3 or an employment plan under 
 77.28  section 256J.521, subdivision 2. 
 77.29     Sec. 85.  Minnesota Statutes 2002, section 256J.54, 
 77.30  subdivision 2, is amended to read: 
 77.31     Subd. 2.  [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 
 77.32  PLAN.] For caregivers who are under age 18 without a high school 
 77.33  diploma or its equivalent, the assessment under subdivision 1 
 77.34  and the employment plan under subdivision 3 must be completed by 
 77.35  the social services agency under section 257.33.  For caregivers 
 77.36  who are age 18 or 19 without a high school diploma or its 
 78.1   equivalent who choose to have an employment plan with an 
 78.2   education option under subdivision 3, the assessment under 
 78.3   subdivision 1 and the employment plan under subdivision 3 must 
 78.4   be completed by the job counselor or, at county option, by the 
 78.5   social services agency under section 257.33.  Upon reaching age 
 78.6   18 or 19 a caregiver who received social services under section 
 78.7   257.33 and is without a high school diploma or its equivalent 
 78.8   has the option to choose whether to continue receiving services 
 78.9   under the caregiver's plan from the social services agency or to 
 78.10  utilize an MFIP employment and training service provider.  The 
 78.11  social services agency or the job counselor shall consult with 
 78.12  representatives of educational agencies that are required to 
 78.13  assist in developing educational plans under section 124D.331. 
 78.14     Sec. 86.  Minnesota Statutes 2002, section 256J.54, 
 78.15  subdivision 3, is amended to read: 
 78.16     Subd. 3.  [EDUCATIONAL EDUCATION OPTION DEVELOPED.] If the 
 78.17  job counselor or county social services agency identifies an 
 78.18  appropriate educational education option for a minor caregiver 
 78.19  under the age of 20 without a high school diploma or its 
 78.20  equivalent, or a caregiver age 18 or 19 without a high school 
 78.21  diploma or its equivalent who chooses an employment plan with an 
 78.22  education option, the job counselor or agency must develop an 
 78.23  employment plan which reflects the identified option.  The plan 
 78.24  must specify that participation in an educational activity is 
 78.25  required, what school or educational program is most 
 78.26  appropriate, the services that will be provided, the activities 
 78.27  the caregiver will take part in, including child care and 
 78.28  supportive services, the consequences to the caregiver for 
 78.29  failing to participate or comply with the specified 
 78.30  requirements, and the right to appeal any adverse action.  The 
 78.31  employment plan must, to the extent possible, reflect the 
 78.32  preferences of the caregiver. 
 78.33     Sec. 87.  Minnesota Statutes 2002, section 256J.54, 
 78.34  subdivision 5, is amended to read: 
 78.35     Subd. 5.  [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 
 78.36  the provisions of section 256J.56, minor parents, or 18- or 
 79.1   19-year-old parents without a high school diploma or its 
 79.2   equivalent who chooses an employment plan with an education 
 79.3   option must attend school unless: 
 79.4      (1) transportation services needed to enable the caregiver 
 79.5   to attend school are not available; 
 79.6      (2) appropriate child care services needed to enable the 
 79.7   caregiver to attend school are not available; 
 79.8      (3) the caregiver is ill or incapacitated seriously enough 
 79.9   to prevent attendance at school; or 
 79.10     (4) the caregiver is needed in the home because of the 
 79.11  illness or incapacity of another member of the household.  This 
 79.12  includes a caregiver of a child who is younger than six weeks of 
 79.13  age. 
 79.14     (b) The caregiver must be enrolled in a secondary school 
 79.15  and meeting the school's attendance requirements.  The county, 
 79.16  social service agency, or job counselor must verify at least 
 79.17  once per quarter that the caregiver is meeting the school's 
 79.18  attendance requirements.  An enrolled caregiver is considered to 
 79.19  be meeting the attendance requirements when the school is not in 
 79.20  regular session, including during holiday and summer breaks.  
 79.21     Sec. 88.  [256J.545] [FAMILY VIOLENCE WAIVER CRITERIA.] 
 79.22     (a) In order to qualify for a family violence waiver, an 
 79.23  individual must provide documentation of past or current family 
 79.24  violence which may prevent the individual from participating in 
 79.25  certain employment activities.  A claim of family violence must 
 79.26  be documented by the applicant or participant providing a sworn 
 79.27  statement which is supported by collateral documentation. 
 79.28     (b) Collateral documentation may consist of: 
 79.29     (1) police, government agency, or court records; 
 79.30     (2) a statement from a battered women's shelter staff with 
 79.31  knowledge of the circumstances or credible evidence that 
 79.32  supports the sworn statement; 
 79.33     (3) a statement from a sexual assault or domestic violence 
 79.34  advocate with knowledge of the circumstances or credible 
 79.35  evidence that supports the sworn statement; 
 79.36     (4) a statement from professionals from whom the applicant 
 80.1   or recipient has sought assistance for the abuse; or 
 80.2      (5) a sworn statement from any other individual with 
 80.3   knowledge of circumstances or credible evidence that supports 
 80.4   the sworn statement. 
 80.5      Sec. 89.  Minnesota Statutes 2002, section 256J.55, 
 80.6   subdivision 1, is amended to read: 
 80.7      Subdivision 1.  [COMPLIANCE WITH JOB SEARCH OR EMPLOYMENT 
 80.8   PLAN; SUITABLE EMPLOYMENT PARTICIPATION REQUIREMENTS.] (a) Each 
 80.9   MFIP participant must comply with the terms of the participant's 
 80.10  job search support plan or employment plan.  When the 
 80.11  participant has completed the steps listed in the employment 
 80.12  plan, the participant must comply with section 256J.53, 
 80.13  subdivision 5, if applicable, and then the participant must not 
 80.14  refuse any offer of suitable employment.  The participant may 
 80.15  choose to accept an offer of suitable employment before the 
 80.16  participant has completed the steps of the employment plan. 
 80.17     (b) For a participant under the age of 20 who is without a 
 80.18  high school diploma or general educational development diploma, 
 80.19  the requirement to comply with the terms of the employment plan 
 80.20  means the participant must meet the requirements of section 
 80.21  256J.54. 
 80.22     (c) Failure to develop or comply with a job search support 
 80.23  plan or an employment plan, or quitting suitable employment 
 80.24  without good cause, shall result in the imposition of a sanction 
 80.25  as specified in sections 256J.46 and 256J.57. 
 80.26     (a) All caregivers must participate in employment services 
 80.27  under sections 256J.515 to 256J.57 concurrent with receipt of 
 80.28  MFIP assistance. 
 80.29     (b) Until July 1, 2004, participants who meet the 
 80.30  requirements of section 256J.56 are exempt from participation 
 80.31  requirements. 
 80.32     (c) Participants under paragraph (a) must develop and 
 80.33  comply with an employment plan under section 256J.521, or 
 80.34  section 256J.54 in the case of a participant under the age of 20 
 80.35  who has not obtained a high school diploma or its equivalent. 
 80.36     (d) With the exception of participants under the age of 20 
 81.1   who must meet the education requirements of section 256J.54, all 
 81.2   participants must meet the hourly participation requirements of 
 81.3   TANF or the hourly requirements listed in clauses (1) to (3), 
 81.4   whichever is higher. 
 81.5      (1) In single-parent families with no children under six 
 81.6   years of age, the job counselor and the caregiver must develop 
 81.7   an employment plan that includes 30 to 35 hours per week of work 
 81.8   activities. 
 81.9      (2) In single-parent families with a child under six years 
 81.10  of age, the job counselor and the caregiver must develop an 
 81.11  employment plan that includes 20 to 35 hours per week of work 
 81.12  activities. 
 81.13     (3) In two-parent families, the job counselor and the 
 81.14  caregivers must develop employment plans which result in a 
 81.15  combined total of at least 55 hours per week of work activities. 
 81.16     (e) Failure to participate in employment services, 
 81.17  including the requirement to develop and comply with an 
 81.18  employment plan, including hourly requirements, without good 
 81.19  cause under section 256J.57, shall result in the imposition of a 
 81.20  sanction under section 256J.46. 
 81.21     Sec. 90.  Minnesota Statutes 2002, section 256J.55, 
 81.22  subdivision 2, is amended to read: 
 81.23     Subd. 2.  [DUTY TO REPORT.] The participant must inform the 
 81.24  job counselor within three ten working days regarding any 
 81.25  changes related to the participant's employment status. 
 81.26     Sec. 91.  Minnesota Statutes 2002, section 256J.56, is 
 81.27  amended to read: 
 81.28     256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 
 81.29  EXEMPTIONS.] 
 81.30     (a) An MFIP participant is exempt from the requirements of 
 81.31  sections 256J.52 256J.515 to 256J.55 256J.57 if the participant 
 81.32  belongs to any of the following groups: 
 81.33     (1) participants who are age 60 or older; 
 81.34     (2) participants who are suffering from a professionally 
 81.35  certified permanent or temporary illness, injury, or incapacity 
 81.36  which has been certified by a qualified professional when the 
 82.1   illness, injury, or incapacity is expected to continue for more 
 82.2   than 30 days and which prevents the person from obtaining or 
 82.3   retaining employment.  Persons in this category with a temporary 
 82.4   illness, injury, or incapacity must be reevaluated at least 
 82.5   quarterly; 
 82.6      (3) participants whose presence in the home is required as 
 82.7   a caregiver because of a professionally certified the illness or 
 82.8   incapacity of another member in the assistance unit, a relative 
 82.9   in the household, or a foster child in the household and when 
 82.10  the illness or incapacity and the need for the participant's 
 82.11  presence in the home has been certified by a qualified 
 82.12  professional and is expected to continue for more than 30 days; 
 82.13     (4) women who are pregnant, if the pregnancy has resulted 
 82.14  in a professionally certified an incapacity that prevents the 
 82.15  woman from obtaining or retaining employment, and the incapacity 
 82.16  has been certified by a qualified professional; 
 82.17     (5) caregivers of a child under the age of one year who 
 82.18  personally provide full-time care for the child.  This exemption 
 82.19  may be used for only 12 months in a lifetime.  In two-parent 
 82.20  households, only one parent or other relative may qualify for 
 82.21  this exemption; 
 82.22     (6) participants experiencing a personal or family crisis 
 82.23  that makes them incapable of participating in the program, as 
 82.24  determined by the county agency.  If the participant does not 
 82.25  agree with the county agency's determination, the participant 
 82.26  may seek professional certification from a qualified 
 82.27  professional, as defined in section 256J.08, that the 
 82.28  participant is incapable of participating in the program. 
 82.29     Persons in this exemption category must be reevaluated 
 82.30  every 60 days.  A personal or family crisis related to family 
 82.31  violence, as determined by the county or a job counselor with 
 82.32  the assistance of a person trained in domestic violence, should 
 82.33  not result in an exemption, but should be addressed through the 
 82.34  development or revision of an alternative employment plan under 
 82.35  section 256J.52 256J.521, subdivision 6 3; or 
 82.36     (7) caregivers with a child or an adult in the household 
 83.1   who meets the disability or medical criteria for home care 
 83.2   services under section 256B.0627, subdivision 1, 
 83.3   paragraph (c) (f), or a home and community-based waiver services 
 83.4   program under chapter 256B, or meets the criteria for severe 
 83.5   emotional disturbance under section 245.4871, subdivision 6, or 
 83.6   for serious and persistent mental illness under section 245.462, 
 83.7   subdivision 20, paragraph (c).  Caregivers in this exemption 
 83.8   category are presumed to be prevented from obtaining or 
 83.9   retaining employment. 
 83.10     A caregiver who is exempt under clause (5) must enroll in 
 83.11  and attend an early childhood and family education class, a 
 83.12  parenting class, or some similar activity, if available, during 
 83.13  the period of time the caregiver is exempt under this section.  
 83.14  Notwithstanding section 256J.46, failure to attend the required 
 83.15  activity shall not result in the imposition of a sanction. 
 83.16     (b) The county agency must provide employment and training 
 83.17  services to MFIP participants who are exempt under this section, 
 83.18  but who volunteer to participate.  Exempt volunteers may request 
 83.19  approval for any work activity under section 256J.49, 
 83.20  subdivision 13.  The hourly participation requirements for 
 83.21  nonexempt participants under section 256J.50 256J.55, 
 83.22  subdivision 5 1, do not apply to exempt participants who 
 83.23  volunteer to participate. 
 83.24     (c) This section expires on June 30, 2004. 
 83.25     Sec. 92.  [256J.561] [UNIVERSAL PARTICIPATION REQUIRED.] 
 83.26     Subdivision 1.  [IMPLEMENTATION OF UNIVERSAL PARTICIPATION 
 83.27  REQUIREMENTS.] (a) All caregivers whose applications were 
 83.28  received July 1, 2004, or after, are immediately subject to the 
 83.29  requirements in subdivision 2. 
 83.30     (b) For all MFIP participants who were exempt from 
 83.31  participating in employment services under section 256J.56 as of 
 83.32  June 30, 2004, between July 1, 2004, and June 30, 2005, the 
 83.33  county, as part of the participant's recertification under 
 83.34  section 256J.32, subdivision 6, shall determine whether a new 
 83.35  employment plan is required to meet the requirements in 
 83.36  subdivision 2.  Counties shall notify each participant who is in 
 84.1   need of an employment plan that the participant must meet with a 
 84.2   job counselor within ten days to develop an employment plan.  
 84.3   Until a participant's employment plan is developed, the 
 84.4   participant shall be considered in compliance with the 
 84.5   participation requirements in this section if the participant 
 84.6   continues to meet the criteria for an exemption under section 
 84.7   256J.56 as in effect on June 30, 2004, and is cooperating in the 
 84.8   development of the new plan. 
 84.9      Subd. 2.  [PARTICIPATION REQUIREMENTS.] (a) All MFIP 
 84.10  caregivers, except caregivers who meet the criteria in 
 84.11  subdivision 3, must participate in employment services.  Except 
 84.12  as specified in paragraphs (b) to (d), the employment plan must 
 84.13  meet the requirements of section 256J.521, subdivision 2, 
 84.14  contain allowable work activities, as defined in section 
 84.15  256J.49, subdivision 13, and, include at a minimum, the number 
 84.16  of participation hours required under section 256J.55, 
 84.17  subdivision 1. 
 84.18     (b) Minor caregivers and caregivers who are less than age 
 84.19  20 who have not completed high school or obtained a GED are 
 84.20  required to comply with section 256J.54. 
 84.21     (c) A participant who has a family violence waiver shall 
 84.22  develop and comply with an employment plan under section 
 84.23  256J.521, subdivision 3. 
 84.24     (d) As specified in section 256J.521, subdivision 2, 
 84.25  paragraph (c), a participant who meets any one of the following 
 84.26  criteria may work with the job counselor to develop an 
 84.27  employment plan that contains less than the number of 
 84.28  participation hours under section 256J.55, subdivision 1.  
 84.29  Employment plans for participants covered under this paragraph 
 84.30  must be tailored to recognize the special circumstances of 
 84.31  caregivers and families including limitations due to illness or 
 84.32  disability and caregiving needs: 
 84.33     (1) a participant who is age 60 or older; 
 84.34     (2) a participant who has been diagnosed by a qualified 
 84.35  professional as suffering from an illness or incapacity that is 
 84.36  expected to last for 30 days or more, including a pregnant 
 85.1   participant who is determined to be unable to obtain or retain 
 85.2   employment due to the pregnancy; or 
 85.3      (3) a participant who is determined by a qualified 
 85.4   professional as being needed in the home to care for an ill or 
 85.5   incapacitated family member, including caregivers with a child 
 85.6   or an adult in the household who meets the disability or medical 
 85.7   criteria for home care services under section 256B.0627, 
 85.8   subdivision 1, paragraph (f), or a home and community-based 
 85.9   waiver services program under chapter 256B, or meets the 
 85.10  criteria for severe emotional disturbance under section 
 85.11  245.4871, subdivision 6, or for serious and persistent mental 
 85.12  illness under section 245.462, subdivision 20, paragraph (c). 
 85.13     (e) For participants covered under paragraphs (c) and (d), 
 85.14  the county shall review the participant's employment services 
 85.15  status every three months to determine whether conditions have 
 85.16  changed.  When it is determined that the participant's status is 
 85.17  no longer covered under paragraph (c) or (d), the county shall 
 85.18  notify the participant that a new or revised employment plan is 
 85.19  needed.  The participant and job counselor shall meet within ten 
 85.20  days of the determination to revise the employment plan. 
 85.21     Subd. 3.  [CHILD UNDER 12 WEEKS OF AGE.] (a) A participant 
 85.22  who has a natural born child who is less than 12 weeks of age 
 85.23  who meets the criteria in clauses (1) and (2) is not required to 
 85.24  participate in employment services until the child reaches 12 
 85.25  weeks of age.  To be eligible for this provision, the following 
 85.26  conditions must be met: 
 85.27     (1) the child must have been born within ten months of the 
 85.28  caregiver's application for the diversionary work program or 
 85.29  MFIP; and 
 85.30     (2) the assistance unit must not have already used this 
 85.31  provision or the previously allowed child under age one 
 85.32  exemption.  However, an assistance unit that has an approved 
 85.33  child under age one exemption at the time this provision becomes 
 85.34  effective may continue to use that exemption until the child 
 85.35  reaches one year of age. 
 85.36     (b) The provision in paragraph (a) ends the first full 
 86.1   month after the child reaches 12 weeks of age.  This provision 
 86.2   is available only once in a caregiver's lifetime.  In a 
 86.3   two-parent household, only one parent shall be allowed to use 
 86.4   this provision.  The participant and job counselor must meet 
 86.5   within ten days after the child reaches 12 weeks of age to 
 86.6   revise the participant's employment plan. 
 86.7      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
 86.8      Sec. 93.  Minnesota Statutes 2002, section 256J.57, is 
 86.9   amended to read: 
 86.10     256J.57 [GOOD CAUSE; FAILURE TO COMPLY; NOTICE; 
 86.11  CONCILIATION CONFERENCE.] 
 86.12     Subdivision 1.  [GOOD CAUSE FOR FAILURE TO COMPLY.] The 
 86.13  county agency shall not impose the sanction under section 
 86.14  256J.46 if it determines that the participant has good cause for 
 86.15  failing to comply with the requirements of sections 256J.52 
 86.16  256J.515 to 256J.55 256J.57.  Good cause exists when: 
 86.17     (1) appropriate child care is not available; 
 86.18     (2) the job does not meet the definition of suitable 
 86.19  employment; 
 86.20     (3) the participant is ill or injured; 
 86.21     (4) a member of the assistance unit, a relative in the 
 86.22  household, or a foster child in the household is ill and needs 
 86.23  care by the participant that prevents the participant from 
 86.24  complying with the job search support plan or employment plan; 
 86.25     (5) the parental caregiver is unable to secure necessary 
 86.26  transportation; 
 86.27     (6) the parental caregiver is in an emergency situation 
 86.28  that prevents compliance with the job search support plan or 
 86.29  employment plan; 
 86.30     (7) the schedule of compliance with the job search support 
 86.31  plan or employment plan conflicts with judicial proceedings; 
 86.32     (8) a mandatory MFIP meeting is scheduled during a time 
 86.33  that conflicts with a judicial proceeding or a meeting related 
 86.34  to a juvenile court matter, or a participant's work schedule; 
 86.35     (9) the parental caregiver is already participating in 
 86.36  acceptable work activities; 
 87.1      (10) the employment plan requires an educational program 
 87.2   for a caregiver under age 20, but the educational program is not 
 87.3   available; 
 87.4      (11) activities identified in the job search support plan 
 87.5   or employment plan are not available; 
 87.6      (12) the parental caregiver is willing to accept suitable 
 87.7   employment, but suitable employment is not available; or 
 87.8      (13) the parental caregiver documents other verifiable 
 87.9   impediments to compliance with the job search support plan or 
 87.10  employment plan beyond the parental caregiver's control. 
 87.11     The job counselor shall work with the participant to 
 87.12  reschedule mandatory meetings for individuals who fall under 
 87.13  clauses (1), (3), (4), (5), (6), (7), and (8). 
 87.14     Subd. 2.  [NOTICE OF INTENT TO SANCTION.] (a) When a 
 87.15  participant fails without good cause to comply with the 
 87.16  requirements of sections 256J.52 256J.515 to 256J.55 256J.57, 
 87.17  the job counselor or the county agency must provide a notice of 
 87.18  intent to sanction to the participant specifying the program 
 87.19  requirements that were not complied with, informing the 
 87.20  participant that the county agency will impose the sanctions 
 87.21  specified in section 256J.46, and informing the participant of 
 87.22  the opportunity to request a conciliation conference as 
 87.23  specified in paragraph (b).  The notice must also state that the 
 87.24  participant's continuing noncompliance with the specified 
 87.25  requirements will result in additional sanctions under section 
 87.26  256J.46, without the need for additional notices or conciliation 
 87.27  conferences under this subdivision.  The notice, written in 
 87.28  English, must include the department of human services language 
 87.29  block, and must be sent to every applicable participant.  If the 
 87.30  participant does not request a conciliation conference within 
 87.31  ten calendar days of the mailing of the notice of intent to 
 87.32  sanction, the job counselor must notify the county agency that 
 87.33  the assistance payment should be reduced.  The county must then 
 87.34  send a notice of adverse action to the participant informing the 
 87.35  participant of the sanction that will be imposed, the reasons 
 87.36  for the sanction, the effective date of the sanction, and the 
 88.1   participant's right to have a fair hearing under section 256J.40.
 88.2   shall combine the information required in this notice with the 
 88.3   information required in a notice of adverse action under section 
 88.4   256J.31, subdivision 4. 
 88.5      (b) The participant may request a conciliation conference 
 88.6   by sending a written request, by making a telephone request, or 
 88.7   by making an in-person request.  The request must be received 
 88.8   within ten calendar days of the date the county agency mailed 
 88.9   the ten-day notice of intent to sanction.  If a timely request 
 88.10  for a conciliation is received, the county agency's service 
 88.11  provider must conduct the conference within five days of the 
 88.12  request.  The job counselor's supervisor, or a designee of the 
 88.13  supervisor, must review the outcome of the conciliation 
 88.14  conference.  If the conciliation conference resolves the 
 88.15  noncompliance, the job counselor must promptly inform the county 
 88.16  agency and request withdrawal of the sanction notice. 
 88.17     (c) Upon receiving a sanction notice, the participant may 
 88.18  request a fair hearing under section 256J.40, without exercising 
 88.19  the option of a conciliation conference.  In such cases, the 
 88.20  county agency shall not require the participant to engage in a 
 88.21  conciliation conference prior to the fair hearing. 
 88.22     (d) If the participant requests a fair hearing or a 
 88.23  conciliation conference, sanctions will not be imposed until 
 88.24  there is a determination of noncompliance.  Sanctions must be 
 88.25  imposed as provided in section 256J.46. 
 88.26     Sec. 94.  Minnesota Statutes 2002, section 256J.62, 
 88.27  subdivision 9, is amended to read: 
 88.28     Subd. 9.  [CONTINUATION OF CERTAIN SERVICES.] Only if 
 88.29  services were approved as part of an employment plan prior to 
 88.30  June 30, 2003, at the request of the participant, the county may 
 88.31  continue to provide case management, counseling, or other 
 88.32  support services to a participant: 
 88.33     (a) (1) who has achieved the employment goal; or 
 88.34     (b) (2) who under section 256J.42 is no longer eligible to 
 88.35  receive MFIP but whose income is below 115 percent of the 
 88.36  federal poverty guidelines for a family of the same size. 
 89.1      These services may be provided for up to 12 months 
 89.2   following termination of the participant's eligibility for MFIP. 
 89.3      Sec. 95.  [256J.626] [MFIP CONSOLIDATED FUND.] 
 89.4      Subdivision 1.  [CONSOLIDATED FUND.] The consolidated fund 
 89.5   is established to support counties and tribes in meeting their 
 89.6   duties under this chapter.  Counties and tribes must use funds 
 89.7   from the consolidated fund to develop programs and services that 
 89.8   are designed to improve participant outcomes as measured in 
 89.9   section 256J.751, subdivision 2.  Counties may use the funds for 
 89.10  any allowable expenditures under subdivision 2.  Tribes may use 
 89.11  the funds for any allowable expenditures under subdivision 2, 
 89.12  except those in clauses (1) and (6). 
 89.13     Subd. 2.  [ALLOWABLE EXPENDITURES.] (a) The commissioner 
 89.14  must restrict expenditures under the consolidated fund to 
 89.15  benefits and services allowed under title IV-A of the federal 
 89.16  Social Security Act.  Allowable expenditures under the 
 89.17  consolidated fund may include, but are not limited to: 
 89.18     (1) short-term, nonrecurring shelter and utility needs that 
 89.19  are excluded from the definition of assistance under Code of 
 89.20  Federal Regulations, title 45, section 260.31, for families who 
 89.21  meet the residency requirement in section 256J.12, subdivisions 
 89.22  1 and 1a.  Payments under this subdivision are not considered 
 89.23  TANF cash assistance and are not counted towards the 60-month 
 89.24  time limit; 
 89.25     (2) transportation needed to obtain or retain employment or 
 89.26  to participate in other approved work activities; 
 89.27     (3) direct and administrative costs of staff to deliver 
 89.28  employment services for MFIP or the diversionary work program, 
 89.29  to administer financial assistance, and to provide specialized 
 89.30  services intended to assist hard-to-employ participants to 
 89.31  transition to work; 
 89.32     (4) costs of education and training including functional 
 89.33  work literacy and English as a second language; 
 89.34     (5) cost of work supports including tools, clothing, boots, 
 89.35  and other work-related expenses; 
 89.36     (6) county administrative expenses as defined in Code of 
 90.1   Federal Regulations, title 45, section 260(b); 
 90.2      (7) services to parenting and pregnant teens; 
 90.3      (8) supported work; 
 90.4      (9) wage subsidies; 
 90.5      (10) child care needed for MFIP or diversionary work 
 90.6   program participants to participate in social services; 
 90.7      (11) child care to ensure that families leaving MFIP or 
 90.8   diversionary work program will continue to receive child care 
 90.9   assistance from the time the family no longer qualifies for 
 90.10  transition year child care until an opening occurs under the 
 90.11  basic sliding fee child care program; and 
 90.12     (12) services to help noncustodial parents who live in 
 90.13  Minnesota and have minor children receiving MFIP or DWP 
 90.14  assistance, but do not live in the same household as the child, 
 90.15  obtain or retain employment. 
 90.16     (b) Administrative costs that are not matched with county 
 90.17  funds as provided in subdivision 8 may not exceed 7.5 percent of 
 90.18  a county's or 15 percent of a tribe's reimbursement under this 
 90.19  section.  The commissioner shall define administrative costs for 
 90.20  purposes of this subdivision. 
 90.21     Subd. 3.  [ELIGIBILITY FOR SERVICES.] Families with a minor 
 90.22  child, a pregnant woman, or a noncustodial parent of a minor 
 90.23  child receiving assistance, with incomes below 200 percent of 
 90.24  the federal poverty guideline for a family of the applicable 
 90.25  size, are eligible for services funded under the consolidated 
 90.26  fund.  Counties and tribes must give priority to families 
 90.27  currently receiving MFIP or diversionary work program, and 
 90.28  families at risk of receiving MFIP or diversionary work program. 
 90.29     Subd. 4.  [COUNTY AND TRIBAL BIENNIAL SERVICE 
 90.30  AGREEMENTS.] (a) Effective January 1, 2004, and each two-year 
 90.31  period thereafter, each county and tribe must have in place an 
 90.32  approved biennial service agreement related to the services and 
 90.33  programs in this chapter.  Counties may collaborate to develop 
 90.34  multicounty, multitribal, or regional service agreements. 
 90.35     (b) The service agreements will be completed in a form 
 90.36  prescribed by the commissioner.  The agreement must include: 
 91.1      (1) a statement of the needs of the service population and 
 91.2   strengths and resources in the community; 
 91.3      (2) numerical goals for participant outcomes measures to be 
 91.4   accomplished during the biennial period.  The commissioner may 
 91.5   identify outcomes from section 256J.751, subdivision 2, as core 
 91.6   outcomes for all counties and tribes; 
 91.7      (3) strategies the county or tribe will pursue to achieve 
 91.8   the outcome targets.  Strategies must include specification of 
 91.9   how funds under this section will be used and may include 
 91.10  community partnerships that will be established or strengthened; 
 91.11  and 
 91.12     (4) other items prescribed by the commissioner in 
 91.13  consultation with counties and tribes. 
 91.14     (c) The commissioner shall provide each county and tribe 
 91.15  with information needed to complete an agreement, including:  
 91.16  (1) information on MFIP cases in the county or tribe; (2) 
 91.17  comparisons with the rest of the state; (3) baseline performance 
 91.18  on outcome measures; and (4) promising program practices. 
 91.19     (d) The service agreement must be submitted to the 
 91.20  commissioner by October 15, 2003, and October 15 of each second 
 91.21  year thereafter.  The county or tribe must allow a period of not 
 91.22  less than 30 days prior to the submission of the agreement to 
 91.23  solicit comments from the public on the contents of the 
 91.24  agreement. 
 91.25     (e) The commissioner must, within 60 days of receiving each 
 91.26  county or tribal service agreement, inform the county or tribe 
 91.27  if the service agreement is approved.  If the service agreement 
 91.28  is not approved, the commissioner must inform the county or 
 91.29  tribe of any revisions needed prior to approval. 
 91.30     (f) The service agreement in this subdivision supersedes 
 91.31  the plan requirements of section 268.88. 
 91.32     Subd. 5.  [INNOVATION PROJECTS.] Beginning January 1, 2005, 
 91.33  no more than $3,000,000 of the funds annually appropriated to 
 91.34  the commissioner for use in the consolidated fund shall be 
 91.35  available to the commissioner for projects testing innovative 
 91.36  approaches to improving outcomes for MFIP participants, and 
 92.1   persons at risk of receiving MFIP as detailed in subdivision 3.  
 92.2   Projects shall be targeted to geographic areas with poor 
 92.3   outcomes as specified in section 256J.751, subdivision 5, or to 
 92.4   subgroups within the MFIP case load who are experiencing poor 
 92.5   outcomes. 
 92.6      Subd. 6.  [BASE ALLOCATION TO COUNTIES AND TRIBES.] (a) For 
 92.7   purposes of this section, the following terms have the meanings 
 92.8   given them: 
 92.9      (1) "2002 historic spending base" means the commissioner's 
 92.10  determination of the sum of the reimbursement related to fiscal 
 92.11  year 2002 of county or tribal agency expenditures for the base 
 92.12  programs listed in clause (4), items (i) to (iv), and earnings 
 92.13  related to calendar year 2002 in the base program listed in 
 92.14  clause (4), item (v), and the amount of spending in fiscal year 
 92.15  2002 in the base program listed in clause (4), item (vi), issued 
 92.16  to or on behalf of persons residing in the county or tribal 
 92.17  service delivery area. 
 92.18     (2) "Initial allocation" means the amount potentially 
 92.19  available to each county or tribe based on the formula in 
 92.20  paragraphs (b) to (d). 
 92.21     (3) "Final allocation" means the amount available to each 
 92.22  county or tribe based on the formula in paragraphs (b) to (d), 
 92.23  after adjustment by subdivision 7. 
 92.24     (4) "Base programs" means the: 
 92.25     (i) MFIP employment and training services under section 
 92.26  256J.62, subdivision 1, in effect June 30, 2002; 
 92.27     (ii) bilingual employment and training services to refugees 
 92.28  under section 256J.62, subdivision 6, in effect June 30, 2002; 
 92.29     (iii) work literacy language programs under section 
 92.30  256J.62, subdivision 7, in effect June 30, 2002; 
 92.31     (iv) supported work program authorized in Laws 2001, First 
 92.32  Special Session chapter 9, article 17, section 2, in effect June 
 92.33  30, 2002; 
 92.34     (v) administrative aid program under section 256J.76 in 
 92.35  effect December 31, 2002; and 
 92.36     (vi) emergency assistance program under section 256J.48 in 
 93.1   effect June 30, 2002. 
 93.2      (b)(1) Beginning July 1, 2003, the commissioner shall 
 93.3   determine the initial allocation of funds available under this 
 93.4   section according to clause (2). 
 93.5      (2)(i) Ninety percent of the funds available for the period 
 93.6   beginning July 1, 2003, and ending December 31, 2004, shall be 
 93.7   allocated to each county or tribe in proportion to the county's 
 93.8   or tribe's share of the statewide 2002 historic spending base; 
 93.9      (ii) the remaining funds for the period beginning July 1, 
 93.10  2003, and ending December 31, 2004, shall be allocated to each 
 93.11  county or tribe in proportion to the average number of MFIP 
 93.12  cases: 
 93.13     (A) the average number of cases must be based upon counts 
 93.14  of MFIP or tribal TANF cases as of March 31, June 30, September 
 93.15  30, and December 31 using the most recent available data, less 
 93.16  the number of child only cases.  Two-parent cases, with the 
 93.17  exception of those with a caregiver age 60 or over, will be 
 93.18  multiplied by a factor of two; 
 93.19     (B) the MFIP or tribal TANF case count for each eligible 
 93.20  tribal provider shall be based upon the number of MFIP or tribal 
 93.21  TANF cases with participating adults who are enrolled in, or are 
 93.22  eligible for enrollment in, the tribe; and to be counted, the 
 93.23  case must be an active MFIP case, and the case members must 
 93.24  reside within the tribal program's service delivery area; 
 93.25     (C) the MFIP or tribal TANF case count for each eligible 
 93.26  tribal provider shall be further adjusted by multiplying the 
 93.27  count by the proportion of base program spending in paragraph 
 93.28  (a), clause (4), item (i), compared to paragraph (a), clause 
 93.29  (4), items (i) to (vi); and 
 93.30     (D) to prevent duplicate counts, MFIP or tribal TANF cases 
 93.31  counted for determining allocations to tribal providers in 
 93.32  clause (C) shall be removed from the case counts of the 
 93.33  respective counties where they reside. 
 93.34     (c)(1) Beginning January 1, 2005, the commissioner shall 
 93.35  determine the initial allocation of funds to be made available 
 93.36  under this section according to clause (2). 
 94.1      (2)(i) Seventy percent of the funds available for the 
 94.2   calendar year shall be allocated to each county or tribe in 
 94.3   proportion to the county's or tribe's share of the statewide 
 94.4   2002 historic spending base; 
 94.5      (ii) the remaining funds shall be allocated to each county 
 94.6   or tribe in proportion to the sum of the average number of MFIP 
 94.7   cases and the average monthly count of diversionary work program 
 94.8   cases.  The commissioner shall determine the count of MFIP and 
 94.9   diversionary work program cases according to subitems (A) to (C):
 94.10     (A) the average number of cases must be based upon counts 
 94.11  of MFIP, tribal TANF, or diversionary work program cases as of 
 94.12  March 31, June 30, September 30, and December 31 using the most 
 94.13  recent available data, less the number of child only cases.  
 94.14  Two-parent cases, with the exception of those with a caregiver 
 94.15  age 60 or over, will be multiplied by a factor of two; 
 94.16     (B) the case count for each eligible tribal provider shall 
 94.17  be based upon the number of MFIP, tribal TANF, or diversionary 
 94.18  work program cases with participating adults who are enrolled 
 94.19  in, or are eligible for enrollment in, the tribe; and to be 
 94.20  counted, the case must be an active MFIP or diversionary work 
 94.21  program case, and the case members must reside within the tribal 
 94.22  program's service delivery area; 
 94.23     (C) the MFIP or tribal TANF case count, including 
 94.24  diversionary work program cases, for each eligible tribal 
 94.25  provider shall be further adjusted by multiplying the count by 
 94.26  the proportion of base program spending in paragraph (a), clause 
 94.27  (4), item (i), compared to paragraph (a), clause (4), items (i) 
 94.28  to (vi); and 
 94.29     (D) to prevent duplicate counts, MFIP, tribal TANF, or 
 94.30  diversionary work program cases counted for determining 
 94.31  allocations to tribal providers under clause (C) shall be 
 94.32  removed from the case counts of the respective counties where 
 94.33  they reside. 
 94.34     (d)(1) Beginning January 1, 2006, and effective January 1 
 94.35  of each subsequent year, the commissioner shall determine the 
 94.36  initial allocation of funds available under this section 
 95.1   according to clause (2). 
 95.2      (2)(i) Fifty percent of the funds available for the 
 95.3   calendar year shall be allocated to each county or tribe in 
 95.4   proportion to the county's or tribe's share of the statewide 
 95.5   2002 historic spending base; 
 95.6      (ii) the remaining funds shall be allocated to each county 
 95.7   or tribe in proportion to the sum of the average number of MFIP 
 95.8   cases and the average monthly count of diversionary work program 
 95.9   cases.  The commissioner shall determine the count of MFIP and 
 95.10  diversionary work program cases according to subitems (A) to (C):
 95.11     (A) the average number of cases must be based upon counts 
 95.12  of MFIP, tribal TANF, or diversionary work program cases as of 
 95.13  March 31, June 30, September 30, and December 31 using the most 
 95.14  recent available data, less the number of child only cases.  
 95.15  Two-parent cases, with the exception of those with a caregiver 
 95.16  age 60 or over, will be multiplied by a factor of two; 
 95.17     (B) the case count for each eligible tribal provider shall 
 95.18  be based upon the number of MFIP, tribal TANF, or diversionary 
 95.19  work program cases with participating adults who are enrolled 
 95.20  in, or are eligible for, enrollment in the tribe; and to be 
 95.21  counted, the case must be an active MFIP or diversionary work 
 95.22  program case, and the case members must reside within the tribal 
 95.23  program's service delivery area; 
 95.24     (C) the MFIP or tribal TANF case count, including 
 95.25  diversionary work program cases, for each eligible tribal 
 95.26  provider shall be further adjusted by multiplying the count by 
 95.27  the proportion of base program spending in paragraph (a), clause 
 95.28  (4), item (i), compared to paragraph (a), clause (4), items (i) 
 95.29  to (vi); and 
 95.30     (D) to prevent duplicate counts, MFIP, tribal TANF, or 
 95.31  diversionary work program cases counted for determining 
 95.32  allocations to tribal providers in clause (C) shall be removed 
 95.33  from the case counts of the respective counties where they 
 95.34  reside. 
 95.35     (e) Before November 30, 2003, a county or tribe may ask for 
 95.36  a review of the commissioner's determination of the historic 
 96.1   base spending when the county or tribe believes the 2002 
 96.2   information was inaccurate or incomplete.  By January 1, 2004, 
 96.3   the commissioner must adjust that county's or tribe's base when 
 96.4   the commissioner has determined that inaccurate or incomplete 
 96.5   information was used to develop that base.  The commissioner 
 96.6   shall adjust each county's or tribe's initial allocation under 
 96.7   paragraph (c) and final allocation under subdivision 7 to 
 96.8   reflect the base change. 
 96.9      (f) Effective January 1, 2005, and effective January 1 of 
 96.10  each succeeding year, counties and tribes will have their final 
 96.11  allocations adjusted based on the performance provisions of 
 96.12  subdivision 7. 
 96.13     Subd. 7.  [PERFORMANCE BASE FUNDS.] (a) Beginning with 
 96.14  allocations for calendar year 2005, each county and tribe will 
 96.15  be allocated 95 percent of their initial allocation.  Counties 
 96.16  and tribes will be allocated additional funds based on 
 96.17  performance as follows: 
 96.18     (1) a county or tribe that achieves a 50 percent rate or 
 96.19  higher on the MFIP participation rate under section 256J.751, 
 96.20  subdivision 2, clause (8), as averaged across the four quarterly 
 96.21  measurements for the most recent year for which the measurements 
 96.22  are available, will receive an additional allocation equal to 
 96.23  2.5 percent of its initial allocation; and 
 96.24     (2) a county or tribe that performs above the top of its 
 96.25  range of expected performance on the three-year self-support 
 96.26  index under section 256J.751, subdivision 2, clause (7), in both 
 96.27  measurements in the preceding year will receive an additional 
 96.28  allocation equal to five percent of its initial allocation; or 
 96.29     (3) a county or tribe that performs within its range of 
 96.30  expected performance on the three-year self-support index under 
 96.31  section 256J.751, subdivision 2, clause (7), in both 
 96.32  measurements in the preceding year, or above the top of its 
 96.33  range of expected performance in one measurement and within its 
 96.34  expected range of performance in the other measurement, will 
 96.35  receive an additional allocation equal to 2.5 percent of its 
 96.36  initial allocation. 
 97.1      (b) Funds remaining unallocated after the performance-based 
 97.2   allocations in paragraph (a) are available to the commissioner 
 97.3   for innovation projects under subdivision 5. 
 97.4      (c)(1) If available funds are insufficient to meet county 
 97.5   and tribal allocations under paragraph (a), the commissioner may 
 97.6   make available for allocation funds that are unobligated and 
 97.7   available from the innovation projects through the end of the 
 97.8   current biennium. 
 97.9      (2) If after the application of clause (1) funds remain 
 97.10  insufficient to meet county and tribal allocations under 
 97.11  paragraph (a), the commissioner must proportionally reduce the 
 97.12  allocation of each county and tribe with respect to their 
 97.13  maximum allocation available under paragraph (a). 
 97.14     Subd. 8.  [REPORTING REQUIREMENT AND REIMBURSEMENT.] (a) 
 97.15  The commissioner shall specify requirements for reporting 
 97.16  according to section 256.01, subdivision 2, clause (17).  Each 
 97.17  county or tribe shall be reimbursed for eligible expenditures up 
 97.18  to the limit of its allocation and subject to availability of 
 97.19  funds. 
 97.20     (b) Reimbursements for county administrative-related 
 97.21  expenditures determined through the income maintenance random 
 97.22  moment time study shall be reimbursed at a rate of 50 percent of 
 97.23  eligible expenditures.  
 97.24     (c) The commissioner of human services shall review county 
 97.25  and tribal agency expenditures of the MFIP consolidated fund as 
 97.26  appropriate and may reallocate unencumbered or unexpended money 
 97.27  appropriated under this section to those county and tribal 
 97.28  agencies that can demonstrate a need for additional money. 
 97.29     Subd. 9.  [REPORT.] The commissioner shall, in consultation 
 97.30  with counties and tribes: 
 97.31     (1) determine how performance-based allocations under 
 97.32  subdivision 7, paragraph (a), clauses (2) and (3), will be 
 97.33  allocated to groupings of counties and tribes when groupings are 
 97.34  used to measure expected performance ranges for the self-support 
 97.35  index under section 256J.751, subdivision 2, clause (7); and 
 97.36     (2) determine how performance-based allocations under 
 98.1   subdivision 7, paragraph (a), clauses (2) and (3), will be 
 98.2   allocated to tribes. 
 98.3   The commissioner shall report to the legislature on the formulas 
 98.4   developed in clauses (1) and (2) by January 1, 2004. 
 98.5      Sec. 96.  Minnesota Statutes 2002, section 256J.645, 
 98.6   subdivision 3, is amended to read: 
 98.7      Subd. 3.  [FUNDING.] If the commissioner and an Indian 
 98.8   tribe are parties to an agreement under this subdivision, the 
 98.9   agreement shall annually provide to the Indian tribe the funding 
 98.10  allocated in section 256J.62, subdivisions 1 and 2a 256J.626. 
 98.11     Sec. 97.  Minnesota Statutes 2002, section 256J.66, 
 98.12  subdivision 2, is amended to read: 
 98.13     Subd. 2.  [TRAINING AND PLACEMENT.] (a) County agencies 
 98.14  shall limit the length of training based on the complexity of 
 98.15  the job and the caregiver's previous experience and training.  
 98.16  Placement in an on-the-job training position with an employer is 
 98.17  for the purpose of training and employment with the same 
 98.18  employer who has agreed to retain the person upon satisfactory 
 98.19  completion of training. 
 98.20     (b) Placement of any participant in an on-the-job training 
 98.21  position must be compatible with the participant's assessment 
 98.22  and employment plan under section 256J.52 256J.521. 
 98.23     Sec. 98.  Minnesota Statutes 2002, section 256J.67, 
 98.24  subdivision 1, is amended to read: 
 98.25     Subdivision 1.  [ESTABLISHING THE COMMUNITY WORK EXPERIENCE 
 98.26  PROGRAM.] To the extent of available resources, each county 
 98.27  agency may establish and operate a work experience component for 
 98.28  MFIP caregivers who are participating in employment and training 
 98.29  services.  This option for county agencies supersedes the 
 98.30  requirement in section 402(a)(1)(B)(iv) of the Social Security 
 98.31  Act that caregivers who have received assistance for two months 
 98.32  and who are not exempt from work requirements must participate 
 98.33  in a work experience program.  The purpose of the work 
 98.34  experience component is to enhance the caregiver's employability 
 98.35  and self-sufficiency and to provide meaningful, productive work 
 98.36  activities.  The county shall use this program for an individual 
 99.1   after exhausting all other unsubsidized employment 
 99.2   opportunities.  The county agency shall not require a caregiver 
 99.3   to participate in the community work experience program unless 
 99.4   the caregiver has been given an opportunity to participate in 
 99.5   other work activities.  
 99.6      Sec. 99.  Minnesota Statutes 2002, section 256J.67, 
 99.7   subdivision 3, is amended to read: 
 99.8      Subd. 3.  [EMPLOYMENT OPTIONS.] (a) Work sites developed 
 99.9   under this section are limited to projects that serve a useful 
 99.10  public service such as:  health, social service, environmental 
 99.11  protection, education, urban and rural development and 
 99.12  redevelopment, welfare, recreation, public facilities, public 
 99.13  safety, community service, services to aged or disabled 
 99.14  citizens, and child care.  To the extent possible, the prior 
 99.15  training, skills, and experience of a caregiver must be 
 99.16  considered in making appropriate work experience assignments. 
 99.17     (b) Structured, supervised volunteer work with an agency or 
 99.18  organization, which is monitored by the county service provider, 
 99.19  may, with the approval of the county agency, be used as a work 
 99.20  experience placement. 
 99.21     (c) As a condition of placing a caregiver in a program 
 99.22  under this section, the county agency shall first provide the 
 99.23  caregiver the opportunity: 
 99.24     (1) for placement in suitable subsidized or unsubsidized 
 99.25  employment through participation in a job search; or 
 99.26     (2) for placement in suitable employment through 
 99.27  participation in on-the-job training, if such employment is 
 99.28  available. 
 99.29     Sec. 100.  Minnesota Statutes 2002, section 256J.69, 
 99.30  subdivision 2, is amended to read: 
 99.31     Subd. 2.  [TRAINING AND PLACEMENT.] (a) County agencies 
 99.32  shall limit the length of training to nine months.  Placement in 
 99.33  a grant diversion training position with an employer is for the 
 99.34  purpose of training and employment with the same employer who 
 99.35  has agreed to retain the person upon satisfactory completion of 
 99.36  training. 
100.1      (b) Placement of any participant in a grant diversion 
100.2   subsidized training position must be compatible with the 
100.3   assessment and employment plan or employability development plan 
100.4   established for the recipient under section 256J.52 or 256K.03, 
100.5   subdivision 8 256J.521. 
100.6      Sec. 101.  Minnesota Statutes 2002, section 256J.75, 
100.7   subdivision 3, is amended to read: 
100.8      Subd. 3.  [RESPONSIBILITY FOR INCORRECT ASSISTANCE 
100.9   PAYMENTS.] A county of residence, when different from the county 
100.10  of financial responsibility, will be charged by the commissioner 
100.11  for the value of incorrect assistance payments and medical 
100.12  assistance paid to or on behalf of a person who was not eligible 
100.13  to receive that amount.  Incorrect payments include payments to 
100.14  an ineligible person or family resulting from decisions, 
100.15  failures to act, miscalculations, or overdue recertification.  
100.16  However, financial responsibility does not accrue for a county 
100.17  when the recertification is overdue at the time the referral is 
100.18  received by the county of residence or when the county of 
100.19  financial responsibility does not act on the recommendation of 
100.20  the county of residence.  When federal or state law requires 
100.21  that medical assistance continue after assistance ends, this 
100.22  subdivision also governs financial responsibility for the 
100.23  extended medical assistance. 
100.24     Sec. 102.  Minnesota Statutes 2002, section 256J.751, 
100.25  subdivision 1, is amended to read: 
100.26     Subdivision 1.  [QUARTERLY MONTHLY COUNTY CASELOAD REPORT.] 
100.27  The commissioner shall report quarterly monthly to each county 
100.28  on the county's performance on the following measures following 
100.29  caseload information: 
100.30     (1) number of cases receiving only the food portion of 
100.31  assistance; 
100.32     (2) number of child-only cases; 
100.33     (3) number of minor caregivers; 
100.34     (4) number of cases that are exempt from the 60-month time 
100.35  limit by the exemption category under section 256J.42; 
100.36     (5) number of participants who are exempt from employment 
101.1   and training services requirements by the exemption category 
101.2   under section 256J.56; 
101.3      (6) number of assistance units receiving assistance under a 
101.4   hardship extension under section 256J.425; 
101.5      (7) number of participants and number of months spent in 
101.6   each level of sanction under section 256J.46, subdivision 1; 
101.7      (8) number of MFIP cases that have left assistance; 
101.8      (9) federal participation requirements as specified in 
101.9   title 1 of Public Law Number 104-193; 
101.10     (10) median placement wage rate; and 
101.11     (11) of each county's total MFIP caseload less the number 
101.12  of cases in clauses (1) to (6): 
101.13     (i) number of one-parent cases; 
101.14     (ii) number of two-parent cases; 
101.15     (iii) percent of one-parent cases that are working more 
101.16  than 20 hours per week; 
101.17     (iv) percent of two-parent cases that are working more than 
101.18  20 hours per week; and 
101.19     (v) percent of cases that have received more than 36 months 
101.20  of assistance. 
101.21     (1) total number of cases receiving MFIP, and subtotals of 
101.22  cases with one eligible parent, two eligible parents, and an 
101.23  eligible caregiver who is not a parent; 
101.24     (2) total number of child only assistance cases; 
101.25     (3) total number of eligible adults and children receiving 
101.26  an MFIP grant, and subtotals for cases with one eligible parent, 
101.27  two eligible parents, an eligible caregiver who is not a parent, 
101.28  and child only cases; 
101.29     (4) number of cases with an exemption from the 60-month 
101.30  time limit based on a family violence waiver; 
101.31     (5) number of MFIP cases with work hours, and subtotals for 
101.32  cases with one eligible parent, two eligible parents, and an 
101.33  eligible caregiver who is not a parent; 
101.34     (6) number of employed MFIP cases, and subtotals for cases 
101.35  with one eligible parent, two eligible parents, and an eligible 
101.36  caregiver who is not a parent; 
102.1      (7) average monthly gross earnings, and averages for 
102.2   subgroups of cases with one eligible parent, two eligible 
102.3   parents, and an eligible caregiver who is not a parent; 
102.4      (8) number of employed cases receiving only the food 
102.5   portion of assistance; 
102.6      (9) number of parents or caregivers exempt from work 
102.7   activity requirements, with subtotals for each exemption type; 
102.8   and 
102.9      (10) number of cases with a sanction, with subtotals by 
102.10  level of sanction for cases with one eligible parent, two 
102.11  eligible parents, and an eligible caregiver who is not a parent. 
102.12     Sec. 103.  Minnesota Statutes 2002, section 256J.751, 
102.13  subdivision 2, is amended to read: 
102.14     Subd. 2.  [QUARTERLY COMPARISON REPORT.] The commissioner 
102.15  shall report quarterly to all counties on each county's 
102.16  performance on the following measures: 
102.17     (1) percent of MFIP caseload working in paid employment; 
102.18     (2) percent of MFIP caseload receiving only the food 
102.19  portion of assistance; 
102.20     (3) number of MFIP cases that have left assistance; 
102.21     (4) federal participation requirements as specified in 
102.22  Title 1 of Public Law Number 104-193; 
102.23     (5) median placement wage rate; and 
102.24     (6) caseload by months of TANF assistance; 
102.25     (7) percent of MFIP cases off cash assistance or working 30 
102.26  or more hours per week at one-year, two-year, and three-year 
102.27  follow-up points from a base line quarter.  This measure is 
102.28  called the self-support index.  Twice annually, the commissioner 
102.29  shall report an expected range of performance for each county, 
102.30  county grouping, and tribe on the self-support index.  The 
102.31  expected range shall be derived by a statistical methodology 
102.32  developed by the commissioner in consultation with the counties 
102.33  and tribes.  The statistical methodology shall control 
102.34  differences across counties in economic conditions and 
102.35  demographics of the MFIP case load; and 
102.36     (8) the MFIP work participation rate, defined as the 
103.1   participation requirements specified in title 1 of Public Law 
103.2   104-193 applied to all MFIP cases except child only cases and 
103.3   cases exempt under section 256J.56. 
103.4      Sec. 104.  Minnesota Statutes 2002, section 256J.751, 
103.5   subdivision 5, is amended to read: 
103.6      Subd. 5.  [FAILURE TO MEET FEDERAL PERFORMANCE STANDARDS.] 
103.7   (a) If sanctions occur for failure to meet the performance 
103.8   standards specified in title 1 of Public Law Number 104-193 of 
103.9   the Personal Responsibility and Work Opportunity Act of 1996, 
103.10  the state shall pay 88 percent of the sanction.  The remaining 
103.11  12 percent of the sanction will be paid by the counties.  The 
103.12  county portion of the sanction will be distributed across all 
103.13  counties in proportion to each county's percentage of the MFIP 
103.14  average monthly caseload during the period for which the 
103.15  sanction was applied. 
103.16     (b) If a county fails to meet the performance standards 
103.17  specified in title 1 of Public Law Number 104-193 of the 
103.18  Personal Responsibility and Work Opportunity Act of 1996 for any 
103.19  year, the commissioner shall work with counties to organize a 
103.20  joint state-county technical assistance team to work with the 
103.21  county.  The commissioner shall coordinate any technical 
103.22  assistance with other departments and agencies including the 
103.23  departments of economic security and children, families, and 
103.24  learning as necessary to achieve the purpose of this paragraph. 
103.25     (c) For state performance measures, a low-performing county 
103.26  is one that: 
103.27     (1) performs below the bottom of their expected range for 
103.28  the measure in subdivision 2, clause (7), in both measurements 
103.29  during the year; or 
103.30     (2) performs below 40 percent for the measure in 
103.31  subdivision 2, clause (8), as averaged across the four quarterly 
103.32  measurements for the year, or the ten counties with the lowest 
103.33  rates if more than ten are below 40 percent. 
103.34     (d) Low-performing counties under paragraph (c) must engage 
103.35  in corrective action planning as defined by the commissioner.  
103.36  The commissioner may coordinate technical assistance as 
104.1   specified in paragraph (b) for low-performing counties under 
104.2   paragraph (c). 
104.3      Sec. 105.  [256J.95] [DIVERSIONARY WORK PROGRAM.] 
104.4      Subdivision 1.  [ESTABLISHING A DIVERSIONARY WORK PROGRAM 
104.5   (DWP).] (a) The Personal Responsibility and Work Opportunity 
104.6   Reconciliation Act of 1996, Public Law 104-193, establishes 
104.7   block grants to states for temporary assistance for needy 
104.8   families (TANF).  TANF provisions allow states to use TANF 
104.9   dollars for nonrecurrent, short-term diversionary benefits.  The 
104.10  diversionary work program established on July 1, 2003, is 
104.11  Minnesota's TANF program to provide short-term diversionary 
104.12  benefits to eligible recipients of the diversionary work program.
104.13     (b) The goal of the diversionary work program is to provide 
104.14  short-term, necessary services and supports to families which 
104.15  will lead to unsubsidized employment, increase economic 
104.16  stability, and reduce the risk of those families needing longer 
104.17  term assistance, under the Minnesota family investment program 
104.18  (MFIP). 
104.19     (c) When a family unit meets the eligibility criteria in 
104.20  this section, the family must receive a diversionary work 
104.21  program grant and is not eligible for MFIP. 
104.22     (d) A family unit is eligible for the diversionary work 
104.23  program for a maximum of four months only once in a 12-month 
104.24  period.  The 12-month period begins at the date of application 
104.25  or the date eligibility is met, whichever is later.  During the 
104.26  four-month period, family maintenance needs as defined in 
104.27  subdivision 2, shall be vendor paid, up to the cash portion of 
104.28  the MFIP standard of need for the same size household.  To the 
104.29  extent there is a balance available between the amount paid for 
104.30  family maintenance needs and the cash portion of the 
104.31  transitional standard, a personal needs allowance of up to $70 
104.32  per DWP recipient in the family unit shall be issued.  The 
104.33  personal needs allowance payment plus the family maintenance 
104.34  needs shall not exceed the cash portion of the MFIP standard of 
104.35  need.  Counties may provide supportive and other allowable 
104.36  services funded by the MFIP consolidated fund under section 
105.1   256J.626 to eligible participants during the four-month 
105.2   diversionary period. 
105.3      Subd. 2.  [DEFINITIONS.] The terms used in this section 
105.4   have the following meanings. 
105.5      (a) "Diversionary Work Program (DWP)" means the program 
105.6   established under this section. 
105.7      (b) "Employment plan" means a plan developed by the job 
105.8   counselor and the participant which identifies the participant's 
105.9   most direct path to unsubsidized employment, lists the specific 
105.10  steps that the caregiver will take on that path, and includes a 
105.11  timetable for the completion of each step.  For participants who 
105.12  request and qualify for a family violence waiver in section 
105.13  256J.521, subdivision 3, an employment plan must be developed by 
105.14  the job counselor, the participant and a person trained in 
105.15  domestic violence and follow the employment plan provisions in 
105.16  section 256J.521, subdivision 3.  Employment plans under this 
105.17  section shall be written for a period of time not to exceed four 
105.18  months. 
105.19     (c) "Employment services" means programs, activities, and 
105.20  services in this section that are designed to assist 
105.21  participants in obtaining and retaining employment. 
105.22     (d) "Family maintenance needs" means current housing costs 
105.23  including rent, manufactured home lot rental costs, or monthly 
105.24  principal, interest, insurance premiums, and property taxes due 
105.25  for mortgages or contracts for deed, association fees required 
105.26  for homeownership, utility costs for current month expenses of 
105.27  gas and electric, garbage, water and sewer, and a flat rate of 
105.28  $35 for telephone services. 
105.29     (e) "Family unit" means a group of people applying for or 
105.30  receiving DWP benefits together.  For the purposes of 
105.31  determining eligibility for this program, the unit includes the 
105.32  relationships in section 256J.24, subdivisions 2 and 4. 
105.33     (f) "Minnesota family investment program (MFIP)" means the 
105.34  assistance program as defined in section 256J.08, subdivision 57.
105.35     (g) "Personal needs allowance" means an allowance of up to 
105.36  $70 per month per DWP unit member to pay for expenses such as 
106.1   household products and personal products. 
106.2      (h) "Work activities" means allowable work activities as 
106.3   defined in section 256J.49, subdivision 13. 
106.4      Subd. 3.  [ELIGIBILITY FOR DIVERSIONARY WORK PROGRAM.] (a) 
106.5   Except for the categories of family units listed below, all 
106.6   family units who apply for cash benefits and who meet MFIP 
106.7   eligibility as required in sections 256J.11 to 256J.15 are 
106.8   eligible and must participate in the diversionary work program.  
106.9   Family units that are not eligible for the diversionary work 
106.10  program include: 
106.11     (1) child only cases; 
106.12     (2) a single-parent family unit that includes a child under 
106.13  12 weeks of age.  A parent is eligible for this exception once 
106.14  in a parent's lifetime and is not eligible if the parent has 
106.15  already used the previously allowed child under age one 
106.16  exemption from MFIP employment services; 
106.17     (3) a minor parent without a high school diploma or its 
106.18  equivalent; 
106.19     (4) a caregiver 18 or 19 years of age without a high school 
106.20  diploma or its equivalent who chooses to have an employment plan 
106.21  with an education option; 
106.22     (5) a caregiver age 60 or over; 
106.23     (6) family units with a parent who received DWP benefits 
106.24  within a 12-month period as defined in subdivision 1, paragraph 
106.25  (d); and 
106.26     (7) family units with a parent who received MFIP within the 
106.27  past 12 months. 
106.28     (b) A two-parent family must participate in DWP unless both 
106.29  parents meet the criteria for an exception under paragraph (a), 
106.30  clauses (1) through (5), or the family unit includes a parent 
106.31  who meets the criteria in paragraph (a), clause (6) or (7). 
106.32     Subd. 4.  [COOPERATION WITH PROGRAM REQUIREMENTS.] (a) To 
106.33  be eligible for DWP, an applicant must comply with the 
106.34  requirements of paragraphs (b) to (d). 
106.35     (b) Applicants and participants must cooperate with the 
106.36  requirements of the child support enforcement program, but will 
107.1   not be charged a fee under section 518.551, subdivision 7. 
107.2      (c) The applicant must provide each member of the family 
107.3   unit's social security number to the county agency.  This 
107.4   requirement is satisfied when each member of the family unit 
107.5   cooperates with the procedures for verification of numbers, 
107.6   issuance of duplicate cards, and issuance of new numbers which 
107.7   have been established jointly between the Social Security 
107.8   Administration and the commissioner. 
107.9      (d) Before DWP benefits can be issued to a family unit, the 
107.10  caregiver must, in conjunction with a job counselor, develop and 
107.11  sign an employment plan.  In two-parent family units, both 
107.12  parents must develop and sign employment plans before benefits 
107.13  can be issued.  Food support and health care benefits are not 
107.14  contingent on the requirement for a signed employment plan. 
107.15     Subd. 5.  [SUBMITTING APPLICATION FORM.] The eligibility 
107.16  date for the diversionary work program begins with the date the 
107.17  signed combined application form (CAF) is received by the county 
107.18  agency or the date diversionary work program eligibility 
107.19  criteria are met, whichever is later.  The county agency must 
107.20  inform the applicant that any delay in submitting the 
107.21  application will reduce the benefits paid for the month of 
107.22  application.  The county agency must inform a person that an 
107.23  application may be submitted before the person has an interview 
107.24  appointment.  Upon receipt of a signed application, the county 
107.25  agency must stamp the date of receipt on the face of the 
107.26  application.  The applicant may withdraw the application at any 
107.27  time prior to approval by giving written or oral notice to the 
107.28  county agency.  The county agency must follow the notice 
107.29  requirements in section 256J.09, subdivision 3, when issuing a 
107.30  notice confirming the withdrawal. 
107.31     Subd. 6.  [INITIAL SCREENING OF APPLICATIONS.] Upon receipt 
107.32  of the application, the county agency must determine if the 
107.33  applicant may be eligible for other benefits as required in 
107.34  sections 256J.09, subdivision 3a, and 256J.28, subdivisions 1 
107.35  and 5.  The county must also follow the provisions in section 
107.36  256J.09, subdivision 3b, clause (2). 
108.1      Subd. 7.  [PROGRAM AND PROCESSING STANDARDS.] (a) The 
108.2   interview to determine financial eligibility for the 
108.3   diversionary work program must be conducted within five working 
108.4   days of the receipt of the cash application form.  During the 
108.5   intake interview the financial worker must discuss: 
108.6      (1) the goals, requirements, and services of the 
108.7   diversionary work program; 
108.8      (2) the availability of child care assistance.  If child 
108.9   care is needed, the worker must obtain a completed application 
108.10  for child care from the applicant before the interview is 
108.11  terminated.  The same day the application for child care is 
108.12  received, the application must be forwarded to the appropriate 
108.13  child care worker.  For purposes of eligibility for child care 
108.14  assistance under chapter 119B, DWP participants shall be 
108.15  eligible for the same benefits as MFIP recipients; and 
108.16     (3) if the applicant has not requested food support and 
108.17  health care assistance on the application, the county agency 
108.18  shall, during the interview process, talk with the applicant 
108.19  about the availability of these benefits. 
108.20     (b) The county shall follow section 256J.74, subdivision 2, 
108.21  paragraph (b), clauses (1) and (2), when an applicant or a 
108.22  recipient of DWP has a person who is a member of more than one 
108.23  assistance unit in a given payment month. 
108.24     (c) If within 30 days the county agency cannot determine 
108.25  eligibility for the diversionary work program, the county must 
108.26  deny the application and inform the applicant of the decision 
108.27  according to the notice provisions in section 256J.31.  A family 
108.28  unit is eligible for a fair hearing under section 256J.40.  
108.29     Subd. 8.  [VERIFICATION REQUIREMENTS.] (a) A county agency 
108.30  must only require verification of information necessary to 
108.31  determine DWP eligibility and the amount of the payment.  The 
108.32  applicant or participant must document the information required 
108.33  or authorize the county agency to verify the information.  The 
108.34  applicant or participant has the burden of providing documentary 
108.35  evidence to verify eligibility.  The county agency shall assist 
108.36  the applicant or participant in obtaining required documents 
109.1   when the applicant or participant is unable to do so. 
109.2      (b) A county agency must not request information about an 
109.3   applicant or participant that is not a matter of public record 
109.4   from a source other than county agencies, the department of 
109.5   human services, or the United States Department of Health and 
109.6   Human Services without the person's prior written consent.  An 
109.7   applicant's signature on an application form constitutes consent 
109.8   for contact with the sources specified on the application.  A 
109.9   county agency may use a single consent form to contact a group 
109.10  of similar sources, but the sources to be contacted must be 
109.11  identified by the county agency prior to requesting an 
109.12  applicant's consent. 
109.13     (c) Factors to be verified shall follow section 256J.32, 
109.14  subdivision 4.  Except for personal needs, family maintenance 
109.15  needs must be verified before the expense can be allowed in the 
109.16  calculation of the DWP grant. 
109.17     Subd. 9.  [PROPERTY AND INCOME LIMITATIONS.] The asset 
109.18  limits and exclusions in section 256J.20, apply to applicants 
109.19  and recipients of DWP.  All payments, unless excluded in section 
109.20  256J.21, must be counted as income to determine eligibility for 
109.21  the diversionary work program.  The county shall treat income as 
109.22  outlined in section 256J.37, except for subdivision 3a.  The 
109.23  initial income test and the disregards in section 256J.21, 
109.24  subdivision 3, shall be followed for determining eligibility for 
109.25  the diversionary work program. 
109.26     Subd. 10.  [DIVERSIONARY WORK PROGRAM GRANT.] (a) The 
109.27  amount of cash benefits that a family unit is eligible for under 
109.28  the diversionary work program is based on the number of persons 
109.29  in the family unit, the family maintenance needs, personal needs 
109.30  allowance, and countable income.  The county agency shall 
109.31  evaluate the income of the family unit that is requesting 
109.32  payments under the diversionary work program.  Countable income 
109.33  means gross earned and unearned income not excluded or 
109.34  disregarded under MFIP.  The same disregards for earned income 
109.35  that are allowed under MFIP are allowed for the diversionary 
109.36  work program. 
110.1      (b) The DWP grant is based on the family maintenance needs 
110.2   for which the DWP family unit is responsible plus a personal 
110.3   needs allowance.  Housing and utilities, except for telephone 
110.4   service, shall be vendor paid.  Unless otherwise stated in this 
110.5   section, actual housing and utility expenses shall be used when 
110.6   determining the amount of the DWP grant. 
110.7      (c) The maximum monthly benefit amount available under the 
110.8   diversionary work program is the difference between the family 
110.9   unit's family maintenance needs under paragraph (b) and the 
110.10  family unit's countable income not to exceed the cash portion of 
110.11  the MFIP standard of need as defined in section 256J.08, 
110.12  subdivision 55a, for the family unit's size.  The family wage 
110.13  level as defined in section 256J.08, subdivision 35, shall be 
110.14  used when determining the amount of countable income for working 
110.15  members. 
110.16     (d) Once the county has determined a grant amount, the DWP 
110.17  grant amount will not be decreased if the determination is based 
110.18  on the best information available at the time of approval and 
110.19  shall not be decreased because of any additional income to the 
110.20  family unit.  The grant can be increased if a participant later 
110.21  verifies an increase in family maintenance needs or family unit 
110.22  size.  The minimum cash benefit amount, if income and asset 
110.23  tests are met, is $10.  Benefits of $10 shall not be vendor paid.
110.24     (e) When all criteria are met, including the development of 
110.25  an employment plan as described in subdivision 14 and 
110.26  eligibility exists for the month of application, the amount of 
110.27  benefits for the diversionary work program retroactive to the 
110.28  date of application is as specified in section 256J.35, 
110.29  paragraph (a). 
110.30     (f) Any month during the four-month DWP period that a 
110.31  person receives a DWP benefit directly or through a vendor 
110.32  payment made on the person's behalf, that person is ineligible 
110.33  for MFIP or any other TANF cash assistance program except for 
110.34  benefits defined in section 256J.626, subdivision 2, clause (1). 
110.35     If during the four-month period a family unit that receives 
110.36  DWP benefits moves to a county that has not established a 
111.1   diversionary work program, the family unit may be eligible for 
111.2   MFIP the month following the last month of the issuance of the 
111.3   DWP benefit. 
111.4      Subd. 11.  [UNIVERSAL PARTICIPATION REQUIRED.] (a) All DWP 
111.5   caregivers, except caregivers who meet the criteria in paragraph 
111.6   (d), are required to participate in DWP employment services.  
111.7   Except as specified in paragraphs (b) and (c), employment plans 
111.8   under DWP must, at a minimum, meet the requirements in section 
111.9   256J.55, subdivision 1. 
111.10     (b) A caregiver who is a member of a two-parent family that 
111.11  is required to participate in DWP who would otherwise be 
111.12  ineligible for DWP under subdivision 3 may be allowed to develop 
111.13  an employment plan under section 256J.521, subdivision 2, 
111.14  paragraph (c), that may contain alternate activities and reduced 
111.15  hours.  
111.16     (c) A participant who has a family violence waiver shall be 
111.17  allowed to develop an employment plan under section 256J.521, 
111.18  subdivision 3. 
111.19     (d) One parent in a two-parent family unit that has a 
111.20  natural born child under 12 weeks of age is not required to have 
111.21  an employment plan until the child reaches 12 weeks of age 
111.22  unless the family unit has already used the exclusion under 
111.23  section 256J.561, subdivision 2, or the previously allowed child 
111.24  under age one exemption under section 256J.56, paragraph (a), 
111.25  clause (5). 
111.26     (e) The provision in paragraph (d) ends the first full 
111.27  month after the child reaches 12 weeks of age.  This provision 
111.28  is allowable only once in a caregiver's lifetime.  In a 
111.29  two-parent household, only one parent shall be allowed to use 
111.30  this category. 
111.31     (f) The participant and job counselor must meet within ten 
111.32  working days after the child reaches 12 weeks of age to revise 
111.33  the participant's employment plan.  The employment plan for a 
111.34  family unit that has a child under 12 weeks of age that has 
111.35  already used the exclusion in section 256J.561 or the previously 
111.36  allowed child under age one exemption under section 256J.56, 
112.1   paragraph (a), clause (5), must be tailored to recognize the 
112.2   caregiving needs of the parent. 
112.3      Subd. 12.  [CONVERSION OR REFERRAL TO MFIP.] (a) If at any 
112.4   time during the DWP application process or during the four-month 
112.5   DWP eligibility period, it is determined that a participant is 
112.6   unlikely to benefit from the diversionary work program, the 
112.7   county shall convert or refer the participant to MFIP as 
112.8   specified in paragraph (d).  Participants who are determined to 
112.9   be unlikely to benefit from the diversionary work program must 
112.10  develop and sign an employment plan.  Participants who meet the 
112.11  criteria in paragraph (b) shall be considered to be unlikely to 
112.12  benefit from DWP, provided the necessary documentation is 
112.13  available to support the determination. 
112.14     (b) A participant who: 
112.15     (1) has been determined by a qualified professional as 
112.16  being unable to obtain or retain employment due to an illness, 
112.17  injury, or incapacity that is expected to last at least 60 days; 
112.18     (2) is determined by a qualified professional as being 
112.19  needed in the home to care for a family member, or a relative in 
112.20  the household, or a foster child, due to an illness, injury, or 
112.21  incapacity that is expected to last at least 60 days; 
112.22     (3) is determined by a qualified professional as being 
112.23  needed in the home to care for a child meeting the special 
112.24  medical criteria in section 256J.425, subdivision 2, clause (3); 
112.25     (4) is pregnant and is determined by a qualified 
112.26  professional as being unable to obtain or retain employment due 
112.27  to the pregnancy; and 
112.28     (5) has applied for SSI or RSDI. 
112.29     (c) In a two-parent family unit, both parents must be 
112.30  determined to be unlikely to benefit from the diversionary work 
112.31  program before the family unit can be converted or referred to 
112.32  MFIP. 
112.33     (d) A participant who is determined to be unlikely to 
112.34  benefit from the diversionary work program shall be converted to 
112.35  MFIP and, if the determination was made within 30 days of the 
112.36  initial application for benefits, a new combined application 
113.1   form will not be required.  A participant who is determined to 
113.2   be unlikely to benefit from the diversionary work program shall 
113.3   be referred to MFIP and, if the determination is made more than 
113.4   30 days after the initial application, the participant must 
113.5   submit a new combined application form.  The county agency shall 
113.6   process the combined application form by the first of the 
113.7   following month to ensure that no gap in benefits is due to 
113.8   delayed action by the county agency.  In processing the combined 
113.9   application form, the county must follow section 256J.32, 
113.10  subdivision 1, except that the county agency shall not require 
113.11  additional verification of the information in the case file from 
113.12  the DWP application unless the information in the case file is 
113.13  inaccurate, questionable, or no longer current. 
113.14     Subd. 13.  [IMMEDIATE REFERRAL TO EMPLOYMENT SERVICES.] 
113.15  Within one working day of determination that the applicant is 
113.16  eligible for the diversionary work program, but before benefits 
113.17  are issued to or on behalf of the family unit, the county shall 
113.18  refer all caregivers to employment services.  The referral to 
113.19  the DWP employment services must be in writing and must contain 
113.20  the following information: 
113.21     (1) notification that, as part of the application process, 
113.22  applicants are required to develop an employment plan or the DWP 
113.23  application will be denied; 
113.24     (2) the employment services provider name and phone number; 
113.25     (3) the date, time, and location of the scheduled 
113.26  employment services interview; 
113.27     (4) the immediate availability of supportive services, 
113.28  including, but not limited to, child care, transportation, and 
113.29  other work-related aid; and 
113.30     (5) the rights, responsibilities, and obligations of 
113.31  participants in the program, including, but not limited to, the 
113.32  grounds for good cause, the consequences of refusing or failing 
113.33  to participate fully with program requirements, and the appeal 
113.34  process. 
113.35     Subd. 14.  [EMPLOYMENT PLAN; DWP BENEFITS.] As soon as 
113.36  possible, but no later than ten working days of being notified 
114.1   that a participant is financially eligible for the diversionary 
114.2   work program, the employment services provider shall provide the 
114.3   participant with an opportunity to meet to develop an initial 
114.4   employment plan.  Once the initial employment plan has been 
114.5   developed and signed by the participant and the job counselor, 
114.6   the employment services provider shall notify the county within 
114.7   one working day that the employment plan has been signed.  The 
114.8   county shall issue DWP benefits within one working day after 
114.9   receiving notice that the employment plan has been signed. 
114.10     Subd. 15.  [LIMITATIONS ON CERTAIN WORK ACTIVITIES.] (a) 
114.11  Except as specified in paragraphs (b) to (d), employment 
114.12  activities listed in section 256J.49, subdivision 13, are 
114.13  allowable under the diversionary work program. 
114.14     (b) Work activities under section 256J.49, subdivision 13, 
114.15  clause (5), shall be allowable only when in combination with 
114.16  approved work activities under section 256J.49, subdivision 13, 
114.17  clauses (1) to (4), and shall be limited to no more than 
114.18  one-half of the hours required in the employment plan. 
114.19     (c) In order for an English as a second language (ESL) 
114.20  class to be an approved work activity, a participant must: 
114.21     (1) be below a spoken language proficiency level of SPL6 or 
114.22  its equivalent, as measured by a nationally recognized test; and 
114.23     (2) not have been enrolled in ESL for more than 24 months 
114.24  while previously participating in MFIP or DWP.  A participant 
114.25  who has been enrolled in ESL for 20 or more months may be 
114.26  approved for ESL until the participant has received 24 total 
114.27  months. 
114.28     (d) Work activities under section 256J.49, subdivision 13, 
114.29  clause (6), shall be allowable only when the training or 
114.30  education program will be completed within the four-month DWP 
114.31  period.  Training or education programs that will not be 
114.32  completed within the four-month DWP period shall not be approved.
114.33     Subd. 16.  [FAILURE TO COMPLY WITH REQUIREMENTS.] A family 
114.34  unit that includes a participant who fails to comply with DWP 
114.35  employment service or child support enforcement requirements, 
114.36  without good cause as defined in sections 256.741 and 256J.57, 
115.1   shall be disqualified from the diversionary work program.  The 
115.2   county shall provide written notice as specified in section 
115.3   256J.31 to the participant prior to disqualifying the family 
115.4   unit due to noncompliance with employment service or child 
115.5   support.  The disqualification does not apply to food support or 
115.6   health care benefits. 
115.7      Subd. 17.  [GOOD CAUSE FOR NOT COMPLYING WITH 
115.8   REQUIREMENTS.] A participant who fails to comply with the 
115.9   requirements of the diversionary work program may claim good 
115.10  cause for reasons listed in sections 256.741 and 256J.57, 
115.11  subdivision 1, clauses (1) to (13).  The county shall not impose 
115.12  a disqualification if good cause exists. 
115.13     Subd. 18.  [REINSTATEMENT FOLLOWING DISQUALIFICATION.] A 
115.14  participant who has been disqualified from the diversionary work 
115.15  program due to noncompliance with employment services may regain 
115.16  eligibility for the diversionary work program by complying with 
115.17  program requirements.  A participant who has been disqualified 
115.18  from the diversionary work program due to noncooperation with 
115.19  child support enforcement requirements may regain eligibility by 
115.20  complying with child support requirements under section 
115.21  256J.741.  Once a participant has been reinstated, the county 
115.22  shall issue prorated benefits for the remaining portion of the 
115.23  month.  A family unit that has been disqualified from the 
115.24  diversionary work program due to noncompliance shall not be 
115.25  eligible for MFIP or any other TANF cash program during the 
115.26  period of time the participant remains noncompliant.  In a 
115.27  two-parent family, both parents must be in compliance before the 
115.28  family unit can regain eligibility for benefits. 
115.29     Subd. 19.  [RECOVERY OF OVERPAYMENTS.] When an overpayment 
115.30  or an ATM error is determined, the overpayment shall be recouped 
115.31  or recovered as specified in section 256J.38. 
115.32     Subd. 20.  [IMPLEMENTATION OF DWP.] Counties may establish 
115.33  a diversionary work program according to this section any time 
115.34  on or after July 1, 2003.  Prior to establishing a diversionary 
115.35  work program, the county must notify the commissioner.  All 
115.36  counties must implement the provisions of this section no later 
116.1   than July 1, 2004. 
116.2      Sec. 106.  Minnesota Statutes 2002, section 261.063, is 
116.3   amended to read: 
116.4      261.063 [TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY; 
116.5   PENALTY.] 
116.6      (a) The board of county commissioners of each county shall 
116.7   annually levy taxes and fix a rate sufficient to produce the 
116.8   full amount required for poor relief, general assistance, 
116.9   Minnesota family investment program, diversionary work program, 
116.10  county share of county and state supplemental aid to 
116.11  supplemental security income applicants or recipients, and any 
116.12  other social security measures wherein there is now or may 
116.13  hereafter be county participation, sufficient to produce the 
116.14  full amount necessary for each such item, including 
116.15  administrative expenses, for the ensuing year, within the time 
116.16  fixed by law in addition to all other tax levies and tax rates, 
116.17  however fixed or determined, and any commissioner who shall fail 
116.18  to comply herewith shall be guilty of a gross misdemeanor and 
116.19  shall be immediately removed from office by the governor.  For 
116.20  the purposes of this paragraph, "poor relief" means county 
116.21  services provided under sections 261.035, 261.04, and 261.21 to 
116.22  261.231. 
116.23     (b) Nothing within the provisions of this section shall be 
116.24  construed as requiring a county agency to provide income support 
116.25  or cash assistance to needy persons when they are no longer 
116.26  eligible for assistance under general assistance, the Minnesota 
116.27  family investment program chapter 256J, or Minnesota 
116.28  supplemental aid. 
116.29     Sec. 107.  Minnesota Statutes 2002, section 393.07, 
116.30  subdivision 10, is amended to read: 
116.31     Subd. 10.  [FEDERAL FOOD STAMP PROGRAM AND THE MATERNAL AND 
116.32  CHILD NUTRITION ACT.] (a) The local social services agency shall 
116.33  establish and administer the food stamp or support program 
116.34  according to rules of the commissioner of human services, the 
116.35  supervision of the commissioner as specified in section 256.01, 
116.36  and all federal laws and regulations.  The commissioner of human 
117.1   services shall monitor food stamp or support program delivery on 
117.2   an ongoing basis to ensure that each county complies with 
117.3   federal laws and regulations.  Program requirements to be 
117.4   monitored include, but are not limited to, number of 
117.5   applications, number of approvals, number of cases pending, 
117.6   length of time required to process each application and deliver 
117.7   benefits, number of applicants eligible for expedited issuance, 
117.8   length of time required to process and deliver expedited 
117.9   issuance, number of terminations and reasons for terminations, 
117.10  client profiles by age, household composition and income level 
117.11  and sources, and the use of phone certification and home 
117.12  visits.  The commissioner shall determine the county-by-county 
117.13  and statewide participation rate.  
117.14     (b) On July 1 of each year, the commissioner of human 
117.15  services shall determine a statewide and county-by-county food 
117.16  stamp program participation rate.  The commissioner may 
117.17  designate a different agency to administer the food stamp 
117.18  program in a county if the agency administering the program 
117.19  fails to increase the food stamp program participation rate 
117.20  among families or eligible individuals, or comply with all 
117.21  federal laws and regulations governing the food stamp program.  
117.22  The commissioner shall review agency performance annually to 
117.23  determine compliance with this paragraph. 
117.24     (c) A person who commits any of the following acts has 
117.25  violated section 256.98 or 609.821, or both, and is subject to 
117.26  both the criminal and civil penalties provided under those 
117.27  sections: 
117.28     (1) obtains or attempts to obtain, or aids or abets any 
117.29  person to obtain by means of a willful statement or 
117.30  misrepresentation, or intentional concealment of a material 
117.31  fact, food stamps or vouchers issued according to sections 
117.32  145.891 to 145.897 to which the person is not entitled or in an 
117.33  amount greater than that to which that person is entitled or 
117.34  which specify nutritional supplements to which that person is 
117.35  not entitled; or 
117.36     (2) presents or causes to be presented, coupons or vouchers 
118.1   issued according to sections 145.891 to 145.897 for payment or 
118.2   redemption knowing them to have been received, transferred or 
118.3   used in a manner contrary to existing state or federal law; or 
118.4      (3) willfully uses, possesses, or transfers food stamp 
118.5   coupons, authorization to purchase cards or vouchers issued 
118.6   according to sections 145.891 to 145.897 in any manner contrary 
118.7   to existing state or federal law, rules, or regulations; or 
118.8      (4) buys or sells food stamp coupons, authorization to 
118.9   purchase cards, other assistance transaction devices, vouchers 
118.10  issued according to sections 145.891 to 145.897, or any food 
118.11  obtained through the redemption of vouchers issued according to 
118.12  sections 145.891 to 145.897 for cash or consideration other than 
118.13  eligible food. 
118.14     (d) A peace officer or welfare fraud investigator may 
118.15  confiscate food stamps, authorization to purchase cards, or 
118.16  other assistance transaction devices found in the possession of 
118.17  any person who is neither a recipient of the food stamp program 
118.18  nor otherwise authorized to possess and use such materials.  
118.19  Confiscated property shall be disposed of as the commissioner 
118.20  may direct and consistent with state and federal food stamp 
118.21  law.  The confiscated property must be retained for a period of 
118.22  not less than 30 days to allow any affected person to appeal the 
118.23  confiscation under section 256.045. 
118.24     (e) Food stamp overpayment claims which are due in whole or 
118.25  in part to client error shall be established by the county 
118.26  agency for a period of six years from the date of any resultant 
118.27  overpayment.  
118.28     (f) With regard to the federal tax revenue offset program 
118.29  only, recovery incentives authorized by the federal food and 
118.30  consumer service shall be retained at the rate of 50 percent by 
118.31  the state agency and 50 percent by the certifying county agency. 
118.32     (g) A peace officer, welfare fraud investigator, federal 
118.33  law enforcement official, or the commissioner of health may 
118.34  confiscate vouchers found in the possession of any person who is 
118.35  neither issued vouchers under sections 145.891 to 145.897, nor 
118.36  otherwise authorized to possess and use such vouchers.  
119.1   Confiscated property shall be disposed of as the commissioner of 
119.2   health may direct and consistent with state and federal law.  
119.3   The confiscated property must be retained for a period of not 
119.4   less than 30 days. 
119.5      (h) The commissioner of human services shall seek a waiver 
119.6   from the United States Department of Agriculture to allow the 
119.7   state to specify foods that may and may not be purchased in 
119.8   Minnesota with benefits funded by the federal Food Stamp Program.
119.9      Sec. 108.  Laws 1997, chapter 203, article 9, section 21, 
119.10  as amended by Laws 1998, chapter 407, article 6, section 111, 
119.11  Laws 2000, chapter 488, article 10, section 28, and Laws 2001, 
119.12  First Special Session chapter 9, article 10, section 62, is 
119.13  amended to read: 
119.14     Sec. 21.  [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 
119.15     (a) Effective on the date specified, the following persons 
119.16  will be ineligible for general assistance and general assistance 
119.17  medical care under Minnesota Statutes, chapter 256D, group 
119.18  residential housing under Minnesota Statutes, chapter 256I, and 
119.19  MFIP assistance under Minnesota Statutes, chapter 256J, funded 
119.20  with state money: 
119.21     (1) Beginning July 1, 2002, persons who are terminated from 
119.22  or denied Supplemental Security Income due to the 1996 changes 
119.23  in the federal law making persons whose alcohol or drug 
119.24  addiction is a material factor contributing to the person's 
119.25  disability ineligible for Supplemental Security Income, and are 
119.26  eligible for general assistance under Minnesota Statutes, 
119.27  section 256D.05, subdivision 1, paragraph (a), clause (15), 
119.28  general assistance medical care under Minnesota Statutes, 
119.29  chapter 256D, or group residential housing under Minnesota 
119.30  Statutes, chapter 256I; and 
119.31     (2) Beginning July 1, 2002, legal noncitizens who are 
119.32  ineligible for Supplemental Security Income due to the 1996 
119.33  changes in federal law making certain noncitizens ineligible for 
119.34  these programs due to their noncitizen status; and 
119.35     (3) Beginning July 1, 2003 2007, legal noncitizens who are 
119.36  eligible for MFIP assistance, either the cash assistance portion 
120.1   or the food assistance portion, funded entirely with state money.
120.2      (b) State money that remains unspent due to changes in 
120.3   federal law enacted after May 12, 1997, that reduce state 
120.4   spending for legal noncitizens or for persons whose alcohol or 
120.5   drug addiction is a material factor contributing to the person's 
120.6   disability, or enacted after February 1, 1998, that reduce state 
120.7   spending for food benefits for legal noncitizens shall not 
120.8   cancel and shall be deposited in the TANF reserve account. 
120.9      Sec. 109.  [REVISOR'S INSTRUCTION.] 
120.10     (a) In the next publication of Minnesota Statutes, the 
120.11  revisor of statutes shall codify section 107 of this act. 
120.12     (b) Wherever "food stamp" or "food stamps" appears in 
120.13  Minnesota Statutes and Rules, the revisor of statutes shall 
120.14  insert "food support" or "or food support" except for instances 
120.15  where federal code or federal law is referenced. 
120.16     (c) For sections in Minnesota Statutes and Minnesota Rules 
120.17  affected by the repealed sections in this article, the revisor 
120.18  shall delete internal cross-references where appropriate and 
120.19  make changes necessary to correct the punctuation, grammar, or 
120.20  structure of the remaining text and preserve its meaning. 
120.21     Sec. 110.  [REPEALER.] 
120.22     (a) Minnesota Statutes 2002, sections 256J.02, subdivision 
120.23  3; 256J.08, subdivisions 28 and 70; 256J.24, subdivision 8; 
120.24  256J.30, subdivision 10; 256J.462; 256J.47; 256J.48; 256J.49, 
120.25  subdivisions 1a, 2, 6, and 7; 256J.50, subdivisions 2, 3, 3a, 5, 
120.26  and 7; 256J.52; 256J.62, subdivisions 1, 2a, 4, 6, 7, and 8; 
120.27  256J.625; 256J.655; 256J.74, subdivision 3; 256J.751, 
120.28  subdivisions 3 and 4; 256J.76; and 256K.30, are repealed. 
120.29     (b) Laws 2000, chapter 488, article 10, section 29, is 
120.30  repealed. 
120.31                             ARTICLE 2 
120.32                            HEALTH CARE 
120.33     Section 1.  Minnesota Statutes 2002, section 16A.724, is 
120.34  amended to read: 
120.35     16A.724 [HEALTH CARE ACCESS FUND.] 
120.36     A health care access fund is created in the state 
121.1   treasury.  The fund is a direct appropriated special revenue 
121.2   fund.  The commissioner shall deposit to the credit of the fund 
121.3   money made available to the fund.  Notwithstanding section 
121.4   11A.20, after June 30, 1997, all investment income and all 
121.5   investment losses attributable to the investment of the health 
121.6   care access fund not currently needed shall be credited to the 
121.7   health care access fund.  The health care access fund shall 
121.8   sunset on June 30, 2005, and all remaining funds shall be 
121.9   deposited in the general fund.  Beginning July 1, 2005, all 
121.10  activities which would otherwise receive funding from the health 
121.11  care access fund shall be funded out of the general fund. 
121.12     Sec. 2.  Minnesota Statutes 2002, section 256.01, 
121.13  subdivision 2, is amended to read: 
121.14     Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
121.15  section 241.021, subdivision 2, the commissioner of human 
121.16  services shall: 
121.17     (1) Administer and supervise all forms of public assistance 
121.18  provided for by state law and other welfare activities or 
121.19  services as are vested in the commissioner.  Administration and 
121.20  supervision of human services activities or services includes, 
121.21  but is not limited to, assuring timely and accurate distribution 
121.22  of benefits, completeness of service, and quality program 
121.23  management.  In addition to administering and supervising human 
121.24  services activities vested by law in the department, the 
121.25  commissioner shall have the authority to: 
121.26     (a) require county agency participation in training and 
121.27  technical assistance programs to promote compliance with 
121.28  statutes, rules, federal laws, regulations, and policies 
121.29  governing human services; 
121.30     (b) monitor, on an ongoing basis, the performance of county 
121.31  agencies in the operation and administration of human services, 
121.32  enforce compliance with statutes, rules, federal laws, 
121.33  regulations, and policies governing welfare services and promote 
121.34  excellence of administration and program operation; 
121.35     (c) develop a quality control program or other monitoring 
121.36  program to review county performance and accuracy of benefit 
122.1   determinations; 
122.2      (d) require county agencies to make an adjustment to the 
122.3   public assistance benefits issued to any individual consistent 
122.4   with federal law and regulation and state law and rule and to 
122.5   issue or recover benefits as appropriate; 
122.6      (e) delay or deny payment of all or part of the state and 
122.7   federal share of benefits and administrative reimbursement 
122.8   according to the procedures set forth in section 256.017; 
122.9      (f) make contracts with and grants to public and private 
122.10  agencies and organizations, both profit and nonprofit, and 
122.11  individuals, using appropriated funds; and 
122.12     (g) enter into contractual agreements with federally 
122.13  recognized Indian tribes with a reservation in Minnesota to the 
122.14  extent necessary for the tribe to operate a federally approved 
122.15  family assistance program or any other program under the 
122.16  supervision of the commissioner.  The commissioner shall consult 
122.17  with the affected county or counties in the contractual 
122.18  agreement negotiations, if the county or counties wish to be 
122.19  included, in order to avoid the duplication of county and tribal 
122.20  assistance program services.  The commissioner may establish 
122.21  necessary accounts for the purposes of receiving and disbursing 
122.22  funds as necessary for the operation of the programs. 
122.23     (2) Inform county agencies, on a timely basis, of changes 
122.24  in statute, rule, federal law, regulation, and policy necessary 
122.25  to county agency administration of the programs. 
122.26     (3) Administer and supervise all child welfare activities; 
122.27  promote the enforcement of laws protecting handicapped, 
122.28  dependent, neglected and delinquent children, and children born 
122.29  to mothers who were not married to the children's fathers at the 
122.30  times of the conception nor at the births of the children; 
122.31  license and supervise child-caring and child-placing agencies 
122.32  and institutions; supervise the care of children in boarding and 
122.33  foster homes or in private institutions; and generally perform 
122.34  all functions relating to the field of child welfare now vested 
122.35  in the state board of control. 
122.36     (4) Administer and supervise all noninstitutional service 
123.1   to handicapped persons, including those who are visually 
123.2   impaired, hearing impaired, or physically impaired or otherwise 
123.3   handicapped.  The commissioner may provide and contract for the 
123.4   care and treatment of qualified indigent children in facilities 
123.5   other than those located and available at state hospitals when 
123.6   it is not feasible to provide the service in state hospitals. 
123.7      (5) Assist and actively cooperate with other departments, 
123.8   agencies and institutions, local, state, and federal, by 
123.9   performing services in conformity with the purposes of Laws 
123.10  1939, chapter 431. 
123.11     (6) Act as the agent of and cooperate with the federal 
123.12  government in matters of mutual concern relative to and in 
123.13  conformity with the provisions of Laws 1939, chapter 431, 
123.14  including the administration of any federal funds granted to the 
123.15  state to aid in the performance of any functions of the 
123.16  commissioner as specified in Laws 1939, chapter 431, and 
123.17  including the promulgation of rules making uniformly available 
123.18  medical care benefits to all recipients of public assistance, at 
123.19  such times as the federal government increases its participation 
123.20  in assistance expenditures for medical care to recipients of 
123.21  public assistance, the cost thereof to be borne in the same 
123.22  proportion as are grants of aid to said recipients. 
123.23     (7) Establish and maintain any administrative units 
123.24  reasonably necessary for the performance of administrative 
123.25  functions common to all divisions of the department. 
123.26     (8) Act as designated guardian of both the estate and the 
123.27  person of all the wards of the state of Minnesota, whether by 
123.28  operation of law or by an order of court, without any further 
123.29  act or proceeding whatever, except as to persons committed as 
123.30  mentally retarded.  For children under the guardianship of the 
123.31  commissioner whose interests would be best served by adoptive 
123.32  placement, the commissioner may contract with a licensed 
123.33  child-placing agency or a Minnesota tribal social services 
123.34  agency to provide adoption services.  A contract with a licensed 
123.35  child-placing agency must be designed to supplement existing 
123.36  county efforts and may not replace existing county programs, 
124.1   unless the replacement is agreed to by the county board and the 
124.2   appropriate exclusive bargaining representative or the 
124.3   commissioner has evidence that child placements of the county 
124.4   continue to be substantially below that of other counties.  
124.5   Funds encumbered and obligated under an agreement for a specific 
124.6   child shall remain available until the terms of the agreement 
124.7   are fulfilled or the agreement is terminated. 
124.8      (9) Act as coordinating referral and informational center 
124.9   on requests for service for newly arrived immigrants coming to 
124.10  Minnesota. 
124.11     (10) The specific enumeration of powers and duties as 
124.12  hereinabove set forth shall in no way be construed to be a 
124.13  limitation upon the general transfer of powers herein contained. 
124.14     (11) Establish county, regional, or statewide schedules of 
124.15  maximum fees and charges which may be paid by county agencies 
124.16  for medical, dental, surgical, hospital, nursing and nursing 
124.17  home care and medicine and medical supplies under all programs 
124.18  of medical care provided by the state and for congregate living 
124.19  care under the income maintenance programs. 
124.20     (12) Have the authority to conduct and administer 
124.21  experimental projects to test methods and procedures of 
124.22  administering assistance and services to recipients or potential 
124.23  recipients of public welfare.  To carry out such experimental 
124.24  projects, it is further provided that the commissioner of human 
124.25  services is authorized to waive the enforcement of existing 
124.26  specific statutory program requirements, rules, and standards in 
124.27  one or more counties.  The order establishing the waiver shall 
124.28  provide alternative methods and procedures of administration, 
124.29  shall not be in conflict with the basic purposes, coverage, or 
124.30  benefits provided by law, and in no event shall the duration of 
124.31  a project exceed four years.  It is further provided that no 
124.32  order establishing an experimental project as authorized by the 
124.33  provisions of this section shall become effective until the 
124.34  following conditions have been met: 
124.35     (a) The secretary of health and human services of the 
124.36  United States has agreed, for the same project, to waive state 
125.1   plan requirements relative to statewide uniformity. 
125.2      (b) A comprehensive plan, including estimated project 
125.3   costs, shall be approved by the legislative advisory commission 
125.4   and filed with the commissioner of administration.  
125.5      (13) According to federal requirements, establish 
125.6   procedures to be followed by local welfare boards in creating 
125.7   citizen advisory committees, including procedures for selection 
125.8   of committee members. 
125.9      (14) Allocate federal fiscal disallowances or sanctions 
125.10  which are based on quality control error rates for the aid to 
125.11  families with dependent children program formerly codified in 
125.12  sections 256.72 to 256.87, medical assistance, or food stamp 
125.13  program in the following manner:  
125.14     (a) One-half of the total amount of the disallowance shall 
125.15  be borne by the county boards responsible for administering the 
125.16  programs.  For the medical assistance and the AFDC program 
125.17  formerly codified in sections 256.72 to 256.87, disallowances 
125.18  shall be shared by each county board in the same proportion as 
125.19  that county's expenditures for the sanctioned program are to the 
125.20  total of all counties' expenditures for the AFDC program 
125.21  formerly codified in sections 256.72 to 256.87, and medical 
125.22  assistance programs.  For the food stamp program, sanctions 
125.23  shall be shared by each county board, with 50 percent of the 
125.24  sanction being distributed to each county in the same proportion 
125.25  as that county's administrative costs for food stamps are to the 
125.26  total of all food stamp administrative costs for all counties, 
125.27  and 50 percent of the sanctions being distributed to each county 
125.28  in the same proportion as that county's value of food stamp 
125.29  benefits issued are to the total of all benefits issued for all 
125.30  counties.  Each county shall pay its share of the disallowance 
125.31  to the state of Minnesota.  When a county fails to pay the 
125.32  amount due hereunder, the commissioner may deduct the amount 
125.33  from reimbursement otherwise due the county, or the attorney 
125.34  general, upon the request of the commissioner, may institute 
125.35  civil action to recover the amount due. 
125.36     (b) Notwithstanding the provisions of paragraph (a), if the 
126.1   disallowance results from knowing noncompliance by one or more 
126.2   counties with a specific program instruction, and that knowing 
126.3   noncompliance is a matter of official county board record, the 
126.4   commissioner may require payment or recover from the county or 
126.5   counties, in the manner prescribed in paragraph (a), an amount 
126.6   equal to the portion of the total disallowance which resulted 
126.7   from the noncompliance, and may distribute the balance of the 
126.8   disallowance according to paragraph (a).  
126.9      (15) Develop and implement special projects that maximize 
126.10  reimbursements and result in the recovery of money to the 
126.11  state.  For the purpose of recovering state money, the 
126.12  commissioner may enter into contracts with third parties.  Any 
126.13  recoveries that result from projects or contracts entered into 
126.14  under this paragraph shall be deposited in the state treasury 
126.15  and credited to a special account until the balance in the 
126.16  account reaches $1,000,000.  When the balance in the account 
126.17  exceeds $1,000,000, the excess shall be transferred and credited 
126.18  to the general fund.  All money in the account is appropriated 
126.19  to the commissioner for the purposes of this paragraph. 
126.20     (16) Have the authority to make direct payments to 
126.21  facilities providing shelter to women and their children 
126.22  according to section 256D.05, subdivision 3.  Upon the written 
126.23  request of a shelter facility that has been denied payments 
126.24  under section 256D.05, subdivision 3, the commissioner shall 
126.25  review all relevant evidence and make a determination within 30 
126.26  days of the request for review regarding issuance of direct 
126.27  payments to the shelter facility.  Failure to act within 30 days 
126.28  shall be considered a determination not to issue direct payments.
126.29     (17) Have the authority to establish and enforce the 
126.30  following county reporting requirements:  
126.31     (a) The commissioner shall establish fiscal and statistical 
126.32  reporting requirements necessary to account for the expenditure 
126.33  of funds allocated to counties for human services programs.  
126.34  When establishing financial and statistical reporting 
126.35  requirements, the commissioner shall evaluate all reports, in 
126.36  consultation with the counties, to determine if the reports can 
127.1   be simplified or the number of reports can be reduced. 
127.2      (b) The county board shall submit monthly or quarterly 
127.3   reports to the department as required by the commissioner.  
127.4   Monthly reports are due no later than 15 working days after the 
127.5   end of the month.  Quarterly reports are due no later than 30 
127.6   calendar days after the end of the quarter, unless the 
127.7   commissioner determines that the deadline must be shortened to 
127.8   20 calendar days to avoid jeopardizing compliance with federal 
127.9   deadlines or risking a loss of federal funding.  Only reports 
127.10  that are complete, legible, and in the required format shall be 
127.11  accepted by the commissioner.  
127.12     (c) If the required reports are not received by the 
127.13  deadlines established in clause (b), the commissioner may delay 
127.14  payments and withhold funds from the county board until the next 
127.15  reporting period.  When the report is needed to account for the 
127.16  use of federal funds and the late report results in a reduction 
127.17  in federal funding, the commissioner shall withhold from the 
127.18  county boards with late reports an amount equal to the reduction 
127.19  in federal funding until full federal funding is received.  
127.20     (d) A county board that submits reports that are late, 
127.21  illegible, incomplete, or not in the required format for two out 
127.22  of three consecutive reporting periods is considered 
127.23  noncompliant.  When a county board is found to be noncompliant, 
127.24  the commissioner shall notify the county board of the reason the 
127.25  county board is considered noncompliant and request that the 
127.26  county board develop a corrective action plan stating how the 
127.27  county board plans to correct the problem.  The corrective 
127.28  action plan must be submitted to the commissioner within 45 days 
127.29  after the date the county board received notice of noncompliance.
127.30     (e) The final deadline for fiscal reports or amendments to 
127.31  fiscal reports is one year after the date the report was 
127.32  originally due.  If the commissioner does not receive a report 
127.33  by the final deadline, the county board forfeits the funding 
127.34  associated with the report for that reporting period and the 
127.35  county board must repay any funds associated with the report 
127.36  received for that reporting period. 
128.1      (f) The commissioner may not delay payments, withhold 
128.2   funds, or require repayment under paragraph (c) or (e) if the 
128.3   county demonstrates that the commissioner failed to provide 
128.4   appropriate forms, guidelines, and technical assistance to 
128.5   enable the county to comply with the requirements.  If the 
128.6   county board disagrees with an action taken by the commissioner 
128.7   under paragraph (c) or (e), the county board may appeal the 
128.8   action according to sections 14.57 to 14.69. 
128.9      (g) Counties subject to withholding of funds under 
128.10  paragraph (c) or forfeiture or repayment of funds under 
128.11  paragraph (e) shall not reduce or withhold benefits or services 
128.12  to clients to cover costs incurred due to actions taken by the 
128.13  commissioner under paragraph (c) or (e). 
128.14     (18) Allocate federal fiscal disallowances or sanctions for 
128.15  audit exceptions when federal fiscal disallowances or sanctions 
128.16  are based on a statewide random sample for the foster care 
128.17  program under title IV-E of the Social Security Act, United 
128.18  States Code, title 42, in direct proportion to each county's 
128.19  title IV-E foster care maintenance claim for that period. 
128.20     (19) Be responsible for ensuring the detection, prevention, 
128.21  investigation, and resolution of fraudulent activities or 
128.22  behavior by applicants, recipients, and other participants in 
128.23  the human services programs administered by the department. 
128.24     (20) Require county agencies to identify overpayments, 
128.25  establish claims, and utilize all available and cost-beneficial 
128.26  methodologies to collect and recover these overpayments in the 
128.27  human services programs administered by the department. 
128.28     (21) Have the authority to administer a drug rebate program 
128.29  for drugs purchased pursuant to the prescription drug program 
128.30  established under section 256.955 after the beneficiary's 
128.31  satisfaction of any deductible established in the program.  The 
128.32  commissioner shall require a rebate agreement from all 
128.33  manufacturers of covered drugs as defined in section 256B.0625, 
128.34  subdivision 13.  Rebate agreements for prescription drugs 
128.35  delivered on or after July 1, 2002, must include rebates for 
128.36  individuals covered under the prescription drug program who are 
129.1   under 65 years of age.  For each drug, the amount of the rebate 
129.2   shall be equal to the basic rebate as defined for purposes of 
129.3   the federal rebate program in United States Code, title 42, 
129.4   section 1396r-8(c)(1).  This basic rebate shall be applied to 
129.5   single-source and multiple-source drugs.  The manufacturers must 
129.6   provide full payment within 30 days of receipt of the state 
129.7   invoice for the rebate within the terms and conditions used for 
129.8   the federal rebate program established pursuant to section 1927 
129.9   of title XIX of the Social Security Act.  The manufacturers must 
129.10  provide the commissioner with any information necessary to 
129.11  verify the rebate determined per drug.  The rebate program shall 
129.12  utilize the terms and conditions used for the federal rebate 
129.13  program established pursuant to section 1927 of title XIX of the 
129.14  Social Security Act. 
129.15     (22) Have the authority to administer the federal drug 
129.16  rebate program for drugs purchased under the medical assistance 
129.17  program as allowed by section 1927 of title XIX of the Social 
129.18  Security Act and according to the terms and conditions of 
129.19  section 1927.  Rebates shall be collected for all drugs that 
129.20  have been dispensed or administered in an outpatient setting and 
129.21  that are from manufacturers who have signed a rebate agreement 
129.22  with the United States Department of Health and Human Services. 
129.23     (23) Have the authority to administer a supplemental drug 
129.24  rebate program for drugs purchased under the medical assistance 
129.25  program.  The commissioner may enter into supplemental rebate 
129.26  contracts with pharmaceutical manufacturers and may require 
129.27  prior authorization for drugs that are from manufacturers that 
129.28  have not signed a supplemental rebate contract.  Prior 
129.29  authorization of drugs shall be subject to the provisions of 
129.30  section 256B.0625, subdivision 13. 
129.31     (24) Operate the department's communication systems account 
129.32  established in Laws 1993, First Special Session chapter 1, 
129.33  article 1, section 2, subdivision 2, to manage shared 
129.34  communication costs necessary for the operation of the programs 
129.35  the commissioner supervises.  A communications account may also 
129.36  be established for each regional treatment center which operates 
130.1   communications systems.  Each account must be used to manage 
130.2   shared communication costs necessary for the operations of the 
130.3   programs the commissioner supervises.  The commissioner may 
130.4   distribute the costs of operating and maintaining communication 
130.5   systems to participants in a manner that reflects actual usage. 
130.6   Costs may include acquisition, licensing, insurance, 
130.7   maintenance, repair, staff time and other costs as determined by 
130.8   the commissioner.  Nonprofit organizations and state, county, 
130.9   and local government agencies involved in the operation of 
130.10  programs the commissioner supervises may participate in the use 
130.11  of the department's communications technology and share in the 
130.12  cost of operation.  The commissioner may accept on behalf of the 
130.13  state any gift, bequest, devise or personal property of any 
130.14  kind, or money tendered to the state for any lawful purpose 
130.15  pertaining to the communication activities of the department.  
130.16  Any money received for this purpose must be deposited in the 
130.17  department's communication systems accounts.  Money collected by 
130.18  the commissioner for the use of communication systems must be 
130.19  deposited in the state communication systems account and is 
130.20  appropriated to the commissioner for purposes of this section. 
130.21     (25) Receive any federal matching money that is made 
130.22  available through the medical assistance program for the 
130.23  consumer satisfaction survey.  Any federal money received for 
130.24  the survey is appropriated to the commissioner for this 
130.25  purpose.  The commissioner may expend the federal money received 
130.26  for the consumer satisfaction survey in either year of the 
130.27  biennium. 
130.28     (26) Incorporate cost reimbursement claims from First Call 
130.29  Minnesota and Greater Twin Cities United Way into the federal 
130.30  cost reimbursement claiming processes of the department 
130.31  according to federal law, rule, and regulations.  Any 
130.32  reimbursement received is appropriated to the commissioner and 
130.33  shall be disbursed to First Call Minnesota and Greater Twin 
130.34  Cities United Way according to normal department payment 
130.35  schedules. 
130.36     (27) Develop recommended standards for foster care homes 
131.1   that address the components of specialized therapeutic services 
131.2   to be provided by foster care homes with those services.  
131.3      Sec. 3.  Minnesota Statutes 2002, section 256.046, 
131.4   subdivision 1, is amended to read: 
131.5      Subdivision 1.  [HEARING AUTHORITY.] A local agency must 
131.6   initiate an administrative fraud disqualification hearing for 
131.7   individuals accused of wrongfully obtaining assistance or 
131.8   intentional program violations, in lieu of a criminal action 
131.9   when it has not been pursued, in the aid to families with 
131.10  dependent children program formerly codified in sections 256.72 
131.11  to 256.87, MFIP, child care assistance programs, general 
131.12  assistance, family general assistance program formerly codified 
131.13  in section 256D.05, subdivision 1, clause (15), Minnesota 
131.14  supplemental aid, medical care, or food stamp programs, general 
131.15  assistance medical care, MinnesotaCare for adults without 
131.16  children, and upon federal approval, all categories of medical 
131.17  assistance and remaining categories of MinnesotaCare except for 
131.18  children through age 18.  The hearing is subject to the 
131.19  requirements of section 256.045 and the requirements in Code of 
131.20  Federal Regulations, title 7, section 273.16, for the food stamp 
131.21  program and title 45, section 235.112, as of September 30, 1995, 
131.22  for the cash grant and medical care programs. 
131.23     Sec. 4.  [256.954] [PRESCRIPTION DRUG DISCOUNT PROGRAM.] 
131.24     Subdivision 1.  [ESTABLISHMENT; ADMINISTRATION.] The 
131.25  commissioner of human services shall establish and administer 
131.26  the prescription drug discount program, effective July 1, 2005.  
131.27     Subd. 2.  [COMMISSIONER'S AUTHORITY.] The commissioner 
131.28  shall administer a drug rebate program for drugs purchased 
131.29  according to the prescription drug discount program.  The 
131.30  commissioner shall require a rebate agreement from all 
131.31  manufacturers of covered drugs as defined in section 256B.0625, 
131.32  subdivision 13.  For each drug, the amount of the rebate shall 
131.33  be equal to the rebate as defined for purposes of the federal 
131.34  rebate program in United States Code, title 42, section 
131.35  1396r-8.  The rebate program shall utilize the terms and 
131.36  conditions used for the federal rebate program established 
132.1   according to section 1927 of title XIX of the federal Social 
132.2   Security Act. 
132.3      Subd. 3.  [DEFINITIONS.] For the purpose of this section, 
132.4   the following terms have the meanings given them: 
132.5      (a) "Commissioner" means the commissioner of human services.
132.6      (b) "Manufacturer" means a manufacturer as defined in 
132.7   section 151.44, paragraph (c). 
132.8      (c) "Covered prescription drug" means a prescription drug 
132.9   as defined in section 151.44, paragraph (d), that is covered 
132.10  under medical assistance as described in section 256B.0625, 
132.11  subdivision 13, and that is provided by a manufacturer that has 
132.12  a fully executed rebate agreement with the commissioner under 
132.13  this section and complies with that agreement.  Multisource 
132.14  drugs for which there are three or more drug products are not 
132.15  subject to the requirements of this section.  This exemption 
132.16  does not apply to innovator multisource drugs.  
132.17     (d) "Health carrier" means an insurance company licensed 
132.18  under chapter 60A to offer, sell, or issue an individual or 
132.19  group policy of accident and sickness insurance as defined in 
132.20  section 62A.01; a nonprofit health service plan corporation 
132.21  operating under chapter 62C; a health maintenance organization 
132.22  operating under chapter 62D; a joint self-insurance employee 
132.23  health plan operating under chapter 62H; a community integrated 
132.24  systems network licensed under chapter 62N; a fraternal benefit 
132.25  society operating under chapter 64B; a city, county, school 
132.26  district, or other political subdivision providing self-insured 
132.27  health coverage under section 461.617 or sections 471.98 to 
132.28  471.982; and a self-funded health plan under the Employee 
132.29  Retirement Income Security Act of 1974, as amended. 
132.30     (e) "Participating pharmacy" means a pharmacy as defined in 
132.31  section 151.01, subdivision 2, that agrees to participate in the 
132.32  prescription drug discount program. 
132.33     (f) "Enrolled individual" means a person who is eligible 
132.34  for the program under subdivision 4 and has enrolled in the 
132.35  program according to subdivision 5. 
132.36     Subd. 4.  [ELIGIBLE PERSONS.] To be eligible for the 
133.1   program, an applicant must: 
133.2      (1) be a permanent resident of Minnesota as defined in 
133.3   section 256L.09, subdivision 4; 
133.4      (2) not be enrolled in medical assistance, general 
133.5   assistance medical care, MinnesotaCare, or the prescription drug 
133.6   program under section 256.955; 
133.7      (3) not be enrolled in and have currently available 
133.8   prescription drug coverage under a health plan offered by a 
133.9   health carrier; 
133.10     (4) not be enrolled in and have currently available 
133.11  prescription drug coverage under a Medicare supplement plan, as 
133.12  defined in sections 62A.31 to 62A.44, or policies, contracts, or 
133.13  certificates that supplement Medicare issued by health 
133.14  maintenance organizations or those policies, contracts, or 
133.15  certificates governed by section 1833 or 1876 of the federal 
133.16  Social Security Act, United States Code, title 42, section 1395, 
133.17  et. seq., as amended; and 
133.18     (5) have a gross household income that does not exceed 250 
133.19  percent of the federal poverty guidelines. 
133.20     Subd. 5.  [APPLICATION PROCEDURE.] (a) Applications and 
133.21  information on the program must be made available at county 
133.22  social services agencies, health care provider offices, and 
133.23  agencies and organizations serving senior citizens.  Individuals 
133.24  shall submit applications and any information specified by the 
133.25  commissioner as being necessary to verify eligibility directly 
133.26  to the commissioner.  The commissioner shall determine an 
133.27  applicant's eligibility for the program within 30 days from the 
133.28  date the application is received.  Eligibility begins the month 
133.29  after approval. 
133.30     (b) The commissioner shall develop an application form that 
133.31  does not exceed one page in length and requires information 
133.32  necessary to determine eligibility for the program. 
133.33     Subd. 6.  [PARTICIPATING PHARMACY.] According to a valid 
133.34  prescription, a participating pharmacy must sell a covered 
133.35  prescription drug to an enrolled individual at the pharmacy's 
133.36  usual and customary retail price, minus an amount that is equal 
134.1   to the rebate amount described in subdivision 8, plus the amount 
134.2   of any administrative fee and switch fee established by the 
134.3   commissioner under subdivision 10.  Each participating pharmacy 
134.4   shall provide the commissioner with all information necessary to 
134.5   administer the program, including, but not limited to, 
134.6   information on prescription drug sales to enrolled individuals 
134.7   and usual and customary retail prices. 
134.8      Subd. 7.  [NOTIFICATION OF REBATE AMOUNT.] The commissioner 
134.9   shall notify each drug manufacturer, each calendar quarter or 
134.10  according to a schedule to be established by the commissioner, 
134.11  of the amount of the rebate owed on the prescription drugs sold 
134.12  by participating pharmacies to enrolled individuals. 
134.13     Subd. 8.  [PROVISION OF REBATE.] To the extent that a 
134.14  manufacturer's prescription drugs are prescribed to a citizen of 
134.15  this state, the manufacturer must provide a rebate equal to the 
134.16  rebate provided under the medical assistance program for any 
134.17  prescription drug distributed by the manufacturer that is 
134.18  purchased by an enrolled individual at a participating 
134.19  pharmacy.  The manufacturer must provide full payment within 30 
134.20  days of receipt of the state invoice for the rebate, or 
134.21  according to a schedule to be established by the commissioner.  
134.22  The commissioner shall deposit all rebates received into the 
134.23  Minnesota prescription drug dedicated fund established under 
134.24  this section.  The manufacturer must provide the commissioner 
134.25  with any information necessary to verify the rebate determined 
134.26  per drug. 
134.27     Subd. 9.  [PAYMENT TO PHARMACIES.] The commissioner shall 
134.28  distribute on a biweekly basis an amount that is equal to an 
134.29  estimate of the rebate amount described in subdivision 8 to each 
134.30  participating pharmacy based on the prescription drugs sold by 
134.31  that pharmacy to enrolled individuals, minus the amount of the 
134.32  administrative fee established by the commissioner under 
134.33  subdivision 10. 
134.34     Subd. 10.  [ADMINISTRATIVE FEE; SWITCH FEE.] The 
134.35  commissioner shall establish a reasonable administrative fee 
134.36  that covers the commissioner's expenses for enrollment, 
135.1   processing claims, repaying the appropriation from the health 
135.2   care access fund over a seven-year period, and distributing 
135.3   rebates under this program.  The commissioner shall establish a 
135.4   reasonable switch fee that covers expenses incurred by 
135.5   pharmacies in formatting for electronic submission claims for 
135.6   prescription drugs sold to enrolled individuals. 
135.7      Subd. 11.  [DEDICATED FUND; CREATION; USE OF FUND.] (a) The 
135.8   Minnesota prescription drug dedicated fund is established as an 
135.9   account in the state treasury.  The commissioner of finance 
135.10  shall credit to the dedicated fund all rebates paid under 
135.11  subdivision 8, any federal funds received for the program, and 
135.12  any appropriations or allocations designated for the fund.  The 
135.13  commissioner of finance shall ensure that fund money is invested 
135.14  under section 11A.25.  All money earned by the fund must be 
135.15  credited to the fund.  The fund shall earn a proportionate share 
135.16  of the total state annual investment income. 
135.17     (b) Money in the fund is appropriated to the commissioner 
135.18  of human services to reimburse participating pharmacies for 
135.19  prescription drug discounts provided to enrolled individuals 
135.20  under this section, to reimburse the commissioner of human 
135.21  services for costs related to enrollment, processing claims, 
135.22  distributing rebates, and for other reasonable administrative 
135.23  costs related to administration of the prescription drug 
135.24  discount program, and to repay the appropriation provided for 
135.25  this section.  The commissioner must administer the program so 
135.26  that the costs total no more than funds appropriated plus the 
135.27  drug rebate proceeds. 
135.28     Subd. 12.  [EXPIRATION.] This section expires upon the 
135.29  effective date of an expanded prescription drug benefit under 
135.30  Medicare. 
135.31     Sec. 5.  Minnesota Statutes 2002, section 256.955, 
135.32  subdivision 2a, is amended to read: 
135.33     Subd. 2a.  [ELIGIBILITY.] An individual satisfying the 
135.34  following requirements and the requirements described in 
135.35  subdivision 2, paragraph (d), is eligible for the prescription 
135.36  drug program: 
136.1      (1) is at least 65 years of age or older; and 
136.2      (2) is eligible as a qualified Medicare beneficiary 
136.3   according to section 256B.057, subdivision 3, or 3a, or 3b, 
136.4   clause (1), or is eligible under section 256B.057, subdivision 
136.5   3, or 3a, or 3b, clause (1), and is also eligible for medical 
136.6   assistance or general assistance medical care with a spenddown 
136.7   as defined in section 256B.056, subdivision 5. 
136.8      Sec. 6.  Minnesota Statutes 2002, section 256.955, 
136.9   subdivision 3, is amended to read: 
136.10     Subd. 3.  [PRESCRIPTION DRUG COVERAGE.] Coverage under the 
136.11  program shall be limited to those prescription drugs that: 
136.12     (1) are covered under the medical assistance program as 
136.13  described in section 256B.0625, subdivision 13; and 
136.14     (2) are provided by manufacturers that have fully executed 
136.15  senior drug rebate agreements with the commissioner and comply 
136.16  with such agreements; and 
136.17     (3) for a specific enrollee, are not covered under an 
136.18  assistance program offered by a pharmaceutical manufacturer, as 
136.19  determined by the board on aging under section 256.975, 
136.20  subdivision 9, except that this shall not apply to qualified 
136.21  individuals under this section who are also eligible for medical 
136.22  assistance with a spenddown as described in subdivision 2a, 
136.23  clause (2), and subdivision 2b, clause (2). 
136.24     <b>[EFFECTIVE DATE.]</b> This section is effective 90 days after 
136.25  implementation by the board of aging of the prescription drug 
136.26  assistance program under section 256.975, subdivision 9. 
136.27     Sec. 7.  Minnesota Statutes 2002, section 256.955, is 
136.28  amended by adding a subdivision to read: 
136.29     Subd. 4a.  [REFERRALS TO PRESCRIPTION DRUG ASSISTANCE 
136.30  PROGRAM.] County social service agencies, in coordination with 
136.31  the commissioner and the Minnesota board on aging, shall refer 
136.32  individuals applying to the prescription drug program, or 
136.33  enrolled in the prescription drug program, to the prescription 
136.34  drug assistance program for all required prescription drugs that 
136.35  the board on aging determines, under section 256.975, 
136.36  subdivision 9, are covered under an assistance program offered 
137.1   by a pharmaceutical manufacturer.  Applicants and enrollees 
137.2   referred to the prescription drug assistance program remain 
137.3   eligible for coverage under the prescription drug program of all 
137.4   prescription drugs covered under subdivision 3.  The board on 
137.5   aging shall phase-in participation of enrollees, over a period 
137.6   of 90 days, after implementation of the program under section 
137.7   256.975, subdivision 9.  This subdivision does not apply to 
137.8   individuals who are also eligible for medical assistance with a 
137.9   spenddown as defined in section 256B.056, subdivision 5. 
137.10     <b>[EFFECTIVE DATE.]</b> This section is effective 90 days after 
137.11  implementation by the board of aging of the prescription drug 
137.12  assistance program under section 256.975, subdivision 9. 
137.13     Sec. 8.  Minnesota Statutes 2002, section 256.955, is 
137.14  amended by adding a subdivision to read: 
137.15     Subd. 10.  [EXPIRATION.] This section expires upon the 
137.16  effective date of an expanded prescription drug benefit under 
137.17  Medicare. 
137.18     Sec. 9.  Minnesota Statutes 2002, section 256.969, 
137.19  subdivision 2b, is amended to read: 
137.20     Subd. 2b.  [OPERATING PAYMENT RATES.] In determining 
137.21  operating payment rates for admissions occurring on or after the 
137.22  rate year beginning January 1, 1991, and every two years after, 
137.23  or more frequently as determined by the commissioner, the 
137.24  commissioner shall obtain operating data from an updated base 
137.25  year and establish operating payment rates per admission for 
137.26  each hospital based on the cost-finding methods and allowable 
137.27  costs of the Medicare program in effect during the base year.  
137.28  Rates under the general assistance medical care, medical 
137.29  assistance, and MinnesotaCare programs shall not be rebased to 
137.30  more current data on January 1, 1997, and January 1, 2005.  The 
137.31  base year operating payment rate per admission is standardized 
137.32  by the case mix index and adjusted by the hospital cost index, 
137.33  relative values, and disproportionate population adjustment.  
137.34  The cost and charge data used to establish operating rates shall 
137.35  only reflect inpatient services covered by medical assistance 
137.36  and shall not include property cost information and costs 
138.1   recognized in outlier payments. 
138.2      Sec. 10.  Minnesota Statutes 2002, section 256.969, 
138.3   subdivision 3a, is amended to read: 
138.4      Subd. 3a.  [PAYMENTS.] (a) Acute care hospital billings 
138.5   under the medical assistance program must not be submitted until 
138.6   the recipient is discharged.  However, the commissioner shall 
138.7   establish monthly interim payments for inpatient hospitals that 
138.8   have individual patient lengths of stay over 30 days regardless 
138.9   of diagnostic category.  Except as provided in section 256.9693, 
138.10  medical assistance reimbursement for treatment of mental illness 
138.11  shall be reimbursed based on diagnostic classifications.  
138.12  Individual hospital payments established under this section and 
138.13  sections 256.9685, 256.9686, and 256.9695, in addition to third 
138.14  party and recipient liability, for discharges occurring during 
138.15  the rate year shall not exceed, in aggregate, the charges for 
138.16  the medical assistance covered inpatient services paid for the 
138.17  same period of time to the hospital.  This payment limitation 
138.18  shall be calculated separately for medical assistance and 
138.19  general assistance medical care services.  The limitation on 
138.20  general assistance medical care shall be effective for 
138.21  admissions occurring on or after July 1, 1991.  Services that 
138.22  have rates established under subdivision 11 or 12, must be 
138.23  limited separately from other services.  After consulting with 
138.24  the affected hospitals, the commissioner may consider related 
138.25  hospitals one entity and may merge the payment rates while 
138.26  maintaining separate provider numbers.  The operating and 
138.27  property base rates per admission or per day shall be derived 
138.28  from the best Medicare and claims data available when rates are 
138.29  established.  The commissioner shall determine the best Medicare 
138.30  and claims data, taking into consideration variables of recency 
138.31  of the data, audit disposition, settlement status, and the 
138.32  ability to set rates in a timely manner.  The commissioner shall 
138.33  notify hospitals of payment rates by December 1 of the year 
138.34  preceding the rate year.  The rate setting data must reflect the 
138.35  admissions data used to establish relative values.  Base year 
138.36  changes from 1981 to the base year established for the rate year 
139.1   beginning January 1, 1991, and for subsequent rate years, shall 
139.2   not be limited to the limits ending June 30, 1987, on the 
139.3   maximum rate of increase under subdivision 1.  The commissioner 
139.4   may adjust base year cost, relative value, and case mix index 
139.5   data to exclude the costs of services that have been 
139.6   discontinued by the October 1 of the year preceding the rate 
139.7   year or that are paid separately from inpatient services.  
139.8   Inpatient stays that encompass portions of two or more rate 
139.9   years shall have payments established based on payment rates in 
139.10  effect at the time of admission unless the date of admission 
139.11  preceded the rate year in effect by six months or more.  In this 
139.12  case, operating payment rates for services rendered during the 
139.13  rate year in effect and established based on the date of 
139.14  admission shall be adjusted to the rate year in effect by the 
139.15  hospital cost index. 
139.16     (b) For fee-for-service admissions occurring on or after 
139.17  July 1, 2002, the total payment, before third-party liability 
139.18  and spenddown, made to hospitals for inpatient services is 
139.19  reduced by .5 percent from the current statutory rates.  
139.20     (c) In addition to the reduction in paragraph (b), the 
139.21  total payment for fee-for-service admissions occurring on or 
139.22  after July 1, 2003, made to hospitals for inpatient services 
139.23  before third-party liability and spenddown, is reduced 2.5 
139.24  percent from the current statutory rates.  Mental health 
139.25  services within diagnosis related groups 424 to 432, and 
139.26  facilities defined under subdivision 16 are excluded from this 
139.27  paragraph. 
139.28     Sec. 11.  Minnesota Statutes 2002, section 256.975, is 
139.29  amended by adding a subdivision to read: 
139.30     Subd. 9.  [PRESCRIPTION DRUG ASSISTANCE.] (a) The Minnesota 
139.31  board on aging shall establish and administer a prescription 
139.32  drug assistance program to assist individuals in accessing 
139.33  programs offered by pharmaceutical manufacturers that provide 
139.34  free or discounted prescription drugs or provide coverage for 
139.35  prescription drugs.  The board shall use computer software 
139.36  programs to link individuals with the pharmaceutical assistance 
140.1   programs most appropriate for the individual.  The board shall 
140.2   make information on the prescription drug assistance program 
140.3   available to interested individuals and health care providers 
140.4   and shall coordinate the program with the statewide information 
140.5   and assistance services provided through the Senior LinkAge Line 
140.6   under subdivision 7. 
140.7      (b) The board shall work with the commissioner and county 
140.8   social service agencies to coordinate the enrollment of 
140.9   individuals who are referred to the prescription drug assistance 
140.10  program from the prescription drug program, as required under 
140.11  section 256.955, subdivision 4a. 
140.12     Sec. 12.  Minnesota Statutes 2002, section 256.98, 
140.13  subdivision 3, is amended to read: 
140.14     Subd. 3.  [AMOUNT OF ASSISTANCE INCORRECTLY PAID.] The 
140.15  amount of the assistance incorrectly paid under this section is: 
140.16     (a) the difference between the amount of assistance 
140.17  actually received on the basis of misrepresented or concealed 
140.18  facts and the amount to which the recipient would have been 
140.19  entitled had the specific concealment or misrepresentation not 
140.20  occurred.  Unless required by law, rule, or regulation, earned 
140.21  income disregards shall not be applied to earnings not reported 
140.22  by the recipient; or 
140.23     (b) equal to all payments for health care services, 
140.24  including capitation payments made to a health plan, made on 
140.25  behalf of a person enrolled in MinnesotaCare, medical 
140.26  assistance, or general assistance medical care, for which the 
140.27  person was not entitled due to the concealment or 
140.28  misrepresentation of facts. 
140.29     Sec. 13.  Minnesota Statutes 2002, section 256.98, 
140.30  subdivision 4, is amended to read: 
140.31     Subd. 4.  [RECOVERY OF ASSISTANCE.] The amount of 
140.32  assistance determined to have been incorrectly paid is 
140.33  recoverable from: 
140.34     (1) the recipient or the recipient's estate by the county 
140.35  or the state as a debt due the county or the state or both; and 
140.36     (2) any person found to have taken independent action to 
141.1   establish eligibility for, conspired with, or aided and abetted, 
141.2   any recipient of public assistance found to have been 
141.3   incorrectly paid. 
141.4      The obligations established under this subdivision shall be 
141.5   joint and several and shall extend to all cases involving client 
141.6   error as well as cases involving wrongfully obtained assistance. 
141.7      MinnesotaCare participants who have been found to have 
141.8   wrongfully obtained assistance as described in subdivision 1, 
141.9   but who otherwise remain eligible for the program, may agree to 
141.10  have their MinnesotaCare premiums increased by an amount equal 
141.11  to ten percent of their premiums or $10 per month, whichever is 
141.12  greater, until the debt is satisfied. 
141.13     Sec. 14.  Minnesota Statutes 2002, section 256.98, 
141.14  subdivision 8, is amended to read: 
141.15     Subd. 8.  [DISQUALIFICATION FROM PROGRAM.] (a) Any person 
141.16  found to be guilty of wrongfully obtaining assistance by a 
141.17  federal or state court or by an administrative hearing 
141.18  determination, or waiver thereof, through a disqualification 
141.19  consent agreement, or as part of any approved diversion plan 
141.20  under section 401.065, or any court-ordered stay which carries 
141.21  with it any probationary or other conditions, in the Minnesota 
141.22  family investment program, the food stamp program, the general 
141.23  assistance program, the group residential housing program, or 
141.24  the Minnesota supplemental aid program shall be disqualified 
141.25  from that program.  In addition, any person disqualified from 
141.26  the Minnesota family investment program shall also be 
141.27  disqualified from the food stamp program.  The needs of that 
141.28  individual shall not be taken into consideration in determining 
141.29  the grant level for that assistance unit:  
141.30     (1) for one year after the first offense; 
141.31     (2) for two years after the second offense; and 
141.32     (3) permanently after the third or subsequent offense.  
141.33     The period of program disqualification shall begin on the 
141.34  date stipulated on the advance notice of disqualification 
141.35  without possibility of postponement for administrative stay or 
141.36  administrative hearing and shall continue through completion 
142.1   unless and until the findings upon which the sanctions were 
142.2   imposed are reversed by a court of competent jurisdiction.  The 
142.3   period for which sanctions are imposed is not subject to 
142.4   review.  The sanctions provided under this subdivision are in 
142.5   addition to, and not in substitution for, any other sanctions 
142.6   that may be provided for by law for the offense involved.  A 
142.7   disqualification established through hearing or waiver shall 
142.8   result in the disqualification period beginning immediately 
142.9   unless the person has become otherwise ineligible for 
142.10  assistance.  If the person is ineligible for assistance, the 
142.11  disqualification period begins when the person again meets the 
142.12  eligibility criteria of the program from which they were 
142.13  disqualified and makes application for that program. 
142.14     (b) A family receiving assistance through child care 
142.15  assistance programs under chapter 119B with a family member who 
142.16  is found to be guilty of wrongfully obtaining child care 
142.17  assistance by a federal court, state court, or an administrative 
142.18  hearing determination or waiver, through a disqualification 
142.19  consent agreement, as part of an approved diversion plan under 
142.20  section 401.065, or a court-ordered stay with probationary or 
142.21  other conditions, is disqualified from child care assistance 
142.22  programs.  The disqualifications must be for periods of three 
142.23  months, six months, and two years for the first, second, and 
142.24  third offenses respectively.  Subsequent violations must result 
142.25  in permanent disqualification.  During the disqualification 
142.26  period, disqualification from any child care program must extend 
142.27  to all child care programs and must be immediately applied. 
142.28     (c) Any person found to be guilty of wrongfully obtaining 
142.29  general assistance medical care, MinnesotaCare for adults 
142.30  without children, and upon federal approval, all categories of 
142.31  medical assistance and remaining categories of MinnesotaCare, 
142.32  except for children through age 18, by a federal or state court 
142.33  or by an administrative hearing determination, or waiver 
142.34  thereof, through a disqualification consent agreement, or as 
142.35  part of any approved diversion plan under section 401.065, or 
142.36  any court-ordered stay which carries with it any probationary or 
143.1   other conditions, is disqualified from that program.  The period 
143.2   of disqualification is one year after the first offense, two 
143.3   years after the second offense, and permanently after the third 
143.4   or subsequent offense.  The period of program disqualification 
143.5   shall begin on the date stipulated on the advance notice of 
143.6   disqualification without possibility of postponement for 
143.7   administrative stay or administrative hearing and shall continue 
143.8   through completion unless and until the findings upon which the 
143.9   sanctions were imposed are reversed by a court of competent 
143.10  jurisdiction.  The period for which sanctions are imposed is not 
143.11  subject to review.  The sanctions provided under this 
143.12  subdivision are in addition to, and not in substitution for, any 
143.13  other sanctions that may be provided for by law for the offense 
143.14  involved. 
143.15     Sec. 15.  Minnesota Statutes 2002, section 256B.055, is 
143.16  amended by adding a subdivision to read: 
143.17     Subd. 13.  [RESIDENTS OF INSTITUTIONS FOR MENTAL DISEASES.] 
143.18  Beginning October 1, 2003, persons who would be eligible for 
143.19  medical assistance under this chapter but for residing in a 
143.20  facility that is determined by the commissioner or the federal 
143.21  Centers for Medicare and Medicaid Services to be an institution 
143.22  for mental diseases are eligible for medical assistance without 
143.23  federal financial participation, except that coverage shall not 
143.24  include payment for a nursing facility determined to be an 
143.25  institution for mental diseases. 
143.26     Sec. 16.  Minnesota Statutes 2002, section 256B.056, 
143.27  subdivision 1a, is amended to read: 
143.28     Subd. 1a.  [INCOME AND ASSETS GENERALLY.] Unless 
143.29  specifically required by state law or rule or federal law or 
143.30  regulation, the methodologies used in counting income and assets 
143.31  to determine eligibility for medical assistance for persons 
143.32  whose eligibility category is based on blindness, disability, or 
143.33  age of 65 or more years, the methodologies for the supplemental 
143.34  security income program shall be used.  Increases in benefits 
143.35  under title II of the Social Security Act shall not be counted 
143.36  as income for purposes of this subdivision until July 1 of each 
144.1   year.  Effective upon federal approval, for children eligible 
144.2   under section 256B.055, subdivision 12, or for home and 
144.3   community-based waiver services whose eligibility for medical 
144.4   assistance is determined without regard to parental income, 
144.5   child support payments, including any payments made by an 
144.6   obligor in satisfaction of or in addition to a temporary or 
144.7   permanent order for child support, and social security payments 
144.8   are not counted as income.  For families and children, which 
144.9   includes all other eligibility categories, the methodologies 
144.10  under the state's AFDC plan in effect as of July 16, 1996, as 
144.11  required by the Personal Responsibility and Work Opportunity 
144.12  Reconciliation Act of 1996 (PRWORA), Public Law Number 104-193, 
144.13  shall be used, except that effective July 1, 2002, the $90 and 
144.14  $30 and one-third earned income disregards shall not apply and 
144.15  the disregard specified in subdivision 1c shall apply October 1, 
144.16  2003, the earned income disregards and deductions are limited to 
144.17  those in subdivision 1c.  For these purposes, a "methodology" 
144.18  does not include an asset or income standard, or accounting 
144.19  method, or method of determining effective dates. 
144.20     Sec. 17.  Minnesota Statutes 2002, section 256B.056, 
144.21  subdivision 1c, is amended to read: 
144.22     Subd. 1c.  [FAMILIES WITH CHILDREN INCOME METHODOLOGY.] 
144.23  (a)(1) For children ages one to five whose eligibility is 
144.24  determined under section 256B.057, subdivision 2, 21 percent of 
144.25  countable earned income shall be disregarded for up to four 
144.26  months.  This clause expires July 1, 2003. 
144.27     (2) For children ages one through 18 whose eligibility is 
144.28  determined under section 256B.057, subdivision 2, the following 
144.29  deductions shall be applied to income counted toward the child's 
144.30  eligibility as allowed under the state's AFDC plan in effect as 
144.31  of July 16, 1996:  $90 work expense, dependent care, and child 
144.32  support paid under court order.  This clause is effective 
144.33  October 1, 2003. 
144.34     (b) For families with children whose eligibility is 
144.35  determined using the standard specified in section 256B.056, 
144.36  subdivision 4, paragraph (c), 17 percent of countable earned 
145.1   income shall be disregarded for up to four months and the 
145.2   following deductions shall be applied to each individual's 
145.3   income counted toward eligibility as allowed under the state's 
145.4   AFDC plan in effect as of July 16, 1996:  dependent care and 
145.5   child support paid under court order. 
145.6      (c) If the four month disregard in paragraph (b) has been 
145.7   applied to the wage earner's income for four months, the 
145.8   disregard shall not be applied again until the wage earner's 
145.9   income has not been considered in determining medical assistance 
145.10  eligibility for 12 consecutive months.  
145.11     <b>[EFFECTIVE DATE.]</b> The amendments to paragraphs (b) and (c) 
145.12  are effective July 1, 2003. 
145.13     Sec. 18.  Minnesota Statutes 2002, section 256B.057, 
145.14  subdivision 1, is amended to read: 
145.15     Subdivision 1.  [PREGNANT WOMEN AND INFANTS.] (a) An infant 
145.16  less than one year of age or a pregnant woman who has written 
145.17  verification of a positive pregnancy test from a physician or 
145.18  licensed registered nurse, is eligible for medical assistance if 
145.19  countable family income is equal to or less than 275 percent of 
145.20  the federal poverty guideline for the same family size.  A 
145.21  pregnant woman who has written verification of a positive 
145.22  pregnancy test from a physician or licensed registered nurse is 
145.23  eligible for medical assistance if countable family income is 
145.24  equal to or less than 200 percent of the federal poverty 
145.25  guideline for the same family size.  For purposes of this 
145.26  subdivision, "countable family income" means the amount of 
145.27  income considered available using the methodology of the AFDC 
145.28  program under the state's AFDC plan as of July 16, 1996, as 
145.29  required by the Personal Responsibility and Work Opportunity 
145.30  Reconciliation Act of 1996 (PRWORA), Public Law Number 104-193, 
145.31  except for the earned income disregard and employment deductions.
145.32     (b) An amount equal to the amount of earned income 
145.33  exceeding 275 percent of the federal poverty guideline, up to a 
145.34  maximum of the amount by which the combined total of 185 percent 
145.35  of the federal poverty guideline plus the earned income 
145.36  disregards and deductions of the AFDC program under the state's 
146.1   AFDC plan as of July 16, 1996, as required by the Personal 
146.2   Responsibility and Work Opportunity Reconciliation Act of 1996 
146.3   (PRWORA), Public Law Number 104-193, exceeds 275 percent of the 
146.4   federal poverty guideline will be deducted for pregnant women 
146.5   and infants less than one year of age.  This paragraph expires 
146.6   July 1, 2003. 
146.7      (c) Dependent care and child support paid under court order 
146.8   shall be deducted from the countable income of pregnant women. 
146.9      (b) (d) An infant born on or after January 1, 1991, to a 
146.10  woman who was eligible for and receiving medical assistance on 
146.11  the date of the child's birth shall continue to be eligible for 
146.12  medical assistance without redetermination until the child's 
146.13  first birthday, as long as the child remains in the woman's 
146.14  household. 
146.15     <b>[EFFECTIVE DATE.]</b> This section is effective February 1, 
146.16  2004, or upon federal approval, whichever is later, except where 
146.17  a different date is specified in the text. 
146.18     Sec. 19.  Minnesota Statutes 2002, section 256B.057, 
146.19  subdivision 2, is amended to read: 
146.20     Subd. 2.  [CHILDREN.] Except as specified in subdivision 
146.21  1b, effective July 1, 2002 October 1, 2003, a child one through 
146.22  18 years of age in a family whose countable income is no greater 
146.23  than 170 150 percent of the federal poverty guidelines for the 
146.24  same family size, is eligible for medical assistance.  
146.25     Sec. 20.  Minnesota Statutes 2002, section 256B.057, 
146.26  subdivision 3b, is amended to read: 
146.27     Subd. 3b.  [QUALIFYING INDIVIDUALS.] Beginning July 1, 
146.28  1998, to the extent of the federal allocation to Minnesota 
146.29  contingent upon federal funding, a person who would otherwise be 
146.30  eligible as a qualified Medicare beneficiary under subdivision 
146.31  3, except that the person's income is in excess of the limit, is 
146.32  eligible as a qualifying individual according to the following 
146.33  criteria: 
146.34     (1) if the person's income is greater than 120 percent, but 
146.35  less than 135 percent of the official federal poverty guidelines 
146.36  for the applicable family size, the person is eligible for 
147.1   medical assistance reimbursement of Medicare Part B premiums; or 
147.2      (2) if the person's income is equal to or greater than 135 
147.3   percent but less than 175 percent of the official federal 
147.4   poverty guidelines for the applicable family size, the person is 
147.5   eligible for medical assistance reimbursement of that portion of 
147.6   the Medicare Part B premium attributable to an increase in Part 
147.7   B expenditures which resulted from the shift of home care 
147.8   services from Medicare Part A to Medicare Part B under Public 
147.9   Law Number 105-33, section 4732, the Balanced Budget Act of 1997.
147.10     The commissioner shall limit enrollment of qualifying 
147.11  individuals under this subdivision according to the requirements 
147.12  of Public Law Number 105-33, section 4732. 
147.13     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
147.14     Sec. 21.  Minnesota Statutes 2002, section 256B.057, 
147.15  subdivision 9, is amended to read: 
147.16     Subd. 9.  [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 
147.17  assistance may be paid for a person who is employed and who: 
147.18     (1) meets the definition of disabled under the supplemental 
147.19  security income program; 
147.20     (2) is at least 16 but less than 65 years of age; 
147.21     (3) meets the asset limits in paragraph (b); and 
147.22     (4) effective November 1, 2003, pays a premium, if 
147.23  required, and other obligations under paragraph (c) (d).  
147.24  Any spousal income or assets shall be disregarded for purposes 
147.25  of eligibility and premium determinations. 
147.26     After the month of enrollment, a person enrolled in medical 
147.27  assistance under this subdivision who: 
147.28     (1) is temporarily unable to work and without receipt of 
147.29  earned income due to a medical condition, as verified by a 
147.30  physician, may retain eligibility for up to four calendar 
147.31  months; or 
147.32     (2) effective January 1, 2004, loses employment for reasons 
147.33  not attributable to the enrollee, may retain eligibility for up 
147.34  to four consecutive months after the month of job loss.  To 
147.35  receive a four-month extension, enrollees must verify the 
147.36  medical condition or provide notification of job loss.  All 
148.1   other eligibility requirements must be met and the enrollee must 
148.2   pay all calculated premium costs for continued eligibility. 
148.3      (b) For purposes of determining eligibility under this 
148.4   subdivision, a person's assets must not exceed $20,000, 
148.5   excluding: 
148.6      (1) all assets excluded under section 256B.056; 
148.7      (2) retirement accounts, including individual accounts, 
148.8   401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 
148.9      (3) medical expense accounts set up through the person's 
148.10  employer. 
148.11     (c)(1) Effective January 1, 2004, for purposes of 
148.12  eligibility, there will be a $65 earned income disregard.  To be 
148.13  eligible, a person applying for medical assistance under this 
148.14  subdivision must have earned income above the disregard level. 
148.15     (2) Effective January 1, 2004, to be considered earned 
148.16  income, Medicare, social security, and applicable state and 
148.17  federal income taxes must be withheld.  To be eligible, a person 
148.18  must document earned income tax withholding. 
148.19     (d)(1) A person whose earned and unearned income is equal 
148.20  to or greater than 100 percent of federal poverty guidelines for 
148.21  the applicable family size must pay a premium to be eligible for 
148.22  medical assistance under this subdivision.  The premium shall be 
148.23  based on the person's gross earned and unearned income and the 
148.24  applicable family size using a sliding fee scale established by 
148.25  the commissioner, which begins at one percent of income at 100 
148.26  percent of the federal poverty guidelines and increases to 7.5 
148.27  percent of income for those with incomes at or above 300 percent 
148.28  of the federal poverty guidelines.  Annual adjustments in the 
148.29  premium schedule based upon changes in the federal poverty 
148.30  guidelines shall be effective for premiums due in July of each 
148.31  year.  
148.32     (2) Effective January 1, 2004, all enrollees must pay a 
148.33  premium to be eligible for medical assistance under this 
148.34  subdivision.  An enrollee shall pay the greater of a $35 premium 
148.35  or the premium calculated in clause (1). 
148.36     (3) Effective November 1, 2003, all enrollees who receive 
149.1   unearned income must pay one-half of one percent of unearned 
149.2   income in addition to the premium amount. 
149.3      (4) Effective November 1, 2003, for enrollees whose income 
149.4   does not exceed 150 percent of the federal poverty guidelines 
149.5   and who are also enrolled in Medicare, the commissioner must 
149.6   reimburse the enrollee for Medicare Part B premiums under 
149.7   section 256B.0625, subdivision 15, paragraph (a). 
149.8      (d) (e) A person's eligibility and premium shall be 
149.9   determined by the local county agency.  Premiums must be paid to 
149.10  the commissioner.  All premiums are dedicated to the 
149.11  commissioner. 
149.12     (e) (f) Any required premium shall be determined at 
149.13  application and redetermined annually at recertification at the 
149.14  enrollee's six-month income review or when a change in income or 
149.15  family household size occurs is reported.  Enrollees must report 
149.16  any change in income or household size within ten days of when 
149.17  the change occurs.  A decreased premium resulting from a 
149.18  reported change in income or household size shall be effective 
149.19  the first day of the next available billing month after the 
149.20  change is reported.  Except for changes occurring from annual 
149.21  cost-of-living increases or verification of income under section 
149.22  256B.061, paragraph (b), a change resulting in an increased 
149.23  premium shall not affect the premium amount until the next 
149.24  six-month review. 
149.25     (f) (g) Premium payment is due upon notification from the 
149.26  commissioner of the premium amount required.  Premiums may be 
149.27  paid in installments at the discretion of the commissioner. 
149.28     (g) (h) Nonpayment of the premium shall result in denial or 
149.29  termination of medical assistance unless the person demonstrates 
149.30  good cause for nonpayment.  Good cause exists if the 
149.31  requirements specified in Minnesota Rules, part 9506.0040, 
149.32  subpart 7, items B to D, are met.  Except when an installment 
149.33  agreement is accepted by the commissioner, all persons 
149.34  disenrolled for nonpayment of a premium must pay any past due 
149.35  premiums as well as current premiums due prior to being 
149.36  reenrolled.  Nonpayment shall include payment with a returned, 
150.1   refused, or dishonored instrument.  The commissioner may require 
150.2   a guaranteed form of payment as the only means to replace a 
150.3   returned, refused, or dishonored instrument. 
150.4      <b>[EFFECTIVE DATE.]</b> This section is effective November 1, 
150.5   2003, except the amendments to Minnesota Statutes 2002, section 
150.6   256B.057, subdivision 9, paragraphs (e) and (g), are effective 
150.7   July 1, 2003. 
150.8      Sec. 22.  Minnesota Statutes 2002, section 256B.057, 
150.9   subdivision 10, is amended to read: 
150.10     Subd. 10.  [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR 
150.11  CERVICAL CANCER.] (a) Medical assistance may be paid for a 
150.12  person who: 
150.13     (1) has been screened for breast or cervical cancer by the 
150.14  Minnesota breast and cervical cancer control program, and 
150.15  program funds have been used to pay for the person's screening; 
150.16     (2) according to the person's treating health professional, 
150.17  needs treatment, including diagnostic services necessary to 
150.18  determine the extent and proper course of treatment, for breast 
150.19  or cervical cancer, including precancerous conditions and early 
150.20  stage cancer; 
150.21     (3) meets the income eligibility guidelines for the 
150.22  Minnesota breast and cervical cancer control program; 
150.23     (4) is under age 65; 
150.24     (5) is not otherwise eligible for medical assistance under 
150.25  United States Code, title 42, section 1396(a)(10)(A)(i); and 
150.26     (6) is not otherwise covered under creditable coverage, as 
150.27  defined under United States Code, title 42, section 
150.28  300gg(c) 1396a(aa). 
150.29     (b) Medical assistance provided for an eligible person 
150.30  under this subdivision shall be limited to services provided 
150.31  during the period that the person receives treatment for breast 
150.32  or cervical cancer. 
150.33     (c) A person meeting the criteria in paragraph (a) is 
150.34  eligible for medical assistance without meeting the eligibility 
150.35  criteria relating to income and assets in section 256B.056, 
150.36  subdivisions 1a to 5b. 
151.1      Sec. 23.  Minnesota Statutes 2002, section 256B.0595, 
151.2   subdivision 1, is amended to read: 
151.3      Subdivision 1.  [PROHIBITED TRANSFERS.] (a) For transfers 
151.4   of assets made on or before August 10, 1993, if a person or the 
151.5   person's spouse has given away, sold, or disposed of, for less 
151.6   than fair market value, any asset or interest therein, except 
151.7   assets other than the homestead that are excluded under the 
151.8   supplemental security program, within 30 months before or any 
151.9   time after the date of institutionalization if the person has 
151.10  been determined eligible for medical assistance, or within 30 
151.11  months before or any time after the date of the first approved 
151.12  application for medical assistance if the person has not yet 
151.13  been determined eligible for medical assistance, the person is 
151.14  ineligible for long-term care services for the period of time 
151.15  determined under subdivision 2.  
151.16     (b) Effective for transfers made after August 10, 1993, a 
151.17  person, a person's spouse, or any person, court, or 
151.18  administrative body with legal authority to act in place of, on 
151.19  behalf of, at the direction of, or upon the request of the 
151.20  person or person's spouse, may not give away, sell, or dispose 
151.21  of, for less than fair market value, any asset or interest 
151.22  therein, except assets other than the homestead that are 
151.23  excluded under the supplemental security income program, for the 
151.24  purpose of establishing or maintaining medical assistance 
151.25  eligibility.  This applies to all transfers, including those 
151.26  made by a community spouse after the month in which the 
151.27  institutionalized spouse is determined eligible for medical 
151.28  assistance.  For purposes of determining eligibility for 
151.29  long-term care services, any transfer of such assets within 36 
151.30  months before or any time after an institutionalized person 
151.31  applies for medical assistance, or 36 months before or any time 
151.32  after a medical assistance recipient becomes institutionalized, 
151.33  for less than fair market value may be considered.  Any such 
151.34  transfer is presumed to have been made for the purpose of 
151.35  establishing or maintaining medical assistance eligibility and 
151.36  the person is ineligible for long-term care services for the 
152.1   period of time determined under subdivision 2, unless the person 
152.2   furnishes convincing evidence to establish that the transaction 
152.3   was exclusively for another purpose, or unless the transfer is 
152.4   permitted under subdivision 3 or 4.  Notwithstanding the 
152.5   provisions of this paragraph, in the case of payments from a 
152.6   trust or portions of a trust that are considered transfers of 
152.7   assets under federal law, any transfers made within 60 months 
152.8   before or any time after an institutionalized person applies for 
152.9   medical assistance and within 60 months before or any time after 
152.10  a medical assistance recipient becomes institutionalized, may be 
152.11  considered. 
152.12     (c) This section applies to transfers, for less than fair 
152.13  market value, of income or assets, including assets that are 
152.14  considered income in the month received, such as inheritances, 
152.15  court settlements, and retroactive benefit payments or income to 
152.16  which the person or the person's spouse is entitled but does not 
152.17  receive due to action by the person, the person's spouse, or any 
152.18  person, court, or administrative body with legal authority to 
152.19  act in place of, on behalf of, at the direction of, or upon the 
152.20  request of the person or the person's spouse.  
152.21     (d) This section applies to payments for care or personal 
152.22  services provided by a relative, unless the compensation was 
152.23  stipulated in a notarized, written agreement which was in 
152.24  existence when the service was performed, the care or services 
152.25  directly benefited the person, and the payments made represented 
152.26  reasonable compensation for the care or services provided.  A 
152.27  notarized written agreement is not required if payment for the 
152.28  services was made within 60 days after the service was provided. 
152.29     (e) This section applies to the portion of any asset or 
152.30  interest that a person, a person's spouse, or any person, court, 
152.31  or administrative body with legal authority to act in place of, 
152.32  on behalf of, at the direction of, or upon the request of the 
152.33  person or the person's spouse, transfers to any annuity that 
152.34  exceeds the value of the benefit likely to be returned to the 
152.35  person or spouse while alive, based on estimated life expectancy 
152.36  using the life expectancy tables employed by the supplemental 
153.1   security income program to determine the value of an agreement 
153.2   for services for life.  The commissioner may adopt rules 
153.3   reducing life expectancies based on the need for long-term 
153.4   care.  This section applies to an annuity described in this 
153.5   paragraph purchased on or after March 1, 2002, that: 
153.6      (1) is not purchased from an insurance company or financial 
153.7   institution that is subject to licensing or regulation by the 
153.8   Minnesota department of commerce or a similar regulatory agency 
153.9   of another state; 
153.10     (2) does not pay out principal and interest in equal 
153.11  monthly installments; or 
153.12     (3) does not begin payment at the earliest possible date 
153.13  after annuitization.  
153.14     (f) For purposes of this section, long-term care services 
153.15  include services in a nursing facility, services that are 
153.16  eligible for payment according to section 256B.0625, subdivision 
153.17  2, because they are provided in a swing bed, intermediate care 
153.18  facility for persons with mental retardation, and home and 
153.19  community-based services provided pursuant to sections 
153.20  256B.0915, 256B.092, and 256B.49.  For purposes of this 
153.21  subdivision and subdivisions 2, 3, and 4, "institutionalized 
153.22  person" includes a person who is an inpatient in a nursing 
153.23  facility or in a swing bed, or intermediate care facility for 
153.24  persons with mental retardation or who is receiving home and 
153.25  community-based services under sections 256B.0915, 256B.092, and 
153.26  256B.49. 
153.27     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003.  
153.28     Sec. 24.  Minnesota Statutes 2002, section 256B.0595, is 
153.29  amended by adding a subdivision to read: 
153.30     Subd. 1b.  [PROHIBITED TRANSFERS.] (a) Notwithstanding any 
153.31  contrary provisions of this section, this subdivision applies to 
153.32  transfers involving recipients of medical assistance that are 
153.33  made on or after July 1, 2003, and to all transfers involving 
153.34  persons who apply for medical assistance on or after July 1, 
153.35  2003, if the transfer occurred within 72 months before the 
153.36  person applies for medical assistance, except that this 
154.1   subdivision does not apply to transfers made prior to July 1, 
154.2   2003.  A person, a person's spouse, or any person, court, or 
154.3   administrative body with legal authority to act in place of, on 
154.4   behalf of, at the direction of, or upon the request of the 
154.5   person or the person's spouse, may not give away, sell, dispose 
154.6   of, or reduce ownership or control of any income, asset, or 
154.7   interest therein for less than fair market value for the purpose 
154.8   of establishing or maintaining medical assistance eligibility.  
154.9   This applies to all transfers, including those made by a 
154.10  community spouse after the month in which the institutionalized 
154.11  spouse is determined eligible for medical assistance.  For 
154.12  purposes of determining eligibility for medical assistance 
154.13  services, any transfer of such income or assets for less than 
154.14  fair market value within 72 months before or any time after a 
154.15  person applies for medical assistance may be considered.  Any 
154.16  such transfer is presumed to have been made for the purpose of 
154.17  establishing or maintaining medical assistance eligibility, and 
154.18  the person is ineligible for medical assistance services for the 
154.19  period of time determined under subdivision 2b, unless the 
154.20  person furnishes convincing evidence to establish that the 
154.21  transaction was exclusively for another purpose or unless the 
154.22  transfer is permitted under subdivision 3b or 4b. 
154.23     (b) This section applies to transfers to trusts.  The 
154.24  commissioner shall determine valid trust purposes under this 
154.25  section.  Assets placed into a trust that is not for a valid 
154.26  purpose shall always be considered available for the purposes of 
154.27  medical assistance eligibility, regardless of when the trust is 
154.28  established. 
154.29     (c) This section applies to transfers of income or assets 
154.30  for less than fair market value, including assets that are 
154.31  considered income in the month received, such as inheritances, 
154.32  court settlements, and retroactive benefit payments or income to 
154.33  which the person or the person's spouse is entitled but does not 
154.34  receive due to action by the person, the person's spouse, or any 
154.35  person, court, or administrative body with legal authority to 
154.36  act in place of, on behalf of, at the direction of, or upon the 
155.1   request of the person or the person's spouse. 
155.2      (d) This section applies to payments for care or personal 
155.3   services provided by a relative, unless the compensation was 
155.4   stipulated in a notarized written agreement that was in 
155.5   existence when the service was performed, the care or services 
155.6   directly benefited the person, and the payments made represented 
155.7   reasonable compensation for the care or services provided.  A 
155.8   notarized written agreement is not required if payment for the 
155.9   services was made within 60 days after the service was provided. 
155.10     (e) This section applies to the portion of any income, 
155.11  asset, or interest therein that a person, a person's spouse, or 
155.12  any person, court, or administrative body with legal authority 
155.13  to act in place of, on behalf of, at the direction of, or upon 
155.14  the request of the person or the person's spouse, transfers to 
155.15  any annuity that exceeds the value of the benefit likely to be 
155.16  returned to the person or the person's spouse while alive, based 
155.17  on estimated life expectancy, using the life expectancy tables 
155.18  employed by the supplemental security income program, or based 
155.19  on a shorter life expectancy if the annuitant had a medical 
155.20  condition that would shorten the annuitant's life expectancy and 
155.21  that was diagnosed before funds were placed into the annuity.  
155.22  The agency may request and receive a physician's statement to 
155.23  determine if the annuitant had a diagnosed medical condition 
155.24  that would shorten the annuitant's life expectancy.  If so, the 
155.25  agency shall determine the expected value of the benefits based 
155.26  upon the physician's statement instead of using a life 
155.27  expectancy table.  This section applies to an annuity described 
155.28  in this paragraph purchased on or after March 1, 2002, that: 
155.29     (1) is not purchased from an insurance company or financial 
155.30  institution that is subject to licensing or regulation by the 
155.31  Minnesota department of commerce or a similar regulatory agency 
155.32  of another state; 
155.33     (2) does not pay out principal and interest in equal 
155.34  monthly installments; or 
155.35     (3) does not begin payment at the earliest possible date 
155.36  after annuitization. 
156.1      (f) Transfers under this section shall affect 
156.2   determinations of eligibility for all medical assistance 
156.3   services or long-term care services, whichever receives federal 
156.4   approval. 
156.5      <b>[EFFECTIVE DATE.]</b> (a) This section is effective July 1, 
156.6   2003, to the extent permitted by federal law.  If any provision 
156.7   of this section is prohibited by federal law, the provision 
156.8   shall become effective when federal law is changed to permit its 
156.9   application or a waiver is received.  The commissioner of human 
156.10  services shall notify the revisor of statutes when federal law 
156.11  is enacted or a waiver or other federal approval is received and 
156.12  publish a notice in the State Register.  The commissioner must 
156.13  include the notice in the first State Register published after 
156.14  the effective date of the federal changes. 
156.15     (b) If, by July 1, 2003, any provision of this section is 
156.16  not effective because of prohibitions in federal law, the 
156.17  commissioner of human services shall apply to the federal 
156.18  government by August 1, 2003, for a waiver of those prohibitions 
156.19  or other federal authority, and that provision shall become 
156.20  effective upon receipt of a federal waiver or other federal 
156.21  approval, notification to the revisor of statutes, and 
156.22  publication of a notice in the State Register to that effect.  
156.23  In applying for federal approval to extend the lookback period, 
156.24  the commissioner shall seek the longest lookback period the 
156.25  federal government will approve, not to exceed 72 months. 
156.26     Sec. 25.  Minnesota Statutes 2002, section 256B.0595, 
156.27  subdivision 2, is amended to read: 
156.28     Subd. 2.  [PERIOD OF INELIGIBILITY.] (a) For any 
156.29  uncompensated transfer occurring on or before August 10, 1993, 
156.30  the number of months of ineligibility for long-term care 
156.31  services shall be the lesser of 30 months, or the uncompensated 
156.32  transfer amount divided by the average medical assistance rate 
156.33  for nursing facility services in the state in effect on the date 
156.34  of application.  The amount used to calculate the average 
156.35  medical assistance payment rate shall be adjusted each July 1 to 
156.36  reflect payment rates for the previous calendar year.  The 
157.1   period of ineligibility begins with the month in which the 
157.2   assets were transferred.  If the transfer was not reported to 
157.3   the local agency at the time of application, and the applicant 
157.4   received long-term care services during what would have been the 
157.5   period of ineligibility if the transfer had been reported, a 
157.6   cause of action exists against the transferee for the cost of 
157.7   long-term care services provided during the period of 
157.8   ineligibility, or for the uncompensated amount of the transfer, 
157.9   whichever is less.  The action may be brought by the state or 
157.10  the local agency responsible for providing medical assistance 
157.11  under chapter 256G.  The uncompensated transfer amount is the 
157.12  fair market value of the asset at the time it was given away, 
157.13  sold, or disposed of, less the amount of compensation received.  
157.14     (b) For uncompensated transfers made after August 10, 1993, 
157.15  the number of months of ineligibility for long-term care 
157.16  services shall be the total uncompensated value of the resources 
157.17  transferred divided by the average medical assistance rate for 
157.18  nursing facility services in the state in effect on the date of 
157.19  application.  The amount used to calculate the average medical 
157.20  assistance payment rate shall be adjusted each July 1 to reflect 
157.21  payment rates for the previous calendar year.  The period of 
157.22  ineligibility begins with the first day of the month after the 
157.23  month in which the assets were transferred except that if one or 
157.24  more uncompensated transfers are made during a period of 
157.25  ineligibility, the total assets transferred during the 
157.26  ineligibility period shall be combined and a penalty period 
157.27  calculated to begin in on the first day of the month after the 
157.28  month in which the first uncompensated transfer was made.  If 
157.29  the transfer was not reported to the local agency at the time of 
157.30  application, and the applicant received medical assistance 
157.31  services during what would have been the period of ineligibility 
157.32  if the transfer had been reported, a cause of action exists 
157.33  against the transferee for the cost of medical assistance 
157.34  services provided during the period of ineligibility, or for the 
157.35  uncompensated amount of the transfer, whichever is less.  The 
157.36  action may be brought by the state or the local agency 
158.1   responsible for providing medical assistance under chapter 
158.2   256G.  The uncompensated transfer amount is the fair market 
158.3   value of the asset at the time it was given away, sold, or 
158.4   disposed of, less the amount of compensation received.  
158.5   Effective for transfers made on or after March 1, 1996, 
158.6   involving persons who apply for medical assistance on or after 
158.7   April 13, 1996, no cause of action exists for a transfer unless: 
158.8      (1) the transferee knew or should have known that the 
158.9   transfer was being made by a person who was a resident of a 
158.10  long-term care facility or was receiving that level of care in 
158.11  the community at the time of the transfer; 
158.12     (2) the transferee knew or should have known that the 
158.13  transfer was being made to assist the person to qualify for or 
158.14  retain medical assistance eligibility; or 
158.15     (3) the transferee actively solicited the transfer with 
158.16  intent to assist the person to qualify for or retain eligibility 
158.17  for medical assistance.  
158.18     (c) If a calculation of a penalty period results in a 
158.19  partial month, payments for long-term care services shall be 
158.20  reduced in an amount equal to the fraction, except that in 
158.21  calculating the value of uncompensated transfers, if the total 
158.22  value of all uncompensated transfers made in a month not 
158.23  included in an existing penalty period does not exceed $200, 
158.24  then such transfers shall be disregarded for each month prior to 
158.25  the month of application for or during receipt of medical 
158.26  assistance. 
158.27     <b>[EFFECTIVE DATE.]</b> Paragraph (b) of this section is 
158.28  effective July 1, 2003. 
158.29     Sec. 26.  Minnesota Statutes 2002, section 256B.0595, is 
158.30  amended by adding a subdivision to read: 
158.31     Subd. 2b.  [PERIOD OF INELIGIBILITY.] (a) Notwithstanding 
158.32  any contrary provisions of this section, this subdivision 
158.33  applies to transfers, including transfers to trusts, involving 
158.34  recipients of medical assistance that are made on or after July 
158.35  1, 2003, and to all transfers involving persons who apply for 
158.36  medical assistance on or after July 1, 2003, regardless of when 
159.1   the transfer occurred, except that this subdivision does not 
159.2   apply to transfers made prior to July 1, 2003.  For any 
159.3   uncompensated transfer occurring within 72 months prior to the 
159.4   date of application, at any time after application, or while 
159.5   eligible, the number of months of cumulative ineligibility for 
159.6   medical assistance services shall be the total uncompensated 
159.7   value of the assets and income transferred divided by the 
159.8   statewide average per-person nursing facility payment made by 
159.9   the state in effect at the time a penalty for a transfer is 
159.10  determined.  The amount used to calculate the average per-person 
159.11  nursing facility payment shall be adjusted each July 1 to 
159.12  reflect average payments for the previous calendar year.  For 
159.13  applicants, the period of ineligibility begins with the month in 
159.14  which the person applied for medical assistance and satisfied 
159.15  all other requirements for eligibility, or the first month the 
159.16  local agency becomes aware of the transfer and can give proper 
159.17  notice, if later.  For recipients, the period of ineligibility 
159.18  begins in the first month after the month the agency becomes 
159.19  aware of the transfer and can give proper notice, except that 
159.20  penalty periods for transfers made during a period of 
159.21  ineligibility as determined under this section shall begin in 
159.22  the month following the existing period of ineligibility.  If 
159.23  the transfer was not reported to the local agency, and the 
159.24  applicant received medical assistance services during what would 
159.25  have been the period of ineligibility if the transfer had been 
159.26  reported, a cause of action exists against the transferee for 
159.27  the cost of medical assistance services provided during the 
159.28  period of ineligibility or for the uncompensated amount of the 
159.29  transfer that was not recovered from the transferor through the 
159.30  implementation of a penalty period under this subdivision, 
159.31  whichever is less.  Recovery shall include the costs incurred 
159.32  due to the action.  The action may be brought by the state or 
159.33  the local agency responsible for providing medical assistance 
159.34  under chapter 256B.  The uncompensated transfer amount is the 
159.35  fair market value of the asset at the time it was given away, 
159.36  sold, or disposed of, less the amount of compensation received.  
160.1   No cause of action exists for a transfer unless: 
160.2      (1) the transferee knew or should have known that the 
160.3   transfer was being made by a person who was a resident of a 
160.4   long-term care facility or was receiving that level of care in 
160.5   the community at the time of the transfer; 
160.6      (2) the transferee knew or should have known that the 
160.7   transfer was being made to assist the person to qualify for or 
160.8   retain medical assistance eligibility; or 
160.9      (3) the transferee actively solicited the transfer with 
160.10  intent to assist the person to qualify for or retain eligibility 
160.11  for medical assistance. 
160.12     (b) If a calculation of a penalty period results in a 
160.13  partial month, payments for medical assistance services shall be 
160.14  reduced in an amount equal to the fraction, except that in 
160.15  calculating the value of uncompensated transfers, if the total 
160.16  value of all uncompensated transfers made in a month not 
160.17  included in an existing penalty period does not exceed $200, 
160.18  then such transfers shall be disregarded for each month prior to 
160.19  the month of application for or during receipt of medical 
160.20  assistance. 
160.21     (c) Ineligibility under this section shall apply to medical 
160.22  assistance services or long-term care services, whichever 
160.23  receives federal approval. 
160.24     <b>[EFFECTIVE DATE.]</b> (a) This section is effective July 1, 
160.25  2003, to the extent permitted by federal law.  If any provision 
160.26  of this section is prohibited by federal law, the provision 
160.27  shall become effective when federal law is changed to permit its 
160.28  application or a waiver is received.  The commissioner of human 
160.29  services shall notify the revisor of statutes when federal law 
160.30  is enacted or a waiver or other federal approval is received and 
160.31  publish a notice in the State Register.  The commissioner must 
160.32  include the notice in the first State Register published after 
160.33  the effective date of the federal changes. 
160.34     (b) If, by July 1, 2003, any provision of this section is 
160.35  not effective because of prohibitions in federal law, the 
160.36  commissioner of human services shall apply to the federal 
161.1   government by August 1, 2003, for a waiver of those prohibitions 
161.2   or other federal authority, and that provision shall become 
161.3   effective upon receipt of a federal waiver or other federal 
161.4   approval, notification to the revisor of statutes, and 
161.5   publication of a notice in the State Register to that effect.  
161.6   In applying for federal approval to extend the lookback period, 
161.7   the commissioner shall seek the longest lookback period the 
161.8   federal government will approve, not to exceed 72 months. 
161.9      Sec. 27.  Minnesota Statutes 2002, section 256B.0595, is 
161.10  amended by adding a subdivision to read: 
161.11     Subd. 3b.  [HOMESTEAD EXCEPTION TO TRANSFER 
161.12  PROHIBITION.] (a) This subdivision applies to transfers 
161.13  involving recipients of medical assistance that are made on or 
161.14  after July 1, 2003, and to all transfers involving persons who 
161.15  apply for medical assistance on or after July 1, 2003, 
161.16  regardless of when the transfer occurred, except that this 
161.17  subdivision does not apply to transfers made prior to July 1, 
161.18  2003.  A person is not ineligible for medical assistance 
161.19  services due to a transfer of assets for less than fair market 
161.20  value as described in subdivision 1b, if the asset transferred 
161.21  was a homestead, and: 
161.22     (1) a satisfactory showing is made that the individual 
161.23  intended to dispose of the homestead at fair market value or for 
161.24  other valuable consideration; or 
161.25     (2) the local agency grants a waiver of a penalty resulting 
161.26  from a transfer for less than fair market value because denial 
161.27  of eligibility would cause undue hardship for the individual and 
161.28  there exists an imminent threat to the individual's health and 
161.29  well-being.  Whenever an applicant or recipient is denied 
161.30  eligibility because of a transfer for less than fair market 
161.31  value, the local agency shall notify the applicant or recipient 
161.32  that the applicant or recipient may request a waiver of the 
161.33  penalty if the denial of eligibility will cause undue hardship.  
161.34  In evaluating a waiver, the local agency shall take into account 
161.35  whether the individual was the victim of financial exploitation, 
161.36  whether the individual has made reasonable efforts to recover 
162.1   the transferred property or resource, and other factors relevant 
162.2   to a determination of hardship.  If the local agency does not 
162.3   approve a hardship waiver, the local agency shall issue a 
162.4   written notice to the individual stating the reasons for the 
162.5   denial and the process for appealing the local agency's decision.
162.6      (b) When a waiver is granted under paragraph (a), clause 
162.7   (2), a cause of action exists against the person to whom the 
162.8   homestead was transferred for that portion of medical assistance 
162.9   services granted within 72 months of the date the transferor 
162.10  applied for medical assistance and satisfied all other 
162.11  requirements for eligibility or the amount of the uncompensated 
162.12  transfer, whichever is less, together with the costs incurred 
162.13  due to the action.  The action shall be brought by the state 
162.14  unless the state delegates this responsibility to the local 
162.15  agency responsible for providing medical assistance under 
162.16  chapter 256B. 
162.17     <b>[EFFECTIVE DATE.]</b> (a) This section is effective July 1, 
162.18  2003, to the extent permitted by federal law.  If any provision 
162.19  of this section is prohibited by federal law, the provision 
162.20  shall become effective when federal law is changed to permit its 
162.21  application or a waiver is received.  The commissioner of human 
162.22  services shall notify the revisor of statutes when federal law 
162.23  is enacted or a waiver or other federal approval is received and 
162.24  publish a notice in the State Register.  The commissioner must 
162.25  include the notice in the first State Register published after 
162.26  the effective date of the federal changes. 
162.27     (b) If, by July 1, 2003, any provision of this section is 
162.28  not effective because of prohibitions in federal law, the 
162.29  commissioner of human services shall apply to the federal 
162.30  government by August 1, 2003, for a waiver of those prohibitions 
162.31  or other federal authority, and that provision shall become 
162.32  effective upon receipt of a federal waiver or other federal 
162.33  approval, notification to the revisor of statutes, and 
162.34  publication of a notice in the State Register to that effect.  
162.35  In applying for federal approval to extend the lookback period, 
162.36  the commissioner shall seek the longest lookback period the 
163.1   federal government will approve, not to exceed 72 months. 
163.2      Sec. 28.  Minnesota Statutes 2002, section 256B.0595, is 
163.3   amended by adding a subdivision to read: 
163.4      Subd. 4b.  [OTHER EXCEPTIONS TO TRANSFER PROHIBITION.] (a) 
163.5   This subdivision applies to transfers involving recipients of 
163.6   medical assistance that are made on or after July 1, 2003, and 
163.7   to all transfers involving persons who apply for medical 
163.8   assistance on or after July 1, 2003, regardless of when the 
163.9   transfer occurred, except that this subdivision does not apply 
163.10  to transfers made prior to July 1, 2003.  A person or a person's 
163.11  spouse who made a transfer prohibited by subdivision 1b is not 
163.12  ineligible for medical assistance services if one of the 
163.13  following conditions applies: 
163.14     (1) the assets or income were transferred to the 
163.15  individual's spouse or to another for the sole benefit of the 
163.16  spouse, except that after eligibility is established and the 
163.17  assets have been divided between the spouses as part of the 
163.18  asset allowance under section 256B.059, no further transfers 
163.19  between spouses may be made; 
163.20     (2) the institutionalized spouse, prior to being 
163.21  institutionalized, transferred assets or income to a spouse, 
163.22  provided that the spouse to whom the assets or income were 
163.23  transferred does not then transfer those assets or income to 
163.24  another person for less than fair market value.  At the time 
163.25  when one spouse is institutionalized, assets must be allocated 
163.26  between the spouses as provided under section 256B.059; 
163.27     (3) the assets or income were transferred to a trust for 
163.28  the sole benefit of the individual's child who is blind or 
163.29  permanently and totally disabled as determined in the 
163.30  supplemental security income program and the trust reverts to 
163.31  the state upon the disabled child's death to the extent the 
163.32  medical assistance has paid for services for the grantor or 
163.33  beneficiary of the trust.  This clause applies to a trust 
163.34  established after the commissioner publishes a notice in the 
163.35  State Register that the commissioner has been authorized to 
163.36  implement this clause due to a change in federal law or the 
164.1   approval of a federal waiver; 
164.2      (4) a satisfactory showing is made that the individual 
164.3   intended to dispose of the assets or income either at fair 
164.4   market value or for other valuable consideration; or 
164.5      (5) the local agency determines that denial of eligibility 
164.6   for medical assistance services would cause undue hardship and 
164.7   grants a waiver of a penalty resulting from a transfer for less 
164.8   than fair market value because there exists an imminent threat 
164.9   to the individual's health and well-being.  Whenever an 
164.10  applicant or recipient is denied eligibility because of a 
164.11  transfer for less than fair market value, the local agency shall 
164.12  notify the applicant or recipient that the applicant or 
164.13  recipient may request a waiver of the penalty if the denial of 
164.14  eligibility will cause undue hardship.  In evaluating a waiver, 
164.15  the local agency shall take into account whether the individual 
164.16  was the victim of financial exploitation, whether the individual 
164.17  has made reasonable efforts to recover the transferred property 
164.18  or resource, and other factors relevant to a determination of 
164.19  hardship.  If the local agency does not approve a hardship 
164.20  waiver, the local agency shall issue a written notice to the 
164.21  individual stating the reasons for the denial and the process 
164.22  for appealing the local agency's decision.  When a waiver is 
164.23  granted, a cause of action exists against the person to whom the 
164.24  assets were transferred for that portion of medical assistance 
164.25  services granted within 72 months of the date the transferor 
164.26  applied for medical assistance and satisfied all other 
164.27  requirements for eligibility, or the amount of the uncompensated 
164.28  transfer, whichever is less, together with the costs incurred 
164.29  due to the action.  The action shall be brought by the state 
164.30  unless the state delegates this responsibility to the local 
164.31  agency responsible for providing medical assistance under this 
164.32  chapter. 
164.33     <b>[EFFECTIVE DATE.]</b> (a) This section is effective July 1, 
164.34  2003, to the extent permitted by federal law.  If any provision 
164.35  of this section is prohibited by federal law, the provision 
164.36  shall become effective when federal law is changed to permit its 
165.1   application or a waiver is received.  The commissioner of human 
165.2   services shall notify the revisor of statutes when federal law 
165.3   is enacted or a waiver or other federal approval is received and 
165.4   publish a notice in the State Register.  The commissioner must 
165.5   include the notice in the first State Register published after 
165.6   the effective date of the federal changes. 
165.7      (b) If, by July 1, 2003, any provision of this section is 
165.8   not effective because of prohibitions in federal law, the 
165.9   commissioner of human services shall apply to the federal 
165.10  government by August 1, 2003, for a waiver of those prohibitions 
165.11  or other federal authority, and that provision shall become 
165.12  effective upon receipt of a federal waiver or other federal 
165.13  approval, notification to the revisor of statutes, and 
165.14  publication of a notice in the State Register to that effect.  
165.15  In applying for federal approval to extend the lookback period, 
165.16  the commissioner shall seek the longest lookback period the 
165.17  federal government will approve, not to exceed 72 months. 
165.18     Sec. 29.  Minnesota Statutes 2002, section 256B.06, 
165.19  subdivision 4, is amended to read: 
165.20     Subd. 4.  [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 
165.21  medical assistance is limited to citizens of the United States, 
165.22  qualified noncitizens as defined in this subdivision, and other 
165.23  persons residing lawfully in the United States. 
165.24     (b) "Qualified noncitizen" means a person who meets one of 
165.25  the following immigration criteria: 
165.26     (1) admitted for lawful permanent residence according to 
165.27  United States Code, title 8; 
165.28     (2) admitted to the United States as a refugee according to 
165.29  United States Code, title 8, section 1157; 
165.30     (3) granted asylum according to United States Code, title 
165.31  8, section 1158; 
165.32     (4) granted withholding of deportation according to United 
165.33  States Code, title 8, section 1253(h); 
165.34     (5) paroled for a period of at least one year according to 
165.35  United States Code, title 8, section 1182(d)(5); 
165.36     (6) granted conditional entrant status according to United 
166.1   States Code, title 8, section 1153(a)(7); 
166.2      (7) determined to be a battered noncitizen by the United 
166.3   States Attorney General according to the Illegal Immigration 
166.4   Reform and Immigrant Responsibility Act of 1996, title V of the 
166.5   Omnibus Consolidated Appropriations Bill, Public Law Number 
166.6   104-200; 
166.7      (8) is a child of a noncitizen determined to be a battered 
166.8   noncitizen by the United States Attorney General according to 
166.9   the Illegal Immigration Reform and Immigrant Responsibility Act 
166.10  of 1996, title V, of the Omnibus Consolidated Appropriations 
166.11  Bill, Public Law Number 104-200; or 
166.12     (9) determined to be a Cuban or Haitian entrant as defined 
166.13  in section 501(e) of Public Law Number 96-422, the Refugee 
166.14  Education Assistance Act of 1980. 
166.15     (c) All qualified noncitizens who were residing in the 
166.16  United States before August 22, 1996, who otherwise meet the 
166.17  eligibility requirements of chapter 256B, are eligible for 
166.18  medical assistance with federal financial participation. 
166.19     (d) All qualified noncitizens who entered the United States 
166.20  on or after August 22, 1996, and who otherwise meet the 
166.21  eligibility requirements of chapter 256B, are eligible for 
166.22  medical assistance with federal financial participation through 
166.23  November 30, 1996. 
166.24     Beginning December 1, 1996, qualified noncitizens who 
166.25  entered the United States on or after August 22, 1996, and who 
166.26  otherwise meet the eligibility requirements of chapter 256B are 
166.27  eligible for medical assistance with federal participation for 
166.28  five years if they meet one of the following criteria: 
166.29     (i) refugees admitted to the United States according to 
166.30  United States Code, title 8, section 1157; 
166.31     (ii) persons granted asylum according to United States 
166.32  Code, title 8, section 1158; 
166.33     (iii) persons granted withholding of deportation according 
166.34  to United States Code, title 8, section 1253(h); 
166.35     (iv) veterans of the United States Armed Forces with an 
166.36  honorable discharge for a reason other than noncitizen status, 
167.1   their spouses and unmarried minor dependent children; or 
167.2      (v) persons on active duty in the United States Armed 
167.3   Forces, other than for training, their spouses and unmarried 
167.4   minor dependent children. 
167.5      Beginning December 1, 1996, qualified noncitizens who do 
167.6   not meet one of the criteria in items (i) to (v) are eligible 
167.7   for medical assistance without federal financial participation 
167.8   as described in paragraph (j) (i). 
167.9      (e) Noncitizens who are not qualified noncitizens as 
167.10  defined in paragraph (b), who are lawfully residing in the 
167.11  United States and who otherwise meet the eligibility 
167.12  requirements of chapter 256B, are eligible for medical 
167.13  assistance under clauses (1) to (3).  These individuals must 
167.14  cooperate with the Immigration and Naturalization Service to 
167.15  pursue any applicable immigration status, including citizenship, 
167.16  that would qualify them for medical assistance with federal 
167.17  financial participation. 
167.18     (1) Persons who were medical assistance recipients on 
167.19  August 22, 1996, are eligible for medical assistance with 
167.20  federal financial participation through December 31, 1996. 
167.21     (2) Beginning January 1, 1997, persons described in clause 
167.22  (1) are eligible for medical assistance without federal 
167.23  financial participation as described in paragraph (j) (i). 
167.24     (3) Beginning December 1, 1996, persons residing in the 
167.25  United States prior to August 22, 1996, who were not receiving 
167.26  medical assistance and persons who arrived on or after August 
167.27  22, 1996, are eligible for medical assistance without federal 
167.28  financial participation as described in paragraph (j) (i). 
167.29     (f) Nonimmigrants who otherwise meet the eligibility 
167.30  requirements of chapter 256B are eligible for the benefits as 
167.31  provided in paragraphs (g) to (i) and (h).  For purposes of this 
167.32  subdivision, a "nonimmigrant" is a person in one of the classes 
167.33  listed in United States Code, title 8, section 1101(a)(15). 
167.34     (g) Payment shall also be made for care and services that 
167.35  are furnished to noncitizens, regardless of immigration status, 
167.36  who otherwise meet the eligibility requirements of chapter 256B, 
168.1   if such care and services are necessary for the treatment of an 
168.2   emergency medical condition, except for organ transplants and 
168.3   related care and services and routine prenatal care.  
168.4      (h) For purposes of this subdivision, the term "emergency 
168.5   medical condition" means a medical condition that meets the 
168.6   requirements of United States Code, title 42, section 1396b(v). 
168.7      (i) Pregnant noncitizens who are undocumented or 
168.8   nonimmigrants, who otherwise meet the eligibility requirements 
168.9   of chapter 256B, are eligible for medical assistance payment 
168.10  without federal financial participation for care and services 
168.11  through the period of pregnancy, and 60 days postpartum, except 
168.12  for labor and delivery.  
168.13     (j) Qualified noncitizens as described in paragraph (d), 
168.14  and all other noncitizens lawfully residing in the United States 
168.15  as described in paragraph (e), who are ineligible for medical 
168.16  assistance with federal financial participation and who 
168.17  otherwise meet the eligibility requirements of chapter 256B and 
168.18  of this paragraph, are eligible for medical assistance without 
168.19  federal financial participation.  Qualified noncitizens as 
168.20  described in paragraph (d) are only eligible for medical 
168.21  assistance without federal financial participation for five 
168.22  years from their date of entry into the United States.  
168.23     (k) The commissioner shall submit to the legislature by 
168.24  December 31, 1998, a report on the number of recipients and cost 
168.25  of coverage of care and services made according to paragraphs 
168.26  (i) and (j). 
168.27     (j) Beginning October 1, 2003, persons who are receiving 
168.28  care and rehabilitation services from a nonprofit center 
168.29  established to serve victims of torture and are otherwise 
168.30  ineligible for medical assistance under chapter 256B or general 
168.31  assistance medical care under section 256D.03 are eligible for 
168.32  medical assistance without federal financial participation.  
168.33  These individuals are eligible only for the period during which 
168.34  they are receiving services from the center.  Individuals 
168.35  eligible under this clause shall not be required to participate 
168.36  in prepaid medical assistance. 
169.1      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
169.2   except where a different date is specified in the text. 
169.3      Sec. 30.  Minnesota Statutes 2002, section 256B.061, is 
169.4   amended to read: 
169.5      256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 
169.6      (a) If any individual has been determined to be eligible 
169.7   for medical assistance, it will be made available for care and 
169.8   services included under the plan and furnished in or after the 
169.9   third month before the month in which the individual made 
169.10  application for such assistance, if such individual was, or upon 
169.11  application would have been, eligible for medical assistance at 
169.12  the time the care and services were furnished.  The commissioner 
169.13  may limit, restrict, or suspend the eligibility of an individual 
169.14  for up to one year upon that individual's conviction of a 
169.15  criminal offense related to application for or receipt of 
169.16  medical assistance benefits. 
169.17     (b) On the basis of information provided on the completed 
169.18  application, an applicant who meets the following criteria shall 
169.19  be determined eligible beginning in the month of application: 
169.20     (1) whose gross income is less than 90 percent of the 
169.21  applicable income standard; 
169.22     (2) whose total liquid assets are less than 90 percent of 
169.23  the asset limit; 
169.24     (3) does not reside in a long-term care facility; and 
169.25     (4) meets all other eligibility requirements. 
169.26  The applicant must provide all required verifications within 30 
169.27  days' notice of the eligibility determination or eligibility 
169.28  shall be terminated. 
169.29     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
169.30     Sec. 31.  Minnesota Statutes 2002, section 256B.0625, 
169.31  subdivision 5a, is amended to read: 
169.32     Subd. 5a.  [INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY 
169.33  SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS.] (a)  
169.34  [COVERAGE.] Medical assistance covers home-based intensive early 
169.35  intervention behavior therapy for children with autism spectrum 
169.36  disorders, effective July 1, 2007.  Children with autism 
170.1   spectrum disorder, and their custodial parents or foster 
170.2   parents, may access other covered services to treat autism 
170.3   spectrum disorder, and are not required to receive intensive 
170.4   early intervention behavior therapy services under this 
170.5   subdivision.  Intensive early intervention behavior therapy does 
170.6   not include coverage for services to treat developmental 
170.7   disorders of language, early onset psychosis, Rett's disorder, 
170.8   selective mutism, social anxiety disorder, stereotypic movement 
170.9   disorder, dementia, obsessive compulsive disorder, schizoid 
170.10  personality disorder, avoidant personality disorder, or reactive 
170.11  attachment disorder.  If a child with autism spectrum disorder 
170.12  is diagnosed to have one or more of these conditions, intensive 
170.13  early intervention behavior therapy includes coverage only for 
170.14  services necessary to treat the autism spectrum disorder. 
170.15     (b) Subd. 5b.  [PURPOSE OF INTENSIVE EARLY INTERVENTION 
170.16  BEHAVIOR THERAPY SERVICES (IEIBTS).] The purpose of IEIBTS is to 
170.17  improve the child's behavioral functioning, to prevent 
170.18  development of challenging behaviors, to eliminate autistic 
170.19  behaviors, to reduce the risk of out-of-home placement, and to 
170.20  establish independent typical functioning in language and social 
170.21  behavior.  The procedures used to accomplish these goals are 
170.22  based upon research in applied behavior analysis. 
170.23     (c) Subd. 5c.  [ELIGIBLE CHILDREN.] A child is eligible to 
170.24  initiate IEIBTS if, the child meets the additional eligibility 
170.25  criteria in paragraph (d) and in a diagnostic assessment by a 
170.26  mental health professional who is not under the employ of the 
170.27  service provider, the child: 
170.28     (1) is found to have an autism spectrum disorder; 
170.29     (2) has a current IQ of either untestable, or at least 30; 
170.30     (3) if nonverbal, initiated behavior therapy by 42 months 
170.31  of age; 
170.32     (4) if verbal, initiated behavior therapy by 48 months of 
170.33  age; or 
170.34     (5) if having an IQ of at least 50, initiated behavior 
170.35  therapy by 84 months of age. 
170.36  To continue after six-month individualized treatment plan (ITP) 
171.1   reviews, at least one of the child's custodial parents or foster 
171.2   parents must participate in an average of at least five hours of 
171.3   documented behavior therapy per week for six months, and 
171.4   consistently implement behavior therapy recommendations 24 hours 
171.5   a day.  To continue after six-month individualized treatment 
171.6   plan (ITP) reviews, the child must show documented progress 
171.7   toward mastery of six-month benchmark behavior objectives.  The 
171.8   maximum number of months during which services may be billed is 
171.9   54, or up to the month of August in the first year in which the 
171.10  child completes first grade, whichever comes last.  If 
171.11  significant progress towards treatment goals has not been 
171.12  achieved after 24 months of treatment, treatment must be 
171.13  discontinued. 
171.14     (d) Subd. 5d.  [ADDITIONAL ELIGIBILITY CRITERIA.] A child 
171.15  is eligible to initiate IEIBTS if: 
171.16     (1) in medical and diagnostic assessments by medical and 
171.17  mental health professionals, it is determined that the child 
171.18  does not have severe or profound mental retardation; 
171.19     (2) an accurate assessment of the child's hearing has been 
171.20  performed, including audiometry if the brain stem auditory 
171.21  evokes response; 
171.22     (3) a blood lead test has been performed prior to 
171.23  initiation of treatment; and 
171.24     (4) an EEG or neurologic evaluation is done, prior to 
171.25  initiation of treatment, if the child has a history of staring 
171.26  spells or developmental regression.  
171.27     (e) Subd. 5e.  [COVERED SERVICES.] The focus of IEIBTS must 
171.28  be to treat the principal diagnostic features of the autism 
171.29  spectrum disorder.  All IEIBTS must be delivered by a team of 
171.30  practitioners under the consistent supervision of a single 
171.31  clinical supervisor.  A mental health professional must develop 
171.32  the ITP for IEIBTS.  The ITP must include six-month benchmark 
171.33  behavior objectives.  All behavior therapy must be based upon 
171.34  research in applied behavior analysis, with an emphasis upon 
171.35  positive reinforcement of carefully task-analyzed skills for 
171.36  optimum rates of progress.  All behavior therapy must be 
172.1   consistently applied and generalized throughout the 24-hour day 
172.2   and seven-day week by all of the child's regular care 
172.3   providers.  When placing the child in school activities, a 
172.4   majority of the peers must have no mental health diagnosis, and 
172.5   the child must have sufficient social skills to succeed with 80 
172.6   percent of the school activities.  Reactive consequences, such 
172.7   as redirection, correction, positive practice, or time-out, must 
172.8   be used only when necessary to improve the child's success when 
172.9   proactive procedures alone have not been effective.  IEIBTS must 
172.10  be delivered by a team of behavior therapy practitioners who are 
172.11  employed under the direction of the same agency.  The team may 
172.12  deliver up to 200 billable hours per year of direct clinical 
172.13  supervisor services, up to 700 billable hours per year of senior 
172.14  behavior therapist services, and up to 1,800 billable hours per 
172.15  year of direct behavior therapist services.  A one-hour clinical 
172.16  review meeting for the child, parents, and staff must be 
172.17  scheduled 50 weeks a year, at which behavior therapy is reviewed 
172.18  and planned.  At least one-quarter of the annual clinical 
172.19  supervisor billable hours shall consist of on-site clinical 
172.20  meeting time.  At least one-half of the annual senior behavior 
172.21  therapist billable hours shall consist of direct services to the 
172.22  child or parents.  All of the behavioral therapist billable 
172.23  hours shall consist of direct on-site services to the child or 
172.24  parents.  None of the senior behavior therapist billable hours 
172.25  or behavior therapist billable hours shall consist of clinical 
172.26  meeting time.  If there is any regression of the autistic 
172.27  spectrum disorder after 12 months of therapy, a neurologic 
172.28  consultation must be performed. 
172.29     (f) Subd. 5f.  [PROVIDER QUALIFICATIONS.] The provider 
172.30  agency must be capable of delivering consistent applied behavior 
172.31  analysis (ABA) based behavior therapy in the home.  The site 
172.32  director of the agency must be a mental health professional and 
172.33  a board certified behavior analyst certified by the behavior 
172.34  analyst certification board.  Each clinical supervisor must be a 
172.35  certified associate behavior analyst certified by the behavior 
172.36  analyst certification board or have equivalent experience in 
173.1   applied behavior analysis. 
173.2      (g) Subd. 5g.  [SUPERVISION REQUIREMENTS.] (1) Each 
173.3   behavior therapist practitioner must be continuously supervised 
173.4   while in the home until the practitioner has mastered 
173.5   competencies for independent practice.  Each behavior therapist 
173.6   must have mastered three credits of academic content and 
173.7   practice in an applied behavior analysis sequence at an 
173.8   accredited university before providing more than 12 months of 
173.9   therapy.  A college degree or minimum hours of experience are 
173.10  not required.  Each behavior therapist must continue training 
173.11  through weekly direct observation by the senior behavior 
173.12  therapist, through demonstrated performance in clinical meetings 
173.13  with the clinical supervisor, and annual training in applied 
173.14  behavior analysis. 
173.15     (2) Each senior behavior therapist practitioner must have 
173.16  mastered the senior behavior therapy competencies, completed one 
173.17  year of practice as a behavior therapist, and six months of 
173.18  co-therapy training with another senior behavior therapist or 
173.19  have an equivalent amount of experience in applied behavior 
173.20  analysis.  Each senior behavior therapist must have mastered 12 
173.21  credits of academic content and practice in an applied behavior 
173.22  analysis sequence at an accredited university before providing 
173.23  more than 12 months of senior behavior therapy.  Each senior 
173.24  behavior therapist must continue training through demonstrated 
173.25  performance in clinical meetings with the clinical supervisor, 
173.26  and annual training in applied behavior analysis. 
173.27     (3) Each clinical supervisor practitioner must have 
173.28  mastered the clinical supervisor and family consultation 
173.29  competencies, completed two years of practice as a senior 
173.30  behavior therapist and one year of co-therapy training with 
173.31  another clinical supervisor, or equivalent experience in applied 
173.32  behavior analysis.  Each clinical supervisor must continue 
173.33  training through annual training in applied behavior analysis. 
173.34     (h) Subd. 5h.  [PLACE OF SERVICE.] IEIBTS are provided 
173.35  primarily in the child's home and community.  Services may be 
173.36  provided in the child's natural school or preschool classroom, 
174.1   home of a relative, natural recreational setting, or day care. 
174.2      (i) Subd. 5i.  [PRIOR AUTHORIZATION REQUIREMENTS.] Prior 
174.3   authorization shall be required for services provided after 200 
174.4   hours of clinical supervisor, 700 hours of senior behavior 
174.5   therapist, or 1,800 hours of behavior therapist services per 
174.6   year. 
174.7      (j) Subd. 5j.  [PAYMENT RATES.] The following payment rates 
174.8   apply: 
174.9      (1) for an IEIBTS clinical supervisor practitioner under 
174.10  supervision of a mental health professional, the lower of the 
174.11  submitted charge or $67 per hour unit; 
174.12     (2) for an IEIBTS senior behavior therapist practitioner 
174.13  under supervision of a mental health professional, the lower of 
174.14  the submitted charge or $37 per hour unit; or 
174.15     (3) for an IEIBTS behavior therapist practitioner under 
174.16  supervision of a mental health professional, the lower of the 
174.17  submitted charge or $27 per hour unit. 
174.18  An IEIBTS practitioner may receive payment for travel time which 
174.19  exceeds 50 minutes one-way.  The maximum payment allowed will be 
174.20  $0.51 per minute for up to a maximum of 300 hours per year. 
174.21     For any week during which the above charges are made to 
174.22  medical assistance, payments for the following services are 
174.23  excluded:  supervising mental health professional hours and 
174.24  personal care attendant, home-based mental health, 
174.25  family-community support, or mental health behavioral aide hours.
174.26     (k) Subd. 5k.  [REPORT.] The commissioner shall collect 
174.27  evidence of the effectiveness of intensive early intervention 
174.28  behavior therapy services and present a report to the 
174.29  legislature by July 1, 2006 2010. 
174.30     Sec. 32.  Minnesota Statutes 2002, section 256B.0625, 
174.31  subdivision 9, is amended to read: 
174.32     Subd. 9.  [DENTAL SERVICES.] (a) Medical assistance covers 
174.33  dental services.  Dental services include, with prior 
174.34  authorization, fixed bridges that are cost-effective for persons 
174.35  who cannot use removable dentures because of their medical 
174.36  condition.  
175.1      (b) Coverage of dental services for adults age 21 and over 
175.2   who are not pregnant is subject to a $500 annual benefit limit 
175.3   and covered services are limited to:  
175.4      (1) diagnostic and preventative services; 
175.5      (2) basic restorative services; and 
175.6      (3) emergency services. 
175.7      Sec. 33.  Minnesota Statutes 2002, section 256B.0625, 
175.8   subdivision 13, is amended to read: 
175.9      Subd. 13.  [DRUGS.] (a) Medical assistance covers drugs, 
175.10  except for fertility drugs when specifically used to enhance 
175.11  fertility, if prescribed by a licensed practitioner and 
175.12  dispensed by a licensed pharmacist, by a physician enrolled in 
175.13  the medical assistance program as a dispensing physician, or by 
175.14  a physician or a nurse practitioner employed by or under 
175.15  contract with a community health board as defined in section 
175.16  145A.02, subdivision 5, for the purposes of communicable disease 
175.17  control.  
175.18     (b) The dispensed quantity of a prescription drug must not 
175.19  exceed a 34-day supply, unless authorized by the commissioner.  
175.20     (c) Medical assistance covers the following 
175.21  over-the-counter drugs when prescribed by a licensed 
175.22  practitioner or by a licensed pharmacist who meets standards 
175.23  established by the commissioner, in consultation with the board 
175.24  of pharmacy:  antacids, acetaminophen, family planning products, 
175.25  aspirin, insulin, products for the treatment of lice, vitamins 
175.26  for adults with documented vitamin deficiencies, vitamins for 
175.27  children under the age of seven and pregnant or nursing women, 
175.28  and any other over-the-counter drug identified by the 
175.29  commissioner, in consultation with the pharmaceutical and 
175.30  therapeutics committee, as necessary, appropriate, and 
175.31  cost-effective for the treatment of certain specified chronic 
175.32  diseases, conditions, or disorders, and this determination shall 
175.33  not be subject to the requirements of chapter 14.  A pharmacist 
175.34  may prescribe over-the-counter medications as provided under 
175.35  this paragraph for purposes of receiving reimbursement under 
175.36  Medicaid.  When prescribing over-the-counter drugs under this 
176.1   paragraph, licensed pharmacists must consult with the recipient 
176.2   to determine necessity, provide drug counseling, review drug 
176.3   therapy for potential adverse interactions, and make referrals 
176.4   as needed to other health care professionals. 
176.5      (d) The commissioner may contract with a pharmacy benefit 
176.6   administrator or pharmacy benefit manager to administer the 
176.7   medical assistance prescription drug benefit in compliance with 
176.8   subdivisions 13 to 13i.  Any contract must require that the 
176.9   entity under contract make transparent and transfer to the state 
176.10  all direct and indirect payments received from pharmaceutical 
176.11  manufacturers.  For purposes of this paragraph, a "pharmacy 
176.12  benefit administrator or pharmacy benefit manager" means an 
176.13  entity under contract to process and adjudicate claims, disburse 
176.14  payments to pharmacy providers, channel communication of 
176.15  eligibility and coverage information to beneficiaries and 
176.16  pharmacy providers, provide information and computer support to 
176.17  enable pharmacy providers to conduct drug utilization review, 
176.18  conduct activities to control fraud, abuse, and waste, and 
176.19  negotiate and collect payments from participating pharmaceutical 
176.20  manufacturers. 
176.21     Subd. 13c.  [LIMITS ON NUMBER OF BRAND NAME 
176.22  PRESCRIPTIONS.] (a) Medical assistance outpatient prescription 
176.23  drug coverage for brand name drugs may be limited to the 
176.24  dispensing of four brand name drug products per recipient per 
176.25  month.  Antiretroviral agents and brand name drugs dispensed to 
176.26  recipients under 18 years of age are exempt from this 
176.27  restriction.  For purposes of this subdivision, "brand name 
176.28  drugs" means single source and innovator multiple source drugs.  
176.29  The commissioner may, through prior authorization, allow 
176.30  exceptions to the limitation on the dispensing of brand name 
176.31  drugs, based on the treatment needs of a recipient. 
176.32     Subd. 13d.  [PHARMACEUTICAL AND THERAPEUTICS COMMITTEE.] (a)
176.33  The commissioner, after receiving recommendations from 
176.34  professional medical associations and professional pharmacist 
176.35  pharmacy associations, and consumer groups, shall designate a 
176.36  formulary committee to advise the commissioner on the names of 
177.1   drugs for which payment is made, recommend a system for 
177.2   reimbursing providers on a set fee or charge basis rather than 
177.3   the present system, and develop methods encouraging use of 
177.4   generic drugs when they are less expensive and equally effective 
177.5   as trademark drugs pharmaceutical and therapeutics committee to 
177.6   develop and assist the commissioner in implementing a medical 
177.7   assistance preferred drug list, to review and recommend to the 
177.8   commissioner drugs which require prior authorization, and to 
177.9   carry out duties as described in subdivisions 13 to 13i and in 
177.10  section 151.21, subdivision 8.  The committee shall meet at 
177.11  least quarterly.  The commissioner may designate the Medicaid 
177.12  drug utilization review board as the committee established under 
177.13  this subdivision.  Committee members shall serve three-year 
177.14  terms and may be reappointed. 
177.15     (b) The formulary pharmaceutical and therapeutics committee 
177.16  shall consist of nine members, four of whom shall be physicians 
177.17  who are not employed by the department of human services, and a 
177.18  majority of whose practice is for persons paying privately or 
177.19  through health insurance, three of whom shall be pharmacists who 
177.20  are not employed by the department of human services, and a 
177.21  majority of whose practice is for persons paying privately or 
177.22  through health insurance, a consumer representative, and a 
177.23  nursing home representative.  Committee members shall serve 
177.24  three-year terms and shall serve without compensation.  Members 
177.25  may be reappointed once the following nine members:  at least 
177.26  three but no more than four licensed physicians actively engaged 
177.27  in the practice of medicine in Minnesota; at least three 
177.28  licensed pharmacists actively engaged in the practice of 
177.29  pharmacy in Minnesota; and one consumer representative; the 
177.30  remainder to be made up of health care professionals who are 
177.31  licensed in their field and have recognized knowledge in the 
177.32  clinically appropriate prescribing, dispensing, and monitoring 
177.33  of covered outpatient drugs.  An honorarium of $100 per meeting 
177.34  and reimbursement for mileage shall be paid to each committee 
177.35  member in attendance. 
177.36     Subd. 13e.  [DRUG FORMULARY.] (b) The commissioner shall 
178.1   establish a drug formulary.  Its establishment and publication 
178.2   shall not be subject to the requirements of the Administrative 
178.3   Procedure Act, but the formulary pharmaceutical and therapeutics 
178.4   committee shall review and comment on the formulary contents.  
178.5      The formulary shall not include:  
178.6      (i) (1) drugs or products for which there is no federal 
178.7   funding; 
178.8      (ii) (2) over-the-counter drugs, except for antacids, 
178.9   acetaminophen, family planning products, aspirin, insulin, 
178.10  products for the treatment of lice, vitamins for adults with 
178.11  documented vitamin deficiencies, vitamins for children under the 
178.12  age of seven and pregnant or nursing women, and any other 
178.13  over-the-counter drug identified by the commissioner, in 
178.14  consultation with the drug formulary committee, as necessary, 
178.15  appropriate, and cost-effective for the treatment of certain 
178.16  specified chronic diseases, conditions or disorders, and this 
178.17  determination shall not be subject to the requirements of 
178.18  chapter 14 as provided in subdivision 13; 
178.19     (iii) anorectics, except that medically necessary 
178.20  anorectics shall be covered for a recipient previously diagnosed 
178.21  as having pickwickian syndrome and currently diagnosed as having 
178.22  diabetes and being morbidly obese (3) drugs used for weight 
178.23  loss; 
178.24     (iv) (4) drugs for which medical value has not been 
178.25  established; and 
178.26     (v) (5) drugs from manufacturers who have not signed a 
178.27  rebate agreement with the Department of Health and Human 
178.28  Services pursuant to section 1927 of title XIX of the Social 
178.29  Security Act. 
178.30     The commissioner shall publish conditions for prohibiting 
178.31  payment for specific drugs after considering the formulary 
178.32  committee's recommendations.  An honorarium of $100 per meeting 
178.33  and reimbursement for mileage shall be paid to each committee 
178.34  member in attendance.  
178.35     Subd. 13f.  [PAYMENT RATES.] (c) (a) The basis for 
178.36  determining the amount of payment shall be the lower of the 
179.1   actual acquisition costs of the drugs plus a fixed dispensing 
179.2   fee; the maximum allowable cost set by the federal government or 
179.3   by the commissioner plus the fixed dispensing fee; or the usual 
179.4   and customary price charged to the public.  The amount of 
179.5   payment basis must be reduced to reflect all discount amounts 
179.6   applied to the charge by any provider/insurer agreement or 
179.7   contract for submitted charges to medical assistance programs.  
179.8   The net submitted charge may not be greater than the patient 
179.9   liability for the service.  The pharmacy dispensing fee shall be 
179.10  $3.65, except that the dispensing fee for intravenous solutions 
179.11  which must be compounded by the pharmacist shall be $8 per bag, 
179.12  $14 per bag for cancer chemotherapy products, and $30 per bag 
179.13  for total parenteral nutritional products dispensed in one liter 
179.14  quantities, or $44 per bag for total parenteral nutritional 
179.15  products dispensed in quantities greater than one liter.  Actual 
179.16  acquisition cost includes quantity and other special discounts 
179.17  except time and cash discounts.  The actual acquisition cost of 
179.18  a drug shall be estimated by the commissioner, at average 
179.19  wholesale price minus nine 11.5 percent, except that where a 
179.20  drug has had its wholesale price reduced as a result of the 
179.21  actions of the National Association of Medicaid Fraud Control 
179.22  Units, the estimated actual acquisition cost shall be the 
179.23  reduced average wholesale price, without the nine 11.5 percent 
179.24  deduction.  The maximum allowable cost of a multisource drug may 
179.25  be set by the commissioner and it shall be comparable to, but no 
179.26  higher than, the maximum amount paid by other third-party payors 
179.27  in this state who have maximum allowable cost programs.  The 
179.28  commissioner shall set maximum allowable costs for multisource 
179.29  drugs that are not on the federal upper limit list as described 
179.30  in United States Code, title 42, chapter 7, section 1396r-8(e), 
179.31  the Social Security Act, and Code of Federal Regulations, title 
179.32  42, part 447, section 447.332.  Establishment of the amount of 
179.33  payment for drugs shall not be subject to the requirements of 
179.34  the Administrative Procedure Act.  
179.35     (b) An additional dispensing fee of $.30 may be added to 
179.36  the dispensing fee paid to pharmacists for legend drug 
180.1   prescriptions dispensed to residents of long-term care 
180.2   facilities when a unit dose blister card system, approved by the 
180.3   department, is used.  Under this type of dispensing system, the 
180.4   pharmacist must dispense a 30-day supply of drug.  The National 
180.5   Drug Code (NDC) from the drug container used to fill the blister 
180.6   card must be identified on the claim to the department.  The 
180.7   unit dose blister card containing the drug must meet the 
180.8   packaging standards set forth in Minnesota Rules, part 
180.9   6800.2700, that govern the return of unused drugs to the 
180.10  pharmacy for reuse.  The pharmacy provider will be required to 
180.11  credit the department for the actual acquisition cost of all 
180.12  unused drugs that are eligible for reuse.  Over-the-counter 
180.13  medications must be dispensed in the manufacturer's unopened 
180.14  package.  The commissioner may permit the drug clozapine to be 
180.15  dispensed in a quantity that is less than a 30-day supply.  
180.16     (c) Whenever a generically equivalent product is available, 
180.17  payment shall be on the basis of the actual acquisition cost of 
180.18  the generic drug, unless the prescriber specifically indicates 
180.19  "dispense as written - brand necessary" on the prescription as 
180.20  required by section 151.21, subdivision 2. 
180.21     (d) For purposes of this subdivision, "multisource drugs" 
180.22  means covered outpatient drugs, excluding innovator multisource 
180.23  drugs for which there are two or more drug products, which: 
180.24     (1) are related as therapeutically equivalent under the 
180.25  Food and Drug Administration's most recent publication of 
180.26  "Approved Drug Products with Therapeutic Equivalence 
180.27  Evaluations"; 
180.28     (2) are pharmaceutically equivalent and bioequivalent as 
180.29  determined by the Food and Drug Administration; and 
180.30     (3) are sold or marketed in Minnesota. 
180.31  "Innovator multisource drug" means a multisource drug that was 
180.32  originally marketed under an original new drug application 
180.33  approved by the Food and Drug Administration. 
180.34     (e) The basis for determining the amount of payment for 
180.35  drugs administered in an outpatient setting shall be the lower 
180.36  of the usual and customary cost submitted by the provider, the 
181.1   average wholesale price minus five percent, or the maximum 
181.2   allowable cost set by the federal government under United States 
181.3   Code, title 42, chapter 7, section 1396r-8(e), and Code of 
181.4   Federal Regulations, title 42, section 447.332, or by the 
181.5   commissioner under paragraphs (a) to (c). 
181.6      Subd. 13g.  [PRIOR AUTHORIZATION.] (a) The formulary 
181.7   pharmaceutical and therapeutics committee shall review and 
181.8   recommend drugs which require prior authorization.  The 
181.9   pharmaceutical and therapeutics committee shall establish 
181.10  general criteria to be used for the prior authorization of 
181.11  brand-name drugs for which generically equivalent drugs are 
181.12  available, but the committee is not required to review each 
181.13  brand-name drug for which a generically equivalent drug is 
181.14  available.  The formulary committee may recommend drugs for 
181.15  prior authorization directly to the commissioner, as long as 
181.16  opportunity for public input is provided.  Prior authorization 
181.17  may be requested by the commissioner based on medical and 
181.18  clinical criteria and on cost before certain drugs are eligible 
181.19  for payment.  Before a drug may be considered for prior 
181.20  authorization at the request of the commissioner: 
181.21     (1) the drug formulary committee must develop criteria to 
181.22  be used for identifying drugs; the development of these criteria 
181.23  is not subject to the requirements of chapter 14, but the 
181.24  formulary committee shall provide opportunity for public input 
181.25  in developing criteria; 
181.26     (2) the drug formulary committee must hold a public forum 
181.27  and receive public comment for an additional 15 days; 
181.28     (3) the drug formulary committee must consider data from 
181.29  the state Medicaid program if such data is available; and 
181.30     (4) the commissioner must provide information to the 
181.31  formulary committee on the impact that placing the drug on prior 
181.32  authorization will have on the quality of patient care and on 
181.33  program costs, and information regarding whether the drug is 
181.34  subject to clinical abuse or misuse.  
181.35     Prior authorization may be required by the commissioner 
181.36  before certain formulary drugs are eligible for payment.  If 
182.1   prior authorization of a drug is required by the commissioner, 
182.2   the commissioner must provide a 30-day notice period before 
182.3   implementing the prior authorization.  If a prior authorization 
182.4   request is denied by the department, the recipient may appeal 
182.5   the denial in accordance with section 256.045.  If an appeal is 
182.6   filed, the drug must be provided without prior authorization 
182.7   until a decision is made on the appeal.  
182.8      (f) The basis for determining the amount of payment for 
182.9   drugs administered in an outpatient setting shall be the lower 
182.10  of the usual and customary cost submitted by the provider; the 
182.11  average wholesale price minus five percent; or the maximum 
182.12  allowable cost set by the federal government under United States 
182.13  Code, title 42, chapter 7, section 1396r-8(e), and Code of 
182.14  Federal Regulations, title 42, section 447.332, or by the 
182.15  commissioner under paragraph (c). 
182.16     (g) Prior authorization shall not be required or utilized 
182.17  for any antipsychotic drug prescribed to an individual before 
182.18  July 1, 2003, for the treatment of mental illness where there is 
182.19  no generically equivalent drug available unless the commissioner 
182.20  determines that prior authorization is necessary for patient 
182.21  safety.  This paragraph applies to any supplemental drug rebate 
182.22  program established or administered by the commissioner. 
182.23     (b) Prior authorization shall not be required for 
182.24  antipsychotic drugs when used for the treatment of mental 
182.25  illness, where there is no generically equivalent drug 
182.26  available, and on which the patient has been stabilized.  All 
182.27  prescriptions for antipsychotic drugs issued after June 30, 
182.28  2003, are subject to the preferred drug list and any step 
182.29  therapy guidelines established by the commissioner. 
182.30     (h) (c) Prior authorization shall not be required or 
182.31  utilized for any antihemophilic factor drug prescribed for the 
182.32  treatment of hemophilia and blood disorders where there is no 
182.33  generically equivalent drug available unless the commissioner 
182.34  determines that prior authorization is necessary for patient 
182.35  safety.  This paragraph applies to any supplemental drug rebate 
182.36  program established or administered by the commissioner.  This 
183.1   paragraph expires July 1, 2003 2005. 
183.2      (d) The commissioner may require prior authorization for 
183.3   brand name drugs whenever a generically equivalent product is 
183.4   available, even if the prescriber specifically indicates 
183.5   "dispense as written-brand necessary" on the prescription as 
183.6   required by section 151.21, subdivision 2. 
183.7      Subd. 13h.  [STEP THERAPY.] (a) The commissioner, in 
183.8   consultation with the pharmaceutical and therapeutics committee, 
183.9   may develop and implement a step therapy program.  For purposes 
183.10  of this subdivision, "step therapy" means a prior authorization 
183.11  or prior utilization review procedure that: 
183.12     (1) requires a prescribing health care provider to 
183.13  prescribe the least costly pharmacological or nonpharmacological 
183.14  therapy which can be used to safely and effectively treat the 
183.15  symptoms of, or effect a cure for, the medical condition for 
183.16  which the therapy is prescribed; and 
183.17     (2) allows the prescribing health care provider to 
183.18  sequentially prescribe increasingly more costly therapies after 
183.19  providing clinical substantiation that therapies previously 
183.20  prescribed were unsafe or ineffective in treating the medical 
183.21  condition or illness. 
183.22     (b) A prescribing health care provider prescribing a 
183.23  pharmacological or nonpharmacological therapy under this 
183.24  subdivision that is less effective than another pharmacological 
183.25  or nonpharmacological therapy known to the prescriber, shall 
183.26  disclose to the patient that another, more effective, therapy 
183.27  exists and that the provider is statutorily required to 
183.28  prescribe the less effective treatment. 
183.29     Subd. 13i.  [PREFERRED DRUG LIST.] (a) The commissioner 
183.30  shall adopt and implement a preferred drug list by January 1, 
183.31  2004.  The commissioner may enter into a contract with a vendor 
183.32  or one or more states for the purpose of participating in a 
183.33  multistate preferred drug list and supplemental rebate program.  
183.34  The commissioner shall ensure that any contract meets all 
183.35  federal requirements and maximizes federal financial 
183.36  participation.  The commissioner shall publish the preferred 
184.1   drug list annually in the State Register and shall maintain an 
184.2   accurate and up-to-date list on the agency Web site. 
184.3      (b) The commissioner may add to, delete from, and otherwise 
184.4   modify the preferred drug list, after consulting with the 
184.5   pharmaceutical and therapeutics committee and appropriate 
184.6   medical specialists and providing public notice and the 
184.7   opportunity for public comment. 
184.8      (c) The commissioner shall adopt and administer the 
184.9   preferred drug list as part of the administration of the 
184.10  supplemental drug rebate program.  Reimbursement for 
184.11  prescription drugs not on the preferred drug list may be subject 
184.12  to prior authorization, unless the drug manufacturer signs a 
184.13  supplemental rebate contract. 
184.14     (d) For purposes of this subdivision, "preferred drug list" 
184.15  means a list of prescription drugs within designated therapeutic 
184.16  classes selected by the commissioner, for which prior 
184.17  authorization based on the identity of the drug or class is not 
184.18  required. 
184.19     (e) The commissioner shall seek any federal waivers or 
184.20  approvals necessary to implement this subdivision. 
184.21     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
184.22     Sec. 34.  Minnesota Statutes 2002, section 256B.0625, 
184.23  subdivision 17, is amended to read: 
184.24     Subd. 17.  [TRANSPORTATION COSTS.] (a) Medical assistance 
184.25  covers transportation costs incurred solely for obtaining 
184.26  emergency medical care or transportation costs incurred by 
184.27  nonambulatory eligible persons in obtaining emergency or 
184.28  nonemergency medical care when paid directly to an ambulance 
184.29  company, common carrier, or other recognized providers of 
184.30  transportation services.  For the purpose of this subdivision, a 
184.31  person who is incapable of transport by taxicab or bus shall be 
184.32  considered to be nonambulatory. 
184.33     (b) Medical assistance covers special transportation, as 
184.34  defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 
184.35  if the provider receives and maintains a current physician's 
184.36  order by the recipient's attending physician certifying that the 
185.1   recipient has a physical or mental impairment that would 
185.2   prohibit the recipient from safely accessing and using a bus, 
185.3   taxi, other commercial transportation, or private automobile.  
185.4   The commissioner may use an order by the recipient's attending 
185.5   physician to certify that the recipient requires special 
185.6   transportation services.  Special transportation includes 
185.7   driver-assisted service to eligible individuals.  
185.8   Driver-assisted service includes passenger pickup at and return 
185.9   to the individual's residence or place of business, assistance 
185.10  with admittance of the individual to the medical facility, and 
185.11  assistance in passenger securement or in securing of wheelchairs 
185.12  or stretchers in the vehicle.  The commissioner shall establish 
185.13  maximum medical assistance reimbursement rates for special 
185.14  transportation services for persons who need a 
185.15  wheelchair-accessible van or stretcher-accessible vehicle and 
185.16  for those who do not need a wheelchair-accessible van or 
185.17  stretcher-accessible vehicle.  The average of these two rates 
185.18  per trip must not exceed $15 for the base rate and $1.40 per 
185.19  mile.  Special transportation provided to nonambulatory persons 
185.20  who do not need a wheelchair-accessible van or 
185.21  stretcher-accessible vehicle, may be reimbursed at a lower rate 
185.22  than special transportation provided to persons who need a 
185.23  wheelchair-accessible van or stretcher-accessible 
185.24  vehicle.  Special transportation providers must obtain written 
185.25  documentation from the health care service provider who is 
185.26  serving the recipient being transported, identifying the time 
185.27  that the recipient arrived.  Special transportation providers 
185.28  may not bill for separate base rates for the continuation of a 
185.29  trip beyond the original destination.  Special transportation 
185.30  providers must take recipients to the nearest appropriate health 
185.31  care provider, using the most direct route available.  The 
185.32  maximum medical assistance reimbursement rates for special 
185.33  transportation services are: 
185.34     (1) $18 for the base rate and $1.40 per mile for services 
185.35  to eligible persons who need a wheelchair-accessible van; 
185.36     (2) $12 for the base rate and $1.40 per mile for services 
186.1   to eligible persons who do not need a wheelchair-accessible van; 
186.2   and 
186.3      (3) for all trips, a base rate of $36 and $1.40 per mile, 
186.4   and an attendant rate of $9 per trip, for eligible persons who 
186.5   need a stretcher-accessible vehicle. 
186.6      Sec. 35.  Minnesota Statutes 2002, section 256B.0625, 
186.7   subdivision 18a, is amended to read: 
186.8      Subd. 18a.  [ACCESS TO MEDICAL SERVICES.] (a) Medical 
186.9   assistance reimbursement for meals for persons traveling to 
186.10  receive medical care shall be provided only for travel involving 
186.11  lodging, and may not exceed $5.50 for breakfast, $6.50 for 
186.12  lunch, or $8 for dinner. 
186.13     (b) Medical assistance reimbursement for lodging for 
186.14  persons traveling to receive medical care shall be provided only 
186.15  if the local agency determines that the medical care service is 
186.16  not available at a location that does not require lodging, and 
186.17  may not exceed $50 per day unless prior authorized by the local 
186.18  agency. 
186.19     (c) Medical assistance direct mileage reimbursement to the 
186.20  eligible person or the eligible person's driver may not exceed 
186.21  20 cents per mile. 
186.22     (d) Medical assistance covers oral language interpreter 
186.23  services when provided by an enrolled health care provider 
186.24  during the course of providing a direct, person-to-person 
186.25  covered health care service to an enrolled recipient with 
186.26  limited English proficiency. 
186.27     Sec. 36.  [256B.0631] [MEDICAL ASSISTANCE CO-PAYMENTS.] 
186.28     Subdivision 1.  [CO-PAYMENTS.] (a) Except as provided in 
186.29  subdivision 2, the medical assistance benefit plan shall include 
186.30  the following co-payments for all recipients, effective for 
186.31  services provided on or after October 1, 2003: 
186.32     (1) $3 per nonpreventive visit.  For purposes of this 
186.33  subdivision, a visit means an episode of service which is 
186.34  required because of a recipient's symptoms, diagnosis, or 
186.35  established illness, and which is delivered in an ambulatory 
186.36  setting by a physician or physician ancillary, chiropractor, 
187.1   podiatrist, nurse midwife, mental health professional, advanced 
187.2   practice nurse, audiologist, optician, or optometrist; 
187.3      (2) $3 for eyeglasses; 
187.4      (3) $6 for nonemergency visits to a hospital-based 
187.5   emergency room; and 
187.6      (4) $3 per brand-name drug prescription and $1 per generic 
187.7   drug prescription, subject to a $20 per month maximum for 
187.8   prescription drug co-payments.  No co-payments shall apply to 
187.9   antipsychotic drugs when used for the treatment of mental 
187.10  illness. 
187.11     (b) Recipients of medical assistance are responsible for 
187.12  all co-payments in this subdivision. 
187.13     Subd. 2.  [EXCEPTIONS.] Co-payments shall be subject to the 
187.14  following exceptions: 
187.15     (1) children under the age of 21; 
187.16     (2) pregnant women for services that relate to the 
187.17  pregnancy or any other medical condition that may complicate the 
187.18  pregnancy; 
187.19     (3) recipients expected to reside for at least 30 days in a 
187.20  hospital, nursing home, or intermediate care facility for the 
187.21  mentally retarded; 
187.22     (4) recipients receiving hospice care; 
187.23     (5) 100 percent federally funded services provided by an 
187.24  Indian health service; 
187.25     (6) emergency services; 
187.26     (7) family planning services; 
187.27     (8) services that are paid by Medicare, resulting in the 
187.28  medical assistance program paying for the coinsurance and 
187.29  deductible; and 
187.30     (9) co-payments that exceed one per day per provider for 
187.31  nonpreventive visits, eyeglasses, and nonemergency visits to a 
187.32  hospital-based emergency room. 
187.33     Subd. 3.  [COLLECTION.] The medical assistance 
187.34  reimbursement to the provider shall be reduced by the amount of 
187.35  the co-payment, except that reimbursement for prescription drugs 
187.36  shall not be reduced once a recipient has reached the $20 per 
188.1   month maximum for prescription drug co-payments.  The provider 
188.2   collects the co-payment from the recipient.  Providers may not 
188.3   deny services to recipients who are unable to pay the 
188.4   co-payment, except as provided in subdivision 4. 
188.5      Subd. 4.  [UNCOLLECTED DEBT.] If it is the routine business 
188.6   practice of a provider to refuse service to an individual with 
188.7   uncollected debt, the provider may include uncollected 
188.8   co-payments under this section.  A provider must give advance 
188.9   notice to a recipient with uncollected debt before services can 
188.10  be denied. 
188.11     Sec. 37.  Minnesota Statutes 2002, section 256B.0635, 
188.12  subdivision 1, is amended to read: 
188.13     Subdivision 1.  [INCREASED EMPLOYMENT.] (a) Until June 30, 
188.14  2002, medical assistance may be paid for persons who received 
188.15  MFIP or medical assistance for families and children in at least 
188.16  three of six months preceding the month in which the person 
188.17  became ineligible for MFIP or medical assistance, if the 
188.18  ineligibility was due to an increase in hours of employment or 
188.19  employment income or due to the loss of an earned income 
188.20  disregard.  In addition, to receive continued assistance under 
188.21  this section, persons who received medical assistance for 
188.22  families and children but did not receive MFIP must have had 
188.23  income less than or equal to the assistance standard for their 
188.24  family size under the state's AFDC plan in effect as of July 16, 
188.25  1996, increased by three percent effective July 1, 2000, at the 
188.26  time medical assistance eligibility began.  A person who is 
188.27  eligible for extended medical assistance is entitled to six 
188.28  months of assistance without reapplication, unless the 
188.29  assistance unit ceases to include a dependent child.  For a 
188.30  person under 21 years of age, medical assistance may not be 
188.31  discontinued within the six-month period of extended eligibility 
188.32  until it has been determined that the person is not otherwise 
188.33  eligible for medical assistance.  Medical assistance may be 
188.34  continued for an additional six months if the person meets all 
188.35  requirements for the additional six months, according to title 
188.36  XIX of the Social Security Act, as amended by section 303 of the 
189.1   Family Support Act of 1988, Public Law Number 100-485. 
189.2      (b) Beginning July 1, 2002, contingent upon federal 
189.3   funding, medical assistance for families and children may be 
189.4   paid for persons who were eligible under section 256B.055, 
189.5   subdivision 3a, in at least three of six months preceding the 
189.6   month in which the person became ineligible under that section 
189.7   if the ineligibility was due to an increase in hours of 
189.8   employment or employment income or due to the loss of an earned 
189.9   income disregard.  A person who is eligible for extended medical 
189.10  assistance is entitled to six months of assistance without 
189.11  reapplication, unless the assistance unit ceases to include a 
189.12  dependent child, except medical assistance may not be 
189.13  discontinued for that dependent child under 21 years of age 
189.14  within the six-month period of extended eligibility until it has 
189.15  been determined that the person is not otherwise eligible for 
189.16  medical assistance.  Medical assistance may be continued for an 
189.17  additional six months if the person meets all requirements for 
189.18  the additional six months, according to title XIX of the Social 
189.19  Security Act, as amended by section 303 of the Family Support 
189.20  Act of 1988, Public Law Number 100-485. 
189.21     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
189.22     Sec. 38.  Minnesota Statutes 2002, section 256B.0635, 
189.23  subdivision 2, is amended to read: 
189.24     Subd. 2.  [INCREASED CHILD OR SPOUSAL SUPPORT.] (a) Until 
189.25  June 30, 2002, medical assistance may be paid for persons who 
189.26  received MFIP or medical assistance for families and children in 
189.27  at least three of the six months preceding the month in which 
189.28  the person became ineligible for MFIP or medical assistance, if 
189.29  the ineligibility was the result of the collection of child or 
189.30  spousal support under part D of title IV of the Social Security 
189.31  Act.  In addition, to receive continued assistance under this 
189.32  section, persons who received medical assistance for families 
189.33  and children but did not receive MFIP must have had income less 
189.34  than or equal to the assistance standard for their family size 
189.35  under the state's AFDC plan in effect as of July 16, 1996, 
189.36  increased by three percent effective July 1, 2000, at the time 
190.1   medical assistance eligibility began.  A person who is eligible 
190.2   for extended medical assistance under this subdivision is 
190.3   entitled to four months of assistance without reapplication, 
190.4   unless the assistance unit ceases to include a dependent child, 
190.5   except medical assistance may not be discontinued for that 
190.6   dependent child under 21 years of age within the four-month 
190.7   period of extended eligibility until it has been determined that 
190.8   the person is not otherwise eligible for medical assistance. 
190.9      (b) Beginning July 1, 2002, contingent upon federal 
190.10  funding, medical assistance for families and children may be 
190.11  paid for persons who were eligible under section 256B.055, 
190.12  subdivision 3a, in at least three of the six months preceding 
190.13  the month in which the person became ineligible under that 
190.14  section if the ineligibility was the result of the collection of 
190.15  child or spousal support under part D of title IV of the Social 
190.16  Security Act.  A person who is eligible for extended medical 
190.17  assistance under this subdivision is entitled to four months of 
190.18  assistance without reapplication, unless the assistance unit 
190.19  ceases to include a dependent child, except medical assistance 
190.20  may not be discontinued for that dependent child under 21 years 
190.21  of age within the four-month period of extended eligibility 
190.22  until it has been determined that the person is not otherwise 
190.23  eligible for medical assistance. 
190.24     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
190.25     Sec. 39.  Minnesota Statutes 2002, section 256B.15, 
190.26  subdivision 1, is amended to read: 
190.27     Subdivision 1.  [POLICY, APPLICABILITY, PURPOSE, AND 
190.28  CONSTRUCTION; DEFINITION.] (a) It is the policy of this state 
190.29  that individuals or couples, either or both of whom participate 
190.30  in the medical assistance program, use their own assets to pay 
190.31  their share of the total cost of their care during or after 
190.32  their enrollment in the program according to applicable federal 
190.33  law and the laws of this state.  The following provisions apply: 
190.34     (1) subdivisions 1c to 1k shall not apply to claims arising 
190.35  under this section which are presented under section 525.313; 
190.36     (2) the provisions of subdivisions 1c to 1k expanding the 
191.1   interests included in an estate for purposes of recovery under 
191.2   this section give effect to the provisions of United States 
191.3   Code, title 42, section 1396p, governing recoveries, but do not 
191.4   give rise to any express or implied liens in favor of any other 
191.5   parties not named in these provisions; 
191.6      (3) the continuation of a recipient's life estate or joint 
191.7   tenancy interest in real property after the recipient's death 
191.8   for the purpose of recovering medical assistance under this 
191.9   section modifies common law principles holding that these 
191.10  interests terminate on the death of the holder; 
191.11     (4) all laws, rules, and regulations governing or involved 
191.12  with a recovery of medical assistance shall be liberally 
191.13  construed to accomplish their intended purposes; 
191.14     (5) a deceased recipient's life estate and joint tenancy 
191.15  interests continued under this section shall be owned by the 
191.16  remaindermen or surviving joint tenants as their interests may 
191.17  appear on the date of the recipient's death.  They shall not be 
191.18  merged into the remainder interest or the interests of the 
191.19  surviving joint tenants by reason of ownership.  They shall be 
191.20  subject to the provisions of this section.  Any conveyance, 
191.21  transfer, sale, assignment, or encumbrance by a remainderman, a 
191.22  surviving joint tenant, or their heirs, successors, and assigns 
191.23  shall be deemed to include all of their interest in the deceased 
191.24  recipient's life estate or joint tenancy interest continued 
191.25  under this section; and 
191.26     (6) the provisions of subdivisions 1c to 1k continuing a 
191.27  recipient's joint tenancy interests in real property after the 
191.28  recipient's death do not apply to a homestead owned of record, 
191.29  on the date the recipient dies, by the recipient and the 
191.30  recipient's spouse as joint tenants with a right of survivorship.
191.31     (b) For purposes of this section, "medical assistance" 
191.32  includes the medical assistance program under this chapter and 
191.33  the general assistance medical care program under chapter 256D, 
191.34  but does not include the alternative care program for nonmedical 
191.35  assistance recipients under section 256B.0913, subdivision 4. 
191.36     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
192.1   and applies to estates of decedents who die on or after that 
192.2   date. 
192.3      Sec. 40.  Minnesota Statutes 2002, section 256B.15, 
192.4   subdivision 1a, is amended to read: 
192.5      Subd. 1a.  [ESTATES SUBJECT TO CLAIMS.] If a person 
192.6   receives any medical assistance hereunder, on the person's 
192.7   death, if single, or on the death of the survivor of a married 
192.8   couple, either or both of whom received medical assistance, or 
192.9   as otherwise provided for in this section, the total amount paid 
192.10  for medical assistance rendered for the person and spouse shall 
192.11  be filed as a claim against the estate of the person or the 
192.12  estate of the surviving spouse in the court having jurisdiction 
192.13  to probate the estate or to issue a decree of descent according 
192.14  to sections 525.31 to 525.313.  
192.15     A claim shall be filed if medical assistance was rendered 
192.16  for either or both persons under one of the following 
192.17  circumstances: 
192.18     (a) the person was over 55 years of age, and received 
192.19  services under this chapter, excluding alternative care; 
192.20     (b) the person resided in a medical institution for six 
192.21  months or longer, received services under this chapter excluding 
192.22  alternative care, and, at the time of institutionalization or 
192.23  application for medical assistance, whichever is later, the 
192.24  person could not have reasonably been expected to be discharged 
192.25  and returned home, as certified in writing by the person's 
192.26  treating physician.  For purposes of this section only, a 
192.27  "medical institution" means a skilled nursing facility, 
192.28  intermediate care facility, intermediate care facility for 
192.29  persons with mental retardation, nursing facility, or inpatient 
192.30  hospital; or 
192.31     (c) the person received general assistance medical care 
192.32  services under chapter 256D.  
192.33     The claim shall be considered an expense of the last 
192.34  illness of the decedent for the purpose of section 524.3-805.  
192.35  Any statute of limitations that purports to limit any county 
192.36  agency or the state agency, or both, to recover for medical 
193.1   assistance granted hereunder shall not apply to any claim made 
193.2   hereunder for reimbursement for any medical assistance granted 
193.3   hereunder.  Notice of the claim shall be given to all heirs and 
193.4   devisees of the decedent whose identity can be ascertained with 
193.5   reasonable diligence.  The notice must include procedures and 
193.6   instructions for making an application for a hardship waiver 
193.7   under subdivision 5; time frames for submitting an application 
193.8   and determination; and information regarding appeal rights and 
193.9   procedures.  Counties are entitled to one-half of the nonfederal 
193.10  share of medical assistance collections from estates that are 
193.11  directly attributable to county effort.  
193.12     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
193.13  and applies to the estates of decedents who die on and after 
193.14  that date. 
193.15     Sec. 41.  Minnesota Statutes 2002, section 256B.15, is 
193.16  amended by adding a subdivision to read: 
193.17     Subd. 1c.  [NOTICE OF POTENTIAL CLAIM.] (a) A state agency 
193.18  with a claim or potential claim under this section may file a 
193.19  notice of potential claim under this subdivision anytime before 
193.20  or within one year after a medical assistance recipient dies.  
193.21  The claimant shall be the state agency.  A notice filed prior to 
193.22  the recipient's death shall not take effect and shall not be 
193.23  effective as notice until the recipient dies.  A notice filed 
193.24  after a recipient dies shall be effective from the time of 
193.25  filing.  
193.26     (b) The notice of claim shall be filed or recorded in the 
193.27  real estate records in the office of the county recorder or 
193.28  registrar of titles for each county in which any part of the 
193.29  property is located.  The recorder shall accept the notice for 
193.30  recording or filing.  The registrar of titles shall accept the 
193.31  notice for filing if the recipient has a recorded interest in 
193.32  the property.  The registrar of titles shall not carry forward 
193.33  to a new certificate of title any notice filed more than one 
193.34  year from the date of the recipient's death. 
193.35     (c) The notice must be dated, state the name of the 
193.36  claimant, the medical assistance recipient's name and social 
194.1   security number if filed before their death and their date of 
194.2   death if filed after they die, the name and date of death of any 
194.3   predeceased spouse of the medical assistance recipient for whom 
194.4   a claim may exist, a statement that the claimant may have a 
194.5   claim arising under this section, generally identify the 
194.6   recipient's interest in the property, contain a legal 
194.7   description for the property and whether it is abstract or 
194.8   registered property, a statement of when the notice becomes 
194.9   effective and the effect of the notice, be signed by an 
194.10  authorized representative of the state agency, and may include 
194.11  such other contents as the state agency may deem appropriate. 
194.12     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
194.13  and applies to the estates of decedents who die on or after that 
194.14  date. 
194.15     Sec. 42.  Minnesota Statutes 2002, section 256B.15, is 
194.16  amended by adding a subdivision to read: 
194.17     Subd. 1d.  [EFFECT OF NOTICE.] From the time it takes 
194.18  effect, the notice shall be notice to remaindermen, joint 
194.19  tenants, or to anyone else owning or acquiring an interest in or 
194.20  encumbrance against the property described in the notice that 
194.21  the medical assistance recipient's life estate, joint tenancy, 
194.22  or other interests in the real estate described in the notice: 
194.23     (1) shall, in the case of life estate and joint tenancy 
194.24  interests, continue to exist for purposes of this section, and 
194.25  be subject to liens and claims as provided in this section; 
194.26     (2) shall be subject to a lien in favor of the claimant 
194.27  effective upon the death of the recipient and dealt with as 
194.28  provided in this section; 
194.29     (3) may be included in the recipient's estate, as defined 
194.30  in this section; and 
194.31     (4) may be subject to administration and all other 
194.32  provisions of chapter 524 and may be sold, assigned, 
194.33  transferred, or encumbered free and clear of their interest or 
194.34  encumbrance to satisfy claims under this section. 
194.35     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
194.36  and applies to the estates of decedents who die on or after that 
195.1   date. 
195.2      Sec. 43.  Minnesota Statutes 2002, section 256B.15, is 
195.3   amended by adding a subdivision to read: 
195.4      Subd. 1e.  [FULL OR PARTIAL RELEASE OF NOTICE.] (a) The 
195.5   claimant may fully or partially release the notice and the lien 
195.6   arising out of the notice of record in the real estate records 
195.7   where the notice is filed or recorded at any time.  The claimant 
195.8   may give a full or partial release to extinguish any life 
195.9   estates or joint tenancy interests which are or may be continued 
195.10  under this section or whose existence or nonexistence may create 
195.11  a cloud on the title to real property at any time whether or not 
195.12  a notice has been filed.  The recorder or registrar of titles 
195.13  shall accept the release for recording or filing.  If the 
195.14  release is a partial release, it must include a legal 
195.15  description of the property being released. 
195.16     (b) At any time, the claimant may, at the claimant's 
195.17  discretion, wholly or partially release, subordinate, modify, or 
195.18  amend the recorded notice and the lien arising out of the notice.
195.19     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
195.20  and applies to the estates of decedents who die on or after that 
195.21  date. 
195.22     Sec. 44.  Minnesota Statutes 2002, section 256B.15, is 
195.23  amended by adding a subdivision to read: 
195.24     Subd. 1f.  [AGENCY LIEN.] (a) The notice shall constitute a 
195.25  lien in favor of the department of human services against the 
195.26  recipient's interests in the real estate it describes for a 
195.27  period of 20 years from the date of filing or the date of the 
195.28  recipient's death, whichever is later.  Notwithstanding any law 
195.29  or rule to the contrary, a recipient's life estate and joint 
195.30  tenancy interests shall not end upon the recipient's death but 
195.31  shall continue according to subdivisions 1h, 1i, and 1j.  The 
195.32  amount of the lien shall be equal to the total amount of the 
195.33  claims that could be presented in the recipient's estate under 
195.34  this section. 
195.35     (b) If no estate has been opened for the deceased 
195.36  recipient, any holder of an interest in the property may apply 
196.1   to the lien holder for a statement of the amount of the lien or 
196.2   for a full or partial release of the lien.  The application 
196.3   shall include the applicant's name, current mailing address, 
196.4   current home and work telephone numbers, and a description of 
196.5   their interest in the property, a legal description of the 
196.6   recipient's interest in the property, and the deceased 
196.7   recipient's name, date of birth, and social security number.  
196.8   The lien holder shall send the applicant by certified mail, 
196.9   return receipt requested, a written statement showing the amount 
196.10  of the lien, whether the lien holder is willing to release the 
196.11  lien and under what conditions, and inform them of the right to 
196.12  a hearing under section 256.045.  The lien holder shall have the 
196.13  discretion to compromise and settle the lien upon any terms and 
196.14  conditions the lien holder deems appropriate. 
196.15     (c) Any holder of an interest in property subject to the 
196.16  lien has a right to request a hearing under section 256.045 to 
196.17  determine the validity, extent, or amount of the lien.  The 
196.18  request must be in writing, and must include the names, current 
196.19  addresses, and home and business telephone numbers for all other 
196.20  parties holding an interest in the property.  A request for a 
196.21  hearing by any holder of an interest in the property shall be 
196.22  deemed to be a request for a hearing by all parties owning 
196.23  interests in the property.  Notice of the hearing shall be given 
196.24  to the lien holder, the party filing the appeal, and all of the 
196.25  other holders of interests in the property at the addresses 
196.26  listed in the appeal by certified mail, return receipt 
196.27  requested, or by ordinary mail.  Any owner of an interest in the 
196.28  property to whom notice of the hearing is mailed shall be deemed 
196.29  to have waived any and all claims or defenses in respect to the 
196.30  lien unless they appear and assert any claims or defenses at the 
196.31  hearing. 
196.32     (d) If the claim the lien secures could be filed under 
196.33  subdivision 1h, the lien holder may collect, compromise, settle, 
196.34  or release the lien upon any terms and conditions it deems 
196.35  appropriate.  If the claim the lien secures could be filed under 
196.36  subdivision 1i or 1j, the lien may be adjusted or enforced to 
197.1   the same extent had it been filed under subdivisions 1i and 1j, 
197.2   and the provisions of subdivisions 1i, clause (f), and lj, 
197.3   clause (d), shall apply to voluntary payment, settlement, or 
197.4   satisfaction of the lien. 
197.5      (e) If no probate proceedings have been commenced for the 
197.6   recipient as of the date the lien holder executes a release of 
197.7   the lien on a recipient's life estate or joint tenancy interest, 
197.8   created for purposes of this section, the release shall 
197.9   terminate the life estate or joint tenancy interest created 
197.10  under this section as of the date it is recorded or filed to the 
197.11  extent of the release.  If the claimant executes a release for 
197.12  purposes of extinguishing a life estate or a joint tenancy 
197.13  interest created under this section to remove a cloud on title 
197.14  to real property, the release shall have the effect of 
197.15  extinguishing any life estate or joint tenancy interests in the 
197.16  property it describes which may have been continued by reason of 
197.17  this section retroactive to the date of death of the deceased 
197.18  life tenant or joint tenant except as provided for in section 
197.19  514.981, subdivision 6. 
197.20     (f) If the deceased recipient's estate is probated, a claim 
197.21  shall be filed under this section.  The amount of the lien shall 
197.22  be limited to the amount of the claim as finally allowed.  If 
197.23  the claim the lien secures is filed under subdivision 1h, the 
197.24  lien may be released in full after any allowance of the claim 
197.25  becomes final or according to any agreement to settle and 
197.26  satisfy the claim.  The release shall release the lien but shall 
197.27  not extinguish or terminate the interest being released.  If the 
197.28  claim the lien secures is filed under subdivision 1i or 1j, the 
197.29  lien shall be released after the lien under subdivision 1i or 1j 
197.30  is filed or recorded, or settled according to any agreement to 
197.31  settle and satisfy the claim.  The release shall not extinguish 
197.32  or terminate the interest being released.  If the claim is 
197.33  finally disallowed in full, the claimant shall release the 
197.34  claimant's lien at the claimant's expense. 
197.35     <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
197.36  2003, and applies to the estates of decedents who die on or 
198.1   after that date. 
198.2      Sec. 45.  Minnesota Statutes 2002, section 256B.15, is 
198.3   amended by adding a subdivision to read: 
198.4      Subd. 1g.  [ESTATE PROPERTY.] Notwithstanding any law or 
198.5   rule to the contrary, if a claim is presented under this 
198.6   section, interests or the proceeds of interests in real property 
198.7   a decedent owned as a life tenant or a joint tenant with a right 
198.8   of survivorship shall be part of the decedent's estate, subject 
198.9   to administration, and shall be dealt with as provided in this 
198.10  section. 
198.11     <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
198.12  2003, and applies to the estates of decedents who die on or 
198.13  after that date. 
198.14     Sec. 46.  Minnesota Statutes 2002, section 256B.15, is 
198.15  amended by adding a subdivision to read: 
198.16     Subd. 1h.  [ESTATES OF SPECIFIC PERSONS RECEIVING MEDICAL 
198.17  ASSISTANCE.] (a) For purposes of this section, paragraphs (b) to 
198.18  (k) apply if a person received medical assistance for which a 
198.19  claim may be filed under this section and died single, or the 
198.20  surviving spouse of the couple and was not survived by any of 
198.21  the persons described in subdivisions 3 and 4. 
198.22     (b) For purposes of this section, the person's estate 
198.23  consists of:  (1) their probate estate; (2) all of the person's 
198.24  interests or proceeds of those interests in real property the 
198.25  person owned as a life tenant or as a joint tenant with a right 
198.26  of survivorship at the time of the person's death; (3) all of 
198.27  the person's interests or proceeds of those interests in 
198.28  securities the person owned in beneficiary form as provided 
198.29  under sections 524.6-301 to 524.6-311 at the time of the 
198.30  person's death, to the extent they become part of the probate 
198.31  estate under section 524.6-307; and (4) all of the person's 
198.32  interests in joint accounts, multiple party accounts, and pay on 
198.33  death accounts, or the proceeds of those accounts, as provided 
198.34  under sections 524.6-201 to 524.6-214 at the time of the 
198.35  person's death to the extent they become part of the probate 
198.36  estate under section 524.6-207.  Notwithstanding any law or rule 
199.1   to the contrary, a state or county agency with a claim under 
199.2   this section shall be a creditor under section 524.6-307. 
199.3      (c) Notwithstanding any law or rule to the contrary, the 
199.4   person's life estate or joint tenancy interest in real property 
199.5   not subject to a medical assistance lien under sections 514.980 
199.6   to 514.985 on the date of the person's death shall not end upon 
199.7   the person's death and shall continue as provided in this 
199.8   subdivision.  The life estate in the person's estate shall be 
199.9   that portion of the interest in the real property subject to the 
199.10  life estate that is equal to the life estate percentage factor 
199.11  for the life estate as listed in the Life Estate Mortality Table 
199.12  of the health care program's manual for a person who was the age 
199.13  of the medical assistance recipient on the date of the person's 
199.14  death.  The joint tenancy interest in real property in the 
199.15  estate shall be equal to the fractional interest the person 
199.16  would have owned in the jointly held interest in the property 
199.17  had they and the other owners held title to the property as 
199.18  tenants in common on the date the person died. 
199.19     (d) The court upon its own motion, or upon motion by the 
199.20  personal representative or any interested party, may enter an 
199.21  order directing the remaindermen or surviving joint tenants and 
199.22  their spouses, if any, to sign all documents, take all actions, 
199.23  and otherwise fully cooperate with the personal representative 
199.24  and the court to liquidate the decedent's life estate or joint 
199.25  tenancy interests in the estate and deliver the cash or the 
199.26  proceeds of those interests to the personal representative and 
199.27  provide for any legal and equitable sanctions as the court deems 
199.28  appropriate to enforce and carry out the order, including an 
199.29  award of reasonable attorney fees. 
199.30     (e) The personal representative may make, execute, and 
199.31  deliver any conveyances or other documents necessary to convey 
199.32  the decedent's life estate or joint tenancy interest in the 
199.33  estate that are necessary to liquidate and reduce to cash the 
199.34  decedent's interest or for any other purposes. 
199.35     (f) Subject to administration, all costs, including 
199.36  reasonable attorney fees, directly and immediately related to 
200.1   liquidating the decedent's life estate or joint tenancy interest 
200.2   in the decedent's estate, shall be paid from the gross proceeds 
200.3   of the liquidation allocable to the decedent's interest and the 
200.4   net proceeds shall be turned over to the personal representative 
200.5   and applied to payment of the claim presented under this section.
200.6      (g) The personal representative shall bring a motion in the 
200.7   district court in which the estate is being probated to compel 
200.8   the remaindermen or surviving joint tenants to account for and 
200.9   deliver to the personal representative all or any part of the 
200.10  proceeds of any sale, mortgage, transfer, conveyance, or any 
200.11  disposition of real property allocable to the decedent's life 
200.12  estate or joint tenancy interest in the decedent's estate, and 
200.13  do everything necessary to liquidate and reduce to cash the 
200.14  decedent's interest and turn the proceeds of the sale or other 
200.15  disposition over to the personal representative.  The court may 
200.16  grant any legal or equitable relief including, but not limited 
200.17  to, ordering a partition of real estate under chapter 558 
200.18  necessary to make the value of the decedent's life estate or 
200.19  joint tenancy interest available to the estate for payment of a 
200.20  claim under this section. 
200.21     (h) Subject to administration, the personal representative 
200.22  shall use all of the cash or proceeds of interests to pay an 
200.23  allowable claim under this section.  The remaindermen or 
200.24  surviving joint tenants and their spouses, if any, may enter 
200.25  into a written agreement with the personal representative or the 
200.26  claimant to settle and satisfy obligations imposed at any time 
200.27  before or after a claim is filed. 
200.28     (i) The personal representative may provide any or all of 
200.29  the other owners, remaindermen, or surviving joint tenants with 
200.30  an affidavit terminating the decedent's estate's interest in 
200.31  real property the decedent owned as a life tenant or as a joint 
200.32  tenant with others, if the personal representative determines 
200.33  that neither the decedent nor any of the decedent's predeceased 
200.34  spouses received any medical assistance for which a claim could 
200.35  be filed under this section, or if the personal representative 
200.36  has filed an affidavit with the court that the estate has other 
201.1   assets sufficient to pay a claim, as presented, or if there is a 
201.2   written agreement under paragraph (h), or if the claim, as 
201.3   allowed, has been paid in full or to the full extent of the 
201.4   assets the estate has available to pay it.  The affidavit may be 
201.5   recorded in the office of the county recorder or filed in the 
201.6   office of the registrar of titles for the county in which the 
201.7   real property is located.  Except as provided in section 
201.8   514.981, subdivision 6, when recorded or filed, the affidavit 
201.9   shall terminate the decedent's interest in real estate the 
201.10  decedent owned as a life tenant or a joint tenant with others.  
201.11  The affidavit shall:  (1) be signed by the personal 
201.12  representative; (2) identify the decedent and the interest being 
201.13  terminated; (3) give recording information sufficient to 
201.14  identify the instrument that created the interest in real 
201.15  property being terminated; (4) legally describe the affected 
201.16  real property; (5) state that the personal representative has 
201.17  determined that neither the decedent nor any of the decedent's 
201.18  predeceased spouses received any medical assistance for which a 
201.19  claim could be filed under this section; (6) state that the 
201.20  decedent's estate has other assets sufficient to pay the claim, 
201.21  as presented, or that there is a written agreement between the 
201.22  personal representative and the claimant and the other owners or 
201.23  remaindermen or other joint tenants to satisfy the obligations 
201.24  imposed under this subdivision; and (7) state that the affidavit 
201.25  is being given to terminate the estate's interest under this 
201.26  subdivision, and any other contents as may be appropriate.  
201.27  The recorder or registrar of titles shall accept the affidavit 
201.28  for recording or filing.  The affidavit shall be effective as 
201.29  provided in this section and shall constitute notice even if it 
201.30  does not include recording information sufficient to identify 
201.31  the instrument creating the interest it terminates.  The 
201.32  affidavit shall be conclusive evidence of the stated facts. 
201.33     (j) The holder of a lien arising under subdivision 1c shall 
201.34  release the lien at the holder's expense against an interest 
201.35  terminated under paragraph (h) to the extent of the termination. 
201.36     (k) If a lien arising under subdivision 1c is not released 
202.1   under paragraph (j), prior to closing the estate, the personal 
202.2   representative shall deed the interest subject to the lien to 
202.3   the remaindermen or surviving joint tenants as their interests 
202.4   may appear.  Upon recording or filing, the deed shall work a 
202.5   merger of the recipient's life estate or joint tenancy interest, 
202.6   subject to the lien, into the remainder interest or interest the 
202.7   decedent and others owned jointly.  The lien shall attach to and 
202.8   run with the property to the extent of the decedent's interest 
202.9   at the time of the decedent's death. 
202.10     <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
202.11  2003, and applies to the estates of decedents who die on or 
202.12  after that date. 
202.13     Sec. 47.  Minnesota Statutes 2002, section 256B.15, is 
202.14  amended by adding a subdivision to read: 
202.15     Subd. 1i.  [ESTATES OF PERSONS RECEIVING MEDICAL ASSISTANCE 
202.16  AND SURVIVED BY OTHERS.] (a) For purposes of this subdivision, 
202.17  the person's estate consists of the person's probate estate and 
202.18  all of the person's interests in real property the person owned 
202.19  as a life tenant or a joint tenant at the time of the person's 
202.20  death. 
202.21     (b) Notwithstanding any law or rule to the contrary, this 
202.22  subdivision applies if a person received medical assistance for 
202.23  which a claim could be filed under this section but for the fact 
202.24  the person was survived by a spouse or by a person listed in 
202.25  subdivision 3, or if subdivision 4 applies to a claim arising 
202.26  under this section. 
202.27     (c) The person's life estate or joint tenancy interests in 
202.28  real property not subject to a medical assistance lien under 
202.29  sections 514.980 to 514.985 on the date of the person's death 
202.30  shall not end upon death and shall continue as provided in this 
202.31  subdivision.  The life estate in the estate shall be the portion 
202.32  of the interest in the property subject to the life estate that 
202.33  is equal to the life estate percentage factor for the life 
202.34  estate as listed in the Life Estate Mortality Table of the 
202.35  health care program's manual for a person who was the age of the 
202.36  medical assistance recipient on the date of the person's death.  
203.1   The joint tenancy interest in the estate shall be equal to the 
203.2   fractional interest the medical assistance recipient would have 
203.3   owned in the jointly held interest in the property had they and 
203.4   the other owners held title to the property as tenants in common 
203.5   on the date the medical assistance recipient died. 
203.6      (d) The county agency shall file a claim in the estate 
203.7   under this section on behalf of the claimant who shall be the 
203.8   commissioner of human services, notwithstanding that the 
203.9   decedent is survived by a spouse or a person listed in 
203.10  subdivision 3.  The claim, as allowed, shall not be paid by the 
203.11  estate and shall be disposed of as provided in this paragraph.  
203.12  The personal representative or the court shall make, execute, 
203.13  and deliver a lien in favor of the claimant on the decedent's 
203.14  interest in real property in the estate in the amount of the 
203.15  allowed claim on forms provided by the commissioner to the 
203.16  county agency filing the lien.  The lien shall bear interest as 
203.17  provided under section 524.3-806, shall attach to the property 
203.18  it describes upon filing or recording, and shall remain a lien 
203.19  on the real property it describes for a period of 20 years from 
203.20  the date it is filed or recorded.  The lien shall be a 
203.21  disposition of the claim sufficient to permit the estate to 
203.22  close. 
203.23     (e) The state or county agency shall file or record the 
203.24  lien in the office of the county recorder or registrar of titles 
203.25  for each county in which any of the real property is located.  
203.26  The recorder or registrar of titles shall accept the lien for 
203.27  filing or recording.  All recording or filing fees shall be paid 
203.28  by the department of human services.  The recorder or registrar 
203.29  of titles shall mail the recorded lien to the department of 
203.30  human services.  The lien need not be attested, certified, or 
203.31  acknowledged as a condition of recording or filing.  Upon 
203.32  recording or filing of a lien against a life estate or a joint 
203.33  tenancy interest, the interest subject to the lien shall merge 
203.34  into the remainder interest or the interest the recipient and 
203.35  others owned jointly.  The lien shall attach to and run with the 
203.36  property to the extent of the decedent's interest in the 
204.1   property at the time of the decedent's death as determined under 
204.2   this section.  
204.3      (f) The department shall make no adjustment or recovery 
204.4   under the lien until after the decedent's spouse, if any, has 
204.5   died, and only at a time when the decedent has no surviving 
204.6   child described in subdivision 3.  The estate, any owner of an 
204.7   interest in the property which is or may be subject to the lien, 
204.8   or any other interested party, may voluntarily pay off, settle, 
204.9   or otherwise satisfy the claim secured or to be secured by the 
204.10  lien at any time before or after the lien is filed or recorded.  
204.11  Such payoffs, settlements, and satisfactions shall be deemed to 
204.12  be voluntary repayments of past medical assistance payments for 
204.13  the benefit of the deceased recipient, and neither the process 
204.14  of settling the claim, the payment of the claim, or the 
204.15  acceptance of a payment shall constitute an adjustment or 
204.16  recovery that is prohibited under this subdivision. 
204.17     (g) The lien under this subdivision may be enforced or 
204.18  foreclosed in the manner provided by law for the enforcement of 
204.19  judgment liens against real estate or by a foreclosure by action 
204.20  under chapter 581.  When the lien is paid, satisfied, or 
204.21  otherwise discharged, the state or county agency shall prepare 
204.22  and file a release of lien at its own expense.  No action to 
204.23  foreclose the lien shall be commenced unless the lien holder has 
204.24  first given 30 days' prior written notice to pay the lien to the 
204.25  owners and parties in possession of the property subject to the 
204.26  lien.  The notice shall:  (1) include the name, address, and 
204.27  telephone number of the lien holder; (2) describe the lien; (3) 
204.28  give the amount of the lien; (4) inform the owner or party in 
204.29  possession that payment of the lien in full must be made to the 
204.30  lien holder within 30 days after service of the notice or the 
204.31  lien holder may begin proceedings to foreclose the lien; and (5) 
204.32  be served by personal service, certified mail, return receipt 
204.33  requested, ordinary first class mail, or by publishing it once 
204.34  in a newspaper of general circulation in the county in which any 
204.35  part of the property is located.  Service of the notice shall be 
204.36  complete upon mailing or publication. 
205.1      <b>[EFFECTIVE DATE.]</b> This section takes effect August 1, 2003, 
205.2   and applies to estates of decedents who die on or after that 
205.3   date. 
205.4      Sec. 48.  Minnesota Statutes 2002, section 256B.15, is 
205.5   amended by adding a subdivision to read: 
205.6      Subd. 1j.  [CLAIMS IN ESTATES OF DECEDENTS SURVIVED BY 
205.7   OTHER SURVIVORS.] For purposes of this subdivision, the 
205.8   provisions in subdivision 1i, paragraphs (a) to (c) apply. 
205.9      (a) If payment of a claim filed under this section is 
205.10  limited as provided in subdivision 4, and if the estate does not 
205.11  have other assets sufficient to pay the claim in full, as 
205.12  allowed, the personal representative or the court shall make, 
205.13  execute, and deliver a lien on the property in the estate that 
205.14  is exempt from the claim under subdivision 4 in favor of the 
205.15  commissioner of human services on forms provided by the 
205.16  commissioner to the county agency filing the claim.  If the 
205.17  estate pays a claim filed under this section in full from other 
205.18  assets of the estate, no lien shall be filed against the 
205.19  property described in subdivision 4. 
205.20     (b) The lien shall be in an amount equal to the unpaid 
205.21  balance of the allowed claim under this section remaining after 
205.22  the estate has applied all other available assets of the estate 
205.23  to pay the claim.  The property exempt under subdivision 4 shall 
205.24  not be sold, assigned, transferred, conveyed, encumbered, or 
205.25  distributed until after the personal representative has 
205.26  determined the estate has other assets sufficient to pay the 
205.27  allowed claim in full, or until after the lien has been filed or 
205.28  recorded.  The lien shall bear interest as provided under 
205.29  section 524.3-806, shall attach to the property it describes 
205.30  upon filing or recording, and shall remain a lien on the real 
205.31  property it describes for a period of 20 years from the date it 
205.32  is filed or recorded.  The lien shall be a disposition of the 
205.33  claim sufficient to permit the estate to close. 
205.34     (c) The state or county agency shall file or record the 
205.35  lien in the office of the county recorder or registrar of titles 
205.36  in each county in which any of the real property is located.  
206.1   The department shall pay the filing fees.  The lien need not be 
206.2   attested, certified, or acknowledged as a condition of recording 
206.3   or filing.  The recorder or registrar of titles shall accept the 
206.4   lien for filing or recording. 
206.5      (d) The commissioner shall make no adjustment or recovery 
206.6   under the lien until none of the persons listed in subdivision 4 
206.7   are residing on the property or until the property is sold or 
206.8   transferred.  The estate or any owner of an interest in the 
206.9   property that is or may be subject to the lien, or any other 
206.10  interested party, may voluntarily pay off, settle, or otherwise 
206.11  satisfy the claim secured or to be secured by the lien at any 
206.12  time before or after the lien is filed or recorded.  The 
206.13  payoffs, settlements, and satisfactions shall be deemed to be 
206.14  voluntary repayments of past medical assistance payments for the 
206.15  benefit of the deceased recipient and neither the process of 
206.16  settling the claim, the payment of the claim, or acceptance of a 
206.17  payment shall constitute an adjustment or recovery that is 
206.18  prohibited under this subdivision. 
206.19     (e) A lien under this subdivision may be enforced or 
206.20  foreclosed in the manner provided for by law for the enforcement 
206.21  of judgment liens against real estate or by a foreclosure by 
206.22  action under chapter 581.  When the lien has been paid, 
206.23  satisfied, or otherwise discharged, the claimant shall prepare 
206.24  and file a release of lien at the claimant's expense.  No action 
206.25  to foreclose the lien shall be commenced unless the lien holder 
206.26  has first given 30 days prior written notice to pay the lien to 
206.27  the record owners of the property and the parties in possession 
206.28  of the property subject to the lien.  The notice shall:  (1) 
206.29  include the name, address, and telephone number of the lien 
206.30  holder; (2) describe the lien; (3) give the amount of the lien; 
206.31  (4) inform the owner or party in possession that payment of the 
206.32  lien in full must be made to the lien holder within 30 days 
206.33  after service of the notice or the lien holder may begin 
206.34  proceedings to foreclose the lien; and (5) be served by personal 
206.35  service, certified mail, return receipt requested, ordinary 
206.36  first class mail, or by publishing it once in a newspaper of 
207.1   general circulation in the county in which any part of the 
207.2   property is located.  Service shall be complete upon mailing or 
207.3   publication. 
207.4      (f) Upon filing or recording of a lien against a life 
207.5   estate or joint tenancy interest under this subdivision, the 
207.6   interest subject to the lien shall merge into the remainder 
207.7   interest or the interest the decedent and others owned jointly, 
207.8   effective on the date of recording and filing.  The lien shall 
207.9   attach to and run with the property to the extent of the 
207.10  decedent's interest in the property at the time of the 
207.11  decedent's death as determined under this section. 
207.12     (g)(1) An affidavit may be provided by a personal 
207.13  representative stating the personal representative has 
207.14  determined in good faith that a decedent survived by a spouse or 
207.15  a person listed in subdivision 3, or by a person listed in 
207.16  subdivision 4, or the decedent's predeceased spouse did not 
207.17  receive any medical assistance giving rise to a claim under this 
207.18  section, or that the real property described in subdivision 4 is 
207.19  not needed to pay in full a claim arising under this section. 
207.20     (2) The affidavit shall:  (i) describe the property and the 
207.21  interest being extinguished; (ii) name the decedent and give the 
207.22  date of death; (iii) state the facts listed in clause (1); (iv) 
207.23  state that the affidavit is being filed to terminate the life 
207.24  estate or joint tenancy interest created under this subdivision; 
207.25  (v) be signed by the personal representative; and (vi) contain 
207.26  any other information that the affiant deems appropriate. 
207.27     (3) Except as provided in section 514.981, subdivision 6, 
207.28  when the affidavit is filed or recorded, the life estate or 
207.29  joint tenancy interest in real property that the affidavit 
207.30  describes shall be terminated effective as of the date of filing 
207.31  or recording.  The termination shall be final and may not be set 
207.32  aside for any reason. 
207.33     <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
207.34  2003, and applies to the estates of decedents who die on or 
207.35  after that date. 
207.36     Sec. 49.  Minnesota Statutes 2002, section 256B.15, is 
208.1   amended by adding a subdivision to read: 
208.2      Subd. 1k.  [FILING.] Any notice, lien, release, or other 
208.3   document filed under subdivisions 1c to 1l, and any lien, 
208.4   release of lien, or other documents relating to a lien filed 
208.5   under subdivisions 1h, 1i, and 1j must be filed or recorded in 
208.6   the office of the county recorder or registrar of titles, as 
208.7   appropriate, in the county where the affected real property is 
208.8   located.  Notwithstanding section 386.77, the state or county 
208.9   agency shall pay any applicable filing fee.  An attestation, 
208.10  certification, or acknowledgment is not required as a condition 
208.11  of filing.  If the property described in the filing is 
208.12  registered property, the registrar of titles shall record the 
208.13  filing on the certificate of title for each parcel of property 
208.14  described in the filing.  If the property described in the 
208.15  filing is abstract property, the recorder shall file and index 
208.16  the property in the county's grantor-grantee indexes and any 
208.17  tract indexes the county maintains for each parcel of property 
208.18  described in the filing.  The recorder or registrar of titles 
208.19  shall return the filed document to the party filing it at no 
208.20  cost.  If the party making the filing provides a duplicate copy 
208.21  of the filing, the recorder or registrar of titles shall show 
208.22  the recording or filing data on the copy and return it to the 
208.23  party at no extra cost. 
208.24     <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
208.25  2003, and applies to the estates of decedents who die on or 
208.26  after that date. 
208.27     Sec. 50.  Minnesota Statutes 2002, section 256B.15, 
208.28  subdivision 3, is amended to read: 
208.29     Subd. 3.  [SURVIVING SPOUSE, MINOR, BLIND, OR DISABLED 
208.30  CHILDREN.] If a decedent who is survived by a spouse, or was 
208.31  single, or who was the surviving spouse of a married couple, and 
208.32  is survived by a child who is under age 21 or blind or 
208.33  permanently and totally disabled according to the supplemental 
208.34  security income program criteria, no a claim shall be filed 
208.35  against the estate according to this section. 
208.36     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
209.1   and applies to decedents who die on or after that date. 
209.2      Sec. 51.  Minnesota Statutes 2002, section 256B.15, 
209.3   subdivision 4, is amended to read: 
209.4      Subd. 4.  [OTHER SURVIVORS.] If the decedent who was single 
209.5   or the surviving spouse of a married couple is survived by one 
209.6   of the following persons, a claim exists against the estate in 
209.7   an amount not to exceed the value of the nonhomestead property 
209.8   included in the estate and the personal representative shall 
209.9   make, execute, and deliver to the county agency a lien against 
209.10  the homestead property in the estate for any unpaid balance of 
209.11  the claim to the claimant as provided under this section: 
209.12     (a) a sibling who resided in the decedent medical 
209.13  assistance recipient's home at least one year before the 
209.14  decedent's institutionalization and continuously since the date 
209.15  of institutionalization; or 
209.16     (b) a son or daughter or a grandchild who resided in the 
209.17  decedent medical assistance recipient's home for at least two 
209.18  years immediately before the parent's or grandparent's 
209.19  institutionalization and continuously since the date of 
209.20  institutionalization, and who establishes by a preponderance of 
209.21  the evidence having provided care to the parent or grandparent 
209.22  who received medical assistance, that the care was provided 
209.23  before institutionalization, and that the care permitted the 
209.24  parent or grandparent to reside at home rather than in an 
209.25  institution. 
209.26     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
209.27  and applies to decedents who die on or after that date. 
209.28     Sec. 52.  Minnesota Statutes 2002, section 256B.195, 
209.29  subdivision 4, is amended to read: 
209.30     Subd. 4.  [ADJUSTMENTS PERMITTED.] (a) The commissioner may 
209.31  adjust the intergovernmental transfers under subdivision 2 and 
209.32  the payments under subdivision 3, and payments and transfers 
209.33  under subdivision 5, based on the commissioner's determination 
209.34  of Medicare upper payment limits, hospital-specific charge 
209.35  limits, and hospital-specific limitations on disproportionate 
209.36  share payments.  Any adjustments must be made on a proportional 
210.1   basis.  If participation by a particular hospital under this 
210.2   section is limited, the commissioner shall adjust the payments 
210.3   that relate to that hospital under subdivisions 2, and 3, and 5 
210.4   on a proportional basis in order to allow the hospital to 
210.5   participate under this section to the fullest extent possible 
210.6   and shall increase other payments under subdivisions 2, and 3, 
210.7   and 5 to the extent allowable to maintain the overall level of 
210.8   payments under this section.  The commissioner may make 
210.9   adjustments under this subdivision only after consultation with 
210.10  the counties and hospitals identified in subdivisions 2 and 3, 
210.11  and, if subdivision 5 receives federal approval, with the 
210.12  hospital and educational institution identified in subdivision 5.
210.13     (b) The ratio of medical assistance payments specified in 
210.14  subdivision 3 to the intergovernmental transfers specified in 
210.15  subdivision 2 shall not be reduced except as provided under 
210.16  paragraph (a).  
210.17     Sec. 53.  Minnesota Statutes 2002, section 256B.195, 
210.18  subdivision 5, is amended to read: 
210.19     Subd. 5.  [INCLUSION OF FAIRVIEW UNIVERSITY MEDICAL 
210.20  CENTER.] (a) Upon federal approval of the inclusion of Fairview 
210.21  University Medical Center in the nonstate government 
210.22  category payments in paragraph (b), the commissioner shall 
210.23  establish an intergovernmental transfer with the University of 
210.24  Minnesota in an amount determined by the commissioner based on 
210.25  the increase in the amount of Medicare upper payment limit due 
210.26  solely to the inclusion of Fairview University Medical Center as 
210.27  a nonstate government hospital and limited available for 
210.28  nongovernment hospitals, adjusted by hospital-specific charge 
210.29  limits and the amount available under the hospital-specific 
210.30  disproportionate share limit. 
210.31     (b) The commissioner shall increase payments for medical 
210.32  assistance admissions at Fairview University Medical Center by 
210.33  71 percent of the transfer plus any federal matching payments on 
210.34  that amount, to increase payments for medical assistance 
210.35  admissions and to recognize higher medical assistance costs in 
210.36  institutions that provide high levels of charity care.  From 
211.1   this payment, Fairview University Medical Center shall pay to 
211.2   the University of Minnesota the cost of the transfer, on the 
211.3   same day the payment is received.  Eighteen percent of the 
211.4   transfer plus any federal matching payments shall be used as 
211.5   specified in subdivision 3, paragraph (b), clause (1).  Payments 
211.6   under section 256.969, subdivision 26, may be increased above 
211.7   the 90 percent level specified in that subdivision within the 
211.8   limits of additional funding available under this subdivision.  
211.9   Eleven percent of the transfer shall be used to increase the 
211.10  grants under section 145.9268. 
211.11     Sec. 54.  Minnesota Statutes 2002, section 256B.31, is 
211.12  amended to read: 
211.13     256B.31 [CONTINUED HOSPITAL CARE FOR LONG-TERM POLIO 
211.14  PATIENT.] 
211.15     A medical assistance recipient who has been a polio patient 
211.16  in an acute care hospital for a period of not less than 25 
211.17  consecutive years is eligible to continue receiving hospital 
211.18  care, whether or not the care is medically necessary for 
211.19  purposes of federal reimbursement.  The cost of continued 
211.20  hospital care not reimbursable by the federal government must be 
211.21  paid with state money allocated for the medical assistance 
211.22  program.  The rate paid to the hospital is the rate per day 
211.23  established using Medicare principles for the hospital's fiscal 
211.24  year ending December 31, 1981, adjusted each year by the annual 
211.25  hospital cost index established under section 256.969, 
211.26  subdivision 1, or by other limits in effect at the time of the 
211.27  adjustment average inpatient routine rate per day for non-MFIP 
211.28  eligibles, excluding rehabilitation and neonate admissions but 
211.29  including property, for hospitals located outside of a 
211.30  metropolitan statistical area, as defined by the United States 
211.31  Census Bureau.  This section does not prohibit a voluntary move 
211.32  to another living arrangement by a recipient whose care is 
211.33  reimbursed under this section. 
211.34     Sec. 55.  Minnesota Statutes 2002, section 256B.32, 
211.35  subdivision 1, is amended to read: 
211.36     Subdivision 1.  [FACILITY FEE PAYMENT.] (a) The 
212.1   commissioner shall establish a facility fee payment mechanism 
212.2   that will pay a facility fee to all enrolled outpatient 
212.3   hospitals for each emergency room or outpatient clinic visit 
212.4   provided on or after July 1, 1989.  This payment mechanism may 
212.5   not result in an overall increase in outpatient payment rates.  
212.6   This section does not apply to federally mandated maximum 
212.7   payment limits, department approved program packages, or 
212.8   services billed using a nonoutpatient hospital provider number. 
212.9      (b) For fee-for-service services provided on or after July 
212.10  1, 2002, the total payment, before third-party liability and 
212.11  spenddown, made to hospitals for outpatient hospital facility 
212.12  services is reduced by .5 percent from the current statutory 
212.13  rates. 
212.14     (c) In addition to the reduction in paragraph (b), the 
212.15  total payment for fee-for-service services provided on or after 
212.16  July 1, 2003, made to hospitals for outpatient hospital facility 
212.17  services before third-party liability and spenddown, is reduced 
212.18  2.5 percent from the current statutory rates.  Facilities 
212.19  defined under section 256.969, subdivision 16, are excluded from 
212.20  this paragraph. 
212.21     Sec. 56.  Minnesota Statutes 2002, section 256B.69, 
212.22  subdivision 2, is amended to read: 
212.23     Subd. 2.  [DEFINITIONS.] For the purposes of this section, 
212.24  the following terms have the meanings given.  
212.25     (a) "Commissioner" means the commissioner of human services.
212.26  For the remainder of this section, the commissioner's 
212.27  responsibilities for methods and policies for implementing the 
212.28  project will be proposed by the project advisory committees and 
212.29  approved by the commissioner.  
212.30     (b) "Demonstration provider" means a health maintenance 
212.31  organization, community integrated service network, or 
212.32  accountable provider network authorized and operating under 
212.33  chapter 62D, 62N, or 62T that participates in the demonstration 
212.34  project according to criteria, standards, methods, and other 
212.35  requirements established for the project and approved by the 
212.36  commissioner.  For purposes of this section, a county board, or 
213.1   group of county boards operating under a joint powers agreement, 
213.2   is considered a demonstration provider if the county or group of 
213.3   county boards meets the requirements of section 256B.692.  
213.4   Notwithstanding the above, Itasca county may continue to 
213.5   participate as a demonstration provider until July 1, 2004. 
213.6      (c) "Eligible individuals" means those persons eligible for 
213.7   medical assistance benefits as defined in sections 256B.055, 
213.8   256B.056, and 256B.06. 
213.9      (d) "Limitation of choice" means suspending freedom of 
213.10  choice while allowing eligible individuals to choose among the 
213.11  demonstration providers.  
213.12     (e) This paragraph supersedes paragraph (c) as long as the 
213.13  Minnesota health care reform waiver remains in effect.  When the 
213.14  waiver expires, this paragraph expires and the commissioner of 
213.15  human services shall publish a notice in the State Register and 
213.16  notify the revisor of statutes.  "Eligible individuals" means 
213.17  those persons eligible for medical assistance benefits as 
213.18  defined in sections 256B.055, 256B.056, and 256B.06.  
213.19  Notwithstanding sections 256B.055, 256B.056, and 256B.06, an 
213.20  individual who becomes ineligible for the program because of 
213.21  failure to submit income reports or recertification forms in a 
213.22  timely manner, shall remain enrolled in the prepaid health plan 
213.23  and shall remain eligible to receive medical assistance coverage 
213.24  through the last day of the month following the month in which 
213.25  the enrollee became ineligible for the medical assistance 
213.26  program. 
213.27     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
213.28     Sec. 57.  Minnesota Statutes 2002, section 256B.69, 
213.29  subdivision 4, is amended to read: 
213.30     Subd. 4.  [LIMITATION OF CHOICE.] (a) The commissioner 
213.31  shall develop criteria to determine when limitation of choice 
213.32  may be implemented in the experimental counties.  The criteria 
213.33  shall ensure that all eligible individuals in the county have 
213.34  continuing access to the full range of medical assistance 
213.35  services as specified in subdivision 6.  
213.36     (b) The commissioner shall exempt the following persons 
214.1   from participation in the project, in addition to those who do 
214.2   not meet the criteria for limitation of choice:  
214.3      (1) persons eligible for medical assistance according to 
214.4   section 256B.055, subdivision 1; 
214.5      (2) persons eligible for medical assistance due to 
214.6   blindness or disability as determined by the social security 
214.7   administration or the state medical review team, unless:  
214.8      (i) they are 65 years of age or older; or 
214.9      (ii) they reside in Itasca county or they reside in a 
214.10  county in which the commissioner conducts a pilot project under 
214.11  a waiver granted pursuant to section 1115 of the Social Security 
214.12  Act; 
214.13     (3) recipients who currently have private coverage through 
214.14  a health maintenance organization; 
214.15     (4) recipients who are eligible for medical assistance by 
214.16  spending down excess income for medical expenses other than the 
214.17  nursing facility per diem expense; 
214.18     (5) recipients who receive benefits under the Refugee 
214.19  Assistance Program, established under United States Code, title 
214.20  8, section 1522(e); 
214.21     (6) children who are both determined to be severely 
214.22  emotionally disturbed and receiving case management services 
214.23  according to section 256B.0625, subdivision 20; 
214.24     (7) adults who are both determined to be seriously and 
214.25  persistently mentally ill and received case management services 
214.26  according to section 256B.0625, subdivision 20; and 
214.27     (8) persons eligible for medical assistance according to 
214.28  section 256B.057, subdivision 10; and 
214.29     (9) persons with access to cost-effective 
214.30  employer-sponsored private health insurance or persons enrolled 
214.31  in an individual health plan determined to be cost-effective 
214.32  according to section 256B.0625, subdivision 15.  
214.33  Children under age 21 who are in foster placement may enroll in 
214.34  the project on an elective basis.  Individuals excluded under 
214.35  clauses (6) and (7) may choose to enroll on an elective basis.  
214.36     (c) The commissioner may allow persons with a one-month 
215.1   spenddown who are otherwise eligible to enroll to voluntarily 
215.2   enroll or remain enrolled, if they elect to prepay their monthly 
215.3   spenddown to the state.  
215.4      (d) The commissioner may require those individuals to 
215.5   enroll in the prepaid medical assistance program who otherwise 
215.6   would have been excluded under paragraph (b), clauses (1), (3), 
215.7   and (8), and under Minnesota Rules, part 9500.1452, subpart 2, 
215.8   items H, K, and L.  
215.9      (e) Before limitation of choice is implemented, eligible 
215.10  individuals shall be notified and after notification, shall be 
215.11  allowed to choose only among demonstration providers.  The 
215.12  commissioner may assign an individual with private coverage 
215.13  through a health maintenance organization, to the same health 
215.14  maintenance organization for medical assistance coverage, if the 
215.15  health maintenance organization is under contract for medical 
215.16  assistance in the individual's county of residence.  After 
215.17  initially choosing a provider, the recipient is allowed to 
215.18  change that choice only at specified times as allowed by the 
215.19  commissioner.  If a demonstration provider ends participation in 
215.20  the project for any reason, a recipient enrolled with that 
215.21  provider must select a new provider but may change providers 
215.22  without cause once more within the first 60 days after 
215.23  enrollment with the second provider. 
215.24     Sec. 58.  Minnesota Statutes 2002, section 256B.69, 
215.25  subdivision 5a, is amended to read: 
215.26     Subd. 5a.  [MANAGED CARE CONTRACTS.] (a) Managed care 
215.27  contracts under this section and sections 256L.12 and 256D.03, 
215.28  shall be entered into or renewed on a calendar year basis 
215.29  beginning January 1, 1996.  Managed care contracts which were in 
215.30  effect on June 30, 1995, and set to renew on July 1, 1995, shall 
215.31  be renewed for the period July 1, 1995 through December 31, 1995 
215.32  at the same terms that were in effect on June 30, 1995. 
215.33     (b) A prepaid health plan providing covered health services 
215.34  for eligible persons pursuant to chapters 256B, 256D, and 256L, 
215.35  is responsible for complying with the terms of its contract with 
215.36  the commissioner.  Requirements applicable to managed care 
216.1   programs under chapters 256B, 256D, and 256L, established after 
216.2   the effective date of a contract with the commissioner take 
216.3   effect when the contract is next issued or renewed. 
216.4      (c) Effective for services rendered on or after January 1, 
216.5   2003, the commissioner shall withhold five percent of managed 
216.6   care plan payments under this section for the prepaid medical 
216.7   assistance and general assistance medical care programs pending 
216.8   completion of performance targets.  Each performance target must 
216.9   be quantifiable, objective, measurable, and reasonably 
216.10  attainable.  Criteria for assessment of each performance target 
216.11  must be outlined in writing prior to the contract effective 
216.12  date.  The withheld funds must be returned no sooner than July 
216.13  of the following year if performance targets in the contract are 
216.14  achieved.  The commissioner may exclude special demonstration 
216.15  projects under subdivision 23.  A managed care plan may include 
216.16  as admitted assets under section 62D.044 any amount withheld 
216.17  under this paragraph that is reasonably expected to be returned. 
216.18     (d) The commissioner may exempt from paragraph (c) a 
216.19  managed care plan that has entered into a managed care contract 
216.20  with the commissioner in accordance with this section if the 
216.21  contract was the initial contract between the managed care plan 
216.22  and the commissioner, and it was entered into after January 1, 
216.23  2000.  This exemption shall apply for the first five years of 
216.24  operation of the managed care plan. 
216.25     <b>[EFFECTIVE DATE.]</b> This section is effective for services 
216.26  rendered on or after July 1, 2003, except that the amendment to 
216.27  paragraph (c) is effective for services rendered on or after 
216.28  January 1, 2004.  
216.29     Sec. 59.  Minnesota Statutes 2002, section 256B.69, 
216.30  subdivision 5c, is amended to read: 
216.31     Subd. 5c.  [MEDICAL EDUCATION AND RESEARCH FUND.] (a) The 
216.32  commissioner of human services shall transfer each year to the 
216.33  medical education and research fund established under section 
216.34  62J.692, the following: 
216.35     (1) an amount equal to the reduction in the prepaid medical 
216.36  assistance and prepaid general assistance medical care payments 
217.1   as specified in this clause.  Until January 1, 2002, the county 
217.2   medical assistance and general assistance medical care 
217.3   capitation base rate prior to plan specific adjustments and 
217.4   after the regional rate adjustments under section 256B.69, 
217.5   subdivision 5b, is reduced 6.3 percent for Hennepin county, two 
217.6   percent for the remaining metropolitan counties, and no 
217.7   reduction for nonmetropolitan Minnesota counties; and after 
217.8   January 1, 2002, the county medical assistance and general 
217.9   assistance medical care capitation base rate prior to plan 
217.10  specific adjustments is reduced 6.3 percent for Hennepin county, 
217.11  two percent for the remaining metropolitan counties, and 1.6 
217.12  percent for nonmetropolitan Minnesota counties.  Nursing 
217.13  facility and elderly waiver payments and demonstration project 
217.14  payments operating under subdivision 23 are excluded from this 
217.15  reduction.  The amount calculated under this clause shall not be 
217.16  adjusted for periods already paid due to subsequent changes to 
217.17  the capitation payments; 
217.18     (2) beginning July 1, 2001, $2,537,000 2003, $2,157,000 
217.19  from the capitation rates paid under this section plus any 
217.20  federal matching funds on this amount; 
217.21     (3) beginning July 1, 2002, an additional $12,700,000 from 
217.22  the capitation rates paid under this section; and 
217.23     (4) beginning July 1, 2003, an additional $4,700,000 from 
217.24  the capitation rates paid under this section. 
217.25     (b) This subdivision shall be effective upon approval of a 
217.26  federal waiver which allows federal financial participation in 
217.27  the medical education and research fund. 
217.28     (c) Effective July 1, 2003, the amount from general 
217.29  assistance medical care under paragraph (a), clause (1), shall 
217.30  be transferred to the general fund. 
217.31     Sec. 60.  Minnesota Statutes 2002, section 256B.69, is 
217.32  amended by adding a subdivision to read: 
217.33     Subd. 5h.  [PAYMENT REDUCTION.] In addition to the 
217.34  reduction in subdivision 5g, the total payment made to managed 
217.35  care plans under the medical assistance program is reduced 0.5 
217.36  percent for services provided on or after October 1, 2003, and 
218.1   an additional 0.5 percent for services provided on or after 
218.2   January 1, 2004.  This provision excludes payments for nursing 
218.3   home services, home and community-based waivers, and payments to 
218.4   demonstration projects for persons with disabilities. 
218.5      Sec. 61.  Minnesota Statutes 2002, section 256B.69, is 
218.6   amended by adding a subdivision to read: 
218.7      Subd. 5i.  [ACTUARIAL SOUNDNESS.] All payments made to 
218.8   managed care plans under the medical assistance program shall be 
218.9   actuarially sound pursuant to Code of Federal Regulations, title 
218.10  42, section 438.6.  In establishing payment rates for managed 
218.11  care plans under the medical assistance program, the 
218.12  commissioner must consider, to the extent this information is 
218.13  available, verifiable, and actuarially significant:  (1) 
218.14  individual health plan annual financial performance for public 
218.15  programs; and (2) rate relationships and geographic payment 
218.16  relativities based on actual health plan experience.  The 
218.17  commissioner may recover any administrative costs related to 
218.18  implementing this subdivision by assessing managed care plans in 
218.19  proportion to their share of enrollees in the prepaid medical 
218.20  assistance program. 
218.21     Sec. 62.  Minnesota Statutes 2002, section 256B.75, is 
218.22  amended to read: 
218.23     256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 
218.24     (a) For outpatient hospital facility fee payments for 
218.25  services rendered on or after October 1, 1992, the commissioner 
218.26  of human services shall pay the lower of (1) submitted charge, 
218.27  or (2) 32 percent above the rate in effect on June 30, 1992, 
218.28  except for those services for which there is a federal maximum 
218.29  allowable payment.  Effective for services rendered on or after 
218.30  January 1, 2000, payment rates for nonsurgical outpatient 
218.31  hospital facility fees and emergency room facility fees shall be 
218.32  increased by eight percent over the rates in effect on December 
218.33  31, 1999, except for those services for which there is a federal 
218.34  maximum allowable payment.  Services for which there is a 
218.35  federal maximum allowable payment shall be paid at the lower of 
218.36  (1) submitted charge, or (2) the federal maximum allowable 
219.1   payment.  Total aggregate payment for outpatient hospital 
219.2   facility fee services shall not exceed the Medicare upper 
219.3   limit.  If it is determined that a provision of this section 
219.4   conflicts with existing or future requirements of the United 
219.5   States government with respect to federal financial 
219.6   participation in medical assistance, the federal requirements 
219.7   prevail.  The commissioner may, in the aggregate, prospectively 
219.8   reduce payment rates to avoid reduced federal financial 
219.9   participation resulting from rates that are in excess of the 
219.10  Medicare upper limitations. 
219.11     (b) Notwithstanding paragraph (a), payment for outpatient, 
219.12  emergency, and ambulatory surgery hospital facility fee services 
219.13  for critical access hospitals designated under section 144.1483, 
219.14  clause (11), shall be paid on a cost-based payment system that 
219.15  is based on the cost-finding methods and allowable costs of the 
219.16  Medicare program. 
219.17     (c) Effective for services provided on or after July 1, 
219.18  2003, rates that are based on the Medicare outpatient 
219.19  prospective payment system shall be replaced by a budget neutral 
219.20  prospective payment system that is derived using medical 
219.21  assistance data.  The commissioner shall provide a proposal to 
219.22  the 2003 legislature to define and implement this provision. 
219.23     (d) For fee-for-service services provided on or after July 
219.24  1, 2002, the total payment, before third-party liability and 
219.25  spenddown, made to hospitals for outpatient hospital facility 
219.26  services is reduced by .5 percent from the current statutory 
219.27  rate. 
219.28     (e) In addition to the reduction in paragraph (d), the 
219.29  total payment for fee-for-service services provided on or after 
219.30  July 1, 2003, made to hospitals for outpatient hospital facility 
219.31  services before third-party liability and spenddown, is reduced 
219.32  2.5 percent from the current statutory rates.  Facilities 
219.33  defined under section 256.969, subdivision 16, are excluded from 
219.34  this paragraph. 
219.35     Sec. 63.  Minnesota Statutes 2002, section 256B.76, is 
219.36  amended to read: 
220.1      256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
220.2      (a) Effective for services rendered on or after October 1, 
220.3   1992, the commissioner shall make payments for physician 
220.4   services as follows: 
220.5      (1) payment for level one Centers for Medicare and Medicaid 
220.6   Services' common procedural coding system codes titled "office 
220.7   and other outpatient services," "preventive medicine new and 
220.8   established patient," "delivery, antepartum, and postpartum 
220.9   care," "critical care," cesarean delivery and pharmacologic 
220.10  management provided to psychiatric patients, and level three 
220.11  codes for enhanced services for prenatal high risk, shall be 
220.12  paid at the lower of (i) submitted charges, or (ii) 25 percent 
220.13  above the rate in effect on June 30, 1992.  If the rate on any 
220.14  procedure code within these categories is different than the 
220.15  rate that would have been paid under the methodology in section 
220.16  256B.74, subdivision 2, then the larger rate shall be paid; 
220.17     (2) payments for all other services shall be paid at the 
220.18  lower of (i) submitted charges, or (ii) 15.4 percent above the 
220.19  rate in effect on June 30, 1992; 
220.20     (3) all physician rates shall be converted from the 50th 
220.21  percentile of 1982 to the 50th percentile of 1989, less the 
220.22  percent in aggregate necessary to equal the above increases 
220.23  except that payment rates for home health agency services shall 
220.24  be the rates in effect on September 30, 1992; 
220.25     (4) effective for services rendered on or after January 1, 
220.26  2000, payment rates for physician and professional services 
220.27  shall be increased by three percent over the rates in effect on 
220.28  December 31, 1999, except for home health agency and family 
220.29  planning agency services; and 
220.30     (5) the increases in clause (4) shall be implemented 
220.31  January 1, 2000, for managed care. 
220.32     (b) Effective for services rendered on or after October 1, 
220.33  1992, the commissioner shall make payments for dental services 
220.34  as follows: 
220.35     (1) dental services shall be paid at the lower of (i) 
220.36  submitted charges, or (ii) 25 percent above the rate in effect 
221.1   on June 30, 1992; 
221.2      (2) dental rates shall be converted from the 50th 
221.3   percentile of 1982 to the 50th percentile of 1989, less the 
221.4   percent in aggregate necessary to equal the above increases; 
221.5      (3) effective for services rendered on or after January 1, 
221.6   2000, payment rates for dental services shall be increased by 
221.7   three percent over the rates in effect on December 31, 1999; 
221.8      (4) the commissioner shall award grants to community 
221.9   clinics or other nonprofit community organizations, political 
221.10  subdivisions, professional associations, or other organizations 
221.11  that demonstrate the ability to provide dental services 
221.12  effectively to public program recipients.  Grants may be used to 
221.13  fund the costs related to coordinating access for recipients, 
221.14  developing and implementing patient care criteria, upgrading or 
221.15  establishing new facilities, acquiring furnishings or equipment, 
221.16  recruiting new providers, or other development costs that will 
221.17  improve access to dental care in a region.  In awarding grants, 
221.18  the commissioner shall give priority to applicants that plan to 
221.19  serve areas of the state in which the number of dental providers 
221.20  is not currently sufficient to meet the needs of recipients of 
221.21  public programs or uninsured individuals.  The commissioner 
221.22  shall consider the following in awarding the grants: 
221.23     (i) potential to successfully increase access to an 
221.24  underserved population; 
221.25     (ii) the ability to raise matching funds; 
221.26     (iii) the long-term viability of the project to improve 
221.27  access beyond the period of initial funding; 
221.28     (iv) the efficiency in the use of the funding; and 
221.29     (v) the experience of the proposers in providing services 
221.30  to the target population. 
221.31     The commissioner shall monitor the grants and may terminate 
221.32  a grant if the grantee does not increase dental access for 
221.33  public program recipients.  The commissioner shall consider 
221.34  grants for the following: 
221.35     (i) implementation of new programs or continued expansion 
221.36  of current access programs that have demonstrated success in 
222.1   providing dental services in underserved areas; 
222.2      (ii) a pilot program for utilizing hygienists outside of a 
222.3   traditional dental office to provide dental hygiene services; 
222.4   and 
222.5      (iii) a program that organizes a network of volunteer 
222.6   dentists, establishes a system to refer eligible individuals to 
222.7   volunteer dentists, and through that network provides donated 
222.8   dental care services to public program recipients or uninsured 
222.9   individuals; 
222.10     (5) beginning October 1, 1999, the payment for tooth 
222.11  sealants and fluoride treatments shall be the lower of (i) 
222.12  submitted charge, or (ii) 80 percent of median 1997 charges; 
222.13     (6) the increases listed in clauses (3) and (5) shall be 
222.14  implemented January 1, 2000, for managed care; and 
222.15     (7) effective for services provided on or after January 1, 
222.16  2002, payment for diagnostic examinations and dental x-rays 
222.17  provided to children under age 21 shall be the lower of (i) the 
222.18  submitted charge, or (ii) 85 percent of median 1999 charges.  
222.19     (c) Effective for dental services rendered on or after 
222.20  January 1, 2002, the commissioner may, within the limits of 
222.21  available appropriation, increase reimbursements to dentists and 
222.22  dental clinics deemed by the commissioner to be critical access 
222.23  dental providers.  Reimbursement to a critical access dental 
222.24  provider may be increased by not more than 50 percent above the 
222.25  reimbursement rate that would otherwise be paid to the 
222.26  provider.  Payments to health plan companies shall be adjusted 
222.27  to reflect increased reimbursements to critical access dental 
222.28  providers as approved by the commissioner.  In determining which 
222.29  dentists and dental clinics shall be deemed critical access 
222.30  dental providers, the commissioner shall review: 
222.31     (1) the utilization rate in the service area in which the 
222.32  dentist or dental clinic operates for dental services to 
222.33  patients covered by medical assistance, general assistance 
222.34  medical care, or MinnesotaCare as their primary source of 
222.35  coverage; 
222.36     (2) the level of services provided by the dentist or dental 
223.1   clinic to patients covered by medical assistance, general 
223.2   assistance medical care, or MinnesotaCare as their primary 
223.3   source of coverage; and 
223.4      (3) whether the level of services provided by the dentist 
223.5   or dental clinic is critical to maintaining adequate levels of 
223.6   patient access within the service area. 
223.7   In the absence of a critical access dental provider in a service 
223.8   area, the commissioner may designate a dentist or dental clinic 
223.9   as a critical access dental provider if the dentist or dental 
223.10  clinic is willing to provide care to patients covered by medical 
223.11  assistance, general assistance medical care, or MinnesotaCare at 
223.12  a level which significantly increases access to dental care in 
223.13  the service area. 
223.14     (d) Effective July 1, 2001, the medical assistance rates 
223.15  for outpatient mental health services provided by an entity that 
223.16  operates: 
223.17     (1) a Medicare-certified comprehensive outpatient 
223.18  rehabilitation facility; and 
223.19     (2) a facility that was certified prior to January 1, 1993, 
223.20  with at least 33 percent of the clients receiving rehabilitation 
223.21  services in the most recent calendar year who are medical 
223.22  assistance recipients, will be increased by 38 percent, when 
223.23  those services are provided within the comprehensive outpatient 
223.24  rehabilitation facility and provided to residents of nursing 
223.25  facilities owned by the entity. 
223.26     (e) An entity that operates both a Medicare certified 
223.27  comprehensive outpatient rehabilitation facility and a facility 
223.28  which was certified prior to January 1, 1993, that is licensed 
223.29  under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
223.30  whom at least 33 percent of the clients receiving rehabilitation 
223.31  services in the most recent calendar year are medical assistance 
223.32  recipients, shall be reimbursed by the commissioner for 
223.33  rehabilitation services at rates that are 38 percent greater 
223.34  than the maximum reimbursement rate allowed under paragraph (a), 
223.35  clause (2), when those services are (1) provided within the 
223.36  comprehensive outpatient rehabilitation facility and (2) 
224.1   provided to residents of nursing facilities owned by the entity. 
224.2      (f) Effective for services rendered on or after January 1, 
224.3   2007, the commissioner shall make payments for physician and 
224.4   professional services based on the Medicare relative value units 
224.5   (RVUs).  This change shall be budget neutral and the cost of 
224.6   implementing RVUs will be incorporated in the established 
224.7   conversion factor. 
224.8      Sec. 64.  Minnesota Statutes 2002, section 256D.03, 
224.9   subdivision 3, is amended to read: 
224.10     Subd. 3.  [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 
224.11  (a) General assistance medical care may be paid for any person 
224.12  who is not eligible for medical assistance under chapter 256B, 
224.13  including eligibility for medical assistance based on a 
224.14  spenddown of excess income according to section 256B.056, 
224.15  subdivision 5, or MinnesotaCare as defined in paragraph (b), 
224.16  except as provided in paragraph (c);, and: 
224.17     (1) who is receiving assistance under section 256D.05, 
224.18  except for families with children who are eligible under 
224.19  Minnesota family investment program (MFIP), who is having a 
224.20  payment made on the person's behalf under sections 256I.01 to 
224.21  256I.06, or who resides in group residential housing as defined 
224.22  in chapter 256I and can meet a spenddown using the cost of 
224.23  remedial services received through group residential housing; or 
224.24     (2)(i) who is a resident of Minnesota; and whose equity in 
224.25  assets is not in excess of $1,000 per assistance unit.  Exempt 
224.26  assets, the reduction of excess assets, and the waiver of excess 
224.27  assets must conform to the medical assistance program in chapter 
224.28  256B, with the following exception:  the maximum amount of 
224.29  undistributed funds in a trust that could be distributed to or 
224.30  on behalf of the beneficiary by the trustee, assuming the full 
224.31  exercise of the trustee's discretion under the terms of the 
224.32  trust, must be applied toward the asset maximum the limits in 
224.33  section 256L.17, subdivision 2; and 
224.34     (ii) (2) who has gross countable income not in excess of 
224.35  the assistance standards established in section 256B.056, 
224.36  subdivision 5c, paragraph (b), or whose excess income is spent 
225.1   down to that standard using a six-month budget period.  The 
225.2   method for calculating earned income disregards and deductions 
225.3   for a person who resides with a dependent child under age 21 
225.4   shall follow the AFDC income disregard and deductions in effect 
225.5   under the July 16, 1996, AFDC state plan.  The earned income and 
225.6   work expense deductions for a person who does not reside with a 
225.7   dependent child under age 21 shall be the same as the method 
225.8   used to determine eligibility for a person under section 
225.9   256D.06, subdivision 1, except the disregard of the first $50 of 
225.10  earned income is not allowed; 
225.11     (3) who would be eligible for medical assistance except 
225.12  that the person resides in a facility that is determined by the 
225.13  commissioner or the federal Centers for Medicare and Medicaid 
225.14  Services to be an institution for mental diseases; or 
225.15     (4) who is ineligible for medical assistance under chapter 
225.16  256B or general assistance medical care under any other 
225.17  provision of this section, and is receiving care and 
225.18  rehabilitation services from a nonprofit center established to 
225.19  serve victims of torture.  These individuals are eligible for 
225.20  general assistance medical care only for the period during which 
225.21  they are receiving services from the center.  During this period 
225.22  of eligibility, individuals eligible under this clause shall not 
225.23  be required to participate in prepaid general assistance medical 
225.24  care 75 percent of the federal poverty guidelines for the family 
225.25  size, using a six-month budget period.  
225.26     (b) Beginning January 1, 2000, General assistance medical 
225.27  care may not be paid for applicants or recipients who meet all 
225.28  eligibility requirements of MinnesotaCare as defined in sections 
225.29  256L.01 to 256L.16, and are: (i) adults with dependent children 
225.30  under 21 whose gross family income is equal to or less than 275 
225.31  percent of the federal poverty guidelines; or. 
225.32     (ii) adults without children with earned income and whose 
225.33  family gross income is between 75 percent of the federal poverty 
225.34  guidelines and the amount set by section 256L.04, subdivision 7, 
225.35  shall be terminated from general assistance medical care upon 
225.36  enrollment in MinnesotaCare.  Earned income is deemed available 
226.1   to family members as defined in section 256D.02, subdivision 8. 
226.2      (c) For services rendered on or after July 1, 1997, 
226.3   eligibility is limited to one month prior to application if the 
226.4   person is determined eligible in the prior month applications 
226.5   received on or after October 1, 2003, eligibility may begin no 
226.6   earlier than the date of application.  A redetermination of 
226.7   eligibility must occur every 12 months.  Beginning January 1, 
226.8   2000, Minnesota health care program applications completed by 
226.9   recipients and applicants who are persons described in paragraph 
226.10  (b), may be returned to the county agency to be forwarded to the 
226.11  department of human services or sent directly to the department 
226.12  of human services for enrollment in MinnesotaCare.  If all other 
226.13  eligibility requirements of this subdivision are met, 
226.14  eligibility for general assistance medical care shall be 
226.15  available in any month during which a MinnesotaCare eligibility 
226.16  determination and enrollment are pending.  Upon notification of 
226.17  eligibility for MinnesotaCare, notice of termination for 
226.18  eligibility for general assistance medical care shall be sent to 
226.19  an applicant or recipient.  If all other eligibility 
226.20  requirements of this subdivision are met, eligibility for 
226.21  general assistance medical care shall be available until 
226.22  enrollment in MinnesotaCare subject to the provisions of 
226.23  paragraph (e). 
226.24     (d) The date of an initial Minnesota health care program 
226.25  application necessary to begin a determination of eligibility 
226.26  shall be the date the applicant has provided a name, address, 
226.27  and social security number, signed and dated, to the county 
226.28  agency or the department of human services.  If the applicant is 
226.29  unable to provide an initial application when health care is 
226.30  delivered due to a medical condition or disability, a health 
226.31  care provider may act on the person's behalf to complete the 
226.32  initial application.  The applicant must complete the remainder 
226.33  of the application and provide necessary verification before 
226.34  eligibility can be determined.  The county agency must assist 
226.35  the applicant in obtaining verification if necessary.  On the 
226.36  basis of information provided on the completed application, an 
227.1   applicant who meets the following criteria shall be determined 
227.2   eligible beginning in the month of application: 
227.3      (1) has gross income less than 90 percent of the applicable 
227.4   income standard; 
227.5      (2) has liquid assets that total within $300 of the asset 
227.6   standard; 
227.7      (3) does not reside in a long-term care facility; and 
227.8      (4) meets all other eligibility requirements. 
227.9   The applicant must provide all required verifications within 30 
227.10  days' notice of the eligibility determination or eligibility 
227.11  shall be terminated. 
227.12     (e) County agencies are authorized to use all automated 
227.13  databases containing information regarding recipients' or 
227.14  applicants' income in order to determine eligibility for general 
227.15  assistance medical care or MinnesotaCare.  Such use shall be 
227.16  considered sufficient in order to determine eligibility and 
227.17  premium payments by the county agency. 
227.18     (f) General assistance medical care is not available for a 
227.19  person in a correctional facility unless the person is detained 
227.20  by law for less than one year in a county correctional or 
227.21  detention facility as a person accused or convicted of a crime, 
227.22  or admitted as an inpatient to a hospital on a criminal hold 
227.23  order, and the person is a recipient of general assistance 
227.24  medical care at the time the person is detained by law or 
227.25  admitted on a criminal hold order and as long as the person 
227.26  continues to meet other eligibility requirements of this 
227.27  subdivision.  
227.28     (g) General assistance medical care is not available for 
227.29  applicants or recipients who do not cooperate with the county 
227.30  agency to meet the requirements of medical assistance.  General 
227.31  assistance medical care is limited to payment of emergency 
227.32  services only for applicants or recipients as described in 
227.33  paragraph (b), whose MinnesotaCare coverage is denied or 
227.34  terminated for nonpayment of premiums as required by sections 
227.35  256L.06 and 256L.07.  
227.36     (h) In determining the amount of assets of an individual, 
228.1   there shall be included any asset or interest in an asset, 
228.2   including an asset excluded under paragraph (a), that was given 
228.3   away, sold, or disposed of for less than fair market value 
228.4   within the 60 months preceding application for general 
228.5   assistance medical care or during the period of eligibility.  
228.6   Any transfer described in this paragraph shall be presumed to 
228.7   have been for the purpose of establishing eligibility for 
228.8   general assistance medical care, unless the individual furnishes 
228.9   convincing evidence to establish that the transaction was 
228.10  exclusively for another purpose.  For purposes of this 
228.11  paragraph, the value of the asset or interest shall be the fair 
228.12  market value at the time it was given away, sold, or disposed 
228.13  of, less the amount of compensation received.  For any 
228.14  uncompensated transfer, the number of months of ineligibility, 
228.15  including partial months, shall be calculated by dividing the 
228.16  uncompensated transfer amount by the average monthly per person 
228.17  payment made by the medical assistance program to skilled 
228.18  nursing facilities for the previous calendar year.  The 
228.19  individual shall remain ineligible until this fixed period has 
228.20  expired.  The period of ineligibility may exceed 30 months, and 
228.21  a reapplication for benefits after 30 months from the date of 
228.22  the transfer shall not result in eligibility unless and until 
228.23  the period of ineligibility has expired.  The period of 
228.24  ineligibility begins in the month the transfer was reported to 
228.25  the county agency, or if the transfer was not reported, the 
228.26  month in which the county agency discovered the transfer, 
228.27  whichever comes first.  For applicants, the period of 
228.28  ineligibility begins on the date of the first approved 
228.29  application. 
228.30     (i) When determining eligibility for any state benefits 
228.31  under this subdivision, the income and resources of all 
228.32  noncitizens shall be deemed to include their sponsor's income 
228.33  and resources as defined in the Personal Responsibility and Work 
228.34  Opportunity Reconciliation Act of 1996, title IV, Public Law 
228.35  Number 104-193, sections 421 and 422, and subsequently set out 
228.36  in federal rules. 
229.1      (j)(1) An Undocumented noncitizen or a nonimmigrant 
229.2   is noncitizens and nonimmigrants are ineligible for general 
229.3   assistance medical care other than emergency services, except an 
229.4   individual eligible under paragraph (a), clause (4), remains 
229.5   eligible through September 30, 2003.  For purposes of this 
229.6   subdivision, a nonimmigrant is an individual in one or more of 
229.7   the classes listed in United States Code, title 8, section 
229.8   1101(a)(15), and an undocumented noncitizen is an individual who 
229.9   resides in the United States without the approval or 
229.10  acquiescence of the Immigration and Naturalization Service. 
229.11     (2) This paragraph does not apply to a child under age 18, 
229.12  to a Cuban or Haitian entrant as defined in Public Law Number 
229.13  96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 
229.14  aged, blind, or disabled as defined in Code of Federal 
229.15  Regulations, title 42, sections 435.520, 435.530, 435.531, 
229.16  435.540, and 435.541, or effective October 1, 1998, to an 
229.17  individual eligible for general assistance medical care under 
229.18  paragraph (a), clause (4), who cooperates with the Immigration 
229.19  and Naturalization Service to pursue any applicable immigration 
229.20  status, including citizenship, that would qualify the individual 
229.21  for medical assistance with federal financial participation. 
229.22     (k) For purposes of paragraphs (g) and (j), "emergency 
229.23  services" has the meaning given in Code of Federal Regulations, 
229.24  title 42, section 440.255(b)(1), except that it also means 
229.25  services rendered because of suspected or actual pesticide 
229.26  poisoning.  
229.27     (l) Notwithstanding any other provision of law, a 
229.28  noncitizen who is ineligible for medical assistance due to the 
229.29  deeming of a sponsor's income and resources, is ineligible for 
229.30  general assistance medical care. 
229.31     (m) Effective July 1, 2003, general assistance medical care 
229.32  emergency services end.  Effective October 1, 2004, the general 
229.33  assistance medical care program ends.  Persons enrolled in 
229.34  general assistance medical care as of September 30, 2004, will 
229.35  be converted to MinnesotaCare if they meet all the requirements 
229.36  of chapter 256L.  
230.1      <b>[EFFECTIVE DATE.]</b> (a) The amendments to paragraphs (a), 
230.2   clauses (1) to (4), and (b) and (c), are effective October 1, 
230.3   2003. 
230.4      (b) The amendments to paragraphs (d), (j), (g), and (k), 
230.5   are effective July 1, 2003. 
230.6      Sec. 65.  Minnesota Statutes 2002, section 256D.03, 
230.7   subdivision 4, is amended to read: 
230.8      Subd. 4.  [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 
230.9   For a person who is eligible under subdivision 3, paragraph (a), 
230.10  clause (3), general assistance medical care covers, except as 
230.11  provided in paragraph (c): 
230.12     (1) inpatient hospital services; 
230.13     (2) outpatient hospital services; 
230.14     (3) services provided by Medicare certified rehabilitation 
230.15  agencies; 
230.16     (4) prescription drugs and other products recommended 
230.17  through the process established in section 256B.0625, 
230.18  subdivision 13; 
230.19     (5) equipment necessary to administer insulin and 
230.20  diagnostic supplies and equipment for diabetics to monitor blood 
230.21  sugar level; 
230.22     (6) eyeglasses and eye examinations provided by a physician 
230.23  or optometrist; 
230.24     (7) hearing aids; 
230.25     (8) prosthetic devices; 
230.26     (9) laboratory and X-ray services; 
230.27     (10) physician's services; 
230.28     (11) medical transportation; 
230.29     (12) chiropractic services as covered under the medical 
230.30  assistance program; 
230.31     (13) podiatric services; 
230.32     (14) dental services and dentures, subject to the 
230.33  limitations specified in section 256B.0625, subdivision 9, 
230.34  except that a 25 percent coinsurance requirement applies to 
230.35  basic restorative dental services; 
230.36     (15) outpatient services provided by a mental health center 
231.1   or clinic that is under contract with the county board and is 
231.2   established under section 245.62; 
231.3      (16) day treatment services for mental illness provided 
231.4   under contract with the county board; 
231.5      (17) prescribed medications for persons who have been 
231.6   diagnosed as mentally ill as necessary to prevent more 
231.7   restrictive institutionalization; 
231.8      (18) psychological services, medical supplies and 
231.9   equipment, and Medicare premiums, coinsurance and deductible 
231.10  payments; 
231.11     (19) medical equipment not specifically listed in this 
231.12  paragraph when the use of the equipment will prevent the need 
231.13  for costlier services that are reimbursable under this 
231.14  subdivision; 
231.15     (20) services performed by a certified pediatric nurse 
231.16  practitioner, a certified family nurse practitioner, a certified 
231.17  adult nurse practitioner, a certified obstetric/gynecological 
231.18  nurse practitioner, a certified neonatal nurse practitioner, or 
231.19  a certified geriatric nurse practitioner in independent 
231.20  practice, if (1) the service is otherwise covered under this 
231.21  chapter as a physician service, (2) the service provided on an 
231.22  inpatient basis is not included as part of the cost for 
231.23  inpatient services included in the operating payment rate, and 
231.24  (3) the service is within the scope of practice of the nurse 
231.25  practitioner's license as a registered nurse, as defined in 
231.26  section 148.171; 
231.27     (21) services of a certified public health nurse or a 
231.28  registered nurse practicing in a public health nursing clinic 
231.29  that is a department of, or that operates under the direct 
231.30  authority of, a unit of government, if the service is within the 
231.31  scope of practice of the public health nurse's license as a 
231.32  registered nurse, as defined in section 148.171; and 
231.33     (22) telemedicine consultations, to the extent they are 
231.34  covered under section 256B.0625, subdivision 3b.  
231.35     (b) Except as provided in paragraph (c), for a recipient 
231.36  who is eligible under subdivision 3, paragraph (a), clause (1) 
232.1   or (2), general assistance medical care covers the services 
232.2   listed in paragraph (a) with the exception of special 
232.3   transportation services. 
232.4      (c) Gender reassignment surgery and related services are 
232.5   not covered services under this subdivision unless the 
232.6   individual began receiving gender reassignment services prior to 
232.7   July 1, 1995.  
232.8      (d) In order to contain costs, the commissioner of human 
232.9   services shall select vendors of medical care who can provide 
232.10  the most economical care consistent with high medical standards 
232.11  and shall where possible contract with organizations on a 
232.12  prepaid capitation basis to provide these services.  The 
232.13  commissioner shall consider proposals by counties and vendors 
232.14  for prepaid health plans, competitive bidding programs, block 
232.15  grants, or other vendor payment mechanisms designed to provide 
232.16  services in an economical manner or to control utilization, with 
232.17  safeguards to ensure that necessary services are provided.  
232.18  Before implementing prepaid programs in counties with a county 
232.19  operated or affiliated public teaching hospital or a hospital or 
232.20  clinic operated by the University of Minnesota, the commissioner 
232.21  shall consider the risks the prepaid program creates for the 
232.22  hospital and allow the county or hospital the opportunity to 
232.23  participate in the program in a manner that reflects the risk of 
232.24  adverse selection and the nature of the patients served by the 
232.25  hospital, provided the terms of participation in the program are 
232.26  competitive with the terms of other participants considering the 
232.27  nature of the population served.  Payment for services provided 
232.28  pursuant to this subdivision shall be as provided to medical 
232.29  assistance vendors of these services under sections 256B.02, 
232.30  subdivision 8, and 256B.0625.  For payments made during fiscal 
232.31  year 1990 and later years, the commissioner shall consult with 
232.32  an independent actuary in establishing prepayment rates, but 
232.33  shall retain final control over the rate methodology.  In 
232.34  establishing payment rates for managed care plans under the 
232.35  prepaid general assistance medical care program, the 
232.36  commissioner must consider, to the extent this information is 
233.1   available, verifiable, and actuarially significant:  (1) 
233.2   individual health plan annual financial performance for public 
233.3   programs; and (2) rate relationships and geographic payment 
233.4   relativities based on actual health plan experience.  The 
233.5   commissioner may recover any administrative costs related to 
233.6   implementing this requirement, by assessing managed care plans 
233.7   in proportion to their share of enrollees in the prepaid general 
233.8   assistance medical care program. Notwithstanding the provisions 
233.9   of subdivision 3, an individual who becomes ineligible for 
233.10  general assistance medical care because of failure to submit 
233.11  income reports or recertification forms in a timely manner, 
233.12  shall remain enrolled in the prepaid health plan and shall 
233.13  remain eligible for general assistance medical care coverage 
233.14  through the last day of the month in which the enrollee became 
233.15  ineligible for general assistance medical care. 
233.16     (e) There shall be no copayment required of any recipient 
233.17  of benefits for any services provided under this subdivision. A 
233.18  hospital receiving a reduced payment as a result of this section 
233.19  may apply the unpaid balance toward satisfaction of the 
233.20  hospital's bad debts. 
233.21     (f) Any county may, from its own resources, provide medical 
233.22  payments for which state payments are not made. 
233.23     (g) Chemical dependency services that are reimbursed under 
233.24  chapter 254B must not be reimbursed under general assistance 
233.25  medical care. 
233.26     (h) The maximum payment for new vendors enrolled in the 
233.27  general assistance medical care program after the base year 
233.28  shall be determined from the average usual and customary charge 
233.29  of the same vendor type enrolled in the base year. 
233.30     (i) The conditions of payment for services under this 
233.31  subdivision are the same as the conditions specified in rules 
233.32  adopted under chapter 256B governing the medical assistance 
233.33  program, unless otherwise provided by statute or rule. 
233.34     Sec. 66.  [256D.031] [GAMC CO-PAYMENTS AND COINSURANCE.] 
233.35     Subdivision 1.  [CO-PAYMENTS AND COINSURANCE.] (a) Except 
233.36  as provided in subdivision 2, the general assistance medical 
234.1   care benefit plan under section 256D.03, subdivision 3, shall 
234.2   include the following co-payments for all recipients effective 
234.3   for services provided on or after October 1, 2003: 
234.4      (1) $3 per nonpreventive visit.  For purposes of this 
234.5   subdivision, a visit means an episode of service which is 
234.6   required because of a recipient's symptoms, diagnosis, or 
234.7   established illness, and which is delivered in an ambulatory 
234.8   setting by a physician or physician ancillary, chiropractor, 
234.9   podiatrist, nurse midwife, mental health professional, advanced 
234.10  practice nurse, physical therapist, occupational therapist, 
234.11  speech therapist, audiologist, optician, or optometrist; 
234.12     (2) $25 for eyeglasses; 
234.13     (3) $25 for nonemergency visits to a hospital-based 
234.14  emergency room; and 
234.15     (4) $3 per brand-name drug prescription and $1 per generic 
234.16  drug prescription, subject to a $20 per month maximum for 
234.17  prescription drug co-payments. 
234.18     (b) Recipients of general assistance medical care are 
234.19  responsible for all co-payments in this subdivision. 
234.20     Subd. 2.  [EXCEPTIONS.] Co-payments shall be subject to the 
234.21  following exceptions: 
234.22     (1) children under the age of 21; 
234.23     (2) pregnant women for services that relate to the 
234.24  pregnancy or any other medical condition that may complicate the 
234.25  pregnancy; 
234.26     (3) recipients expected to reside for at least 30 days in a 
234.27  hospital, nursing home, or intermediate care facility for the 
234.28  mentally retarded; 
234.29     (4) recipients receiving hospice care; 
234.30     (5) 100 percent federally funded services provided by an 
234.31  Indian health service; 
234.32     (6) emergency services; 
234.33     (7) family planning services; 
234.34     (8) services that are paid by Medicare, resulting in the 
234.35  general assistance medical care program paying for the 
234.36  coinsurance and deductible; and 
235.1      (9) co-payments that exceed one per day per provider for 
235.2   nonpreventive office visits, eyeglasses, and nonemergency visits 
235.3   to a hospital-based emergency room. 
235.4      Subd. 3.  [COLLECTION.] The general assistance medical care 
235.5   reimbursement to the provider shall be reduced by the amount of 
235.6   the co-payment, except that reimbursement for prescription drugs 
235.7   shall not be reduced once a recipient has reached the $20 per 
235.8   month maximum for prescription drug co-payments.  The provider 
235.9   collects the co-payment from the recipient.  Providers may not 
235.10  deny services to recipients who are unable to pay the 
235.11  co-payment, except as provided in subdivision 4. 
235.12     Subd. 4.  [UNCOLLECTED DEBT.] If it is the routine business 
235.13  practice of a provider to refuse service to an individual with 
235.14  uncollected debt, the provider may include uncollected 
235.15  co-payments under this section.  A provider must give advance 
235.16  notice to a recipient with uncollected debt before services can 
235.17  be denied. 
235.18     Sec. 67.  Minnesota Statutes 2002, section 256G.05, 
235.19  subdivision 2, is amended to read: 
235.20     Subd. 2.  [NON-MINNESOTA RESIDENTS.] State residence is not 
235.21  required for receiving emergency assistance in the Minnesota 
235.22  supplemental aid program.  The receipt of emergency assistance 
235.23  must not be used as a factor in determining county or state 
235.24  residence.  Non-Minnesota residents are not eligible for 
235.25  emergency general assistance medical care, except emergency 
235.26  hospital services, and professional services incident to the 
235.27  hospital services, for the treatment of acute trauma resulting 
235.28  from an accident occurring in Minnesota.  To be eligible under 
235.29  this subdivision a non-Minnesota resident must verify that they 
235.30  are not eligible for coverage under any other health care 
235.31  program, including coverage from a program in their state of 
235.32  residence. 
235.33     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
235.34     Sec. 68.  Minnesota Statutes 2002, section 256L.02, is 
235.35  amended by adding a subdivision to read: 
235.36     Subd. 3a.  [FUNDING SOURCE.] Beginning July 1, 2005, all 
236.1   MinnesotaCare obligations shall be funded out of the general 
236.2   fund. 
236.3      Sec. 69.  Minnesota Statutes 2002, section 256L.03, 
236.4   subdivision 1, is amended to read: 
236.5      Subdivision 1.  [COVERED HEALTH SERVICES.] "Covered health 
236.6   services" means the health services reimbursed under chapter 
236.7   256B, with the exception of inpatient hospital services, special 
236.8   education services, private duty nursing services, adult dental 
236.9   care services other than preventive services services covered 
236.10  under section 256B.0625, subdivision 9, paragraph (b), 
236.11  orthodontic services, nonemergency medical transportation 
236.12  services, personal care assistant and case management services, 
236.13  nursing home or intermediate care facilities services, inpatient 
236.14  mental health services, and chemical dependency 
236.15  services.  Effective July 1, 1998, adult dental care for 
236.16  nonpreventive services with the exception of orthodontic 
236.17  services is available to persons who qualify under section 
236.18  256L.04, subdivisions 1 to 7, with family gross income equal to 
236.19  or less than 175 percent of the federal poverty guidelines.  
236.20  Outpatient mental health services covered under the 
236.21  MinnesotaCare program are limited to diagnostic assessments, 
236.22  psychological testing, explanation of findings, medication 
236.23  management by a physician, day treatment, partial 
236.24  hospitalization, and individual, family, and group psychotherapy.
236.25     No public funds shall be used for coverage of abortion 
236.26  under MinnesotaCare except where the life of the female would be 
236.27  endangered or substantial and irreversible impairment of a major 
236.28  bodily function would result if the fetus were carried to term; 
236.29  or where the pregnancy is the result of rape or incest. 
236.30     Covered health services shall be expanded as provided in 
236.31  this section. 
236.32     Sec. 70.  Minnesota Statutes 2002, section 256L.03, 
236.33  subdivision 3, is amended to read: 
236.34     Subd. 3.  [INPATIENT HOSPITAL SERVICES.] (a) Covered health 
236.35  services shall include inpatient hospital services, including 
236.36  inpatient hospital mental health services and inpatient hospital 
237.1   and residential chemical dependency treatment, subject to those 
237.2   limitations necessary to coordinate the provision of these 
237.3   services with eligibility under the medical assistance 
237.4   spenddown.  Prior to July 1, 1997, the inpatient hospital 
237.5   benefit for adult enrollees is subject to an annual benefit 
237.6   limit of $10,000.  The inpatient hospital benefit for adult 
237.7   enrollees who qualify under section 256L.04, subdivision 7, or 
237.8   who qualify under section 256L.04, subdivisions 1 and 2, with 
237.9   family gross income that exceeds 175 percent of the federal 
237.10  poverty guidelines and who are not pregnant, is subject to an 
237.11  annual limit of $10,000.  For services provided on or after 
237.12  October 1, 2004, the annual limit of $10,000 does not apply to 
237.13  adults who qualify under section 256L.04, subdivision 7, whose 
237.14  gross income is at or below 75 percent of the federal poverty 
237.15  guidelines.  
237.16     (b) Admissions for inpatient hospital services paid for 
237.17  under section 256L.11, subdivision 3, must be certified as 
237.18  medically necessary in accordance with Minnesota Rules, parts 
237.19  9505.0500 to 9505.0540, except as provided in clauses (1) and 
237.20  (2): 
237.21     (1) all admissions must be certified, except those 
237.22  authorized under rules established under section 254A.03, 
237.23  subdivision 3, or approved under Medicare; and 
237.24     (2) payment under section 256L.11, subdivision 3, shall be 
237.25  reduced by five percent for admissions for which certification 
237.26  is requested more than 30 days after the day of admission.  The 
237.27  hospital may not seek payment from the enrollee for the amount 
237.28  of the payment reduction under this clause. 
237.29     Sec. 71.  Minnesota Statutes 2002, section 256L.03, 
237.30  subdivision 5, is amended to read: 
237.31     Subd. 5.  [COPAYMENTS AND COINSURANCE.] (a) Except as 
237.32  provided in paragraphs (b) and (c), the MinnesotaCare benefit 
237.33  plan shall include the following copayments and coinsurance 
237.34  requirements for all enrollees effective for services provided 
237.35  on or after October 1, 2003:  
237.36     (1) ten percent of the paid charges for inpatient hospital 
238.1   services for adult enrollees, subject to an annual inpatient 
238.2   out-of-pocket maximum of $1,000 per individual and $3,000 per 
238.3   family; 
238.4      (2) $3 per prescription for adult enrollees nonpreventive 
238.5   visit.  For purposes of this subdivision, a visit means an 
238.6   episode of service which is required because of a recipient's 
238.7   symptoms, diagnosis, or established illness, and which is 
238.8   delivered in an ambulatory setting by a physician or physician 
238.9   ancillary, chiropractor, podiatrist, nurse, midwife, mental 
238.10  health professional, advanced practice nurse, physical 
238.11  therapist, occupational therapist, speech therapist, 
238.12  audiologist, optician, or optometrist; 
238.13     (3) $25 for eyeglasses for adult enrollees; 
238.14     (4) $6 for nonemergency visits to a hospital-based 
238.15  emergency room, except that a $25 co-payment applies to parents 
238.16  with incomes exceeding 100 percent of the federal poverty 
238.17  guidelines for nonemergency visits to a hospital-based emergency 
238.18  room; and 
238.19     (4) 50 percent of the fee-for-service rate for adult dental 
238.20  care services other than preventive care services for persons 
238.21  eligible under section 256L.04, subdivisions 1 to 7, with income 
238.22  equal to or less than 175 percent of the federal poverty 
238.23  guidelines (5) $3 per prescription, subject to a $20 per month 
238.24  maximum for prescription drug co-payments; and 
238.25     (6) basic restorative dental services for adults age 21 and 
238.26  over who are not pregnant are subject to a 25 percent 
238.27  coinsurance requirement. 
238.28     (b) Paragraph (a), clause (1), does not apply to parents 
238.29  and relative caretakers of children under the age of 21 in 
238.30  households with family income equal to or less than 175 percent 
238.31  of the federal poverty guidelines.  Paragraph (a), clause (1), 
238.32  does not apply to parents and relative caretakers of children 
238.33  under the age of 21 in households with family income greater 
238.34  than 175 percent of the federal poverty guidelines for inpatient 
238.35  hospital admissions occurring on or after January 1, 
238.36  2001.  Effective for services provided on or after October 1, 
239.1   2004, paragraph (a), clause (1), does not apply to single adults 
239.2   and households without children whose gross income is at or 
239.3   below 75 percent of the federal poverty guidelines. 
239.4      (c) Paragraph (a), clauses (1) to (4) (6), do not apply to 
239.5   pregnant women and children under the age of 21.: 
239.6      (1) children under the age of 21; 
239.7      (2) pregnant women for services that relate to the 
239.8   pregnancy or any other medical condition that may complicate the 
239.9   pregnancy; 
239.10     (3) enrollees expected to reside for at least 30 days in a 
239.11  hospital, nursing home, or intermediate care facility for the 
239.12  mentally retarded; 
239.13     (4) enrollees receiving hospice care; 
239.14     (5) 100 percent federally funded services provided by an 
239.15  Indian Health Service; 
239.16     (6) emergency services; 
239.17     (7) family planning services; and 
239.18     (8) co-payments that exceed one per day per provider for 
239.19  nonpreventive office visits, eyeglasses, and nonemergency visits 
239.20  to a hospital emergency room. 
239.21     (d) Adult enrollees with family gross income that exceeds 
239.22  175 percent of the federal poverty guidelines and who are not 
239.23  pregnant shall be financially responsible for the coinsurance 
239.24  amount, if applicable, and amounts which exceed the $10,000 
239.25  inpatient hospital benefit limit. 
239.26     (e) When a MinnesotaCare enrollee becomes a member of a 
239.27  prepaid health plan, or changes from one prepaid health plan to 
239.28  another during a calendar year, any charges submitted towards 
239.29  the $10,000 annual inpatient benefit limit, and any 
239.30  out-of-pocket expenses incurred by the enrollee for inpatient 
239.31  services, that were submitted or incurred prior to enrollment, 
239.32  or prior to the change in health plans, shall be disregarded. 
239.33     (f) Enrollees are responsible for all co-payments and 
239.34  coinsurance in this subdivision. 
239.35     (g) The MinnesotaCare reimbursement to the provider shall 
239.36  be reduced by the amount of the co-payment, except that 
240.1   reimbursement for prescription drugs shall not be reduced once a 
240.2   recipient has reached the $20 per month maximum for prescription 
240.3   drug co-payments.  The provider collects the co-payment from the 
240.4   enrollee and may not deny services to enrollees who are unable 
240.5   to pay the co-payment, except as provided in paragraph (h). 
240.6      (h) If it is the routine business practice of a provider to 
240.7   refuse service to an individual with uncollected debt, the 
240.8   provider may include uncollected co-payments under this 
240.9   section.  A provider must give advance notice to a recipient 
240.10  with uncollected debt before services can be denied. 
240.11     Sec. 72.  Minnesota Statutes 2002, section 256L.04, 
240.12  subdivision 1, is amended to read: 
240.13     Subdivision 1.  [FAMILIES WITH CHILDREN.] (a) Families with 
240.14  children with family income equal to or less than 275 percent of 
240.15  the federal poverty guidelines for the applicable family size 
240.16  shall be eligible for MinnesotaCare according to this section.  
240.17  All other provisions of sections 256L.01 to 256L.18, including 
240.18  the insurance-related barriers to enrollment under section 
240.19  256L.07, shall apply unless otherwise specified. 
240.20     (b) Parents who enroll in the MinnesotaCare program must 
240.21  also enroll their children and dependent siblings, if the 
240.22  children and their dependent siblings are eligible.  Children 
240.23  and dependent siblings may be enrolled separately without 
240.24  enrollment by parents.  However, if one parent in the household 
240.25  enrolls, both parents must enroll, unless other insurance is 
240.26  available.  If one child from a family is enrolled, all children 
240.27  must be enrolled, unless other insurance is available.  If one 
240.28  spouse in a household enrolls, the other spouse in the household 
240.29  must also enroll, unless other insurance is available.  Families 
240.30  cannot choose to enroll only certain uninsured members.  
240.31     (c) Beginning February 1, 2004, the dependent sibling 
240.32  definition no longer applies to the MinnesotaCare program.  
240.33  These persons are no longer counted in the parental household 
240.34  and may apply as a separate household. 
240.35     (d) Beginning July 1, 2003, parents are not eligible for 
240.36  MinnesotaCare if their gross income exceeds $50,000. 
241.1      <b>[EFFECTIVE DATE.]</b> This section is effective February 1, 
241.2   2004, unless the statutory language specifies a different 
241.3   effective date. 
241.4      Sec. 73.  Minnesota Statutes 2002, section 256L.05, 
241.5   subdivision 1, is amended to read: 
241.6      Subdivision 1.  [APPLICATION AND INFORMATION AVAILABILITY.] 
241.7   Applications and other information must be made available to 
241.8   provider offices, local human services agencies, school 
241.9   districts, public and private elementary schools in which 25 
241.10  percent or more of the students receive free or reduced price 
241.11  lunches, community health offices, and Women, Infants and 
241.12  Children (WIC) program sites.  These sites may accept 
241.13  applications and forward the forms to the commissioner.  
241.14  Otherwise, applicants may apply directly to the commissioner.  
241.15  Beginning January 1, 2000, MinnesotaCare enrollment sites will 
241.16  be expanded to include local county human services agencies 
241.17  which choose to participate.  Beginning October 1, 2004, all 
241.18  local county human service agencies must accept and process 
241.19  applications and renewals for single adults and households 
241.20  without children with income at or below 75 percent of the 
241.21  federal poverty guidelines who choose to have the county 
241.22  administer their case. 
241.23     Sec. 74.  Minnesota Statutes 2002, section 256L.05, 
241.24  subdivision 3, is amended to read: 
241.25     Subd. 3.  [EFFECTIVE DATE OF COVERAGE.] (a) The effective 
241.26  date of coverage is the first day of the month following the 
241.27  month in which eligibility is approved and the first premium 
241.28  payment has been received.  As provided in section 256B.057, 
241.29  coverage for newborns is automatic from the date of birth and 
241.30  must be coordinated with other health coverage.  The effective 
241.31  date of coverage for eligible newly adoptive children added to a 
241.32  family receiving covered health services is the date of entry 
241.33  into the family.  The effective date of coverage for other new 
241.34  recipients added to the family receiving covered health services 
241.35  is the first day of the month following the month in which 
241.36  eligibility is approved or at renewal, whichever the family 
242.1   receiving covered health services prefers.  All eligibility 
242.2   criteria must be met by the family at the time the new family 
242.3   member is added.  The income of the new family member is 
242.4   included with the family's gross income and the adjusted premium 
242.5   begins in the month the new family member is added.  
242.6      (b) The initial premium must be received by the last 
242.7   working day of the month for coverage to begin the first day of 
242.8   the following month.  
242.9      (c) Benefits are not available until the day following 
242.10  discharge if an enrollee is hospitalized on the first day of 
242.11  coverage.  
242.12     (d) Notwithstanding any other law to the contrary, benefits 
242.13  under sections 256L.01 to 256L.18 are secondary to a plan of 
242.14  insurance or benefit program under which an eligible person may 
242.15  have coverage and the commissioner shall use cost avoidance 
242.16  techniques to ensure coordination of any other health coverage 
242.17  for eligible persons.  The commissioner shall identify eligible 
242.18  persons who may have coverage or benefits under other plans of 
242.19  insurance or who become eligible for medical assistance. 
242.20     (e) Notwithstanding paragraphs (a) and (b), effective 
242.21  October 1, 2004, coverage begins for single adults and 
242.22  households without children with gross family income at or below 
242.23  75 percent of the federal poverty guidelines the first day of 
242.24  the month following approval.  
242.25     (f) Effective October 1, 2004, the date of an initial 
242.26  application necessary to begin a determination of eligibility 
242.27  for single adults and households without children with gross 
242.28  family income at or below 75 percent of the federal poverty 
242.29  guidelines shall be the date the applicant has provided a name, 
242.30  address, and social security number, signed and dated, to the 
242.31  county agency or the department of human services.  If the 
242.32  applicant is unable to provide an initial application when 
242.33  health care is delivered due to a medical condition or 
242.34  disability, a health care provider may act on the person's 
242.35  behalf to complete the initial application.  The applicant must 
242.36  complete the remainder of the application and provide necessary 
243.1   verification before eligibility can be determined.  The county 
243.2   agency must assist the applicant in obtaining verification if 
243.3   necessary. 
243.4      Sec. 75.  Minnesota Statutes 2002, section 256L.05, 
243.5   subdivision 3a, is amended to read: 
243.6      Subd. 3a.  [RENEWAL OF ELIGIBILITY.] (a) Beginning January 
243.7   1, 1999, an enrollee's eligibility must be renewed every 12 
243.8   months.  The 12-month period begins in the month after the month 
243.9   the application is approved.  
243.10     (b) Beginning October 1, 2004, an enrollee's eligibility 
243.11  must be renewed every six months.  The first six-month period of 
243.12  eligibility begins in the month after the month the application 
243.13  is approved.  Each new period of eligibility must take into 
243.14  account any changes in circumstances that impact eligibility and 
243.15  premium amount.  An enrollee must provide all the information 
243.16  needed to redetermine eligibility by the first day of the month 
243.17  that ends the eligibility period.  The premium for the new 
243.18  period of eligibility must be received as provided in section 
243.19  256L.06 in order for eligibility to continue. 
243.20     Sec. 76.  Minnesota Statutes 2002, section 256L.05, 
243.21  subdivision 3c, is amended to read: 
243.22     Subd. 3c.  [RETROACTIVE COVERAGE.] Notwithstanding 
243.23  subdivision 3, the effective date of coverage shall be the first 
243.24  day of the month following termination from medical assistance 
243.25  or general assistance medical care for families and individuals 
243.26  who are eligible for MinnesotaCare and who submitted a written 
243.27  request for retroactive MinnesotaCare coverage with a completed 
243.28  application within 30 days of the mailing of notification of 
243.29  termination from medical assistance or general assistance 
243.30  medical care.  The applicant must provide all required 
243.31  verifications within 30 days of the written request for 
243.32  verification.  For retroactive coverage, premiums must be paid 
243.33  in full for any retroactive month, current month, and next month 
243.34  within 30 days of the premium billing. 
243.35     <b>[EFFECTIVE DATE.]</b> This section is effective November 1, 
243.36  2004. 
244.1      Sec. 77.  Minnesota Statutes 2002, section 256L.05, 
244.2   subdivision 4, is amended to read: 
244.3      Subd. 4.  [APPLICATION PROCESSING.] The commissioner of 
244.4   human services shall determine an applicant's eligibility for 
244.5   MinnesotaCare no more than 30 days from the date that the 
244.6   application is received by the department of human services.  
244.7   Beginning January 1, 2000, this requirement also applies to 
244.8   local county human services agencies that determine eligibility 
244.9   for MinnesotaCare.  Once annually at application or 
244.10  reenrollment, to prevent processing delays, applicants or 
244.11  enrollees who, from the information provided on the application, 
244.12  appear to meet eligibility requirements shall be enrolled upon 
244.13  timely payment of premiums.  The enrollee must provide all 
244.14  required verifications within 30 days of notification of the 
244.15  eligibility determination or coverage from the program shall be 
244.16  terminated.  Enrollees who are determined to be ineligible when 
244.17  verifications are provided shall be disenrolled from the program.
244.18     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
244.19     Sec. 78.  Minnesota Statutes 2002, section 256L.06, 
244.20  subdivision 3, is amended to read: 
244.21     Subd. 3.  [COMMISSIONER'S DUTIES AND PAYMENT.] (a) Premiums 
244.22  are dedicated to the commissioner for MinnesotaCare. 
244.23     (b) The commissioner shall develop and implement procedures 
244.24  to:  (1) require enrollees to report changes in income; (2) 
244.25  adjust sliding scale premium payments, based upon changes in 
244.26  enrollee income; and (3) disenroll enrollees from MinnesotaCare 
244.27  for failure to pay required premiums.  Failure to pay includes 
244.28  payment with a dishonored check, a returned automatic bank 
244.29  withdrawal, or a refused credit card or debit card payment.  The 
244.30  commissioner may demand a guaranteed form of payment, including 
244.31  a cashier's check or a money order, as the only means to replace 
244.32  a dishonored, returned, or refused payment. 
244.33     (c) Premiums are calculated on a calendar month basis and 
244.34  may be paid on a monthly, quarterly, or annual semiannual basis, 
244.35  with the first payment due upon notice from the commissioner of 
244.36  the premium amount required.  The commissioner shall inform 
245.1   applicants and enrollees of these premium payment options. 
245.2   Premium payment is required before enrollment is complete and to 
245.3   maintain eligibility in MinnesotaCare.  Premium payments 
245.4   received before noon are credited the same day.  Premium 
245.5   payments received after noon are credited on the next working 
245.6   day.  
245.7      (d) Nonpayment of the premium will result in disenrollment 
245.8   from the plan effective for the calendar month for which the 
245.9   premium was due.  Persons disenrolled for nonpayment or who 
245.10  voluntarily terminate coverage from the program may not reenroll 
245.11  until four calendar months have elapsed.  Persons disenrolled 
245.12  for nonpayment who pay all past due premiums as well as current 
245.13  premiums due, including premiums due for the period of 
245.14  disenrollment, within 20 days of disenrollment, shall be 
245.15  reenrolled retroactively to the first day of disenrollment.  
245.16  Persons disenrolled for nonpayment or who voluntarily terminate 
245.17  coverage from the program may not reenroll for four calendar 
245.18  months unless the person demonstrates good cause for 
245.19  nonpayment.  Good cause does not exist if a person chooses to 
245.20  pay other family expenses instead of the premium.  The 
245.21  commissioner shall define good cause in rule. 
245.22     <b>[EFFECTIVE DATE.]</b> This section is effective October 1, 2004.
245.23     Sec. 79.  Minnesota Statutes 2002, section 256L.07, 
245.24  subdivision 1, is amended to read: 
245.25     Subdivision 1.  [GENERAL REQUIREMENTS.] (a) Children 
245.26  enrolled in the original children's health plan as of September 
245.27  30, 1992, children who enrolled in the MinnesotaCare program 
245.28  after September 30, 1992, pursuant to Laws 1992, chapter 549, 
245.29  article 4, section 17, and children who have family gross 
245.30  incomes that are equal to or less than 175 150 percent of the 
245.31  federal poverty guidelines are eligible without meeting the 
245.32  requirements of subdivision 2 and the four-month requirement in 
245.33  subdivision 3, as long as they maintain continuous coverage in 
245.34  the MinnesotaCare program or medical assistance.  Children who 
245.35  apply for MinnesotaCare on or after the implementation date of 
245.36  the employer-subsidized health coverage program as described in 
246.1   Laws 1998, chapter 407, article 5, section 45, who have family 
246.2   gross incomes that are equal to or less than 175 150 percent of 
246.3   the federal poverty guidelines, must meet the requirements of 
246.4   subdivision 2 to be eligible for MinnesotaCare. 
246.5      (b) Families enrolled in MinnesotaCare under section 
246.6   256L.04, subdivision 1, whose income increases above 275 percent 
246.7   of the federal poverty guidelines, are no longer eligible for 
246.8   the program and shall be disenrolled by the commissioner.  
246.9   Individuals enrolled in MinnesotaCare under section 256L.04, 
246.10  subdivision 7, whose income increases above 175 percent of the 
246.11  federal poverty guidelines are no longer eligible for the 
246.12  program and shall be disenrolled by the commissioner.  For 
246.13  persons disenrolled under this subdivision, MinnesotaCare 
246.14  coverage terminates the last day of the calendar month following 
246.15  the month in which the commissioner determines that the income 
246.16  of a family or individual exceeds program income limits.  
246.17     (c)(1) Notwithstanding paragraph (b), individuals and 
246.18  families enrolled in MinnesotaCare under section 256L.04, 
246.19  subdivision 1, may remain enrolled in MinnesotaCare if ten 
246.20  percent of their annual income is less than the annual premium 
246.21  for a policy with a $500 deductible available through the 
246.22  Minnesota comprehensive health association.  Individuals and 
246.23  Families who are no longer eligible for MinnesotaCare under this 
246.24  subdivision shall be given an 18-month notice period from the 
246.25  date that ineligibility is determined before 
246.26  disenrollment.  This clause expires February 1, 2004. 
246.27     (2) Effective February 1, 2004, notwithstanding paragraph 
246.28  (b), children may remain enrolled in MinnesotaCare if ten 
246.29  percent of their annual family income is less than the annual 
246.30  premium for a policy with a $500 deductible available through 
246.31  the Minnesota comprehensive health association.  Children who 
246.32  are no longer eligible for MinnesotaCare under this clause shall 
246.33  be given a 12-month notice period from the date that 
246.34  ineligibility is determined before disenrollment.  The premium 
246.35  for children remaining eligible under this clause shall be the 
246.36  maximum premium determined under section 256L.15, subdivision 2, 
247.1   paragraph (b), until July 1, 2005, when the premium shall be 
247.2   determined by section 256L.15, subdivision 2, paragraph (c). 
247.3      <b>[EFFECTIVE DATE.]</b> The amendments to paragraph (a) are 
247.4   effective July 1, 2003.  The amendments to paragraph (c), clause 
247.5   (1), are effective October 1, 2003. 
247.6      Sec. 80.  Minnesota Statutes 2002, section 256L.07, 
247.7   subdivision 2, is amended to read: 
247.8      Subd. 2.  [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 
247.9   COVERAGE.] (a) To be eligible, a family or individual must not 
247.10  have access to subsidized health coverage through an employer 
247.11  and must not have had access to employer-subsidized coverage 
247.12  through a current employer for 18 months prior to application or 
247.13  reapplication.  A family or individual whose employer-subsidized 
247.14  coverage is lost due to an employer terminating health care 
247.15  coverage as an employee benefit during the previous 18 months is 
247.16  not eligible.  
247.17     (b) This subdivision does not apply to a family or 
247.18  individual who was enrolled in MinnesotaCare within six months 
247.19  or less of reapplication and who no longer has 
247.20  employer-subsidized coverage due to the employer terminating 
247.21  health care coverage as an employee benefit.  
247.22     (c) For purposes of this requirement, subsidized health 
247.23  coverage means health coverage for which the employer pays at 
247.24  least 50 percent of the cost of coverage for the employee or 
247.25  dependent, or a higher percentage as specified by the 
247.26  commissioner.  Children are eligible for employer-subsidized 
247.27  coverage through either parent, including the noncustodial 
247.28  parent.  The commissioner must treat employer contributions to 
247.29  Internal Revenue Code Section 125 plans and any other employer 
247.30  benefits intended to pay health care costs as qualified employer 
247.31  subsidies toward the cost of health coverage for employees for 
247.32  purposes of this subdivision. 
247.33     (d) Notwithstanding paragraph (c), beginning February 1, 
247.34  2004, health coverage for single adults and households without 
247.35  children and adults in families with children shall be 
247.36  considered to be subsidized health coverage if the employer 
248.1   contributes any amount towards the cost of coverage. 
248.2      Sec. 81.  Minnesota Statutes 2002, section 256L.07, 
248.3   subdivision 3, is amended to read: 
248.4      Subd. 3.  [OTHER HEALTH COVERAGE.] (a) Families and 
248.5   individuals enrolled in the MinnesotaCare program must have no 
248.6   health coverage while enrolled or for at least four months prior 
248.7   to application and renewal.  Children enrolled in the original 
248.8   children's health plan and children in families with income 
248.9   equal to or less than 175 150 percent of the federal poverty 
248.10  guidelines, who have other health insurance, are eligible if the 
248.11  coverage: 
248.12     (1) lacks two or more of the following: 
248.13     (i) basic hospital insurance; 
248.14     (ii) medical-surgical insurance; 
248.15     (iii) prescription drug coverage; 
248.16     (iv) dental coverage; or 
248.17     (v) vision coverage; 
248.18     (2) requires a deductible of $100 or more per person per 
248.19  year; or 
248.20     (3) lacks coverage because the child has exceeded the 
248.21  maximum coverage for a particular diagnosis or the policy 
248.22  excludes a particular diagnosis. 
248.23     The commissioner may change this eligibility criterion for 
248.24  sliding scale premiums in order to remain within the limits of 
248.25  available appropriations.  The requirement of no health coverage 
248.26  does not apply to newborns.  
248.27     (b) Medical assistance, general assistance medical care, 
248.28  and the Civilian Health and Medical Program of the Uniformed 
248.29  Service, CHAMPUS, or other coverage provided under United States 
248.30  Code, title 10, subtitle A, part II, chapter 55, are not 
248.31  considered insurance or health coverage for purposes of the 
248.32  four-month requirement described in this subdivision. 
248.33     (c) For purposes of this subdivision, Medicare Part A or B 
248.34  coverage under title XVIII of the Social Security Act, United 
248.35  States Code, title 42, sections 1395c to 1395w-4, is considered 
248.36  health coverage.  An applicant or enrollee may not refuse 
249.1   Medicare coverage to establish eligibility for MinnesotaCare. 
249.2      (d) Applicants who were recipients of medical assistance or 
249.3   general assistance medical care within one month of application 
249.4   must meet the provisions of this subdivision and subdivision 2. 
249.5      (e) Effective October 1, 2003, applicants who were 
249.6   recipients of medical assistance and had cost-effective health 
249.7   insurance which was paid for by medical assistance are exempt 
249.8   from the four-month requirement under this section. 
249.9      (f) Notwithstanding paragraph (a), effective October 1, 
249.10  2004, individuals enrolled in the MinnesotaCare program under 
249.11  section 256L.04, subdivision 7, who have gross family income at 
249.12  or below 75 percent are not subject to the requirement of having 
249.13  no other health coverage for four months prior to application 
249.14  and renewal. 
249.15     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
249.16  except where a different effective date is specified in the text.
249.17     Sec. 82.  Minnesota Statutes 2002, section 256L.09, 
249.18  subdivision 4, is amended to read: 
249.19     Subd. 4.  [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 
249.20  purposes of this section, a permanent Minnesota resident is a 
249.21  person who has demonstrated, through persuasive and objective 
249.22  evidence, that the person is domiciled in the state and intends 
249.23  to live in the state permanently. 
249.24     (b) To be eligible as a permanent resident, an applicant 
249.25  must demonstrate the requisite intent to live in the state 
249.26  permanently by: 
249.27     (1) showing that the applicant maintains a residence at a 
249.28  verified address other than a place of public accommodation, 
249.29  through the use of evidence of residence described in section 
249.30  256D.02, subdivision 12a, clause (1); 
249.31     (2) demonstrating that the applicant has been continuously 
249.32  domiciled in the state for no less than 180 days immediately 
249.33  before the application; and 
249.34     (3) signing an affidavit declaring that (A) the applicant 
249.35  currently resides in the state and intends to reside in the 
249.36  state permanently; and (B) the applicant did not come to the 
250.1   state for the primary purpose of obtaining medical coverage or 
250.2   treatment; 
250.3      (4) effective October 1, 2004, single adults and adults in 
250.4   households without children who have gross family income at or 
250.5   below 75 percent of the federal poverty guidelines are exempt 
250.6   from the requirements of clause (1); 
250.7      (5) effective October 1, 2004, single adults and adults in 
250.8   households without children who have gross family income at or 
250.9   below 75 percent of the federal poverty guidelines are exempt 
250.10  from clause (2), but shall demonstrate that they have been 
250.11  continuously domiciled in the state for no less than 30 days 
250.12  before the date of application.  In cases of medical 
250.13  emergencies, the 30-day residency requirement is waived; and 
250.14     (6) effective October 1, 2004, migrant workers as defined 
250.15  in section 256J.08 who are single adults and adults in 
250.16  households without children who have gross family income at or 
250.17  below 75 percent of the federal poverty guidelines are exempt 
250.18  from the residency requirements of this section, provided the 
250.19  migrant worker provides verification that the migrant family 
250.20  worked in this state within the last 12 months and earned at 
250.21  least $1,000 in gross wages during the time the migrant worker 
250.22  worked in this state. 
250.23     (c) A person who is temporarily absent from the state does 
250.24  not lose eligibility for MinnesotaCare.  "Temporarily absent 
250.25  from the state" means the person is out of the state for a 
250.26  temporary purpose and intends to return when the purpose of the 
250.27  absence has been accomplished.  A person is not temporarily 
250.28  absent from the state if another state has determined that the 
250.29  person is a resident for any purpose.  If temporarily absent 
250.30  from the state, the person must follow the requirements of the 
250.31  health plan in which the person is enrolled to receive services. 
250.32     Sec. 83.  Minnesota Statutes 2002, section 256L.12, 
250.33  subdivision 6, is amended to read: 
250.34     Subd. 6.  [COPAYMENTS AND BENEFIT LIMITS.] Enrollees are 
250.35  responsible for all copayments in section 256L.03, subdivision 4 
250.36  5, and shall pay copayments to the managed care plan or to its 
251.1   participating providers.  The enrollee is also responsible for 
251.2   payment of inpatient hospital charges which exceed the 
251.3   MinnesotaCare benefit limit. 
251.4      Sec. 84.  Minnesota Statutes 2002, section 256L.12, 
251.5   subdivision 9, is amended to read: 
251.6      Subd. 9.  [RATE SETTING; PERFORMANCE WITHHOLDS.] (a) Rates 
251.7   will be prospective, per capita, where possible.  The 
251.8   commissioner may allow health plans to arrange for inpatient 
251.9   hospital services on a risk or nonrisk basis.  The commissioner 
251.10  shall consult with an independent actuary to determine 
251.11  appropriate rates. 
251.12     (b) For services rendered on or after January 1, 2003, to 
251.13  December 31, 2003, the commissioner shall withhold .5 percent of 
251.14  managed care plan payments under this section pending completion 
251.15  of performance targets.  The withheld funds must be returned no 
251.16  sooner than July 1 and no later than July 31 of the following 
251.17  year if performance targets in the contract are achieved.  A 
251.18  managed care plan may include as admitted assets under section 
251.19  62D.044 any amount withheld under this paragraph that is 
251.20  reasonably expected to be returned.  
251.21     (c) For services rendered on or after January 1, 2004, the 
251.22  commissioner shall withhold five percent of managed care plan 
251.23  payments under this section pending completion of performance 
251.24  targets.  Each performance target must be quantifiable, 
251.25  objective, measurable, and reasonably attainable.  Criteria for 
251.26  assessment of each performance target must be outlined in 
251.27  writing prior to the contract effective date.  The withheld 
251.28  funds must be returned no sooner than July 1 and no later than 
251.29  July 31 of the following calendar year if performance targets in 
251.30  the contract are achieved.  A managed care plan may include as 
251.31  admitted assets under section 62D.044 any amount withheld under 
251.32  this paragraph that is reasonably expected to be returned. 
251.33     (d) The commissioner may exempt from paragraph (b) a 
251.34  managed care plan that has entered into a managed care contract 
251.35  with the commissioner in accordance with this section if the 
251.36  contract was the initial contract between the managed care plan 
252.1   and the commissioner, and it was entered into after January 1, 
252.2   2000.  This exemption shall apply for five years after the 
252.3   initial contract was entered into by the managed care plan. 
252.4      <b>[EFFECTIVE DATE.]</b> This section is effective for services 
252.5   rendered on or after July 1, 2003, except as otherwise provided 
252.6   in the statutory language. 
252.7      Sec. 85.  Minnesota Statutes 2002, section 256L.12, is 
252.8   amending by adding a subdivision to read: 
252.9      Subd. 9a.  [RATE SETTING; RATABLE REDUCTION.] For services 
252.10  rendered on or after October 1, 2003, the total payment made to 
252.11  managed care plans under the MinnesotaCare program is reduced 
252.12  0.5 percent. 
252.13     Sec. 86.  Minnesota Statutes 2002, section 256L.12, is 
252.14  amended by adding a subdivision to read: 
252.15     Subd. 9b.  [ACTUARIAL SOUNDNESS.] All payments made to 
252.16  managed care plans under the MinnesotaCare program shall be 
252.17  actuarially sound pursuant to Code of Federal Regulations, title 
252.18  42, section 438.6.  In establishing payment rates for managed 
252.19  care plans under the MinnesotaCare program, the commissioner 
252.20  must consider, to the extent this information is available, 
252.21  verifiable, and actuarially significant:  (1) individual health 
252.22  plan annual financial performance for public programs; and (2) 
252.23  rate relationships and geographic payment relativities based on 
252.24  actual health plan experience.  The commissioner may recover any 
252.25  administrative costs related to implementing this subdivision, 
252.26  by assessing managed care plans in proportion to their share of 
252.27  enrollees in the MinnesotaCare program. 
252.28     Sec. 87.  Minnesota Statutes 2002, section 256L.15, 
252.29  subdivision 1, is amended to read: 
252.30     Subdivision 1.  [PREMIUM DETERMINATION.] (a) Families with 
252.31  children and individuals shall pay a premium determined 
252.32  according to a sliding fee based on a percentage of the family's 
252.33  gross family income subdivision 2.  
252.34     (b) Pregnant women and children under age two are exempt 
252.35  from the provisions of section 256L.06, subdivision 3, paragraph 
252.36  (b), clause (3), requiring disenrollment for failure to pay 
253.1   premiums.  For pregnant women, this exemption continues until 
253.2   the first day of the month following the 60th day postpartum.  
253.3   Women who remain enrolled during pregnancy or the postpartum 
253.4   period, despite nonpayment of premiums, shall be disenrolled on 
253.5   the first of the month following the 60th day postpartum for the 
253.6   penalty period that otherwise applies under section 256L.06, 
253.7   unless they begin paying premiums. 
253.8      (c) Effective October 1, 2004, single adults and households 
253.9   without children with gross family income at or below 75 percent 
253.10  of the federal poverty guidelines who are eligible under section 
253.11  256L.04, subdivision 7, do not have a premium obligation. 
253.12     Sec. 88.  Minnesota Statutes 2002, section 256L.15, 
253.13  subdivision 2, is amended to read: 
253.14     Subd. 2.  [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 
253.15  GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 
253.16  establish a sliding fee scale to determine the percentage of 
253.17  gross individual or family income that households at different 
253.18  income levels must pay to obtain coverage through the 
253.19  MinnesotaCare program.  The sliding fee scale must be based on 
253.20  the enrollee's gross individual or family income.  The sliding 
253.21  fee scale must contain separate tables based on enrollment of 
253.22  one, two, or three or more persons.  The sliding fee scale 
253.23  begins with a premium of 1.5 percent of gross individual or 
253.24  family income for individuals or families with incomes below the 
253.25  limits for the medical assistance program for families and 
253.26  children in effect on January 1, 1999, and proceeds through the 
253.27  following evenly spaced steps:  1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 
253.28  7.4, and 8.8 percent.  These percentages are matched to evenly 
253.29  spaced income steps ranging from the medical assistance income 
253.30  limit for families and children in effect on January 1, 1999, to 
253.31  275 percent of the federal poverty guidelines for the applicable 
253.32  family size, up to a family size of five.  The sliding fee scale 
253.33  for a family of five must be used for families of more than 
253.34  five.  Effective October 1, 2003, the commissioner shall 
253.35  increase each percentage by 0.5 percentage points for families 
253.36  and children with incomes greater than 100 percent but not 
254.1   exceeding 200 percent of the federal poverty guidelines and 
254.2   shall increase each percentage by 1.0 percentage points for 
254.3   families and children with incomes greater than 200 percent of 
254.4   the federal poverty guidelines.  The sliding fee scale and 
254.5   percentages are not subject to the provisions of chapter 14.  If 
254.6   a family or individual reports increased income after 
254.7   enrollment, premiums shall not be adjusted until eligibility 
254.8   renewal. 
254.9      (b)(1) Enrolled individuals and families whose gross annual 
254.10  income increases above 275 percent of the federal poverty 
254.11  guideline shall pay the maximum premium.  This clause expires 
254.12  effective February 1, 2004. 
254.13     (2) Effective October 1, 2003, enrolled single adults and 
254.14  households without children who have gross family income above 
254.15  75 percent of the federal poverty guidelines shall pay the 
254.16  maximum premium. 
254.17     (3) Effective February 1, 2004, adults in families with 
254.18  children whose gross income is above 200 percent of the federal 
254.19  poverty guidelines shall pay the maximum premium. 
254.20     (4) The maximum premium is defined as a base charge for 
254.21  one, two, or three or more enrollees so that if all 
254.22  MinnesotaCare cases paid the maximum premium, the total revenue 
254.23  would equal the total cost of MinnesotaCare medical coverage and 
254.24  administration.  In this calculation, administrative costs shall 
254.25  be assumed to equal ten percent of the total.  The costs of 
254.26  medical coverage for pregnant women and children under age two 
254.27  and the enrollees in these groups shall be excluded from the 
254.28  total.  The maximum premium for two enrollees shall be twice the 
254.29  maximum premium for one, and the maximum premium for three or 
254.30  more enrollees shall be three times the maximum premium for one. 
254.31     (c) Effective July 1, 2005, single adults and households 
254.32  without children who have gross family income above 75 percent 
254.33  of the federal poverty guidelines and adults in families with 
254.34  children whose gross income is above 200 percent of the federal 
254.35  poverty guidelines shall pay the full cost premium.  The full 
254.36  cost premium is defined as a base charge for one, two, or three 
255.1   or more enrollees so that if the base charge were paid by all 
255.2   MinnesotaCare cases subject to the full cost premium, the total 
255.3   revenue would approximately equal the total cost of 
255.4   MinnesotaCare medical coverage and administration for cases 
255.5   subject to the full cost premium.  In this calculation, 
255.6   administrative costs shall be assumed to equal ten percent of 
255.7   the total.  The full cost premium for two enrollees shall be 
255.8   twice the full cost premium for one, and the full cost premium 
255.9   for three or more enrollees shall be three times the full cost 
255.10  premium for one. 
255.11     <b>[EFFECTIVE DATE.]</b> The amendments to this section are 
255.12  effective October 1, 2004, unless specified otherwise in the 
255.13  statutory text. 
255.14     Sec. 89.  Minnesota Statutes 2002, section 256L.15, 
255.15  subdivision 3, is amended to read: 
255.16     Subd. 3.  [EXCEPTIONS TO SLIDING SCALE.] An annual premium 
255.17  of $48 is required for all children in families with income at 
255.18  or less than 175 150 percent of federal poverty guidelines. 
255.19     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
255.20     Sec. 90.  Minnesota Statutes 2002, section 256L.17, 
255.21  subdivision 2, is amended to read: 
255.22     Subd. 2.  [LIMIT ON TOTAL ASSETS.] (a) Effective July 1, 
255.23  2002, or upon federal approval, whichever is later, in order to 
255.24  be eligible for the MinnesotaCare program, a household of two or 
255.25  more persons must not own more than $30,000 in total net assets, 
255.26  and a household of one person must not own more than $15,000 in 
255.27  total net assets. 
255.28     (b) For purposes of this subdivision, assets are determined 
255.29  according to section 256B.056, subdivision 3c.  In addition to 
255.30  these maximum amounts, an eligible individual or family may 
255.31  accrue interest on these amounts, but they must be reduced to 
255.32  the maximum at the time of an eligibility redetermination.  The 
255.33  value of assets that are not considered in determining 
255.34  eligibility is the value of those assets excluded under the AFDC 
255.35  state plan as of July 16, 1996, as required by the Personal 
255.36  Responsibility and Work Opportunity Reconciliation Act of 1996 
256.1   (PRWORA), Public Law 104-193, with the following exceptions: 
256.2      (1) household goods and personal effects are not 
256.3   considered; 
256.4      (2) capital and operating assets of a trade or business up 
256.5   to $200,000 are not considered; 
256.6      (3) one motor vehicle is excluded for each person of legal 
256.7   driving age who is employed or seeking employment; 
256.8      (4) one burial plot and all other burial expenses equal to 
256.9   the supplemental security income program asset limit are not 
256.10  considered for each individual; 
256.11     (5) court-ordered settlements up to $10,000 are not 
256.12  considered; 
256.13     (6) individual retirement accounts and funds are not 
256.14  considered; and 
256.15     (7) assets owned by children are not considered.  
256.16     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
256.17     Sec. 91.  Minnesota Statutes 2002, section 514.981, 
256.18  subdivision 6, is amended to read: 
256.19     Subd. 6.  [TIME LIMITS; CLAIM LIMITS; LIENS ON LIFE ESTATES 
256.20  AND JOINT TENANCIES.] (a) A medical assistance lien is a lien on 
256.21  the real property it describes for a period of ten years from 
256.22  the date it attaches according to section 514.981, subdivision 
256.23  2, paragraph (a), except as otherwise provided for in sections 
256.24  514.980 to 514.985.  The agency may renew a medical assistance 
256.25  lien for an additional ten years from the date it would 
256.26  otherwise expire by recording or filing a certificate of renewal 
256.27  before the lien expires.  The certificate shall be recorded or 
256.28  filed in the office of the county recorder or registrar of 
256.29  titles for the county in which the lien is recorded or filed.  
256.30  The certificate must refer to the recording or filing data for 
256.31  the medical assistance lien it renews.  The certificate need not 
256.32  be attested, certified, or acknowledged as a condition for 
256.33  recording or filing.  The registrar of titles or the recorder 
256.34  shall file, record, index, and return the certificate of renewal 
256.35  in the same manner as provided for medical assistance liens in 
256.36  section 514.982, subdivision 2. 
257.1      (b) A medical assistance lien is not enforceable against 
257.2   the real property of an estate to the extent there is a 
257.3   determination by a court of competent jurisdiction, or by an 
257.4   officer of the court designated for that purpose, that there are 
257.5   insufficient assets in the estate to satisfy the agency's 
257.6   medical assistance lien in whole or in part because of the 
257.7   homestead exemption under section 256B.15, subdivision 4, the 
257.8   rights of the surviving spouse or minor children under section 
257.9   524.2-403, paragraphs (a) and (b), or claims with a priority 
257.10  under section 524.3-805, paragraph (a), clauses (1) to (4).  For 
257.11  purposes of this section, the rights of the decedent's adult 
257.12  children to exempt property under section 524.2-403, paragraph 
257.13  (b), shall not be considered costs of administration under 
257.14  section 524.3-805, paragraph (a), clause (1). 
257.15     (c) Notwithstanding any law or rule to the contrary, the 
257.16  provisions in clauses (1) to (7) apply if a life estate subject 
257.17  to a medical assistance lien ends according to its terms, or if 
257.18  a medical assistance recipient who owns a life estate or any 
257.19  interest in real property as a joint tenant that is subject to a 
257.20  medical assistance lien dies. 
257.21     (1) The medical assistance recipient's life estate or joint 
257.22  tenancy interest in the real property shall not end upon the 
257.23  recipient's death but shall merge into the remainder interest or 
257.24  other interest in real property the medical assistance recipient 
257.25  owned in joint tenancy with others.  The medical assistance lien 
257.26  shall attach to and run with the remainder or other interest in 
257.27  the real property to the extent of the medical assistance 
257.28  recipient's interest in the property at the time of the 
257.29  recipient's death as determined under this section. 
257.30     (2) If the medical assistance recipient's interest was a 
257.31  life estate in real property, the lien shall be a lien against 
257.32  the portion of the remainder equal to the percentage factor for 
257.33  the life estate of a person the medical assistance recipient's 
257.34  age on the date the life estate ended according to its terms or 
257.35  the date of the medical assistance recipient's death as listed 
257.36  in the Life Estate Mortality Table in the health care program's 
258.1   manual. 
258.2      (3) If the medical assistance recipient owned the interest 
258.3   in real property in joint tenancy with others, the lien shall be 
258.4   a lien against the portion of that interest equal to the 
258.5   fractional interest the medical assistance recipient would have 
258.6   owned in the jointly owned interest had the medical assistance 
258.7   recipient and the other owners held title to that interest as 
258.8   tenants in common on the date the medical assistance recipient 
258.9   died. 
258.10     (4) The medical assistance lien shall remain a lien against 
258.11  the remainder or other jointly owned interest for the length of 
258.12  time and be renewable as provided in paragraph (a). 
258.13     (5) Section 514.981, subdivision 5, paragraphs (a), clause 
258.14  (4), (b), clauses (1) and (2); and subdivision 6, paragraph (b), 
258.15  do not apply to medical assistance liens which attach to 
258.16  interests in real property as provided under this subdivision. 
258.17     (6) The continuation of a medical assistance recipient's 
258.18  life estate or joint tenancy interest in real property after the 
258.19  medical assistance recipient's death for the purpose of 
258.20  recovering medical assistance provided for in sections 514.980 
258.21  to 514.985 modifies common law principles holding that these 
258.22  interests terminate on the death of the holder. 
258.23     (7) Notwithstanding any law or rule to the contrary, no 
258.24  release, satisfaction, discharge, or affidavit under section 
258.25  256B.15 shall extinguish or terminate the life estate or joint 
258.26  tenancy interest of a medical assistance recipient subject to a 
258.27  lien under sections 514.980 to 514.985 on the date the recipient 
258.28  dies. 
258.29     (8) The provisions of clauses (1) to (7) do not apply to a 
258.30  homestead owned of record, on the date the recipient dies, by 
258.31  the recipient and the recipient's spouse as joint tenants with a 
258.32  right of survivorship. 
258.33     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
258.34  and applies to all medical assistance liens recorded or filed on 
258.35  or after that date. 
258.36     Sec. 92.  Minnesota Statutes 2002, section 641.15, 
259.1   subdivision 2, is amended to read: 
259.2      Subd. 2.  [MEDICAL AID.] Except as provided in section 
259.3   466.101, the county board shall pay the costs of medical 
259.4   services provided to prisoners.  The amount paid by a county 
259.5   board for a medical service shall not exceed the maximum allowed 
259.6   medical assistance payment rate for the service, as determined 
259.7   by the commissioner of human services.  The county is entitled 
259.8   to reimbursement from the prisoner for payment of medical bills 
259.9   to the extent that the prisoner to whom the medical aid was 
259.10  provided has the ability to pay the bills.  The prisoner shall, 
259.11  at a minimum, incur copayment obligations for health care 
259.12  services provided by a county correctional facility.  The county 
259.13  board shall determine the copayment amount.  Notwithstanding any 
259.14  law to the contrary, the copayment shall be deducted from any of 
259.15  the prisoner's funds held by the county, to the extent 
259.16  possible.  If there is a disagreement between the county and a 
259.17  prisoner concerning the prisoner's ability to pay, the court 
259.18  with jurisdiction over the defendant shall determine the extent, 
259.19  if any, of the prisoner's ability to pay for the medical 
259.20  services.  If a prisoner is covered by health or medical 
259.21  insurance or other health plan when medical services are 
259.22  provided, the county providing the medical services has a right 
259.23  of subrogation to be reimbursed by the insurance carrier for all 
259.24  sums spent by it for medical services to the prisoner that are 
259.25  covered by the policy of insurance or health plan, in accordance 
259.26  with the benefits, limitations, exclusions, provider 
259.27  restrictions, and other provisions of the policy or health 
259.28  plan.  The county may maintain an action to enforce this 
259.29  subrogation right.  The county does not have a right of 
259.30  subrogation against the medical assistance program or the 
259.31  general assistance medical care program. 
259.32     Sec. 93.  [PHARMACY PLUS WAIVER.] 
259.33     The commissioner of human services shall seek a pharmacy 
259.34  plus waiver from the Department of Health and Human Services 
259.35  that uses the accumulated savings from all pharmacy and asset 
259.36  transfer provisions in this act and previously adopted pharmacy 
260.1   savings strategies as the factor to prove fiscal neutrality.  
260.2   The commissioner shall expand eligibility for seniors and the 
260.3   disabled up to 135 percent of the federal poverty guidelines for 
260.4   the prescription drug program under Minnesota Statutes, section 
260.5   256.955, to the extent that the new federal funding under this 
260.6   waiver allows an expansion without an additional state 
260.7   appropriation.  
260.8      The commissioner shall also request that the prescription 
260.9   drug discount program established under Minnesota Statutes, 
260.10  section 256.954, be included in the waiver to require 
260.11  manufacturer rebates and to reduce the administrative costs of 
260.12  the program to the state. 
260.13     Sec. 94.  [REPORT ON PRESCRIPTION DRUG PROGRAMS.] 
260.14     The commissioner of human services shall report to the 
260.15  chairs and ranking minority members of the house and senate 
260.16  committees with jurisdiction over health and human services 
260.17  financing by November 1, 2004, on the status of the prescription 
260.18  drug discount program under Minnesota Statutes, section 256.954, 
260.19  and the prescription drug assistance program under Minnesota 
260.20  Statutes, section 256.975, subdivision 9.  The report must: 
260.21     (1) describe the status of the pharmacy plus waiver for 
260.22  Minnesota; 
260.23     (2) evaluate the impact of the prescription drug assistance 
260.24  program on the prescription drug program and the prescription 
260.25  drug assistance program; and 
260.26     (3) provide recommendations on the most efficient 
260.27  enrollment process for the prescription drug assistance program, 
260.28  considering state, county, or private options and the benefit of 
260.29  any automated enrollment systems under development by the 
260.30  commissioner. 
260.31     Sec. 95.  [REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY 
260.32  CRITERIA AND POTENTIAL COST SAVINGS.] 
260.33     The commissioner of human services, in consultation with 
260.34  the commissioner of transportation and special transportation 
260.35  service providers, shall review eligibility criteria for medical 
260.36  assistance special transportation services and shall evaluate 
261.1   whether the level of special transportation services provided 
261.2   should be based on the degree of impairment of the client, as 
261.3   well as the medical diagnosis.  The commissioner shall also 
261.4   evaluate methods for reducing the cost of special transportation 
261.5   services, including, but not limited to: 
261.6      (1) requiring providers to maintain a daily log book 
261.7   confirming delivery of clients to medical facilities; 
261.8      (2) requiring providers to implement commercially available 
261.9   computer mapping programs to calculate mileage for purposes of 
261.10  reimbursement; and 
261.11     (3) restricting special transportation service from being 
261.12  provided solely for trips to pharmacies. 
261.13     The commissioner shall present recommendations for changes 
261.14  in the eligibility criteria and potential cost-savings for 
261.15  special transportation services to the chairs and ranking 
261.16  minority members of the house and senate committees having 
261.17  jurisdiction over health and human services spending by January 
261.18  15, 2004.  The commissioner is prohibited from using a broker or 
261.19  coordinator to manage special transportation services through 
261.20  June 30, 2005, except for the purposes of checking for recipient 
261.21  eligibility, authorizing recipients for the appropriate level of 
261.22  transportation, and monitoring provider compliance with 
261.23  Minnesota Statutes, section 256B.0625, subdivision 17.  This 
261.24  prohibition does not apply to the purchase or management of 
261.25  common carrier transportation. 
261.26     Sec. 96.  [REBATES FOR MANAGED CARE.] 
261.27     The commissioner of human services shall develop a proposal 
261.28  to obtain increased pharmacy rebate revenue for recipients 
261.29  served through the prepaid medical assistance program and the 
261.30  MinnesotaCare program.  The commissioner may recommend excluding 
261.31  coverage for prescription drugs from prepaid medical assistance 
261.32  programs and MinnesotaCare contracts, or may propose other 
261.33  methods to obtain supplemental drug rebates for this 
261.34  population.  The commissioner shall present the proposal to the 
261.35  chairs and ranking minority members of the house and senate 
261.36  committees with jurisdiction over health and human services 
262.1   finance issues. 
262.2      Sec. 97.  [FEDERAL APPROVAL.] 
262.3      If the amendments to Minnesota Statutes, sections 256.046, 
262.4   subdivision 1, and 256.98, subdivision 8, are not effective 
262.5   because of prohibitions in federal law, the commissioner of 
262.6   human services shall seek the federal waivers and authority 
262.7   necessary to implement the provisions. 
262.8      Sec. 98.  [REVISOR'S INSTRUCTION.] 
262.9      For sections in Minnesota Statutes and Minnesota Rules 
262.10  affected by the repealed sections in this article, the revisor 
262.11  shall delete internal cross-references where appropriate and 
262.12  make changes necessary to correct the punctuation, grammar, or 
262.13  structure of the remaining text and preserve its meaning. 
262.14     Sec. 99.  [REPEALER.] 
262.15     (a) Minnesota Statutes 2002, sections 256.955, subdivision 
262.16  8; 256B.056, subdivision 3c; 256B.057, subdivision 1b; and 
262.17  256B.195, subdivision 5, are repealed July 1, 2003.  
262.18     (b) Minnesota Statutes 2002, section 256L.04, subdivision 
262.19  9, is repealed October 1, 2004. 
262.20     (c) Minnesota Statutes 2002, section 256B.055, subdivision 
262.21  10a, is repealed July 1, 2003, or upon federal approval, 
262.22  whichever is later. 
262.23     (d) Minnesota Statutes 2002, section 256L.02, subdivision 
262.24  3, is repealed June 30, 2005. 
262.25                             ARTICLE 3 
262.26                           LONG-TERM CARE 
262.27     Section 1.  Minnesota Statutes 2002, section 61A.072, 
262.28  subdivision 6, is amended to read: 
262.29     Subd. 6.  [ACCELERATED BENEFITS.] (a) "Accelerated 
262.30  benefits" covered under this section are benefits payable under 
262.31  the life insurance contract: 
262.32     (1) to a policyholder or certificate holder, during the 
262.33  lifetime of the insured, in anticipation of death upon the 
262.34  occurrence of a specified life-threatening or catastrophic 
262.35  condition as defined by the policy or rider; 
262.36     (2) that reduce the death benefit otherwise payable under 
263.1   the life insurance contract; and 
263.2      (3) that are payable upon the occurrence of a single 
263.3   qualifying event that results in the payment of a benefit amount 
263.4   fixed at the time of acceleration. 
263.5      (b) "Qualifying event" means one or more of the following: 
263.6      (1) a medical condition that would result in a drastically 
263.7   limited life span as specified in the contract; 
263.8      (2) a medical condition that has required or requires 
263.9   extraordinary medical intervention, such as, but not limited to, 
263.10  major organ transplant or continuous artificial life support 
263.11  without which the insured would die; or 
263.12     (3) a condition that requires continuous confinement in an 
263.13  eligible institution as defined in the contract if the insured 
263.14  is expected to remain there for the rest of the insured's life; 
263.15     (4) a long-term care illness or physical condition that 
263.16  results in cognitive impairment or the inability to perform the 
263.17  activities of daily life or the substantial and material duties 
263.18  of any occupation; or 
263.19     (5) other qualifying events that the commissioner approves 
263.20  for a particular filing. 
263.21     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
263.22  following final enactment and applies to policies issued on or 
263.23  after that date. 
263.24     Sec. 2.  Minnesota Statutes 2002, section 62A.315, is 
263.25  amended to read: 
263.26     62A.315 [EXTENDED BASIC MEDICARE SUPPLEMENT PLAN; 
263.27  COVERAGE.] 
263.28     The extended basic Medicare supplement plan must have a 
263.29  level of coverage so that it will be certified as a qualified 
263.30  plan pursuant to section 62E.07, and will provide: 
263.31     (1) coverage for all of the Medicare part A inpatient 
263.32  hospital deductible and coinsurance amounts, and 100 percent of 
263.33  all Medicare part A eligible expenses for hospitalization not 
263.34  covered by Medicare; 
263.35     (2) coverage for the daily copayment amount of Medicare 
263.36  part A eligible expenses for the calendar year incurred for 
264.1   skilled nursing facility care; 
264.2      (3) coverage for the copayment amount of Medicare eligible 
264.3   expenses under Medicare part B regardless of hospital 
264.4   confinement, and the Medicare part B deductible amount; 
264.5      (4) 80 percent of the usual and customary hospital and 
264.6   medical expenses and supplies described in section 62E.06, 
264.7   subdivision 1, not to exceed any charge limitation established 
264.8   by the Medicare program or state law, the usual and customary 
264.9   hospital and medical expenses and supplies, described in section 
264.10  62E.06, subdivision 1, while in a foreign country, and 
264.11  prescription drug expenses, not covered by Medicare; 
264.12     (5) coverage for the reasonable cost of the first three 
264.13  pints of blood, or equivalent quantities of packed red blood 
264.14  cells as defined under federal regulations under Medicare parts 
264.15  A and B, unless replaced in accordance with federal regulations; 
264.16     (6) 100 percent of the cost of immunizations and routine 
264.17  screening procedures for cancer, including mammograms and pap 
264.18  smears; 
264.19     (7) preventive medical care benefit:  coverage for the 
264.20  following preventive health services: 
264.21     (i) an annual clinical preventive medical history and 
264.22  physical examination that may include tests and services from 
264.23  clause (ii) and patient education to address preventive health 
264.24  care measures; 
264.25     (ii) any one or a combination of the following preventive 
264.26  screening tests or preventive services, the frequency of which 
264.27  is considered medically appropriate: 
264.28     (A) fecal occult blood test and/or digital rectal 
264.29  examination; 
264.30     (B) dipstick urinalysis for hematuria, bacteriuria, and 
264.31  proteinuria; 
264.32     (C) pure tone (air only) hearing screening test 
264.33  administered or ordered by a physician; 
264.34     (D) serum cholesterol screening every five years; 
264.35     (E) thyroid function test; 
264.36     (F) diabetes screening; 
265.1      (iii) any other tests or preventive measures determined 
265.2   appropriate by the attending physician.  
265.3      Reimbursement shall be for the actual charges up to 100 
265.4   percent of the Medicare-approved amount for each service as if 
265.5   Medicare were to cover the service as identified in American 
265.6   Medical Association current procedural terminology (AMA CPT) 
265.7   codes to a maximum of $120 annually under this benefit.  This 
265.8   benefit shall not include payment for any procedure covered by 
265.9   Medicare; 
265.10     (8) at-home recovery benefit:  coverage for services to 
265.11  provide short-term at-home assistance with activities of daily 
265.12  living for those recovering from an illness, injury, or surgery: 
265.13     (i) for purposes of this benefit, the following definitions 
265.14  shall apply: 
265.15     (A) "activities of daily living" include, but are not 
265.16  limited to, bathing, dressing, personal hygiene, transferring, 
265.17  eating, ambulating, assistance with drugs that are normally 
265.18  self-administered, and changing bandages or other dressings; 
265.19     (B) "care provider" means a duly qualified or licensed home 
265.20  health aide/homemaker, personal care aide, or nurse provided 
265.21  through a licensed home health care agency or referred by a 
265.22  licensed referral agency or licensed nurses registry; 
265.23     (C) "home" means a place used by the insured as a place of 
265.24  residence, provided that the place would qualify as a residence 
265.25  for home health care services covered by Medicare.  A hospital 
265.26  or skilled nursing facility shall not be considered the 
265.27  insured's place of residence; 
265.28     (D) "at-home recovery visit" means the period of a visit 
265.29  required to provide at-home recovery care, without limit on the 
265.30  duration of the visit, except each consecutive four hours in a 
265.31  24-hour period of services provided by a care provider is one 
265.32  visit; 
265.33     (ii) coverage requirements and limitations: 
265.34     (A) at-home recovery services provided must be primarily 
265.35  services that assist in activities of daily living; 
265.36     (B) the insured's attending physician must certify that the 
266.1   specific type and frequency of at-home recovery services are 
266.2   necessary because of a condition for which a home care plan of 
266.3   treatment was approved by Medicare; 
266.4      (C) coverage is limited to: 
266.5      (I) no more than the number and type of at-home recovery 
266.6   visits certified as medically necessary by the insured's 
266.7   attending physician.  The total number of at-home recovery 
266.8   visits shall not exceed the number of Medicare-approved home 
266.9   health care visits under a Medicare-approved home care plan of 
266.10  treatment; 
266.11     (II) the actual charges for each visit up to a maximum 
266.12  reimbursement of $40 $100 per visit; 
266.13     (III) $1,600 $4,000 per calendar year; 
266.14     (IV) seven visits in any one week; 
266.15     (V) care furnished on a visiting basis in the insured's 
266.16  home; 
266.17     (VI) services provided by a care provider as defined in 
266.18  this section; 
266.19     (VII) at-home recovery visits while the insured is covered 
266.20  under the policy or certificate and not otherwise excluded; 
266.21     (VIII) at-home recovery visits received during the period 
266.22  the insured is receiving Medicare-approved home care services or 
266.23  no more than eight weeks after the service date of the last 
266.24  Medicare-approved home health care visit; 
266.25     (iii) coverage is excluded for: 
266.26     (A) home care visits paid for by Medicare or other 
266.27  government programs; and 
266.28     (B) care provided by family members, unpaid volunteers, or 
266.29  providers who are not care providers. 
266.30     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 
266.31  2004, and applies to policies issued on or after that date. 
266.32     Sec. 3.  Minnesota Statutes 2002, section 62A.48, is 
266.33  amended by adding a subdivision to read: 
266.34     Subd. 12.  [REGULATORY FLEXIBILITY.] The commissioner may 
266.35  upon written request issue an order to modify or suspend a 
266.36  specific provision or provisions of sections 62A.46 to 62A.56 
267.1   with respect to a specific long-term care insurance policy or 
267.2   certificate upon a written finding that: 
267.3      (1) the modification or suspension is in the best interest 
267.4   of the insureds; 
267.5      (2) the purpose to be achieved could not be effectively or 
267.6   efficiently achieved without the modifications or suspension; 
267.7   and 
267.8      (3)(i) the modification or suspension is necessary to the 
267.9   development of an innovative and reasonable approach for 
267.10  insuring long-term care; 
267.11     (ii) the policy or certificate is to be issued to residents 
267.12  of a life care or continuing care retirement community or some 
267.13  other residential community for the elderly and the modification 
267.14  or suspension is reasonably related to the special needs or 
267.15  nature of such a community; or 
267.16     (iii) the modification or suspension is necessary to permit 
267.17  long-term care insurance to be sold as part of, or in 
267.18  conjunction with, another insurance product. 
267.19     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 
267.20  2004, and applies to policies issued on or after that date. 
267.21     Sec. 4.  Minnesota Statutes 2002, section 62A.49, is 
267.22  amended by adding a subdivision to read: 
267.23     Subd. 3.  [PROHIBITED LIMITATIONS.] A long-term care 
267.24  insurance policy or certificate shall not, if it provides 
267.25  benefits for home health care or community care services, limit 
267.26  or exclude benefits by: 
267.27     (1) requiring that the insured would need care in a skilled 
267.28  nursing facility if home health care services were not provided; 
267.29     (2) requiring that the insured first or simultaneously 
267.30  receive nursing or therapeutic services in a home, community, or 
267.31  institutional setting before home health care services are 
267.32  covered; 
267.33     (3) limiting eligible services to services provided by a 
267.34  registered nurse or licensed practical nurse; 
267.35     (4) requiring that a nurse or therapist provide services 
267.36  covered by the policy that can be provided by a home health aide 
268.1   or other licensed or certified home care worker acting within 
268.2   the scope of licensure or certification; 
268.3      (5) excluding coverage for personal care services provided 
268.4   by a home health aide; 
268.5      (6) requiring that the provision of home health care 
268.6   services be at a level of certification or licensure greater 
268.7   than that required by the eligible service; 
268.8      (7) requiring that the insured have an acute condition 
268.9   before home health care services are covered; 
268.10     (8) limiting benefits to services provided by 
268.11  Medicare-certified agencies or providers; 
268.12     (9) excluding coverage for adult day care services; or 
268.13     (10) excluding coverage based upon location or type of 
268.14  residence in which the home health care services would be 
268.15  provided. 
268.16     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 
268.17  2004, and applies to policies issued on or after that date. 
268.18     Sec. 5.  Minnesota Statutes 2002, section 62S.22, 
268.19  subdivision 1, is amended to read: 
268.20     Subdivision 1.  [PROHIBITED LIMITATIONS.] A long-term care 
268.21  insurance policy or certificate shall not, if it provides 
268.22  benefits for home health care or community care services, limit 
268.23  or exclude benefits by: 
268.24     (1) requiring that the insured would need care in a skilled 
268.25  nursing facility if home health care services were not provided; 
268.26     (2) requiring that the insured first or simultaneously 
268.27  receive nursing or therapeutic services in a home, community, or 
268.28  institutional setting before home health care services are 
268.29  covered; 
268.30     (3) limiting eligible services to services provided by a 
268.31  registered nurse or licensed practical nurse; 
268.32     (4) requiring that a nurse or therapist provide services 
268.33  covered by the policy that can be provided by a home health aide 
268.34  or other licensed or certified home care worker acting within 
268.35  the scope of licensure or certification; 
268.36     (5) excluding coverage for personal care services provided 
269.1   by a home health aide; 
269.2      (6) requiring that the provision of home health care 
269.3   services be at a level of certification or licensure greater 
269.4   than that required by the eligible service; 
269.5      (7) requiring that the insured have an acute condition 
269.6   before home health care services are covered; 
269.7      (8) limiting benefits to services provided by 
269.8   Medicare-certified agencies or providers; or 
269.9      (9) excluding coverage for adult day care services; or 
269.10     (10) excluding coverage based upon location or type of 
269.11  residence in which the home health care services would be 
269.12  provided. 
269.13     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 
269.14  2004, and applies to policies issued on or after that date. 
269.15     Sec. 6.  [62S.34] [REGULATORY FLEXIBILITY.] 
269.16     The commissioner may upon written request issue an order to 
269.17  modify or suspend a specific provision or provisions of this 
269.18  chapter with respect to a specific long-term care insurance 
269.19  policy or certificate upon a written finding that: 
269.20     (1) the modification or suspension is in the best interest 
269.21  of the insureds; 
269.22     (2) the purpose to be achieved could not be effectively or 
269.23  efficiently achieved without the modifications or suspension; 
269.24  and 
269.25     (3)(i) the modification or suspension is necessary to the 
269.26  development of an innovative and reasonable approach for 
269.27  insuring long-term care; 
269.28     (ii) the policy or certificate is to be issued to residents 
269.29  of a life care or continuing care retirement community or some 
269.30  other residential community for the elderly and the modification 
269.31  or suspension is reasonably related to the special needs or 
269.32  nature of such a community; or 
269.33     (iii) the modification or suspension is necessary to permit 
269.34  long-term care insurance to be sold as part of, or in 
269.35  conjunction with, another insurance product. 
269.36     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 
270.1   2004, and applies to policies issued on or after that date. 
270.2      Sec. 7.  Minnesota Statutes 2002, section 144A.04, 
270.3   subdivision 3, is amended to read: 
270.4      Subd. 3.  [STANDARDS.] (a) The facility must meet the 
270.5   minimum health, sanitation, safety and comfort standards 
270.6   prescribed by the rules of the commissioner of health with 
270.7   respect to the construction, equipment, maintenance and 
270.8   operation of a nursing home.  The commissioner of health may 
270.9   temporarily waive compliance with one or more of the standards 
270.10  if the commissioner determines that: 
270.11     (a) (1) temporary noncompliance with the standard will not 
270.12  create an imminent risk of harm to a nursing home resident; and 
270.13     (b) (2) a controlling person on behalf of all other 
270.14  controlling persons: 
270.15     (1) (i) has entered into a contract to obtain the materials 
270.16  or labor necessary to meet the standard set by the commissioner 
270.17  of health, but the supplier or other contractor has failed to 
270.18  perform the terms of the contract and the inability of the 
270.19  nursing home to meet the standard is due solely to that failure; 
270.20  or 
270.21     (2) (ii) is otherwise making a diligent good faith effort 
270.22  to meet the standard. 
270.23     The commissioner shall make available to other nursing 
270.24  homes information on facility-specific waivers related to 
270.25  technology or physical plant that are granted.  The commissioner 
270.26  shall, upon the request of a facility, extend a waiver granted 
270.27  to a specific facility related to technology or physical plant 
270.28  to the facility making the request, if the commissioner 
270.29  determines that the facility also satisfies clauses (1) and (2) 
270.30  and any other terms and conditions of the waiver.  
270.31     The commissioner of health shall allow, by rule, a nursing 
270.32  home to provide fewer hours of nursing care to intermediate care 
270.33  residents of a nursing home than required by the present rules 
270.34  of the commissioner if the commissioner determines that the 
270.35  needs of the residents of the home will be adequately met by a 
270.36  lesser amount of nursing care. 
271.1      (b) A facility is not required to seek a waiver for room 
271.2   furniture or equipment under paragraph (a) when responding to 
271.3   resident-specific requests, if the facility has discussed health 
271.4   and safety concerns with the resident and the resident request 
271.5   and discussion of health and safety concerns are documented in 
271.6   the resident's patient record. 
271.7      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
271.8      Sec. 8.  Minnesota Statutes 2002, section 144A.04, is 
271.9   amended by adding a subdivision to read: 
271.10     Subd. 11.  [INCONTINENT RESIDENTS.] Notwithstanding 
271.11  Minnesota Rules, part 4658.0520, an incontinent resident must be 
271.12  checked according to a specific time interval written in the 
271.13  resident's care plan.  The resident's attending physician must 
271.14  authorize in writing any interval longer than two hours unless 
271.15  the resident, if competent, or a family member or legally 
271.16  appointed conservator, guardian, or health care agent of a 
271.17  resident who is not competent, agrees in writing to waive 
271.18  physician involvement in determining this interval, and this 
271.19  waiver is documented in the resident's care plan. 
271.20     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
271.21     Sec. 9. Minnesota Statutes 2002, section 144A.071, 
271.22  subdivision 4a, is amended to read: 
271.23     Subd. 4a.  [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 
271.24  best interest of the state to ensure that nursing homes and 
271.25  boarding care homes continue to meet the physical plant 
271.26  licensing and certification requirements by permitting certain 
271.27  construction projects.  Facilities should be maintained in 
271.28  condition to satisfy the physical and emotional needs of 
271.29  residents while allowing the state to maintain control over 
271.30  nursing home expenditure growth. 
271.31     The commissioner of health in coordination with the 
271.32  commissioner of human services, may approve the renovation, 
271.33  replacement, upgrading, or relocation of a nursing home or 
271.34  boarding care home, under the following conditions: 
271.35     (a) to license or certify beds in a new facility 
271.36  constructed to replace a facility or to make repairs in an 
272.1   existing facility that was destroyed or damaged after June 30, 
272.2   1987, by fire, lightning, or other hazard provided:  
272.3      (i) destruction was not caused by the intentional act of or 
272.4   at the direction of a controlling person of the facility; 
272.5      (ii) at the time the facility was destroyed or damaged the 
272.6   controlling persons of the facility maintained insurance 
272.7   coverage for the type of hazard that occurred in an amount that 
272.8   a reasonable person would conclude was adequate; 
272.9      (iii) the net proceeds from an insurance settlement for the 
272.10  damages caused by the hazard are applied to the cost of the new 
272.11  facility or repairs; 
272.12     (iv) the new facility is constructed on the same site as 
272.13  the destroyed facility or on another site subject to the 
272.14  restrictions in section 144A.073, subdivision 5; 
272.15     (v) the number of licensed and certified beds in the new 
272.16  facility does not exceed the number of licensed and certified 
272.17  beds in the destroyed facility; and 
272.18     (vi) the commissioner determines that the replacement beds 
272.19  are needed to prevent an inadequate supply of beds. 
272.20  Project construction costs incurred for repairs authorized under 
272.21  this clause shall not be considered in the dollar threshold 
272.22  amount defined in subdivision 2; 
272.23     (b) to license or certify beds that are moved from one 
272.24  location to another within a nursing home facility, provided the 
272.25  total costs of remodeling performed in conjunction with the 
272.26  relocation of beds does not exceed $1,000,000; 
272.27     (c) to license or certify beds in a project recommended for 
272.28  approval under section 144A.073; 
272.29     (d) to license or certify beds that are moved from an 
272.30  existing state nursing home to a different state facility, 
272.31  provided there is no net increase in the number of state nursing 
272.32  home beds; 
272.33     (e) to certify and license as nursing home beds boarding 
272.34  care beds in a certified boarding care facility if the beds meet 
272.35  the standards for nursing home licensure, or in a facility that 
272.36  was granted an exception to the moratorium under section 
273.1   144A.073, and if the cost of any remodeling of the facility does 
273.2   not exceed $1,000,000.  If boarding care beds are licensed as 
273.3   nursing home beds, the number of boarding care beds in the 
273.4   facility must not increase beyond the number remaining at the 
273.5   time of the upgrade in licensure.  The provisions contained in 
273.6   section 144A.073 regarding the upgrading of the facilities do 
273.7   not apply to facilities that satisfy these requirements; 
273.8      (f) to license and certify up to 40 beds transferred from 
273.9   an existing facility owned and operated by the Amherst H. Wilder 
273.10  Foundation in the city of St. Paul to a new unit at the same 
273.11  location as the existing facility that will serve persons with 
273.12  Alzheimer's disease and other related disorders.  The transfer 
273.13  of beds may occur gradually or in stages, provided the total 
273.14  number of beds transferred does not exceed 40.  At the time of 
273.15  licensure and certification of a bed or beds in the new unit, 
273.16  the commissioner of health shall delicense and decertify the 
273.17  same number of beds in the existing facility.  As a condition of 
273.18  receiving a license or certification under this clause, the 
273.19  facility must make a written commitment to the commissioner of 
273.20  human services that it will not seek to receive an increase in 
273.21  its property-related payment rate as a result of the transfers 
273.22  allowed under this paragraph; 
273.23     (g) to license and certify nursing home beds to replace 
273.24  currently licensed and certified boarding care beds which may be 
273.25  located either in a remodeled or renovated boarding care or 
273.26  nursing home facility or in a remodeled, renovated, newly 
273.27  constructed, or replacement nursing home facility within the 
273.28  identifiable complex of health care facilities in which the 
273.29  currently licensed boarding care beds are presently located, 
273.30  provided that the number of boarding care beds in the facility 
273.31  or complex are decreased by the number to be licensed as nursing 
273.32  home beds and further provided that, if the total costs of new 
273.33  construction, replacement, remodeling, or renovation exceed ten 
273.34  percent of the appraised value of the facility or $200,000, 
273.35  whichever is less, the facility makes a written commitment to 
273.36  the commissioner of human services that it will not seek to 
274.1   receive an increase in its property-related payment rate by 
274.2   reason of the new construction, replacement, remodeling, or 
274.3   renovation.  The provisions contained in section 144A.073 
274.4   regarding the upgrading of facilities do not apply to facilities 
274.5   that satisfy these requirements; 
274.6      (h) to license as a nursing home and certify as a nursing 
274.7   facility a facility that is licensed as a boarding care facility 
274.8   but not certified under the medical assistance program, but only 
274.9   if the commissioner of human services certifies to the 
274.10  commissioner of health that licensing the facility as a nursing 
274.11  home and certifying the facility as a nursing facility will 
274.12  result in a net annual savings to the state general fund of 
274.13  $200,000 or more; 
274.14     (i) to certify, after September 30, 1992, and prior to July 
274.15  1, 1993, existing nursing home beds in a facility that was 
274.16  licensed and in operation prior to January 1, 1992; 
274.17     (j) to license and certify new nursing home beds to replace 
274.18  beds in a facility acquired by the Minneapolis community 
274.19  development agency as part of redevelopment activities in a city 
274.20  of the first class, provided the new facility is located within 
274.21  three miles of the site of the old facility.  Operating and 
274.22  property costs for the new facility must be determined and 
274.23  allowed under section 256B.431 or 256B.434; 
274.24     (k) to license and certify up to 20 new nursing home beds 
274.25  in a community-operated hospital and attached convalescent and 
274.26  nursing care facility with 40 beds on April 21, 1991, that 
274.27  suspended operation of the hospital in April 1986.  The 
274.28  commissioner of human services shall provide the facility with 
274.29  the same per diem property-related payment rate for each 
274.30  additional licensed and certified bed as it will receive for its 
274.31  existing 40 beds; 
274.32     (l) to license or certify beds in renovation, replacement, 
274.33  or upgrading projects as defined in section 144A.073, 
274.34  subdivision 1, so long as the cumulative total costs of the 
274.35  facility's remodeling projects do not exceed $1,000,000; 
274.36     (m) to license and certify beds that are moved from one 
275.1   location to another for the purposes of converting up to five 
275.2   four-bed wards to single or double occupancy rooms in a nursing 
275.3   home that, as of January 1, 1993, was county-owned and had a 
275.4   licensed capacity of 115 beds; 
275.5      (n) to allow a facility that on April 16, 1993, was a 
275.6   106-bed licensed and certified nursing facility located in 
275.7   Minneapolis to layaway all of its licensed and certified nursing 
275.8   home beds.  These beds may be relicensed and recertified in a 
275.9   newly-constructed teaching nursing home facility affiliated with 
275.10  a teaching hospital upon approval by the legislature.  The 
275.11  proposal must be developed in consultation with the interagency 
275.12  committee on long-term care planning.  The beds on layaway 
275.13  status shall have the same status as voluntarily delicensed and 
275.14  decertified beds, except that beds on layaway status remain 
275.15  subject to the surcharge in section 256.9657.  This layaway 
275.16  provision expires July 1, 1998; 
275.17     (o) to allow a project which will be completed in 
275.18  conjunction with an approved moratorium exception project for a 
275.19  nursing home in southern Cass county and which is directly 
275.20  related to that portion of the facility that must be repaired, 
275.21  renovated, or replaced, to correct an emergency plumbing problem 
275.22  for which a state correction order has been issued and which 
275.23  must be corrected by August 31, 1993; 
275.24     (p) to allow a facility that on April 16, 1993, was a 
275.25  368-bed licensed and certified nursing facility located in 
275.26  Minneapolis to layaway, upon 30 days prior written notice to the 
275.27  commissioner, up to 30 of the facility's licensed and certified 
275.28  beds by converting three-bed wards to single or double 
275.29  occupancy.  Beds on layaway status shall have the same status as 
275.30  voluntarily delicensed and decertified beds except that beds on 
275.31  layaway status remain subject to the surcharge in section 
275.32  256.9657, remain subject to the license application and renewal 
275.33  fees under section 144A.07 and shall be subject to a $100 per 
275.34  bed reactivation fee.  In addition, at any time within three 
275.35  years of the effective date of the layaway, the beds on layaway 
275.36  status may be: 
276.1      (1) relicensed and recertified upon relocation and 
276.2   reactivation of some or all of the beds to an existing licensed 
276.3   and certified facility or facilities located in Pine River, 
276.4   Brainerd, or International Falls; provided that the total 
276.5   project construction costs related to the relocation of beds 
276.6   from layaway status for any facility receiving relocated beds 
276.7   may not exceed the dollar threshold provided in subdivision 2 
276.8   unless the construction project has been approved through the 
276.9   moratorium exception process under section 144A.073; 
276.10     (2) relicensed and recertified, upon reactivation of some 
276.11  or all of the beds within the facility which placed the beds in 
276.12  layaway status, if the commissioner has determined a need for 
276.13  the reactivation of the beds on layaway status. 
276.14     The property-related payment rate of a facility placing 
276.15  beds on layaway status must be adjusted by the incremental 
276.16  change in its rental per diem after recalculating the rental per 
276.17  diem as provided in section 256B.431, subdivision 3a, paragraph 
276.18  (c).  The property-related payment rate for a facility 
276.19  relicensing and recertifying beds from layaway status must be 
276.20  adjusted by the incremental change in its rental per diem after 
276.21  recalculating its rental per diem using the number of beds after 
276.22  the relicensing to establish the facility's capacity day 
276.23  divisor, which shall be effective the first day of the month 
276.24  following the month in which the relicensing and recertification 
276.25  became effective.  Any beds remaining on layaway status more 
276.26  than three years after the date the layaway status became 
276.27  effective must be removed from layaway status and immediately 
276.28  delicensed and decertified; 
276.29     (q) to license and certify beds in a renovation and 
276.30  remodeling project to convert 12 four-bed wards into 24 two-bed 
276.31  rooms, expand space, and add improvements in a nursing home 
276.32  that, as of January 1, 1994, met the following conditions:  the 
276.33  nursing home was located in Ramsey county; had a licensed 
276.34  capacity of 154 beds; and had been ranked among the top 15 
276.35  applicants by the 1993 moratorium exceptions advisory review 
276.36  panel.  The total project construction cost estimate for this 
277.1   project must not exceed the cost estimate submitted in 
277.2   connection with the 1993 moratorium exception process; 
277.3      (r) to license and certify up to 117 beds that are 
277.4   relocated from a licensed and certified 138-bed nursing facility 
277.5   located in St. Paul to a hospital with 130 licensed hospital 
277.6   beds located in South St. Paul, provided that the nursing 
277.7   facility and hospital are owned by the same or a related 
277.8   organization and that prior to the date the relocation is 
277.9   completed the hospital ceases operation of its inpatient 
277.10  hospital services at that hospital.  After relocation, the 
277.11  nursing facility's status under section 256B.431, subdivision 
277.12  2j, shall be the same as it was prior to relocation.  The 
277.13  nursing facility's property-related payment rate resulting from 
277.14  the project authorized in this paragraph shall become effective 
277.15  no earlier than April 1, 1996.  For purposes of calculating the 
277.16  incremental change in the facility's rental per diem resulting 
277.17  from this project, the allowable appraised value of the nursing 
277.18  facility portion of the existing health care facility physical 
277.19  plant prior to the renovation and relocation may not exceed 
277.20  $2,490,000; 
277.21     (s) to license and certify two beds in a facility to 
277.22  replace beds that were voluntarily delicensed and decertified on 
277.23  June 28, 1991; 
277.24     (t) to allow 16 licensed and certified beds located on July 
277.25  1, 1994, in a 142-bed nursing home and 21-bed boarding care home 
277.26  facility in Minneapolis, notwithstanding the licensure and 
277.27  certification after July 1, 1995, of the Minneapolis facility as 
277.28  a 147-bed nursing home facility after completion of a 
277.29  construction project approved in 1993 under section 144A.073, to 
277.30  be laid away upon 30 days' prior written notice to the 
277.31  commissioner.  Beds on layaway status shall have the same status 
277.32  as voluntarily delicensed or decertified beds except that they 
277.33  shall remain subject to the surcharge in section 256.9657.  The 
277.34  16 beds on layaway status may be relicensed as nursing home beds 
277.35  and recertified at any time within five years of the effective 
277.36  date of the layaway upon relocation of some or all of the beds 
278.1   to a licensed and certified facility located in Watertown, 
278.2   provided that the total project construction costs related to 
278.3   the relocation of beds from layaway status for the Watertown 
278.4   facility may not exceed the dollar threshold provided in 
278.5   subdivision 2 unless the construction project has been approved 
278.6   through the moratorium exception process under section 144A.073. 
278.7      The property-related payment rate of the facility placing 
278.8   beds on layaway status must be adjusted by the incremental 
278.9   change in its rental per diem after recalculating the rental per 
278.10  diem as provided in section 256B.431, subdivision 3a, paragraph 
278.11  (c).  The property-related payment rate for the facility 
278.12  relicensing and recertifying beds from layaway status must be 
278.13  adjusted by the incremental change in its rental per diem after 
278.14  recalculating its rental per diem using the number of beds after 
278.15  the relicensing to establish the facility's capacity day 
278.16  divisor, which shall be effective the first day of the month 
278.17  following the month in which the relicensing and recertification 
278.18  became effective.  Any beds remaining on layaway status more 
278.19  than five years after the date the layaway status became 
278.20  effective must be removed from layaway status and immediately 
278.21  delicensed and decertified; 
278.22     (u) to license and certify beds that are moved within an 
278.23  existing area of a facility or to a newly constructed addition 
278.24  which is built for the purpose of eliminating three- and 
278.25  four-bed rooms and adding space for dining, lounge areas, 
278.26  bathing rooms, and ancillary service areas in a nursing home 
278.27  that, as of January 1, 1995, was located in Fridley and had a 
278.28  licensed capacity of 129 beds; 
278.29     (v) to relocate 36 beds in Crow Wing county and four beds 
278.30  from Hennepin county to a 160-bed facility in Crow Wing county, 
278.31  provided all the affected beds are under common ownership; 
278.32     (w) to license and certify a total replacement project of 
278.33  up to 49 beds located in Norman county that are relocated from a 
278.34  nursing home destroyed by flood and whose residents were 
278.35  relocated to other nursing homes.  The operating cost payment 
278.36  rates for the new nursing facility shall be determined based on 
279.1   the interim and settle-up payment provisions of Minnesota Rules, 
279.2   part 9549.0057, and the reimbursement provisions of section 
279.3   256B.431, except that subdivision 26, paragraphs (a) and (b), 
279.4   shall not apply until the second rate year after the settle-up 
279.5   cost report is filed.  Property-related reimbursement rates 
279.6   shall be determined under section 256B.431, taking into account 
279.7   any federal or state flood-related loans or grants provided to 
279.8   the facility; 
279.9      (x) to license and certify a total replacement project of 
279.10  up to 129 beds located in Polk county that are relocated from a 
279.11  nursing home destroyed by flood and whose residents were 
279.12  relocated to other nursing homes.  The operating cost payment 
279.13  rates for the new nursing facility shall be determined based on 
279.14  the interim and settle-up payment provisions of Minnesota Rules, 
279.15  part 9549.0057, and the reimbursement provisions of section 
279.16  256B.431, except that subdivision 26, paragraphs (a) and (b), 
279.17  shall not apply until the second rate year after the settle-up 
279.18  cost report is filed.  Property-related reimbursement rates 
279.19  shall be determined under section 256B.431, taking into account 
279.20  any federal or state flood-related loans or grants provided to 
279.21  the facility; 
279.22     (y) to license and certify beds in a renovation and 
279.23  remodeling project to convert 13 three-bed wards into 13 two-bed 
279.24  rooms and 13 single-bed rooms, expand space, and add 
279.25  improvements in a nursing home that, as of January 1, 1994, met 
279.26  the following conditions:  the nursing home was located in 
279.27  Ramsey county, was not owned by a hospital corporation, had a 
279.28  licensed capacity of 64 beds, and had been ranked among the top 
279.29  15 applicants by the 1993 moratorium exceptions advisory review 
279.30  panel.  The total project construction cost estimate for this 
279.31  project must not exceed the cost estimate submitted in 
279.32  connection with the 1993 moratorium exception process; 
279.33     (z) to license and certify up to 150 nursing home beds to 
279.34  replace an existing 285 bed nursing facility located in St. 
279.35  Paul.  The replacement project shall include both the renovation 
279.36  of existing buildings and the construction of new facilities at 
280.1   the existing site.  The reduction in the licensed capacity of 
280.2   the existing facility shall occur during the construction 
280.3   project as beds are taken out of service due to the construction 
280.4   process.  Prior to the start of the construction process, the 
280.5   facility shall provide written information to the commissioner 
280.6   of health describing the process for bed reduction, plans for 
280.7   the relocation of residents, and the estimated construction 
280.8   schedule.  The relocation of residents shall be in accordance 
280.9   with the provisions of law and rule; 
280.10     (aa) to allow the commissioner of human services to license 
280.11  an additional 36 beds to provide residential services for the 
280.12  physically handicapped under Minnesota Rules, parts 9570.2000 to 
280.13  9570.3400, in a 198-bed nursing home located in Red Wing, 
280.14  provided that the total number of licensed and certified beds at 
280.15  the facility does not increase; 
280.16     (bb) to license and certify a new facility in St. Louis 
280.17  county with 44 beds constructed to replace an existing facility 
280.18  in St. Louis county with 31 beds, which has resident rooms on 
280.19  two separate floors and an antiquated elevator that creates 
280.20  safety concerns for residents and prevents nonambulatory 
280.21  residents from residing on the second floor.  The project shall 
280.22  include the elimination of three- and four-bed rooms; 
280.23     (cc) to license and certify four beds in a 16-bed certified 
280.24  boarding care home in Minneapolis to replace beds that were 
280.25  voluntarily delicensed and decertified on or before March 31, 
280.26  1992.  The licensure and certification is conditional upon the 
280.27  facility periodically assessing and adjusting its resident mix 
280.28  and other factors which may contribute to a potential 
280.29  institution for mental disease declaration.  The commissioner of 
280.30  human services shall retain the authority to audit the facility 
280.31  at any time and shall require the facility to comply with any 
280.32  requirements necessary to prevent an institution for mental 
280.33  disease declaration, including delicensure and decertification 
280.34  of beds, if necessary; 
280.35     (dd) to license and certify 72 beds in an existing facility 
280.36  in Mille Lacs county with 80 beds as part of a renovation 
281.1   project.  The renovation must include construction of an 
281.2   addition to accommodate ten residents with beginning and 
281.3   midstage dementia in a self-contained living unit; creation of 
281.4   three resident households where dining, activities, and support 
281.5   spaces are located near resident living quarters; designation of 
281.6   four beds for rehabilitation in a self-contained area; 
281.7   designation of 30 private rooms; and other improvements; 
281.8      (ee) to license and certify beds in a facility that has 
281.9   undergone replacement or remodeling as part of a planned closure 
281.10  under section 256B.437; 
281.11     (ff) to license and certify a total replacement project of 
281.12  up to 124 beds located in Wilkin county that are in need of 
281.13  relocation from a nursing home significantly damaged by flood.  
281.14  The operating cost payment rates for the new nursing facility 
281.15  shall be determined based on the interim and settle-up payment 
281.16  provisions of Minnesota Rules, part 9549.0057, and the 
281.17  reimbursement provisions of section 256B.431, except that 
281.18  section 256B.431, subdivision 26, paragraphs (a) and (b), shall 
281.19  not apply until the second rate year after the settle-up cost 
281.20  report is filed.  Property-related reimbursement rates shall be 
281.21  determined under section 256B.431, taking into account any 
281.22  federal or state flood-related loans or grants provided to the 
281.23  facility; 
281.24     (gg) to allow the commissioner of human services to license 
281.25  an additional nine beds to provide residential services for the 
281.26  physically handicapped under Minnesota Rules, parts 9570.2000 to 
281.27  9570.3400, in a 240-bed nursing home located in Duluth, provided 
281.28  that the total number of licensed and certified beds at the 
281.29  facility does not increase; 
281.30     (hh) to license and certify up to 120 new nursing facility 
281.31  beds to replace beds in a facility in Anoka county, which was 
281.32  licensed for 98 beds as of July 1, 2000, provided the new 
281.33  facility is located within four miles of the existing facility 
281.34  and is in Anoka county.  Operating and property rates shall be 
281.35  determined and allowed under section 256B.431 and Minnesota 
281.36  Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 
282.1   256B.435.  The provisions of section 256B.431, subdivision 26, 
282.2   paragraphs (a) and (b), do not apply until the second rate year 
282.3   following settle-up; or 
282.4      (ii) to transfer up to 98 beds of a 129-licensed bed 
282.5   facility located in Anoka county that, as of March 25, 2001, is 
282.6   in the active process of closing, to a 122-licensed bed 
282.7   nonprofit nursing facility located in the city of Columbia 
282.8   Heights or its affiliate.  The transfer is effective when the 
282.9   receiving facility notifies the commissioner in writing of the 
282.10  number of beds accepted.  The commissioner shall place all 
282.11  transferred beds on layaway status held in the name of the 
282.12  receiving facility.  The layaway adjustment provisions of 
282.13  section 256B.431, subdivision 30, do not apply to this layaway.  
282.14  The receiving facility may only remove the beds from layaway for 
282.15  recertification and relicensure at the receiving facility's 
282.16  current site, or at a newly constructed facility located in 
282.17  Anoka county.  The receiving facility must receive statutory 
282.18  authorization before removing these beds from layaway status; or 
282.19     (jj) to license and certify beds as part of a project 
282.20  involving the construction of a new addition, conversion of 
282.21  existing space to a special care unit and short-term 
282.22  rehabilitation unit, expansion of dining and activity 
282.23  facilities, and related remodeling and improvements, in a 
282.24  nursing facility located in Hubbard county licensed for 124 beds 
282.25  as of March 3, 2003, provided that the total number of licensed 
282.26  and certified beds at the facility does not increase. 
282.27     Sec. 10.  Minnesota Statutes 2002, section 144A.10, is 
282.28  amended by adding a subdivision to read: 
282.29     Subd. 16.  [INDEPENDENT INFORMAL DISPUTE RESOLUTION.] (a) 
282.30  Notwithstanding subdivision 15, a facility certified under the 
282.31  federal Medicare or Medicaid programs may request from the 
282.32  commissioner, in writing, an independent informal dispute 
282.33  resolution process regarding any deficiency citation issued to 
282.34  the facility.  The facility must specify in its written request 
282.35  each deficiency citation that it disputes.  The commissioner 
282.36  shall provide a hearing under sections 14.57 to 14.62.  Upon the 
283.1   written request of the facility, the parties must submit the 
283.2   issues raised to arbitration by an administrative law judge. 
283.3      (b) Upon receipt of a written request for an arbitration 
283.4   proceeding, the commissioner shall file with the office of 
283.5   administrative hearings a request for the appointment of an 
283.6   arbitrator and simultaneously serve the facility with notice of 
283.7   the request.  The arbitrator for the dispute shall be an 
283.8   administrative law judge appointed by the office of 
283.9   administrative hearings.  The disclosure provisions of section 
283.10  572.10 and the notice provisions of section 572.12 apply.  The 
283.11  facility and the commissioner have the right to be represented 
283.12  by an attorney. 
283.13     (c) The commissioner and the facility may present written 
283.14  evidence, depositions, and oral statements and arguments at the 
283.15  arbitration proceeding.  Oral statements and arguments may be 
283.16  made by telephone. 
283.17     (d) Within ten working days of the close of the arbitration 
283.18  proceeding, the administrative law judge shall issue findings 
283.19  regarding each of the deficiencies in dispute.  The findings 
283.20  shall be one or more of the following: 
283.21     (1) Supported in full.  The citation is supported in full, 
283.22  with no deletion of findings and no change in the scope or 
283.23  severity assigned to the deficiency citation. 
283.24     (2) Supported in substance.  The citation is supported, but 
283.25  one or more findings are deleted without any change in the scope 
283.26  or severity assigned to the deficiency. 
283.27     (3) Deficient practice cited under wrong requirement of 
283.28  participation.  The citation is amended by moving it to the 
283.29  correct requirement of participation. 
283.30     (4) Scope not supported.  The citation is amended through a 
283.31  change in the scope assigned to the citation. 
283.32     (5) Severity not supported.  The citation is amended 
283.33  through a change in the severity assigned to the citation. 
283.34     (6) No deficient practice.  The citation is deleted because 
283.35  the findings did not support the citation or the negative 
283.36  resident outcome was unavoidable.  The findings of the 
284.1   arbitrator are not binding on the commissioner.  
284.2      (e) The commissioner shall reimburse the office of 
284.3   administrative hearings for the costs incurred by that office 
284.4   for the arbitration proceeding.  The facility shall reimburse 
284.5   the commissioner for the proportion of the costs that represent 
284.6   the sum of deficiency citations supported in full under 
284.7   paragraph (d), clause (1), or in substance under paragraph (d), 
284.8   clause (2), divided by the total number of deficiencies 
284.9   disputed.  A deficiency citation for which the administrative 
284.10  law judge's sole finding is that the deficient practice was 
284.11  cited under the wrong requirements of participation shall not be 
284.12  counted in the numerator or denominator in the calculation of 
284.13  the proportion of costs. 
284.14     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
284.15     Sec. 11.  [144A.351] [BALANCING LONG-TERM CARE:  REPORT 
284.16  REQUIRED.] 
284.17     The commissioners of health and human services, with the 
284.18  cooperation of counties and regional entities, shall prepare a 
284.19  report to the legislature by January 15, 2004, and biennially 
284.20  thereafter, regarding the status of the full range of long-term 
284.21  care services for the elderly in Minnesota.  The report shall 
284.22  address: 
284.23     (1) demographics and need for long-term care in Minnesota; 
284.24     (2) summary of county and regional reports on long-term 
284.25  care gaps, surpluses, imbalances, and corrective action plans; 
284.26     (3) status of long-term care services by county and region 
284.27  including: 
284.28     (i) changes in availability of the range of long-term care 
284.29  services and housing options; 
284.30     (ii) access problems regarding long-term care; and 
284.31     (iii) comparative measures of long-term care availability 
284.32  and progress over time; and 
284.33     (4) recommendations regarding goals for the future of 
284.34  long-term care services, policy changes, and resource needs. 
284.35     Sec. 12.  Minnesota Statutes 2002, section 144A.4605, 
284.36  subdivision 4, is amended to read: 
285.1      Subd. 4.  [LICENSE REQUIRED.] (a) A housing with services 
285.2   establishment registered under chapter 144D that is required to 
285.3   obtain a home care license must obtain an assisted living home 
285.4   care license according to this section or a class A or class E 
285.5   license according to rule.  A housing with services 
285.6   establishment that obtains a class E license under this 
285.7   subdivision remains subject to the payment limitations in 
285.8   sections 256B.0913, subdivision 5 5f, paragraph (h) (b), and 
285.9   256B.0915, subdivision 3, paragraph (g) 3d. 
285.10     (b) A board and lodging establishment registered for 
285.11  special services as of December 31, 1996, and also registered as 
285.12  a housing with services establishment under chapter 144D, must 
285.13  deliver home care services according to sections 144A.43 to 
285.14  144A.47, and may apply for a waiver from requirements under 
285.15  Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 
285.16  licensed agency under the standards of section 157.17.  Such 
285.17  waivers as may be granted by the department will expire upon 
285.18  promulgation of home care rules implementing section 144A.4605. 
285.19     (c) An adult foster care provider licensed by the 
285.20  department of human services and registered under chapter 144D 
285.21  may continue to provide health-related services under its foster 
285.22  care license until the promulgation of home care rules 
285.23  implementing this section. 
285.24     (d) An assisted living home care provider licensed under 
285.25  this section must comply with the disclosure provisions of 
285.26  section 325F.72 to the extent they are applicable. 
285.27     Sec. 13.  Minnesota Statutes 2002, section 256.9657, 
285.28  subdivision 1, is amended to read: 
285.29     Subdivision 1.  [NURSING HOME LICENSE SURCHARGE.] (a) 
285.30  Effective July 1, 1993, each non-state-operated nursing home 
285.31  licensed under chapter 144A shall pay to the commissioner an 
285.32  annual surcharge according to the schedule in subdivision 4.  
285.33  The surcharge shall be calculated as $620 per licensed bed.  If 
285.34  the number of licensed beds is reduced, the surcharge shall be 
285.35  based on the number of remaining licensed beds the second month 
285.36  following the receipt of timely notice by the commissioner of 
286.1   human services that beds have been delicensed.  The nursing home 
286.2   must notify the commissioner of health in writing when beds are 
286.3   delicensed.  The commissioner of health must notify the 
286.4   commissioner of human services within ten working days after 
286.5   receiving written notification.  If the notification is received 
286.6   by the commissioner of human services by the 15th of the month, 
286.7   the invoice for the second following month must be reduced to 
286.8   recognize the delicensing of beds.  Beds on layaway status 
286.9   continue to be subject to the surcharge.  The commissioner of 
286.10  human services must acknowledge a medical care surcharge appeal 
286.11  within 30 days of receipt of the written appeal from the 
286.12  provider. 
286.13     (b) Effective July 1, 1994, the surcharge in paragraph (a) 
286.14  shall be increased to $625. 
286.15     (c) Effective August 15, 2002, the surcharge under 
286.16  paragraph (b) shall be increased to $990. 
286.17     (d) Effective July 15, 2003, the surcharge under paragraph 
286.18  (c) shall be increased to $2,700. 
286.19     (e) The commissioner may reduce, and may subsequently 
286.20  restore, the surcharge under paragraph (d) based on the 
286.21  commissioner's determination of a permissible surcharge. 
286.22     (f) Between April 1, 2002, and August 15, 2003 2004, a 
286.23  facility governed by this subdivision may elect to assume full 
286.24  participation in the medical assistance program by agreeing to 
286.25  comply with all of the requirements of the medical assistance 
286.26  program, including the rate equalization law in section 256B.48, 
286.27  subdivision 1, paragraph (a), and all other requirements 
286.28  established in law or rule, and to begin intake of new medical 
286.29  assistance recipients.  Rates will be determined under Minnesota 
286.30  Rules, parts 9549.0010 to 9549.0080.  Notwithstanding section 
286.31  256B.431, subdivision 27, paragraph (i), rate calculations will 
286.32  be subject to limits as prescribed in rule and law.  Other than 
286.33  the adjustments in sections 256B.431, subdivisions 30 and 32; 
286.34  256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 
286.35  9549.0057, and any other applicable legislation enacted prior to 
286.36  the finalization of rates, facilities assuming full 
287.1   participation in medical assistance under this paragraph are not 
287.2   eligible for any rate adjustments until the July 1 following 
287.3   their settle-up period. 
287.4      <b>[EFFECTIVE DATE.]</b> This section is effective June 30, 2003. 
287.5      Sec. 14.  Minnesota Statutes 2002, section 256.9657, is 
287.6   amended by adding a subdivision to read: 
287.7      Subd. 3a.  [ICF/MR LICENSE SURCHARGE.] Effective July 1, 
287.8   2003, each nonstate-operated facility as defined under section 
287.9   256B.501, subdivision 1, shall pay to the commissioner an annual 
287.10  surcharge according to the schedule in subdivision 4, paragraph 
287.11  (d).  The annual surcharge shall be $1,040 per licensed bed.  If 
287.12  the number of licensed beds is reduced, the surcharge shall be 
287.13  based on the number of remaining licensed beds the second month 
287.14  following the receipt of timely notice by the commissioner of 
287.15  human services that beds have been delicensed.  The facility 
287.16  must notify the commissioner of health in writing when beds are 
287.17  delicensed.  The commissioner of health must notify the 
287.18  commissioner of human services within ten working days after 
287.19  receiving written notification.  If the notification is received 
287.20  by the commissioner of human services by the 15th of the month, 
287.21  the invoice for the second following month must be reduced to 
287.22  recognize the delicensing of beds.  The commissioner may reduce, 
287.23  and may subsequently restore, the surcharge under this 
287.24  subdivision based on the commissioner's determination of a 
287.25  permissible surcharge. 
287.26     Sec. 15.  Minnesota Statutes 2002, section 256.9657, 
287.27  subdivision 4, is amended to read: 
287.28     Subd. 4.  [PAYMENTS INTO THE ACCOUNT.] (a) Payments to the 
287.29  commissioner under subdivisions 1 to 3 must be paid in monthly 
287.30  installments due on the 15th of the month beginning October 15, 
287.31  1992.  The monthly payment must be equal to the annual surcharge 
287.32  divided by 12.  Payments to the commissioner under subdivisions 
287.33  2 and 3 for fiscal year 1993 must be based on calendar year 1990 
287.34  revenues.  Effective July 1 of each year, beginning in 1993, 
287.35  payments under subdivisions 2 and 3 must be based on revenues 
287.36  earned in the second previous calendar year. 
288.1      (b) Effective October 1, 1995, and each October 1 
288.2   thereafter, the payments in subdivisions 2 and 3 must be based 
288.3   on revenues earned in the previous calendar year. 
288.4      (c) If the commissioner of health does not provide by 
288.5   August 15 of any year data needed to update the base year for 
288.6   the hospital and health maintenance organization surcharges, the 
288.7   commissioner of human services may estimate base year revenue 
288.8   and use that estimate for the purposes of this section until 
288.9   actual data is provided by the commissioner of health. 
288.10     (d) Payments to the commissioner under subdivision 3a must 
288.11  be paid in monthly installments due on the 15th of the month 
288.12  beginning August 15, 2003.  The monthly payment must be equal to 
288.13  the annual surcharge divided by 12. 
288.14     Sec. 16.  Minnesota Statutes 2002, section 256.9754, 
288.15  subdivision 2, is amended to read: 
288.16     Subd. 2.  [CREATION.] The community services development 
288.17  grants program There is created under the administration of the 
288.18  commissioner of human services the consolidated ElderCare 
288.19  development grant fund for the purpose of rebalancing the 
288.20  long-term care system and increasing home and community-based 
288.21  care alternatives that sustain independent living.  
288.22     Sec. 17.  Minnesota Statutes 2002, section 256.9754, 
288.23  subdivision 3, is amended to read: 
288.24     Subd. 3.  [PROVISION OF GRANTS.] The commissioner shall 
288.25  make grants available to communities, providers of older adult 
288.26  services identified in subdivision 1, or to a consortium of 
288.27  providers of older adult services, to establish older adult 
288.28  services.  Grants may be provided for capital and other costs 
288.29  including, but not limited to, start-up and training costs, 
288.30  equipment, and supplies related to older adult services or other 
288.31  residential or service alternatives to nursing facility care.  
288.32  Grants may also be made to renovate current buildings, provide 
288.33  transportation services, fund programs that would allow older 
288.34  adults or disabled individuals to stay in their own homes by 
288.35  sharing a home, fund programs that coordinate and manage formal 
288.36  and informal services to older adults in their homes to enable 
289.1   them to live as independently as possible in their own homes as 
289.2   an alternative to nursing home care, or expand state-funded 
289.3   programs in the area.  Other services eligible for funding 
289.4   include:  transportation; chore services and homemaking; home 
289.5   health care and personal care assistance; care coordination; 
289.6   housing with services, such as assisted living and foster care; 
289.7   home modification; adult day services; caregiver support and 
289.8   respite; living-at-home block nurse; service integration and 
289.9   development; telemedicine, telehomecare, or other 
289.10  technology-based solutions; grocery shopping; and services 
289.11  identified as needed for community transition. 
289.12     Sec. 18.  Minnesota Statutes 2002, section 256.9754, 
289.13  subdivision 4, is amended to read: 
289.14     Subd. 4.  [ELIGIBILITY.] Grants may be awarded only to 
289.15  communities and providers, including for-profits, nonprofits, 
289.16  and governmental units, or to a consortium of providers that 
289.17  have a local match of 25 percent in the form of cash or in-kind 
289.18  services, except that for capital costs the match is 50 percent 
289.19  of the costs for the project in the form of donations, local tax 
289.20  dollars, in-kind donations, fund-raising, or other local matches.
289.21     Sec. 19.  Minnesota Statutes 2002, section 256.9754, 
289.22  subdivision 5, is amended to read: 
289.23     Subd. 5.  [GRANT PREFERENCE.] The commissioner of human 
289.24  services shall give preference when awarding grants under this 
289.25  section to areas where nursing facility closures have occurred 
289.26  or are occurring.  The commissioner may award grants to the 
289.27  extent grant funds are available and to the extent applications 
289.28  are approved by the commissioner.  Denial of approval of an 
289.29  application in one year does not preclude submission of an 
289.30  application in a subsequent year.  The maximum grant amount is 
289.31  limited to $750,000. 
289.32     Sec. 20.  Minnesota Statutes 2002, section 256B.056, 
289.33  subdivision 6, is amended to read: 
289.34     Subd. 6.  [ASSIGNMENT OF BENEFITS.] To be eligible for 
289.35  medical assistance a person must have applied or must agree to 
289.36  apply all proceeds received or receivable by the person or the 
290.1   person's spouse legal representative from any third person party 
290.2   liable for the costs of medical care for the person, the spouse, 
290.3   and children.  The state agency shall require from any applicant 
290.4   or recipient of medical assistance the assignment of any rights 
290.5   to medical support and third party payments.  By accepting or 
290.6   receiving assistance, the person is deemed to have assigned the 
290.7   person's rights to medical support and third party payments as 
290.8   required by Title 19 of the Social Security Act.  Persons must 
290.9   cooperate with the state in establishing paternity and obtaining 
290.10  third party payments.  By signing an application for accepting 
290.11  medical assistance, a person assigns to the department of human 
290.12  services all rights the person may have to medical support or 
290.13  payments for medical expenses from any other person or entity on 
290.14  their own or their dependent's behalf and agrees to cooperate 
290.15  with the state in establishing paternity and obtaining third 
290.16  party payments.  Any rights or amounts so assigned shall be 
290.17  applied against the cost of medical care paid for under this 
290.18  chapter.  Any assignment takes effect upon the determination 
290.19  that the applicant is eligible for medical assistance and up to 
290.20  three months prior to the date of application if the applicant 
290.21  is determined eligible for and receives medical assistance 
290.22  benefits.  The application must contain a statement explaining 
290.23  this assignment.  Any assignment shall not be effective as to 
290.24  benefits paid or provided under automobile accident coverage and 
290.25  private health care coverage prior to notification of the 
290.26  assignment by the person or organization providing the 
290.27  benefits.  For the purposes of this section, "the department of 
290.28  human services or the state" includes prepaid health plans under 
290.29  contract with the commissioner according to sections 256B.031, 
290.30  256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 
290.31  children's mental health collaboratives under section 245.493; 
290.32  demonstration projects for persons with disabilities under 
290.33  section 256B.77; nursing facilities under the alternative 
290.34  payment demonstration project under section 256B.434; and the 
290.35  county-based purchasing entities under section 256B.692.  
290.36     Sec. 21.  Minnesota Statutes 2002, section 256B.064, 
291.1   subdivision 2, is amended to read: 
291.2      Subd. 2.  [IMPOSITION OF MONETARY RECOVERY AND SANCTIONS.] 
291.3   (a) The commissioner shall determine any monetary amounts to be 
291.4   recovered and sanctions to be imposed upon a vendor of medical 
291.5   care under this section.  Except as provided in 
291.6   paragraph paragraphs (b) and (d), neither a monetary recovery 
291.7   nor a sanction will be imposed by the commissioner without prior 
291.8   notice and an opportunity for a hearing, according to chapter 
291.9   14, on the commissioner's proposed action, provided that the 
291.10  commissioner may suspend or reduce payment to a vendor of 
291.11  medical care, except a nursing home or convalescent care 
291.12  facility, after notice and prior to the hearing if in the 
291.13  commissioner's opinion that action is necessary to protect the 
291.14  public welfare and the interests of the program. 
291.15     (b) Except for a nursing home or convalescent care 
291.16  facility, the commissioner may withhold or reduce payments to a 
291.17  vendor of medical care without providing advance notice of such 
291.18  withholding or reduction if either of the following occurs: 
291.19     (1) the vendor is convicted of a crime involving the 
291.20  conduct described in subdivision 1a; or 
291.21     (2) the commissioner receives reliable evidence of fraud or 
291.22  willful misrepresentation by the vendor. 
291.23     (c) The commissioner must send notice of the withholding or 
291.24  reduction of payments under paragraph (b) within five days of 
291.25  taking such action.  The notice must: 
291.26     (1) state that payments are being withheld according to 
291.27  paragraph (b); 
291.28     (2) except in the case of a conviction for conduct 
291.29  described in subdivision 1a, state that the withholding is for a 
291.30  temporary period and cite the circumstances under which 
291.31  withholding will be terminated; 
291.32     (3) identify the types of claims to which the withholding 
291.33  applies; and 
291.34     (4) inform the vendor of the right to submit written 
291.35  evidence for consideration by the commissioner. 
291.36     The withholding or reduction of payments will not continue 
292.1   after the commissioner determines there is insufficient evidence 
292.2   of fraud or willful misrepresentation by the vendor, or after 
292.3   legal proceedings relating to the alleged fraud or willful 
292.4   misrepresentation are completed, unless the commissioner has 
292.5   sent notice of intention to impose monetary recovery or 
292.6   sanctions under paragraph (a). 
292.7      (d) The commissioner may suspend or terminate a vendor's 
292.8   participation in the program without providing advance notice 
292.9   and an opportunity for a hearing when the suspension or 
292.10  termination is required because of the vendor's exclusion from 
292.11  participation in Medicare.  Within five days of taking such 
292.12  action, the commissioner must send notice of the suspension or 
292.13  termination.  The notice must: 
292.14     (1) state that suspension or termination is the result of 
292.15  the vendor's exclusion from Medicare; 
292.16     (2) identify the effective date of the suspension or 
292.17  termination; 
292.18     (3) inform the vendor of the need to be reinstated to 
292.19  Medicare before reapplying for participation in the program; and 
292.20     (4) inform the vendor of the right to submit written 
292.21  evidence for consideration by the commissioner. 
292.22     (e) Upon receipt of a notice under paragraph (a) that a 
292.23  monetary recovery or sanction is to be imposed, a vendor may 
292.24  request a contested case, as defined in section 14.02, 
292.25  subdivision 3, by filing with the commissioner a written request 
292.26  of appeal.  The appeal request must be received by the 
292.27  commissioner no later than 30 days after the date the 
292.28  notification of monetary recovery or sanction was mailed to the 
292.29  vendor.  The appeal request must specify: 
292.30     (1) each disputed item, the reason for the dispute, and an 
292.31  estimate of the dollar amount involved for each disputed item; 
292.32     (2) the computation that the vendor believes is correct; 
292.33     (3) the authority in statute or rule upon which the vendor 
292.34  relies for each disputed item; 
292.35     (4) the name and address of the person or entity with whom 
292.36  contacts may be made regarding the appeal; and 
293.1      (5) other information required by the commissioner. 
293.2      Sec. 22.  Minnesota Statutes 2002, section 256B.0913, 
293.3   subdivision 2, is amended to read: 
293.4      Subd. 2.  [ELIGIBILITY FOR SERVICES.] Alternative care 
293.5   services are available to Minnesotans age 65 or older who are 
293.6   not eligible for medical assistance without a spenddown or 
293.7   waiver obligation but who would be eligible for medical 
293.8   assistance within 180 days of admission to a nursing facility 
293.9   and subject to subdivisions 4 to 13. 
293.10     Sec. 23.  Minnesota Statutes 2002, section 256B.0913, 
293.11  subdivision 4, is amended to read: 
293.12     Subd. 4.  [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 
293.13  NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 
293.14  under the alternative care program is available to persons who 
293.15  meet the following criteria: 
293.16     (1) the person has been determined by a community 
293.17  assessment under section 256B.0911 to be a person who would 
293.18  require the level of care provided in a nursing facility, but 
293.19  for the provision of services under the alternative care 
293.20  program; 
293.21     (2) the person is age 65 or older; 
293.22     (3) the person would be eligible for medical assistance 
293.23  within 180 days of admission to a nursing facility; 
293.24     (4) the person is not ineligible for the medical assistance 
293.25  program due to an asset transfer penalty; 
293.26     (5) the person needs services that are not funded through 
293.27  other state or federal funding; and 
293.28     (6) the monthly cost of the alternative care services 
293.29  funded by the program for this person does not exceed 75 percent 
293.30  of the statewide weighted average monthly nursing facility rate 
293.31  of the case mix resident class to which the individual 
293.32  alternative care client would be assigned under Minnesota Rules, 
293.33  parts 9549.0050 to 9549.0059, less the recipient's maintenance 
293.34  needs allowance as described in section 256B.0915, subdivision 
293.35  1d, paragraph (a), until the first day of the state fiscal year 
293.36  in which the resident assessment system, under section 256B.437, 
294.1   for nursing home rate determination is implemented.  Effective 
294.2   on the first day of the state fiscal year in which a resident 
294.3   assessment system, under section 256B.437, for nursing home rate 
294.4   determination is implemented and the first day of each 
294.5   subsequent state fiscal year, the monthly cost of alternative 
294.6   care services for this person shall not exceed the alternative 
294.7   care monthly cap for the case mix resident class to which the 
294.8   alternative care client would be assigned under Minnesota Rules, 
294.9   parts 9549.0050 to 9549.0059, which was in effect on the last 
294.10  day of the previous state fiscal year, and adjusted by the 
294.11  greater of any legislatively adopted home and community-based 
294.12  services cost-of-living percentage increase or any legislatively 
294.13  adopted statewide percent rate increase for nursing 
294.14  facilities monthly limit described under section 256B.0915, 
294.15  subdivision 3a.  This monthly limit does not prohibit the 
294.16  alternative care client from payment for additional services, 
294.17  but in no case may the cost of additional services purchased 
294.18  under this section exceed the difference between the client's 
294.19  monthly service limit defined under section 256B.0915, 
294.20  subdivision 3, and the alternative care program monthly service 
294.21  limit defined in this paragraph.  If medical supplies and 
294.22  equipment or environmental modifications are or will be 
294.23  purchased for an alternative care services recipient, the costs 
294.24  may be prorated on a monthly basis for up to 12 consecutive 
294.25  months beginning with the month of purchase.  If the monthly 
294.26  cost of a recipient's other alternative care services exceeds 
294.27  the monthly limit established in this paragraph, the annual cost 
294.28  of the alternative care services shall be determined.  In this 
294.29  event, the annual cost of alternative care services shall not 
294.30  exceed 12 times the monthly limit described in this paragraph.; 
294.31  and 
294.32     (7) the person is making timely payments of the assessed 
294.33  monthly premium charge.  A person is ineligible if payment or 
294.34  the assessed monthly premium charge is over 60 days past due. 
294.35  Following disenrollment due to nonpayment of a monthly premium, 
294.36  eligibility shall not be reinstated for a period of 90 days 
295.1   pending eligibility redetermination. 
295.2      (b) Alternative care funding under this subdivision is not 
295.3   available for a person who is a medical assistance recipient or 
295.4   who would be eligible for medical assistance without a spenddown 
295.5   or waiver obligation.  A person whose initial application for 
295.6   medical assistance and the elderly waiver program is being 
295.7   processed may be served under the alternative care program for a 
295.8   period up to 60 days.  If the individual is found to be eligible 
295.9   for medical assistance, medical assistance must be billed for 
295.10  services payable under the federally approved elderly waiver 
295.11  plan and delivered from the date the individual was found 
295.12  eligible for the federally approved elderly waiver plan.  
295.13  Notwithstanding this provision, upon federal approval, 
295.14  alternative care funds may not be used to pay for any service 
295.15  the cost of which:  (i) is payable by medical assistance or 
295.16  which; (ii) is used by a recipient to meet a medical assistance 
295.17  income spenddown or waiver obligation; or (iii) is used to pay a 
295.18  medical assistance income spenddown for a person who is eligible 
295.19  to participate in the federally approved elderly waiver program 
295.20  under the special income standard provision. 
295.21     (c) Alternative care funding is not available for a person 
295.22  who resides in a licensed nursing home, certified boarding care 
295.23  home, hospital, or intermediate care facility, except for case 
295.24  management services which are provided in support of the 
295.25  discharge planning process to for a nursing home resident or 
295.26  certified boarding care home resident to assist with a 
295.27  relocation process to a community-based setting. 
295.28     (d) Alternative care funding is not available for a person 
295.29  whose income is greater than the maintenance needs allowance 
295.30  under section 256B.0915, subdivision 1d, but equal to or less 
295.31  than 120 percent of the federal poverty guideline effective July 
295.32  1, in the year for which alternative care eligibility is 
295.33  determined, who would be eligible for the elderly waiver with a 
295.34  waiver obligation. 
295.35     Sec. 24.  Minnesota Statutes 2002, section 256B.0913, 
295.36  subdivision 5, is amended to read: 
296.1      Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
296.2   Alternative care funding may be used for payment of costs of: 
296.3      (1) adult foster care; 
296.4      (2) adult day care; 
296.5      (3) home health aide; 
296.6      (4) homemaker services; 
296.7      (5) personal care; 
296.8      (6) case management; 
296.9      (7) respite care; 
296.10     (8) assisted living; 
296.11     (9) residential care services; 
296.12     (10) care-related supplies and equipment; 
296.13     (11) meals delivered to the home; 
296.14     (12) transportation; 
296.15     (13) nursing services; 
296.16     (14) chore services; 
296.17     (15) companion services; 
296.18     (16) nutrition services; 
296.19     (17) training for direct informal caregivers; 
296.20     (18) telehome care devices to monitor recipients provide 
296.21  services in their own homes as an alternative to hospital care, 
296.22  nursing home care, or home in conjunction with in-home visits; 
296.23     (19) other services which includes discretionary funds and 
296.24  direct cash payments to clients, services, for which counties 
296.25  may make payment from their alternative care program allocation 
296.26  or services not otherwise defined in this section or section 
296.27  256B.0625, following approval by the commissioner, subject to 
296.28  the provisions of paragraph (j).  Total annual payments for 
296.29  "other services" for all clients within a county may not exceed 
296.30  25 percent of that county's annual alternative care program base 
296.31  allocation; and 
296.32     (20) environmental modifications.; and 
296.33     (21) direct cash payments for which counties may make 
296.34  payment from their alternative care program allocation to 
296.35  clients for the purpose of purchasing services, following 
296.36  approval by the commissioner, and subject to the provisions of 
297.1   subdivision 5h, until approval and implementation of 
297.2   consumer-directed services through the federally approved 
297.3   elderly waiver plan.  Upon implementation, consumer-directed 
297.4   services under the alternative care program are available 
297.5   statewide and limited to the average monthly expenditures 
297.6   representative of all alternative care program participants for 
297.7   the same case mix resident class assigned in the most recent 
297.8   fiscal year for which complete expenditure data is available. 
297.9      Total annual payments for discretionary services and direct 
297.10  cash payments, until the federally approved consumer-directed 
297.11  service option is implemented statewide, for all clients within 
297.12  a county may not exceed 25 percent of that county's annual 
297.13  alternative care program base allocation.  Thereafter, 
297.14  discretionary services are limited to 25 percent of the county's 
297.15  annual alternative care program base allocation. 
297.16     Subd. 5a.  [SERVICES; SERVICE DEFINITIONS; SERVICE 
297.17  STANDARDS.] (a) Unless specified in statute, the services, 
297.18  service definitions, and standards for alternative care services 
297.19  shall be the same as the services, service definitions, and 
297.20  standards specified in the federally approved elderly waiver 
297.21  plan, except for transitional support services. 
297.22     (b) The county agency must ensure that the funds are not 
297.23  used to supplant services available through other public 
297.24  assistance or services programs. 
297.25     (c) Unless specified in statute, the services, service 
297.26  definitions, and standards for alternative care services shall 
297.27  be the same as the services, service definitions, and standards 
297.28  specified in the federally approved elderly waiver plan.  Except 
297.29  for the county agencies' approval of direct cash payments to 
297.30  clients as described in paragraph (j) or For a provider of 
297.31  supplies and equipment when the monthly cost of the supplies and 
297.32  equipment is less than $250, persons or agencies must be 
297.33  employed by or under a contract with the county agency or the 
297.34  public health nursing agency of the local board of health in 
297.35  order to receive funding under the alternative care program.  
297.36  Supplies and equipment may be purchased from a vendor not 
298.1   certified to participate in the Medicaid program if the cost for 
298.2   the item is less than that of a Medicaid vendor.  
298.3      (c) Personal care services must meet the service standards 
298.4   defined in the federally approved elderly waiver plan, except 
298.5   that a county agency may contract with a client's relative who 
298.6   meets the relative hardship waiver requirements or a relative 
298.7   who meets the criteria and is also the responsible party under 
298.8   an individual service plan that ensures the client's health and 
298.9   safety and supervision of the personal care services by a 
298.10  qualified professional as defined in section 256B.0625, 
298.11  subdivision 19c.  Relative hardship is established by the county 
298.12  when the client's care causes a relative caregiver to do any of 
298.13  the following:  resign from a paying job, reduce work hours 
298.14  resulting in lost wages, obtain a leave of absence resulting in 
298.15  lost wages, incur substantial client-related expenses, provide 
298.16  services to address authorized, unstaffed direct care time, or 
298.17  meet special needs of the client unmet in the formal service 
298.18  plan. 
298.19     (d) Subd. 5b.  [ADULT FOSTER CARE RATE.] The adult foster 
298.20  care rate shall be considered a difficulty of care payment and 
298.21  shall not include room and board.  The adult foster care rate 
298.22  shall be negotiated between the county agency and the foster 
298.23  care provider.  The alternative care payment for the foster care 
298.24  service in combination with the payment for other alternative 
298.25  care services, including case management, must not exceed the 
298.26  limit specified in subdivision 4, paragraph (a), clause (6). 
298.27     (e) Personal care services must meet the service standards 
298.28  defined in the federally approved elderly waiver plan, except 
298.29  that a county agency may contract with a client's relative who 
298.30  meets the relative hardship waiver requirement as defined in 
298.31  section 256B.0627, subdivision 4, paragraph (b), clause (10), to 
298.32  provide personal care services if the county agency ensures 
298.33  supervision of this service by a qualified professional as 
298.34  defined in section 256B.0625, subdivision 19c.  
298.35     (f)  Subd. 5c.  [RESIDENTIAL CARE SERVICES; SUPPORTIVE 
298.36  SERVICES; HEALTH-RELATED SERVICES.] For purposes of this 
299.1   section, residential care services are services which are 
299.2   provided to individuals living in residential care homes.  
299.3   Residential care homes are currently licensed as board and 
299.4   lodging establishments under section 157.16, and are registered 
299.5   with the department of health as providing special services 
299.6   under section 157.17 and are not subject to registration except 
299.7   settings that are currently registered under chapter 144D.  
299.8   Residential care services are defined as "supportive services" 
299.9   and "health-related services."  "Supportive services" means the 
299.10  provision of up to 24-hour supervision and oversight.  
299.11  Supportive services includes:  (1) transportation, when provided 
299.12  by the residential care home only; (2) socialization, when 
299.13  socialization is part of the plan of care, has specific goals 
299.14  and outcomes established, and is not diversional or recreational 
299.15  in nature; (3) assisting clients in setting up meetings and 
299.16  appointments; (4) assisting clients in setting up medical and 
299.17  social services; (5) providing assistance with personal laundry, 
299.18  such as carrying the client's laundry to the laundry room.  
299.19  Assistance with personal laundry does not include any laundry, 
299.20  such as bed linen, that is included in the room and board rate 
299.21  services as defined in section 157.17, subdivision 1, paragraph 
299.22  (a).  "Health-related services" are limited to minimal 
299.23  assistance with dressing, grooming, and bathing and providing 
299.24  reminders to residents to take medications that are 
299.25  self-administered or providing storage for medications, if 
299.26  requested means services covered in section 157.17, subdivision 
299.27  1, paragraph (b).  Individuals receiving residential care 
299.28  services cannot receive homemaking services funded under this 
299.29  section.  
299.30     (g) Subd. 5d.  [ASSISTED LIVING SERVICES.] For the purposes 
299.31  of this section, "assisted living" refers to supportive services 
299.32  provided by a single vendor to clients who reside in the same 
299.33  apartment building of three or more units which are not subject 
299.34  to registration under chapter 144D and are licensed by the 
299.35  department of health as a class A home care provider or a class 
299.36  E home care provider.  Assisted living services are defined as 
300.1   up to 24-hour supervision, and oversight, and supportive 
300.2   services as defined in clause (1) section 157.17, subdivision 1, 
300.3   paragraph (a), individualized home care aide tasks as defined in 
300.4   clause (2) Minnesota Rules, part 4668.0110, and individualized 
300.5   home management tasks as defined in clause (3) Minnesota Rules, 
300.6   part 4668.0120 provided to residents of a residential center 
300.7   living in their units or apartments with a full kitchen and 
300.8   bathroom.  A full kitchen includes a stove, oven, refrigerator, 
300.9   food preparation counter space, and a kitchen utensil storage 
300.10  compartment.  Assisted living services must be provided by the 
300.11  management of the residential center or by providers under 
300.12  contract with the management or with the county. 
300.13     (1) Supportive services include:  
300.14     (i) socialization, when socialization is part of the plan 
300.15  of care, has specific goals and outcomes established, and is not 
300.16  diversional or recreational in nature; 
300.17     (ii) assisting clients in setting up meetings and 
300.18  appointments; and 
300.19     (iii) providing transportation, when provided by the 
300.20  residential center only.  
300.21     (2) Home care aide tasks means:  
300.22     (i) preparing modified diets, such as diabetic or low 
300.23  sodium diets; 
300.24     (ii) reminding residents to take regularly scheduled 
300.25  medications or to perform exercises; 
300.26     (iii) household chores in the presence of technically 
300.27  sophisticated medical equipment or episodes of acute illness or 
300.28  infectious disease; 
300.29     (iv) household chores when the resident's care requires the 
300.30  prevention of exposure to infectious disease or containment of 
300.31  infectious disease; and 
300.32     (v) assisting with dressing, oral hygiene, hair care, 
300.33  grooming, and bathing, if the resident is ambulatory, and if the 
300.34  resident has no serious acute illness or infectious disease.  
300.35  Oral hygiene means care of teeth, gums, and oral prosthetic 
300.36  devices.  
301.1      (3) Home management tasks means:  
301.2      (i) housekeeping; 
301.3      (ii) laundry; 
301.4      (iii) preparation of regular snacks and meals; and 
301.5      (iv) shopping.  
301.6      Subd. 5e.  [FURTHER ASSISTED LIVING REQUIREMENTS.] (a) 
301.7   Individuals receiving assisted living services shall not receive 
301.8   both assisted living services and homemaking services.  
301.9   Individualized means services are chosen and designed 
301.10  specifically for each resident's needs, rather than provided or 
301.11  offered to all residents regardless of their illnesses, 
301.12  disabilities, or physical conditions.  Assisted living services 
301.13  as defined in this section shall not be authorized in boarding 
301.14  and lodging establishments licensed according to sections 
301.15  157.011 and 157.15 to 157.22. 
301.16     (h) (b) For establishments registered under chapter 144D, 
301.17  assisted living services under this section means either the 
301.18  services described in paragraph (g) subdivision 5d and delivered 
301.19  by a class E home care provider licensed by the department of 
301.20  health or the services described under section 144A.4605 and 
301.21  delivered by an assisted living home care provider or a class A 
301.22  home care provider licensed by the commissioner of health. 
301.23     (i) Subd. 5f.  [PAYMENT RATES FOR ASSISTED LIVING SERVICES 
301.24  AND RESIDENTIAL CARE.] (a) Payment for assisted living services 
301.25  and residential care services shall be a monthly rate negotiated 
301.26  and authorized by the county agency based on an individualized 
301.27  service plan for each resident and may not cover direct rent or 
301.28  food costs.  
301.29     (1) (b) The individualized monthly negotiated payment for 
301.30  assisted living services as described in paragraph 
301.31  (g) subdivision 5d or (h) 5e, paragraph (b), and residential 
301.32  care services as described in paragraph (f) subdivision 5c, 
301.33  shall not exceed the nonfederal share in effect on July 1 of the 
301.34  state fiscal year for which the rate limit is being calculated 
301.35  of the greater of either the statewide or any of the geographic 
301.36  groups' weighted average monthly nursing facility payment rate 
302.1   of the case mix resident class to which the alternative care 
302.2   eligible client would be assigned under Minnesota Rules, parts 
302.3   9549.0050 to 9549.0059, less the maintenance needs allowance as 
302.4   described in section 256B.0915, subdivision 1d, paragraph (a), 
302.5   until the first day of the state fiscal year in which a resident 
302.6   assessment system, under section 256B.437, of nursing home rate 
302.7   determination is implemented.  Effective on the first day of the 
302.8   state fiscal year in which a resident assessment system, under 
302.9   section 256B.437, of nursing home rate determination is 
302.10  implemented and the first day of each subsequent state fiscal 
302.11  year, the individualized monthly negotiated payment for the 
302.12  services described in this clause shall not exceed the limit 
302.13  described in this clause which was in effect on the last day of 
302.14  the previous state fiscal year and which has been adjusted by 
302.15  the greater of any legislatively adopted home and 
302.16  community-based services cost-of-living percentage increase or 
302.17  any legislatively adopted statewide percent rate increase for 
302.18  nursing facilities groups according to subdivision 4, paragraph 
302.19  (a), clause (6). 
302.20     (2) (c) The individualized monthly negotiated payment for 
302.21  assisted living services described under section 144A.4605 and 
302.22  delivered by a provider licensed by the department of health as 
302.23  a class A home care provider or an assisted living home care 
302.24  provider and provided in a building that is registered as a 
302.25  housing with services establishment under chapter 144D and that 
302.26  provides 24-hour supervision in combination with the payment for 
302.27  other alternative care services, including case management, must 
302.28  not exceed the limit specified in subdivision 4, paragraph (a), 
302.29  clause (6). 
302.30     (j) Subd. 5g.  [PROVISIONS GOVERNING DIRECT CASH PAYMENTS.] 
302.31  A county agency may make payment from their alternative care 
302.32  program allocation for "other services" which include use of 
302.33  "discretionary funds" for services that are not otherwise 
302.34  defined in this section and direct cash payments to the client 
302.35  for the purpose of purchasing the services.  The following 
302.36  provisions apply to payments under this paragraph subdivision: 
303.1      (1) a cash payment to a client under this provision cannot 
303.2   exceed the monthly payment limit for that client as specified in 
303.3   subdivision 4, paragraph (a), clause (6); and 
303.4      (2) a county may not approve any cash payment for a client 
303.5   who meets either of the following: 
303.6      (i) has been assessed as having a dependency in 
303.7   orientation, unless the client has an authorized 
303.8   representative.  An "authorized representative" means an 
303.9   individual who is at least 18 years of age and is designated by 
303.10  the person or the person's legal representative to act on the 
303.11  person's behalf.  This individual may be a family member, 
303.12  guardian, representative payee, or other individual designated 
303.13  by the person or the person's legal representative, if any, to 
303.14  assist in purchasing and arranging for supports; or 
303.15     (ii) is concurrently receiving adult foster care, 
303.16  residential care, or assisted living services;. 
303.17     (3)  Subd. 5h.  [CASH PAYMENTS TO PERSONS.] (a) Cash 
303.18  payments to a person or a person's family will be provided 
303.19  through a monthly payment and be in the form of cash, voucher, 
303.20  or direct county payment to a vendor.  Fees or premiums assessed 
303.21  to the person for eligibility for health and human services are 
303.22  not reimbursable through this service option.  Services and 
303.23  goods purchased through cash payments must be identified in the 
303.24  person's individualized care plan and must meet all of the 
303.25  following criteria: 
303.26     (i) (1) they must be over and above the normal cost of 
303.27  caring for the person if the person did not have functional 
303.28  limitations; 
303.29     (ii) (2) they must be directly attributable to the person's 
303.30  functional limitations; 
303.31     (iii) (3) they must have the potential to be effective at 
303.32  meeting the goals of the program; and 
303.33     (iv) (4) they must be consistent with the needs identified 
303.34  in the individualized service plan.  The service plan shall 
303.35  specify the needs of the person and family, the form and amount 
303.36  of payment, the items and services to be reimbursed, and the 
304.1   arrangements for management of the individual grant; and. 
304.2      (v) (b) The person, the person's family, or the legal 
304.3   representative shall be provided sufficient information to 
304.4   ensure an informed choice of alternatives.  The local agency 
304.5   shall document this information in the person's care plan, 
304.6   including the type and level of expenditures to be reimbursed;. 
304.7      (c) Persons receiving grants under this section shall have 
304.8   the following responsibilities: 
304.9      (1) spend the grant money in a manner consistent with their 
304.10  individualized service plan with the local agency; 
304.11     (2) notify the local agency of any necessary changes in the 
304.12  grant expenditures; 
304.13     (3) arrange and pay for supports; and 
304.14     (4) inform the local agency of areas where they have 
304.15  experienced difficulty securing or maintaining supports. 
304.16     (d) The county shall report client outcomes, services, and 
304.17  costs under this paragraph in a manner prescribed by the 
304.18  commissioner. 
304.19     (4) Subd. 5i.  [IMMUNITY.] The state of Minnesota, county, 
304.20  lead agency under contract, or tribal government under contract 
304.21  to administer the alternative care program shall not be liable 
304.22  for damages, injuries, or liabilities sustained through the 
304.23  purchase of direct supports or goods by the person, the person's 
304.24  family, or the authorized representative with funds received 
304.25  through the cash payments under this section.  Liabilities 
304.26  include, but are not limited to, workers' compensation, the 
304.27  Federal Insurance Contributions Act (FICA), or the Federal 
304.28  Unemployment Tax Act (FUTA);. 
304.29     (5) persons receiving grants under this section shall have 
304.30  the following responsibilities: 
304.31     (i) spend the grant money in a manner consistent with their 
304.32  individualized service plan with the local agency; 
304.33     (ii) notify the local agency of any necessary changes in 
304.34  the grant expenditures; 
304.35     (iii) arrange and pay for supports; and 
304.36     (iv) inform the local agency of areas where they have 
305.1   experienced difficulty securing or maintaining supports; and 
305.2      (6) the county shall report client outcomes, services, and 
305.3   costs under this paragraph in a manner prescribed by the 
305.4   commissioner. 
305.5      Sec. 25.  Minnesota Statutes 2002, section 256B.0913, 
305.6   subdivision 6, is amended to read: 
305.7      Subd. 6.  [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] (a) 
305.8   The alternative care program is administered by the county 
305.9   agency.  This agency is the lead agency responsible for the 
305.10  local administration of the alternative care program as 
305.11  described in this section.  However, it may contract with the 
305.12  public health nursing service to be the lead agency.  The 
305.13  commissioner may contract with federally recognized Indian 
305.14  tribes with a reservation in Minnesota to serve as the lead 
305.15  agency responsible for the local administration of the 
305.16  alternative care program as described in the contract. 
305.17     (b) Alternative care pilot projects operate according to 
305.18  this section and the provisions of Laws 1993, First Special 
305.19  Session chapter 1, article 5, section 133, under agreement with 
305.20  the commissioner.  Each pilot project agreement period shall 
305.21  begin no later than the first payment cycle of the state fiscal 
305.22  year and continue through the last payment cycle of the state 
305.23  fiscal year. 
305.24     Sec. 26.  Minnesota Statutes 2002, section 256B.0913, 
305.25  subdivision 7, is amended to read: 
305.26     Subd. 7.  [CASE MANAGEMENT.] Providers of case management 
305.27  services for persons receiving services funded by the 
305.28  alternative care program must meet the qualification 
305.29  requirements and standards specified in section 256B.0915, 
305.30  subdivision 1b.  The case manager must not approve alternative 
305.31  care funding for a client in any setting in which the case 
305.32  manager cannot reasonably ensure the client's health and 
305.33  safety.  The case manager is responsible for the 
305.34  cost-effectiveness of the alternative care individual care plan 
305.35  and must not approve any care plan in which the cost of services 
305.36  funded by alternative care and client contributions exceeds the 
306.1   limit specified in section 256B.0915, subdivision 3, paragraph 
306.2   (b).  The county may allow a case manager employed by the county 
306.3   to delegate certain aspects of the case management activity to 
306.4   another individual employed by the county provided there is 
306.5   oversight of the individual by the case manager.  The case 
306.6   manager may not delegate those aspects which require 
306.7   professional judgment including assessments, reassessments, and 
306.8   care plan development. 
306.9      Sec. 27.  Minnesota Statutes 2002, section 256B.0913, 
306.10  subdivision 8, is amended to read: 
306.11     Subd. 8.  [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 
306.12  case manager shall implement the plan of care for each 
306.13  alternative care client and ensure that a client's service needs 
306.14  and eligibility are reassessed at least every 12 months.  The 
306.15  plan shall include any services prescribed by the individual's 
306.16  attending physician as necessary to allow the individual to 
306.17  remain in a community setting.  In developing the individual's 
306.18  care plan, the case manager should include the use of volunteers 
306.19  from families and neighbors, religious organizations, social 
306.20  clubs, and civic and service organizations to support the formal 
306.21  home care services.  The county shall be held harmless for 
306.22  damages or injuries sustained through the use of volunteers 
306.23  under this subdivision including workers' compensation 
306.24  liability.  The lead agency shall provide documentation in each 
306.25  individual's plan of care and, if requested, to the commissioner 
306.26  that the most cost-effective alternatives available have been 
306.27  offered to the individual and that the individual was free to 
306.28  choose among available qualified providers, both public and 
306.29  private, including qualified case management or service 
306.30  coordination providers other than those employed by the lead 
306.31  agency when the lead agency maintains responsibility for prior 
306.32  authorizing services in accordance with statutory and 
306.33  administrative requirements.  The case manager must give the 
306.34  individual a ten-day written notice of any denial, termination, 
306.35  or reduction of alternative care services. 
306.36     (b) If the county administering alternative care services 
307.1   is different than the county of financial responsibility, the 
307.2   care plan may be implemented without the approval of the county 
307.3   of financial responsibility. 
307.4      Sec. 28.  Minnesota Statutes 2002, section 256B.0913, 
307.5   subdivision 10, is amended to read: 
307.6      Subd. 10.  [ALLOCATION FORMULA.] (a) The alternative care 
307.7   appropriation for fiscal years 1992 and beyond shall cover only 
307.8   alternative care eligible clients.  By July 1 of each year, the 
307.9   commissioner shall allocate to county agencies the state funds 
307.10  available for alternative care for persons eligible under 
307.11  subdivision 2. 
307.12     (b) The adjusted base for each county is the county's 
307.13  current fiscal year base allocation plus any targeted funds 
307.14  approved during the current fiscal year.  Calculations for 
307.15  paragraphs (c) and (d) are to be made as follows:  for each 
307.16  county, the determination of alternative care program 
307.17  expenditures shall be based on payments for services rendered 
307.18  from April 1 through March 31 in the base year, to the extent 
307.19  that claims have been submitted and paid by June 1 of that year. 
307.20     (c) If the alternative care program expenditures as defined 
307.21  in paragraph (b) are 95 percent or more of the county's adjusted 
307.22  base allocation, the allocation for the next fiscal year is 100 
307.23  percent of the adjusted base, plus inflation to the extent that 
307.24  inflation is included in the state budget. 
307.25     (d) If the alternative care program expenditures as defined 
307.26  in paragraph (b) are less than 95 percent of the county's 
307.27  adjusted base allocation, the allocation for the next fiscal 
307.28  year is the adjusted base allocation less the amount of unspent 
307.29  funds below the 95 percent level. 
307.30     (e) If the annual legislative appropriation for the 
307.31  alternative care program is inadequate to fund the combined 
307.32  county allocations for a biennium, the commissioner shall 
307.33  distribute to each county the entire annual appropriation as 
307.34  that county's percentage of the computed base as calculated in 
307.35  paragraphs (c) and (d). 
307.36     (f) On agreement between the commissioner and the lead 
308.1   agency, the commissioner may have discretion to reallocate 
308.2   alternative care base allocations distributed to lead agencies 
308.3   in which the base amount exceeds program expenditures. 
308.4      Sec. 29.  Minnesota Statutes 2002, section 256B.0913, 
308.5   subdivision 12, is amended to read: 
308.6      Subd. 12.  [CLIENT PREMIUMS.] (a) A premium is required for 
308.7   all alternative care eligible clients to help pay for the cost 
308.8   of participating in the program.  The amount of the premium for 
308.9   the alternative care client shall be determined as follows: 
308.10     (1) when the alternative care client's income less 
308.11  recurring and predictable medical expenses is greater than the 
308.12  recipient's maintenance needs allowance as defined in section 
308.13  256B.0915, subdivision 1d, paragraph (a), but less than 150 
308.14  percent of the federal poverty guideline effective on July 1 of 
308.15  the state fiscal year in which the premium is being computed, 
308.16  and total assets are less than $10,000, the fee is zero ten 
308.17  percent of the cost of alternative care services; or 
308.18     (2) when the alternative care client's income less 
308.19  recurring and predictable medical expenses is greater than or 
308.20  equal to 150 percent of the federal poverty guideline effective 
308.21  on July 1 of the state fiscal year in which the premium is being 
308.22  computed, and total assets are less than $10,000, the fee is 25 
308.23  percent of the cost of alternative care services or the 
308.24  difference between 150 percent of the federal poverty guideline 
308.25  effective on July 1 of the state fiscal year in which the 
308.26  premium is being computed and the client's income less recurring 
308.27  and predictable medical expenses, whichever is less; and 
308.28     (3) when the alternative care client's or total assets are 
308.29  greater than or equal to $10,000, the fee is 25 percent of the 
308.30  cost of alternative care services.  
308.31     For married persons, total assets are defined as the total 
308.32  marital assets less the estimated community spouse asset 
308.33  allowance, under section 256B.059, if applicable.  For married 
308.34  persons, total income is defined as the client's income less the 
308.35  monthly spousal allotment, under section 256B.058. 
308.36     All alternative care services except case management shall 
309.1   be included in the estimated costs for the purpose of 
309.2   determining 25 percent of the costs premium amount. 
309.3      Premiums are due and payable each month alternative care 
309.4   services are received unless the actual cost of the services is 
309.5   less than the premium, in which case the fee is the lesser 
309.6   amount. 
309.7      (b) The fee shall be waived by the commissioner when: 
309.8      (1) a person who is residing in a nursing facility is 
309.9   receiving case management only; 
309.10     (2) a person is applying for medical assistance; 
309.11     (3) a married couple is requesting an asset assessment 
309.12  under the spousal impoverishment provisions; 
309.13     (4) (3) a person is found eligible for alternative care, 
309.14  but is not yet receiving alternative care services; or 
309.15     (5) (4) a person's fee under paragraph (a) is less than 
309.16  $25; or 
309.17     (5) a person has chosen to participate in a 
309.18  consumer-directed service plan for which the cost is no greater 
309.19  than the total cost of the person's alternative care service 
309.20  plan less the monthly premium amount that would otherwise be 
309.21  assessed. 
309.22     (c) The county agency must record in the state's receivable 
309.23  system the client's assessed premium amount or the reason the 
309.24  premium has been waived.  The commissioner will bill and collect 
309.25  the premium from the client.  Money collected must be deposited 
309.26  in the general fund and is appropriated to the commissioner for 
309.27  the alternative care program.  The client must supply the county 
309.28  with the client's social security number at the time of 
309.29  application.  The county shall supply the commissioner with the 
309.30  client's social security number and other information the 
309.31  commissioner requires to collect the premium from the client.  
309.32  The commissioner shall collect unpaid premiums using the Revenue 
309.33  Recapture Act in chapter 270A and other methods available to the 
309.34  commissioner.  The commissioner may require counties to inform 
309.35  clients of the collection procedures that may be used by the 
309.36  state if a premium is not paid.  This paragraph does not apply 
310.1   to alternative care pilot projects authorized in Laws 1993, 
310.2   First Special Session chapter 1, article 5, section 133, if a 
310.3   county operating under the pilot project reports the following 
310.4   dollar amounts to the commissioner quarterly: 
310.5      (1) total premiums billed to clients; 
310.6      (2) total collections of premiums billed; and 
310.7      (3) balance of premiums owed by clients. 
310.8   If a county does not adhere to these reporting requirements, the 
310.9   commissioner may terminate the billing, collecting, and 
310.10  remitting portions of the pilot project and require the county 
310.11  involved to operate under the procedures set forth in this 
310.12  paragraph. 
310.13     Sec. 30.  Minnesota Statutes 2002, section 256B.0915, 
310.14  subdivision 3, is amended to read: 
310.15     Subd. 3.  [LIMITS OF CASES, RATES, PAYMENTS, AND 
310.16  FORECASTING.] (a) The number of medical assistance waiver 
310.17  recipients that a county may serve must be allocated according 
310.18  to the number of medical assistance waiver cases open on July 1 
310.19  of each fiscal year.  Additional recipients may be served with 
310.20  the approval of the commissioner. 
310.21     (b) Subd. 3a.  [ELDERLY WAIVER COST LIMITS.] (a) The 
310.22  monthly limit for the cost of waivered services to an individual 
310.23  elderly waiver client shall be the weighted average monthly 
310.24  nursing facility rate of the case mix resident class to which 
310.25  the elderly waiver client would be assigned under Minnesota 
310.26  Rules, parts 9549.0050 to 9549.0059, less the recipient's 
310.27  maintenance needs allowance as described in subdivision 1d, 
310.28  paragraph (a), until the first day of the state fiscal year in 
310.29  which the resident assessment system as described in section 
310.30  256B.437 for nursing home rate determination is implemented.  
310.31  Effective on the first day of the state fiscal year in which the 
310.32  resident assessment system as described in section 256B.437 for 
310.33  nursing home rate determination is implemented and the first day 
310.34  of each subsequent state fiscal year, the monthly limit for the 
310.35  cost of waivered services to an individual elderly waiver client 
310.36  shall be the rate of the case mix resident class to which the 
311.1   waiver client would be assigned under Minnesota Rules, parts 
311.2   9549.0050 to 9549.0059, in effect on the last day of the 
311.3   previous state fiscal year, adjusted by the greater of any 
311.4   legislatively adopted home and community-based services 
311.5   cost-of-living percentage increase or any legislatively adopted 
311.6   statewide percent rate increase for nursing facilities. 
311.7      (c) (b) If extended medical supplies and equipment or 
311.8   environmental modifications are or will be purchased for an 
311.9   elderly waiver client, the costs may be prorated for up to 12 
311.10  consecutive months beginning with the month of purchase.  If the 
311.11  monthly cost of a recipient's waivered services exceeds the 
311.12  monthly limit established in paragraph (b) (a), the annual cost 
311.13  of all waivered services shall be determined.  In this event, 
311.14  the annual cost of all waivered services shall not exceed 12 
311.15  times the monthly limit of waivered services as described in 
311.16  paragraph (b) (a).  
311.17     (d) Subd. 3b.  [COST LIMITS FOR ELDERLY WAIVER APPLICANTS 
311.18  WHO RESIDE IN A NURSING FACILITY.] (a) For a person who is a 
311.19  nursing facility resident at the time of requesting a 
311.20  determination of eligibility for elderly waivered services, a 
311.21  monthly conversion limit for the cost of elderly waivered 
311.22  services may be requested.  The monthly conversion limit for the 
311.23  cost of elderly waiver services shall be the resident class 
311.24  assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 
311.25  for that resident in the nursing facility where the resident 
311.26  currently resides until July 1 of the state fiscal year in which 
311.27  the resident assessment system as described in section 256B.437 
311.28  for nursing home rate determination is implemented.  Effective 
311.29  on July 1 of the state fiscal year in which the resident 
311.30  assessment system as described in section 256B.437 for nursing 
311.31  home rate determination is implemented, the monthly conversion 
311.32  limit for the cost of elderly waiver services shall be the per 
311.33  diem nursing facility rate as determined by the resident 
311.34  assessment system as described in section 256B.437 for that 
311.35  resident in the nursing facility where the resident currently 
311.36  resides multiplied by 365 and divided by 12, less the 
312.1   recipient's maintenance needs allowance as described in 
312.2   subdivision 1d.  The initially approved conversion rate may be 
312.3   adjusted by the greater of any subsequent legislatively adopted 
312.4   home and community-based services cost-of-living percentage 
312.5   increase or any subsequent legislatively adopted statewide 
312.6   percentage rate increase for nursing facilities.  The limit 
312.7   under this clause subdivision only applies to persons discharged 
312.8   from a nursing facility after a minimum 30-day stay and found 
312.9   eligible for waivered services on or after July 1, 1997.  
312.10     (b) The following costs must be included in determining the 
312.11  total monthly costs for the waiver client: 
312.12     (1) cost of all waivered services, including extended 
312.13  medical supplies and equipment and environmental modifications; 
312.14  and 
312.15     (2) cost of skilled nursing, home health aide, and personal 
312.16  care services reimbursable by medical assistance.  
312.17     (e) Subd. 3c.  [SERVICE APPROVAL AND CONTRACTING 
312.18  PROVISIONS.] (a) Medical assistance funding for skilled nursing 
312.19  services, private duty nursing, home health aide, and personal 
312.20  care services for waiver recipients must be approved by the case 
312.21  manager and included in the individual care plan. 
312.22     (f) (b) A county is not required to contract with a 
312.23  provider of supplies and equipment if the monthly cost of the 
312.24  supplies and equipment is less than $250.  
312.25     (g) Subd. 3d.  [ADULT FOSTER CARE RATE.] The adult foster 
312.26  care rate shall be considered a difficulty of care payment and 
312.27  shall not include room and board.  The adult foster care service 
312.28  rate shall be negotiated between the county agency and the 
312.29  foster care provider.  The elderly waiver payment for the foster 
312.30  care service in combination with the payment for all other 
312.31  elderly waiver services, including case management, must not 
312.32  exceed the limit specified in subdivision 3a, paragraph (b) (a). 
312.33     (h) Subd. 3e.  [ASSISTED LIVING SERVICE RATE.] (a) Payment 
312.34  for assisted living service shall be a monthly rate negotiated 
312.35  and authorized by the county agency based on an individualized 
312.36  service plan for each resident and may not cover direct rent or 
313.1   food costs. 
313.2      (1) (b) The individualized monthly negotiated payment for 
313.3   assisted living services as described in section 256B.0913, 
313.4   subdivision 5, paragraph (g) or (h) subdivisions 5d to 5f, and 
313.5   residential care services as described in section 256B.0913, 
313.6   subdivision 5, paragraph (f) 5c, shall not exceed the nonfederal 
313.7   share, in effect on July 1 of the state fiscal year for which 
313.8   the rate limit is being calculated, of the greater of either the 
313.9   statewide or any of the geographic groups' weighted average 
313.10  monthly nursing facility rate of the case mix resident class to 
313.11  which the elderly waiver eligible client would be assigned under 
313.12  Minnesota Rules, parts 9549.0050 to 9549.0059, less the 
313.13  maintenance needs allowance as described in subdivision 1d, 
313.14  paragraph (a), until the July 1 of the state fiscal year in 
313.15  which the resident assessment system as described in section 
313.16  256B.437 for nursing home rate determination is implemented.  
313.17  Effective on July 1 of the state fiscal year in which the 
313.18  resident assessment system as described in section 256B.437 for 
313.19  nursing home rate determination is implemented and July 1 of 
313.20  each subsequent state fiscal year, the individualized monthly 
313.21  negotiated payment for the services described in this clause 
313.22  shall not exceed the limit described in this clause which was in 
313.23  effect on June 30 of the previous state fiscal year and which 
313.24  has been adjusted by the greater of any legislatively adopted 
313.25  home and community-based services cost-of-living percentage 
313.26  increase or any legislatively adopted statewide percent rate 
313.27  increase for nursing facilities. 
313.28     (2) (c) The individualized monthly negotiated payment for 
313.29  assisted living services described in section 144A.4605 and 
313.30  delivered by a provider licensed by the department of health as 
313.31  a class A home care provider or an assisted living home care 
313.32  provider and provided in a building that is registered as a 
313.33  housing with services establishment under chapter 144D and that 
313.34  provides 24-hour supervision in combination with the payment for 
313.35  other elderly waiver services, including case management, must 
313.36  not exceed the limit specified in paragraph (b) subdivision 3a. 
314.1      (i) Subd. 3f.  [INDIVIDUAL SERVICE RATES; EXPENDITURE 
314.2   FORECASTS.] (a) The county shall negotiate individual service 
314.3   rates with vendors and may authorize payment for actual costs up 
314.4   to the county's current approved rate.  Persons or agencies must 
314.5   be employed by or under a contract with the county agency or the 
314.6   public health nursing agency of the local board of health in 
314.7   order to receive funding under the elderly waiver program, 
314.8   except as a provider of supplies and equipment when the monthly 
314.9   cost of the supplies and equipment is less than $250.  
314.10     (j) (b) Reimbursement for the medical assistance recipients 
314.11  under the approved waiver shall be made from the medical 
314.12  assistance account through the invoice processing procedures of 
314.13  the department's Medicaid Management Information System (MMIS), 
314.14  only with the approval of the client's case manager.  The budget 
314.15  for the state share of the Medicaid expenditures shall be 
314.16  forecasted with the medical assistance budget, and shall be 
314.17  consistent with the approved waiver.  
314.18     (k) Subd. 3g.  [SERVICE RATE LIMITS; STATE ASSUMPTION OF 
314.19  COSTS.] (a) To improve access to community services and 
314.20  eliminate payment disparities between the alternative care 
314.21  program and the elderly waiver, the commissioner shall establish 
314.22  statewide maximum service rate limits and eliminate 
314.23  county-specific service rate limits. 
314.24     (1) (b) Effective July 1, 2001, for service rate limits, 
314.25  except those described or defined in paragraphs (g) and 
314.26  (h) subdivisions 3d and 3e, the rate limit for each service 
314.27  shall be the greater of the alternative care statewide maximum 
314.28  rate or the elderly waiver statewide maximum rate. 
314.29     (2) (c) Counties may negotiate individual service rates 
314.30  with vendors for actual costs up to the statewide maximum 
314.31  service rate limit. 
314.32     Sec. 31.  Minnesota Statutes 2002, section 256B.15, 
314.33  subdivision 1, is amended to read: 
314.34     Subdivision 1.  [DEFINITION.] For purposes of this section, 
314.35  "medical assistance" includes the medical assistance program 
314.36  under this chapter and the general assistance medical care 
315.1   program under chapter 256D, but does not include the alternative 
315.2   care program for nonmedical assistance recipients under section 
315.3   256B.0913, subdivision 4 and alternative care for nonmedical 
315.4   assistance recipients under section 256B.0913. 
315.5      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
315.6   for decedents dying on or after that date. 
315.7      Sec. 32.  Minnesota Statutes 2002, section 256B.15, 
315.8   subdivision 1a, is amended to read: 
315.9      Subd. 1a.  [ESTATES SUBJECT TO CLAIMS.] If a person 
315.10  receives any medical assistance hereunder, on the person's 
315.11  death, if single, or on the death of the survivor of a married 
315.12  couple, either or both of whom received medical assistance, the 
315.13  total amount paid for medical assistance rendered for the person 
315.14  and spouse shall be filed as a claim against the estate of the 
315.15  person or the estate of the surviving spouse in the court having 
315.16  jurisdiction to probate the estate or to issue a decree of 
315.17  descent according to sections 525.31 to 525.313.  
315.18     A claim shall be filed if medical assistance was rendered 
315.19  for either or both persons under one of the following 
315.20  circumstances: 
315.21     (a) the person was over 55 years of age, and received 
315.22  services under this chapter, excluding alternative care; 
315.23     (b) the person resided in a medical institution for six 
315.24  months or longer, received services under this chapter excluding 
315.25  alternative care, and, at the time of institutionalization or 
315.26  application for medical assistance, whichever is later, the 
315.27  person could not have reasonably been expected to be discharged 
315.28  and returned home, as certified in writing by the person's 
315.29  treating physician.  For purposes of this section only, a 
315.30  "medical institution" means a skilled nursing facility, 
315.31  intermediate care facility, intermediate care facility for 
315.32  persons with mental retardation, nursing facility, or inpatient 
315.33  hospital; or 
315.34     (c) the person received general assistance medical care 
315.35  services under chapter 256D.  
315.36     The claim shall be considered an expense of the last 
316.1   illness of the decedent for the purpose of section 524.3-805.  
316.2   Any statute of limitations that purports to limit any county 
316.3   agency or the state agency, or both, to recover for medical 
316.4   assistance granted hereunder shall not apply to any claim made 
316.5   hereunder for reimbursement for any medical assistance granted 
316.6   hereunder.  Notice of the claim shall be given to all heirs and 
316.7   devisees of the decedent whose identity can be ascertained with 
316.8   reasonable diligence.  The notice must include procedures and 
316.9   instructions for making an application for a hardship waiver 
316.10  under subdivision 5; time frames for submitting an application 
316.11  and determination; and information regarding appeal rights and 
316.12  procedures.  Counties are entitled to one-half of the nonfederal 
316.13  share of medical assistance collections from estates that are 
316.14  directly attributable to county effort.  Counties are entitled 
316.15  to ten percent of the collections for alternative care directly 
316.16  attributable to county effort. 
316.17     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
316.18  for decedents dying on or after that date. 
316.19     Sec. 33.  Minnesota Statutes 2002, section 256B.15, 
316.20  subdivision 2, is amended to read: 
316.21     Subd. 2.  [LIMITATIONS ON CLAIMS.] The claim shall include 
316.22  only the total amount of medical assistance rendered after age 
316.23  55 or during a period of institutionalization described in 
316.24  subdivision 1a, clause (b), and the total amount of general 
316.25  assistance medical care rendered, and shall not include 
316.26  interest.  Claims that have been allowed but not paid shall bear 
316.27  interest according to section 524.3-806, paragraph (d).  A claim 
316.28  against the estate of a surviving spouse who did not receive 
316.29  medical assistance, for medical assistance rendered for the 
316.30  predeceased spouse, is limited to the value of the assets of the 
316.31  estate that were marital property or jointly owned property at 
316.32  any time during the marriage.  Claims for alternative care shall 
316.33  be net of all premiums paid under section 256B.0913, subdivision 
316.34  12, on or after July 1, 2003, and shall be limited to services 
316.35  provided on or after July 1, 2003. 
316.36     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
317.1   for decedents dying on or after that date. 
317.2      Sec. 34.  Minnesota Statutes 2002, section 256B.431, 
317.3   subdivision 2r, is amended to read: 
317.4      Subd. 2r.  [PAYMENT RESTRICTIONS ON LEAVE DAYS.] Effective 
317.5   July 1, 1993, the commissioner shall limit payment for leave 
317.6   days in a nursing facility to 79 percent of that nursing 
317.7   facility's total payment rate for the involved resident.  For 
317.8   services rendered on or after July 1, 2003, for facilities 
317.9   reimbursed under this section or section 256B.434, the 
317.10  commissioner shall limit payment for leave days in a nursing 
317.11  facility to 60 percent of that nursing facility's total payment 
317.12  rate for the involved resident. 
317.13     Sec. 35.  Minnesota Statutes 2002, section 256B.431, is 
317.14  amended by adding a subdivision to read: 
317.15     Subd. 2t.  [PAYMENT LIMITATION.] For services rendered on 
317.16  or after July 1, 2003, for facilities reimbursed under this 
317.17  section or section 256B.434, the amount that shall be paid by 
317.18  the Medicaid program shall only include a co-payment during a 
317.19  Medicare-covered skilled nursing facility stay if the Medicare 
317.20  rate less the resident's co-payment responsibility is less than 
317.21  the Medicaid RUG-III case-mix payment rate.  The amount that 
317.22  shall be paid by the Medicaid program is equal to the amount by 
317.23  which the Medicaid RUG-III case-mix payment rate exceeds the 
317.24  Medicare rate less the co-payment responsibility.  Managed care 
317.25  plans paying for nursing home services under section 256B.69, 
317.26  subdivision 6a, may limit payment under this subdivision. 
317.27     Sec. 36.  Minnesota Statutes 2002, section 256B.431, 
317.28  subdivision 32, is amended to read: 
317.29     Subd. 32.  [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 
317.30  years beginning on or after July 1, 2001, the total payment rate 
317.31  for a facility reimbursed under this section, section 256B.434, 
317.32  or any other section for the first 90 paid days after admission 
317.33  shall be: 
317.34     (1) for the first 30 paid days, the rate shall be 120 
317.35  percent of the facility's medical assistance rate for each case 
317.36  mix class; and 
318.1      (2) for the next 60 paid days after the first 30 paid days, 
318.2   the rate shall be 110 percent of the facility's medical 
318.3   assistance rate for each case mix class.; 
318.4      (b) (3) beginning with the 91st paid day after admission, 
318.5   the payment rate shall be the rate otherwise determined under 
318.6   this section, section 256B.434, or any other section.; and 
318.7      (c) (4) payments under this subdivision applies paragraph 
318.8   apply to admissions occurring on or after July 1, 2001, and 
318.9   before July 1, 2003, and resident days before July 30, 2003.  
318.10     (b) For rate years beginning on or after July 1, 2003, the 
318.11  total payment rate for a facility reimbursed under this section, 
318.12  section 256B.434, or any other section shall be: 
318.13     (1) for the first 30 calendar days after admission, the 
318.14  rate shall be 120 percent of the facility's medical assistance 
318.15  rate for each RUG class; 
318.16     (2) beginning with the 31st calendar day after admission, 
318.17  the payment rate shall be the rate otherwise determined under 
318.18  this section, section 256B.434, or any other section; and 
318.19     (3) payments under this paragraph apply to admissions 
318.20  occurring on or after July 1, 2003. 
318.21     (c) Effective January 1, 2004, the enhanced rates under 
318.22  this subdivision shall not be allowed if a resident has resided 
318.23  in any nursing facility during the previous 30 calendar days. 
318.24     Sec. 37.  Minnesota Statutes 2002, section 256B.431, 
318.25  subdivision 36, is amended to read: 
318.26     Subd. 36.  [EMPLOYEE SCHOLARSHIP COSTS AND TRAINING IN 
318.27  ENGLISH AS A SECOND LANGUAGE.] (a) For the period between July 
318.28  1, 2001, and June 30, 2003, the commissioner shall provide to 
318.29  each nursing facility reimbursed under this section, section 
318.30  256B.434, or any other section, a scholarship per diem of 25 
318.31  cents to the total operating payment rate to be used: 
318.32     (1) for employee scholarships that satisfy the following 
318.33  requirements: 
318.34     (i) scholarships are available to all employees who work an 
318.35  average of at least 20 hours per week at the facility except the 
318.36  administrator, department supervisors, and registered nurses; 
319.1   and 
319.2      (ii) the course of study is expected to lead to career 
319.3   advancement with the facility or in long-term care, including 
319.4   medical care interpreter services and social work; and 
319.5      (2) to provide job-related training in English as a second 
319.6   language. 
319.7      (b) A facility receiving a rate adjustment under this 
319.8   subdivision may submit to the commissioner on a schedule 
319.9   determined by the commissioner and on a form supplied by the 
319.10  commissioner a calculation of the scholarship per diem, 
319.11  including:  the amount received from this rate adjustment; the 
319.12  amount used for training in English as a second language; the 
319.13  number of persons receiving the training; the name of the person 
319.14  or entity providing the training; and for each scholarship 
319.15  recipient, the name of the recipient, the amount awarded, the 
319.16  educational institution attended, the nature of the educational 
319.17  program, the program completion date, and a determination of the 
319.18  per diem amount of these costs based on actual resident days. 
319.19     (c) On July 1, 2003, the commissioner shall remove the 25 
319.20  cent scholarship per diem from the total operating payment rate 
319.21  of each facility. 
319.22     (d) For rate years beginning after June 30, 2003, the 
319.23  commissioner shall provide to each facility the scholarship per 
319.24  diem determined in paragraph (b). 
319.25     Sec. 38.  Minnesota Statutes 2002, section 256B.431, is 
319.26  amended by adding a subdivision to read: 
319.27     Subd. 38.  [NURSING HOME RATE INCREASES EFFECTIVE IN FISCAL 
319.28  YEAR 2003.] Effective June 1, 2003, the commissioner shall 
319.29  provide to each nursing home reimbursed under this section or 
319.30  section 256B.434, an increase in each case mix payment rate 
319.31  equal to the increase in the per-bed surcharge paid under 
319.32  section 256.9657, subdivision 1, paragraph (d), divided by 365 
319.33  and further divided by .90.  The increase shall not be subject 
319.34  to any annual percentage increase.  The 30-day advance notice 
319.35  requirement in section 256B.47, subdivision 2, shall not apply 
319.36  to rate increases resulting from this section.  The commissioner 
320.1   shall not adjust the rate increase under this subdivision unless 
320.2   an adjustment under section 256.9657, subdivision 1, paragraph 
320.3   (e), is greater than 1.5 percent of the surcharge amount. 
320.4      <b>[EFFECTIVE DATE.]</b> This section is effective May 31, 2003. 
320.5      Sec. 39.  Minnesota Statutes 2002, section 256B.431, is 
320.6   amended by adding a subdivision to read: 
320.7      Subd. 39.  [FACILITY RATES BEGINNING ON OR AFTER JULY 1, 
320.8   2003.] For rate years beginning on or after July 1, 2003, 
320.9   nursing facilities reimbursed under this section shall have 
320.10  their July 1 operating payment rate be equal to their operating 
320.11  payment rate in effect on the prior June 30th. 
320.12     Sec. 40.  Minnesota Statutes 2002, section 256B.431, is 
320.13  amended by adding a subdivision to read: 
320.14     Subd. 40.  [DESIGNATION OF AREAS TO RECEIVE METROPOLITAN 
320.15  RATES.] (a) For rate years beginning on or after July 1, 2003, 
320.16  and subject to paragraph (b), nursing facilities located in 
320.17  areas designated as metropolitan areas by the federal Office of 
320.18  Management and Budget using census bureau data shall be 
320.19  considered metro, in order to: 
320.20     (1) determine rate increases under this section, section 
320.21  256B.434, or any other section; and 
320.22     (2) establish nursing facility reimbursement rates for the 
320.23  new nursing facility reimbursement system developed under Laws 
320.24  2002, chapter 220, article 14, section 19. 
320.25     (b) Paragraph (a) applies only if designation as a metro 
320.26  facility results in a level of reimbursement that is higher than 
320.27  the level the facility would have received without application 
320.28  of that paragraph. 
320.29     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
320.30     Sec. 41.  Minnesota Statutes 2002, section 256B.434, 
320.31  subdivision 4, is amended to read: 
320.32     Subd. 4.  [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 
320.33  nursing facilities which have their payment rates determined 
320.34  under this section rather than section 256B.431, the 
320.35  commissioner shall establish a rate under this subdivision.  The 
320.36  nursing facility must enter into a written contract with the 
321.1   commissioner. 
321.2      (b) A nursing facility's case mix payment rate for the 
321.3   first rate year of a facility's contract under this section is 
321.4   the payment rate the facility would have received under section 
321.5   256B.431. 
321.6      (c) A nursing facility's case mix payment rates for the 
321.7   second and subsequent years of a facility's contract under this 
321.8   section are the previous rate year's contract payment rates plus 
321.9   an inflation adjustment and, for facilities reimbursed under 
321.10  this section or section 256B.431, an adjustment to include the 
321.11  cost of any increase in health department licensing fees for the 
321.12  facility taking effect on or after July 1, 2001.  The index for 
321.13  the inflation adjustment must be based on the change in the 
321.14  Consumer Price Index-All Items (United States City average) 
321.15  (CPI-U) forecasted by Data Resources, Inc. the commissioner of 
321.16  finance's national economic consultant, as forecasted in the 
321.17  fourth quarter of the calendar year preceding the rate year.  
321.18  The inflation adjustment must be based on the 12-month period 
321.19  from the midpoint of the previous rate year to the midpoint of 
321.20  the rate year for which the rate is being determined.  For the 
321.21  rate years beginning on July 1, 1999, July 1, 2000, July 1, 
321.22  2001, and July 1, 2002, July 1, 2003, and July 1, 2004, this 
321.23  paragraph shall apply only to the property-related payment rate, 
321.24  except that adjustments to include the cost of any increase in 
321.25  health department licensing fees taking effect on or after July 
321.26  1, 2001, shall be provided.  In determining the amount of the 
321.27  property-related payment rate adjustment under this paragraph, 
321.28  the commissioner shall determine the proportion of the 
321.29  facility's rates that are property-related based on the 
321.30  facility's most recent cost report. 
321.31     (d) The commissioner shall develop additional 
321.32  incentive-based payments of up to five percent above the 
321.33  standard contract rate for achieving outcomes specified in each 
321.34  contract.  The specified facility-specific outcomes must be 
321.35  measurable and approved by the commissioner.  The commissioner 
321.36  may establish, for each contract, various levels of achievement 
322.1   within an outcome.  After the outcomes have been specified the 
322.2   commissioner shall assign various levels of payment associated 
322.3   with achieving the outcome.  Any incentive-based payment cancels 
322.4   if there is a termination of the contract.  In establishing the 
322.5   specified outcomes and related criteria the commissioner shall 
322.6   consider the following state policy objectives: 
322.7      (1) improved cost effectiveness and quality of life as 
322.8   measured by improved clinical outcomes; 
322.9      (2) successful diversion or discharge to community 
322.10  alternatives; 
322.11     (3) decreased acute care costs; 
322.12     (4) improved consumer satisfaction; 
322.13     (5) the achievement of quality; or 
322.14     (6) any additional outcomes proposed by a nursing facility 
322.15  that the commissioner finds desirable. 
322.16     Sec. 42.  Minnesota Statutes 2002, section 256B.434, 
322.17  subdivision 10, is amended to read: 
322.18     Subd. 10.  [EXEMPTIONS.] (a) To the extent permitted by 
322.19  federal law, (1) a facility that has entered into a contract 
322.20  under this section is not required to file a cost report, as 
322.21  defined in Minnesota Rules, part 9549.0020, subpart 13, for any 
322.22  year after the base year that is the basis for the calculation 
322.23  of the contract payment rate for the first rate year of the 
322.24  alternative payment demonstration project contract; and (2) a 
322.25  facility under contract is not subject to audits of historical 
322.26  costs or revenues, or paybacks or retroactive adjustments based 
322.27  on these costs or revenues, except audits, paybacks, or 
322.28  adjustments relating to the cost report that is the basis for 
322.29  calculation of the first rate year under the contract. 
322.30     (b) A facility that is under contract with the commissioner 
322.31  under this section is not subject to the moratorium on licensure 
322.32  or certification of new nursing home beds in section 144A.071, 
322.33  unless the project results in a net increase in bed capacity or 
322.34  involves relocation of beds from one site to another.  Contract 
322.35  payment rates must not be adjusted to reflect any additional 
322.36  costs that a nursing facility incurs as a result of a 
323.1   construction project undertaken under this paragraph.  In 
323.2   addition, as a condition of entering into a contract under this 
323.3   section, a nursing facility must agree that any future medical 
323.4   assistance payments for nursing facility services will not 
323.5   reflect any additional costs attributable to the sale of a 
323.6   nursing facility under this section and to construction 
323.7   undertaken under this paragraph that otherwise would not be 
323.8   authorized under the moratorium in section 144A.073.  Nothing in 
323.9   this section prevents a nursing facility participating in the 
323.10  alternative payment demonstration project under this section 
323.11  from seeking approval of an exception to the moratorium through 
323.12  the process established in section 144A.073, and if approved the 
323.13  facility's rates shall be adjusted to reflect the cost of the 
323.14  project.  Nothing in this section prevents a nursing facility 
323.15  participating in the alternative payment demonstration project 
323.16  from seeking legislative approval of an exception to the 
323.17  moratorium under section 144A.071, and, if enacted, the 
323.18  facility's rates shall be adjusted to reflect the cost of the 
323.19  project. 
323.20     (c) Notwithstanding section 256B.48, subdivision 6, 
323.21  paragraphs (c), (d), and (e), and pursuant to any terms and 
323.22  conditions contained in the facility's contract, a nursing 
323.23  facility that is under contract with the commissioner under this 
323.24  section is in compliance with section 256B.48, subdivision 6, 
323.25  paragraph (b), if the facility is Medicare certified. 
323.26     (d) Notwithstanding paragraph (a), if by April 1, 1996, the 
323.27  health care financing administration has not approved a required 
323.28  waiver, or the Centers for Medicare and Medicaid Services 
323.29  otherwise requires cost reports to be filed prior to the 
323.30  waiver's approval, the commissioner shall require a cost report 
323.31  for the rate year. 
323.32     (e) A facility that is under contract with the commissioner 
323.33  under this section shall be allowed to change therapy 
323.34  arrangements from an unrelated vendor to a related vendor during 
323.35  the term of the contract.  The commissioner may develop 
323.36  reasonable requirements designed to prevent an increase in 
324.1   therapy utilization for residents enrolled in the medical 
324.2   assistance program. 
324.3      (f) Nursing facilities participating in the alternative 
324.4   payment system demonstration project must either participate in 
324.5   the alternative payment system quality improvement program 
324.6   established by the commissioner or submit information on their 
324.7   own quality improvement process to the commissioner for 
324.8   approval.  Nursing facilities that have had their own quality 
324.9   improvement process approved by the commissioner must report 
324.10  results for at least one key area of quality improvement 
324.11  annually to the commissioner.  
324.12     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
324.13     Sec. 43.  Minnesota Statutes 2002, section 256B.48, 
324.14  subdivision 1, is amended to read: 
324.15     Subdivision 1.  [PROHIBITED PRACTICES.] A nursing facility 
324.16  is not eligible to receive medical assistance payments unless it 
324.17  refrains from all of the following: 
324.18     (a) Charging private paying residents rates for similar 
324.19  services which exceed those which are approved by the state 
324.20  agency for medical assistance recipients as determined by the 
324.21  prospective desk audit rate, except under the following 
324.22  circumstances:  (1) the nursing facility may (1) (i) charge 
324.23  private paying residents a higher rate for a private room, and 
324.24  (2) (ii) charge for special services which are not included in 
324.25  the daily rate if medical assistance residents are charged 
324.26  separately at the same rate for the same services in addition to 
324.27  the daily rate paid by the commissioner.; (2) effective July 1, 
324.28  2003, nursing facilities may charge private paying residents 
324.29  rates up to two percent higher than the allowable payment rate 
324.30  in effect on June 30, 2003, plus an adjustment equal to any 
324.31  other rate increase provided in law, for the RUGs group 
324.32  currently assigned to the resident; (3) effective July 1, 2004, 
324.33  nursing facilities may charge private paying residents rates up 
324.34  to four percent higher than the allowable payment rate in effect 
324.35  on June 30, 2003, plus an adjustment equal to any other rate 
324.36  increase provided in law, for the RUGs group currently assigned 
325.1   to the resident; (4) effective July 1, 2005, nursing facilities 
325.2   may charge private paying residents rates up to six percent 
325.3   higher than the allowable payment rate in effect on June 30, 
325.4   2003, plus an adjustment equal to any other rate increase 
325.5   provided in law, for the RUGs group currently assigned to the 
325.6   resident; and (5) effective July 1, 2006, nursing facilities may 
325.7   charge private paying residents rates up to eight percent higher 
325.8   than the allowable payment rate in effect on June 30, 2003, plus 
325.9   an adjustment equal to any other rate increase provided in law, 
325.10  for the RUGs group currently assigned to the resident.  For 
325.11  purposes of this subdivision, the allowable payment rate is the 
325.12  total payment rate under section 256B.431 or 256B.434 including 
325.13  adjustments for enhanced rates during the first 30 days under 
325.14  section 256B.431, subdivision 32, and private room differentials 
325.15  under clause (1), item (i), and Minnesota Rules, part 9549.0060, 
325.16  subpart 11, item C.  Nothing in this section precludes a nursing 
325.17  facility from charging a rate allowable under the facility's 
325.18  single room election option under Minnesota Rules, part 
325.19  9549.0060, subpart 11.  Services covered by the payment rate 
325.20  must be the same regardless of payment source.  Special 
325.21  services, if offered, must be available to all residents in all 
325.22  areas of the nursing facility and charged separately at the same 
325.23  rate.  Residents are free to select or decline special services. 
325.24  Special services must not include services which must be 
325.25  provided by the nursing facility in order to comply with 
325.26  licensure or certification standards and that if not provided 
325.27  would result in a deficiency or violation by the nursing 
325.28  facility.  Services beyond those required to comply with 
325.29  licensure or certification standards must not be charged 
325.30  separately as a special service if they were included in the 
325.31  payment rate for the previous reporting year.  A nursing 
325.32  facility that charges a private paying resident a rate in 
325.33  violation of this clause is subject to an action by the state of 
325.34  Minnesota or any of its subdivisions or agencies for civil 
325.35  damages.  A private paying resident or the resident's legal 
325.36  representative has a cause of action for civil damages against a 
326.1   nursing facility that charges the resident rates in violation of 
326.2   this clause.  The damages awarded shall include three times the 
326.3   payments that result from the violation, together with costs and 
326.4   disbursements, including reasonable attorneys' fees or their 
326.5   equivalent.  A private paying resident or the resident's legal 
326.6   representative, the state, subdivision or agency, or a nursing 
326.7   facility may request a hearing to determine the allowed rate or 
326.8   rates at issue in the cause of action.  Within 15 calendar days 
326.9   after receiving a request for such a hearing, the commissioner 
326.10  shall request assignment of an administrative law judge under 
326.11  sections 14.48 to 14.56 to conduct the hearing as soon as 
326.12  possible or according to agreement by the parties.  The 
326.13  administrative law judge shall issue a report within 15 calendar 
326.14  days following the close of the hearing.  The prohibition set 
326.15  forth in this clause shall not apply to facilities licensed as 
326.16  boarding care facilities which are not certified as skilled or 
326.17  intermediate care facilities level I or II for reimbursement 
326.18  through medical assistance. 
326.19     (b) Effective July 1, 2007, paragraph (a) no longer 
326.20  applies, except that special services, if offered, must be 
326.21  available to all residents of the nursing facility and charged 
326.22  separately at the same rate.  Residents are free to select or 
326.23  decline special services.  Special services must not include 
326.24  services which must be provided by the nursing facility in order 
326.25  to comply with licensure or certification standards and that if 
326.26  not provided would result in a deficiency or violation by the 
326.27  nursing facility. 
326.28     (b) (c)(1) Charging, soliciting, accepting, or receiving 
326.29  from an applicant for admission to the facility, or from anyone 
326.30  acting in behalf of the applicant, as a condition of admission, 
326.31  expediting the admission, or as a requirement for the 
326.32  individual's continued stay, any fee, deposit, gift, money, 
326.33  donation, or other consideration not otherwise required as 
326.34  payment under the state plan.  For residents on medical 
326.35  assistance, medical assistance payment according to the state 
326.36  plan must be accepted as payment in full for continued stay, 
327.1   except where otherwise provided for under statute; 
327.2      (2) requiring an individual, or anyone acting in behalf of 
327.3   the individual, to loan any money to the nursing facility; 
327.4      (3) requiring an individual, or anyone acting in behalf of 
327.5   the individual, to promise to leave all or part of the 
327.6   individual's estate to the facility; or 
327.7      (4) requiring a third-party guarantee of payment to the 
327.8   facility as a condition of admission, expedited admission, or 
327.9   continued stay in the facility.  
327.10  Nothing in this paragraph would prohibit discharge for 
327.11  nonpayment of services in accordance with state and federal 
327.12  regulations. 
327.13     (c) (d) Requiring any resident of the nursing facility to 
327.14  utilize a vendor of health care services chosen by the nursing 
327.15  facility.  A nursing facility may require a resident to use 
327.16  pharmacies that utilize unit dose packing systems approved by 
327.17  the Minnesota board of pharmacy, and may require a resident to 
327.18  use pharmacies that are able to meet the federal regulations for 
327.19  safe and timely administration of medications such as systems 
327.20  with specific number of doses, prompt delivery of medications, 
327.21  or access to medications on a 24-hour basis.  Notwithstanding 
327.22  the provisions of this paragraph, nursing facilities shall not 
327.23  restrict a resident's choice of pharmacy because the pharmacy 
327.24  utilizes a specific system of unit dose drug packing. 
327.25     (d) (e) Providing differential treatment on the basis of 
327.26  status with regard to public assistance.  
327.27     (e) (f) Discriminating in admissions, services offered, or 
327.28  room assignment on the basis of status with regard to public 
327.29  assistance or refusal to purchase special 
327.30  services.  Discrimination in admissions discrimination, services 
327.31  offered, or room assignment shall include, but is not limited to:
327.32     (1) basing admissions decisions upon assurance by the 
327.33  applicant to the nursing facility, or the applicant's guardian 
327.34  or conservator, that the applicant is neither eligible for nor 
327.35  will seek information or assurances regarding current or future 
327.36  eligibility for public assistance for payment of nursing 
328.1   facility care costs; and. 
328.2      (2) engaging in preferential selection from waiting lists 
328.3   based on an applicant's ability to pay privately or an 
328.4   applicant's refusal to pay for a special service. 
328.5      The collection and use by a nursing facility of financial 
328.6   information of any applicant pursuant to a preadmission 
328.7   screening program established by law shall not raise an 
328.8   inference that the nursing facility is utilizing that 
328.9   information for any purpose prohibited by this paragraph.  
328.10     (f) (g) Requiring any vendor of medical care as defined by 
328.11  section 256B.02, subdivision 7, who is reimbursed by medical 
328.12  assistance under a separate fee schedule, to pay any amount 
328.13  based on utilization or service levels or any portion of the 
328.14  vendor's fee to the nursing facility except as payment for 
328.15  renting or leasing space or equipment or purchasing support 
328.16  services from the nursing facility as limited by section 
328.17  256B.433.  All agreements must be disclosed to the commissioner 
328.18  upon request of the commissioner.  Nursing facilities and 
328.19  vendors of ancillary services that are found to be in violation 
328.20  of this provision shall each be subject to an action by the 
328.21  state of Minnesota or any of its subdivisions or agencies for 
328.22  treble civil damages on the portion of the fee in excess of that 
328.23  allowed by this provision and section 256B.433.  Damages awarded 
328.24  must include three times the excess payments together with costs 
328.25  and disbursements including reasonable attorney's fees or their 
328.26  equivalent.  
328.27     (g) (h)  Refusing, for more than 24 hours, to accept a 
328.28  resident returning to the same bed or a bed certified for the 
328.29  same level of care, in accordance with a physician's order 
328.30  authorizing transfer, after receiving inpatient hospital 
328.31  services. 
328.32     (i) For a period not to exceed 180 days, the commissioner 
328.33  may continue to make medical assistance payments to a nursing 
328.34  facility or boarding care home which is in violation of this 
328.35  section if extreme hardship to the residents would result.  In 
328.36  these cases the commissioner shall issue an order requiring the 
329.1   nursing facility to correct the violation.  The nursing facility 
329.2   shall have 20 days from its receipt of the order to correct the 
329.3   violation.  If the violation is not corrected within the 20-day 
329.4   period the commissioner may reduce the payment rate to the 
329.5   nursing facility by up to 20 percent.  The amount of the payment 
329.6   rate reduction shall be related to the severity of the violation 
329.7   and shall remain in effect until the violation is corrected.  
329.8   The nursing facility or boarding care home may appeal the 
329.9   commissioner's action pursuant to the provisions of chapter 14 
329.10  pertaining to contested cases.  An appeal shall be considered 
329.11  timely if written notice of appeal is received by the 
329.12  commissioner within 20 days of notice of the commissioner's 
329.13  proposed action.  
329.14     In the event that the commissioner determines that a 
329.15  nursing facility is not eligible for reimbursement for a 
329.16  resident who is eligible for medical assistance, the 
329.17  commissioner may authorize the nursing facility to receive 
329.18  reimbursement on a temporary basis until the resident can be 
329.19  relocated to a participating nursing facility.  
329.20     Certified beds in facilities which do not allow medical 
329.21  assistance intake on July 1, 1984, or after shall be deemed to 
329.22  be decertified for purposes of section 144A.071 only.  
329.23     Sec. 44.  Minnesota Statutes 2002, section 256B.5012, is 
329.24  amended by adding a subdivision to read: 
329.25     Subd. 5.  [RATE INCREASE EFFECTIVE JUNE 1, 2003.] For rate 
329.26  periods beginning on or after June 1, 2003, the commissioner 
329.27  shall increase the total operating payment rate for each 
329.28  facility reimbursed under this section by $3 per day.  The 
329.29  increase shall not be subject to any annual percentage increase. 
329.30     <b>[EFFECTIVE DATE.]</b> This section is effective June 1, 2003. 
329.31     Sec. 45.  Minnesota Statutes 2002, section 256B.76, is 
329.32  amended to read: 
329.33     256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
329.34     (a) Effective for services rendered on or after October 1, 
329.35  1992, the commissioner shall make payments for physician 
329.36  services as follows: 
330.1      (1) payment for level one Centers for Medicare and Medicaid 
330.2   Services' common procedural coding system codes titled "office 
330.3   and other outpatient services," "preventive medicine new and 
330.4   established patient," "delivery, antepartum, and postpartum 
330.5   care," "critical care," cesarean delivery and pharmacologic 
330.6   management provided to psychiatric patients, and level three 
330.7   codes for enhanced services for prenatal high risk, shall be 
330.8   paid at the lower of (i) submitted charges, or (ii) 25 percent 
330.9   above the rate in effect on June 30, 1992.  If the rate on any 
330.10  procedure code within these categories is different than the 
330.11  rate that would have been paid under the methodology in section 
330.12  256B.74, subdivision 2, then the larger rate shall be paid; 
330.13     (2) payments for all other services shall be paid at the 
330.14  lower of (i) submitted charges, or (ii) 15.4 percent above the 
330.15  rate in effect on June 30, 1992; 
330.16     (3) all physician rates shall be converted from the 50th 
330.17  percentile of 1982 to the 50th percentile of 1989, less the 
330.18  percent in aggregate necessary to equal the above increases 
330.19  except that payment rates for home health agency services shall 
330.20  be the rates in effect on September 30, 1992; 
330.21     (4) effective for services rendered on or after January 1, 
330.22  2000, payment rates for physician and professional services 
330.23  shall be increased by three percent over the rates in effect on 
330.24  December 31, 1999, except for home health agency and family 
330.25  planning agency services; and 
330.26     (5) the increases in clause (4) shall be implemented 
330.27  January 1, 2000, for managed care. 
330.28     (b) Effective for services rendered on or after October 1, 
330.29  1992, the commissioner shall make payments for dental services 
330.30  as follows: 
330.31     (1) dental services shall be paid at the lower of (i) 
330.32  submitted charges, or (ii) 25 percent above the rate in effect 
330.33  on June 30, 1992; 
330.34     (2) dental rates shall be converted from the 50th 
330.35  percentile of 1982 to the 50th percentile of 1989, less the 
330.36  percent in aggregate necessary to equal the above increases; 
331.1      (3) effective for services rendered on or after January 1, 
331.2   2000, payment rates for dental services shall be increased by 
331.3   three percent over the rates in effect on December 31, 1999; 
331.4      (4) the commissioner shall award grants to community 
331.5   clinics or other nonprofit community organizations, political 
331.6   subdivisions, professional associations, or other organizations 
331.7   that demonstrate the ability to provide dental services 
331.8   effectively to public program recipients.  Grants may be used to 
331.9   fund the costs related to coordinating access for recipients, 
331.10  developing and implementing patient care criteria, upgrading or 
331.11  establishing new facilities, acquiring furnishings or equipment, 
331.12  recruiting new providers, or other development costs that will 
331.13  improve access to dental care in a region.  In awarding grants, 
331.14  the commissioner shall give priority to applicants that plan to 
331.15  serve areas of the state in which the number of dental providers 
331.16  is not currently sufficient to meet the needs of recipients of 
331.17  public programs or uninsured individuals.  The commissioner 
331.18  shall consider the following in awarding the grants: 
331.19     (i) potential to successfully increase access to an 
331.20  underserved population; 
331.21     (ii) the ability to raise matching funds; 
331.22     (iii) the long-term viability of the project to improve 
331.23  access beyond the period of initial funding; 
331.24     (iv) the efficiency in the use of the funding; and 
331.25     (v) the experience of the proposers in providing services 
331.26  to the target population. 
331.27     The commissioner shall monitor the grants and may terminate 
331.28  a grant if the grantee does not increase dental access for 
331.29  public program recipients.  The commissioner shall consider 
331.30  grants for the following: 
331.31     (i) implementation of new programs or continued expansion 
331.32  of current access programs that have demonstrated success in 
331.33  providing dental services in underserved areas; 
331.34     (ii) a pilot program for utilizing hygienists outside of a 
331.35  traditional dental office to provide dental hygiene services; 
331.36  and 
332.1      (iii) a program that organizes a network of volunteer 
332.2   dentists, establishes a system to refer eligible individuals to 
332.3   volunteer dentists, and through that network provides donated 
332.4   dental care services to public program recipients or uninsured 
332.5   individuals; 
332.6      (5) beginning October 1, 1999, the payment for tooth 
332.7   sealants and fluoride treatments shall be the lower of (i) 
332.8   submitted charge, or (ii) 80 percent of median 1997 charges; 
332.9      (6) the increases listed in clauses (3) and (5) shall be 
332.10  implemented January 1, 2000, for managed care; and 
332.11     (7) effective for services provided on or after January 1, 
332.12  2002, payment for diagnostic examinations and dental x-rays 
332.13  provided to children under age 21 shall be the lower of (i) the 
332.14  submitted charge, or (ii) 85 percent of median 1999 charges.  
332.15     (c) Effective for dental services rendered on or after 
332.16  January 1, 2002, the commissioner may, within the limits of 
332.17  available appropriation, increase reimbursements to dentists and 
332.18  dental clinics deemed by the commissioner to be critical access 
332.19  dental providers.  Reimbursement to a critical access dental 
332.20  provider may be increased by not more than 50 percent above the 
332.21  reimbursement rate that would otherwise be paid to the 
332.22  provider.  Payments to health plan companies shall be adjusted 
332.23  to reflect increased reimbursements to critical access dental 
332.24  providers as approved by the commissioner.  In determining which 
332.25  dentists and dental clinics shall be deemed critical access 
332.26  dental providers, the commissioner shall review: 
332.27     (1) the utilization rate in the service area in which the 
332.28  dentist or dental clinic operates for dental services to 
332.29  patients covered by medical assistance, general assistance 
332.30  medical care, or MinnesotaCare as their primary source of 
332.31  coverage; 
332.32     (2) the level of services provided by the dentist or dental 
332.33  clinic to patients covered by medical assistance, general 
332.34  assistance medical care, or MinnesotaCare as their primary 
332.35  source of coverage; and 
332.36     (3) whether the level of services provided by the dentist 
333.1   or dental clinic is critical to maintaining adequate levels of 
333.2   patient access within the service area. 
333.3   In the absence of a critical access dental provider in a service 
333.4   area, the commissioner may designate a dentist or dental clinic 
333.5   as a critical access dental provider if the dentist or dental 
333.6   clinic is willing to provide care to patients covered by medical 
333.7   assistance, general assistance medical care, or MinnesotaCare at 
333.8   a level which significantly increases access to dental care in 
333.9   the service area. 
333.10     (d) Effective July 1, 2001, the medical assistance rates 
333.11  for outpatient mental health services provided by an entity that 
333.12  operates: 
333.13     (1) a Medicare-certified comprehensive outpatient 
333.14  rehabilitation facility; and 
333.15     (2) a facility that was certified prior to January 1, 1993, 
333.16  with at least 33 percent of the clients receiving rehabilitation 
333.17  services in the most recent calendar year who are medical 
333.18  assistance recipients, will be increased by 38 percent, when 
333.19  those services are provided within the comprehensive outpatient 
333.20  rehabilitation facility and provided to residents of nursing 
333.21  facilities owned by the entity. 
333.22     (e) An entity that operates both a Medicare certified 
333.23  comprehensive outpatient rehabilitation facility and a facility 
333.24  which was certified prior to January 1, 1993, that is licensed 
333.25  under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
333.26  whom at least 33 percent of the clients receiving rehabilitation 
333.27  services in the most recent calendar year are medical assistance 
333.28  recipients, shall be reimbursed by the commissioner for 
333.29  rehabilitation services at rates that are 38 percent greater 
333.30  than the maximum reimbursement rate allowed under paragraph (a), 
333.31  clause (2), when those services are (1) provided within the 
333.32  comprehensive outpatient rehabilitation facility and (2) 
333.33  provided to residents of nursing facilities owned by the entity. 
333.34     Sec. 46.  Minnesota Statutes 2002, section 256B.761, is 
333.35  amended to read: 
333.36     256B.761 [REIMBURSEMENT FOR MENTAL HEALTH SERVICES.] 
334.1      (a) Effective for services rendered on or after July 1, 
334.2   2001, payment for medication management provided to psychiatric 
334.3   patients, outpatient mental health services, day treatment 
334.4   services, home-based mental health services, and family 
334.5   community support services shall be paid at the lower of (1) 
334.6   submitted charges, or (2) 75.6 percent of the 50th percentile of 
334.7   1999 charges. 
334.8      (b) Effective July 1, 2001, the medical assistance rates 
334.9   for outpatient mental health services provided by an entity that 
334.10  operates:  (1) a Medicare-certified comprehensive outpatient 
334.11  rehabilitation facility; and (2) a facility that was certified 
334.12  prior to January 1, 1993, with at least 33 percent of the 
334.13  clients receiving rehabilitation services in the most recent 
334.14  calendar year who are medical assistance recipients, will be 
334.15  increased by 38 percent, when those services are provided within 
334.16  the comprehensive outpatient rehabilitation facility and 
334.17  provided to residents of nursing facilities owned by the entity. 
334.18     Sec. 47.  Minnesota Statutes 2002, section 256D.03, 
334.19  subdivision 3a, is amended to read: 
334.20     Subd. 3a.  [CLAIMS; ASSIGNMENT OF BENEFITS.] Claims must be 
334.21  filed pursuant to section 256D.16.  General assistance medical 
334.22  care applicants and recipients must apply or agree to apply 
334.23  third party health and accident benefits to the costs of medical 
334.24  care.  They must cooperate with the state in establishing 
334.25  paternity and obtaining third party payments.  By signing an 
334.26  application for accepting general assistance, a person assigns 
334.27  to the department of human services all rights to medical 
334.28  support or payments for medical expenses from another person or 
334.29  entity on their own or their dependent's behalf and agrees to 
334.30  cooperate with the state in establishing paternity and obtaining 
334.31  third party payments.  The application shall contain a statement 
334.32  explaining the assignment.  Any rights or amounts assigned shall 
334.33  be applied against the cost of medical care paid for under this 
334.34  chapter.  An assignment is effective on the date general 
334.35  assistance medical care eligibility takes effect.  The 
334.36  assignment shall not affect benefits paid or provided under 
335.1   automobile accident coverage and private health care coverage 
335.2   until the person or organization providing the benefits has 
335.3   received notice of the assignment.  
335.4      Sec. 48.  Minnesota Statutes 2002, section 256I.02, is 
335.5   amended to read: 
335.6      256I.02 [PURPOSE.] 
335.7      The Group Residential Housing Act establishes a 
335.8   comprehensive system of rates and payments for persons who 
335.9   reside in a group residence the community and who meet the 
335.10  eligibility criteria under section 256I.04, subdivision 1. 
335.11     Sec. 49.  Minnesota Statutes 2002, section 256I.04, 
335.12  subdivision 3, is amended to read: 
335.13     Subd. 3.  [MORATORIUM ON THE DEVELOPMENT OF GROUP 
335.14  RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 
335.15  into agreements for new group residential housing beds with 
335.16  total rates in excess of the MSA equivalent rate except:  (1) 
335.17  for group residential housing establishments meeting the 
335.18  requirements of subdivision 2a, clause (2) with department 
335.19  approval; (2) for group residential housing establishments 
335.20  licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 
335.21  provided the facility is needed to meet the census reduction 
335.22  targets for persons with mental retardation or related 
335.23  conditions at regional treatment centers; (3) (2) to ensure 
335.24  compliance with the federal Omnibus Budget Reconciliation Act 
335.25  alternative disposition plan requirements for inappropriately 
335.26  placed persons with mental retardation or related conditions or 
335.27  mental illness; (4) (3) up to 80 beds in a single, specialized 
335.28  facility located in Hennepin county that will provide housing 
335.29  for chronic inebriates who are repetitive users of 
335.30  detoxification centers and are refused placement in emergency 
335.31  shelters because of their state of intoxication, and planning 
335.32  for the specialized facility must have been initiated before 
335.33  July 1, 1991, in anticipation of receiving a grant from the 
335.34  housing finance agency under section 462A.05, subdivision 20a, 
335.35  paragraph (b); (5) (4) notwithstanding the provisions of 
335.36  subdivision 2a, for up to 190 supportive housing units in Anoka, 
336.1   Dakota, Hennepin, or Ramsey county for homeless adults with a 
336.2   mental illness, a history of substance abuse, or human 
336.3   immunodeficiency virus or acquired immunodeficiency syndrome.  
336.4   For purposes of this section, "homeless adult" means a person 
336.5   who is living on the street or in a shelter or discharged from a 
336.6   regional treatment center, community hospital, or residential 
336.7   treatment program and has no appropriate housing available and 
336.8   lacks the resources and support necessary to access appropriate 
336.9   housing.  At least 70 percent of the supportive housing units 
336.10  must serve homeless adults with mental illness, substance abuse 
336.11  problems, or human immunodeficiency virus or acquired 
336.12  immunodeficiency syndrome who are about to be or, within the 
336.13  previous six months, has been discharged from a regional 
336.14  treatment center, or a state-contracted psychiatric bed in a 
336.15  community hospital, or a residential mental health or chemical 
336.16  dependency treatment program.  If a person meets the 
336.17  requirements of subdivision 1, paragraph (a), and receives a 
336.18  federal or state housing subsidy, the group residential housing 
336.19  rate for that person is limited to the supplementary rate under 
336.20  section 256I.05, subdivision 1a, and is determined by 
336.21  subtracting the amount of the person's countable income that 
336.22  exceeds the MSA equivalent rate from the group residential 
336.23  housing supplementary rate.  A resident in a demonstration 
336.24  project site who no longer participates in the demonstration 
336.25  program shall retain eligibility for a group residential housing 
336.26  payment in an amount determined under section 256I.06, 
336.27  subdivision 8, using the MSA equivalent rate.  Service funding 
336.28  under section 256I.05, subdivision 1a, will end June 30, 1997, 
336.29  if federal matching funds are available and the services can be 
336.30  provided through a managed care entity.  If federal matching 
336.31  funds are not available, then service funding will continue 
336.32  under section 256I.05, subdivision 1a; or (6) for group 
336.33  residential housing beds in settings meeting the requirements of 
336.34  subdivision 2a, clauses (1) and (3), which are used exclusively 
336.35  for recipients receiving home and community-based waiver 
336.36  services under sections 256B.0915, 256B.092, subdivision 5, 
337.1   256B.093, and 256B.49, and who resided in a nursing facility for 
337.2   the six months immediately prior to the month of entry into the 
337.3   group residential housing setting.  The group residential 
337.4   housing rate for these beds must be set so that the monthly 
337.5   group residential housing payment for an individual occupying 
337.6   the bed when combined with the nonfederal share of services 
337.7   delivered under the waiver for that person does not exceed the 
337.8   nonfederal share of the monthly medical assistance payment made 
337.9   for the person to the nursing facility in which the person 
337.10  resided prior to entry into the group residential housing 
337.11  establishment.  The rate may not exceed the MSA equivalent rate 
337.12  plus $426.37 for any case. 
337.13     (b) A county agency may enter into a group residential 
337.14  housing agreement for beds with rates in excess of the MSA 
337.15  equivalent rate in addition to those currently covered under a 
337.16  group residential housing agreement if the additional beds are 
337.17  only a replacement of beds with rates in excess of the MSA 
337.18  equivalent rate which have been made available due to closure of 
337.19  a setting, a change of licensure or certification which removes 
337.20  the beds from group residential housing payment, or as a result 
337.21  of the downsizing of a group residential housing setting.  The 
337.22  transfer of available beds from one county to another can only 
337.23  occur by the agreement of both counties. 
337.24     Sec. 50.  Minnesota Statutes 2002, section 256I.05, 
337.25  subdivision 1, is amended to read: 
337.26     Subdivision 1.  [MAXIMUM RATES.] (a) Monthly room and board 
337.27  rates negotiated by a county agency for a recipient living in 
337.28  group residential housing must not exceed the MSA equivalent 
337.29  rate specified under section 256I.03, subdivision 5,. with the 
337.30  exception that a county agency may negotiate a supplementary 
337.31  room and board rate that exceeds the MSA equivalent rate for 
337.32  recipients of waiver services under title XIX of the Social 
337.33  Security Act.  This exception is subject to the following 
337.34  conditions: 
337.35     (1) the setting is licensed by the commissioner of human 
337.36  services under Minnesota Rules, parts 9555.5050 to 9555.6265; 
338.1      (2) the setting is not the primary residence of the license 
338.2   holder and in which the license holder is not the primary 
338.3   caregiver; and 
338.4      (3) the average supplementary room and board rate in a 
338.5   county for a calendar year may not exceed the average 
338.6   supplementary room and board rate for that county in effect on 
338.7   January 1, 2000.  For calendar years beginning on or after 
338.8   January 1, 2002, within the limits of appropriations 
338.9   specifically for this purpose, the commissioner shall increase 
338.10  each county's supplemental room and board rate average on an 
338.11  annual basis by a factor consisting of the percentage change in 
338.12  the Consumer Price Index-All items, United States city average 
338.13  (CPI-U) for that calendar year compared to the preceding 
338.14  calendar year as forecasted by Data Resources, Inc., in the 
338.15  third quarter of the preceding calendar year.  If a county has 
338.16  not negotiated supplementary room and board rates for any 
338.17  facilities located in the county as of January 1, 2000, or has 
338.18  an average supplemental room and board rate under $100 per 
338.19  person as of January 1, 2000, it may submit a supplementary room 
338.20  and board rate request with budget information for a facility to 
338.21  the commissioner for approval. 
338.22  The county agency may at any time negotiate a higher or lower 
338.23  room and board rate than the average supplementary room and 
338.24  board rate. 
338.25     (b) Notwithstanding paragraph (a), clause (3), county 
338.26  agencies may negotiate a supplementary room and board rate that 
338.27  exceeds the MSA equivalent rate by up to $426.37 for up to five 
338.28  facilities, serving not more than 20 individuals in total, that 
338.29  were established to replace an intermediate care facility for 
338.30  persons with mental retardation and related conditions located 
338.31  in the city of Roseau that became uninhabitable due to flood 
338.32  damage in June 2002. 
338.33     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004, 
338.34  or upon receipt of federal approval of waiver amendment, 
338.35  whichever is later. 
338.36     Sec. 51.  Minnesota Statutes 2002, section 256I.05, 
339.1   subdivision 1a, is amended to read: 
339.2      Subd. 1a.  [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 
339.3   the provisions of section 256I.04, subdivision 3, in addition to 
339.4   the room and board rate specified in subdivision 1, the county 
339.5   agency may negotiate a payment not to exceed $426.37 for other 
339.6   services necessary to provide room and board provided by the 
339.7   group residence if the residence is licensed by or registered by 
339.8   the department of health, or licensed by the department of human 
339.9   services to provide services in addition to room and board, and 
339.10  if the provider of services is not also concurrently receiving 
339.11  funding for services for a recipient under a home and 
339.12  community-based waiver under title XIX of the Social Security 
339.13  Act; or funding from the medical assistance program under 
339.14  section 256B.0627, subdivision 4, for personal care services for 
339.15  residents in the setting; or residing in a setting which 
339.16  receives funding under Minnesota Rules, parts 9535.2000 to 
339.17  9535.3000.  If funding is available for other necessary services 
339.18  through a home and community-based waiver, or personal care 
339.19  services under section 256B.0627, subdivision 4, then the GRH 
339.20  rate is limited to the rate set in subdivision 1.  Unless 
339.21  otherwise provided in law, in no case may the supplementary 
339.22  service rate plus the supplementary room and board rate exceed 
339.23  $426.37.  The registration and licensure requirement does not 
339.24  apply to establishments which are exempt from state licensure 
339.25  because they are located on Indian reservations and for which 
339.26  the tribe has prescribed health and safety requirements.  
339.27  Service payments under this section may be prohibited under 
339.28  rules to prevent the supplanting of federal funds with state 
339.29  funds.  The commissioner shall pursue the feasibility of 
339.30  obtaining the approval of the Secretary of Health and Human 
339.31  Services to provide home and community-based waiver services 
339.32  under title XIX of the Social Security Act for residents who are 
339.33  not eligible for an existing home and community-based waiver due 
339.34  to a primary diagnosis of mental illness or chemical dependency 
339.35  and shall apply for a waiver if it is determined to be 
339.36  cost-effective.  
340.1      (b) The commissioner is authorized to make cost-neutral 
340.2   transfers from the GRH fund for beds under this section to other 
340.3   funding programs administered by the department after 
340.4   consultation with the county or counties in which the affected 
340.5   beds are located.  The commissioner may also make cost-neutral 
340.6   transfers from the GRH fund to county human service agencies for 
340.7   beds permanently removed from the GRH census under a plan 
340.8   submitted by the county agency and approved by the 
340.9   commissioner.  The commissioner shall report the amount of any 
340.10  transfers under this provision annually to the legislature. 
340.11     (c) The provisions of paragraph (b) do not apply to a 
340.12  facility that has its reimbursement rate established under 
340.13  section 256B.431, subdivision 4, paragraph (c). 
340.14     Sec. 52.  Minnesota Statutes 2002, section 256I.05, 
340.15  subdivision 7c, is amended to read: 
340.16     Subd. 7c.  [DEMONSTRATION PROJECT.] The commissioner is 
340.17  authorized to pursue a demonstration project under federal food 
340.18  stamp regulation for the purpose of gaining federal 
340.19  reimbursement of food and nutritional costs currently paid by 
340.20  the state group residential housing program.  The commissioner 
340.21  shall seek approval no later than January 1, 2004.  Any 
340.22  reimbursement received is nondedicated revenue to the general 
340.23  fund. 
340.24     Sec. 53.  [514.991] [ALTERNATIVE CARE LIENS; DEFINITIONS.] 
340.25     Subdivision 1.  [APPLICABILITY.] The definitions in this 
340.26  section apply to sections 514.991 to 514.995. 
340.27     Subd. 2.  [ALTERNATIVE CARE AGENCY, AGENCY, OR 
340.28  DEPARTMENT.] "Alternative care agency," "agency," or "department"
340.29  means the department of human services when it pays for or 
340.30  provides alternative care benefits for a nonmedical assistance 
340.31  recipient directly or through a county social services agency 
340.32  under chapter 256B according to section 256B.0913. 
340.33     Subd. 3.  [ALTERNATIVE CARE BENEFIT OR 
340.34  BENEFITS.] "Alternative care benefit" or "benefits" means a 
340.35  benefit provided to a nonmedical assistance recipient under 
340.36  chapter 256B according to section 256B.0913. 
341.1      Subd. 4.  [ALTERNATIVE CARE RECIPIENT OR 
341.2   RECIPIENT.] "Alternative care recipient" or "recipient" means a 
341.3   person who receives alternative care grant benefits. 
341.4      Subd. 5.  [ALTERNATIVE CARE LIEN OR LIEN.] "Alternative 
341.5   care lien" or "lien" means a lien filed under sections 514.992 
341.6   to 514.995. 
341.7      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
341.8   for services for persons first enrolling in the alternative care 
341.9   program on or after that date and on the first day of the first 
341.10  eligibility renewal period for persons enrolled in the 
341.11  alternative care program prior to July 1, 2003. 
341.12     Sec. 54.  [514.992] [ALTERNATIVE CARE LIEN.] 
341.13     Subdivision 1.  [PROPERTY SUBJECT TO LIEN; LIEN AMOUNT.] (a)
341.14  Subject to sections 514.991 to 514.995, payments made by an 
341.15  alternative care agency to provide benefits to a recipient or to 
341.16  the recipient's spouse who owns property in this state 
341.17  constitute a lien in favor of the agency on all real property 
341.18  the recipient owns at and after the time the benefits are first 
341.19  paid. 
341.20     (b) The amount of the lien is limited to benefits paid for 
341.21  services provided to recipients over 55 years of age and 
341.22  provided on and after July 1, 2003. 
341.23     Subd. 2.  [ATTACHMENT.] (a) A lien attaches to and becomes 
341.24  enforceable against specific real property as of the date when 
341.25  all of the following conditions are met: 
341.26     (1) the agency has paid benefits for a recipient; 
341.27     (2) the recipient has been given notice and an opportunity 
341.28  for a hearing under paragraph (b); 
341.29     (3) the lien has been filed as provided for in section 
341.30  514.993 or memorialized on the certificate of title for the 
341.31  property it describes; and 
341.32     (4) all restrictions against enforcement have ceased to 
341.33  apply. 
341.34     (b) An agency may not file a lien until it has sent the 
341.35  recipient, their authorized representative, or their legal 
341.36  representative written notice of its lien rights by certified 
342.1   mail, return receipt requested, or registered mail and there has 
342.2   been an opportunity for a hearing under section 256.045.  No 
342.3   person other than the recipient shall have a right to a hearing 
342.4   under section 256.045 prior to the time the lien is filed.  The 
342.5   hearing shall be limited to whether the agency has met all of 
342.6   the prerequisites for filing the lien and whether any of the 
342.7   exceptions in this section apply. 
342.8      (c) An agency may not file a lien against the recipient's 
342.9   homestead when any of the following exceptions apply: 
342.10     (1) while the recipient's spouse is also physically present 
342.11  and lawfully and continuously residing in the homestead; 
342.12     (2) a child of the recipient who is under age 21 or who is 
342.13  blind or totally and permanently disabled according to 
342.14  supplemental security income criteria is also physically present 
342.15  on the property and lawfully and continuously residing on the 
342.16  property from and after the date the recipient first receives 
342.17  benefits; 
342.18     (3) a child of the recipient who has also lawfully and 
342.19  continuously resided on the property for a period beginning at 
342.20  least two years before the first day of the month in which the 
342.21  recipient began receiving alternative care, and who provided 
342.22  uncompensated care to the recipient which enabled the recipient 
342.23  to live without alternative care services for the two-year 
342.24  period; 
342.25     (4) a sibling of the recipient who has an ownership 
342.26  interest in the property of record in the office of the county 
342.27  recorder or registrar of titles for the county in which the real 
342.28  property is located and who has also continuously occupied the 
342.29  homestead for a period of at least one year immediately prior to 
342.30  the first day of the first month in which the recipient received 
342.31  benefits and continuously since that date. 
342.32     (d) A lien only applies to the real property it describes. 
342.33     Subd. 3.  [CONTINUATION OF LIEN.] A lien remains effective 
342.34  from the time it is filed until it is paid, satisfied, 
342.35  discharged, or becomes unenforceable under sections 514.991 to 
342.36  514.995. 
343.1      Subd. 4.  [PRIORITY OF LIEN.] (a) A lien which attaches to 
343.2   the real property it describes is subject to the rights of 
343.3   anyone else whose interest in the real property is perfected of 
343.4   record before the lien has been recorded or filed under section 
343.5   514.993, including: 
343.6      (1) an owner, other than the recipient or the recipient's 
343.7   spouse; 
343.8      (2) a good faith purchaser for value without notice of the 
343.9   lien; 
343.10     (3) a holder of a mortgage or security interest; or 
343.11     (4) a judgment lien creditor whose judgment lien has 
343.12  attached to the recipient's interest in the real property. 
343.13     (b) The rights of the other person have the same 
343.14  protections against an alternative care lien as are afforded 
343.15  against a judgment lien that arises out of an unsecured 
343.16  obligation and arises as of the time of the filing of an 
343.17  alternative care grant lien under section 514.993.  The lien 
343.18  shall be inferior to a lien for property taxes and special 
343.19  assessments and shall be superior to all other matters first 
343.20  appearing of record after the time and date the lien is filed or 
343.21  recorded. 
343.22     Subd. 5.  [SETTLEMENT, SUBORDINATION, AND RELEASE.] (a) An 
343.23  agency may, with absolute discretion, settle or subordinate the 
343.24  lien to any other lien or encumbrance of record upon the terms 
343.25  and conditions it deems appropriate. 
343.26     (b) The agency filing the lien shall release and discharge 
343.27  the lien: 
343.28     (1) if it has been paid, discharged, or satisfied; 
343.29     (2) if it has received reimbursement for the amounts 
343.30  secured by the lien, has entered into a binding and legally 
343.31  enforceable agreement under which it is reimbursed for the 
343.32  amount of the lien, or receives other collateral sufficient to 
343.33  secure payment of the lien; 
343.34     (3) against some, but not all, of the property it describes 
343.35  upon the terms, conditions, and circumstances the agency deems 
343.36  appropriate; 
344.1      (4) to the extent it cannot be lawfully enforced against 
344.2   the property it describes because of an error, omission, or 
344.3   other material defect in the legal description contained in the 
344.4   lien or a necessary prerequisite to enforcement of the lien; and 
344.5      (5) if, in its discretion, it determines the filing or 
344.6   enforcement of the lien is contrary to the public interest. 
344.7      (c) The agency executing the lien shall execute and file 
344.8   the release as provided for in section 514.993, subdivision 2. 
344.9      Subd. 6.  [LENGTH OF LIEN.] (a) A lien shall be a lien on 
344.10  the real property it describes for a period of ten years from 
344.11  the date it attaches according to subdivision 2, paragraph (a), 
344.12  except as otherwise provided for in sections 514.992 to 
344.13  514.995.  The agency filing the lien may renew the lien for one 
344.14  additional ten-year period from the date it would otherwise 
344.15  expire by recording or filing a certificate of renewal before 
344.16  the lien expires.  The certificate of renewal shall be recorded 
344.17  or filed in the office of the county recorder or registrar of 
344.18  titles for the county in which the lien is recorded or filed.  
344.19  The certificate must refer to the recording or filing data for 
344.20  the lien it renews.  The certificate need not be attested, 
344.21  certified, or acknowledged as a condition for recording or 
344.22  filing.  The recorder or registrar of titles shall record, file, 
344.23  index, and return the certificate of renewal in the same manner 
344.24  provided for liens in section 514.993, subdivision 2. 
344.25     (b) An alternative care lien is not enforceable against the 
344.26  real property of an estate to the extent there is a 
344.27  determination by a court of competent jurisdiction, or by an 
344.28  officer of the court designated for that purpose, that there are 
344.29  insufficient assets in the estate to satisfy the lien in whole 
344.30  or in part because of the homestead exemption under section 
344.31  256B.15, subdivision 4, the rights of a surviving spouse or a 
344.32  minor child under section 524.2-403, paragraphs (a) and (b), or 
344.33  claims with a priority under section 524.3-805, paragraph (a), 
344.34  clauses (1) to (4).  For purposes of this section, the rights of 
344.35  the decedent's adult children to exempt property under section 
344.36  524.2-403, paragraph (b), shall not be considered costs of 
345.1   administration under section 524.3-805, paragraph (a), clause 
345.2   (1). 
345.3      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
345.4   for services for persons first enrolling in the alternative care 
345.5   program on or after that date and on the first day of the first 
345.6   eligibility renewal period for persons enrolled in the 
345.7   alternative care program prior to July 1, 2003. 
345.8      Sec. 55.  [514.993] [LIEN; CONTENTS AND FILING.] 
345.9      Subdivision 1.  [CONTENTS.] A lien shall be dated and must 
345.10  contain: 
345.11     (1) the recipient's full name, last known address, and 
345.12  social security number; 
345.13     (2) a statement that benefits have been paid to or for the 
345.14  recipient's benefit; 
345.15     (3) a statement that all of the recipient's interests in 
345.16  the in the real property described in the lien may be subject to 
345.17  or affected by the agency's right to reimbursement for benefits; 
345.18     (4) a legal description of the real property subject to the 
345.19  lien and whether it is registered or abstract property; 
345.20     (5) such other contents, if any, as the agency deems 
345.21  appropriate. 
345.22     Subd. 2.  [FILING.] Any lien, release, or other document 
345.23  required or permitted to be filed under sections 514.991 to 
345.24  514.995 must be recorded or filed in the office of the county 
345.25  recorder or registrar of titles, as appropriate, in the county 
345.26  where the real property is located.  Notwithstanding section 
345.27  386.77, the agency shall pay the applicable filing fee for any 
345.28  documents filed under sections 514.991 to 514.995.  An 
345.29  attestation, certification, or acknowledgment is not required as 
345.30  a condition of filing.  If the property described in the lien is 
345.31  registered property, the registrar of titles shall record it on 
345.32  the certificate of title for each parcel of property described 
345.33  in the lien.  If the property described in the lien is abstract 
345.34  property, the recorder shall file the lien in the county's 
345.35  grantor-grantee indexes and any tract indexes the county 
345.36  maintains for each parcel of property described in the lien.  
346.1   The recorder or registrar shall return the recorded or filed 
346.2   lien to the agency at no cost.  If the agency provides a 
346.3   duplicate copy of the lien, the recorder or registrar of titles 
346.4   shall show the recording or filing data on the copy and return 
346.5   it to the agency at no cost.  The agency is responsible for 
346.6   filing any lien, release, or other documents under sections 
346.7   514.991 to 514.995. 
346.8      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
346.9   for services for persons first enrolling in the alternative care 
346.10  program on or after that date and on the first day of the first 
346.11  eligibility renewal period for persons enrolled in the 
346.12  alternative care program prior to July 1, 2003. 
346.13     Sec. 56.  [514.994] [ENFORCEMENT; OTHER REMEDIES.] 
346.14     Subdivision 1.  [FORECLOSURE OR ENFORCEMENT OF LIEN.] The 
346.15  agency may enforce or foreclose a lien filed under sections 
346.16  514.991 to 514.995 in the manner provided for by law for 
346.17  enforcement of judgment liens against real estate or by a 
346.18  foreclosure by action under chapter 581.  The lien shall remain 
346.19  enforceable as provided for in sections 514.991 to 514.995 
346.20  notwithstanding any laws limiting the enforceability of 
346.21  judgments. 
346.22     Subd. 2.  [HOMESTEAD EXEMPTION.] The lien may not be 
346.23  enforced against the homestead property of the recipient or the 
346.24  spouse while they physically occupy it as their lawful residence.
346.25     Subd. 3.  [AGENCY CLAIM OR REMEDY.] Sections 514.992 to 
346.26  514.995 do not limit the agency's right to file a claim against 
346.27  the recipient's estate or the estate of the recipient's spouse, 
346.28  do not limit any other claims for reimbursement the agency may 
346.29  have, and do not limit the availability of any other remedy to 
346.30  the agency. 
346.31     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
346.32  for services for persons first enrolling in the alternative care 
346.33  program on or after that date and on the first day of the first 
346.34  eligibility renewal period for persons enrolled in the 
346.35  alternative care program prior to July 1, 2003. 
346.36     Sec. 57.  [514.995] [AMOUNTS RECEIVED TO SATISFY LIEN.] 
347.1      Amounts the agency receives to satisfy the lien must be 
347.2   deposited in the state treasury and credited to the fund from 
347.3   which the benefits were paid. 
347.4      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
347.5   for services for persons first enrolling in the alternative care 
347.6   program on or after that date and on the first day of the first 
347.7   eligibility renewal period for persons enrolled in the 
347.8   alternative care program prior to July 1, 2003. 
347.9      Sec. 58.  Minnesota Statutes 2002, section 524.3-805, is 
347.10  amended to read: 
347.11     524.3-805 [CLASSIFICATION OF CLAIMS.] 
347.12     (a) If the applicable assets of the estate are insufficient 
347.13  to pay all claims in full, the personal representative shall 
347.14  make payment in the following order: 
347.15     (1) costs and expenses of administration; 
347.16     (2) reasonable funeral expenses; 
347.17     (3) debts and taxes with preference under federal law; 
347.18     (4) reasonable and necessary medical, hospital, or nursing 
347.19  home expenses of the last illness of the decedent, including 
347.20  compensation of persons attending the decedent, a claim filed 
347.21  under section 256B.15 for recovery of expenditures for 
347.22  alternative care for nonmedical assistance recipients under 
347.23  section 256B.0913, and including a claim filed pursuant to 
347.24  section 256B.15; 
347.25     (5) reasonable and necessary medical, hospital, and nursing 
347.26  home expenses for the care of the decedent during the year 
347.27  immediately preceding death; 
347.28     (6) debts with preference under other laws of this state, 
347.29  and state taxes; 
347.30     (7) all other claims. 
347.31     (b) No preference shall be given in the payment of any 
347.32  claim over any other claim of the same class, and a claim due 
347.33  and payable shall not be entitled to a preference over claims 
347.34  not due, except that if claims for expenses of the last illness 
347.35  involve only claims filed under section 256B.15 for recovery of 
347.36  expenditures for alternative care for nonmedical assistance 
348.1   recipients under section 256B.0913, section 246.53 for costs of 
348.2   state hospital care and claims filed under section 256B.15, 
348.3   claims filed to recover expenditures for alternative care for 
348.4   nonmedical assistance recipients under section 256B.0913 shall 
348.5   have preference over claims filed under both sections 246.53 and 
348.6   other claims filed under section 256B.15, and claims filed under 
348.7   section 246.53 have preference over claims filed under section 
348.8   256B.15 for recovery of amounts other than those for 
348.9   expenditures for alternative care for nonmedical assistance 
348.10  recipients under section 256B.0913. 
348.11     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
348.12  for decedents dying on or after that date. 
348.13     Sec. 59.  [IMPOSITION OF FEDERAL CERTIFICATION REMEDIES.] 
348.14     The commissioner of health shall seek changes in the 
348.15  federal policy that mandates the imposition of federal sanctions 
348.16  without providing an opportunity for a nursing facility to 
348.17  correct deficiencies, solely as the result of previous 
348.18  deficiencies issued to the nursing facility.  
348.19     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
348.20     Sec. 60.  [REPORT ON LONG-TERM CARE.] 
348.21     The report on long-term care services required under 
348.22  Minnesota Statutes, section 144A.351, that is presented to the 
348.23  legislature by January 15, 2004, must also address the 
348.24  feasibility of offering government or private sector loans or 
348.25  lines of credit to individuals age 65 and over, for the purchase 
348.26  of long-term care services. 
348.27     Sec. 61.  [REPORTS; POTENTIAL SAVINGS TO STATE FROM CERTAIN 
348.28  LONG-TERM CARE INSURANCE PURCHASE INCENTIVES.] 
348.29     Subdivision 1.  [LONG-TERM CARE INSURANCE 
348.30  PARTNERSHIPS.] The commissioner of human services, in 
348.31  consultation with the commissioner of commerce, shall report to 
348.32  the legislature by January 15, 2004, on the feasibility of 
348.33  Minnesota adopting a long-term care insurance partnership 
348.34  program similar to those adopted in other states.  In such a 
348.35  program, the state would encourage purchase of private long-term 
348.36  care insurance by permitting the insured to retain assets in 
349.1   excess of those otherwise permitted for medical assistance 
349.2   eligibility, if the insured later exhausts the private long-term 
349.3   care insurance benefits.  The report must include the 
349.4   feasibility of obtaining any necessary federal waiver.  The 
349.5   report must comply with Minnesota Statutes, sections 3.195 and 
349.6   3.197. 
349.7      Subd. 2.  [USE OF MEDICAL ASSISTANCE FUNDS TO SUBSIDIZE 
349.8   PURCHASE OF LONG-TERM CARE INSURANCE.] The commissioner of human 
349.9   services shall report to the legislature by January 15, 2004, on 
349.10  the feasibility of using state medical assistance funds to 
349.11  subsidize the purchase of private long-term care insurance by 
349.12  individuals who would be unlikely to purchase it without a 
349.13  subsidy, in order to generate long-term savings of medical 
349.14  assistance expenditures.  The report must comply with Minnesota 
349.15  Statutes, sections 3.195 and 3.197. 
349.16     Subd. 3.  [NURSING FACILITY BENEFITS IN MEDICARE SUPPLEMENT 
349.17  COVERAGE.] The commissioner of human services must study and 
349.18  quantify the cost or savings to the state if a nursing facility 
349.19  benefit were added to Medicare-related coverage, as defined in 
349.20  Minnesota Statutes, section 62Q.01, subdivision 6.  The 
349.21  commissioner shall report to the legislature by January 15, 
349.22  2004.  The report must comply with Minnesota Statutes, sections 
349.23  3.195 and 3.197. 
349.24     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
349.25     Sec. 62.  [REVISOR'S INSTRUCTION.] 
349.26     For sections in Minnesota Statutes and Minnesota Rules 
349.27  affected by the repealed sections in this article, the revisor 
349.28  shall delete internal cross-references where appropriate and 
349.29  make changes necessary to correct the punctuation, grammar, or 
349.30  structure of the remaining text and preserve its meaning. 
349.31     Sec. 63.  [REPEALER.] 
349.32     (a) Minnesota Statutes 2002, sections 256.973; 256.9772; 
349.33  256B.0928; and 256B.437, subdivision 2, are repealed effective 
349.34  July 1, 2003. 
349.35     (b) Minnesota Statutes 2002, sections 62J.66; 62J.68; 
349.36  144A.071, subdivision 5; and 144A.35, are repealed. 
350.1      (c) Laws 1998, chapter 407, article 4, section 63, is 
350.2   repealed. 
350.3      (d) Minnesota Rules, parts 9505.3045; 9505.3050; 9505.3055; 
350.4   9505.3060; 9505.3068; 9505.3070; 9505.3075; 9505.3080; 
350.5   9505.3090; 9505.3095; 9505.3100; 9505.3105; 9505.3107; 
350.6   9505.3110; 9505.3115; 9505.3120; 9505.3125; 9505.3130; 
350.7   9505.3138; 9505.3139; 9505.3140; 9505.3680; 9505.3690; and 
350.8   9505.3700, are repealed effective July 1, 2003. 
350.9                              ARTICLE 4 
350.10           CONTINUING CARE FOR PERSONS WITH DISABILITIES 
350.11     Section 1.  Minnesota Statutes 2002, section 174.30, 
350.12  subdivision 1, is amended to read: 
350.13     Subdivision 1.  [APPLICABILITY.] (a) The operating 
350.14  standards for special transportation service adopted under this 
350.15  section do not apply to special transportation provided by:  
350.16     (1) a common carrier operating on fixed routes and 
350.17  schedules; 
350.18     (2) a volunteer driver using a private automobile; 
350.19     (3) a school bus as defined in section 169.01, subdivision 
350.20  6; or 
350.21     (4) an emergency ambulance regulated under chapter 144. 
350.22     (b) The operating standards adopted under this section only 
350.23  apply to providers of special transportation service who receive 
350.24  grants or other financial assistance from either the state or 
350.25  the federal government, or both, to provide or assist in 
350.26  providing that service; except that the operating standards 
350.27  adopted under this section do not apply to any nursing home 
350.28  licensed under section 144A.02, to any board and care facility 
350.29  licensed under section 144.50, or to any day training and 
350.30  habilitation services, day care, or group home facility licensed 
350.31  under sections 245A.01 to 245A.19 unless the facility or program 
350.32  provides transportation to nonresidents on a regular basis and 
350.33  the facility receives reimbursement, other than per diem 
350.34  payments, for that service under rules promulgated by the 
350.35  commissioner of human services.  
350.36     (c) Notwithstanding paragraph (b), the operating standards 
351.1   adopted under this section do not apply to any vendor of 
351.2   services licensed under chapter 245B that provides 
351.3   transportation services to consumers or residents of other 
351.4   vendors licensed under chapter 245B. 
351.5      Sec. 2.  Minnesota Statutes 2002, section 245B.06, 
351.6   subdivision 8, is amended to read: 
351.7      Subd. 8.  [LEAVING THE RESIDENCE.] As specified in each 
351.8   consumer's individual service plan, each consumer requiring a 
351.9   24-hour plan of care must may leave the residence to participate 
351.10  in regular education, employment, or community activities.  
351.11  License holders, providing services to consumers living in a 
351.12  licensed site, shall ensure that they are prepared to care for 
351.13  consumers whenever they are at the residence during the day 
351.14  because of illness, work schedules, or other reasons. 
351.15     Sec. 3.  Minnesota Statutes 2002, section 245B.07, 
351.16  subdivision 11, is amended to read: 
351.17     Subd. 11.  [TRAVEL TIME TO AND FROM A DAY TRAINING AND 
351.18  HABILITATION SITE.] Except in unusual circumstances, the license 
351.19  holder must not transport a consumer receiving services for 
351.20  longer than one hour 90 minutes per one-way trip.  Nothing in 
351.21  this subdivision relieves the provider of the obligation to 
351.22  provide the number of program hours as identified in the 
351.23  individualized service plan. 
351.24     Sec. 4.  Minnesota Statutes 2002, section 246.54, is 
351.25  amended to read: 
351.26     246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.] 
351.27     Subdivision 1.  [COUNTY PORTION FOR COST OF CARE.] Except 
351.28  for chemical dependency services provided under sections 254B.01 
351.29  to 254B.09, the client's county shall pay to the state of 
351.30  Minnesota a portion of the cost of care provided in a regional 
351.31  treatment center or a state nursing facility to a client legally 
351.32  settled in that county.  A county's payment shall be made from 
351.33  the county's own sources of revenue and payments shall be paid 
351.34  as follows:  payments to the state from the county shall 
351.35  equal ten 20 percent of the cost of care, as determined by the 
351.36  commissioner, for each day, or the portion thereof, that the 
352.1   client spends at a regional treatment center or a state nursing 
352.2   facility.  If payments received by the state under sections 
352.3   246.50 to 246.53 exceed 90 80 percent of the cost of care, the 
352.4   county shall be responsible for paying the state only the 
352.5   remaining amount.  The county shall not be entitled to 
352.6   reimbursement from the client, the client's estate, or from the 
352.7   client's relatives, except as provided in section 246.53.  No 
352.8   such payments shall be made for any client who was last 
352.9   committed prior to July 1, 1947. 
352.10     Subd. 2.  [EXCEPTIONS.] Subdivision 1 does not apply to 
352.11  services provided at the Minnesota security hospital, the 
352.12  Minnesota sex offender program, or the Minnesota extended 
352.13  treatment options program.  For services at these facilities, a 
352.14  county's payment shall be made from the county's own sources of 
352.15  revenue and payments shall be paid as follows:  payments to the 
352.16  state from the county shall equal ten percent of the cost of 
352.17  care, as determined by the commissioner, for each day, or the 
352.18  portion thereof, that the client spends at the facility.  If 
352.19  payments received by the state under sections 246.50 to 246.53 
352.20  exceed 90 percent of the cost of care, the county shall be 
352.21  responsible for paying the state only the remaining amount.  The 
352.22  county shall not be entitled to reimbursement from the client, 
352.23  the client's estate, or from the client's relatives, except as 
352.24  provided in section 246.53. 
352.25     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2004.
352.26     Sec. 5.  Minnesota Statutes 2002, section 252.32, 
352.27  subdivision 1, is amended to read: 
352.28     Subdivision 1.  [PROGRAM ESTABLISHED.] In accordance with 
352.29  state policy established in section 256F.01 that all children 
352.30  are entitled to live in families that offer safe, nurturing, 
352.31  permanent relationships, and that public services be directed 
352.32  toward preventing the unnecessary separation of children from 
352.33  their families, and because many families who have children with 
352.34  mental retardation or related conditions disabilities have 
352.35  special needs and expenses that other families do not have, the 
352.36  commissioner of human services shall establish a program to 
353.1   assist families who have dependents dependent children with 
353.2   mental retardation or related conditions disabilities living in 
353.3   their home.  The program shall make support grants available to 
353.4   the families. 
353.5      Sec. 6.  Minnesota Statutes 2002, section 252.32, 
353.6   subdivision 1a, is amended to read: 
353.7      Subd. 1a.  [SUPPORT GRANTS.] (a) Provision of support 
353.8   grants must be limited to families who require support and whose 
353.9   dependents are under the age of 22 21 and who have mental 
353.10  retardation or who have a related condition and who have been 
353.11  determined by a screening team established certified disabled 
353.12  under section 256B.092 to be at risk of 
353.13  institutionalization 256B.055, subdivision 12, paragraphs (a), 
353.14  (b), (c), (d), and (e).  Families who are receiving home and 
353.15  community-based waivered services for persons with mental 
353.16  retardation or related conditions are not eligible for support 
353.17  grants. 
353.18     Families receiving grants who will be receiving home and 
353.19  community-based waiver services for persons with mental 
353.20  retardation or a related condition for their family member 
353.21  within the grant year, and who have ongoing payments for 
353.22  environmental or vehicle modifications which have been approved 
353.23  by the county as a grant expense and would have qualified for 
353.24  payment under this waiver may receive a onetime grant payment 
353.25  from the commissioner to reduce or eliminate the principal of 
353.26  the remaining debt for the modifications, not to exceed the 
353.27  maximum amount allowable for the remaining years of eligibility 
353.28  for a family support grant.  The commissioner is authorized to 
353.29  use up to $20,000 annually from the grant appropriation for this 
353.30  purpose.  Any amount unexpended at the end of the grant year 
353.31  shall be allocated by the commissioner in accordance with 
353.32  subdivision 3a, paragraph (b), clause (2).  Families whose 
353.33  annual adjusted gross income is $60,000 or more are not eligible 
353.34  for support grants except in cases where extreme hardship is 
353.35  demonstrated.  Beginning in state fiscal year 1994, the 
353.36  commissioner shall adjust the income ceiling annually to reflect 
354.1   the projected change in the average value in the United States 
354.2   Department of Labor Bureau of Labor Statistics consumer price 
354.3   index (all urban) for that year. 
354.4      (b) Support grants may be made available as monthly subsidy 
354.5   grants and lump sum grants. 
354.6      (c) Support grants may be issued in the form of cash, 
354.7   voucher, and direct county payment to a vendor.  
354.8      (d) Applications for the support grant shall be made by the 
354.9   legal guardian to the county social service agency.  The 
354.10  application shall specify the needs of the families, the form of 
354.11  the grant requested by the families, and that the families have 
354.12  agreed to use the support grant for items and services within 
354.13  the designated reimbursable expense categories and 
354.14  recommendations of the county to be reimbursed.  
354.15     (e) Families who were receiving subsidies on the date of 
354.16  implementation of the $60,000 income limit in paragraph (a) 
354.17  continue to be eligible for a family support grant until 
354.18  December 31, 1991, if all other eligibility criteria are met.  
354.19  After December 31, 1991, these families are eligible for a grant 
354.20  in the amount of one-half the grant they would otherwise 
354.21  receive, for as long as they remain eligible under other 
354.22  eligibility criteria. 
354.23     Sec. 7.  Minnesota Statutes 2002, section 252.32, 
354.24  subdivision 3, is amended to read: 
354.25     Subd. 3.  [AMOUNT OF SUPPORT GRANT; USE.] Support grant 
354.26  amounts shall be determined by the county social service 
354.27  agency.  Each service Services and item items purchased with a 
354.28  support grant must: 
354.29     (1) be over and above the normal costs of caring for the 
354.30  dependent if the dependent did not have a disability; 
354.31     (2) be directly attributable to the dependent's disabling 
354.32  condition; and 
354.33     (3) enable the family to delay or prevent the out-of-home 
354.34  placement of the dependent. 
354.35     The design and delivery of services and items purchased 
354.36  under this section must suit the dependent's chronological age 
355.1   and be provided in the least restrictive environment possible, 
355.2   consistent with the needs identified in the individual service 
355.3   plan. 
355.4      Items and services purchased with support grants must be 
355.5   those for which there are no other public or private funds 
355.6   available to the family.  Fees assessed to parents for health or 
355.7   human services that are funded by federal, state, or county 
355.8   dollars are not reimbursable through this program. 
355.9      In approving or denying applications, the county shall 
355.10  consider the following factors:  
355.11     (1) the extent and areas of the functional limitations of 
355.12  the disabled child; 
355.13     (2) the degree of need in the home environment for 
355.14  additional support; and 
355.15     (3) the potential effectiveness of the grant to maintain 
355.16  and support the person in the family environment. 
355.17     The maximum monthly grant amount shall be $250 per eligible 
355.18  dependent, or $3,000 per eligible dependent per state fiscal 
355.19  year, within the limits of available funds.  The county social 
355.20  service agency may consider the dependent's supplemental 
355.21  security income in determining the amount of the support grant.  
355.22  The county social service agency may exceed $3,000 per state 
355.23  fiscal year per eligible dependent for emergency circumstances 
355.24  in cases where exceptional resources of the family are required 
355.25  to meet the health, welfare-safety needs of the child.  
355.26     County social service agencies shall continue to provide 
355.27  funds to families receiving state grants on June 30, 1997, if 
355.28  eligibility criteria continue to be met.  Any adjustments to 
355.29  their monthly grant amount must be based on the needs of the 
355.30  family and funding availability. 
355.31     Sec. 8.  Minnesota Statutes 2002, section 252.32, 
355.32  subdivision 3c, is amended to read: 
355.33     Subd. 3c.  [COUNTY BOARD RESPONSIBILITIES.] County boards 
355.34  receiving funds under this section shall:  
355.35     (1) determine the needs of families for services in 
355.36  accordance with section 256B.092 or 256E.08 and any rules 
356.1   adopted under those sections; submit a plan to the department 
356.2   for the management of the family support grant program.  The 
356.3   plan must include the projected number of families the county 
356.4   will serve and policies and procedures for:  
356.5      (i) identifying potential families for the program; 
356.6      (ii) grant distribution; 
356.7      (iii) waiting list procedures; and 
356.8      (iv) prioritization of families to receive grants; 
356.9      (2) determine the eligibility of all persons proposed for 
356.10  program participation; 
356.11     (3) approve a plan for items and services to be reimbursed 
356.12  and inform families of the county's approval decision; 
356.13     (4) issue support grants directly to, or on behalf of, 
356.14  eligible families; 
356.15     (5) inform recipients of their right to appeal under 
356.16  subdivision 3e; 
356.17     (6) submit quarterly financial reports under subdivision 3b 
356.18  and indicate on the screening documents the annual grant level 
356.19  for each family, the families denied grants, and the families 
356.20  eligible but waiting for funding; and 
356.21     (7) coordinate services with other programs offered by the 
356.22  county. 
356.23     Sec. 9.  Minnesota Statutes 2002, section 252.41, 
356.24  subdivision 3, is amended to read: 
356.25     Subd. 3.  [DAY TRAINING AND HABILITATION SERVICES FOR 
356.26  ADULTS WITH MENTAL RETARDATION, RELATED CONDITIONS.] "Day 
356.27  training and habilitation services for adults with mental 
356.28  retardation and related conditions" means services that: 
356.29     (1) include supervision, training, assistance, and 
356.30  supported employment, work-related activities, or other 
356.31  community-integrated activities designed and implemented in 
356.32  accordance with the individual service and individual 
356.33  habilitation plans required under Minnesota Rules, parts 
356.34  9525.0015 to 9525.0165, to help an adult reach and maintain the 
356.35  highest possible level of independence, productivity, and 
356.36  integration into the community; and 
357.1      (2) are provided under contract with the county where the 
357.2   services are delivered by a vendor licensed under sections 
357.3   245A.01 to 245A.16 and 252.28, subdivision 2, to provide day 
357.4   training and habilitation services; and 
357.5      (3) are regularly provided to one or more adults with 
357.6   mental retardation or related conditions in a place other than 
357.7   the adult's own home or residence unless medically 
357.8   contraindicated. 
357.9      Day training and habilitation services reimbursable under 
357.10  this section do not include special education and related 
357.11  services as defined in the Education of the Handicapped Act, 
357.12  United States Code, title 20, chapter 33, section 1401, clauses 
357.13  (6) and (17), or vocational services funded under section 110 of 
357.14  the Rehabilitation Act of 1973, United States Code, title 29, 
357.15  section 720, as amended. 
357.16     Sec. 10.  Minnesota Statutes 2002, section 252.46, 
357.17  subdivision 1, is amended to read: 
357.18     Subdivision 1.  [RATES.] (a) Payment rates to vendors, 
357.19  except regional centers, for county-funded day training and 
357.20  habilitation services and transportation provided to persons 
357.21  receiving day training and habilitation services established by 
357.22  a county board are governed by subdivisions 2 to 19.  The 
357.23  commissioner shall approve the following three payment rates for 
357.24  services provided by a vendor: 
357.25     (1) a full-day service rate for persons who receive at 
357.26  least six service hours a day, including the time it takes to 
357.27  transport the person to and from the service site; 
357.28     (2) a partial-day service rate that must not exceed 75 
357.29  percent of the full-day service rate for persons who receive 
357.30  less than a full day of service; and 
357.31     (3) a transportation rate for providing, or arranging and 
357.32  paying for, transportation of a person to and from the person's 
357.33  residence to the service site.  
357.34     (b) The commissioner may also approve an hourly job-coach, 
357.35  follow-along rate for services provided by one employee at or en 
357.36  route to or from community locations to supervise, support, and 
358.1   assist one person receiving the vendor's services to learn 
358.2   job-related skills necessary to obtain or retain employment when 
358.3   and where no other persons receiving services are present and 
358.4   when all the following criteria are met: 
358.5      (1) the vendor requests and the county recommends the 
358.6   optional rate; 
358.7      (2) the service is prior authorized by the county on the 
358.8   Medicaid Management Information System for no more than 414 
358.9   hours in a 12-month period and the daily per person charge to 
358.10  medical assistance does not exceed the vendor's approved full 
358.11  day plus transportation rates; 
358.12     (3) separate full day, partial day, and transportation 
358.13  rates are not billed for the same person on the same day; 
358.14     (4) the approved hourly rate does not exceed the sum of the 
358.15  vendor's current average hourly direct service wage, including 
358.16  fringe benefits and taxes, plus a component equal to the 
358.17  vendor's average hourly nondirect service wage expenses; and 
358.18     (5) the actual revenue received for provision of hourly 
358.19  job-coach, follow-along services is subtracted from the vendor's 
358.20  total expenses for the same time period and those adjusted 
358.21  expenses are used for determining recommended full day and 
358.22  transportation payment rates under subdivision 5 in accordance 
358.23  with the limitations in subdivision 3. 
358.24     (b) Notwithstanding any law or rule to the contrary, the 
358.25  commissioner may authorize county participation in a voluntary 
358.26  individualized payment rate structure for day training and 
358.27  habilitation services to allow a county the flexibility to 
358.28  change, after consulting with providers, from a site-based 
358.29  payment rate structure to an individual payment rate structure 
358.30  for the providers of day training and habilitation services in 
358.31  the county.  The commissioner shall seek input from providers 
358.32  and consumers in establishing procedures for determining the 
358.33  structure of voluntary individualized payment rates to ensure 
358.34  that there is no additional cost to the state or counties and 
358.35  that the rate structure is cost-neutral to providers of day 
358.36  training and habilitation services, on July 1, 2004, or on day 
359.1   one of the individual rate structure, whichever is later. 
359.2      (c) Medical assistance rates for home and community-based 
359.3   service provided under section 256B.501, subdivision 4, by 
359.4   licensed vendors of day training and habilitation services must 
359.5   not be greater than the rates for the same services established 
359.6   by counties under sections 252.40 to 252.46.  For very dependent 
359.7   persons with special needs the commissioner may approve an 
359.8   exception to the approved payment rate under section 256B.501, 
359.9   subdivision 4 or 8. 
359.10     Sec. 11.  Minnesota Statutes 2002, section 256.476, 
359.11  subdivision 3, is amended to read: 
359.12     Subd. 3.  [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 
359.13  is eligible to apply for a consumer support grant if the person 
359.14  meets all of the following criteria: 
359.15     (1) the person is eligible for and has been approved to 
359.16  receive services under medical assistance as determined under 
359.17  sections 256B.055 and 256B.056 or the person has been approved 
359.18  to receive a grant under the developmental disability family 
359.19  support program under section 252.32; 
359.20     (2) the person is able to direct and purchase the person's 
359.21  own care and supports, or the person has a family member, legal 
359.22  representative, or other authorized representative who can 
359.23  purchase and arrange supports on the person's behalf; 
359.24     (3) the person has functional limitations, requires ongoing 
359.25  supports to live in the community, and is at risk of or would 
359.26  continue institutionalization without such supports; and 
359.27     (4) the person will live in a home.  For the purpose of 
359.28  this section, "home" means the person's own home or home of a 
359.29  person's family member.  These homes are natural home settings 
359.30  and are not licensed by the department of health or human 
359.31  services. 
359.32     (b) Persons may not concurrently receive a consumer support 
359.33  grant if they are: 
359.34     (1) receiving home and community-based services under 
359.35  United States Code, title 42, section 1396h(c); personal care 
359.36  attendant and home health aide services, or private duty nursing 
360.1   under section 256B.0625; a developmental disability family 
360.2   support grant; or alternative care services under section 
360.3   256B.0913; or 
360.4      (2) residing in an institutional or congregate care setting.
360.5      (c) A person or person's family receiving a consumer 
360.6   support grant shall not be charged a fee or premium by a local 
360.7   agency for participating in the program.  
360.8      (d) The commissioner may limit the participation of 
360.9   recipients of services from federal waiver programs in the 
360.10  consumer support grant program if the participation of these 
360.11  individuals will result in an increase in the cost to the 
360.12  state.  Individuals receiving home and community-based waivers 
360.13  under United States Code, title 42, section 1396h(c), are not 
360.14  eligible for the consumer support grant, except for individuals 
360.15  receiving consumer support grants before July 1, 2003, as long 
360.16  as other eligibility criteria are met. 
360.17     (e) The commissioner shall establish a budgeted 
360.18  appropriation each fiscal year for the consumer support grant 
360.19  program.  The number of individuals participating in the program 
360.20  will be adjusted so the total amount allocated to counties does 
360.21  not exceed the amount of the budgeted appropriation.  The 
360.22  budgeted appropriation will be adjusted annually to accommodate 
360.23  changes in demand for the consumer support grants. 
360.24     Sec. 12.  Minnesota Statutes 2002, section 256.476, 
360.25  subdivision 4, is amended to read: 
360.26     Subd. 4.  [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 
360.27  county board may choose to participate in the consumer support 
360.28  grant program.  If a county has not chosen to participate by 
360.29  July 1, 2002, the commissioner shall contract with another 
360.30  county or other entity to provide access to residents of the 
360.31  nonparticipating county who choose the consumer support grant 
360.32  option.  The commissioner shall notify the county board in a 
360.33  county that has declined to participate of the commissioner's 
360.34  intent to enter into a contract with another county or other 
360.35  entity at least 30 days in advance of entering into the 
360.36  contract.  The local agency shall establish written procedures 
361.1   and criteria to determine the amount and use of support grants.  
361.2   These procedures must include, at least, the availability of 
361.3   respite care, assistance with daily living, and adaptive aids.  
361.4   The local agency may establish monthly or annual maximum amounts 
361.5   for grants and procedures where exceptional resources may be 
361.6   required to meet the health and safety needs of the person on a 
361.7   time-limited basis, however, the total amount awarded to each 
361.8   individual may not exceed the limits established in subdivision 
361.9   11. 
361.10     (b) Support grants to a person or a person's family will be 
361.11  provided through a monthly subsidy payment and be in the form of 
361.12  cash, voucher, or direct county payment to vendor.  Support 
361.13  grant amounts must be determined by the local agency.  Each 
361.14  service and item purchased with a support grant must meet all of 
361.15  the following criteria:  
361.16     (1) it must be over and above the normal cost of caring for 
361.17  the person if the person did not have functional limitations; 
361.18     (2) it must be directly attributable to the person's 
361.19  functional limitations; 
361.20     (3) it must enable the person or the person's family to 
361.21  delay or prevent out-of-home placement of the person; and 
361.22     (4) it must be consistent with the needs identified in the 
361.23  service plan agreement, when applicable. 
361.24     (c) Items and services purchased with support grants must 
361.25  be those for which there are no other public or private funds 
361.26  available to the person or the person's family.  Fees assessed 
361.27  to the person or the person's family for health and human 
361.28  services are not reimbursable through the grant. 
361.29     (d) In approving or denying applications, the local agency 
361.30  shall consider the following factors:  
361.31     (1) the extent and areas of the person's functional 
361.32  limitations; 
361.33     (2) the degree of need in the home environment for 
361.34  additional support; and 
361.35     (3) the potential effectiveness of the grant to maintain 
361.36  and support the person in the family environment or the person's 
362.1   own home. 
362.2      (e) At the time of application to the program or screening 
362.3   for other services, the person or the person's family shall be 
362.4   provided sufficient information to ensure an informed choice of 
362.5   alternatives by the person, the person's legal representative, 
362.6   if any, or the person's family.  The application shall be made 
362.7   to the local agency and shall specify the needs of the person 
362.8   and family, the form and amount of grant requested, the items 
362.9   and services to be reimbursed, and evidence of eligibility for 
362.10  medical assistance. 
362.11     (f) Upon approval of an application by the local agency and 
362.12  agreement on a support plan for the person or person's family, 
362.13  the local agency shall make grants to the person or the person's 
362.14  family.  The grant shall be in an amount for the direct costs of 
362.15  the services or supports outlined in the service agreement.  
362.16     (g) Reimbursable costs shall not include costs for 
362.17  resources already available, such as special education classes, 
362.18  day training and habilitation, case management, other services 
362.19  to which the person is entitled, medical costs covered by 
362.20  insurance or other health programs, or other resources usually 
362.21  available at no cost to the person or the person's family. 
362.22     (h) The state of Minnesota, the county boards participating 
362.23  in the consumer support grant program, or the agencies acting on 
362.24  behalf of the county boards in the implementation and 
362.25  administration of the consumer support grant program shall not 
362.26  be liable for damages, injuries, or liabilities sustained 
362.27  through the purchase of support by the individual, the 
362.28  individual's family, or the authorized representative under this 
362.29  section with funds received through the consumer support grant 
362.30  program.  Liabilities include but are not limited to:  workers' 
362.31  compensation liability, the Federal Insurance Contributions Act 
362.32  (FICA), or the Federal Unemployment Tax Act (FUTA).  For 
362.33  purposes of this section, participating county boards and 
362.34  agencies acting on behalf of county boards are exempt from the 
362.35  provisions of section 268.04. 
362.36     Sec. 13.  Minnesota Statutes 2002, section 256.476, 
363.1   subdivision 5, is amended to read: 
363.2      Subd. 5.  [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 
363.3   For the purpose of transferring persons to the consumer support 
363.4   grant program from specific programs or services, such as the 
363.5   developmental disability family support program and personal 
363.6   care assistant services, home health aide services, or private 
363.7   duty nursing services, the amount of funds transferred by the 
363.8   commissioner between the developmental disability family support 
363.9   program account, the medical assistance account, or the consumer 
363.10  support grant account shall be based on each county's 
363.11  participation in transferring persons to the consumer support 
363.12  grant program from those programs and services. 
363.13     (b) At the beginning of each fiscal year, county 
363.14  allocations for consumer support grants shall be based on: 
363.15     (1) the number of persons to whom the county board expects 
363.16  to provide consumer supports grants; 
363.17     (2) their eligibility for current program and services; 
363.18     (3) the amount of nonfederal dollars allowed under 
363.19  subdivision 11; and 
363.20     (4) projected dates when persons will start receiving 
363.21  grants.  County allocations shall be adjusted periodically by 
363.22  the commissioner based on the actual transfer of persons or 
363.23  service openings, and the nonfederal dollars associated with 
363.24  those persons or service openings, to the consumer support grant 
363.25  program. 
363.26     (c) The amount of funds transferred by the commissioner 
363.27  from the medical assistance account for an individual may be 
363.28  changed if it is determined by the county or its agent that the 
363.29  individual's need for support has changed. 
363.30     (d) The authority to utilize funds transferred to the 
363.31  consumer support grant account for the purposes of implementing 
363.32  and administering the consumer support grant program will not be 
363.33  limited or constrained by the spending authority provided to the 
363.34  program of origination. 
363.35     (e) The commissioner may use up to five percent of each 
363.36  county's allocation, as adjusted, for payments for 
364.1   administrative expenses, to be paid as a proportionate addition 
364.2   to reported direct service expenditures. 
364.3      (f) The county allocation for each individual or 
364.4   individual's family cannot exceed the amount allowed under 
364.5   subdivision 11. 
364.6      (g) The commissioner may recover, suspend, or withhold 
364.7   payments if the county board, local agency, or grantee does not 
364.8   comply with the requirements of this section. 
364.9      (h) Grant funds unexpended by consumers shall return to the 
364.10  state once a year.  The annual return of unexpended grant funds 
364.11  shall occur in the quarter following the end of the state fiscal 
364.12  year. 
364.13     Sec. 14.  Minnesota Statutes 2002, section 256.482, 
364.14  subdivision 8, is amended to read: 
364.15     Subd. 8.  [SUNSET.] Notwithstanding section 15.059, 
364.16  subdivision 5, the council on disability shall not sunset until 
364.17  June 30, 2003 2007. 
364.18     <b>[EFFECTIVE DATE.]</b> This section is effective May 30, 2003. 
364.19     Sec. 15.  Minnesota Statutes 2002, section 256B.0621, 
364.20  subdivision 4, is amended to read: 
364.21     Subd. 4.  [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 
364.22  QUALIFICATIONS.] The following qualifications and certification 
364.23  standards must be met by providers of relocation targeted case 
364.24  management: 
364.25     (a) The commissioner must certify each provider of 
364.26  relocation targeted case management before enrollment.  The 
364.27  certification process shall examine the provider's ability to 
364.28  meet the requirements in this subdivision and other federal and 
364.29  state requirements of this service.  A certified relocation 
364.30  targeted case management provider may subcontract with another 
364.31  provider to deliver relocation targeted case management 
364.32  services.  Subcontracted providers must demonstrate the ability 
364.33  to provide the services outlined in subdivision 6. 
364.34     (b) (a) A relocation targeted case management provider is 
364.35  an enrolled medical assistance provider who is determined by the 
364.36  commissioner to have all of the following characteristics: 
365.1      (1) the legal authority to provide public welfare under 
365.2   sections 393.01, subdivision 7; and 393.07; or a federally 
365.3   recognized Indian tribe; 
365.4      (2) the demonstrated capacity and experience to provide the 
365.5   components of case management to coordinate and link community 
365.6   resources needed by the eligible population; 
365.7      (3) the administrative capacity and experience to serve the 
365.8   target population for whom it will provide services and ensure 
365.9   quality of services under state and federal requirements; 
365.10     (4) the legal authority to provide complete investigative 
365.11  and protective services under section 626.556, subdivision 10; 
365.12  and child welfare and foster care services under section 393.07, 
365.13  subdivisions 1 and 2; or a federally recognized Indian tribe; 
365.14     (5) a financial management system that provides accurate 
365.15  documentation of services and costs under state and federal 
365.16  requirements; and 
365.17     (6) the capacity to document and maintain individual case 
365.18  records under state and federal requirements. 
365.19     (b) A provider of targeted case management under section 
365.20  256B.0625, subdivision 20, may be deemed a certified provider of 
365.21  relocation targeted case management. 
365.22     (c) A relocation targeted case management provider may 
365.23  subcontract with another provider to deliver relocation targeted 
365.24  case management services.  Subcontracted providers must 
365.25  demonstrate the ability to provide the services outlined in 
365.26  subdivision 6, and have a procedure in place that notifies the 
365.27  recipient and the recipient's legal representative of any 
365.28  conflict of interest if the contracted targeted case management 
365.29  provider also provides, or will provide, the recipient's 
365.30  services and supports.  Contracted providers must provide 
365.31  information on all conflicts of interest and obtain the 
365.32  recipient's informed consent or provide the recipient with 
365.33  alternatives.  
365.34     Sec. 16.  [256B.0622] [INTENSIVE REHABILITATIVE MENTAL 
365.35  HEALTH SERVICES.] 
365.36     Subdivision 1.  [SCOPE.] Subject to federal approval, 
366.1   medical assistance covers medically necessary, intensive 
366.2   nonresidential and residential rehabilitative mental health 
366.3   services as defined in subdivision 2, for recipients as defined 
366.4   in subdivision 3, when the services are provided by an entity 
366.5   meeting the standards in this section. 
366.6      Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
366.7   following terms have the meanings given them.  
366.8      (a) "Intensive nonresidential rehabilitative mental health 
366.9   services" means adult rehabilitative mental health services as 
366.10  defined in section 256B.0623, subdivision 2, paragraph (a), 
366.11  except that these services are provided by a multidisciplinary 
366.12  staff using a total team approach consistent with assertive 
366.13  community treatment, the Fairweather Lodge treatment model, and 
366.14  other evidence-based practices, and directed to recipients with 
366.15  a serious mental illness who require intensive services. 
366.16     (b) "Intensive residential rehabilitative mental health 
366.17  services" means short-term, time-limited services provided in a 
366.18  residential setting to recipients who are in need of more 
366.19  restrictive settings and are at risk of significant functional 
366.20  deterioration if they do not receive these services.  Services 
366.21  are designed to develop and enhance psychiatric stability, 
366.22  personal and emotional adjustment, self-sufficiency, and skills 
366.23  to live in a more independent setting.  Services must be 
366.24  directed toward a targeted discharge date with specified client 
366.25  outcomes and must be consistent with evidence-based practices. 
366.26     (c) "Evidence-based practices" are nationally recognized 
366.27  mental health services that are proven by substantial research 
366.28  to be effective in helping individuals with serious mental 
366.29  illness obtain specific treatment goals. 
366.30     (d) "Overnight staff" means a member of the intensive 
366.31  residential rehabilitative mental health treatment team who is 
366.32  responsible during hours when recipients are typically asleep. 
366.33     (e) "Treatment team" means all staff who provide services 
366.34  under this section to recipients.  At a minimum, this includes 
366.35  the clinical supervisor, mental health professionals, mental 
366.36  health practitioners, and mental health rehabilitation workers. 
367.1      Subd. 3.  [ELIGIBILITY.] An eligible recipient is an 
367.2   individual who: 
367.3      (1) is age 18 or older; 
367.4      (2) is eligible for medical assistance; 
367.5      (3) is diagnosed with a mental illness; 
367.6      (4) because of a mental illness, has substantial disability 
367.7   and functional impairment in three or more of the areas listed 
367.8   in section 245.462, subdivision 11a, so that self-sufficiency is 
367.9   markedly reduced; 
367.10     (5) has one or more of the following:  a history of two or 
367.11  more inpatient hospitalizations in the past year, significant 
367.12  independent living instability, homelessness, or very frequent 
367.13  use of mental health and related services yielding poor 
367.14  outcomes; and 
367.15     (6) in the written opinion of a licensed mental health 
367.16  professional, has the need for mental health services that 
367.17  cannot be met with other available community-based services, or 
367.18  is likely to experience a mental health crisis or require a more 
367.19  restrictive setting if intensive rehabilitative mental health 
367.20  services are not provided. 
367.21     Subd. 4.  [PROVIDER CERTIFICATION AND CONTRACT 
367.22  REQUIREMENTS.] (a) The intensive nonresidential rehabilitative 
367.23  mental health services provider must: 
367.24     (1) have a contract with the host county to provide 
367.25  intensive adult rehabilitative mental health services; and 
367.26     (2) be certified by the commissioner as being in compliance 
367.27  with this section and section 256B.0623. 
367.28     (b) The intensive residential rehabilitative mental health 
367.29  services provider must: 
367.30     (1) be licensed under Minnesota Rules, parts 9520.0500 to 
367.31  9520.0670; 
367.32     (2) not exceed 16 beds per site; 
367.33     (3) comply with the additional standards in this section; 
367.34  and 
367.35     (4) have a contract with the host county to provide these 
367.36  services. 
368.1      (c) The commissioner shall develop procedures for counties 
368.2   and providers to submit contracts and other documentation as 
368.3   needed to allow the commissioner to determine whether the 
368.4   standards in this section are met. 
368.5      Subd. 5.  [STANDARDS APPLICABLE TO BOTH NONRESIDENTIAL AND 
368.6   RESIDENTIAL PROVIDERS.] (a) Services must be provided by 
368.7   qualified staff as defined in section 256B.0623, subdivision 5, 
368.8   who are trained and supervised according to section 256B.0623, 
368.9   subdivision 6, except that mental health rehabilitation workers 
368.10  acting as overnight staff are not required to comply with 
368.11  section 256B.0623, subdivision 5, clause (3)(iv). 
368.12     (b) The clinical supervisor must be an active member of the 
368.13  treatment team.  The treatment team must meet with the clinical 
368.14  supervisor at least weekly to discuss recipients' progress and 
368.15  make rapid adjustments to meet recipients' needs.  The team 
368.16  meeting shall include recipient-specific case reviews and 
368.17  general treatment discussions among team members.  
368.18  Recipient-specific case reviews and planning must be documented 
368.19  in the individual recipient's treatment record. 
368.20     (c) Treatment staff must have prompt access in person or by 
368.21  telephone to a mental health practitioner or mental health 
368.22  professional.  The provider must have the capacity to promptly 
368.23  and appropriately respond to emergent needs and make any 
368.24  necessary staffing adjustments to assure the health and safety 
368.25  of recipients. 
368.26     (d) The initial functional assessment must be completed 
368.27  within ten days of intake and updated at least every three 
368.28  months or prior to discharge from the service, whichever comes 
368.29  first. 
368.30     (e) The initial individual treatment plan must be completed 
368.31  within ten days of intake and reviewed and updated at least 
368.32  monthly with the recipient.  
368.33     Subd. 6.  [ADDITIONAL STANDARDS APPLICABLE ONLY TO 
368.34  INTENSIVE RESIDENTIAL REHABILITATIVE MENTAL HEALTH 
368.35  SERVICES.] (a) The provider of intensive residential services 
368.36  must have sufficient staff to provide 24 hour per day coverage 
369.1   to deliver the rehabilitative services described in the 
369.2   treatment plan and to safely supervise and direct the activities 
369.3   of recipients given the recipient's level of behavioral and 
369.4   psychiatric stability, cultural needs, and vulnerability.  The 
369.5   provider must have the capacity within the facility to provide 
369.6   integrated services for chemical dependency, illness management 
369.7   services, and family education when appropriate. 
369.8      (b) At a minimum: 
369.9      (1) staff must be available and provide direction and 
369.10  supervision whenever recipients are present in the facility; 
369.11     (2) staff must remain awake during all work hours; 
369.12     (3) there must be a staffing ratio of at least one to nine 
369.13  recipients for each day and evening shift.  If more than nine 
369.14  recipients are present at the residential site, there must be a 
369.15  minimum of two staff during day and evening shifts, one of whom 
369.16  must be a mental health practitioner or mental health 
369.17  professional; 
369.18     (4) if services are provided to recipients who need the 
369.19  services of a medical professional, the provider shall assure 
369.20  that these services are provided either by the provider's own 
369.21  medical staff or through referral to a medical professional; and 
369.22     (5) the provider must employ or contract with a licensed 
369.23  registered nurse to ensure the effectiveness and safety of 
369.24  medication administration in the facility. 
369.25     Subd. 7.  [ADDITIONAL STANDARDS FOR NONRESIDENTIAL 
369.26  SERVICES.] The standards in this subdivision apply to intensive 
369.27  nonresidential rehabilitative mental health services. 
369.28     (1) The treatment team must use team treatment, not an 
369.29  individual treatment model. 
369.30     (2) The clinical supervisor must function as a practicing 
369.31  clinician at least on a part-time basis. 
369.32     (3) The staffing ratio must not exceed ten recipients to 
369.33  one full-time equivalent treatment team position. 
369.34     (4) Services must be available at times that meet client 
369.35  needs.  
369.36     (5) The treatment team must actively and assertively engage 
370.1   and reach out to the recipient's family members and significant 
370.2   others, after obtaining the recipient's permission.  
370.3      (6) The treatment team must establish ongoing communication 
370.4   and collaboration between the team, family, and significant 
370.5   others and educate the family and significant others about 
370.6   mental illness, symptom management, and the family's role in 
370.7   treatment. 
370.8      (7) The treatment team must provide interventions to 
370.9   promote positive interpersonal relationships. 
370.10     Subd. 8.  [MEDICAL ASSISTANCE PAYMENT FOR INTENSIVE 
370.11  REHABILITATIVE MENTAL HEALTH SERVICES.] (a) Payment for 
370.12  residential and nonresidential services in this section shall be 
370.13  based on one daily rate per provider inclusive of the following 
370.14  services received by an eligible recipient in a given calendar 
370.15  day:  all rehabilitative services under this section and crisis 
370.16  stabilization services under section 256B.0624. 
370.17     (b) Except as indicated in paragraph (c), payment will not 
370.18  be made to more than one entity for each recipient for services 
370.19  provided under this section on a given day.  If services under 
370.20  this section are provided by a team that includes staff from 
370.21  more than one entity, the team must determine how to distribute 
370.22  the payment among the members. 
370.23     (c) The host county shall recommend to the commissioner one 
370.24  rate for each entity that will bill medical assistance for 
370.25  residential services under this section and two rates for each 
370.26  nonresidential provider.  The first nonresidential rate is for 
370.27  recipients who are not receiving residential services.  The 
370.28  second nonresidential rate is for recipients who are temporarily 
370.29  receiving residential services and need continued contact with 
370.30  the nonresidential team to assure timely discharge from 
370.31  residential services.  In developing these rates, the host 
370.32  county shall consider and document: 
370.33     (1) the cost for similar services in the local trade area; 
370.34     (2) actual costs incurred by entities providing the 
370.35  services; 
370.36     (3) the intensity and frequency of services to be provided 
371.1   to each recipient; 
371.2      (4) the degree to which recipients will receive services 
371.3   other than services under this section; 
371.4      (5) the costs of other services, such as case management, 
371.5   that will be separately reimbursed; and 
371.6      (6) input from the local planning process authorized by the 
371.7   adult mental health initiative under section 245.4661, regarding 
371.8   recipients' service needs. 
371.9      (d) The rate for intensive rehabilitative mental health 
371.10  services must exclude room and board, as defined in section 
371.11  256I.03, subdivision 6, and services not covered under this 
371.12  section, such as case management, partial hospitalization, home 
371.13  care, and inpatient services.  Physician services that are not 
371.14  separately billed may be included in the rate to the extent that 
371.15  a psychiatrist is a member of the treatment team.  The county's 
371.16  recommendation shall specify the period for which the rate will 
371.17  be applicable, not to exceed two years. 
371.18     (e) When services under this section are provided by an 
371.19  assertive community team, case management functions must be an 
371.20  integral part of the team.  The county must allocate costs which 
371.21  are reimbursable under this section versus costs which are 
371.22  reimbursable through case management or other reimbursement, so 
371.23  that payment is not duplicated. 
371.24     (f) The rate for a provider must not exceed the rate 
371.25  charged by that provider for the same service to other payors. 
371.26     (g) The commissioner shall approve or reject the county's 
371.27  rate recommendation, based on the commissioner's own analysis of 
371.28  the criteria in paragraph (c). 
371.29     Subd. 9.  [PROVIDER ENROLLMENT; RATE SETTING FOR 
371.30  COUNTY-OPERATED ENTITIES.] Counties that employ their own staff 
371.31  to provide services under this section shall apply directly to 
371.32  the commissioner for enrollment and rate setting.  In this case, 
371.33  a county contract is not required and the commissioner shall 
371.34  perform the program review and rate setting duties which would 
371.35  otherwise be required of counties under this section. 
371.36     Subd. 10.  [PROVIDER ENROLLMENT; RATE SETTING FOR 
372.1   SPECIALIZED PROGRAM.] A provider proposing to serve a 
372.2   subpopulation of eligible recipients may bypass the county 
372.3   approval procedures in this section and receive approval for 
372.4   provider enrollment and rate setting directly from the 
372.5   commissioner under the following circumstances: 
372.6      (1) the provider demonstrates that the subpopulation to be 
372.7   served requires a specialized program which is not available 
372.8   from county-approved entities; and 
372.9      (2) the subpopulation to be served is of such a low 
372.10  incidence that it is not feasible to develop a program serving a 
372.11  single county or regional group of counties. 
372.12     For providers meeting the criteria in clauses (1) and (2), 
372.13  the commissioner shall perform the program review and rate 
372.14  setting duties which would otherwise be required of counties 
372.15  under this section. 
372.16     Sec. 17.  Minnesota Statutes 2002, section 256B.0623, 
372.17  subdivision 2, is amended to read: 
372.18     Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
372.19  following terms have the meanings given them. 
372.20     (a) "Adult rehabilitative mental health services" means 
372.21  mental health services which are rehabilitative and enable the 
372.22  recipient to develop and enhance psychiatric stability, social 
372.23  competencies, personal and emotional adjustment, and independent 
372.24  living and community skills, when these abilities are impaired 
372.25  by the symptoms of mental illness.  Adult rehabilitative mental 
372.26  health services are also appropriate when provided to enable a 
372.27  recipient to retain stability and functioning, if the recipient 
372.28  would be at risk of significant functional decompensation or 
372.29  more restrictive service settings without these services. 
372.30     (1) Adult rehabilitative mental health services instruct, 
372.31  assist, and support the recipient in areas such as:  
372.32  interpersonal communication skills, community resource 
372.33  utilization and integration skills, crisis assistance, relapse 
372.34  prevention skills, health care directives, budgeting and 
372.35  shopping skills, healthy lifestyle skills and practices, cooking 
372.36  and nutrition skills, transportation skills, medication 
373.1   education and monitoring, mental illness symptom management 
373.2   skills, household management skills, employment-related skills, 
373.3   and transition to community living services. 
373.4      (2) These services shall be provided to the recipient on a 
373.5   one-to-one basis in the recipient's home or another community 
373.6   setting or in groups. 
373.7      (b) "Medication education services" means services provided 
373.8   individually or in groups which focus on educating the recipient 
373.9   about mental illness and symptoms; the role and effects of 
373.10  medications in treating symptoms of mental illness; and the side 
373.11  effects of medications.  Medication education is coordinated 
373.12  with medication management services and does not duplicate it.  
373.13  Medication education services are provided by physicians, 
373.14  pharmacists, physician's assistants, or registered nurses. 
373.15     (c) "Transition to community living services" means 
373.16  services which maintain continuity of contact between the 
373.17  rehabilitation services provider and the recipient and which 
373.18  facilitate discharge from a hospital, residential treatment 
373.19  program under Minnesota Rules, chapter 9505, board and lodging 
373.20  facility, or nursing home.  Transition to community living 
373.21  services are not intended to provide other areas of adult 
373.22  rehabilitative mental health services.  
373.23     Sec. 18.  Minnesota Statutes 2002, section 256B.0623, 
373.24  subdivision 4, is amended to read: 
373.25     Subd. 4.  [PROVIDER ENTITY STANDARDS.] (a) The provider 
373.26  entity must be: 
373.27     (1) a county operated entity certified by the state; or 
373.28     (2) a noncounty entity certified by the entity's host 
373.29  county certified by the state following the certification 
373.30  process and procedures developed by the commissioner. 
373.31     (b) The certification process is a determination as to 
373.32  whether the entity meets the standards in this subdivision.  The 
373.33  certification must specify which adult rehabilitative mental 
373.34  health services the entity is qualified to provide. 
373.35     (c) If an entity seeks to provide services outside its host 
373.36  county, it A noncounty provider entity must obtain additional 
374.1   certification from each county in which it will provide 
374.2   services.  The additional certification must be based on the 
374.3   adequacy of the entity's knowledge of that county's local health 
374.4   and human service system, and the ability of the entity to 
374.5   coordinate its services with the other services available in 
374.6   that county.  A county-operated entity must obtain this 
374.7   additional certification from any other county in which it will 
374.8   provide services. 
374.9      (d) Recertification must occur at least every two three 
374.10  years. 
374.11     (e) The commissioner may intervene at any time and 
374.12  decertify providers with cause.  The decertification is subject 
374.13  to appeal to the state.  A county board may recommend that the 
374.14  state decertify a provider for cause. 
374.15     (f) The adult rehabilitative mental health services 
374.16  provider entity must meet the following standards: 
374.17     (1) have capacity to recruit, hire, manage, and train 
374.18  mental health professionals, mental health practitioners, and 
374.19  mental health rehabilitation workers; 
374.20     (2) have adequate administrative ability to ensure 
374.21  availability of services; 
374.22     (3) ensure adequate preservice and inservice and ongoing 
374.23  training for staff; 
374.24     (4) ensure that mental health professionals, mental health 
374.25  practitioners, and mental health rehabilitation workers are 
374.26  skilled in the delivery of the specific adult rehabilitative 
374.27  mental health services provided to the individual eligible 
374.28  recipient; 
374.29     (5) ensure that staff is capable of implementing culturally 
374.30  specific services that are culturally competent and appropriate 
374.31  as determined by the recipient's culture, beliefs, values, and 
374.32  language as identified in the individual treatment plan; 
374.33     (6) ensure enough flexibility in service delivery to 
374.34  respond to the changing and intermittent care needs of a 
374.35  recipient as identified by the recipient and the individual 
374.36  treatment plan; 
375.1      (7) ensure that the mental health professional or mental 
375.2   health practitioner, who is under the clinical supervision of a 
375.3   mental health professional, involved in a recipient's services 
375.4   participates in the development of the individual treatment 
375.5   plan; 
375.6      (8) assist the recipient in arranging needed crisis 
375.7   assessment, intervention, and stabilization services; 
375.8      (9) ensure that services are coordinated with other 
375.9   recipient mental health services providers and the county mental 
375.10  health authority and the federally recognized American Indian 
375.11  authority and necessary others after obtaining the consent of 
375.12  the recipient.  Services must also be coordinated with the 
375.13  recipient's case manager or care coordinator if the recipient is 
375.14  receiving case management or care coordination services; 
375.15     (10) develop and maintain recipient files, individual 
375.16  treatment plans, and contact charting; 
375.17     (11) develop and maintain staff training and personnel 
375.18  files; 
375.19     (12) submit information as required by the state; 
375.20     (13) establish and maintain a quality assurance plan to 
375.21  evaluate the outcome of services provided; 
375.22     (14) keep all necessary records required by law; 
375.23     (15) deliver services as required by section 245.461; 
375.24     (16) comply with all applicable laws; 
375.25     (17) be an enrolled Medicaid provider; 
375.26     (18) maintain a quality assurance plan to determine 
375.27  specific service outcomes and the recipient's satisfaction with 
375.28  services; and 
375.29     (19) develop and maintain written policies and procedures 
375.30  regarding service provision and administration of the provider 
375.31  entity. 
375.32     (g) The commissioner shall develop statewide procedures for 
375.33  provider certification, including timelines for counties to 
375.34  certify qualified providers. 
375.35     Sec. 19.  Minnesota Statutes 2002, section 256B.0623, 
375.36  subdivision 5, is amended to read: 
376.1      Subd. 5.  [QUALIFICATIONS OF PROVIDER STAFF.] Adult 
376.2   rehabilitative mental health services must be provided by 
376.3   qualified individual provider staff of a certified provider 
376.4   entity.  Individual provider staff must be qualified under one 
376.5   of the following criteria: 
376.6      (1) a mental health professional as defined in section 
376.7   245.462, subdivision 18, clauses (1) to (5); 
376.8      (2) a mental health practitioner as defined in section 
376.9   245.462, subdivision 17.  The mental health practitioner must 
376.10  work under the clinical supervision of a mental health 
376.11  professional; or 
376.12     (3) a mental health rehabilitation worker.  A mental health 
376.13  rehabilitation worker means a staff person working under the 
376.14  direction of a mental health practitioner or mental health 
376.15  professional and under the clinical supervision of a mental 
376.16  health professional in the implementation of rehabilitative 
376.17  mental health services as identified in the recipient's 
376.18  individual treatment plan who: 
376.19     (i) is at least 21 years of age; 
376.20     (ii) has a high school diploma or equivalent; 
376.21     (iii) has successfully completed 30 hours of training 
376.22  during the past two years in all of the following areas:  
376.23  recipient rights, recipient-centered individual treatment 
376.24  planning, behavioral terminology, mental illness, co-occurring 
376.25  mental illness and substance abuse, psychotropic medications and 
376.26  side effects, functional assessment, local community resources, 
376.27  adult vulnerability, recipient confidentiality; and 
376.28     (iv) meets the qualifications in subitem (A) or (B): 
376.29     (A) has an associate of arts degree in one of the 
376.30  behavioral sciences or human services, or is a registered nurse 
376.31  without a bachelor's degree, or who within the previous ten 
376.32  years has:  
376.33     (1) three years of personal life experience with serious 
376.34  and persistent mental illness; 
376.35     (2) three years of life experience as a primary caregiver 
376.36  to an adult with a serious mental illness or traumatic brain 
377.1   injury; or 
377.2      (3) 4,000 hours of supervised paid work experience in the 
377.3   delivery of mental health services to adults with a serious 
377.4   mental illness or traumatic brain injury; or 
377.5      (B)(1) is fluent in the non-English language or competent 
377.6   in the culture of the ethnic group to which at least 50 20 
377.7   percent of the mental health rehabilitation worker's clients 
377.8   belong; 
377.9      (2) receives during the first 2,000 hours of work, monthly 
377.10  documented individual clinical supervision by a mental health 
377.11  professional; 
377.12     (3) has 18 hours of documented field supervision by a 
377.13  mental health professional or practitioner during the first 160 
377.14  hours of contact work with recipients, and at least six hours of 
377.15  field supervision quarterly during the following year; 
377.16     (4) has review and cosignature of charting of recipient 
377.17  contacts during field supervision by a mental health 
377.18  professional or practitioner; and 
377.19     (5) has 40 hours of additional continuing education on 
377.20  mental health topics during the first year of employment. 
377.21     Sec. 20.  Minnesota Statutes 2002, section 256B.0623, 
377.22  subdivision 6, is amended to read: 
377.23     Subd. 6.  [REQUIRED TRAINING AND SUPERVISION.] (a) Mental 
377.24  health rehabilitation workers must receive ongoing continuing 
377.25  education training of at least 30 hours every two years in areas 
377.26  of mental illness and mental health services and other areas 
377.27  specific to the population being served.  Mental health 
377.28  rehabilitation workers must also be subject to the ongoing 
377.29  direction and clinical supervision standards in paragraphs (c) 
377.30  and (d). 
377.31     (b) Mental health practitioners must receive ongoing 
377.32  continuing education training as required by their professional 
377.33  license; or if the practitioner is not licensed, the 
377.34  practitioner must receive ongoing continuing education training 
377.35  of at least 30 hours every two years in areas of mental illness 
377.36  and mental health services.  Mental health practitioners must 
378.1   meet the ongoing clinical supervision standards in paragraph (c).
378.2      (c) Clinical supervision may be provided by a full or 
378.3   part-time qualified professional employed by or under contract 
378.4   with the provider entity.  Clinical supervision may be provided 
378.5   by interactive videoconferencing according to procedures 
378.6   developed by the commissioner.  A mental health professional 
378.7   providing clinical supervision of staff delivering adult 
378.8   rehabilitative mental health services must provide the following 
378.9   guidance: 
378.10     (1) review the information in the recipient's file; 
378.11     (2) review and approve initial and updates of individual 
378.12  treatment plans; 
378.13     (3) meet with mental health rehabilitation workers and 
378.14  practitioners, individually or in small groups, at least monthly 
378.15  to discuss treatment topics of interest to the workers and 
378.16  practitioners; 
378.17     (4) meet with mental health rehabilitation workers and 
378.18  practitioners, individually or in small groups, at least monthly 
378.19  to discuss treatment plans of recipients, and approve by 
378.20  signature and document in the recipient's file any resulting 
378.21  plan updates; 
378.22     (5) meet at least twice a month monthly with the directing 
378.23  mental health practitioner, if there is one, to review needs of 
378.24  the adult rehabilitative mental health services program, review 
378.25  staff on-site observations and evaluate mental health 
378.26  rehabilitation workers, plan staff training, review program 
378.27  evaluation and development, and consult with the directing 
378.28  practitioner; and 
378.29     (6) be available for urgent consultation as the individual 
378.30  recipient needs or the situation necessitates; and 
378.31     (7) provide clinical supervision by full- or part-time 
378.32  mental health professionals employed by or under contract with 
378.33  the provider entity. 
378.34     (d) An adult rehabilitative mental health services provider 
378.35  entity must have a treatment director who is a mental health 
378.36  practitioner or mental health professional.  The treatment 
379.1   director must ensure the following: 
379.2      (1) while delivering direct services to recipients, a newly 
379.3   hired mental health rehabilitation worker must be directly 
379.4   observed delivering services to recipients by the a mental 
379.5   health practitioner or mental health professional for at least 
379.6   six hours per 40 hours worked during the first 160 hours that 
379.7   the mental health rehabilitation worker works; 
379.8      (2) the mental health rehabilitation worker must receive 
379.9   ongoing on-site direct service observation by a mental health 
379.10  professional or mental health practitioner for at least six 
379.11  hours for every six months of employment; 
379.12     (3) progress notes are reviewed from on-site service 
379.13  observation prepared by the mental health rehabilitation worker 
379.14  and mental health practitioner for accuracy and consistency with 
379.15  actual recipient contact and the individual treatment plan and 
379.16  goals; 
379.17     (4) immediate availability by phone or in person for 
379.18  consultation by a mental health professional or a mental health 
379.19  practitioner to the mental health rehabilitation services worker 
379.20  during service provision; 
379.21     (5) oversee the identification of changes in individual 
379.22  recipient treatment strategies, revise the plan, and communicate 
379.23  treatment instructions and methodologies as appropriate to 
379.24  ensure that treatment is implemented correctly; 
379.25     (6) model service practices which:  respect the recipient, 
379.26  include the recipient in planning and implementation of the 
379.27  individual treatment plan, recognize the recipient's strengths, 
379.28  collaborate and coordinate with other involved parties and 
379.29  providers; 
379.30     (7) ensure that mental health practitioners and mental 
379.31  health rehabilitation workers are able to effectively 
379.32  communicate with the recipients, significant others, and 
379.33  providers; and 
379.34     (8) oversee the record of the results of on-site 
379.35  observation and charting evaluation and corrective actions taken 
379.36  to modify the work of the mental health practitioners and mental 
380.1   health rehabilitation workers. 
380.2      (e) A mental health practitioner who is providing treatment 
380.3   direction for a provider entity must receive supervision at 
380.4   least monthly from a mental health professional to: 
380.5      (1) identify and plan for general needs of the recipient 
380.6   population served; 
380.7      (2) identify and plan to address provider entity program 
380.8   needs and effectiveness; 
380.9      (3) identify and plan provider entity staff training and 
380.10  personnel needs and issues; and 
380.11     (4) plan, implement, and evaluate provider entity quality 
380.12  improvement programs.  
380.13     Sec. 21.  Minnesota Statutes 2002, section 256B.0623, 
380.14  subdivision 8, is amended to read: 
380.15     Subd. 8.  [DIAGNOSTIC ASSESSMENT.] Providers of adult 
380.16  rehabilitative mental health services must complete a diagnostic 
380.17  assessment as defined in section 245.462, subdivision 9, within 
380.18  five days after the recipient's second visit or within 30 days 
380.19  after intake, whichever occurs first.  In cases where a 
380.20  diagnostic assessment is available that reflects the recipient's 
380.21  current status, and has been completed within 180 days preceding 
380.22  admission, an update must be completed.  An update shall include 
380.23  a written summary by a mental health professional of the 
380.24  recipient's current mental health status and service needs.  If 
380.25  the recipient's mental health status has changed significantly 
380.26  since the adult's most recent diagnostic assessment, a new 
380.27  diagnostic assessment is required.  For initial implementation 
380.28  of adult rehabilitative mental health services, until June 30, 
380.29  2005, a diagnostic assessment that reflects the recipient's 
380.30  current status and has been completed within the past three 
380.31  years preceding admission is acceptable. 
380.32     Sec. 22.  Minnesota Statutes 2002, section 256B.0625, 
380.33  subdivision 19c, is amended to read: 
380.34     Subd. 19c.  [PERSONAL CARE.] Medical assistance covers 
380.35  personal care assistant services provided by an individual who 
380.36  is qualified to provide the services according to subdivision 
381.1   19a and section 256B.0627, where the services are prescribed by 
381.2   a physician in accordance with a plan of treatment and are 
381.3   supervised by the recipient or a qualified professional.  
381.4   "Qualified professional" means a mental health professional as 
381.5   defined in section 245.462, subdivision 18, or 245.4871, 
381.6   subdivision 27; or a registered nurse as defined in sections 
381.7   148.171 to 148.285, or a licensed social worker as defined in 
381.8   section 148B.21.  As part of the assessment, the county public 
381.9   health nurse will assist the recipient or responsible party to 
381.10  identify the most appropriate person to provide supervision of 
381.11  the personal care assistant.  The qualified professional shall 
381.12  perform the duties described in Minnesota Rules, part 9505.0335, 
381.13  subpart 4.  
381.14     Sec. 23.  Minnesota Statutes 2002, section 256B.0627, 
381.15  subdivision 1, is amended to read: 
381.16     Subdivision 1.  [DEFINITION.] (a) "Activities of daily 
381.17  living" includes eating, toileting, grooming, dressing, bathing, 
381.18  transferring, mobility, and positioning.  
381.19     (b) "Assessment" means a review and evaluation of a 
381.20  recipient's need for home care services conducted in person.  
381.21  Assessments for private duty nursing shall be conducted by a 
381.22  registered private duty nurse.  Assessments for home health 
381.23  agency services shall be conducted by a home health agency 
381.24  nurse.  Assessments for personal care assistant services shall 
381.25  be conducted by the county public health nurse or a certified 
381.26  public health nurse under contract with the county.  A 
381.27  face-to-face assessment must include:  documentation of health 
381.28  status, determination of need, evaluation of service 
381.29  effectiveness, identification of appropriate services, service 
381.30  plan development or modification, coordination of services, 
381.31  referrals and follow-up to appropriate payers and community 
381.32  resources, completion of required reports, recommendation of 
381.33  service authorization, and consumer education.  Once the need 
381.34  for personal care assistant services is determined under this 
381.35  section, the county public health nurse or certified public 
381.36  health nurse under contract with the county is responsible for 
382.1   communicating this recommendation to the commissioner and the 
382.2   recipient.  A face-to-face assessment for personal care 
382.3   assistant services is conducted on those recipients who have 
382.4   never had a county public health nurse assessment.  A 
382.5   face-to-face assessment must occur at least annually or when 
382.6   there is a significant change in the recipient's condition or 
382.7   when there is a change in the need for personal care assistant 
382.8   services.  A service update may substitute for the annual 
382.9   face-to-face assessment when there is not a significant change 
382.10  in recipient condition or a change in the need for personal care 
382.11  assistant service.  A service update or review for temporary 
382.12  increase includes a review of initial baseline data, evaluation 
382.13  of service effectiveness, redetermination of service need, 
382.14  modification of service plan and appropriate referrals, update 
382.15  of initial forms, obtaining service authorization, and on going 
382.16  consumer education.  Assessments for medical assistance home 
382.17  care services for mental retardation or related conditions and 
382.18  alternative care services for developmentally disabled home and 
382.19  community-based waivered recipients may be conducted by the 
382.20  county public health nurse to ensure coordination and avoid 
382.21  duplication.  Assessments must be completed on forms provided by 
382.22  the commissioner within 30 days of a request for home care 
382.23  services by a recipient or responsible party. 
382.24     (c) "Care plan" means a written description of personal 
382.25  care assistant services developed by the qualified professional 
382.26  or the recipient's physician with the recipient or responsible 
382.27  party to be used by the personal care assistant with a copy 
382.28  provided to the recipient or responsible party. 
382.29     (d) "Complex and regular private duty nursing care" means: 
382.30     (1) complex care is private duty nursing provided to 
382.31  recipients who are ventilator dependent or for whom a physician 
382.32  has certified that were it not for private duty nursing the 
382.33  recipient would meet the criteria for inpatient hospital 
382.34  intensive care unit (ICU) level of care; and 
382.35     (2) regular care is private duty nursing provided to all 
382.36  other recipients. 
383.1      (e) "Health-related functions" means functions that can be 
383.2   delegated or assigned by a licensed health care professional 
383.3   under state law to be performed by a personal care attendant. 
383.4      (f) "Home care services" means a health service, determined 
383.5   by the commissioner as medically necessary, that is ordered by a 
383.6   physician and documented in a service plan that is reviewed by 
383.7   the physician at least once every 60 days for the provision of 
383.8   home health services, or private duty nursing, or at least once 
383.9   every 365 days for personal care.  Home care services are 
383.10  provided to the recipient at the recipient's residence that is a 
383.11  place other than a hospital or long-term care facility or as 
383.12  specified in section 256B.0625.  
383.13     (g) "Instrumental activities of daily living" includes meal 
383.14  planning and preparation, managing finances, shopping for food, 
383.15  clothing, and other essential items, performing essential 
383.16  household chores, communication by telephone and other media, 
383.17  and getting around and participating in the community. 
383.18     (h) "Medically necessary" has the meaning given in 
383.19  Minnesota Rules, parts 9505.0170 to 9505.0475.  
383.20     (i) "Personal care assistant" means a person who:  
383.21     (1) is at least 18 years old, except for persons 16 to 18 
383.22  years of age who participated in a related school-based job 
383.23  training program or have completed a certified home health aide 
383.24  competency evaluation; 
383.25     (2) is able to effectively communicate with the recipient 
383.26  and personal care provider organization; 
383.27     (3) effective July 1, 1996, has completed one of the 
383.28  training requirements as specified in Minnesota Rules, part 
383.29  9505.0335, subpart 3, items A to D; 
383.30     (4) has the ability to, and provides covered personal care 
383.31  assistant services according to the recipient's care plan, 
383.32  responds appropriately to recipient needs, and reports changes 
383.33  in the recipient's condition to the supervising qualified 
383.34  professional or physician; 
383.35     (5) is not a consumer of personal care assistant services; 
383.36  and 
384.1      (6) is subject to criminal background checks and procedures 
384.2   specified in section 245A.04.  
384.3      (j) "Personal care provider organization" means an 
384.4   organization enrolled to provide personal care assistant 
384.5   services under the medical assistance program that complies with 
384.6   the following:  (1) owners who have a five percent interest or 
384.7   more, and managerial officials are subject to a background study 
384.8   as provided in section 245A.04.  This applies to currently 
384.9   enrolled personal care provider organizations and those agencies 
384.10  seeking enrollment as a personal care provider organization.  An 
384.11  organization will be barred from enrollment if an owner or 
384.12  managerial official of the organization has been convicted of a 
384.13  crime specified in section 245A.04, or a comparable crime in 
384.14  another jurisdiction, unless the owner or managerial official 
384.15  meets the reconsideration criteria specified in section 245A.04; 
384.16  (2) the organization must maintain a surety bond and liability 
384.17  insurance throughout the duration of enrollment and provides 
384.18  proof thereof.  The insurer must notify the department of human 
384.19  services of the cancellation or lapse of policy; and (3) the 
384.20  organization must maintain documentation of services as 
384.21  specified in Minnesota Rules, part 9505.2175, subpart 7, as well 
384.22  as evidence of compliance with personal care assistant training 
384.23  requirements. 
384.24     (k) "Responsible party" means an individual residing with a 
384.25  recipient of personal care assistant services who is capable of 
384.26  providing the supportive care support necessary to assist the 
384.27  recipient to live in the community, is at least 18 years 
384.28  old, actively participates in planning and directing of personal 
384.29  care assistant services, and is not a the personal care 
384.30  assistant.  The responsible party must be accessible to the 
384.31  recipient and the personal care assistant when personal care 
384.32  services are being provided and monitor the services at least 
384.33  weekly according to the plan of care.  The responsible party 
384.34  must be identified at the time of assessment and listed on the 
384.35  recipient's service agreement and care plan.  Responsible 
384.36  parties who are parents of minors or guardians of minors or 
385.1   incapacitated persons may delegate the responsibility to another 
385.2   adult during a temporary absence of at least 24 hours but not 
385.3   more than six months.  The person delegated as a responsible 
385.4   party must be able to meet the definition of responsible party, 
385.5   except that the delegated responsible party is required to 
385.6   reside with the recipient only while serving as the responsible 
385.7   party who is not the personal care assistant.  The responsible 
385.8   party must assure that the delegate performs the functions of 
385.9   the responsible party, is identified at the time of the 
385.10  assessment, and is listed on the service agreement and the care 
385.11  plan.  Foster care license holders may be designated the 
385.12  responsible party for residents of the foster care home if case 
385.13  management is provided as required in section 256B.0625, 
385.14  subdivision 19a.  For persons who, as of April 1, 1992, are 
385.15  sharing personal care assistant services in order to obtain the 
385.16  availability of 24-hour coverage, an employee of the personal 
385.17  care provider organization may be designated as the responsible 
385.18  party if case management is provided as required in section 
385.19  256B.0625, subdivision 19a. 
385.20     (l) "Service plan" means a written description of the 
385.21  services needed based on the assessment developed by the nurse 
385.22  who conducts the assessment together with the recipient or 
385.23  responsible party.  The service plan shall include a description 
385.24  of the covered home care services, frequency and duration of 
385.25  services, and expected outcomes and goals.  The recipient and 
385.26  the provider chosen by the recipient or responsible party must 
385.27  be given a copy of the completed service plan within 30 calendar 
385.28  days of the request for home care services by the recipient or 
385.29  responsible party. 
385.30     (m) "Skilled nurse visits" are provided in a recipient's 
385.31  residence under a plan of care or service plan that specifies a 
385.32  level of care which the nurse is qualified to provide.  These 
385.33  services are: 
385.34     (1) nursing services according to the written plan of care 
385.35  or service plan and accepted standards of medical and nursing 
385.36  practice in accordance with chapter 148; 
386.1      (2) services which due to the recipient's medical condition 
386.2   may only be safely and effectively provided by a registered 
386.3   nurse or a licensed practical nurse; 
386.4      (3) assessments performed only by a registered nurse; and 
386.5      (4) teaching and training the recipient, the recipient's 
386.6   family, or other caregivers requiring the skills of a registered 
386.7   nurse or licensed practical nurse. 
386.8      (n) "Telehomecare" means the use of telecommunications 
386.9   technology by a home health care professional to deliver home 
386.10  health care services, within the professional's scope of 
386.11  practice, to a patient located at a site other than the site 
386.12  where the practitioner is located. 
386.13     Sec. 24.  Minnesota Statutes 2002, section 256B.0627, 
386.14  subdivision 4, is amended to read: 
386.15     Subd. 4.  [PERSONAL CARE ASSISTANT SERVICES.] (a) The 
386.16  personal care assistant services that are eligible for payment 
386.17  are services and supports furnished to an individual, as needed, 
386.18  to assist in accomplishing activities of daily living; 
386.19  instrumental activities of daily living; health-related 
386.20  functions through hands-on assistance, supervision, and cuing; 
386.21  and redirection and intervention for behavior including 
386.22  observation and monitoring.  
386.23     (b) Payment for services will be made within the limits 
386.24  approved using the prior authorized process established in 
386.25  subdivision 5. 
386.26     (c) The amount and type of services authorized shall be 
386.27  based on an assessment of the recipient's needs in these areas: 
386.28     (1) bowel and bladder care; 
386.29     (2) skin care to maintain the health of the skin; 
386.30     (3) repetitive maintenance range of motion, muscle 
386.31  strengthening exercises, and other tasks specific to maintaining 
386.32  a recipient's optimal level of function; 
386.33     (4) respiratory assistance; 
386.34     (5) transfers and ambulation; 
386.35     (6) bathing, grooming, and hairwashing necessary for 
386.36  personal hygiene; 
387.1      (7) turning and positioning; 
387.2      (8) assistance with furnishing medication that is 
387.3   self-administered; 
387.4      (9) application and maintenance of prosthetics and 
387.5   orthotics; 
387.6      (10) cleaning medical equipment; 
387.7      (11) dressing or undressing; 
387.8      (12) assistance with eating and meal preparation and 
387.9   necessary grocery shopping; 
387.10     (13) accompanying a recipient to obtain medical diagnosis 
387.11  or treatment; 
387.12     (14) assisting, monitoring, or prompting the recipient to 
387.13  complete the services in clauses (1) to (13); 
387.14     (15) redirection, monitoring, and observation that are 
387.15  medically necessary and an integral part of completing the 
387.16  personal care assistant services described in clauses (1) to 
387.17  (14); 
387.18     (16) redirection and intervention for behavior, including 
387.19  observation and monitoring; 
387.20     (17) interventions for seizure disorders, including 
387.21  monitoring and observation if the recipient has had a seizure 
387.22  that requires intervention within the past three months; 
387.23     (18) tracheostomy suctioning using a clean procedure if the 
387.24  procedure is properly delegated by a registered nurse.  Before 
387.25  this procedure can be delegated to a personal care assistant, a 
387.26  registered nurse must determine that the tracheostomy suctioning 
387.27  can be accomplished utilizing a clean rather than a sterile 
387.28  procedure and must ensure that the personal care assistant has 
387.29  been taught the proper procedure; and 
387.30     (19) incidental household services that are an integral 
387.31  part of a personal care service described in clauses (1) to (18).
387.32  For purposes of this subdivision, monitoring and observation 
387.33  means watching for outward visible signs that are likely to 
387.34  occur and for which there is a covered personal care service or 
387.35  an appropriate personal care intervention.  For purposes of this 
387.36  subdivision, a clean procedure refers to a procedure that 
388.1   reduces the numbers of microorganisms or prevents or reduces the 
388.2   transmission of microorganisms from one person or place to 
388.3   another.  A clean procedure may be used beginning 14 days after 
388.4   insertion. 
388.5      (d) The personal care assistant services that are not 
388.6   eligible for payment are the following:  
388.7      (1) services not ordered by the physician; 
388.8      (2) assessments by personal care assistant provider 
388.9   organizations or by independently enrolled registered nurses; 
388.10     (3) services that are not in the service plan; 
388.11     (4) services provided by the recipient's spouse, legal 
388.12  guardian for an adult or child recipient, or parent of a 
388.13  recipient under age 18; 
388.14     (5) services provided by a foster care provider of a 
388.15  recipient who cannot direct the recipient's own care, unless 
388.16  monitored by a county or state case manager under section 
388.17  256B.0625, subdivision 19a; 
388.18     (6) services provided by the residential or program license 
388.19  holder in a residence for more than four persons; 
388.20     (7) services that are the responsibility of a residential 
388.21  or program license holder under the terms of a service agreement 
388.22  and administrative rules; 
388.23     (8) sterile procedures; 
388.24     (9) injections of fluids into veins, muscles, or skin; 
388.25     (10) services provided by parents of adult recipients, 
388.26  adult children, or siblings of the recipient, unless these 
388.27  relatives meet one of the following hardship criteria and the 
388.28  commissioner waives this requirement: 
388.29     (i) the relative resigns from a part-time or full-time job 
388.30  to provide personal care for the recipient; 
388.31     (ii) the relative goes from a full-time to a part-time job 
388.32  with less compensation to provide personal care for the 
388.33  recipient; 
388.34     (iii) the relative takes a leave of absence without pay to 
388.35  provide personal care for the recipient; 
388.36     (iv) the relative incurs substantial expenses by providing 
389.1   personal care for the recipient; or 
389.2      (v) because of labor conditions, special language needs, or 
389.3   intermittent hours of care needed, the relative is needed in 
389.4   order to provide an adequate number of qualified personal care 
389.5   assistants to meet the medical needs of the recipient; 
389.6      (11) homemaker services that are not an integral part of a 
389.7   personal care assistant services; 
389.8      (12) (11) home maintenance, or chore services; 
389.9      (13) (12) services not specified under paragraph (a); and 
389.10     (14) (13) services not authorized by the commissioner or 
389.11  the commissioner's designee. 
389.12     (e) The recipient or responsible party may choose to 
389.13  supervise the personal care assistant or to have a qualified 
389.14  professional, as defined in section 256B.0625, subdivision 19c, 
389.15  provide the supervision.  As required under section 256B.0625, 
389.16  subdivision 19c, the county public health nurse, as a part of 
389.17  the assessment, will assist the recipient or responsible party 
389.18  to identify the most appropriate person to provide supervision 
389.19  of the personal care assistant.  Health-related delegated tasks 
389.20  performed by the personal care assistant will be under the 
389.21  supervision of a qualified professional or the direction of the 
389.22  recipient's physician.  If the recipient has a qualified 
389.23  professional, Minnesota Rules, part 9505.0335, subpart 4, 
389.24  applies. 
389.25     Sec. 25.  Minnesota Statutes 2002, section 256B.0627, 
389.26  subdivision 9, is amended to read: 
389.27     Subd. 9.  [FLEXIBLE USE OF PERSONAL CARE ASSISTANT HOURS.] 
389.28  (a) The commissioner may allow for the flexible use of personal 
389.29  care assistant hours.  "Flexible use" means the scheduled use of 
389.30  authorized hours of personal care assistant services, which vary 
389.31  within the length of the service authorization in order to more 
389.32  effectively meet the needs and schedule of the recipient.  
389.33  Recipients may use their approved hours flexibly within the 
389.34  service authorization period for medically necessary covered 
389.35  services specified in the assessment required in subdivision 1.  
389.36  The flexible use of authorized hours does not increase the total 
390.1   amount of authorized hours available to a recipient as 
390.2   determined under subdivision 5.  The commissioner shall not 
390.3   authorize additional personal care assistant services to 
390.4   supplement a service authorization that is exhausted before the 
390.5   end date under a flexible service use plan, unless the county 
390.6   public health nurse determines a change in condition and a need 
390.7   for increased services is established. 
390.8      (b) The recipient or responsible party, together with the 
390.9   county public health nurse, shall determine whether flexible use 
390.10  is an appropriate option based on the needs and preferences of 
390.11  the recipient or responsible party, and, if appropriate, must 
390.12  ensure that the allocation of hours covers the ongoing needs of 
390.13  the recipient over the entire service authorization period.  As 
390.14  part of the assessment and service planning process, the 
390.15  recipient or responsible party must work with the county public 
390.16  health nurse to develop a written month-to-month plan of the 
390.17  projected use of personal care assistant services that is part 
390.18  of the service plan and ensures that the: 
390.19     (1) health and safety needs of the recipient will be met; 
390.20     (2) total annual authorization will not exceed before the 
390.21  end date; and 
390.22     (3) how actual use of hours will be monitored.  
390.23     (c) If the actual use of personal care assistant service 
390.24  varies significantly from the use projected in the plan, the 
390.25  written plan must be promptly updated by the recipient or 
390.26  responsible party and the county public health nurse. 
390.27     (d) The recipient or responsible party, together with the 
390.28  provider, must work to monitor and document the use of 
390.29  authorized hours and ensure that a recipient is able to manage 
390.30  services effectively throughout the authorized period.  The 
390.31  provider must ensure that the month-to-month plan is 
390.32  incorporated into the care plan.  Upon request of the recipient 
390.33  or responsible party, the provider must furnish regular updates 
390.34  to the recipient or responsible party on the amount of personal 
390.35  care assistant services used.  
390.36     (e) The recipient or responsible party may revoke the 
391.1   authorization for flexible use of hours by notifying the 
391.2   provider and county public health nurse in writing. 
391.3      (f) If the requirements in paragraphs (a) to (e) have not 
391.4   substantially been met, the commissioner shall deny, revoke, or 
391.5   suspend the authorization to use authorized hours flexibly.  The 
391.6   recipient or responsible party may appeal the commissioner's 
391.7   action according to section 256.045.  The denial, revocation, or 
391.8   suspension to use the flexible hours option shall not affect the 
391.9   recipient's authorized level of personal care assistant services 
391.10  as determined under subdivision 5. 
391.11     Sec. 26.  Minnesota Statutes 2002, section 256B.0911, 
391.12  subdivision 4d, is amended to read: 
391.13     Subd. 4d.  [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 
391.14  YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 
391.15  ensure that individuals with disabilities or chronic illness are 
391.16  served in the most integrated setting appropriate to their needs 
391.17  and have the necessary information to make informed choices 
391.18  about home and community-based service options. 
391.19     (b) Individuals under 65 years of age who are admitted to a 
391.20  nursing facility from a hospital must be screened prior to 
391.21  admission as outlined in subdivisions 4a through 4c. 
391.22     (c) Individuals under 65 years of age who are admitted to 
391.23  nursing facilities with only a telephone screening must receive 
391.24  a face-to-face assessment from the long-term care consultation 
391.25  team member of the county in which the facility is located or 
391.26  from the recipient's county case manager within 20 working 40 
391.27  calendar days of admission. 
391.28     (d) Individuals under 65 years of age who are admitted to a 
391.29  nursing facility without preadmission screening according to the 
391.30  exemption described in subdivision 4b, paragraph (a), clause 
391.31  (3), and who remain in the facility longer than 30 days must 
391.32  receive a face-to-face assessment within 40 days of admission.  
391.33     (e) At the face-to-face assessment, the long-term care 
391.34  consultation team member or county case manager must perform the 
391.35  activities required under subdivision 3b. 
391.36     (f) For individuals under 21 years of age, a screening 
392.1   interview which recommends nursing facility admission must be 
392.2   face-to-face and approved by the commissioner before the 
392.3   individual is admitted to the nursing facility. 
392.4      (g) In the event that an individual under 65 years of age 
392.5   is admitted to a nursing facility on an emergency basis, the 
392.6   county must be notified of the admission on the next working 
392.7   day, and a face-to-face assessment as described in paragraph (c) 
392.8   must be conducted within 20 working days 40 calendar days of 
392.9   admission. 
392.10     (h) At the face-to-face assessment, the long-term care 
392.11  consultation team member or the case manager must present 
392.12  information about home and community-based options so the 
392.13  individual can make informed choices.  If the individual chooses 
392.14  home and community-based services, the long-term care 
392.15  consultation team member or case manager must complete a written 
392.16  relocation plan within 20 working days of the visit.  The plan 
392.17  shall describe the services needed to move out of the facility 
392.18  and a time line for the move which is designed to ensure a 
392.19  smooth transition to the individual's home and community. 
392.20     (i) An individual under 65 years of age residing in a 
392.21  nursing facility shall receive a face-to-face assessment at 
392.22  least every 12 months to review the person's service choices and 
392.23  available alternatives unless the individual indicates, in 
392.24  writing, that annual visits are not desired.  In this case, the 
392.25  individual must receive a face-to-face assessment at least once 
392.26  every 36 months for the same purposes. 
392.27     (j) Notwithstanding the provisions of subdivision 6, the 
392.28  commissioner may pay county agencies directly for face-to-face 
392.29  assessments for individuals under 65 years of age who are being 
392.30  considered for placement or residing in a nursing facility. 
392.31     Sec. 27.  Minnesota Statutes 2002, section 256B.0915, is 
392.32  amended by adding a subdivision to read: 
392.33     Subd. 9.  [TRIBAL MANAGEMENT OF ELDERLY WAIVER.] 
392.34  Notwithstanding contrary provisions of this section, or those in 
392.35  other state laws or rules, the commissioner and White Earth 
392.36  reservation may develop a model for tribal management of the 
393.1   elderly waiver program and implement this model through a 
393.2   contract between the state and White Earth reservation.  The 
393.3   model shall include the provision of tribal waiver case 
393.4   management, assessment for personal care assistance, and 
393.5   administrative requirements otherwise carried out by counties 
393.6   but shall not include tribal financial eligibility determination 
393.7   for medical assistance. 
393.8      Sec. 28.  Minnesota Statutes 2002, section 256B.092, 
393.9   subdivision 1a, is amended to read: 
393.10     Subd. 1a.  [CASE MANAGEMENT ADMINISTRATION AND SERVICES.] 
393.11  (a) The administrative functions of case management provided to 
393.12  or arranged for a person include: 
393.13     (1) intake review of eligibility for services; 
393.14     (2) diagnosis screening; 
393.15     (3) screening intake; 
393.16     (4) service authorization diagnosis; 
393.17     (5) review of eligibility for services the completion and 
393.18  authorization of services based upon an individualized service 
393.19  plan; and 
393.20     (6) responding to requests for conciliation conferences and 
393.21  appeals according to section 256.045 made by the person, the 
393.22  person's legal guardian or conservator, or the parent if the 
393.23  person is a minor. 
393.24     (b) Case management service activities provided to or 
393.25  arranged for a person include: 
393.26     (1) development of the individual service plan; 
393.27     (2) informing the individual or the individual's legal 
393.28  guardian or conservator, or parent if the person is a minor, of 
393.29  service options; 
393.30     (3) consulting with relevant medical experts or service 
393.31  providers; 
393.32     (3) (4) assisting the person in the identification of 
393.33  potential providers; 
393.34     (4) (5) assisting the person to access services; 
393.35     (5) (6) coordination of services, if coordination is not 
393.36  provided by another service provider; 
394.1      (6) (7) evaluation and monitoring of the services 
394.2   identified in the plan; and 
394.3      (7) (8) annual reviews of service plans and services 
394.4   provided. 
394.5      (c) Case management administration and service activities 
394.6   that are provided to the person with mental retardation or a 
394.7   related condition shall be provided directly by county agencies 
394.8   or under contract.  
394.9      (d) Case managers are responsible for the administrative 
394.10  duties and service provisions listed in paragraphs (a) and (b).  
394.11  Case managers shall collaborate with consumers, families, legal 
394.12  representatives, and relevant medical experts and service 
394.13  providers in the development and annual review of the 
394.14  individualized service and habilitation plans. 
394.15     (e) The department of human services shall offer ongoing 
394.16  education in case management to case managers.  Case managers 
394.17  shall receive no less than ten hours of case management 
394.18  education and disability-related training each year. 
394.19     Sec. 29.  Minnesota Statutes 2002, section 256B.092, 
394.20  subdivision 5, is amended to read: 
394.21     Subd. 5.  [FEDERAL WAIVERS.] (a) The commissioner shall 
394.22  apply for any federal waivers necessary to secure, to the extent 
394.23  allowed by law, federal financial participation under United 
394.24  States Code, title 42, sections 1396 et seq., as amended, for 
394.25  the provision of services to persons who, in the absence of the 
394.26  services, would need the level of care provided in a regional 
394.27  treatment center or a community intermediate care facility for 
394.28  persons with mental retardation or related conditions.  The 
394.29  commissioner may seek amendments to the waivers or apply for 
394.30  additional waivers under United States Code, title 42, sections 
394.31  1396 et seq., as amended, to contain costs.  The commissioner 
394.32  shall ensure that payment for the cost of providing home and 
394.33  community-based alternative services under the federal waiver 
394.34  plan shall not exceed the cost of intermediate care services 
394.35  including day training and habilitation services that would have 
394.36  been provided without the waivered services.  
395.1      (b) The commissioner, in administering home and 
395.2   community-based waivers for persons with mental retardation and 
395.3   related conditions, shall ensure that day services for eligible 
395.4   persons are not provided by the person's residential service 
395.5   provider, unless the person or the person's legal representative 
395.6   is offered a choice of providers and agrees in writing to 
395.7   provision of day services by the residential service provider.  
395.8   The individual service plan for individuals who choose to have 
395.9   their residential service provider provide their day services 
395.10  must describe how health, safety, and protection, and 
395.11  habilitation needs will be met by, including how frequent and 
395.12  regular contact with persons other than the residential service 
395.13  provider will occur.  The individualized service plan must 
395.14  address the provision of services during the day outside the 
395.15  residence on weekdays.  
395.16     Sec. 30.  Minnesota Statutes 2002, section 256B.095, is 
395.17  amended to read: 
395.18     256B.095 [QUALITY ASSURANCE PROJECT SYSTEM ESTABLISHED.] 
395.19     (a) Effective July 1, 1998, an alternative a quality 
395.20  assurance licensing system project for persons with 
395.21  developmental disabilities, which includes an alternative 
395.22  quality assurance licensing system for programs for persons with 
395.23  developmental disabilities, is established in Dodge, Fillmore, 
395.24  Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, 
395.25  Wabasha, and Winona counties for the purpose of improving the 
395.26  quality of services provided to persons with developmental 
395.27  disabilities.  A county, at its option, may choose to have all 
395.28  programs for persons with developmental disabilities located 
395.29  within the county licensed under chapter 245A using standards 
395.30  determined under the alternative quality assurance licensing 
395.31  system project or may continue regulation of these programs 
395.32  under the licensing system operated by the commissioner.  The 
395.33  project expires on June 30, 2005 2007. 
395.34     (b) Effective July 1, 2003, a county not listed in 
395.35  paragraph (a) may apply to participate in the quality assurance 
395.36  system established under paragraph (a).  The commission 
396.1   established under section 256B.0951 may, at its option, allow 
396.2   additional counties to participate in the system. 
396.3      (c) Effective July 1, 2003, any county or group of counties 
396.4   not listed in paragraph (a) may establish a quality assurance 
396.5   system under this section.  A new system established under this 
396.6   section shall have the same rights and duties as the system 
396.7   established under paragraph (a).  A new system shall be governed 
396.8   by a commission under section 256B.0951.  The commissioner shall 
396.9   appoint the initial commission members based on recommendations 
396.10  from advocates, families, service providers, and counties in the 
396.11  geographic area included in the new system.  Counties that 
396.12  choose to participate in a new system shall have the duties 
396.13  assigned under section 256B.0952.  The new system shall 
396.14  establish a quality assurance process under section 256B.0953.  
396.15  The provisions of section 256B.0954 shall apply to a new system 
396.16  established under this paragraph.  The commissioner shall 
396.17  delegate authority to a new system established under this 
396.18  paragraph according to section 256B.0955. 
396.19     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
396.20     Sec. 31.  Minnesota Statutes 2002, section 256B.0951, 
396.21  subdivision 1, is amended to read: 
396.22     Subdivision 1.  [MEMBERSHIP.] The region 10 quality 
396.23  assurance commission is established.  The commission consists of 
396.24  at least 14 but not more than 21 members as follows:  at least 
396.25  three but not more than five members representing advocacy 
396.26  organizations; at least three but not more than five members 
396.27  representing consumers, families, and their legal 
396.28  representatives; at least three but not more than five members 
396.29  representing service providers; at least three but not more than 
396.30  five members representing counties; and the commissioner of 
396.31  human services or the commissioner's designee.  Initial 
396.32  membership of the commission shall be recruited and approved by 
396.33  the region 10 stakeholders group.  Prior to approving the 
396.34  commission's membership, the stakeholders group shall provide to 
396.35  the commissioner a list of the membership in the stakeholders 
396.36  group, as of February 1, 1997, a brief summary of meetings held 
397.1   by the group since July 1, 1996, and copies of any materials 
397.2   prepared by the group for public distribution.  The first 
397.3   commission shall establish membership guidelines for the 
397.4   transition and recruitment of membership for the commission's 
397.5   ongoing existence.  Members of the commission who do not receive 
397.6   a salary or wages from an employer for time spent on commission 
397.7   duties may receive a per diem payment when performing commission 
397.8   duties and functions.  All members may be reimbursed for 
397.9   expenses related to commission activities.  Notwithstanding the 
397.10  provisions of section 15.059, subdivision 5, the commission 
397.11  expires on June 30, 2005 2007. 
397.12     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
397.13     Sec. 32.  Minnesota Statutes 2002, section 256B.0951, 
397.14  subdivision 2, is amended to read: 
397.15     Subd. 2.  [AUTHORITY TO HIRE STAFF; CHARGE FEES; PROVIDE 
397.16  TECHNICAL ASSISTANCE.] (a) The commission may hire staff to 
397.17  perform the duties assigned in this section.  
397.18     (b) The commission may charge fees for its services. 
397.19     (c) The commission may provide technical assistance to 
397.20  other counties, families, providers, and advocates interested in 
397.21  participating in a quality assurance system under section 
397.22  256B.095, paragraph (b) or (c). 
397.23     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
397.24     Sec. 33.  Minnesota Statutes 2002, section 256B.0951, 
397.25  subdivision 3, is amended to read: 
397.26     Subd. 3.  [COMMISSION DUTIES.] (a) By October 1, 1997, the 
397.27  commission, in cooperation with the commissioners of human 
397.28  services and health, shall do the following:  (1) approve an 
397.29  alternative quality assurance licensing system based on the 
397.30  evaluation of outcomes; (2) approve measurable outcomes in the 
397.31  areas of health and safety, consumer evaluation, education and 
397.32  training, providers, and systems that shall be evaluated during 
397.33  the alternative licensing process; and (3) establish variable 
397.34  licensure periods not to exceed three years based on outcomes 
397.35  achieved.  For purposes of this subdivision, "outcome" means the 
397.36  behavior, action, or status of a person that can be observed or 
398.1   measured and can be reliably and validly determined. 
398.2      (b) By January 15, 1998, the commission shall approve, in 
398.3   cooperation with the commissioner of human services, a training 
398.4   program for members of the quality assurance teams established 
398.5   under section 256B.0952, subdivision 4. 
398.6      (c) The commission and the commissioner shall establish an 
398.7   ongoing review process for the alternative quality assurance 
398.8   licensing system.  The review shall take into account the 
398.9   comprehensive nature of the alternative system, which is 
398.10  designed to evaluate the broad spectrum of licensed and 
398.11  unlicensed entities that provide services to clients, as 
398.12  compared to the current licensing system.  
398.13     (d) The commission shall contract with an independent 
398.14  entity to conduct a financial review of the alternative quality 
398.15  assurance project.  The review shall take into account the 
398.16  comprehensive nature of the alternative system, which is 
398.17  designed to evaluate the broad spectrum of licensed and 
398.18  unlicensed entities that provide services to clients, as 
398.19  compared to the current licensing system.  The review shall 
398.20  include an evaluation of possible budgetary savings within the 
398.21  department of human services as a result of implementation of 
398.22  the alternative quality assurance project.  If a federal waiver 
398.23  is approved under subdivision 7, the financial review shall also 
398.24  evaluate possible savings within the department of health.  This 
398.25  review must be completed by December 15, 2000. 
398.26     (e) The commission shall submit a report to the legislature 
398.27  by January 15, 2001, on the results of the review process for 
398.28  the alternative quality assurance project, a summary of the 
398.29  results of the independent financial review, and a 
398.30  recommendation on whether the project should be extended beyond 
398.31  June 30, 2001. 
398.32     (f) The commissioner commission, in consultation with 
398.33  the commission commissioner, shall examine the feasibility of 
398.34  expanding work cooperatively with other populations to expand 
398.35  the project system to other those populations or geographic 
398.36  areas and identify barriers to expansion.  The commissioner 
399.1   shall report findings and recommendations to the legislature by 
399.2   December 15, 2004. 
399.3      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
399.4      Sec. 34.  Minnesota Statutes 2002, section 256B.0951, 
399.5   subdivision 5, is amended to read: 
399.6      Subd. 5.  [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The 
399.7   safety standards, rights, or procedural protections under 
399.8   sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a, 
399.9   3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2) 
399.10  and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, 
399.11  subdivisions 1b, clause (7), and 10; 626.556; 626.557, and 
399.12  procedures for the monitoring of psychotropic medications shall 
399.13  not be varied under the alternative licensing quality assurance 
399.14  licensing system project.  The commission may make 
399.15  recommendations to the commissioners of human services and 
399.16  health or to the legislature regarding alternatives to or 
399.17  modifications of the rules and procedures referenced in this 
399.18  subdivision. 
399.19     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
399.20     Sec. 35.  Minnesota Statutes 2002, section 256B.0951, 
399.21  subdivision 7, is amended to read: 
399.22     Subd. 7.  [WAIVER OF RULES.] If a federal waiver is 
399.23  approved under subdivision 8, the commissioner of health may 
399.24  exempt residents of intermediate care facilities for persons 
399.25  with mental retardation (ICFs/MR) who participate in the 
399.26  alternative quality assurance project system established in 
399.27  section 256B.095 from the requirements of Minnesota Rules, 
399.28  chapter 4665. 
399.29     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
399.30     Sec. 36.  Minnesota Statutes 2002, section 256B.0951, 
399.31  subdivision 9, is amended to read: 
399.32     Subd. 9.  [EVALUATION.] The commission, in consultation 
399.33  with the commissioner of human services, shall conduct an 
399.34  evaluation of the alternative quality assurance system, and 
399.35  present a report to the commissioner by June 30, 2004. 
399.36     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
400.1      Sec. 37.  Minnesota Statutes 2002, section 256B.0952, 
400.2   subdivision 1, is amended to read: 
400.3      Subdivision 1.  [NOTIFICATION.] For each year of the 
400.4   project, region 10 Counties shall give notice to the commission 
400.5   and commissioners of human services and health by March 15 of 
400.6   intent to join the quality assurance alternative quality 
400.7   assurance licensing system, effective July 1 of that year.  A 
400.8   county choosing to participate in the alternative quality 
400.9   assurance licensing system commits to participate until June 30, 
400.10  2005.  Counties participating in the quality assurance 
400.11  alternative licensing system as of January 1, 2001, shall notify 
400.12  the commission and the commissioners of human services and 
400.13  health by March 15, 2001, of intent to continue participation.  
400.14  Counties that elect to continue participation must participate 
400.15  in the alternative licensing system until June 30, 2005 for 
400.16  three years. 
400.17     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
400.18     Sec. 38.  Minnesota Statutes 2002, section 256B.0953, 
400.19  subdivision 2, is amended to read: 
400.20     Subd. 2.  [LICENSURE PERIODS.] (a) In order to be licensed 
400.21  under the alternative quality assurance process licensing 
400.22  system, a facility, program, or service must satisfy the health 
400.23  and safety outcomes approved for the pilot project alternative 
400.24  quality assurance licensing system. 
400.25     (b) Licensure shall be approved for periods of one to three 
400.26  years for a facility, program, or service that satisfies the 
400.27  requirements of paragraph (a) and achieves the outcome 
400.28  measurements in the categories of consumer evaluation, education 
400.29  and training, providers, and systems. 
400.30     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
400.31     Sec. 39.  Minnesota Statutes 2002, section 256B.0955, is 
400.32  amended to read: 
400.33     256B.0955 [DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.] 
400.34     (a) Effective July 1, 1998, the commissioner of human 
400.35  services shall delegate authority to perform licensing functions 
400.36  and activities, in accordance with section 245A.16, to counties 
401.1   participating in the alternative quality assurance licensing 
401.2   system.  The commissioner shall not license or reimburse a 
401.3   facility, program, or service for persons with developmental 
401.4   disabilities in a county that participates in the 
401.5   alternative quality assurance licensing system if the 
401.6   commissioner has received from the appropriate county 
401.7   notification that the facility, program, or service has been 
401.8   reviewed by a quality assurance team and has failed to qualify 
401.9   for licensure. 
401.10     (b) The commissioner may conduct random licensing 
401.11  inspections based on outcomes adopted under section 256B.0951 at 
401.12  facilities, programs, and services governed by the alternative 
401.13  quality assurance licensing system.  The role of such random 
401.14  inspections shall be to verify that the alternative quality 
401.15  assurance licensing system protects the safety and well-being of 
401.16  consumers and maintains the availability of high-quality 
401.17  services for persons with developmental disabilities.  
401.18     (c) The commissioner shall provide technical assistance and 
401.19  support or training to the alternative licensing system pilot 
401.20  project. 
401.21     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
401.22     Sec. 40.  Minnesota Statutes 2002, section 256B.19, 
401.23  subdivision 1, is amended to read: 
401.24     Subdivision 1.  [DIVISION OF COST.] The state and county 
401.25  share of medical assistance costs not paid by federal funds 
401.26  shall be as follows:  
401.27     (1) beginning January 1, 1992, 50 percent state funds and 
401.28  50 percent county funds for the cost of placement of severely 
401.29  emotionally disturbed children in regional treatment centers; 
401.30  and 
401.31     (2) beginning January 1, 2003, 80 percent state funds and 
401.32  20 percent county funds for the costs of nursing facility 
401.33  placements of persons with disabilities under the age of 65 that 
401.34  have exceeded 90 days.  This clause shall be subject to chapter 
401.35  256G and shall not apply to placements in facilities not 
401.36  certified to participate in medical assistance.; 
402.1      (3) beginning January 1, 2004, 90 percent state funds and 
402.2   10 percent county funds for the costs of placements that have 
402.3   exceeded 90 days in intermediate care facilities for persons 
402.4   with mental retardation or a related condition that have seven 
402.5   or more beds.  This provision includes pass-through payments 
402.6   made under section 256B.5015; and 
402.7      (4) beginning January 1, 2004, when state funds are used to 
402.8   pay for a nursing facility placement due to the facility's 
402.9   status as an institution for mental diseases (IMD), the county 
402.10  shall pay 20 percent of the nonfederal share of costs that have 
402.11  exceeded 90 days.  This clause is subject to chapter 256G. 
402.12     For counties that participate in a Medicaid demonstration 
402.13  project under sections 256B.69 and 256B.71, the division of the 
402.14  nonfederal share of medical assistance expenses for payments 
402.15  made to prepaid health plans or for payments made to health 
402.16  maintenance organizations in the form of prepaid capitation 
402.17  payments, this division of medical assistance expenses shall be 
402.18  95 percent by the state and five percent by the county of 
402.19  financial responsibility.  
402.20     In counties where prepaid health plans are under contract 
402.21  to the commissioner to provide services to medical assistance 
402.22  recipients, the cost of court ordered treatment ordered without 
402.23  consulting the prepaid health plan that does not include 
402.24  diagnostic evaluation, recommendation, and referral for 
402.25  treatment by the prepaid health plan is the responsibility of 
402.26  the county of financial responsibility. 
402.27     Sec. 41.  Minnesota Statutes 2002, section 256B.47, 
402.28  subdivision 2, is amended to read: 
402.29     Subd. 2.  [NOTICE TO RESIDENTS.] (a) No increase in nursing 
402.30  facility rates for private paying residents shall be effective 
402.31  unless the nursing facility notifies the resident or person 
402.32  responsible for payment of the increase in writing 30 days 
402.33  before the increase takes effect.  
402.34     A nursing facility may adjust its rates without giving the 
402.35  notice required by this subdivision when the purpose of the rate 
402.36  adjustment is to reflect a necessary change in the level of care 
403.1   provided to a case-mix classification of the resident.  If the 
403.2   state fails to set rates as required by section 
403.3   256B.431, subdivision 1, the time required for giving notice is 
403.4   decreased by the number of days by which the state was late in 
403.5   setting the rates. 
403.6      (b) If the state does not set rates by the date required in 
403.7   section 256B.431, subdivision 1, nursing facilities shall meet 
403.8   the requirement for advance notice by informing the resident or 
403.9   person responsible for payments, on or before the effective date 
403.10  of the increase, that a rate increase will be effective on that 
403.11  date.  If the exact amount has not yet been determined, the 
403.12  nursing facility may raise the rates by the amount anticipated 
403.13  to be allowed.  Any amounts collected from private pay residents 
403.14  in excess of the allowable rate must be repaid to private pay 
403.15  residents with interest at the rate used by the commissioner of 
403.16  revenue for the late payment of taxes and in effect on the date 
403.17  the rate increase is effective. 
403.18     Sec. 42.  [256B.492] [REGIONAL MANAGEMENT OF HOME AND 
403.19  COMMUNITY-BASED WAIVER SERVICES.] 
403.20     Subdivision 1.  [REGION.] For the purposes of this section, 
403.21  "region" means a county or a group of counties that have formed 
403.22  a joint powers agreement to manage the home and community-based 
403.23  waiver services. 
403.24     Subd. 2.  [PURPOSE.] Counties may form joint powers 
403.25  agreements for the purpose of regionally managing the home and 
403.26  community-based waiver services under sections 256B.0916 and 
403.27  256B.49.  Counties are encouraged to form joint powers 
403.28  agreements with other counties to regionally manage the home and 
403.29  community-based waiver services under sections 256B.0916 and 
403.30  256B.49. 
403.31     Subd. 3.  [REGIONAL WAIVER AUTHORITY.] One of the parties 
403.32  to the joint powers agreement or a new regional waiver authority 
403.33  entity shall be designated the regional waiver authority and 
403.34  shall monitor regional authorizations and expenditures.  The 
403.35  joint powers agreement shall specify how decisions are made on 
403.36  authorizations and expenditures from the home and 
404.1   community-based waiver allocation. 
404.2      Subd. 4.  [FISCAL MANAGEMENT.] A region may reserve up to 
404.3   two percent of its home and community-based allocation in a 
404.4   given fiscal year to meet unanticipated needs.  
404.5      Subd. 5.  [ALTERNATIVE METHOD.] When waiver resources are 
404.6   to be distributed to a group of counties that elect not to form 
404.7   a region, the commissioner may (1) require a joint powers 
404.8   agreement; (2) contract with a public or private agency; or (3) 
404.9   require both to administer the waiver program for that 
404.10  geographic area.  The commissioner is responsible for assuring 
404.11  that funds are used properly within the amount allocated. 
404.12     Sec. 43.  [256B.493] [COST MANAGEMENT OF HOME AND 
404.13  COMMUNITY-BASED WAIVERED SERVICES.] 
404.14     (a) The commissioner of human services shall efficiently 
404.15  allocate and manage limited home and community-based waiver 
404.16  services program resources to achieve the following outcomes: 
404.17     (1) the establishment of feasible and viable alternatives 
404.18  for persons in institutional or hospital settings to relocate to 
404.19  home and community-based settings; 
404.20     (2) the availability of timely assistance to persons at 
404.21  imminent risk of institutional or hospital placement or whose 
404.22  health and safety is at immediate risk; and 
404.23     (3) the maximum provision of essential community supports 
404.24  to eligible persons in need of and waiting for home and 
404.25  community-based service alternatives. 
404.26     (b) The commissioner shall monitor the costs of home and 
404.27  community-based services, and may adjust home and 
404.28  community-based service allocations, as necessary, to assure 
404.29  that program costs are managed within available funding.  When 
404.30  making this determination, the commissioner shall give 
404.31  consideration to offsets that may occur in other programs as a 
404.32  result of the availability and use of home and community-based 
404.33  services. 
404.34     (c) The commissioner shall allocate home and 
404.35  community-based resources to local/regional entities in a manner 
404.36  that considers: 
405.1      (1) the historical costs of serving individuals in a county 
405.2   or region; 
405.3      (2) the individualized service plans for current recipients 
405.4   and eligible individuals expected to enter the waiver during the 
405.5   fiscal year; and 
405.6      (3) the need for crisis services or other short-term 
405.7   services required because of unforeseen circumstances. 
405.8      (d) The commissioner may reallocate resources from one 
405.9   county or region to another if available funding in that county 
405.10  or region is not likely to be spent and the reallocation is 
405.11  necessary to achieve the outcomes specified in paragraph (a). 
405.12     Sec. 44.  Minnesota Statutes 2002, section 256B.501, 
405.13  subdivision 1, is amended to read: 
405.14     Subdivision 1.  [DEFINITIONS.] For the purposes of this 
405.15  section, the following terms have the meaning given them.  
405.16     (a) "Commissioner" means the commissioner of human services.
405.17     (b) "Facility" means a facility licensed as a mental 
405.18  retardation residential facility under section 252.28, licensed 
405.19  as a supervised living facility under chapter 144, and certified 
405.20  as an intermediate care facility for persons with mental 
405.21  retardation or related conditions.  The term does not include a 
405.22  state regional treatment center. 
405.23     (c) "Habilitation services" means health and social 
405.24  services directed toward increasing and maintaining the 
405.25  physical, intellectual, emotional, and social functioning of 
405.26  persons with mental retardation or related conditions.  
405.27  Habilitation services include therapeutic activities, 
405.28  assistance, training, supervision, and monitoring in the areas 
405.29  of self-care, sensory and motor development, interpersonal 
405.30  skills, communication, socialization, reduction or elimination 
405.31  of maladaptive behavior, community living and mobility, health 
405.32  care, leisure and recreation, money management, and household 
405.33  chores. 
405.34     (d) "Services during the day" means services or supports 
405.35  provided to a person that enables the person to be fully 
405.36  integrated into the community.  Services during the day must 
406.1   include habilitation services, and may include a variety of 
406.2   supports to enable the person to exercise choices for community 
406.3   integration and inclusion activities.  Services during the day 
406.4   may include, but are not limited to:  supported work, support 
406.5   during community activities, community volunteer opportunities, 
406.6   adult day care, recreational activities, and other 
406.7   individualized integrated supports. 
406.8      (e) "Waivered service" means home or community-based 
406.9   service authorized under United States Code, title 42, section 
406.10  1396n(c), as amended through December 31, 1987, and defined in 
406.11  the Minnesota state plan for the provision of medical assistance 
406.12  services.  Waivered services include, at a minimum, case 
406.13  management, family training and support, developmental training 
406.14  homes, supervised living arrangements, semi-independent living 
406.15  services, respite care, and training and habilitation services. 
406.16     Sec. 45.  Minnesota Statutes 2002, section 256B.501, is 
406.17  amended by adding a subdivision to read: 
406.18     Subd. 3m.  [SERVICES DURING THE DAY.] When establishing a 
406.19  rate for services during the day, the commissioner shall ensure 
406.20  that these services comply with active treatment requirements 
406.21  for persons residing in an ICF/MR as defined under federal 
406.22  regulations and shall ensure that day services for eligible 
406.23  persons are not provided by the person's residential service 
406.24  provider, unless the person or the person's legal representative 
406.25  is offered a choice of providers and agrees in writing to 
406.26  provision of day services by the residential service provider, 
406.27  consistent with the individual service plan.  The individual 
406.28  service plan for individuals who choose to have their 
406.29  residential service provider provide their day services must 
406.30  describe how health, safety, protection, and habilitation needs 
406.31  will be met, including how frequent and regular contact with 
406.32  persons other than the residential service provider will occur.  
406.33  The individualized service plan must address the provision of 
406.34  services during the day outside the residence.  
406.35     Sec. 46.  Minnesota Statutes 2002, section 256B.5013, 
406.36  subdivision 4, is amended to read: 
407.1      Subd. 4.  [TEMPORARY RATE ADJUSTMENTS TO ADDRESS OCCUPANCY 
407.2   AND ACCESS FOR SHORT-TERM ADMISSIONS FOR CRISIS OR SPECIALIZED 
407.3   MEDICAL CARE.] Beginning July 1, 2002 2003, the 
407.4   commissioner shall adjust the total payment rate for up to 75 
407.5   days for the remaining recipients for facilities in which the 
407.6   monthly occupancy rate of licensed beds is 75 percent or 
407.7   greater.  This mechanism shall not be used to pay for hospital 
407.8   or therapeutic leave days beyond the maximums allowed may 
407.9   designate up to 25 beds in ICF/MR facilities statewide for the 
407.10  purpose of providing short-term admissions due to crisis care 
407.11  needs or care for medically fragile individuals.  The 
407.12  commissioner shall adjust the total payment rate for up to 75 
407.13  days for the remaining recipients of the facility when the 
407.14  monthly rate of the crisis or respite bed is 50 percent or 
407.15  greater.  
407.16     Sec. 47.  Minnesota Statutes 2002, section 256B.5015, is 
407.17  amended to read: 
407.18     256B.5015 [PASS-THROUGH OF TRAINING AND HABILITATION OTHER 
407.19  SERVICES COSTS.] 
407.20     Subdivision 1.  [DAY TRAINING AND HABILITATION SERVICES.] 
407.21  Day training and habilitation services costs shall be paid as a 
407.22  pass-through payment at the lowest rate paid for the comparable 
407.23  services at that site under sections 252.40 to 252.46.  The 
407.24  pass-through payments for training and habilitation services 
407.25  shall be paid separately by the commissioner and shall not be 
407.26  included in the computation of the ICF/MR facility total payment 
407.27  rate. 
407.28     Subd. 2.  [SERVICES DURING THE DAY.] Services during the 
407.29  day, as defined in section 256B.501, but excluding day training 
407.30  and habilitation services, shall be paid as a pass-through 
407.31  payment no later than January 1, 2004.  The commissioner shall 
407.32  establish rates for these services, other than day training and 
407.33  habilitation services, at levels that do not exceed 75 percent 
407.34  of a recipient's day training and habilitation service costs 
407.35  prior to the service change. 
407.36     When establishing a rate for these services, the 
408.1   commissioner shall also consider an individual recipient's needs 
408.2   as identified in the individualized service plan and the 
408.3   person's need for active treatment as defined under federal 
408.4   regulations.  The pass-through payments for services during the 
408.5   day shall be paid separately by the commissioner and shall not 
408.6   be included in the computation of the ICF/MR facility total 
408.7   payment rate.  
408.8      Sec. 48.  Minnesota Statutes 2002, section 256B.82, is 
408.9   amended to read: 
408.10     256B.82 [PREPAID PLANS AND MENTAL HEALTH REHABILITATIVE 
408.11  SERVICES.] 
408.12     Medical assistance and MinnesotaCare prepaid health plans 
408.13  may include coverage for adult mental health rehabilitative 
408.14  services under section 256B.0623, intensive rehabilitative 
408.15  services under section 256B.0622, and adult mental health crisis 
408.16  response services under section 256B.0624, beginning January 1, 
408.17  2004 2005. 
408.18     By January 15, 2003 2004, the commissioner shall report to 
408.19  the legislature how these services should be included in prepaid 
408.20  plans.  The commissioner shall consult with mental health 
408.21  advocates, health plans, and counties in developing this 
408.22  report.  The report recommendations must include a plan to 
408.23  ensure coordination of these services between health plans and 
408.24  counties, assure recipient access to essential community 
408.25  providers, and monitor the health plans' delivery of services 
408.26  through utilization review and quality standards. 
408.27     Sec. 49.  [256I.08] [COUNTY SHARE FOR CERTAIN NURSING 
408.28  FACILITY STAYS.] 
408.29     Beginning January 1, 2004, if group residential housing is 
408.30  used to pay for a nursing facility placement due to the 
408.31  facility's status as an Institution for Mental Diseases, the 
408.32  county is liable for 20 percent of the nonfederal share of costs 
408.33  for persons under the age of 65 that have exceeded 90 days. 
408.34     Sec. 50.  [HOME AND COMMUNITY-BASED WAIVERED SERVICE 
408.35  PRIORITIES.] 
408.36     For the 2004-2005 biennium, the commissioner shall monitor 
409.1   all available home and community-based waiver resources to 
409.2   support the following service priorities: 
409.3      (1) children or adults who cannot be maintained safely in 
409.4   their current living situation without waiver services; 
409.5      (2) children or adults in unstable living situations due to 
409.6   significant needs, age, or incapacity of the primary caregiver; 
409.7   and 
409.8      (3) other persons who have been screened and are eligible, 
409.9   including those living in an institution. 
409.10     Sec. 51.  [HOME AND COMMUNITY-BASED WAIVER FOR PERSONS WITH 
409.11  MENTAL RETARDATION OR A RELATED CONDITION; RESOURCE MANAGEMENT 
409.12  STATEWIDE.] 
409.13     The commissioner shall manage MR/RC waiver resources during 
409.14  the 2004-2005 biennium to assure that all available funds are 
409.15  allocated to meet the service priority needs and maintain a 
409.16  reserve statewide of no more than three percent of available 
409.17  funds.  In order to effectively manage available resources to 
409.18  meet service priorities, the commissioner shall enable counties 
409.19  to manage resources on a regional basis. 
409.20     Sec. 52.  [DENIAL, REDUCTION, OR TERMINATION OF WAIVER 
409.21  SERVICES.] 
409.22     For the 2004-2005 biennium, when a county is evaluating 
409.23  individual denials, reductions, or terminations of home and 
409.24  community-based services under sections 256B.0916 and 256B.49 
409.25  for an individual, the case manager shall offer to meet with the 
409.26  individual or the individual's guardian and prioritize service 
409.27  needs based on the individualized service plan.  The reduction 
409.28  in the authorized services for an individual due to changes in 
409.29  funding for waivered services may not exceed the amount needed 
409.30  to assure medically necessary services to meet the individual's 
409.31  health, safety, and welfare. 
409.32     Sec. 53.  [DIRECTION TO THE COMMISSIONER; HOME AND 
409.33  COMMUNITY-BASED SERVICES RESOURCE ALLOCATION METHOD 
409.34  DEVELOPMENT.] 
409.35     The commissioner shall consult with representatives of 
409.36  persons with disabilities, their families and guardians, 
410.1   counties, service providers, and advocacy organizations to 
410.2   develop recommendations for a statewide method of allocating 
410.3   resources sufficient to meet the identified needs of persons 
410.4   eligible for home and community-based waiver services under 
410.5   Minnesota Statutes, sections 256B.0916 and 256B.49.  The 
410.6   recommendations shall include provisions that address the 
410.7   feasibility of (1) offering incentives to persons with less 
410.8   urgent service needs who are receiving services or on the 
410.9   waiting list to postpone their access to home and 
410.10  community-based service options, (2) providing case management 
410.11  services to individuals on the MR/RC waiting list, (3) analyzing 
410.12  the impact of allocating resources on rates, payments, and 
410.13  changes in services to people, (4) analyzing individual 
410.14  capitation, and (5) evaluating whether the parental fee 
410.15  structure should be modified to reflect service utilization 
410.16  differences.  The recommendations shall be provided to the 
410.17  legislative committees with jurisdiction over health and human 
410.18  services issues by January 15, 2005.  A status report shall be 
410.19  provided to the committee by January 15, 2004. 
410.20     Sec. 54.  [HOME AND COMMUNITY-BASED SERVICES FUNDING 
410.21  METHODOLOGY.] 
410.22     Beginning July 1, 2003, before making significant 
410.23  administrative changes in the funding methodology for the home 
410.24  and community-based waiver for persons with mental retardation 
410.25  or a related condition, the commissioner shall consult with 
410.26  representatives of counties, service providers, and persons with 
410.27  disabilities and their families to provide specific information 
410.28  about the funding formula and funding changes and the 
410.29  opportunity to comment at least 90 days before the changes 
410.30  become effective. 
410.31     Sec. 55.  [CASE MANAGEMENT ACCESS FOR PERSONS SEEKING 
410.32  COMMUNITY-BASED SERVICES.] 
410.33     When a person requests services authorized under Minnesota 
410.34  Statutes, section 256B.0621, 256B.092, or 256B.49, subdivision 
410.35  13, the county must determine whether the person qualifies, 
410.36  begin the screening process, begin individualized service plan 
411.1   development, and provide mandated case management services or 
411.2   relocation service coordination to those eligible within a 
411.3   reasonable time.  If a county is unable to provide case 
411.4   management services within the required time period under 
411.5   sections 256B.0621, subdivision 7; 256B.49, subdivision 13; and 
411.6   Minnesota Rules, parts 9525.0004 to 9525.0036, the county shall 
411.7   contract for case management services to meet the obligation.  
411.8      Sec. 56.  [CASE MANAGEMENT SERVICES REDESIGN.] 
411.9      In consultation with representatives for consumers, 
411.10  consumer advocates, counties, and service providers, the 
411.11  commissioner shall develop proposed legislation for case 
411.12  management changes that will (1) streamline administration, (2) 
411.13  improve consumer access to case management services, (3) assess 
411.14  the feasibility of a comprehensive universal assessment protocol 
411.15  for persons seeking community supports, (4) provide 
411.16  recommendations to case managers on reasonable means to meet 
411.17  consumer needs given resource allocation methods, (5) establish 
411.18  accountability for funds and performance measures, (6) provide 
411.19  for consumer choice of the case management service vendor, and 
411.20  (7) evaluate whether case management services to individuals 
411.21  with mental retardation or a related condition under Minnesota 
411.22  Statutes, section 256B.092, not reimbursed as a waivered service 
411.23  should be paid by the state.  The proposed legislation shall be 
411.24  provided to the legislative committees with jurisdiction over 
411.25  health and human services issues by January 15, 2005. 
411.26     Sec. 57.  [VACANCY LISTINGS.] 
411.27     The commissioner of human services shall work with 
411.28  interested stakeholders on how provider and industry specific 
411.29  Web sites can provide useful information to consumers on bed 
411.30  vacancies for group residential housing providers and 
411.31  intermediate care facilities for persons with mental retardation 
411.32  and related conditions.  Providers and industry trade 
411.33  organizations are responsible for all costs related to 
411.34  maintaining Web sites listing bed vacancies. 
411.35     Sec. 58.  [HOMELESS SERVICES; STATE CONTRACTS.] 
411.36     The commissioner of human services may contract directly 
412.1   with nonprofit organizations providing homeless services in two 
412.2   or more counties.  No more than two percent of the Children's 
412.3   and Community Social Services Act funds may be set aside to 
412.4   provide for contracts under this section.  
412.5      Sec. 59.  [GOVERNOR'S COUNCIL ON DEVELOPMENTAL DISABILITY, 
412.6   OMBUDSMAN FOR MENTAL HEALTH AND MENTAL RETARDATION, AND COUNCIL 
412.7   ON DISABILITIES.] 
412.8      The governor's council on developmental disability under 
412.9   Minnesota Statutes, section 16B.053, the ombudsman for mental 
412.10  health and mental retardation under Minnesota Statutes, section 
412.11  245.92, the centers for independent living, and the council on 
412.12  disability under Minnesota Statutes, section 256.482, must study 
412.13  the feasibility of (1) space coordination, (2) shared use of 
412.14  technology, (3) coordination of resource priorities, and (4) 
412.15  consolidation and make recommendations to the house and senate 
412.16  committees with jurisdiction over these entities by January 15, 
412.17  2004. 
412.18     Sec. 60.  [GOVERNOR'S COUNCIL ON DEVELOPMENTAL DISABILITY.] 
412.19     The governor's council on developmental disability under 
412.20  Minnesota Statutes, section 16B.053, shall provide an annual 
412.21  report of its activities to the house and senate committees with 
412.22  jurisdiction over human services by February 1 of each year. 
412.23     Sec. 61.  [LICENSING CHANGE.] 
412.24     Notwithstanding any law or rule to the contrary, the 
412.25  commissioner of human services shall allow an existing 
412.26  intermediate care facility for persons with mental retardation 
412.27  or related conditions located in Goodhue county serving 39 
412.28  children to be converted to four separately licensed or 
412.29  certified cottages serving up to six children each. 
412.30     Sec. 62.  [REVISOR'S INSTRUCTION.] 
412.31     For sections in Minnesota Statutes and Minnesota Rules 
412.32  affected by the repealed sections in this article, the revisor 
412.33  shall delete internal cross-references where appropriate and 
412.34  make changes necessary to correct the punctuation, grammar, or 
412.35  structure of the remaining text and preserve its meaning. 
412.36     Sec. 63.  [REPEALER.] 
413.1      (a) Minnesota Statutes 2002, section 252.32, subdivision 2, 
413.2   is repealed July 1, 2003. 
413.3      (b) Minnesota Statutes 2002, section 245.4712, subdivision 
413.4   2, is repealed July 1, 2005. 
413.5      (c) Laws 2001, First Special Session chapter 9, article 13, 
413.6   section 24, is repealed July 1, 2003. 
413.7                              ARTICLE 5 
413.8                         CHILDREN'S SERVICES 
413.9      Section 1.  Minnesota Statutes 2002, section 256B.0625, 
413.10  subdivision 20, is amended to read: 
413.11     Subd. 20.  [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 
413.12  extent authorized by rule of the state agency, medical 
413.13  assistance covers case management services to persons with 
413.14  serious and persistent mental illness and children with severe 
413.15  emotional disturbance.  Services provided under this section 
413.16  must meet the relevant standards in sections 245.461 to 
413.17  245.4888, the Comprehensive Adult and Children's Mental Health 
413.18  Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 
413.19  9505.0322, excluding subpart 10. 
413.20     (b) Entities meeting program standards set out in rules 
413.21  governing family community support services as defined in 
413.22  section 245.4871, subdivision 17, are eligible for medical 
413.23  assistance reimbursement for case management services for 
413.24  children with severe emotional disturbance when these services 
413.25  meet the program standards in Minnesota Rules, parts 9520.0900 
413.26  to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 
413.27     (c) Medical assistance and MinnesotaCare payment for mental 
413.28  health case management shall be made on a monthly basis.  In 
413.29  order to receive payment for an eligible child, the provider 
413.30  must document at least a face-to-face contact with the child, 
413.31  the child's parents, or the child's legal representative.  To 
413.32  receive payment for an eligible adult, the provider must 
413.33  document: 
413.34     (1) at least a face-to-face contact with the adult or the 
413.35  adult's legal representative; or 
413.36     (2) at least a telephone contact with the adult or the 
414.1   adult's legal representative and document a face-to-face contact 
414.2   with the adult or the adult's legal representative within the 
414.3   preceding two months. 
414.4      (d) Payment for mental health case management provided by 
414.5   county or state staff shall be based on the monthly rate 
414.6   methodology under section 256B.094, subdivision 6, paragraph 
414.7   (b), with separate rates calculated for child welfare and mental 
414.8   health, and within mental health, separate rates for children 
414.9   and adults. 
414.10     (e) Payment for mental health case management provided by 
414.11  Indian health services or by agencies operated by Indian tribes 
414.12  may be made according to this section or other relevant 
414.13  federally approved rate setting methodology. 
414.14     (f) Payment for mental health case management provided by 
414.15  vendors who contract with a county or Indian tribe shall be 
414.16  based on a monthly rate negotiated by the host county or tribe.  
414.17  The negotiated rate must not exceed the rate charged by the 
414.18  vendor for the same service to other payers.  If the service is 
414.19  provided by a team of contracted vendors, the county or tribe 
414.20  may negotiate a team rate with a vendor who is a member of the 
414.21  team.  The team shall determine how to distribute the rate among 
414.22  its members.  No reimbursement received by contracted vendors 
414.23  shall be returned to the county or tribe, except to reimburse 
414.24  the county or tribe for advance funding provided by the county 
414.25  or tribe to the vendor. 
414.26     (g) If the service is provided by a team which includes 
414.27  contracted vendors, tribal staff, and county or state staff, the 
414.28  costs for county or state staff participation in the team shall 
414.29  be included in the rate for county-provided services.  In this 
414.30  case, the contracted vendor, the tribal agency, and the county 
414.31  may each receive separate payment for services provided by each 
414.32  entity in the same month.  In order to prevent duplication of 
414.33  services, each entity must document, in the recipient's file, 
414.34  the need for team case management and a description of the roles 
414.35  of the team members. 
414.36     (h) The commissioner shall calculate the nonfederal share 
415.1   of actual medical assistance and general assistance medical care 
415.2   payments for each county, based on the higher of calendar year 
415.3   1995 or 1996, by service date, project that amount forward to 
415.4   1999, and transfer one-half of the result from medical 
415.5   assistance and general assistance medical care to each county's 
415.6   mental health grants under sections 245.4886 and 256E.12 for 
415.7   calendar year 1999.  The annualized minimum amount added to each 
415.8   county's mental health grant shall be $3,000 per year for 
415.9   children and $5,000 per year for adults.  The commissioner may 
415.10  reduce the statewide growth factor in order to fund these 
415.11  minimums.  The annualized total amount transferred shall become 
415.12  part of the base for future mental health grants for each county.
415.13     (i) Any net increase in revenue to the county or tribe as a 
415.14  result of the change in this section must be used to provide 
415.15  expanded mental health services as defined in sections 245.461 
415.16  to 245.4888, the Comprehensive Adult and Children's Mental 
415.17  Health Acts, excluding inpatient and residential treatment.  For 
415.18  adults, increased revenue may also be used for services and 
415.19  consumer supports which are part of adult mental health projects 
415.20  approved under Laws 1997, chapter 203, article 7, section 25.  
415.21  For children, increased revenue may also be used for respite 
415.22  care and nonresidential individualized rehabilitation services 
415.23  as defined in section 245.492, subdivisions 17 and 23.  
415.24  "Increased revenue" has the meaning given in Minnesota Rules, 
415.25  part 9520.0903, subpart 3.  
415.26     (j) Notwithstanding section 256B.19, subdivision 1, the 
415.27  nonfederal share of costs for mental health case management 
415.28  shall be provided by the recipient's county of responsibility, 
415.29  as defined in sections 256G.01 to 256G.12, from sources other 
415.30  than federal funds or funds used to match other federal funds.  
415.31  If the service is provided by a tribal agency, the nonfederal 
415.32  share, if any, shall be provided by the recipient's tribe.  
415.33     (k) (j) The commissioner may suspend, reduce, or terminate 
415.34  the reimbursement to a provider that does not meet the reporting 
415.35  or other requirements of this section.  The county of 
415.36  responsibility, as defined in sections 256G.01 to 256G.12, or, 
416.1   if applicable, the tribal agency, is responsible for any federal 
416.2   disallowances.  The county or tribe may share this 
416.3   responsibility with its contracted vendors.  
416.4      (l) (k) The commissioner shall set aside a portion of the 
416.5   federal funds earned under this section to repay the special 
416.6   revenue maximization account under section 256.01, subdivision 
416.7   2, clause (15).  The repayment is limited to: 
416.8      (1) the costs of developing and implementing this section; 
416.9   and 
416.10     (2) programming the information systems. 
416.11     (m) (l) Payments to counties and tribal agencies for case 
416.12  management expenditures under this section shall only be made 
416.13  from federal earnings from services provided under this 
416.14  section.  Payments to county-contracted vendors shall include 
416.15  both the federal earnings and the county share. 
416.16     (n) (m) Notwithstanding section 256B.041, county payments 
416.17  for the cost of mental health case management services provided 
416.18  by county or state staff shall not be made to the state 
416.19  treasurer.  For the purposes of mental health case management 
416.20  services provided by county or state staff under this section, 
416.21  the centralized disbursement of payments to counties under 
416.22  section 256B.041 consists only of federal earnings from services 
416.23  provided under this section. 
416.24     (o) (n) Case management services under this subdivision do 
416.25  not include therapy, treatment, legal, or outreach services. 
416.26     (p) (o) If the recipient is a resident of a nursing 
416.27  facility, intermediate care facility, or hospital, and the 
416.28  recipient's institutional care is paid by medical assistance, 
416.29  payment for case management services under this subdivision is 
416.30  limited to the last 180 days of the recipient's residency in 
416.31  that facility and may not exceed more than six months in a 
416.32  calendar year. 
416.33     (q) (p) Payment for case management services under this 
416.34  subdivision shall not duplicate payments made under other 
416.35  program authorities for the same purpose. 
416.36     (r) (q) By July 1, 2000, the commissioner shall evaluate 
417.1   the effectiveness of the changes required by this section, 
417.2   including changes in number of persons receiving mental health 
417.3   case management, changes in hours of service per person, and 
417.4   changes in caseload size. 
417.5      (s) (r) For each calendar year beginning with the calendar 
417.6   year 2001, the annualized amount of state funds for each county 
417.7   determined under paragraph (h) shall be adjusted by the county's 
417.8   percentage change in the average number of clients per month who 
417.9   received case management under this section during the fiscal 
417.10  year that ended six months prior to the calendar year in 
417.11  question, in comparison to the prior fiscal year. 
417.12     (t) (s) For counties receiving the minimum allocation of 
417.13  $3,000 or $5,000 described in paragraph (h), the adjustment in 
417.14  paragraph (s) (r) shall be determined so that the county 
417.15  receives the higher of the following amounts: 
417.16     (1) a continuation of the minimum allocation in paragraph 
417.17  (h); or 
417.18     (2) an amount based on that county's average number of 
417.19  clients per month who received case management under this 
417.20  section during the fiscal year that ended six months prior to 
417.21  the calendar year in question, times the average statewide grant 
417.22  per person per month for counties not receiving the minimum 
417.23  allocation. 
417.24     (u) (t) The adjustments in paragraphs (s) (r) and 
417.25  (t) (s) shall be calculated separately for children and adults. 
417.26     Sec. 2.  Minnesota Statutes 2002, section 256B.0625, 
417.27  subdivision 23, is amended to read: 
417.28     Subd. 23.  [DAY TREATMENT SERVICES.] Medical assistance 
417.29  covers day treatment services as specified in sections 245.462, 
417.30  subdivision 8, and 245.4871, subdivision 10, that are provided 
417.31  under contract with the county board.  Notwithstanding Minnesota 
417.32  Rules, part 9505.0323, subpart 15, the commissioner may set 
417.33  authorization thresholds for day treatment for adults according 
417.34  to section 256B.0625, subdivision 25.  Effective July 1, 2004, 
417.35  medical assistance covers day treatment services for children as 
417.36  specified under section 256B.0943.  Medical assistance coverage 
418.1   for day treatment for adults ends on June 30, 2005. 
418.2      Sec. 3.  Minnesota Statutes 2002, section 256B.0625, is 
418.3   amended by adding a subdivision to read: 
418.4      Subd. 35a.  [CHILDREN'S MENTAL HEALTH CRISIS RESPONSE 
418.5   SERVICES.] Medical assistance covers children's mental health 
418.6   crisis response services according to section 256B.0944. 
418.7      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
418.8      Sec. 4.  Minnesota Statutes 2002, section 256B.0625, is 
418.9   amended by adding a subdivision to read: 
418.10     Subd. 35b.  [CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.] 
418.11  Medical assistance covers children's therapeutic services and 
418.12  supports according to section 256B.0943. 
418.13     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
418.14     Sec. 5.  Minnesota Statutes 2002, section 256B.0625, is 
418.15  amended by adding a subdivision to read: 
418.16     Subd. 45.  [SUBACUTE PSYCHIATRIC CARE FOR PERSONS UNDER 21 
418.17  YEARS OF AGE.] Medical assistance covers subacute psychiatric 
418.18  care for person under 21 years of age when: 
418.19     (1) the services meet the requirements of Code of Federal 
418.20  Regulations, title 42, section 440.160; 
418.21     (2) the facility is accredited as a psychiatric treatment 
418.22  facility by the joint commission on accreditation of healthcare 
418.23  organizations, the commission on accreditation of rehabilitation 
418.24  facilities, or the council on accreditation; and 
418.25     (3) the facility is licensed by the commissioner of health 
418.26  under section 144.50. 
418.27     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
418.28     Sec. 6.  [256B.0943] [CHILDREN'S THERAPEUTIC SERVICES AND 
418.29  SUPPORTS.] 
418.30     Subdivision 1.  [DEFINITIONS.] For purposes of this 
418.31  section, the following terms have the meanings given them. 
418.32     (a) "Children's therapeutic services and supports" means 
418.33  the flexible package of mental health services for children who 
418.34  require varying therapeutic and rehabilitative levels of 
418.35  intervention.  The services are time-limited interventions that 
418.36  are delivered using various treatment modalities and 
419.1   combinations of services designed to reach treatment outcomes 
419.2   identified in the individual treatment plan. 
419.3      (b) "Clinical supervision" means the overall responsibility 
419.4   of the mental health professional for the control and direction 
419.5   of individualized treatment planning, service delivery, and 
419.6   treatment review for each client.  A mental health professional 
419.7   who is an enrolled Minnesota health care program provider 
419.8   accepts full professional responsibility for a supervisee's 
419.9   actions and decisions, instructs the supervisee in the 
419.10  supervisee's work, and oversees or directs the supervisee's work.
419.11     (c) "County board" means the county board of commissioners 
419.12  or board established under sections 402.01 to 402.10 or 471.59. 
419.13     (d) "Crisis assistance" has the meaning given in section 
419.14  245.4871, subdivision 9a. 
419.15     (e) "Culturally competent provider" means a provider who 
419.16  understands and can utilize to a client's benefit the client's 
419.17  culture when providing services to the client.  A provider may 
419.18  be culturally competent because the provider is of the same 
419.19  cultural or ethnic group as the client or the provider has 
419.20  developed the knowledge and skills through training and 
419.21  experience to provide services to culturally diverse clients. 
419.22     (f) "Day treatment program" for children means a site-based 
419.23  structured program consisting of group psychotherapy for more 
419.24  than three individuals and other intensive therapeutic services 
419.25  provided by a multidisciplinary team, under the clinical 
419.26  supervision of a mental health professional. 
419.27     (g) "Diagnostic assessment" has the meaning given in 
419.28  section 245.4871, subdivision 11. 
419.29     (h) "Direct service time" means the time that a mental 
419.30  health professional, mental health practitioner, or mental 
419.31  health behavioral aide spends face-to-face with a client and the 
419.32  client's family.  Direct service time includes time in which the 
419.33  provider obtains a client's history or provides service 
419.34  components of children's therapeutic services and supports.  
419.35  Direct service time does not include time doing work before and 
419.36  after providing direct services, including scheduling, 
420.1   maintaining clinical records, consulting with others about the 
420.2   client's mental health status, preparing reports, receiving 
420.3   clinical supervision directly related to the client's 
420.4   psychotherapy session, and revising the client's individual 
420.5   treatment plan. 
420.6      (i) "Direction of mental health behavioral aide" means the 
420.7   activities of a mental health professional or mental health 
420.8   practitioner in guiding the mental health behavioral aide in 
420.9   providing services to a client.  The direction of a mental 
420.10  health behavioral aide must be based on the client's 
420.11  individualized treatment plan and meet the requirements in 
420.12  subdivision 6, paragraph (b), clause (5). 
420.13     (j) "Emotional disturbance" has the meaning given in 
420.14  section 245.4871, subdivision 15.  For persons at least age 18 
420.15  but under age 21, mental illness has the meaning given in 
420.16  section 245.462, subdivision 20, paragraph (a). 
420.17     (k) "Individual behavioral plan" means a plan of 
420.18  intervention, treatment, and services for a child written by a 
420.19  mental health professional or mental health practitioner, under 
420.20  the clinical supervision of a mental health professional, to 
420.21  guide the work of the mental health behavioral aide. 
420.22     (l) "Individual treatment plan" has the meaning given in 
420.23  section 245.4871, subdivision 21. 
420.24     (m) "Mental health professional" means an individual as 
420.25  defined in section 245.4871, subdivision 27, clauses (1) to (5), 
420.26  or tribal vendor as defined in section 256B.02, subdivision 7, 
420.27  paragraph (b). 
420.28     (n) "Preschool program" means a day program licensed under 
420.29  Minnesota Rules, parts 9503.0005 to 9503.0175, and enrolled as a 
420.30  children's therapeutic services and supports provider to provide 
420.31  a structured treatment program to a child who is at least 33 
420.32  months old but who has not yet attended the first day of 
420.33  kindergarten. 
420.34     (o) "Skills training" means individual, family, or group 
420.35  training designed to improve the basic functioning of the child 
420.36  with emotional disturbance and the child's family in the 
421.1   activities of daily living and community living, and to improve 
421.2   the social functioning of the child and the child's family in 
421.3   areas important to the child's maintaining or reestablishing 
421.4   residency in the community.  Individual, family, and group 
421.5   skills training must: 
421.6      (1) consist of activities designed to promote skill 
421.7   development of the child and the child's family in the use of 
421.8   age-appropriate daily living skills, interpersonal and family 
421.9   relationships, and leisure and recreational services; 
421.10     (2) consist of activities that will assist the family's 
421.11  understanding of normal child development and to use parenting 
421.12  skills that will help the child with emotional disturbance 
421.13  achieve the goals outlined in the child's individual treatment 
421.14  plan; and 
421.15     (3) promote family preservation and unification, promote 
421.16  the family's integration with the community, and reduce the use 
421.17  of unnecessary out-of-home placement or institutionalization of 
421.18  children with emotional disturbance. 
421.19     Subd. 2.  [COVERED SERVICE COMPONENTS OF CHILDREN'S 
421.20  THERAPEUTIC SERVICES AND SUPPORTS.] (a) Subject to federal 
421.21  approval, medical assistance covers medically necessary 
421.22  children's therapeutic services and supports as defined in this 
421.23  section that an eligible provider entity under subdivisions 4 
421.24  and 5 provides to a client eligible under subdivision 3. 
421.25     (b) The service components of children's therapeutic 
421.26  services and supports are: 
421.27     (1) individual, family, and group psychotherapy; 
421.28     (2) individual, family, or group skills training provide by 
421.29  a mental health professional or mental health practitioner; 
421.30     (3) crisis assistance; 
421.31     (4) mental health behavioral aide services; and 
421.32     (5) direction of a mental health behavioral aide. 
421.33     (c) Service components may be combined to constitute 
421.34  therapeutic programs, including day treatment programs and 
421.35  preschool programs.  Although day treatment and preschool 
421.36  programs have specific client and provider eligibility 
422.1   requirements, medical assistance only pays for the service 
422.2   components listed in paragraph (b). 
422.3      Subd. 3.  [DETERMINATION OF CLIENT ELIGIBILITY.] A client's 
422.4   eligibility to receive children's therapeutic services and 
422.5   supports under this section shall be determined based on a 
422.6   diagnostic assessment by a mental health professional that is 
422.7   performed within 180 days of the initial start of service.  The 
422.8   diagnostic assessment must: 
422.9      (1) include current diagnoses on all five axes of the 
422.10  client's current mental health status; 
422.11     (2) determine whether a child under age 18 has a diagnosis 
422.12  of emotional disturbance or, if the person is between the ages 
422.13  of 18 and 21, whether the person has a mental illness; 
422.14     (3) document children's therapeutic services and supports 
422.15  as medically necessary to address an identified disability, 
422.16  functional impairment, and the individual client's needs and 
422.17  goals; 
422.18     (4) be used in the development of the individualized 
422.19  treatment plan; and 
422.20     (5) be completed annually until age 18.  For individuals 
422.21  between age 18 and 21, unless a client's mental health condition 
422.22  has changed markedly since the client's most recent diagnostic 
422.23  assessment, annual updating is necessary.  For the purpose of 
422.24  this section, "updating" means a written summary, including 
422.25  current diagnoses on all five axes, by a mental health 
422.26  professional of the client's current mental health status and 
422.27  service needs. 
422.28     Subd. 4.  [PROVIDER ENTITY CERTIFICATION.] (a) Effective 
422.29  July 1, 2003, the commissioner shall establish an initial 
422.30  provider entity application and certification process and 
422.31  recertification process to determine whether a provider entity 
422.32  has an administrative and clinical infrastructure that meets the 
422.33  requirements in subdivisions 5 and 6.  The commissioner shall 
422.34  recertify a provider entity at least every three years.  The 
422.35  commissioner shall establish a process for decertification of a 
422.36  provider entity that no longer meets the requirements in this 
423.1   section.  The county, tribe, and the commissioner shall be 
423.2   mutually responsible and accountable for the county's, tribe's, 
423.3   and state's part of the certification, recertification, and 
423.4   decertification processes. 
423.5      (b) For purposes of this section, a provider entity must be:
423.6      (1) an Indian health services facility or a facility owned 
423.7   and operated by a tribe or tribal organization operating as a 
423.8   638 facility under Public Law 93-368 certified by the state; 
423.9      (2) a county-operated entity certified by the state; or 
423.10     (3) a noncounty entity recommended for certification by the 
423.11  provider's host county and certified by the state. 
423.12     Subd. 5.  [PROVIDER ENTITY ADMINISTRATIVE INFRASTRUCTURE 
423.13  REQUIREMENTS.] (a) To be an eligible provider entity under this 
423.14  section, a provider entity must have an administrative 
423.15  infrastructure that establishes authority and accountability for 
423.16  decision making and oversight of functions, including finance, 
423.17  personnel, system management, clinical practice, and performance 
423.18  measurement.  The provider must have written policies and 
423.19  procedures that it reviews and updates every three years and 
423.20  distributes to staff initially and upon each subsequent update. 
423.21     (b) The administrative infrastructure written policies and 
423.22  procedures must include: 
423.23     (1) personnel procedures, including a process for:  (i) 
423.24  recruiting, hiring, training, and retention of culturally and 
423.25  linguistically competent providers; (ii) conducting a criminal 
423.26  background check on all direct service providers and volunteers; 
423.27  (iii) investigating, reporting, and acting on violations of 
423.28  ethical conduct standards; (iv) investigating, reporting, and 
423.29  acting on violations of data privacy policies that are compliant 
423.30  with federal and state laws; (v) utilizing volunteers, including 
423.31  screening applicants, training and supervising volunteers, and 
423.32  providing liability coverage for volunteers; and (vi) 
423.33  documenting that a mental health professional, mental health 
423.34  practitioner, or mental health behavioral aide meets the 
423.35  applicable provider qualification criteria, training criteria 
423.36  under subdivision 8, and clinical supervision or direction of a 
424.1   mental health behavioral aide requirements under subdivision 6; 
424.2      (2) fiscal procedures, including internal fiscal control 
424.3   practices and a process for collecting revenue that is compliant 
424.4   with federal and state laws; 
424.5      (3) if a client is receiving services from a case manager 
424.6   or other provider entity, a service coordination process that 
424.7   ensures services are provided in the most appropriate manner to 
424.8   achieve maximum benefit to the client.  The provider entity must 
424.9   ensure coordination and nonduplication of services consistent 
424.10  with county board coordination procedures established under 
424.11  section 245.4881, subdivision 5; 
424.12     (4) a performance measurement system, including monitoring 
424.13  to determine cultural appropriateness of services identified in 
424.14  the individual treatment plan, as determined by the client's 
424.15  culture, beliefs, values, and language, and family-driven 
424.16  services; and 
424.17     (5) a process to establish and maintain individual client 
424.18  records.  The client's records must include:  (i) the client's 
424.19  personal information; (ii) forms applicable to data privacy; 
424.20  (iii) the client's diagnostic assessment, updates, tests, 
424.21  individual treatment plan, and individual behavior plan, if 
424.22  necessary; (iv) documentation of service delivery as specified 
424.23  under subdivision 6; (v) telephone contacts; (vi) discharge 
424.24  plan; and (vii) if applicable, insurance information. 
424.25     Subd. 6.  [PROVIDER ENTITY CLINICAL INFRASTRUCTURE 
424.26  REQUIREMENTS.] (a) To be an eligible provider entity under this 
424.27  section, a provider entity must have a clinical infrastructure 
424.28  that utilizes diagnostic assessment, an individualized treatment 
424.29  plan, service delivery, and individual treatment plan review 
424.30  that are culturally competent, child-centered, and family-driven 
424.31  to achieve maximum benefit for the client.  The provider entity 
424.32  must review and update the clinical policies and procedures 
424.33  every three years and must distribute the policies and 
424.34  procedures to staff initially and upon each subsequent update. 
424.35     (b) The clinical infrastructure written policies and 
424.36  procedures must include policies and procedures for: 
425.1      (1) providing or obtaining a client's diagnostic assessment 
425.2   that identifies acute and chronic clinical disorders, 
425.3   co-occurring medical conditions, sources of psychological and 
425.4   environmental problems, and a functional assessment.  The 
425.5   functional assessment must clearly summarize the client's 
425.6   individual strengths and needs; 
425.7      (2) developing an individual treatment plan that is:  (i) 
425.8   based on the information in the client's diagnostic assessment; 
425.9   (ii) developed no later than the end of the first psychotherapy 
425.10  session after the completion of the client's diagnostic 
425.11  assessment by the mental health professional who provides the 
425.12  client's psychotherapy; (iii) developed through a 
425.13  child-centered, family-driven planning process that identifies 
425.14  service needs and individualized, planned, and 
425.15  culturally-appropriate interventions that contain specific 
425.16  treatment goals and objectives for the client and the client's 
425.17  family or foster family; (iv) reviewed at least once every 90 
425.18  days and revised, if necessary; and (v) signed by the client or, 
425.19  if appropriate, by the client's parent or other person 
425.20  authorized by statute to consent to mental health services for 
425.21  the client; 
425.22     (3) developing an individual behavior plan that documents 
425.23  services to be provided by the mental health behavioral aide.  
425.24  The individual behavior plan must include:  (i) detailed 
425.25  instructions on the service to be provided; (ii) time allocated 
425.26  to each service; (iii) methods of documenting the child's 
425.27  behavior; (iv) methods of monitoring the child's progress in 
425.28  reaching objectives; and (v) goals to increase or decrease 
425.29  targeted behavior as identified in the individual treatment 
425.30  plan; 
425.31     (4) clinical supervision of the mental health practitioner 
425.32  and mental health behavioral aide.  A mental health professional 
425.33  must document the clinical supervision the professional provides 
425.34  by cosigning individual treatment plans and making entries in 
425.35  the client's record on supervisory activities.  Clinical 
425.36  supervision does not include the authority to make or terminate 
426.1   court-ordered placements of the child.  A clinical supervisor 
426.2   must be available for urgent consultation as required by the 
426.3   individual client's needs or the situation.  Clinical 
426.4   supervision may occur individually or in a small group to 
426.5   discuss treatment and review progress toward goals.  The focus 
426.6   of clinical supervision must be the client's treatment needs and 
426.7   progress and the mental health practitioner's or behavioral 
426.8   aide's ability to provide services; 
426.9      (5) providing direction to a mental health behavioral 
426.10  aide.  For entities that employ mental health behavioral aides, 
426.11  the clinical supervisor must be employed by the provider entity 
426.12  to ensure necessary and appropriate oversight for the client's 
426.13  treatment and continuity of care.  The mental health 
426.14  professional or mental health practitioner giving direction must 
426.15  begin with the goals on the individualized treatment plan, and 
426.16  instruct the mental health behavioral aide on how to construct 
426.17  therapeutic activities and interventions that will lead to goal 
426.18  attainment.  The professional or practitioner giving direction 
426.19  must also instruct the mental health behavioral aide about the 
426.20  client's diagnosis, functional status, and other characteristics 
426.21  that are likely to affect service delivery.  Direction must also 
426.22  include determining that the mental health behavioral aide has 
426.23  the skills to interact with the client and the client's family 
426.24  in ways that convey personal and cultural respect and that the 
426.25  aide actively solicits information relevant to treatment from 
426.26  the family.  The aide must be able to clearly explain the 
426.27  activities the aide is doing with the client and the activities' 
426.28  relationship to treatment goals.  Direction is more didactic 
426.29  than is supervision and requires the professional or 
426.30  practitioner providing it to continuously evaluate the mental 
426.31  health behavioral aide's ability to carry out the activities of 
426.32  the individualized treatment plan and the individualized 
426.33  behavior plan.  When providing direction, the professional or 
426.34  practitioner must:  (i) review progress notes prepared by the 
426.35  mental health behavioral aide for accuracy and consistency with 
426.36  diagnostic assessment, treatment plan, and behavior goals and 
427.1   the professional or practitioner must approve and sign the 
427.2   progress notes; (ii) identify changes in treatment strategies, 
427.3   revise the individual behavior plan, and communicate treatment 
427.4   instructions and methodologies as appropriate to ensure that 
427.5   treatment is implemented correctly; (iii) demonstrate 
427.6   family-friendly behaviors that support healthy collaboration 
427.7   among the child, the child's family, and providers as treatment 
427.8   is planned and implemented; (iv) ensure that the mental health 
427.9   behavioral aide is able to effectively communicate with the 
427.10  child, the child's family, and the provider; and (v) record the 
427.11  results of any evaluation and corrective actions taken to modify 
427.12  the work of the mental health behavioral aide; 
427.13     (6) providing service delivery that implements the 
427.14  individual treatment plan and meets the requirements under 
427.15  subdivision 9; and 
427.16     (7) individual treatment plan review.  The review must 
427.17  determine the extent to which the services have met the goals 
427.18  and objectives in the previous treatment plan.  The review must 
427.19  assess the client's progress and ensure that services and 
427.20  treatment goals continue to be necessary and appropriate to the 
427.21  client and the client's family or foster family.  Revision of 
427.22  the individual treatment plan does not require a new diagnostic 
427.23  assessment unless the client's mental health status has changed 
427.24  markedly.  The updated treatment plan must be signed by the 
427.25  client, if appropriate, and by the client's parent or other 
427.26  person authorized by statute to give consent to the mental 
427.27  health services for the child. 
427.28     Subd. 7.  [QUALIFICATIONS OF INDIVIDUAL AND TEAM 
427.29  PROVIDERS.] (a) An individual or team provider working within 
427.30  the scope of the provider's practice or qualifications may 
427.31  provide service components of children's therapeutic services 
427.32  and supports that are identified as medically necessary in a 
427.33  client's individual treatment plan. 
427.34     (b) An individual provider and multidisciplinary team 
427.35  include: 
427.36     (1) a mental health professional as defined in subdivision 
428.1   1, paragraph (m); 
428.2      (2) a mental health practitioner as defined in section 
428.3   245.4871, subdivision 26.  The mental health practitioner must 
428.4   work under the clinical supervision of a mental health 
428.5   professional; 
428.6      (3) a mental health behavioral aide working under the 
428.7   direction of a mental health professional to implement the 
428.8   rehabilitative mental health services identified in the client's 
428.9   individual treatment plan.  A level I mental health behavioral 
428.10  aide must:  (i) be at least 18 years old; (ii) have a high 
428.11  school diploma or general equivalency diploma (GED) or two years 
428.12  of experience as a primary caregiver to a child with severe 
428.13  emotional disturbance within the previous ten years; and (iii) 
428.14  meet preservices and continuing education requirements under 
428.15  subdivision 8.  A level II mental health behavioral aide must: 
428.16  (i) be at least 18 years old; (ii) have an associate or 
428.17  bachelor's degree or 4,000 hours of experience in delivering 
428.18  clinical services in the treatment of mental illness concerning 
428.19  children or adolescents; and (iii) meet preservice and 
428.20  continuing education requirements in subdivision 8; 
428.21     (4) a preschool program multidisciplinary team that 
428.22  includes at least one mental health professional and one or more 
428.23  of the following individuals under the clinical supervision of a 
428.24  mental health professional:  (i) a mental health practitioner; 
428.25  or (ii) a program person, including a teacher, assistant 
428.26  teacher, or aide, who meets the qualifications and training 
428.27  standards of a level I mental health behavioral aide; or 
428.28     (5) a day treatment multidisciplinary team that includes at 
428.29  least one mental health professional and one mental health 
428.30  practitioner. 
428.31     Subd. 8.  [REQUIRED PRESERVICE AND CONTINUING 
428.32  EDUCATION.] (a) A provider entity shall establish a plan to 
428.33  provide preservice and continuing education for staff.  The plan 
428.34  must clearly describe the type of training necessary to maintain 
428.35  current skills and obtain new skills, and that relates to the 
428.36  provider entity's goals and objectives for services offered. 
429.1      (b) A provider that employs a mental health behavioral aide 
429.2   under this section must require the mental health behavioral 
429.3   aide to complete 30 hours of preservice training.  The 
429.4   preservice training must include topics specified in Minnesota 
429.5   Rules, part 9535.4068, subparts 1 and 2, and parent team 
429.6   training.  The preservice training must include 15 hours of 
429.7   in-person training of a mental health behavioral aide in mental 
429.8   health services delivery and eight hours of parent team 
429.9   training.  Components of parent team training include:  
429.10     (1) partnering with parents; 
429.11     (2) fundamentals of family support; 
429.12     (3) fundamentals of policy and decision making; 
429.13     (4) defining equal partnership; 
429.14     (5) complexities of the parent and service provider 
429.15  partnership in multiple service delivery systems due to system 
429.16  strengths and weaknesses; 
429.17     (6) sibling impacts; 
429.18     (7) support networks; and 
429.19     (8) community resources. 
429.20     (c) A provider entity that employs a mental health 
429.21  practitioner and a mental health behavioral aide to provide 
429.22  children's therapeutic services and supports under this section 
429.23  must require the mental health practitioner and mental health 
429.24  behavioral aide to complete 20 hours of continuing education 
429.25  every two calendar years.  The continuing education must be 
429.26  related to serving the needs of a child with emotional 
429.27  disturbance in the child's home environment and the child's 
429.28  family.  The topics covered in orientation and training must 
429.29  conform to Minnesota Rules, part 9535.4068. 
429.30     (d) The provider entity must document the mental health 
429.31  practitioner's or mental health behavioral aide's annual 
429.32  completion of the required continuing education.  The 
429.33  documentation must include the date, subject, and number of 
429.34  hours of the continuing education, and attendance records, as 
429.35  verified by the staff member's signature, job title, and the 
429.36  instructor's name.  The provider entity must keep documentation 
430.1   for each employee, including records of attendance at 
430.2   professional workshops and conferences, at a central location 
430.3   and in the employee's personnel file. 
430.4      Subd. 9.  [SERVICE DELIVERY CRITERIA.] (a) In delivering 
430.5   services under this section, a certified provider entity must 
430.6   ensure that: 
430.7      (1) each individual provider's caseload size permits the 
430.8   provider to deliver services to both clients with severe, 
430.9   complex needs and clients with less intensive needs.  The 
430.10  provider's caseload size should reasonably enable the provider 
430.11  to play an active role in service planning, monitoring, and 
430.12  delivering services to meet the client's and client's family's 
430.13  needs, as specified in each client's individual treatment plan; 
430.14     (2) site-based programs, including day treatment and 
430.15  preschool programs, provide staffing and facilities to ensure 
430.16  the client's health, safety, and protection of rights, and that 
430.17  the programs are able to implement each client's individual 
430.18  treatment plan; 
430.19     (3) a day treatment program is provided to a group of 
430.20  clients by a multidisciplinary staff under the clinical 
430.21  supervision of a mental health professional.  The day treatment 
430.22  program must be provided in and by:  (i) an outpatient hospital 
430.23  accredited by the joint commission on accreditation of health 
430.24  organizations and licensed under sections 144.50 to 144.55; (ii) 
430.25  a community mental health center under section 245.62; and (iii) 
430.26  an entity that is under contract with the county board to 
430.27  operate a program that meets the requirements of sections 
430.28  245.4712, subdivision 2, and 245.4884, subdivision 2, and 
430.29  Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment 
430.30  program must stabilize the client's mental health status while 
430.31  developing and improving the client's independent living and 
430.32  socialization skills.  The goal of the day treatment program 
430.33  must be to reduce or relieve the effects of mental illness and 
430.34  provide training to enable the client to live in the community.  
430.35  The program must be available at least one day a week for a 
430.36  minimum three-hour time block.  The three-hour time block must 
431.1   include at least one hour, but no more than two hours, of 
431.2   individual or group psychotherapy.  The remainder of the 
431.3   three-hour time block may include recreation therapy, 
431.4   socialization therapy, or independent living skills therapy, but 
431.5   only if the therapies are included in the client's individual 
431.6   treatment plan.  Day treatment programs are not part of 
431.7   inpatient or residential treatment services; and 
431.8      (4) a preschool program is a structured treatment program 
431.9   offered to a child who is at least 33 months old, but who has 
431.10  not yet reached the first day of kindergarten, by a preschool 
431.11  multidisciplinary team in a day program licensed under Minnesota 
431.12  Rules, parts 9503.0005 to 9503.0175.  The program must be 
431.13  available at least one day a week for a minimum two-hour time 
431.14  block.  The structured treatment program may include individual 
431.15  or group psychotherapy and recreation therapy, socialization 
431.16  therapy, or independent living skills therapy, if included in 
431.17  the client's individual treatment plan. 
431.18     (b) A provider entity must delivery the service components 
431.19  of children's therapeutic services and supports in compliance 
431.20  with the following requirements: 
431.21     (1) individual, family, and group psychotherapy must be 
431.22  delivered as specified in Minnesota Rules, parts 9505.0523; 
431.23     (2) individual, family, or group skills training must be 
431.24  provided by a mental health professional or a mental health 
431.25  practitioner who has a consulting relationship with a mental 
431.26  health professional who accepts full professional responsibility 
431.27  for the training; 
431.28     (3) crisis assistance must be an intense, time-limited, and 
431.29  designed to resolve or stabilize crisis through arrangements for 
431.30  direct intervention and support services to the child and the 
431.31  child's family.  Crisis assistance must utilize resources 
431.32  designed to address abrupt or substantial changes in the 
431.33  functioning of the child or the child's family as evidenced by a 
431.34  sudden change in behavior with negative consequences for well 
431.35  being, a loss of usual coping mechanisms, or the presentation of 
431.36  danger to self or others; 
432.1      (4) medically necessary services that are provided by a 
432.2   mental health behavioral aide must be designed to improve the 
432.3   functioning of the child and support the family in activities of 
432.4   daily and community living.  A mental health behavioral aide 
432.5   must document the delivery of services in written progress 
432.6   notes.  The mental health behavioral aide must implement goals 
432.7   in the treatment plan for the child's emotional disturbance that 
432.8   allow the child to acquire developmentally and therapeutically 
432.9   appropriate daily living skills, social skills, and leisure and 
432.10  recreational skills through targeted activities.  These 
432.11  activities may include: 
432.12     (i) assisting a child as needed with skills development in 
432.13  dressing, eating, and toileting; 
432.14     (ii) assisting, monitoring, and guiding the child to 
432.15  complete tasks, including facilitating the child's participation 
432.16  in medical appointments; 
432.17     (iii) observing the child and intervening to redirect the 
432.18  child's inappropriate behavior; 
432.19     (iv) assisting the child in using age-appropriate 
432.20  self-management skills as related to the child's emotional 
432.21  disorder or mental illness, including problem solving, decision 
432.22  making, communication, conflict resolution, anger management, 
432.23  social skills, and recreational skills; 
432.24     (v) implementing deescalation techniques as recommended by 
432.25  the mental health professional; 
432.26     (vi) implementing any other mental health service that the 
432.27  mental health professional has approved as being within the 
432.28  scope of the behavioral aide's duties; or 
432.29     (vii) assisting the parents to develop and use parenting 
432.30  skills that help the child achieve the goals outlined in the 
432.31  child's individual treatment plan or individual behavioral 
432.32  plan.  Parenting skills must be directed exclusively to the 
432.33  child's treatment; and 
432.34     (5) direction of a mental health behavioral aide must 
432.35  include the following: 
432.36     (i) a total of one hour of on-site observation by a mental 
433.1   health professional during the first 12 hours of service 
433.2   provided to a child; 
433.3      (ii) ongoing on-site observation by a mental health 
433.4   professional or mental health practitioner for at least a total 
433.5   of one hour during every 40 hours of service provided to a 
433.6   child; and 
433.7      (iii) immediate accessibility of the mental health 
433.8   professional or mental health practitioner to the mental health 
433.9   behavioral aide during service provision. 
433.10     Subd. 10.  [SERVICE AUTHORIZATION.] The commissioner shall 
433.11  publish in the State Register a list of health services that 
433.12  require prior authorization, as well as the criteria and 
433.13  standards used to select health services on the list.  The list 
433.14  and the criteria and standards used to formulate the list are 
433.15  not subject to the requirements of sections 14.001 to 14.69.  
433.16  The commissioner's decision on whether prior authorization is 
433.17  required for a health service is not subject to administrative 
433.18  appeal. 
433.19     Subd. 11.  [DOCUMENTATION AND BILLING.] (a) A provider 
433.20  entity must document the services it provides under this 
433.21  section.  The provider entity must ensure that the entity's 
433.22  documentation standards meet the requirements of federal and 
433.23  state laws.  Services billed under this section that are not 
433.24  documented according to this subdivision shall be subject to 
433.25  monetary recovery by the commissioner. 
433.26     (b) An individual mental health provider must promptly 
433.27  document the following in a client's record after providing 
433.28  services to the client: 
433.29     (1) each occurrence of the client's mental health service, 
433.30  including the date, type, length, and scope of the service; 
433.31     (2) the name of the person who gave the service; 
433.32     (3) contact made with other persons interested in the 
433.33  client, including representatives of the courts, corrections 
433.34  systems, or schools.  The provider must document the name and 
433.35  date of each contact; 
433.36     (4) any contact made with the client's other mental health 
434.1   providers, case manager, family members, primary caregiver, 
434.2   legal representative, or the reason the provider did not contact 
434.3   the client's family members, primary caregiver, or legal 
434.4   representative, if applicable; and 
434.5      (5) required clinical supervision, as appropriate. 
434.6      Subd. 12.  [EXCLUDED SERVICES.] The following services are 
434.7   not eligible for medical assistance payment as children's 
434.8   therapeutic services and supports: 
434.9      (1) service components of children's therapeutic services 
434.10  and supports simultaneously provided by more than one provider 
434.11  entity unless prior authorization is obtained; 
434.12     (2) children's therapeutic services and supports provided 
434.13  in violation of medical assistance policy in Minnesota Rules, 
434.14  part 9505.0220; 
434.15     (3) mental health behavioral aide services provided by a 
434.16  personal care assistant who is not qualified as a mental health 
434.17  behavioral aide and employed by a certified children's 
434.18  therapeutic services and supports provider entity; 
434.19     (4) services that are the responsibility of a residential 
434.20  or program license holder, including foster care providers under 
434.21  the terms of a service agreement or administrative rules 
434.22  governing licensure; 
434.23     (5) up to 15 hours of children's therapeutic services and 
434.24  supports provided within a six-month period to a child with 
434.25  severe emotional disturbance who is residing in a hospital, a 
434.26  group home as defined in Minnesota Rules, part 9560.0520, 
434.27  subpart 4, a residential treatment facility licensed under 
434.28  Minnesota Rules, parts 9545.0900 to 9545.1090, a regional 
434.29  treatment center, or other institutional group setting or who is 
434.30  participating in a program of partial hospitalization are 
434.31  eligible for medical assistance payment if part of the discharge 
434.32  plan; and 
434.33     (6) adjunctive activities that may be offered by a provider 
434.34  entity but are not otherwise covered by medical assistance, 
434.35  including: 
434.36     (i) a service that is primarily recreation oriented or that 
435.1   is provided in a setting that is not medically supervised.  This 
435.2   includes sports activities, exercise groups, activities such as 
435.3   craft hours, leisure time, social hours, meal or snack time, 
435.4   trips to community activities, and tours; 
435.5      (ii) a social or educational service that does not have or 
435.6   cannot reasonably be expected to have a therapeutic outcome 
435.7   related to the client's emotional disturbance; 
435.8      (iii) consultation with other providers or service agency 
435.9   staff about the care or progress of a client; 
435.10     (iv) prevention or education programs provided to the 
435.11  community; and 
435.12     (v) treatment for clients with primary diagnoses of alcohol 
435.13  or other drug abuse. 
435.14     <b>[EFFECTIVE DATE.]</b> Unless otherwise specified, this section 
435.15  is effective July 1, 2004. 
435.16     Sec. 7.  [256B.0944] [COVERED SERVICES; CHILDREN'S MENTAL 
435.17  HEALTH CRISIS RESPONSE SERVICES.] 
435.18     Subdivision 1.  [DEFINITIONS.] For purposes of this 
435.19  section, the following terms have the meanings given them. 
435.20     (a) "Mental health crisis" means a child's behavioral, 
435.21  emotional, or psychiatric situation that, but for the provision 
435.22  of crisis response services to the child, would likely result in 
435.23  significantly reduced levels of functioning in primary 
435.24  activities of daily living, an emergency situation, or the 
435.25  child's placement in a more restrictive setting, including, but 
435.26  not limited to, inpatient hospitalization. 
435.27     (b) "Mental health emergency" means a child's behavioral, 
435.28  emotional, or psychiatric situation that causes an immediate 
435.29  need for mental health services and is consistent with section 
435.30  62Q.55.  A physician, mental health professional, or crisis 
435.31  mental health practitioner determines a mental health crisis or 
435.32  emergency for medical assistance reimbursement with input from 
435.33  the client and the client's family, if possible. 
435.34     (c) "Mental health crisis assessment" means an immediate 
435.35  face-to-face assessment by a physician, mental health 
435.36  professional, or mental health practitioner under the clinical 
436.1   supervision of a mental health professional, following a 
436.2   screening that suggests the child may be experiencing a mental 
436.3   health crisis or mental health emergency situation. 
436.4      (d) "Mental health mobile crisis intervention services" 
436.5   means face-to-face, short-term intensive mental health services 
436.6   initiated during a mental health crisis or mental health 
436.7   emergency.  Mental health mobile crisis services must help the 
436.8   recipient cope with immediate stressors, identify and utilize 
436.9   available resources and strengths, and begin to return to the 
436.10  recipient's baseline level of functioning.  Mental health mobile 
436.11  services must be provided on-site by a mobile crisis 
436.12  intervention team outside of an emergency room, urgent care, or 
436.13  an inpatient hospital setting. 
436.14     (e) "Mental health crisis stabilization services" means 
436.15  individualized mental health services provided to a recipient 
436.16  following crisis intervention services that are designed to 
436.17  restore the recipient to the recipient's prior functional 
436.18  level.  The individual treatment plan recommending mental health 
436.19  crisis stabilization must be completed by the intervention team 
436.20  or by staff after an inpatient or urgent care visit.  Mental 
436.21  health crisis stabilization services may be provided in the 
436.22  recipient's home, the home of a family member or friend of the 
436.23  recipient, schools, another community setting, or a short-term 
436.24  supervised, licensed residential program if the service is not 
436.25  included in the facility's cost pool or per diem.  Mental health 
436.26  crisis stabilization is not reimbursable when provided as part 
436.27  of a partial hospitalization or day treatment program. 
436.28     Subd. 2.  [MEDICAL ASSISTANCE COVERAGE.] Medical assistance 
436.29  covers medically necessary children's mental health crisis 
436.30  response services, subject to federal approval, if provided to 
436.31  an eligible recipient under subdivision 3, by a qualified 
436.32  provider entity under subdivision 4 or a qualified individual 
436.33  provider working within the provider's scope of practice, and 
436.34  identified in the recipient's individual crisis treatment plan 
436.35  under subdivision 8. 
436.36     Subd. 3.  [ELIGIBILITY.] An eligible recipient is an 
437.1   individual who: 
437.2      (1) is eligible for medical assistance; 
437.3      (2) is under age 18 or between the ages of 18 and 21; 
437.4      (3) is screened as possibly experiencing a mental health 
437.5   crisis or mental health emergency where a mental health crisis 
437.6   assessment is needed; 
437.7      (4) is assessed as experiencing a mental health crisis or 
437.8   mental health emergency, and mental health mobile crisis 
437.9   intervention or mental health crisis stabilization services are 
437.10  determined to be medically necessary; and 
437.11     (5) meets the criteria for emotional disturbance or mental 
437.12  illness. 
437.13     Subd. 4.  [PROVIDER ENTITY STANDARDS.] (a) A crisis 
437.14  intervention and crisis stabilization provider entity must meet 
437.15  the administrative and clinical standards specified in section 
437.16  256B.0943, subdivisions 5 and 6, meet the standards listed in 
437.17  paragraph (b), and be: 
437.18     (1) an Indian health service facility or facility owned and 
437.19  operated by a tribe or a tribal organization operating under 
437.20  Public Law 93-638 as a 638 facility; 
437.21     (2) a county-board operated entity; or 
437.22     (3) a provider entity that is under contract with the 
437.23  county board in the county where the potential crisis or 
437.24  emergency is occurring. 
437.25     (b) The children's mental health crisis response services 
437.26  provider entity must: 
437.27     (1) ensure that mental health crisis assessment and mobile 
437.28  crisis intervention services are available 24 hours a day, seven 
437.29  days a week; 
437.30     (2) directly provide the services or, if services are 
437.31  subcontracted, the provider entity must maintain clinical 
437.32  responsibility for services and billing; 
437.33     (3) ensure that crisis intervention services are provided 
437.34  in a manner consistent with sections 245.487 to 245.4888; and 
437.35     (4) develop and maintain written policies and procedures 
437.36  regarding service provision that include safety of staff and 
438.1   recipients in high-risk situations. 
438.2      Subd. 5.  [MOBILE CRISIS INTERVENTION STAFF 
438.3   QUALIFICATIONS.] (a) To provide children's mental health mobile 
438.4   crisis intervention services, a mobile crisis intervention team 
438.5   must include: 
438.6      (1) at least two mental health professionals as defined in 
438.7   section 256B.0943, subdivision 1, paragraph (m); or 
438.8      (2) a combination of at least one mental health 
438.9   professional and one mental health practitioner as defined in 
438.10  section 245.4871, subdivision 26, with the required mental 
438.11  health crisis training and under the clinical supervision of a 
438.12  mental health professional on the team. 
438.13     (b) The team must have at least two people with at least 
438.14  one member providing on-site crisis intervention services when 
438.15  needed.  Team members must be experienced in mental health 
438.16  assessment, crisis intervention techniques, and clinical 
438.17  decision making under emergency conditions and have knowledge of 
438.18  local services and resources.  The team must recommend and 
438.19  coordinate the team's services with appropriate local resources, 
438.20  including as the county social services agency, mental health 
438.21  service providers, and local law enforcement, if necessary. 
438.22     Subd. 6.  [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 
438.23  INTERVENTION TREATMENT PLANNING.] (a) Before initiating mobile 
438.24  crisis intervention services, a screening of the potential 
438.25  crisis situation must be conducted.  The screening may use the 
438.26  resources of crisis assistance and emergency services as defined 
438.27  in sections 245.4871, subdivision 14, and 245.4879, subdivisions 
438.28  1 and 2.  The screening must gather information, determine 
438.29  whether a crisis situation exists, identify the parties 
438.30  involved, and determine an appropriate response. 
438.31     (b) If a crisis exists, a crisis assessment must be 
438.32  completed.  A crisis assessment must evaluate any immediate 
438.33  needs for which emergency services are needed and, as time 
438.34  permits, the recipient's current life situation, sources of 
438.35  stress, mental health problems and symptoms, strengths, cultural 
438.36  considerations, support network, vulnerabilities, and current 
439.1   functioning. 
439.2      (c) If the crisis assessment determines mobile crisis 
439.3   intervention services are needed, the intervention services must 
439.4   be provided promptly.  As the opportunity presents itself during 
439.5   the intervention, at least two members of the mobile crisis 
439.6   intervention team must confer directly or by telephone about the 
439.7   assessment, treatment plan, and actions taken and needed.  At 
439.8   least one of the team members must be on site providing crisis 
439.9   intervention services.  If providing on-site crisis intervention 
439.10  services, a mental health practitioner must seek clinical 
439.11  supervision as required under subdivision 9. 
439.12     (d) The mobile crisis intervention team must develop an 
439.13  initial, brief crisis treatment plan as soon as appropriate but 
439.14  no later than 24 hours after the initial face-to-face 
439.15  intervention.  The plan must address the needs and problems 
439.16  noted in the crisis assessment and include measurable short-term 
439.17  goals, cultural considerations, and frequency and type of 
439.18  services to be provided to achieve the goals and reduce or 
439.19  eliminate the crisis.  The crisis treatment plan must be updated 
439.20  as needed to reflect current goals and services.  The team must 
439.21  involve the client and the client's family in developing and 
439.22  implementing the plan. 
439.23     (e) The team must document in progress notes which 
439.24  short-term goals have been met and when no further crisis 
439.25  intervention services are required. 
439.26     (f) If the client's crisis is stabilized, but the client 
439.27  needs a referral for mental health crisis stabilization services 
439.28  or to other services, the team must provide a referral to these 
439.29  services.  If the recipient has a case manager, planning for 
439.30  other services must be coordinated with the case manager. 
439.31     Subd. 7.  [CRISIS STABILIZATION SERVICES.] (a) Crisis 
439.32  stabilization services must be provided by a mental health 
439.33  professional or a mental health practitioner who works under the 
439.34  clinical supervision of a mental health professional and for a 
439.35  crisis stabilization services provider entity, and must meet the 
439.36  following standards: 
440.1      (1) a crisis stabilization treatment plan must be developed 
440.2   which meets the criteria in subdivision 8; 
440.3      (2) services must be delivered according to the treatment 
440.4   plan and include face-to-face contact with the recipient by 
440.5   qualified staff for further assessment, help with referrals, 
440.6   updating the crisis stabilization treatment plan, supportive 
440.7   counseling, skills training, and collaboration with other 
440.8   service providers in the community; and 
440.9      (3) mental health practitioners must have completed at 
440.10  least 30 hours of training in crisis intervention and 
440.11  stabilization during the past two years. 
440.12     Subd. 8.  [TREATMENT PLAN.] (a)The individual crisis 
440.13  stabilization treatment plan must include, at a minimum: 
440.14     (1) a list of problems identified in the assessment; 
440.15     (2) a list of the recipient's strengths and resources; 
440.16     (3) concrete, measurable short-term goals and tasks to be 
440.17  achieved, including time frames for achievement of the goals; 
440.18     (4) specific objectives directed toward the achievement of 
440.19  each goal; 
440.20     (5) documentation of the participants involved in the 
440.21  service planning; 
440.22     (6) planned frequency and type of services initiated; 
440.23     (7) a crisis response action plan if a crisis should occur; 
440.24  and 
440.25     (8) clear progress notes on the outcome of goals. 
440.26     (b) The client, if clinically appropriate, must be a 
440.27  participant in the development of the crisis stabilization 
440.28  treatment plan.  The client or the client's legal guardian must 
440.29  sign the service plan or documentation must be provided why this 
440.30  was not possible.  A copy of the plan must be given to the 
440.31  client and the client's legal guardian.  The plan should include 
440.32  services arranged, including specific providers where applicable.
440.33     (c) A treatment plan must be developed by a mental health 
440.34  professional or mental health practitioner under the clinical 
440.35  supervision of a mental health professional.  A written plan 
440.36  must be completed within 24 hours of beginning services with the 
441.1   client. 
441.2      Subd. 9.  [SUPERVISION.] (a) A mental health practitioner 
441.3   may provide crisis assessment and mobile crisis intervention 
441.4   services if the following clinical supervision requirements are 
441.5   met: 
441.6      (1) the mental health provider entity must accept full 
441.7   responsibility for the services provided; 
441.8      (2) the mental health professional of the provider entity, 
441.9   who is an employee or under contract with the provider entity, 
441.10  must be immediately available by telephone or in person for 
441.11  clinical supervision; 
441.12     (3) the mental health professional is consulted, in person 
441.13  or by telephone, during the first three hours when a mental 
441.14  health practitioner provides on-site service; and 
441.15     (4) the mental health professional must review and approve 
441.16  the tentative crisis assessment and crisis treatment plan, 
441.17  document the consultation, and sign the crisis assessment and 
441.18  treatment plan within the next business day. 
441.19     (b) If the mobile crisis intervention services continue 
441.20  into a second calendar day, a mental health professional must 
441.21  contact the client face-to-face on the second day to provide 
441.22  services and update the crisis treatment plan.  The on-site 
441.23  observation must be documented in the client's record and signed 
441.24  by the mental health professional. 
441.25     Subd. 10.  [CLIENT RECORD.] The provider must maintain a 
441.26  file for each client that complies with the requirements under 
441.27  section 256B.0943, subdivision 11, and contains the following 
441.28  information: 
441.29     (1) individual crisis treatment plans signed by the 
441.30  recipient, mental health professional, and mental health 
441.31  practitioner who developed the crisis treatment plan, or if the 
441.32  recipient refused to sign the plan, the date and reason stated 
441.33  by the recipient for not signing the plan; 
441.34     (2) signed release of information forms; 
441.35     (3) recipient health information and current medications; 
441.36     (4) emergency contacts for the recipient; 
442.1      (5) case records that document the date of service, place 
442.2   of service delivery, signature of the person providing the 
442.3   service, and the nature, extent, and units of service.  Direct 
442.4   or telephone contact with the recipient's family or others 
442.5   should be documented; 
442.6      (6) required clinical supervision by mental health 
442.7   professionals; 
442.8      (7) summary of the recipient's case reviews by staff; and 
442.9      (8) any written information by the recipient that the 
442.10  recipient wants in the file. 
442.11     Subd. 11.  [EXCLUDED SERVICES.] The following services are 
442.12  excluded from reimbursement under this section: 
442.13     (1) room and board services; 
442.14     (2) services delivered to a recipient while admitted to an 
442.15  inpatient hospital; 
442.16     (3) transportation services under children's mental health 
442.17  crisis response service; 
442.18     (4) services provided and billed by a provider who is not 
442.19  enrolled under medical assistance to provide children's mental 
442.20  health crisis response services; 
442.21     (5) crisis response services provided by a residential 
442.22  treatment center to clients in their facility; 
442.23     (6) services performed by volunteers; 
442.24     (7) direct billing of time spent "on call" when not 
442.25  delivering services to a recipient; 
442.26     (8) provider service time included in case management 
442.27  reimbursement; 
442.28     (9) outreach services to potential recipients; and 
442.29     (10) a mental health service that is not medically 
442.30  necessary. 
442.31     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
442.32     Sec. 8.  Minnesota Statutes 2002, section 256B.0945, 
442.33  subdivision 2, is amended to read: 
442.34     Subd. 2.  [COVERED SERVICES.] All services must be included 
442.35  in a child's individualized treatment or multiagency plan of 
442.36  care as defined in chapter 245.  
443.1      (a) For facilities that are institutions for mental 
443.2   diseases according to statute and regulation or are not 
443.3   institutions for mental diseases but are approved by the 
443.4   commissioner to provide services under this paragraph, medical 
443.5   assistance covers the full contract rate, including room and 
443.6   board if the services meet the requirements of Code of Federal 
443.7   Regulations, title 42, section 440.160.  
443.8      (b) For facilities that are not institutions for mental 
443.9   diseases according to federal statute and regulation and are not 
443.10  providing services under paragraph (a), medical assistance 
443.11  covers mental health related services that are required to be 
443.12  provided by a residential facility under section 245.4882 and 
443.13  administrative rules promulgated thereunder, except for room and 
443.14  board. 
443.15     Sec. 9.  Minnesota Statutes 2002, section 256B.0945, 
443.16  subdivision 4, is amended to read: 
443.17     Subd. 4.  [PAYMENT RATES.] (a) Notwithstanding sections 
443.18  256B.19 and 256B.041, payments to counties for residential 
443.19  services provided by a residential facility shall only be made 
443.20  of federal earnings for services provided under this section, 
443.21  and the nonfederal share of costs for services provided under 
443.22  this section shall be paid by the county from sources other than 
443.23  federal funds or funds used to match other federal funds.  
443.24  Payment to counties for services provided according to 
443.25  subdivision 2, paragraph (a), shall be the federal share of the 
443.26  contract rate.  Payment to counties for services provided 
443.27  according to subdivision 2, paragraph (b), this section shall be 
443.28  a proportion of the per day contract rate that relates to 
443.29  rehabilitative mental health services and shall not include 
443.30  payment for costs or services that are billed to the IV-E 
443.31  program as room and board.  
443.32     (b) The commissioner shall set aside a portion not to 
443.33  exceed five percent of the federal funds earned under this 
443.34  section to cover the state costs of administering this section.  
443.35  Any unexpended funds from the set-aside shall be distributed to 
443.36  the counties in proportion to their earnings under this section. 
444.1      Sec. 10.  Minnesota Statutes 2002, section 256F.10, 
444.2   subdivision 6, is amended to read: 
444.3      Subd. 6.  [DISTRIBUTION OF NEW FEDERAL REVENUE.] (a) Except 
444.4   for portion set aside in paragraph (b), the federal funds earned 
444.5   under this section and section 256B.094 by providers shall be 
444.6   paid to each provider based on its earnings, and must be used by 
444.7   each provider to expand preventive child welfare services. 
444.8   If a county or tribal social services agency chooses to be a 
444.9   provider of child welfare targeted case management and if that 
444.10  county or tribal social services agency also joins a local 
444.11  children's mental health collaborative as authorized by the 1993 
444.12  legislature, then the federal reimbursement received by the 
444.13  county or tribal social services agency for providing child 
444.14  welfare targeted case management services to children served by 
444.15  the local collaborative shall be transferred by the county or 
444.16  tribal social services agency to the integrated fund.  The 
444.17  federal reimbursement transferred to the integrated fund by the 
444.18  county or tribal social services agency must not be used for 
444.19  residential care other than respite care described under 
444.20  subdivision 7, paragraph (d). 
444.21     (b) The commissioner shall set aside a portion of the 
444.22  federal funds earned under this section to repay the special 
444.23  revenue maximization account under section 256.01, subdivision 
444.24  2, clause (15).  The repayment is limited to: 
444.25     (1) the costs of developing and implementing this section 
444.26  and sections 256B.094 and 256J.48; 
444.27     (2) programming the information systems; and 
444.28     (3) the lost federal revenue for the central office claim 
444.29  directly caused by the implementation of these sections. 
444.30     Any unexpended funds from the set aside under this 
444.31  paragraph shall be distributed to providers according to 
444.32  paragraph (a). 
444.33     Sec. 11.  Minnesota Statutes 2002, section 257.05, is 
444.34  amended to read: 
444.35     257.05 [IMPORTATION.] 
444.36     Subdivision 1.  [NOTIFICATION AND DUTIES OF COMMISSIONER.] 
445.1   No person, except as provided by subdivision subdivisions 2 and 
445.2   3, shall bring or send into the state any child for the purpose 
445.3   of placing the child out or procuring the child's adoption 
445.4   without first obtaining the consent of the commissioner of human 
445.5   services, and such person shall conform to all rules of the 
445.6   commissioner of human services and laws of the state of 
445.7   Minnesota relating to protection of children in foster care.  
445.8   Before any child shall be brought or sent into the state for the 
445.9   purpose of being placed in foster care, the person bringing or 
445.10  sending the child into the state shall first notify the 
445.11  commissioner of human services of the person's intention, and 
445.12  shall obtain from the commissioner of human services a 
445.13  certificate stating that the home in which the child is to be 
445.14  placed is, in the opinion of the commissioner of human services, 
445.15  a suitable adoptive home for the child if legal adoption is 
445.16  contemplated or that the home meets the commissioner's 
445.17  requirements for licensing of foster homes if legal adoption is 
445.18  not contemplated.  The commissioner is responsible for 
445.19  protecting the child's interests so long as the child remains 
445.20  within the state and until the child reaches the age of 18 or is 
445.21  legally adopted.  Notice to the commissioner shall state the 
445.22  name, age, and personal description of the child, and the name 
445.23  and address of the person with whom the child is to be placed, 
445.24  and such other information about the child and the foster home 
445.25  as may be required by the commissioner. 
445.26     Subd. 2.  [EXEMPT RELATIVES.] A parent, stepparent, 
445.27  grandparent, brother, sister and aunt or uncle in the first 
445.28  degree of the minor child who bring a child into the state for 
445.29  placement within their own home shall be exempt from the 
445.30  provisions of subdivision 1.  This relationship may be by blood 
445.31  or marriage.  
445.32     Subd. 3.  [INTERNATIONAL ADOPTIONS.] Subject to state and 
445.33  federal laws and rules, adoption agencies licensed under chapter 
445.34  245A and Minnesota Rules, parts 9545.0755 to 9545.0845, and 
445.35  county social services agencies are authorized to certify that 
445.36  the prospective adoptive home of a child brought into the state 
446.1   from another country for the purpose of adoption is a suitable 
446.2   home, or that the home meets the commissioner's requirements for 
446.3   licensing of foster homes if legal adoption is not contemplated. 
446.4      Sec. 12.  Minnesota Statutes 2002, section 259.67, 
446.5   subdivision 4, is amended to read: 
446.6      Subd. 4.  [ELIGIBILITY CONDITIONS.] (a) The placing agency 
446.7   shall use the AFDC requirements as specified in federal law as 
446.8   of July 16, 1996, when determining the child's eligibility for 
446.9   adoption assistance under title IV-E of the Social Security 
446.10  Act.  If the child does not qualify, the placing agency shall 
446.11  certify a child as eligible for state funded adoption assistance 
446.12  only if the following criteria are met:  
446.13     (1) Due to the child's characteristics or circumstances it 
446.14  would be difficult to provide the child an adoptive home without 
446.15  adoption assistance.  
446.16     (2)(i) A placement agency has made reasonable efforts to 
446.17  place the child for adoption without adoption assistance, but 
446.18  has been unsuccessful; or 
446.19     (ii) the child's licensed foster parents desire to adopt 
446.20  the child and it is determined by the placing agency that the 
446.21  adoption is in the best interest of the child. 
446.22     (3) The child has been a ward of the commissioner or, a 
446.23  Minnesota-licensed child-placing agency, or a tribal social 
446.24  service agency of Minnesota recognized by the Secretary of the 
446.25  Interior.  
446.26     (b) For purposes of this subdivision, the characteristics 
446.27  or circumstances that may be considered in determining whether a 
446.28  child is a child with special needs under United States Code, 
446.29  title 42, chapter 7, subchapter IV, part E, or meets the 
446.30  requirements of paragraph (a), clause (1), are the following: 
446.31     (1) The child is a member of a sibling group to be placed 
446.32  as one unit in which at least one sibling is older than 15 
446.33  months of age or is described in clause (2) or (3). 
446.34     (2) The child has documented physical, mental, emotional, 
446.35  or behavioral disabilities. 
446.36     (3) The child has a high risk of developing physical, 
447.1   mental, emotional, or behavioral disabilities. 
447.2      (4) The child is adopted according to tribal law without a 
447.3   termination of parental rights or relinquishment, provided that 
447.4   the tribe has documented the valid reason why the child cannot 
447.5   or should not be returned to the home of the child's parent. 
447.6      (c) When a child's eligibility for adoption assistance is 
447.7   based upon the high risk of developing physical, mental, 
447.8   emotional, or behavioral disabilities, payments shall not be 
447.9   made under the adoption assistance agreement unless and until 
447.10  the potential disability manifests itself as documented by an 
447.11  appropriate health care professional. 
447.12     Sec. 13.  Minnesota Statutes 2002, section 260C.141, 
447.13  subdivision 2, is amended to read: 
447.14     Subd. 2.  [REVIEW OF FOSTER CARE STATUS.] The social 
447.15  services agency responsible for the placement of a child in a 
447.16  residential facility, as defined in section 260C.212, 
447.17  subdivision 1, pursuant to a voluntary release by the child's 
447.18  parent or parents must proceed in juvenile court to review the 
447.19  foster care status of the child in the manner provided in this 
447.20  section.  
447.21     (a) Except for a child in placement due solely to the 
447.22  child's developmental disability or emotional disturbance, when 
447.23  a child continues in voluntary placement according to section 
447.24  260C.212, subdivision 8, a petition shall be filed alleging the 
447.25  child to be in need of protection or services or seeking 
447.26  termination of parental rights or other permanent placement of 
447.27  the child away from the parent within 90 days of the date of the 
447.28  voluntary placement agreement.  The petition shall state the 
447.29  reasons why the child is in placement, the progress on the 
447.30  out-of-home placement plan required under section 260C.212, 
447.31  subdivision 1, and the statutory basis for the petition under 
447.32  section 260C.007, subdivision 6, 260C.201, subdivision 11, or 
447.33  260C.301. 
447.34     (1) In the case of a petition alleging the child to be in 
447.35  need of protection or services filed under this paragraph, if 
447.36  all parties agree and the court finds it is in the best 
448.1   interests of the child, the court may find the petition states a 
448.2   prima facie case that: 
448.3      (i) the child's needs are being met; 
448.4      (ii) the placement of the child in foster care is in the 
448.5   best interests of the child; 
448.6      (iii) reasonable efforts to reunify the child and the 
448.7   parent or guardian are being made; and 
448.8      (iv) the child will be returned home in the next three 
448.9   months. 
448.10     (2) If the court makes findings under paragraph (1), the 
448.11  court shall approve the voluntary arrangement and continue the 
448.12  matter for up to three more months to ensure the child returns 
448.13  to the parents' home.  The responsible social services agency 
448.14  shall: 
448.15     (i) report to the court when the child returns home and the 
448.16  progress made by the parent on the out-of-home placement plan 
448.17  required under section 260C.212, in which case the court shall 
448.18  dismiss jurisdiction; 
448.19     (ii) report to the court that the child has not returned 
448.20  home, in which case the matter shall be returned to the court 
448.21  for further proceedings under section 260C.163; or 
448.22     (iii) if any party does not agree to continue the matter 
448.23  under paragraph (1) and this paragraph, the matter shall proceed 
448.24  under section 260C.163. 
448.25     (b) In the case of a child in voluntary placement due 
448.26  solely to the child's developmental disability or emotional 
448.27  disturbance according to section 260C.212, subdivision 9, the 
448.28  following procedures apply: 
448.29     (1)  [REPORT TO COURT.] (i) Unless the county attorney 
448.30  determines that a petition under subdivision 1 is appropriate, 
448.31  without filing a petition, a written report shall be forwarded 
448.32  to the court within 165 days of the date of the voluntary 
448.33  placement agreement.  The written report shall contain necessary 
448.34  identifying information for the court to proceed, a copy of the 
448.35  out-of-home placement plan required under section 260C.212, 
448.36  subdivision 1, a written summary of the proceedings of any 
449.1   administrative review required under section 260C.212, 
449.2   subdivision 7, and any other information the responsible social 
449.3   services agency, parent or guardian, the child or the foster 
449.4   parent or other residential facility wants the court to consider.
449.5      (ii) The responsible social services agency, where 
449.6   appropriate, must advise the child, parent or guardian, the 
449.7   foster parent, or representative of the residential facility of 
449.8   the requirements of this section and of their right to submit 
449.9   information to the court.  If the child, parent or guardian, 
449.10  foster parent, or representative of the residential facility 
449.11  wants to send information to the court, the responsible social 
449.12  services agency shall advise those persons of the reporting date 
449.13  and the identifying information necessary for the court 
449.14  administrator to accept the information and submit it to a judge 
449.15  with the agency's report.  The responsible social services 
449.16  agency must also notify those persons that they have the right 
449.17  to be heard in person by the court and how to exercise that 
449.18  right.  The responsible social services agency must also provide 
449.19  notice that an in-court hearing will not be held unless 
449.20  requested by a parent or guardian, foster parent, or the child. 
449.21     (iii) After receiving the required report, the court has 
449.22  jurisdiction to make the following determinations and must do so 
449.23  within ten days of receiving the forwarded report:  (A) whether 
449.24  or not the placement of the child is in the child's best 
449.25  interests; and (B) whether the parent and agency are 
449.26  appropriately planning for the child.  Unless requested by a 
449.27  parent or guardian, foster parent, or child, no in-court hearing 
449.28  need be held in order for the court to make findings and issue 
449.29  an order under this paragraph. 
449.30     (iv) If the court finds the placement is in the child's 
449.31  best interests and that the agency and parent are appropriately 
449.32  planning for the child, the court shall issue an order 
449.33  containing explicit, individualized findings to support its 
449.34  determination.  The court shall send a copy of the order to the 
449.35  county attorney, the responsible social services agency, the 
449.36  parent or guardian, the child, and the foster parents.  The 
450.1   court shall also send the parent or guardian, the child, and the 
450.2   foster parent notice of the required review under clause (2).  
450.3      (v) If the court finds continuing the placement not to be 
450.4   in the child's best interests or that the agency or the parent 
450.5   or guardian is not appropriately planning for the child, the 
450.6   court shall notify the county attorney, the responsible social 
450.7   services agency, the parent or guardian, the foster parent, the 
450.8   child, and the county attorney of the court's determinations and 
450.9   the basis for the court's determinations. 
450.10     (2)  [PERMANENCY REVIEW BY PETITION.] If a child with a 
450.11  developmental disability or an emotional disturbance continues 
450.12  in out-of-home placement for 13 months from the date of a 
450.13  voluntary placement, a petition alleging the child to be in need 
450.14  of protection or services, for termination of parental rights, 
450.15  or for permanent placement of the child away from the parent 
450.16  under section 260C.201 shall be filed.  The court shall conduct 
450.17  a permanency hearing on the petition no later than 14 months 
450.18  after the date of the voluntary placement.  At the permanency 
450.19  hearing, the court shall determine the need for an order 
450.20  permanently placing the child away from the parent or determine 
450.21  whether there are compelling reasons that continued voluntary 
450.22  placement is in the child's best interests.  A petition alleging 
450.23  the child to be in need of protection or services shall state 
450.24  the date of the voluntary placement agreement, the nature of the 
450.25  child's developmental disability or emotional disturbance, the 
450.26  plan for the ongoing care of the child, the parents' 
450.27  participation in the plan, the responsible social services 
450.28  agency's efforts to finalize a plan for the permanent placement 
450.29  of the child, and the statutory basis for the petition. 
450.30     (i) If a petition alleging the child to be in need of 
450.31  protection or services is filed under this paragraph, the court 
450.32  may find, based on the contents of the sworn petition, and the 
450.33  agreement of all parties, including the child, where 
450.34  appropriate, that there are compelling reasons that the 
450.35  voluntary arrangement is in the best interests of the child and 
450.36  that the responsible social services agency has made reasonable 
451.1   efforts to finalize a plan for the permanent placement of the 
451.2   child, approve the continued voluntary placement, and continue 
451.3   the matter under the court's jurisdiction for the purpose of 
451.4   reviewing the child's placement as a continued voluntary 
451.5   arrangement every 12 months as long as the child continues in 
451.6   out-of-home placement.  The matter must be returned to the court 
451.7   for further review every 12 months as long as the child remains 
451.8   in placement.  The court shall give notice to the parent or 
451.9   guardian of the continued review requirements under this 
451.10  section.  Nothing in this paragraph shall be construed to mean 
451.11  the court must order permanent placement for the child under 
451.12  section 260C.201, subdivision 11, as long as the court finds 
451.13  compelling reasons at the first review required under this 
451.14  section. 
451.15     (ii) If a petition for termination of parental rights, for 
451.16  transfer of permanent legal and physical custody to a relative, 
451.17  for long-term foster care, or for foster care for a specified 
451.18  period of time is filed, the court must proceed under section 
451.19  260C.201, subdivision 11. 
451.20     (3) If any party, including the child, disagrees with the 
451.21  voluntary arrangement, the court shall proceed under section 
451.22  260C.163. 
451.23     Sec. 14.  Minnesota Statutes 2002, section 626.559, 
451.24  subdivision 5, is amended to read: 
451.25     Subd. 5.  [REVENUE.] The commissioner of human services 
451.26  shall add the following funds to the funds appropriated under 
451.27  section 626.5591, subdivision 2, to develop and support training:
451.28     (a) The commissioner of human services shall submit claims 
451.29  for federal reimbursement earned through the activities and 
451.30  services supported through department of human services child 
451.31  protection or child welfare training funds.  Federal revenue 
451.32  earned must be used to improve and expand training services by 
451.33  the department.  The department expenditures eligible for 
451.34  federal reimbursement under this section must not be made from 
451.35  federal funds or funds used to match other federal funds. 
451.36     (b) Each year, the commissioner of human services shall 
452.1   withhold from funds distributed to each county under Minnesota 
452.2   Rules, parts 9550.0300 to 9550.0370, an amount equivalent to 1.5 
452.3   percent of each county's annual title XX allocation under 
452.4   section 256E.07 256M.50.  The commissioner must use these funds 
452.5   to ensure decentralization of training. 
452.6      (c) The federal revenue under this subdivision is available 
452.7   for these purposes until the funds are expended. 
452.8      Sec. 15.  [TRANSITION TO CHILDREN'S THERAPEUTIC SERVICES 
452.9   AND SUPPORTS.] 
452.10     Beginning July 1, 2003, the commissioner shall use the 
452.11  provider entity certification process under section 256B.0943 
452.12  instead of the provider certification process required under 
452.13  Minnesota Rules, parts 9505.0324; 9505.0326; and 9505.0327. 
452.14     Sec. 16.  [CONFLICTS.] 
452.15     The amendments to Minnesota Statutes 2002, section 256F.10, 
452.16  subdivision 6, in this article prevail over any conflicting law 
452.17  that amends or repeals it regardless of the order or date of 
452.18  enactment. 
452.19     Sec. 17.  [REVISOR'S INSTRUCTION.] 
452.20     For sections in Minnesota Statutes and Minnesota Rules 
452.21  affected by the repealed sections in this article, the revisor 
452.22  shall delete internal cross-references where appropriate and 
452.23  make changes necessary to correct the punctuation, grammar, or 
452.24  structure of the remaining text and preserve its meaning. 
452.25     Sec. 18.  [REPEALER.] 
452.26     (a) Minnesota Statutes 2002, sections 256B.0945, 
452.27  subdivision 10; and 256F.10, subdivision 7, are repealed. 
452.28     (b) Minnesota Statutes 2002, section 256B.0625, 
452.29  subdivisions 35 and 36, are repealed effective July 1, 2004. 
452.30     (c) Minnesota Rules, parts 9505.0324; 9505.0326; and 
452.31  9505.0327, are repealed effective July 1, 2004. 
452.32                             ARTICLE 6 
452.33                       COMMUNITY SERVICES ACT 
452.34     Section 1.  [256M.01] [CITATION.] 
452.35     Sections 256M.01 to 256M.80 may be cited as the "Children 
452.36  and Community Services Act."  This act establishes a fund to 
453.1   address the needs of children, adolescents, and adults within 
453.2   each county in accordance with a service plan entered into by 
453.3   the board of county commissioners of each county in consultation 
453.4   with stakeholders.  The service plan shall specify the outcomes 
453.5   to be achieved, the general strategies to be employed, and the 
453.6   respective state and county roles.  The service plan shall be 
453.7   reviewed and updated every two years, or sooner if both the 
453.8   state and the county deem it necessary.  Nothing in this act is 
453.9   intended to limit the ability of counties to provide services to 
453.10  adults over age 25. 
453.11     Sec. 2.  [256M.10] [DEFINITIONS.] 
453.12     Subdivision 1.  [SCOPE.] For the purposes of sections 
453.13  256M.01 to 256M.80, the terms defined in this section have the 
453.14  meanings given them. 
453.15     Subd. 2.  [CHILDREN AND COMMUNITY SERVICES.] (a) "Children 
453.16  and community services" means services provided or arranged for 
453.17  by county boards for children, adolescents and other individuals 
453.18  in transition from childhood to adulthood, and adults who 
453.19  experience dependency, abuse, neglect, poverty, disability, 
453.20  chronic health conditions, or other factors, including ethnicity 
453.21  and race, that may result in poor outcomes or disparities, as 
453.22  well as services for family members to support those individuals.
453.23  These services may be provided by professionals or 
453.24  nonprofessionals, including the person's natural supports in the 
453.25  community.  
453.26     (b) Children and community services do not include services 
453.27  under the public assistance programs known as the Minnesota 
453.28  family investment program, Minnesota supplemental aid, medical 
453.29  assistance, general assistance, general assistance medical care, 
453.30  MinnesotaCare, or community health services. 
453.31     Subd. 3.  [COMMISSIONER.] "Commissioner" means the 
453.32  commissioner of human services. 
453.33     Subd. 4.  [COUNTY BOARD.] "County board" means the board of 
453.34  county commissioners in each county. 
453.35     Subd. 5.  [FORMER CHILDREN'S SERVICES AND COMMUNITY SERVICE 
453.36  GRANTS.] "Former children's services and community service 
454.1   grants" means allocations for the following grants: 
454.2      (1) community social service grants under sections 252.24, 
454.3   256E.06, and 256E.14; 
454.4      (2) family preservation grants under section 256F.05, 
454.5   subdivision 3; 
454.6      (3) concurrent permanency planning grants under section 
454.7   260C.213, subdivision 5; 
454.8      (4) social service block grants (Title XX) under section 
454.9   256E.07; and 
454.10     (5) children's mental health grants under sections 245.4886 
454.11  and 260.152. 
454.12     Subd. 6.  [HUMAN SERVICES BOARD.] "Human services board" 
454.13  means a board established under section 402.02; Laws 1974, 
454.14  chapter 293; or Laws 1976, chapter 340.  
454.15     Sec. 3.  [256M.20] [DUTIES OF COMMISSIONER OF HUMAN 
454.16  SERVICES.] 
454.17     Subdivision 1.  [GENERAL SUPERVISION.] Each year the 
454.18  commissioner shall allocate funds to each county according to 
454.19  section 256M.40 and service plans under section 256M.30.  The 
454.20  funds shall be used to address the needs of children, 
454.21  adolescents, and adults.  The commissioner, in consultation with 
454.22  counties, shall provide technical assistance and evaluate county 
454.23  performance in achieving outcomes. 
454.24     Subd. 2.  [ADDITIONAL DUTIES.] The commissioner shall: 
454.25     (1) provide necessary information and assistance to each 
454.26  county for establishing baselines and desired improvements on 
454.27  safety, permanency, and well-being for children, adolescents, 
454.28  and adults; 
454.29     (2) provide training, technical assistance, and other 
454.30  supports to each county board to assist in needs assessment, 
454.31  planning, implementation, and monitoring of outcomes and service 
454.32  quality; 
454.33     (3) specify requirements for reports, including fiscal 
454.34  reports to account for funds distributed; 
454.35     (4) request waivers from federal programs as necessary to 
454.36  implement this act; and 
455.1      (5) have authority under sections 14.055 and 14.056 to 
455.2   grant a variance to existing state rules as needed to eliminate 
455.3   barriers to achieving desired outcomes. 
455.4      Subd. 3.  [SANCTIONS.] The commissioner shall establish and 
455.5   maintain a monitoring program designed to reduce the possibility 
455.6   of noncompliance with federal laws and federal regulations that 
455.7   may result in federal fiscal sanctions.  If a county is not 
455.8   complying with federal law or federal regulation and the 
455.9   noncompliance may result in federal fiscal sanctions, the 
455.10  commissioner may withhold a portion of the county's share of 
455.11  state and federal funds for that program.  The amount withheld 
455.12  must be equal to the percentage difference between the level of 
455.13  compliance maintained by the county and the level of compliance 
455.14  required by the federal regulations, multiplied by the county's 
455.15  share of state and federal funds for the program.  The state and 
455.16  federal funds may be withheld until the county is found to be in 
455.17  compliance with all federal laws or federal regulations 
455.18  applicable to the program.  If a county remains out of 
455.19  compliance for more than six consecutive months, the 
455.20  commissioner may reallocate the withheld funds to counties that 
455.21  are in compliance with the federal regulations. 
455.22     Subd. 4.  [CORRECTIVE ACTION PROCEDURE.] The commissioner 
455.23  must comply with the following procedures when reducing county 
455.24  funds under subdivision 3. 
455.25     (a) The commissioner shall notify the county, by certified 
455.26  mail, of the statute, rule, federal law, or federal regulation 
455.27  with which the county has not complied. 
455.28     (b) The commissioner shall give the county 30 days to 
455.29  demonstrate to the commissioner that the county is in compliance 
455.30  with the statute, rule, federal law, or federal regulation cited 
455.31  in the notice or to develop a corrective action plan to address 
455.32  the problem.  Upon request from the county, the commissioner 
455.33  shall provide technical assistance to the county in developing a 
455.34  corrective action plan.  The county shall have 30 days from the 
455.35  date the technical assistance is provided to develop the 
455.36  corrective action plan. 
456.1      (c) The commissioner shall take no further action if the 
456.2   county demonstrates compliance with the statute, rule, federal 
456.3   law, or federal regulation cited in the notice. 
456.4      (d) The commissioner shall review and approve or disapprove 
456.5   the corrective action plan within 30 days after the commissioner 
456.6   receives the corrective action plan. 
456.7      (e) If the commissioner approves the corrective action plan 
456.8   submitted by the county, the county has 90 days after the date 
456.9   of approval to implement the corrective action plan. 
456.10     (f) If the county fails to demonstrate compliance or fails 
456.11  to implement the corrective action plan approved by the 
456.12  commissioner, the commissioner may reduce the county's share of 
456.13  state or federal funds according to subdivision 3. 
456.14     Sec. 4.  [256M.30] [SERVICE PLAN.] 
456.15     Subdivision 1.  [SERVICE PLAN SUBMITTED TO COMMISSIONER.] 
456.16  Effective January 1, 2004, and each two-year period thereafter, 
456.17  each county must have a biennial service plan submitted to the 
456.18  commissioner in order to receive funds.  Counties may submit 
456.19  multicounty or regional service plans. 
456.20     Subd. 2.  [CONTENTS.] The service plan shall be completed 
456.21  in a form prescribed by the commissioner.  The plan must include:
456.22     (1) a statement of the needs of the children, adolescents, 
456.23  and adults who experience the conditions defined in section 
456.24  256M.10, subdivision 2, paragraph (a), and strengths and 
456.25  resources available in the community to address those needs; 
456.26     (2) strategies the county will pursue to achieve the 
456.27  performance targets.  Strategies must include specification of 
456.28  how funds under this section and other community resources will 
456.29  be used to achieve desired performance targets; and 
456.30     (3) description of the county's process to solicit public 
456.31  input and a summary of that input. 
456.32     Subd. 3.  [CHILDREN'S SERVICES.] In developing the plan 
456.33  required under this section, a county shall endeavor, within the 
456.34  limits of funds available, to consider the continuing need for 
456.35  services and programs that were funded by the former children's 
456.36  services and community service grants. 
457.1      Subd. 4.  [INFORMATION.] The commissioner shall provide 
457.2   each county with information and technical assistance needed to 
457.3   complete the service plan, including:  information on child 
457.4   safety, permanency, and well-being in the county; comparisons 
457.5   with other counties; baseline performance on outcome measures; 
457.6   and promising program practices. 
457.7      Subd. 5.  [TIMELINES.] The preliminary service plan must be 
457.8   submitted to the commissioner by October 15, 2003, and October 
457.9   15 of every two years thereafter.  
457.10     Subd. 6.  [PUBLIC COMMENT.] The county board must determine 
457.11  how citizens in the county will participate in the development 
457.12  of the service plan and provide opportunities for such 
457.13  participation.  The county must allow a period of no less than 
457.14  30 days prior to the submission of the plan to the commissioner 
457.15  to solicit comments from the public on the contents of the plan. 
457.16     Sec. 5.  [256M.40] [STATE CHILDREN AND COMMUNITY SERVICES 
457.17  GRANT ALLOCATION.] 
457.18     Subdivision 1.  [FORMULA.] The commissioner shall allocate 
457.19  state funds appropriated for children and community services 
457.20  grants to each county board on a calendar year basis in an 
457.21  amount determined according to the formula in paragraphs (a) to 
457.22  (c). 
457.23     (a) For July 1, 2003, through December 31, 2003, the 
457.24  commissioner shall allocate funds to each county equal to that 
457.25  county's allocation for the grants under section 256M.10, 
457.26  subdivision 5, for calendar year 2003 less payments made on or 
457.27  before June 30, 2003. 
457.28     (b) For calendar year 2004 and 2005, the commissioner shall 
457.29  allocate available funds to each county in proportion to that 
457.30  county's share of the calendar year 2003 allocations for the 
457.31  grants under section 256M.10, subdivision 5. 
457.32     (c) For calendar year 2006 and each calendar year 
457.33  thereafter, the commissioner shall allocate available funds to 
457.34  each county in proportion to that county's share in the 
457.35  preceding calendar year. 
457.36     Subd. 2.  [PROJECT OF REGIONAL SIGNIFICANCE; STUDY.] The 
458.1   commissioner shall study whether and how to dedicate a portion 
458.2   of the allocated funds for projects of regional significance.  
458.3   The study shall include an analysis of the amount of annual 
458.4   funding to be dedicated for projects of regional significance 
458.5   and what efforts these projects must support.  The commissioner 
458.6   shall submit a report to the chairs of the house and senate 
458.7   committees with jurisdiction over children and community 
458.8   services grants by January 15, 2005.  The commissioner of 
458.9   finance, in preparing the proposed biennial budget for fiscal 
458.10  years 2006 and 2007, is instructed to include $25 million each 
458.11  year in funding for projects of regional significance under this 
458.12  chapter. 
458.13     Subd. 3.  [PAYMENTS.] Calendar year allocations under 
458.14  subdivision 1 shall be paid to counties on or before July 10 of 
458.15  each year. 
458.16     Sec. 6.  [256M.50] [FEDERAL CHILDREN AND COMMUNITY SERVICES 
458.17  GRANT ALLOCATION.] 
458.18     In federal fiscal year 2004 and subsequent years, money for 
458.19  social services received from the federal government to 
458.20  reimburse counties for social service expenditures according to 
458.21  Title XX of the Social Security Act shall be allocated to each 
458.22  county according to section 256M.40, except for funds allocated 
458.23  for administrative purposes and migrant day care. 
458.24     Sec. 7.  [256M.60] [DUTIES OF COUNTY BOARDS.] 
458.25     Subdivision 1.  [RESPONSIBILITIES.] The county board of 
458.26  each county shall be responsible for administration and funding 
458.27  of children and community services as defined in section 
458.28  256M.10, subdivision 1.  Each county board shall singly or in 
458.29  combination with other county boards use funds available to the 
458.30  county under this act to carry out these responsibilities. The 
458.31  county board shall coordinate and facilitate the effective use 
458.32  of formal and informal helping systems to best support and 
458.33  nurture children, adolescents, and adults within the county who 
458.34  experience dependency, abuse, neglect, poverty, disability, 
458.35  chronic health conditions, or other factors, including ethnicity 
458.36  and race, that may result in poor outcomes or disparities, as 
459.1   well as services for family members to support such 
459.2   individuals.  This includes assisting individuals to function at 
459.3   the highest level of ability while maintaining family and 
459.4   community relationships to the greatest extent possible.  
459.5      Subd. 2.  [DAY TRAINING AND HABILITATION SERVICES; 
459.6   ALTERNATIVE HABILITATION SERVICES.] To the extent provided in 
459.7   the county service plan under section 256M.30, the county board 
459.8   of each county shall be responsible for providing day training 
459.9   and habilitation services or alternative habilitation services 
459.10  during the day for persons with developmental disabilities to 
459.11  the extent this is required by the person's individualized 
459.12  service plan. 
459.13     Subd. 3.  [REPORTS.] The county board shall provide 
459.14  necessary reports and data as required by the commissioner. 
459.15     Subd. 4.  [CONTRACTS FOR SERVICES.] The county board may 
459.16  contract with a human services board, a multicounty board 
459.17  established by a joint powers agreement, other political 
459.18  subdivisions, a children's mental health collaborative, a family 
459.19  services collaborative, or private organizations in discharging 
459.20  its duties. 
459.21     Subd. 5.  [EXEMPTION FROM LIABILITY.] The state of 
459.22  Minnesota, the county boards, or the agencies acting on behalf 
459.23  of the county boards in the implementation and administration of 
459.24  children and community services shall not be liable for damages, 
459.25  injuries, or liabilities sustained through the purchase of 
459.26  services by the individual, the individual's family, or the 
459.27  authorized representative under this section. 
459.28     Subd. 6.  [FEES FOR SERVICES.] The county board may 
459.29  establish a schedule of fees based upon clients' ability to pay 
459.30  to be charged to recipients of children and community services. 
459.31  Payment, in whole or in part, for services may be accepted from 
459.32  any person except that no fee may be charged to persons or 
459.33  families whose adjusted gross household income is below the 
459.34  federal poverty level.  When services are provided to any 
459.35  person, including a recipient of aids administered by the 
459.36  federal, state, or county government, payment of any charges due 
460.1   may be billed to and accepted from a public assistance agency or 
460.2   from any public or private corporation. 
460.3      Sec. 8.  [256M.70] [FISCAL LIMITATIONS.] 
460.4      Subdivision 1.  [DEMONSTRATION OF REASONABLE EFFORT.] The 
460.5   county shall make reasonable efforts to comply with all children 
460.6   and community services requirements.  For the purposes of this 
460.7   section, a county is making reasonable efforts if the county has 
460.8   made efforts to comply with requirements within the limits of 
460.9   available funding, including efforts to identify and apply for 
460.10  commonly available state and federal funding for services. 
460.11     Subd. 2.  [IDENTIFICATION OF SERVICES TO BE PROVIDED.] If a 
460.12  county has made reasonable efforts to provide services according 
460.13  to the service plan under section 256M.30, but funds 
460.14  appropriated for purposes of sections 256M.01 to 256M.80 are 
460.15  insufficient, then the county may limit services according to 
460.16  the following criteria:  
460.17     (1) whether the services are needed to protect individuals 
460.18  from maltreatment, abuse, and neglect; 
460.19     (2) whether emergency and crisis services are needed to 
460.20  protect clients from physical, emotional, or psychological harm; 
460.21     (3) the need for assessment of persons applying for 
460.22  services and referral to appropriate services when necessary; 
460.23     (4) whether there is a need for public guardianship 
460.24  services; 
460.25     (5) the need for case management for persons with 
460.26  developmental disabilities, children with serious emotional 
460.27  disturbances, and adults with serious and persistent mental 
460.28  illness; 
460.29     (6) the need for day training and habilitation services or 
460.30  alternative habilitative services during the day for adults with 
460.31  developmental disabilities based on the individualized service 
460.32  plan; 
460.33     (7) whether there is a need to fulfill licensing 
460.34  responsibilities delegated to the county by the commissioner 
460.35  under section 245A.16; and 
460.36     (8) whether subacute detoxification services are needed. 
461.1      Subd. 3.  [DENIAL, REDUCTION, OR TERMINATION OF SERVICES 
461.2   DUE TO FISCAL LIMITATIONS.] Before a county denies, reduces, or 
461.3   terminates services to an individual due to fiscal limitations, 
461.4   the county must meet the requirements in this section.  The 
461.5   county must notify the individual and the individual's guardian 
461.6   in writing of the reason for the denial, reduction, or 
461.7   termination of services and must inform the individual and the 
461.8   individual's guardian in writing that the county will, upon 
461.9   request, meet to discuss alternatives before services are 
461.10  terminated or reduced.  No reduction in services for an 
461.11  individual may be greater than twice the amount of the county 
461.12  average reduction. 
461.13     Sec. 9.  [256M.80] [PROGRAM EVALUATION.] 
461.14     Subdivision 1.  [COUNTY EVALUATION.] Each county shall 
461.15  submit to the commissioner data from the past calendar year on 
461.16  the outcomes in the service plan.  The commissioner shall 
461.17  prescribe standard methods to be used by the counties in 
461.18  providing the data.  The data shall be submitted no later than 
461.19  March 1 of each year, beginning with March 1, 2005. 
461.20     Subd. 2.  [STATEWIDE EVALUATION.] Six months after the end 
461.21  of the first full calendar year and annually thereafter, the 
461.22  commissioner shall prepare a report on the counties' progress in 
461.23  improving the outcomes of children, adolescents, and adults 
461.24  related to safety, permanency, and well-being.  This report 
461.25  shall be disseminated throughout the state.  
461.26     Sec. 10.  [256M.90] [GRANTS AND PURCHASE OF SERVICE 
461.27  CONTRACTS.] 
461.28     Subdivision 1.  [AUTHORITY.] The local agency may purchase 
461.29  community social services by grant or purchase of service 
461.30  contract from agencies or individuals approved as vendors. 
461.31     Subd. 2.  [DUTIES OF LOCAL AGENCY.] The local agency must: 
461.32     (1) use a written grant or purchase of service contract 
461.33  when purchasing community social services.  Every grant and 
461.34  purchase of service contract must be completed, signed, and 
461.35  approved by all parties to the agreement, including the county 
461.36  board, unless the county board has designated the local agency 
462.1   to sign on its behalf.  No service shall be provided before the 
462.2   effective date of the grant or purchase of service contract; 
462.3      (2) determine a client's eligibility for purchased 
462.4   services, or delegate the responsibility for making the 
462.5   preliminary determination to the approved vendor under the terms 
462.6   of the grant or purchase of service contract; 
462.7      (3) ensure the development of an individual social service 
462.8   plan based on the client's needs; 
462.9      (4) monitor purchased services and evaluate grants and 
462.10  contracts on the basis of client outcomes; and 
462.11     (5) purchase only from approved vendors. 
462.12     Subd. 3.  [LOCAL AGENCY CRITERIA.] When the local agency 
462.13  chooses to purchase community social services from a vendor that 
462.14  is not subject to state licensing laws or department rules, the 
462.15  local agency must establish written criteria for vendor approval 
462.16  to ensure the health, safety, and well being of clients. 
462.17     Subd. 4.  [CASE RECORDS AND REPORTING REQUIREMENTS.] Case 
462.18  records and data reporting requirements for grants and purchased 
462.19  services are the same as case record and data reporting 
462.20  requirements for direct services. 
462.21     Subd. 5.  [FILES.] The local agency must keep an 
462.22  administrative file for each grant and contract. 
462.23     Subd. 6.  [CONTRACTING WITHIN AND ACROSS COUNTY LINES; LEAD 
462.24  COUNTY CONTRACTS.] Paragraphs (a) to (e) govern contracting 
462.25  within and across county lines and lead county contracts. 
462.26     (a) Once a local agency and an approved vendor execute a 
462.27  contract that meets the requirements of this subdivision, the 
462.28  contract governs all other purchases of service from the vendor 
462.29  by all other local agencies for the term of the contract.  The 
462.30  local agency that negotiated and entered into the contract 
462.31  becomes the lead county for the contract. 
462.32     (b) When the local agency in the county where a vendor is 
462.33  located wants to purchase services from that vendor and the 
462.34  vendor has no contract with the local agency or any other 
462.35  county, the local agency must negotiate and execute a contract 
462.36  with the vendor. 
463.1      (c) When a local agency in one county wants to purchase 
463.2   services from a vendor located in another county, it must notify 
463.3   the local agency in the county where the vendor is located.  
463.4   Within 30 days of being notified, the local agency in the 
463.5   vendor's county must: 
463.6      (1) if it has a contract with the vendor, send a copy to 
463.7   the inquiring agency; 
463.8      (2) if there is a contract with the vendor for which 
463.9   another local agency is the lead county, identify the lead 
463.10  county to the inquiring agency; or 
463.11     (3) if no local agency has a contract with the vendor, 
463.12  inform the inquiring agency whether it will negotiate a contract 
463.13  and become the lead county.  If the agency where the vendor is 
463.14  located will not negotiate a contract with the vendor because of 
463.15  concerns related to clients' health and safety, the agency must 
463.16  share those concerns with the inquiring agency. 
463.17     (d) If the local agency in the county where the vendor is 
463.18  located declines to negotiate a contract with the vendor or 
463.19  fails to respond within 30 days of receiving the notification 
463.20  under paragraph (c), the inquiring agency is authorized to 
463.21  negotiate a contract and must notify the local agency that 
463.22  declined or failed to respond. 
463.23     (e) When the inquiring county under paragraph (d) becomes 
463.24  the lead county for a contract and the contract expires and 
463.25  needs to be renegotiated, that county must again follow the 
463.26  requirements under paragraph (c) and notify the local agency 
463.27  where the vendor is located.  The local agency where the vendor 
463.28  is located has the option of becoming the lead county for the 
463.29  new contract.  If the local agency does not exercise the option, 
463.30  paragraph (d) applies. 
463.31     (f) This subdivision does not affect the requirement to 
463.32  seek county concurrence under section 256B.092, subdivision 8a, 
463.33  when the services are to be purchased for a person with mental 
463.34  retardation or a related condition or under section 245.4711, 
463.35  subdivision 3, when the services to be purchased are for an 
463.36  adult with serious and persistent mental illness. 
464.1      Subd. 7.  [CONTRACTS WITH COMMUNITY MENTAL HEALTH 
464.2   BOARDS.] A local agency within the geographic area served by a 
464.3   community mental health board authorized by sections 245.61 to 
464.4   245.69, may contract directly with the community mental health 
464.5   board.  However, if a local agency outside of the geographic 
464.6   area served by a community mental health board wishes to 
464.7   purchase services from the board, the local agency must follow 
464.8   the requirements under subdivision 6. 
464.9      Subd. 8.  [PLACEMENT AGREEMENTS.] A placement agreement 
464.10  must be used for residential services.  Placement agreements are 
464.11  valid when signed by authorized representatives of the facility 
464.12  and the county of financial responsibility.  If the county of 
464.13  financial responsibility and the county where the approved 
464.14  vendor is located are not the same, the county of financial 
464.15  responsibility must, if requested, mail a copy of the placement 
464.16  agreement to the county where the approved vendor is providing 
464.17  the service and to the lead county within ten calendar days 
464.18  after the date on which the placement agreement is signed.  The 
464.19  placement agreement must specify that the service will be 
464.20  provided in accordance with the individual service plan as 
464.21  required and must specify the unit cost, the date of placement, 
464.22  and the date for the review of the placement.  A placement 
464.23  agreement may also be used for nonresidential services. 
464.24     Sec. 11.  [REVISOR'S INSTRUCTION.] 
464.25     For sections in Minnesota Statutes and Minnesota Rules 
464.26  affected by the repealed sections in this article, the revisor 
464.27  shall delete internal cross-references where appropriate and 
464.28  make changes necessary to correct the punctuation, grammar, or 
464.29  structure of the remaining text and preserve its meaning. 
464.30     Sec. 12.  [REPEALER.] 
464.31     (a) Minnesota Statutes 2002, sections 245.478; 245.4886; 
464.32  245.4888; 245.496; 254A.17; 256B.0945, subdivisions 6, 7, 8, 9, 
464.33  and 10; 256B.83; 256E.01; 256E.02; 256E.03; 256E.04; 256E.05; 
464.34  256E.06; 256E.07; 256E.08; 256E.081; 256E.09; 256E.10; 256E.11; 
464.35  256E.115; 256E.13; 256E.14; 256E.15; 256F.01; 256F.02; 256F.03; 
464.36  256F.04; 256F.05; 256F.06; 256F.07; 256F.08; 256F.11; 256F.12; 
465.1   256F.14; 257.075; 257.81; 260.152; and 626.562, are repealed. 
465.2      (b) Minnesota Rules, parts 9550.0010; 9550.0020; 9550.0030; 
465.3   9550.0040; 9550.0050; 9550.0060; 9550.0070; 9550.0080; 
465.4   9550.0090; 9550.0091; 9550.0092; and 9550.0093, are repealed. 
465.5                              ARTICLE 7 
465.6            HUMAN SERVICES LICENSING, COUNTY INITIATIVES, 
465.7                           AND MISCELLANEOUS 
465.8      Section 1.  Minnesota Statutes 2002, section 69.021, 
465.9   subdivision 11, is amended to read: 
465.10     Subd. 11.  [EXCESS POLICE STATE-AID HOLDING ACCOUNT.] (a) 
465.11  The excess police state-aid holding account is established in 
465.12  the general fund.  The excess police state-aid holding account 
465.13  must be administered by the commissioner. 
465.14     (b) Excess police state aid determined according to 
465.15  subdivision 10, must be deposited in the excess police state-aid 
465.16  holding account. 
465.17     (c) From the balance in the excess police state-aid holding 
465.18  account, $1,000,000 $900,000 is appropriated to and must be 
465.19  transferred annually to the ambulance service personnel 
465.20  longevity award and incentive suspense account established by 
465.21  section 144E.42, subdivision 2. 
465.22     (d) If a police officer stress reduction program is created 
465.23  by law and money is appropriated for that program, an amount 
465.24  equal to that appropriation must be transferred from the balance 
465.25  in the excess police state-aid holding account. 
465.26     (e) On October 1, 1997, and annually on each subsequent 
465.27  October 1, one-half of the balance of the excess police 
465.28  state-aid holding account remaining after the deductions under 
465.29  paragraphs (c) and (d) is appropriated for additional 
465.30  amortization aid under section 423A.02, subdivision 1b. 
465.31     (f) Annually, the remaining balance in the excess police 
465.32  state-aid holding account, after the deductions under paragraphs 
465.33  (c), (d), and (e), cancels to the general fund. 
465.34     Sec. 2.  Minnesota Statutes 2002, section 124D.23, 
465.35  subdivision 2, is amended to read: 
465.36     Subd. 2.  [DUTIES.] (a) Each collaborative must: 
466.1      (1) establish, with assistance from families and service 
466.2   providers, clear goals for addressing the health, developmental, 
466.3   educational, and family-related needs of children and youth and 
466.4   use outcome-based indicators to measure progress toward 
466.5   achieving those goals; 
466.6      (2) establish a comprehensive planning process that 
466.7   involves all sectors of the community, identifies local needs, 
466.8   and surveys existing local programs; 
466.9      (3) integrate service funding sources so that children and 
466.10  their families obtain services from providers best able to 
466.11  anticipate and meet their needs; 
466.12     (4) coordinate families' services to avoid duplicative and 
466.13  overlapping assessment and intake procedures; 
466.14     (5) focus primarily on family-centered services; 
466.15     (6) encourage parents and volunteers to actively 
466.16  participate by using flexible scheduling and actively recruiting 
466.17  volunteers; 
466.18     (7) provide services in locations that are readily 
466.19  accessible to children and families; 
466.20     (8) use new or reallocated funds to improve or 
466.21  enhance provide services provided to children and their 
466.22  families; 
466.23     (9) identify federal, state, and local institutional 
466.24  barriers to coordinating services and suggest ways to remove 
466.25  these barriers; and 
466.26     (10) design and implement an integrated local service 
466.27  delivery system for children and their families that coordinates 
466.28  services across agencies and is client centered.  The delivery 
466.29  system shall provide a continuum of services for children birth 
466.30  to age 18, or birth through age 21 for individuals with 
466.31  disabilities.  The collaborative shall describe the community 
466.32  plan for serving pregnant women and children from birth to age 
466.33  six. 
466.34     (b) The outcome-based indicators developed in paragraph 
466.35  (a), clause (1), may include the number of low birth weight 
466.36  babies, the infant mortality rate, the number of children who 
467.1   are adequately immunized and healthy, require out-of-home 
467.2   placement or long-term special education services, and the 
467.3   number of minor parents. 
467.4      Sec. 3.  Minnesota Statutes 2002, section 245.4932, 
467.5   subdivision 1, is amended to read: 
467.6      Subdivision 1.  [COLLABORATIVE RESPONSIBILITIES.] The 
467.7   children's mental health collaborative shall have the following 
467.8   authority and responsibilities regarding federal revenue 
467.9   enhancement: 
467.10     (1) the collaborative must establish an integrated fund; 
467.11     (2) the collaborative shall designate a lead county or 
467.12  other qualified entity as the fiscal agency for reporting, 
467.13  claiming, and receiving payments; 
467.14     (3) the collaborative or lead county may enter into 
467.15  subcontracts with other counties, school districts, special 
467.16  education cooperatives, municipalities, and other public and 
467.17  nonprofit entities for purposes of identifying and claiming 
467.18  eligible expenditures to enhance federal reimbursement; 
467.19     (4) the collaborative shall use any enhanced revenue 
467.20  attributable to the activities of the collaborative, including 
467.21  administrative and service revenue, solely to provide mental 
467.22  health services or to expand the operational target population.  
467.23  The lead county or other qualified entity may not use enhanced 
467.24  federal revenue for any other purpose; 
467.25     (5) the members of the collaborative must continue the base 
467.26  level of expenditures, as defined in section 245.492, 
467.27  subdivision 2, for services for children with emotional or 
467.28  behavioral disturbances and their families from any state, 
467.29  county, federal, or other public or private funding source 
467.30  which, in the absence of the new federal reimbursement earned 
467.31  under sections 245.491 to 245.496, would have been available for 
467.32  those services.  The base year for purposes of this subdivision 
467.33  shall be the accounting period closest to state fiscal year 
467.34  1993; 
467.35     (6) the collaborative or lead county must develop and 
467.36  maintain an accounting and financial management system adequate 
468.1   to support all claims for federal reimbursement, including a 
468.2   clear audit trail and any provisions specified in the contract 
468.3   with the commissioner of human services; 
468.4      (7) (6) the collaborative or its members may elect to pay 
468.5   the nonfederal share of the medical assistance costs for 
468.6   services designated by the collaborative; and 
468.7      (8) (7) the lead county or other qualified entity may not 
468.8   use federal funds or local funds designated as matching for 
468.9   other federal funds to provide the nonfederal share of medical 
468.10  assistance. 
468.11     Sec. 4.  Minnesota Statutes 2002, section 245A.035, 
468.12  subdivision 3, is amended to read: 
468.13     Subd. 3.  [REQUIREMENTS FOR EMERGENCY LICENSE.] Before an 
468.14  emergency license may be issued, the following requirements must 
468.15  be met: 
468.16     (1) the county agency must conduct an initial inspection of 
468.17  the premises where the foster care is to be provided to ensure 
468.18  the health and safety of any child placed in the home.  The 
468.19  county agency shall conduct the inspection using a form 
468.20  developed by the commissioner; 
468.21     (2) at the time of the inspection or placement, whichever 
468.22  is earlier, the relative being considered for an emergency 
468.23  license shall receive an application form for a child foster 
468.24  care license; 
468.25     (3) whenever possible, prior to placing the child in the 
468.26  relative's home, the relative being considered for an emergency 
468.27  license shall provide the information required by section 
468.28  245A.04, subdivision 3, paragraph (b) (k); and 
468.29     (4) if the county determines, prior to the issuance of an 
468.30  emergency license, that anyone requiring a background study may 
468.31  be disqualified under section 245A.04, and the disqualification 
468.32  is one which the commissioner cannot set aside, an emergency 
468.33  license shall not be issued. 
468.34     Sec. 5.  Minnesota Statutes 2002, section 245A.04, 
468.35  subdivision 3, is amended to read: 
468.36     Subd. 3.  [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 
469.1   (a) Individuals and organizations that are required in statute 
469.2   to initiate background studies under this section shall comply 
469.3   with the following requirements: 
469.4      (1) Applicants for licensure, license holders, and other 
469.5   entities as provided in this section must submit completed 
469.6   background study forms to the commissioner before individuals 
469.7   specified in paragraph (c), clauses (1) to (4), (6), and (7), 
469.8   begin positions allowing direct contact in any licensed program. 
469.9      (2) Applicants and license holders under the jurisdiction 
469.10  of other state agencies who are required in other statutory 
469.11  sections to initiate background studies under this section must 
469.12  submit completed background study forms to the commissioner 
469.13  prior to the background study subject beginning in a position 
469.14  allowing direct contact in the licensed program, or where 
469.15  applicable, prior to being employed. 
469.16     (3) Organizations required to initiate background studies 
469.17  under section 256B.0627 for individuals described in paragraph 
469.18  (c), clause (5), must submit a completed background study form 
469.19  to the commissioner before those individuals begin a position 
469.20  allowing direct contact with persons served by the 
469.21  organization.  The commissioner shall recover the cost of these 
469.22  background studies through a fee of no more than $12 per study 
469.23  charged to the organization responsible for submitting the 
469.24  background study form.  The fees collected under this paragraph 
469.25  are appropriated to the commissioner for the purpose of 
469.26  conducting background studies.  
469.27     Upon receipt of the background study forms from the 
469.28  entities in clauses (1) to (3), the commissioner shall complete 
469.29  the background study as specified under this section and provide 
469.30  notices required in subdivision 3a.  Unless otherwise specified, 
469.31  the subject of a background study may have direct contact with 
469.32  persons served by a program after the background study form is 
469.33  mailed or submitted to the commissioner pending notification of 
469.34  the study results under subdivision 3a.  A county agency may 
469.35  accept a background study completed by the commissioner under 
469.36  this section in place of the background study required under 
470.1   section 245A.16, subdivision 3, in programs with joint licensure 
470.2   as home and community-based services and adult foster care for 
470.3   people with developmental disabilities when the license holder 
470.4   does not reside in the foster care residence and the subject of 
470.5   the study has been continuously affiliated with the license 
470.6   holder since the date of the commissioner's study. 
470.7      (b) The definitions in this paragraph apply only to 
470.8   subdivisions 3 to 3e. 
470.9      (1) "Background study" means the review of records 
470.10  conducted by the commissioner to determine whether a subject is 
470.11  disqualified from direct contact with persons served by a 
470.12  program, and where specifically provided in statutes, whether a 
470.13  subject is disqualified from having access to persons served by 
470.14  a program. 
470.15     (2) "Continuous, direct supervision" means an individual is 
470.16  within sight or hearing of the supervising person to the extent 
470.17  that supervising person is capable at all times of intervening 
470.18  to protect the health and safety of the persons served by the 
470.19  program. 
470.20     (3) "Contractor" means any person, regardless of employer, 
470.21  who is providing program services for hire under the control of 
470.22  the provider. 
470.23     (4) "Direct contact" means providing face-to-face care, 
470.24  training, supervision, counseling, consultation, or medication 
470.25  assistance to persons served by the program. 
470.26     (5) "Reasonable cause" means information or circumstances 
470.27  exist which provide the commissioner with articulable suspicion 
470.28  that further pertinent information may exist concerning a 
470.29  subject.  The commissioner has reasonable cause when, but not 
470.30  limited to, the commissioner has received a report from the 
470.31  subject, the license holder, or a third party indicating that 
470.32  the subject has a history that would disqualify the person or 
470.33  that may pose a risk to the health or safety of persons 
470.34  receiving services. 
470.35     (6) "Subject of a background study" means an individual on 
470.36  whom a background study is required or completed. 
471.1      (c) The applicant, license holder, registrant under section 
471.2   144A.71, subdivision 1, bureau of criminal apprehension, 
471.3   commissioner of health, and county agencies, after written 
471.4   notice to the individual who is the subject of the study, shall 
471.5   help with the study by giving the commissioner criminal 
471.6   conviction data and reports about the maltreatment of adults 
471.7   substantiated under section 626.557 and the maltreatment of 
471.8   minors in licensed programs substantiated under section 
471.9   626.556.  If a background study is initiated by an applicant or 
471.10  license holder and the applicant or license holder receives 
471.11  information about the possible criminal or maltreatment history 
471.12  of an individual who is the subject of the background study, the 
471.13  applicant or license holder must immediately provide the 
471.14  information to the commissioner.  The individuals to be studied 
471.15  shall include: 
471.16     (1) the applicant; 
471.17     (2) persons age 13 and over living in the household where 
471.18  the licensed program will be provided; 
471.19     (3) current employees or contractors of the applicant who 
471.20  will have direct contact with persons served by the facility, 
471.21  agency, or program; 
471.22     (4) volunteers or student volunteers who have direct 
471.23  contact with persons served by the program to provide program 
471.24  services, if the contact is not under the continuous, direct 
471.25  supervision by an individual listed in clause (1) or (3); 
471.26     (5) any person required under section 256B.0627 to have a 
471.27  background study completed under this section; 
471.28     (6) persons ages 10 to 12 living in the household where the 
471.29  licensed services will be provided when the commissioner has 
471.30  reasonable cause; and 
471.31     (7) persons who, without providing direct contact services 
471.32  at a licensed program, may have unsupervised access to children 
471.33  or vulnerable adults receiving services from the program 
471.34  licensed to provide family child care for children, foster care 
471.35  for children in the provider's own home, or foster care or day 
471.36  care services for adults in the provider's own home when the 
472.1   commissioner has reasonable cause. 
472.2      (d) According to paragraph (c), clauses (2) and (6), the 
472.3   commissioner shall review records from the juvenile courts.  For 
472.4   persons under paragraph (c), clauses (1), (3), (4), (5), and 
472.5   (7), who are ages 13 to 17, the commissioner shall review 
472.6   records from the juvenile courts when the commissioner has 
472.7   reasonable cause.  The juvenile courts shall help with the study 
472.8   by giving the commissioner existing juvenile court records on 
472.9   individuals described in paragraph (c), clauses (2), (6), and 
472.10  (7), relating to delinquency proceedings held within either the 
472.11  five years immediately preceding the background study or the 
472.12  five years immediately preceding the individual's 18th birthday, 
472.13  whichever time period is longer.  The commissioner shall destroy 
472.14  juvenile records obtained pursuant to this subdivision when the 
472.15  subject of the records reaches age 23. 
472.16     (e) Beginning August 1, 2001, the commissioner shall 
472.17  conduct all background studies required under this chapter and 
472.18  initiated by supplemental nursing services agencies registered 
472.19  under section 144A.71, subdivision 1.  Studies for the agencies 
472.20  must be initiated annually by each agency.  The commissioner 
472.21  shall conduct the background studies according to this chapter.  
472.22  The commissioner shall recover the cost of the background 
472.23  studies through a fee of no more than $8 per study, charged to 
472.24  the supplemental nursing services agency.  The fees collected 
472.25  under this paragraph are appropriated to the commissioner for 
472.26  the purpose of conducting background studies. 
472.27     (f) For purposes of this section, a finding that a 
472.28  delinquency petition is proven in juvenile court shall be 
472.29  considered a conviction in state district court. 
472.30     (g) A study of an individual in paragraph (c), clauses (1) 
472.31  to (7), shall be conducted at least upon application for initial 
472.32  license for all license types or registration under section 
472.33  144A.71, subdivision 1, and at reapplication for a license for 
472.34  family child care, child foster care, and adult foster care.  
472.35  The commissioner is not required to conduct a study of an 
472.36  individual at the time of reapplication for a license or if the 
473.1   individual has been continuously affiliated with a foster care 
473.2   provider licensed by the commissioner of human services and 
473.3   registered under chapter 144D, other than a family day care or 
473.4   foster care license, if:  (i) a study of the individual was 
473.5   conducted either at the time of initial licensure or when the 
473.6   individual became affiliated with the license holder; (ii) the 
473.7   individual has been continuously affiliated with the license 
473.8   holder since the last study was conducted; and (iii) the 
473.9   procedure described in paragraph (j) has been implemented and 
473.10  was in effect continuously since the last study was conducted.  
473.11  For the purposes of this section, a physician licensed under 
473.12  chapter 147 is considered to be continuously affiliated upon the 
473.13  license holder's receipt from the commissioner of health or 
473.14  human services of the physician's background study results.  For 
473.15  individuals who are required to have background studies under 
473.16  paragraph (c) and who have been continuously affiliated with a 
473.17  foster care provider that is licensed in more than one county, 
473.18  criminal conviction data may be shared among those counties in 
473.19  which the foster care programs are licensed.  A county agency's 
473.20  receipt of criminal conviction data from another county agency 
473.21  shall meet the criminal data background study requirements of 
473.22  this section. 
473.23     (h) The commissioner may also conduct studies on 
473.24  individuals specified in paragraph (c), clauses (3) and (4), 
473.25  when the studies are initiated by: 
473.26     (i) personnel pool agencies; 
473.27     (ii) temporary personnel agencies; 
473.28     (iii) educational programs that train persons by providing 
473.29  direct contact services in licensed programs; and 
473.30     (iv) professional services agencies that are not licensed 
473.31  and which contract with licensed programs to provide direct 
473.32  contact services or individuals who provide direct contact 
473.33  services. 
473.34     (i) Studies on individuals in paragraph (h), items (i) to 
473.35  (iv), must be initiated annually by these agencies, programs, 
473.36  and individuals.  Except as provided in paragraph (a), clause 
474.1   (3), no applicant, license holder, or individual who is the 
474.2   subject of the study shall pay any fees required to conduct the 
474.3   study. 
474.4      (1) At the option of the licensed facility, rather than 
474.5   initiating another background study on an individual required to 
474.6   be studied who has indicated to the licensed facility that a 
474.7   background study by the commissioner was previously completed, 
474.8   the facility may make a request to the commissioner for 
474.9   documentation of the individual's background study status, 
474.10  provided that: 
474.11     (i) the facility makes this request using a form provided 
474.12  by the commissioner; 
474.13     (ii) in making the request the facility informs the 
474.14  commissioner that either: 
474.15     (A) the individual has been continuously affiliated with a 
474.16  licensed facility since the individual's previous background 
474.17  study was completed, or since October 1, 1995, whichever is 
474.18  shorter; or 
474.19     (B) the individual is affiliated only with a personnel pool 
474.20  agency, a temporary personnel agency, an educational program 
474.21  that trains persons by providing direct contact services in 
474.22  licensed programs, or a professional services agency that is not 
474.23  licensed and which contracts with licensed programs to provide 
474.24  direct contact services or individuals who provide direct 
474.25  contact services; and 
474.26     (iii) the facility provides notices to the individual as 
474.27  required in paragraphs (a) to (j), and that the facility is 
474.28  requesting written notification of the individual's background 
474.29  study status from the commissioner.  
474.30     (2) The commissioner shall respond to each request under 
474.31  paragraph (1) with a written or electronic notice to the 
474.32  facility and the study subject.  If the commissioner determines 
474.33  that a background study is necessary, the study shall be 
474.34  completed without further request from a licensed agency or 
474.35  notifications to the study subject.  
474.36     (3) When a background study is being initiated by a 
475.1   licensed facility or a foster care provider that is also 
475.2   registered under chapter 144D, a study subject affiliated with 
475.3   multiple licensed facilities may attach to the background study 
475.4   form a cover letter indicating the additional facilities' names, 
475.5   addresses, and background study identification numbers.  When 
475.6   the commissioner receives such notices, each facility identified 
475.7   by the background study subject shall be notified of the study 
475.8   results.  The background study notice sent to the subsequent 
475.9   agencies shall satisfy those facilities' responsibilities for 
475.10  initiating a background study on that individual. 
475.11     (j) If an individual who is affiliated with a program or 
475.12  facility regulated by the department of human services or 
475.13  department of health or who is affiliated with any type of home 
475.14  care agency or provider of personal care assistance services, is 
475.15  convicted of a crime constituting a disqualification under 
475.16  subdivision 3d, the probation officer or corrections agent shall 
475.17  notify the commissioner of the conviction.  For the purpose of 
475.18  this paragraph, "conviction" has the meaning given it in section 
475.19  609.02, subdivision 5.  The commissioner, in consultation with 
475.20  the commissioner of corrections, shall develop forms and 
475.21  information necessary to implement this paragraph and shall 
475.22  provide the forms and information to the commissioner of 
475.23  corrections for distribution to local probation officers and 
475.24  corrections agents.  The commissioner shall inform individuals 
475.25  subject to a background study that criminal convictions for 
475.26  disqualifying crimes will be reported to the commissioner by the 
475.27  corrections system.  A probation officer, corrections agent, or 
475.28  corrections agency is not civilly or criminally liable for 
475.29  disclosing or failing to disclose the information required by 
475.30  this paragraph.  Upon receipt of disqualifying information, the 
475.31  commissioner shall provide the notifications required in 
475.32  subdivision 3a, as appropriate to agencies on record as having 
475.33  initiated a background study or making a request for 
475.34  documentation of the background study status of the individual.  
475.35  This paragraph does not apply to family day care and child 
475.36  foster care programs. 
476.1      (k) The individual who is the subject of the study must 
476.2   provide the applicant or license holder with sufficient 
476.3   information to ensure an accurate study including the 
476.4   individual's first, middle, and last name and all other names by 
476.5   which the individual has been known; home address, city, county, 
476.6   and state of residence for the past five years; zip code; sex; 
476.7   date of birth; and driver's license number or state 
476.8   identification number.  The applicant or license holder shall 
476.9   provide this information about an individual in paragraph (c), 
476.10  clauses (1) to (7), on forms prescribed by the commissioner.  By 
476.11  January 1, 2000, for background studies conducted by the 
476.12  department of human services, the commissioner shall implement a 
476.13  system for the electronic transmission of:  (1) background study 
476.14  information to the commissioner; and (2) background study 
476.15  results to the license holder.  The commissioner may request 
476.16  additional information of the individual, which shall be 
476.17  optional for the individual to provide, such as the individual's 
476.18  social security number or race. 
476.19     (l) For programs directly licensed by the commissioner, a 
476.20  study must include information related to names of substantiated 
476.21  perpetrators of maltreatment of vulnerable adults that has been 
476.22  received by the commissioner as required under section 626.557, 
476.23  subdivision 9c, paragraph (i), and the commissioner's records 
476.24  relating to the maltreatment of minors in licensed programs, 
476.25  information from juvenile courts as required in paragraph (c) 
476.26  for persons listed in paragraph (c), clauses (2), (6), and (7), 
476.27  and information from the bureau of criminal apprehension.  For 
476.28  child foster care, adult foster care, and family day care homes, 
476.29  the study must include information from the county agency's 
476.30  record of substantiated maltreatment of adults, and the 
476.31  maltreatment of minors, information from juvenile courts as 
476.32  required in paragraph (c) for persons listed in paragraph (c), 
476.33  clauses (2), (6), and (7), and information from the bureau of 
476.34  criminal apprehension.  The commissioner may also review arrest 
476.35  and investigative information from the bureau of criminal 
476.36  apprehension, the commissioner of health, a county attorney, 
477.1   county sheriff, county agency, local chief of police, other 
477.2   states, the courts, or the Federal Bureau of Investigation if 
477.3   the commissioner has reasonable cause to believe the information 
477.4   is pertinent to the disqualification of an individual listed in 
477.5   paragraph (c), clauses (1) to (7).  The commissioner is not 
477.6   required to conduct more than one review of a subject's records 
477.7   from the Federal Bureau of Investigation if a review of the 
477.8   subject's criminal history with the Federal Bureau of 
477.9   Investigation has already been completed by the commissioner and 
477.10  there has been no break in the subject's affiliation with the 
477.11  license holder who initiated the background study. 
477.12     (m) For any background study completed under this section, 
477.13  when the commissioner has reasonable cause to believe that 
477.14  further pertinent information may exist on the subject, the 
477.15  subject shall provide a set of classifiable fingerprints 
477.16  obtained from an authorized law enforcement agency.  For 
477.17  purposes of requiring fingerprints, the commissioner shall be 
477.18  considered to have reasonable cause under, but not limited to, 
477.19  the following circumstances: 
477.20     (1) information from the bureau of criminal apprehension 
477.21  indicates that the subject is a multistate offender; 
477.22     (2) information from the bureau of criminal apprehension 
477.23  indicates that multistate offender status is undetermined; or 
477.24     (3) the commissioner has received a report from the subject 
477.25  or a third party indicating that the subject has a criminal 
477.26  history in a jurisdiction other than Minnesota. 
477.27     (n) The failure or refusal of an applicant, license holder, 
477.28  or registrant under section 144A.71, subdivision 1, to cooperate 
477.29  with the commissioner is reasonable cause to disqualify a 
477.30  subject, deny a license application or immediately suspend, 
477.31  suspend, or revoke a license or registration.  Failure or 
477.32  refusal of an individual to cooperate with the study is just 
477.33  cause for denying or terminating employment of the individual if 
477.34  the individual's failure or refusal to cooperate could cause the 
477.35  applicant's application to be denied or the license holder's 
477.36  license to be immediately suspended, suspended, or revoked. 
478.1      (o) The commissioner shall not consider an application to 
478.2   be complete until all of the information required to be provided 
478.3   under this subdivision has been received.  
478.4      (p) No person in paragraph (c), clauses (1) to (7), who is 
478.5   disqualified as a result of this section may be retained by the 
478.6   agency in a position involving direct contact with persons 
478.7   served by the program and no person in paragraph (c), clauses 
478.8   (2), (6), and (7), or as provided elsewhere in statute who is 
478.9   disqualified as a result of this section may be allowed access 
478.10  to persons served by the program, unless the commissioner has 
478.11  provided written notice to the agency stating that: 
478.12     (1) the individual may remain in direct contact during the 
478.13  period in which the individual may request reconsideration as 
478.14  provided in subdivision 3a, paragraph (b), clause (2) or (3); 
478.15     (2) the individual's disqualification has been set aside 
478.16  for that agency as provided in subdivision 3b, paragraph (b); or 
478.17     (3) the license holder has been granted a variance for the 
478.18  disqualified individual under subdivision 3e. 
478.19     (q) Termination of affiliation with persons in paragraph 
478.20  (c), clauses (1) to (7), made in good faith reliance on a notice 
478.21  of disqualification provided by the commissioner shall not 
478.22  subject the applicant or license holder to civil liability. 
478.23     (r) The commissioner may establish records to fulfill the 
478.24  requirements of this section. 
478.25     (s) The commissioner may not disqualify an individual 
478.26  subject to a study under this section because that person has, 
478.27  or has had, a mental illness as defined in section 245.462, 
478.28  subdivision 20. 
478.29     (t) An individual subject to disqualification under this 
478.30  subdivision has the applicable rights in subdivision 3a, 3b, or 
478.31  3c. 
478.32     (u) For the purposes of background studies completed by 
478.33  tribal organizations performing licensing activities otherwise 
478.34  required of the commissioner under this chapter, after obtaining 
478.35  consent from the background study subject, tribal licensing 
478.36  agencies shall have access to criminal history data in the same 
479.1   manner as county licensing agencies and private licensing 
479.2   agencies under this chapter. 
479.3      (v) County agencies shall have access to the criminal 
479.4   history data in the same manner as county licensing agencies 
479.5   under this chapter for purposes of background studies completed 
479.6   by county agencies on legal nonlicensed child care providers to 
479.7   determine eligibility for child care funds under chapter 119B. 
479.8      Sec. 6.  Minnesota Statutes 2002, section 245A.04, 
479.9   subdivision 3b, is amended to read: 
479.10     Subd. 3b.  [RECONSIDERATION OF DISQUALIFICATION.] (a) The 
479.11  individual who is the subject of the disqualification may 
479.12  request a reconsideration of the disqualification.  
479.13     The individual must submit the request for reconsideration 
479.14  to the commissioner in writing.  A request for reconsideration 
479.15  for an individual who has been sent a notice of disqualification 
479.16  under subdivision 3a, paragraph (b), clause (1) or (2), must be 
479.17  submitted within 30 calendar days of the disqualified 
479.18  individual's receipt of the notice of disqualification.  Upon 
479.19  showing that the information in clause (1) or (2) cannot be 
479.20  obtained within 30 days, the disqualified individual may request 
479.21  additional time, not to exceed 30 days, to obtain that 
479.22  information.  A request for reconsideration for an individual 
479.23  who has been sent a notice of disqualification under subdivision 
479.24  3a, paragraph (b), clause (3), must be submitted within 15 
479.25  calendar days of the disqualified individual's receipt of the 
479.26  notice of disqualification.  An individual who was determined to 
479.27  have maltreated a child under section 626.556 or a vulnerable 
479.28  adult under section 626.557, and who was disqualified under this 
479.29  section on the basis of serious or recurring maltreatment, may 
479.30  request reconsideration of both the maltreatment and the 
479.31  disqualification determinations.  The request for 
479.32  reconsideration of the maltreatment determination and the 
479.33  disqualification must be submitted within 30 calendar days of 
479.34  the individual's receipt of the notice of disqualification.  
479.35  Removal of a disqualified individual from direct contact shall 
479.36  be ordered if the individual does not request reconsideration 
480.1   within the prescribed time, and for an individual who submits a 
480.2   timely request for reconsideration, if the disqualification is 
480.3   not set aside.  The individual must present information showing 
480.4   that: 
480.5      (1) the information the commissioner relied upon in 
480.6   determining that the underlying conduct giving rise to the 
480.7   disqualification occurred, and for maltreatment, that the 
480.8   maltreatment was serious or recurring, is incorrect; or 
480.9      (2) the subject of the study does not pose a risk of harm 
480.10  to any person served by the applicant, license holder, or 
480.11  registrant under section 144A.71, subdivision 1. 
480.12     (b) The commissioner shall rescind the disqualification if 
480.13  the commissioner finds that the information relied on to 
480.14  disqualify the subject is incorrect.  The commissioner may set 
480.15  aside the disqualification under this section if the 
480.16  commissioner finds that the individual does not pose a risk of 
480.17  harm to any person served by the applicant, license holder, or 
480.18  registrant under section 144A.71, subdivision 1.  In determining 
480.19  that an individual does not pose a risk of harm, the 
480.20  commissioner shall consider the nature, severity, and 
480.21  consequences of the event or events that lead to 
480.22  disqualification, whether there is more than one disqualifying 
480.23  event, the age and vulnerability of the victim at the time of 
480.24  the event, the harm suffered by the victim, the similarity 
480.25  between the victim and persons served by the program, the time 
480.26  elapsed without a repeat of the same or similar event, 
480.27  documentation of successful completion by the individual studied 
480.28  of training or rehabilitation pertinent to the event, and any 
480.29  other information relevant to reconsideration.  In reviewing a 
480.30  disqualification under this section, the commissioner shall give 
480.31  preeminent weight to the safety of each person to be served by 
480.32  the license holder, applicant, or registrant under section 
480.33  144A.71, subdivision 1, over the interests of the license 
480.34  holder, applicant, or registrant under section 144A.71, 
480.35  subdivision 1.  If the commissioner sets aside a 
480.36  disqualification under this section, the disqualified individual 
481.1   remains disqualified, but may hold a license and have direct 
481.2   contact with or access to persons receiving services.  The 
481.3   commissioner's set aside of a disqualification is limited solely 
481.4   to the licensed program, applicant, or agency specified in the 
481.5   set aside notice, unless otherwise specified in the notice.  The 
481.6   commissioner may rescind a previous set aside of a 
481.7   disqualification under this section based on new information 
481.8   that indicates the individual may pose a risk of harm to persons 
481.9   served by the applicant, license holder, or registrant.  If the 
481.10  commissioner rescinds a set aside of a disqualification under 
481.11  this paragraph, the appeal rights under paragraphs (a) and (e) 
481.12  shall apply. 
481.13     (c) Unless the information the commissioner relied on in 
481.14  disqualifying an individual is incorrect, the commissioner may 
481.15  not set aside the disqualification of an individual in 
481.16  connection with a license to provide family day care for 
481.17  children, foster care for children in the provider's own home, 
481.18  or foster care or day care services for adults in the provider's 
481.19  own home if: 
481.20     (1) less than ten years have passed since the discharge of 
481.21  the sentence imposed for the offense; and the individual has 
481.22  been convicted of a violation of any offense listed in sections 
481.23  609.165 (felon ineligible to possess firearm), criminal 
481.24  vehicular homicide under 609.21 (criminal vehicular homicide and 
481.25  injury), 609.215 (aiding suicide or aiding attempted suicide), 
481.26  felony violations under 609.223 or 609.2231 (assault in the 
481.27  third or fourth degree), 609.713 (terroristic threats), 609.235 
481.28  (use of drugs to injure or to facilitate crime), 609.24 (simple 
481.29  robbery), 609.255 (false imprisonment), 609.562 (arson in the 
481.30  second degree), 609.71 (riot), 609.498, subdivision 1 or 1a 1b 
481.31  (aggravated first degree or first degree tampering with a 
481.32  witness), burglary in the first or second degree under 609.582 
481.33  (burglary), 609.66 (dangerous weapon), 609.665 (spring guns), 
481.34  609.67 (machine guns and short-barreled shotguns), 609.749, 
481.35  subdivision 2 (gross misdemeanor harassment; stalking), 152.021 
481.36  or 152.022 (controlled substance crime in the first or second 
482.1   degree), 152.023, subdivision 1, clause (3) or (4), or 
482.2   subdivision 2, clause (4) (controlled substance crime in the 
482.3   third degree), 152.024, subdivision 1, clause (2), (3), or (4) 
482.4   (controlled substance crime in the fourth degree), 609.224, 
482.5   subdivision 2, paragraph (c) (fifth-degree assault by a 
482.6   caregiver against a vulnerable adult), 609.23 (mistreatment of 
482.7   persons confined), 609.231 (mistreatment of residents or 
482.8   patients), 609.2325 (criminal abuse of a vulnerable adult), 
482.9   609.233 (criminal neglect of a vulnerable adult), 609.2335 
482.10  (financial exploitation of a vulnerable adult), 609.234 (failure 
482.11  to report), 609.265 (abduction), 609.2664 to 609.2665 
482.12  (manslaughter of an unborn child in the first or second degree), 
482.13  609.267 to 609.2672 (assault of an unborn child in the first, 
482.14  second, or third degree), 609.268 (injury or death of an unborn 
482.15  child in the commission of a crime), 617.293 (disseminating or 
482.16  displaying harmful material to minors), a felony level 
482.17  conviction involving alcohol or drug use, a gross misdemeanor 
482.18  offense under 609.324, subdivision 1 (other prohibited acts), a 
482.19  gross misdemeanor offense under 609.378 (neglect or endangerment 
482.20  of a child), a gross misdemeanor offense under 609.377 
482.21  (malicious punishment of a child), 609.72, subdivision 3 
482.22  (disorderly conduct against a vulnerable adult); or an attempt 
482.23  or conspiracy to commit any of these offenses, as each of these 
482.24  offenses is defined in Minnesota Statutes; or an offense in any 
482.25  other state, the elements of which are substantially similar to 
482.26  the elements of any of the foregoing offenses; 
482.27     (2) regardless of how much time has passed since the 
482.28  involuntary termination of parental rights under section 
482.29  260C.301 or the discharge of the sentence imposed for the 
482.30  offense, the individual was convicted of a violation of any 
482.31  offense listed in sections 609.185 to 609.195 (murder in the 
482.32  first, second, or third degree), 609.20 (manslaughter in the 
482.33  first degree), 609.205 (manslaughter in the second degree), 
482.34  609.245 (aggravated robbery), 609.25 (kidnapping), 609.561 
482.35  (arson in the first degree), 609.749, subdivision 3, 4, or 5 
482.36  (felony-level harassment; stalking), 609.228 (great bodily harm 
483.1   caused by distribution of drugs), 609.221 or 609.222 (assault in 
483.2   the first or second degree), 609.66, subdivision 1e (drive-by 
483.3   shooting), 609.855, subdivision 5 (shooting in or at a public 
483.4   transit vehicle or facility), 609.2661 to 609.2663 (murder of an 
483.5   unborn child in the first, second, or third degree), a felony 
483.6   offense under 609.377 (malicious punishment of a child), a 
483.7   felony offense under 609.324, subdivision 1 (other prohibited 
483.8   acts), a felony offense under 609.378 (neglect or endangerment 
483.9   of a child), 609.322 (solicitation, inducement, and promotion of 
483.10  prostitution), 609.342 to 609.345 (criminal sexual conduct in 
483.11  the first, second, third, or fourth degree), 609.352 
483.12  (solicitation of children to engage in sexual conduct), 617.246 
483.13  (use of minors in a sexual performance), 617.247 (possession of 
483.14  pictorial representations of a minor), 609.365 (incest), a 
483.15  felony offense under sections 609.2242 and 609.2243 (domestic 
483.16  assault), a felony offense of spousal abuse, a felony offense of 
483.17  child abuse or neglect, a felony offense of a crime against 
483.18  children, or an attempt or conspiracy to commit any of these 
483.19  offenses as defined in Minnesota Statutes, or an offense in any 
483.20  other state, the elements of which are substantially similar to 
483.21  any of the foregoing offenses; 
483.22     (3) within the seven years preceding the study, the 
483.23  individual committed an act that constitutes maltreatment of a 
483.24  child under section 626.556, subdivision 10e, and that resulted 
483.25  in substantial bodily harm as defined in section 609.02, 
483.26  subdivision 7a, or substantial mental or emotional harm as 
483.27  supported by competent psychological or psychiatric evidence; or 
483.28     (4) within the seven years preceding the study, the 
483.29  individual was determined under section 626.557 to be the 
483.30  perpetrator of a substantiated incident of maltreatment of a 
483.31  vulnerable adult that resulted in substantial bodily harm as 
483.32  defined in section 609.02, subdivision 7a, or substantial mental 
483.33  or emotional harm as supported by competent psychological or 
483.34  psychiatric evidence. 
483.35     In the case of any ground for disqualification under 
483.36  clauses (1) to (4), if the act was committed by an individual 
484.1   other than the applicant, license holder, or registrant under 
484.2   section 144A.71, subdivision 1, residing in the applicant's or 
484.3   license holder's home, or the home of a registrant under section 
484.4   144A.71, subdivision 1, the applicant, license holder, or 
484.5   registrant under section 144A.71, subdivision 1, may seek 
484.6   reconsideration when the individual who committed the act no 
484.7   longer resides in the home.  
484.8      The disqualification periods provided under clauses (1), 
484.9   (3), and (4) are the minimum applicable disqualification 
484.10  periods.  The commissioner may determine that an individual 
484.11  should continue to be disqualified from licensure or 
484.12  registration under section 144A.71, subdivision 1, because the 
484.13  license holder, applicant, or registrant under section 144A.71, 
484.14  subdivision 1, poses a risk of harm to a person served by that 
484.15  individual after the minimum disqualification period has passed. 
484.16     (d) The commissioner shall respond in writing or by 
484.17  electronic transmission to all reconsideration requests for 
484.18  which the basis for the request is that the information relied 
484.19  upon by the commissioner to disqualify is incorrect or 
484.20  inaccurate within 30 working days of receipt of a request and 
484.21  all relevant information.  If the basis for the request is that 
484.22  the individual does not pose a risk of harm, the commissioner 
484.23  shall respond to the request within 15 working days after 
484.24  receiving the request for reconsideration and all relevant 
484.25  information.  If the request is based on both the correctness or 
484.26  accuracy of the information relied on to disqualify the 
484.27  individual and the risk of harm, the commissioner shall respond 
484.28  to the request within 45 working days after receiving the 
484.29  request for reconsideration and all relevant information.  If 
484.30  the disqualification is set aside, the commissioner shall notify 
484.31  the applicant or license holder in writing or by electronic 
484.32  transmission of the decision. 
484.33     (e) Except as provided in subdivision 3c, if a 
484.34  disqualification for which reconsideration was requested is not 
484.35  set aside or is not rescinded, an individual who was 
484.36  disqualified on the basis of a preponderance of evidence that 
485.1   the individual committed an act or acts that meet the definition 
485.2   of any of the crimes listed in subdivision 3d, paragraph (a), 
485.3   clauses (1) to (4); for a determination under section 626.556 or 
485.4   626.557 of substantiated maltreatment that was serious or 
485.5   recurring under subdivision 3d, paragraph (a), clause (4); or 
485.6   for failure to make required reports under section 626.556, 
485.7   subdivision 3, or 626.557, subdivision 3, pursuant to 
485.8   subdivision 3d, paragraph (a), clause (4), may request a fair 
485.9   hearing under section 256.045.  Except as provided under 
485.10  subdivision 3c, the fair hearing is the only administrative 
485.11  appeal of the final agency determination for purposes of appeal 
485.12  by the disqualified individual, specifically, including a 
485.13  challenge to the accuracy and completeness of data under section 
485.14  13.04.  If the individual was disqualified based on a conviction 
485.15  or admission to any crimes listed in subdivision 3d, paragraph 
485.16  (a), clauses (1) to (4), the reconsideration decision under this 
485.17  subdivision is the final agency determination for purposes of 
485.18  appeal by the disqualified individual and is not subject to a 
485.19  hearing under section 256.045. 
485.20     (f) Except as provided under subdivision 3c, if an 
485.21  individual was disqualified on the basis of a determination of 
485.22  maltreatment under section 626.556 or 626.557, which was serious 
485.23  or recurring, and the individual has requested reconsideration 
485.24  of the maltreatment determination under section 626.556, 
485.25  subdivision 10i, or 626.557, subdivision 9d, and also requested 
485.26  reconsideration of the disqualification under this subdivision, 
485.27  reconsideration of the maltreatment determination and 
485.28  reconsideration of the disqualification shall be consolidated 
485.29  into a single reconsideration.  For maltreatment and 
485.30  disqualification determinations made by county agencies, the 
485.31  consolidated reconsideration shall be conducted by the county 
485.32  agency.  If the county agency has disqualified an individual on 
485.33  multiple bases, one of which is a county maltreatment 
485.34  determination for which the individual has a right to request 
485.35  reconsideration, the county shall conduct the reconsideration of 
485.36  all disqualifications.  Except as provided under subdivision 3c, 
486.1   if an individual who was disqualified on the basis of serious or 
486.2   recurring maltreatment requests a fair hearing on the 
486.3   maltreatment determination under section 626.556, subdivision 
486.4   10i, or 626.557, subdivision 9d, and requests a fair hearing on 
486.5   the disqualification, which has not been set aside or rescinded 
486.6   under this subdivision, the scope of the fair hearing under 
486.7   section 256.045 shall include the maltreatment determination and 
486.8   the disqualification.  Except as provided under subdivision 3c, 
486.9   a fair hearing is the only administrative appeal of the final 
486.10  agency determination, specifically, including a challenge to the 
486.11  accuracy and completeness of data under section 13.04. 
486.12     (g) In the notice from the commissioner that a 
486.13  disqualification has been set aside, the license holder must be 
486.14  informed that information about the nature of the 
486.15  disqualification and which factors under paragraph (b) were the 
486.16  bases of the decision to set aside the disqualification is 
486.17  available to the license holder upon request without consent of 
486.18  the background study subject.  With the written consent of a 
486.19  background study subject, the commissioner may release to the 
486.20  license holder copies of all information related to the 
486.21  background study subject's disqualification and the 
486.22  commissioner's decision to set aside the disqualification as 
486.23  specified in the written consent. 
486.24     Sec. 7.  Minnesota Statutes 2002, section 245A.04, 
486.25  subdivision 3d, is amended to read: 
486.26     Subd. 3d.  [DISQUALIFICATION.] (a) Upon receipt of 
486.27  information showing, or when a background study completed under 
486.28  subdivision 3 shows any of the following:  a conviction of one 
486.29  or more crimes listed in clauses (1) to (4); the individual has 
486.30  admitted to or a preponderance of the evidence indicates the 
486.31  individual has committed an act or acts that meet the definition 
486.32  of any of the crimes listed in clauses (1) to (4); or an 
486.33  investigation results in an administrative determination listed 
486.34  under clause (4), the individual shall be disqualified from any 
486.35  position allowing direct contact with persons receiving services 
486.36  from the license holder, entity identified in subdivision 3, 
487.1   paragraph (a), or registrant under section 144A.71, subdivision 
487.2   1, and for individuals studied under section 245A.04, 
487.3   subdivision 3, paragraph (c), clauses (2), (6), and (7), the 
487.4   individual shall also be disqualified from access to a person 
487.5   receiving services from the license holder: 
487.6      (1) regardless of how much time has passed since the 
487.7   involuntary termination of parental rights under section 
487.8   260C.301 or the discharge of the sentence imposed for the 
487.9   offense, and unless otherwise specified, regardless of the level 
487.10  of the conviction, the individual was convicted of any of the 
487.11  following offenses:  sections 609.185 (murder in the first 
487.12  degree); 609.19 (murder in the second degree); 609.195 (murder 
487.13  in the third degree); 609.2661 (murder of an unborn child in the 
487.14  first degree); 609.2662 (murder of an unborn child in the second 
487.15  degree); 609.2663 (murder of an unborn child in the third 
487.16  degree); 609.20 (manslaughter in the first degree); 609.205 
487.17  (manslaughter in the second degree); 609.221 or 609.222 (assault 
487.18  in the first or second degree); 609.228 (great bodily harm 
487.19  caused by distribution of drugs); 609.245 (aggravated robbery); 
487.20  609.25 (kidnapping); 609.561 (arson in the first degree); 
487.21  609.749, subdivision 3, 4, or 5 (felony-level harassment; 
487.22  stalking); 609.66, subdivision 1e (drive-by shooting); 609.855, 
487.23  subdivision 5 (shooting at or in a public transit vehicle or 
487.24  facility); 609.322 (solicitation, inducement, and promotion of 
487.25  prostitution); 609.342 (criminal sexual conduct in the first 
487.26  degree); 609.343 (criminal sexual conduct in the second degree); 
487.27  609.344 (criminal sexual conduct in the third degree); 609.345 
487.28  (criminal sexual conduct in the fourth degree); 609.352 
487.29  (solicitation of children to engage in sexual conduct); 609.365 
487.30  (incest); felony offense under 609.377 (malicious punishment of 
487.31  a child); a felony offense under 609.378 (neglect or 
487.32  endangerment of a child); a felony offense under 609.324, 
487.33  subdivision 1 (other prohibited acts); 617.246 (use of minors in 
487.34  sexual performance prohibited); 617.247 (possession of pictorial 
487.35  representations of minors); a felony offense under sections 
487.36  609.2242 and 609.2243 (domestic assault), a felony offense of 
488.1   spousal abuse, a felony offense of child abuse or neglect, a 
488.2   felony offense of a crime against children; or attempt or 
488.3   conspiracy to commit any of these offenses as defined in 
488.4   Minnesota Statutes, or an offense in any other state or country, 
488.5   where the elements are substantially similar to any of the 
488.6   offenses listed in this clause; 
488.7      (2) if less than 15 years have passed since the discharge 
488.8   of the sentence imposed for the offense; and the individual has 
488.9   received a felony conviction for a violation of any of these 
488.10  offenses:  sections 609.21 (criminal vehicular homicide and 
488.11  injury); 609.165 (felon ineligible to possess firearm); 609.215 
488.12  (suicide); 609.223 or 609.2231 (assault in the third or fourth 
488.13  degree); repeat offenses under 609.224 (assault in the fifth 
488.14  degree); repeat offenses under 609.3451 (criminal sexual conduct 
488.15  in the fifth degree); 609.498, subdivision 1 or 1a 
488.16  1b (aggravated first degree or first degree tampering with a 
488.17  witness); 609.713 (terroristic threats); 609.235 (use of drugs 
488.18  to injure or facilitate crime); 609.24 (simple robbery); 609.255 
488.19  (false imprisonment); 609.562 (arson in the second degree); 
488.20  609.563 (arson in the third degree); repeat offenses under 
488.21  617.23 (indecent exposure; penalties); repeat offenses under 
488.22  617.241 (obscene materials and performances; distribution and 
488.23  exhibition prohibited; penalty); 609.71 (riot); 609.66 
488.24  (dangerous weapons); 609.67 (machine guns and short-barreled 
488.25  shotguns); 609.2325 (criminal abuse of a vulnerable adult); 
488.26  609.2664 (manslaughter of an unborn child in the first degree); 
488.27  609.2665 (manslaughter of an unborn child in the second degree); 
488.28  609.267 (assault of an unborn child in the first degree); 
488.29  609.2671 (assault of an unborn child in the second degree); 
488.30  609.268 (injury or death of an unborn child in the commission of 
488.31  a crime); 609.52 (theft); 609.2335 (financial exploitation of a 
488.32  vulnerable adult); 609.521 (possession of shoplifting gear); 
488.33  609.582 (burglary); 609.625 (aggravated forgery); 609.63 
488.34  (forgery); 609.631 (check forgery; offering a forged check); 
488.35  609.635 (obtaining signature by false pretense); 609.27 
488.36  (coercion); 609.275 (attempt to coerce); 609.687 (adulteration); 
489.1   260C.301 (grounds for termination of parental rights); chapter 
489.2   152 (drugs; controlled substance); and a felony level conviction 
489.3   involving alcohol or drug use.  An attempt or conspiracy to 
489.4   commit any of these offenses, as each of these offenses is 
489.5   defined in Minnesota Statutes; or an offense in any other state 
489.6   or country, the elements of which are substantially similar to 
489.7   the elements of the offenses in this clause.  If the individual 
489.8   studied is convicted of one of the felonies listed in this 
489.9   clause, but the sentence is a gross misdemeanor or misdemeanor 
489.10  disposition, the lookback period for the conviction is the 
489.11  period applicable to the disposition, that is the period for 
489.12  gross misdemeanors or misdemeanors; 
489.13     (3) if less than ten years have passed since the discharge 
489.14  of the sentence imposed for the offense; and the individual has 
489.15  received a gross misdemeanor conviction for a violation of any 
489.16  of the following offenses:  sections 609.224 (assault in the 
489.17  fifth degree); 609.2242 and 609.2243 (domestic assault); 
489.18  violation of an order for protection under 518B.01, subdivision 
489.19  14; 609.3451 (criminal sexual conduct in the fifth degree); 
489.20  repeat offenses under 609.746 (interference with privacy); 
489.21  repeat offenses under 617.23 (indecent exposure); 617.241 
489.22  (obscene materials and performances); 617.243 (indecent 
489.23  literature, distribution); 617.293 (harmful materials; 
489.24  dissemination and display to minors prohibited); 609.71 (riot); 
489.25  609.66 (dangerous weapons); 609.749, subdivision 2 (harassment; 
489.26  stalking); 609.224, subdivision 2, paragraph (c) (assault in the 
489.27  fifth degree by a caregiver against a vulnerable adult); 609.23 
489.28  (mistreatment of persons confined); 609.231 (mistreatment of 
489.29  residents or patients); 609.2325 (criminal abuse of a vulnerable 
489.30  adult); 609.233 (criminal neglect of a vulnerable adult); 
489.31  609.2335 (financial exploitation of a vulnerable adult); 609.234 
489.32  (failure to report maltreatment of a vulnerable adult); 609.72, 
489.33  subdivision 3 (disorderly conduct against a vulnerable adult); 
489.34  609.265 (abduction); 609.378 (neglect or endangerment of a 
489.35  child); 609.377 (malicious punishment of a child); 609.324, 
489.36  subdivision 1a (other prohibited acts; minor engaged in 
490.1   prostitution); 609.33 (disorderly house); 609.52 (theft); 
490.2   609.582 (burglary); 609.631 (check forgery; offering a forged 
490.3   check); 609.275 (attempt to coerce); or an attempt or conspiracy 
490.4   to commit any of these offenses, as each of these offenses is 
490.5   defined in Minnesota Statutes; or an offense in any other state 
490.6   or country, the elements of which are substantially similar to 
490.7   the elements of any of the offenses listed in this clause.  If 
490.8   the defendant is convicted of one of the gross misdemeanors 
490.9   listed in this clause, but the sentence is a misdemeanor 
490.10  disposition, the lookback period for the conviction is the 
490.11  period applicable to misdemeanors; or 
490.12     (4) if less than seven years have passed since the 
490.13  discharge of the sentence imposed for the offense; and the 
490.14  individual has received a misdemeanor conviction for a violation 
490.15  of any of the following offenses:  sections 609.224 (assault in 
490.16  the fifth degree); 609.2242 (domestic assault); violation of an 
490.17  order for protection under 518B.01 (Domestic Abuse Act); 
490.18  violation of an order for protection under 609.3232 (protective 
490.19  order authorized; procedures; penalties); 609.746 (interference 
490.20  with privacy); 609.79 (obscene or harassing phone calls); 
490.21  609.795 (letter, telegram, or package; opening; harassment); 
490.22  617.23 (indecent exposure; penalties); 609.2672 (assault of an 
490.23  unborn child in the third degree); 617.293 (harmful materials; 
490.24  dissemination and display to minors prohibited); 609.66 
490.25  (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 
490.26  exploitation of a vulnerable adult); 609.234 (failure to report 
490.27  maltreatment of a vulnerable adult); 609.52 (theft); 609.27 
490.28  (coercion); or an attempt or conspiracy to commit any of these 
490.29  offenses, as each of these offenses is defined in Minnesota 
490.30  Statutes; or an offense in any other state or country, the 
490.31  elements of which are substantially similar to the elements of 
490.32  any of the offenses listed in this clause; a determination or 
490.33  disposition of failure to make required reports under section 
490.34  626.556, subdivision 3, or 626.557, subdivision 3, for incidents 
490.35  in which:  (i) the final disposition under section 626.556 or 
490.36  626.557 was substantiated maltreatment, and (ii) the 
491.1   maltreatment was recurring or serious; or a determination or 
491.2   disposition of substantiated serious or recurring maltreatment 
491.3   of a minor under section 626.556 or of a vulnerable adult under 
491.4   section 626.557 for which there is a preponderance of evidence 
491.5   that the maltreatment occurred, and that the subject was 
491.6   responsible for the maltreatment. 
491.7      For the purposes of this section, "serious maltreatment" 
491.8   means sexual abuse; maltreatment resulting in death; or 
491.9   maltreatment resulting in serious injury which reasonably 
491.10  requires the care of a physician whether or not the care of a 
491.11  physician was sought; or abuse resulting in serious injury.  For 
491.12  purposes of this section, "abuse resulting in serious injury" 
491.13  means:  bruises, bites, skin laceration or tissue damage; 
491.14  fractures; dislocations; evidence of internal injuries; head 
491.15  injuries with loss of consciousness; extensive second-degree or 
491.16  third-degree burns and other burns for which complications are 
491.17  present; extensive second-degree or third-degree frostbite, and 
491.18  others for which complications are present; irreversible 
491.19  mobility or avulsion of teeth; injuries to the eyeball; 
491.20  ingestion of foreign substances and objects that are harmful; 
491.21  near drowning; and heat exhaustion or sunstroke.  For purposes 
491.22  of this section, "care of a physician" is treatment received or 
491.23  ordered by a physician, but does not include diagnostic testing, 
491.24  assessment, or observation.  For the purposes of this section, 
491.25  "recurring maltreatment" means more than one incident of 
491.26  maltreatment for which there is a preponderance of evidence that 
491.27  the maltreatment occurred, and that the subject was responsible 
491.28  for the maltreatment.  For purposes of this section, "access" 
491.29  means physical access to an individual receiving services or the 
491.30  individual's personal property without continuous, direct 
491.31  supervision as defined in section 245A.04, subdivision 3.  
491.32     (b) Except for background studies related to child foster 
491.33  care, adult foster care, or family child care licensure, when 
491.34  the subject of a background study is regulated by a 
491.35  health-related licensing board as defined in chapter 214, and 
491.36  the regulated person has been determined to have been 
492.1   responsible for substantiated maltreatment under section 626.556 
492.2   or 626.557, instead of the commissioner making a decision 
492.3   regarding disqualification, the board shall make a determination 
492.4   whether to impose disciplinary or corrective action under 
492.5   chapter 214. 
492.6      (1) The commissioner shall notify the health-related 
492.7   licensing board: 
492.8      (i) upon completion of a background study that produces a 
492.9   record showing that the individual was determined to have been 
492.10  responsible for substantiated maltreatment; 
492.11     (ii) upon the commissioner's completion of an investigation 
492.12  that determined the individual was responsible for substantiated 
492.13  maltreatment; or 
492.14     (iii) upon receipt from another agency of a finding of 
492.15  substantiated maltreatment for which the individual was 
492.16  responsible. 
492.17     (2) The commissioner's notice shall indicate whether the 
492.18  individual would have been disqualified by the commissioner for 
492.19  the substantiated maltreatment if the individual were not 
492.20  regulated by the board.  The commissioner shall concurrently 
492.21  send this notice to the individual. 
492.22     (3) Notwithstanding the exclusion from this subdivision for 
492.23  individuals who provide child foster care, adult foster care, or 
492.24  family child care, when the commissioner or a local agency has 
492.25  reason to believe that the direct contact services provided by 
492.26  the individual may fall within the jurisdiction of a 
492.27  health-related licensing board, a referral shall be made to the 
492.28  board as provided in this section. 
492.29     (4) If, upon review of the information provided by the 
492.30  commissioner, a health-related licensing board informs the 
492.31  commissioner that the board does not have jurisdiction to take 
492.32  disciplinary or corrective action, the commissioner shall make 
492.33  the appropriate disqualification decision regarding the 
492.34  individual as otherwise provided in this chapter. 
492.35     (5) The commissioner has the authority to monitor the 
492.36  facility's compliance with any requirements that the 
493.1   health-related licensing board places on regulated persons 
493.2   practicing in a facility either during the period pending a 
493.3   final decision on a disciplinary or corrective action or as a 
493.4   result of a disciplinary or corrective action.  The commissioner 
493.5   has the authority to order the immediate removal of a regulated 
493.6   person from direct contact or access when a board issues an 
493.7   order of temporary suspension based on a determination that the 
493.8   regulated person poses an immediate risk of harm to persons 
493.9   receiving services in a licensed facility. 
493.10     (6) A facility that allows a regulated person to provide 
493.11  direct contact services while not complying with the 
493.12  requirements imposed by the health-related licensing board is 
493.13  subject to action by the commissioner as specified under 
493.14  sections 245A.06 and 245A.07. 
493.15     (7) The commissioner shall notify a health-related 
493.16  licensing board immediately upon receipt of knowledge of 
493.17  noncompliance with requirements placed on a facility or upon a 
493.18  person regulated by the board. 
493.19     Sec. 8.  Minnesota Statutes 2002, section 245A.09, 
493.20  subdivision 7, is amended to read: 
493.21     Subd. 7.  [REGULATORY METHODS.] (a) Where appropriate and 
493.22  feasible the commissioner shall identify and implement 
493.23  alternative methods of regulation and enforcement to the extent 
493.24  authorized in this subdivision.  These methods shall include: 
493.25     (1) expansion of the types and categories of licenses that 
493.26  may be granted; 
493.27     (2) when the standards of another state or federal 
493.28  governmental agency or an independent accreditation body have 
493.29  been shown to predict compliance with the rules require the same 
493.30  standards, methods, or alternative methods to achieve 
493.31  substantially the same intended outcomes as the licensing 
493.32  standards, the commissioner shall consider compliance with the 
493.33  governmental or accreditation standards to be equivalent to 
493.34  partial compliance with the rules licensing standards; and 
493.35     (3) use of an abbreviated inspection that employs key 
493.36  standards that have been shown to predict full compliance with 
494.1   the rules. 
494.2      (b) If the commissioner accepts accreditation as 
494.3   documentation of compliance with a licensing standard under 
494.4   paragraph (a), the commissioner shall continue to investigate 
494.5   complaints related to noncompliance with all licensing standards.
494.6   The commissioner may take a licensing action for noncompliance 
494.7   under this chapter and shall recognize all existing appeal 
494.8   rights regarding any licensing actions taken under this chapter. 
494.9      (c) The commissioner shall work with the commissioners of 
494.10  health, public safety, administration, and children, families, 
494.11  and learning in consolidating duplicative licensing and 
494.12  certification rules and standards if the commissioner determines 
494.13  that consolidation is administratively feasible, would 
494.14  significantly reduce the cost of licensing, and would not reduce 
494.15  the protection given to persons receiving services in licensed 
494.16  programs.  Where administratively feasible and appropriate, the 
494.17  commissioner shall work with the commissioners of health, public 
494.18  safety, administration, and children, families, and learning in 
494.19  conducting joint agency inspections of programs. 
494.20     (c) (d) The commissioner shall work with the commissioners 
494.21  of health, public safety, administration, and children, 
494.22  families, and learning in establishing a single point of 
494.23  application for applicants who are required to obtain concurrent 
494.24  licensure from more than one of the commissioners listed in this 
494.25  clause. 
494.26     (d) (e) Unless otherwise specified in statute, the 
494.27  commissioner may specify in rule periods of licensure up to two 
494.28  years conduct routine inspections biennially. 
494.29     Sec. 9.  Minnesota Statutes 2002, section 245A.10, is 
494.30  amended to read: 
494.31     245A.10 [FEES.] 
494.32     Subdivision 1.  [APPLICATION OR LICENSE FEE REQUIRED, 
494.33  PROGRAMS EXEMPT FROM FEE.] (a) Unless exempt under paragraph 
494.34  (b), the commissioner shall charge a fee for evaluation of 
494.35  applications and inspection of programs, other than family day 
494.36  care and foster care, which are licensed under this chapter.  
495.1   The commissioner may charge a fee for the licensing of school 
495.2   age child care programs, in an amount sufficient to cover the 
495.3   cost to the state agency of processing the license. 
495.4      (b) Except as provided under subdivision 2, no application 
495.5   or license fee shall be charged for child foster care, adult 
495.6   foster care, family and group family child care or 
495.7   state-operated programs, unless the state-operated program is an 
495.8   intermediate care facility for persons with mental retardation 
495.9   or related conditions (ICF/MR). 
495.10     Subd. 2.  [COUNTY FEES FOR BACKGROUND STUDIES AND LICENSING 
495.11  INSPECTIONS IN FAMILY AND GROUP FAMILY CHILD CARE.] (a) For 
495.12  purposes of family and group family child care licensing under 
495.13  this chapter, a county agency may charge a fee to an applicant 
495.14  or license holder to recover the actual cost of background 
495.15  studies, but in any case not to exceed $100 annually.  A county 
495.16  agency may also charge a fee to an applicant or license holder 
495.17  to recover the actual cost of licensing inspections, but in any 
495.18  case not to exceed $150 annually. 
495.19     (b) A county agency may charge a fee to a legal nonlicensed 
495.20  child care provider or applicant for authorization to recover 
495.21  the actual cost of background studies completed under section 
495.22  119B.125, but in any case not to exceed $100 annually. 
495.23     (c) Counties may elect to reduce or waive the fees in 
495.24  paragraph (a) or (b):  
495.25     (1) in cases of financial hardship; and 
495.26     (2) if the county has a shortage of providers in the 
495.27  county's area. 
495.28     (d) Counties may allow providers to pay the applicant fees 
495.29  in paragraph (a) or (b) on an installment basis for up to one 
495.30  year.  If the provider is receiving child care assistance 
495.31  payments from the state, the provider may have the fees under 
495.32  paragraph (a) or (b) deducted from the child care assistance 
495.33  payments for up to one year and the state shall reimburse the 
495.34  county for the county fees collected in this manner. 
495.35     Subd. 3.  [APPLICATION FEE FOR INITIAL LICENSE OR 
495.36  CERTIFICATION.] (a) For fees required under subdivision 1, an 
496.1   applicant for an initial license or certification issued by the 
496.2   commissioner shall submit a $500 application fee with each new 
496.3   application required under this subdivision.  The application 
496.4   fee shall not be prorated, is nonrefundable, and is in lieu of 
496.5   the annual license or certification fee that expires on December 
496.6   31.  The commissioner shall not process an application until the 
496.7   application fee is paid.  
496.8      (b) Except as provided in clauses (1) to (3), an applicant 
496.9   shall apply for a license to provide services at a specific 
496.10  location.  
496.11     (1) For a license to provide waivered services to persons 
496.12  with developmental disabilities or related conditions, an 
496.13  applicant shall submit an application for each county in which 
496.14  the waivered services will be provided.  
496.15     (2) For a license to provide semi-independent living 
496.16  services to persons with developmental disabilities or related 
496.17  conditions, an applicant shall submit a single application to 
496.18  provide services statewide. 
496.19     (3) For a license to provide independent living assistance 
496.20  for youth under section 245A.22, an applicant shall submit a 
496.21  single application to provide services statewide.  
496.22     Subd. 4.  [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 
496.23  WITH LICENSED CAPACITY.] (a) Child care centers and programs 
496.24  with a licensed capacity shall pay an annual nonrefundable 
496.25  license or certification fee based on the following schedule: 
496.26      Licensed Capacity        Child Care         Residential
496.27                               Center             Program
496.28                               License Fee        License Fee
496.29      1 to 24 persons               $200               $400
496.30      25 to 49 persons              $300               $600
496.31      50 to 74 persons              $400               $800
496.32      75 to 99 persons              $500             $1,000
496.33      100 to 124 persons            $600             $1,200
496.34      125 to 149 persons            $700             $1,400
496.35      150 to 174 persons            $900             $1,600
496.36      175 to 199 persons          $1,200             $1,800
497.1       200 to 224 persons          $1,400             $2,000
497.2       225 or more persons         $1,600             $2,500
497.3      (b) A day training and habilitation program serving persons 
497.4   with developmental disabilities or related conditions shall be 
497.5   assessed a license fee based on the schedule in paragraph (a) 
497.6   unless the license holder serves more than 50 percent of the 
497.7   same persons at two or more locations in the community.  When a 
497.8   day training and habilitation program serves more than 50 
497.9   percent of the same persons in two or more locations in a 
497.10  community, the day training and habilitation program shall pay a 
497.11  license fee based on the licensed capacity of the largest 
497.12  facility and the other facility or facilities shall be charged a 
497.13  license fee based on a licensed capacity of a residential 
497.14  program serving one to 24 persons. 
497.15     Subd. 5.  [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 
497.16  WITHOUT A LICENSED CAPACITY.] (a) Except as provided in 
497.17  paragraph (b), a program without a stated licensed capacity 
497.18  shall pay a license or certification fee of $400.  
497.19     (b) A mental health center or mental health clinic 
497.20  requesting certification for purposes of insurance and 
497.21  subscriber contract reimbursement under Minnesota Rules, parts 
497.22  9520.0750 to 9520.0870 shall pay a certification fee of $1,000 
497.23  per year.  If the mental health center or mental health clinic 
497.24  provides services at a primary location with satellite 
497.25  facilities, the satellite facilities shall be certified with the 
497.26  primary location without an additional charge. 
497.27     Subd. 6.  [LICENSE NOT ISSUED UNTIL LICENSE OR 
497.28  CERTIFICATION FEE IS PAID.] The commissioner shall not issue a 
497.29  license or certification until the license or certification fee 
497.30  is paid.  The commissioner shall send a bill for the license or 
497.31  certification fee to the billing address identified by the 
497.32  license holder.  If the license holder does not submit the 
497.33  license or certification fee payment by the due date, the 
497.34  commissioner shall send the license holder a past due notice.  
497.35  If the license holder fails to pay the license or certification 
497.36  fee by the due date on the past due notice, the commissioner 
498.1   shall send a final notice to the license holder informing the 
498.2   license holder that the program license will expire on December 
498.3   31 unless the license fee is paid before December 31.  If a 
498.4   license expires, the program is no longer licensed and, unless 
498.5   exempt from licensure under section 245A.03, subdivision 2, must 
498.6   not operate after the expiration date.  After a license expires, 
498.7   if the former license holder wishes to provide licensed 
498.8   services, the former license holder must submit a new license 
498.9   application and application fee under subdivision 3. 
498.10     Sec. 10.  Minnesota Statutes 2002, section 245A.11, 
498.11  subdivision 2a, is amended to read: 
498.12     Subd. 2a.  [ADULT FOSTER CARE LICENSE CAPACITY.] (a) An 
498.13  adult foster care license holder may have a maximum license 
498.14  capacity of five if all persons in care are age 55 or over and 
498.15  do not have a serious and persistent mental illness or a 
498.16  developmental disability.  
498.17     (b) The commissioner may grant variances to paragraph (a) 
498.18  to allow a foster care provider with a licensed capacity of five 
498.19  persons to admit an individual under the age of 55 if the 
498.20  variance complies with section 245A.04, subdivision 9, and 
498.21  approval of the variance is recommended by the county in which 
498.22  the licensed foster care provider is located. 
498.23     (c) The commissioner may grant variances to paragraph (a) 
498.24  to allow the use of a fifth bed for emergency crisis services 
498.25  for a person with serious and persistent mental illness or a 
498.26  developmental disability, regardless of age, if the variance 
498.27  complies with section 245A.04, subdivision 9, and approval of 
498.28  the variance is recommended by the county in which the licensed 
498.29  foster care provider is located. 
498.30     (d) Notwithstanding paragraph (a), the commissioner may 
498.31  issue an adult foster care license with a capacity of five or 
498.32  six adults when the capacity is recommended by the county 
498.33  licensing agency of the county in which the facility is located 
498.34  and if the recommendation verifies that: 
498.35     (1) the facility meets the physical environment 
498.36  requirements in the adult foster care licensing rule; 
499.1      (2) the five- or six-bed living arrangement is specified 
499.2   for each resident in the resident's (i) individualized plan of 
499.3   care; (ii) individual service plan under section 256B.092, 
499.4   subdivision 1b, if required; or (iii) individual resident 
499.5   placement agreement under Minnesota Rules, part 9555.5105, 
499.6   subpart 19, if required; 
499.7      (3) the license holder obtains written and signed informed 
499.8   consent from each resident or resident's legal representative 
499.9   documenting the resident's informed choice to living in the home 
499.10  and that the resident's refusal to consent would not have 
499.11  resulted in service termination; and 
499.12     (4) the facility was licensed for adult foster care before 
499.13  March 1, 2003. 
499.14     (e) The commissioner shall not issue a new adult foster 
499.15  care license under paragraph (d) after June 30, 2005.  The 
499.16  commissioner shall allow a facility with an adult foster care 
499.17  license issued under paragraph (d) before June 30, 2005, to 
499.18  continue with a capacity of five or six adults if the license 
499.19  holder continues to comply with the requirements in paragraph 
499.20  (d). 
499.21     Sec. 11.  Minnesota Statutes 2002, section 245A.11, 
499.22  subdivision 2b, is amended to read: 
499.23     Subd. 2b.  [ADULT FOSTER CARE; FAMILY ADULT DAY CARE.] An 
499.24  adult foster care license holder licensed under the conditions 
499.25  in subdivision 2a may also provide family adult day care for 
499.26  adults age 55 or over if no persons in the adult foster or adult 
499.27  family day care program have a serious and persistent mental 
499.28  illness or a developmental disability.  The maximum combined 
499.29  capacity for adult foster care and family adult day care is five 
499.30  adults, except that the commissioner may grant a variance for a 
499.31  family adult day care provider to admit up to seven individuals 
499.32  for day care services and one individual for respite care 
499.33  services, if all of the following requirements are met:  (1) the 
499.34  variance complies with section 245A.04, subdivision 9; (2) a 
499.35  second caregiver is present whenever six or more clients are 
499.36  being served; and (3) the variance is recommended by the county 
500.1   social service agency in the county where the provider is 
500.2   located.  A separate license is not required to provide family 
500.3   adult day care under this subdivision.  Adult foster care homes 
500.4   providing services to five adults under this section shall not 
500.5   be subject to licensure by the commissioner of health under the 
500.6   provisions of chapter 144, 144A, 157, or any other law requiring 
500.7   facility licensure by the commissioner of health. 
500.8      Sec. 12.  Minnesota Statutes 2002, section 245A.11, is 
500.9   amended by adding a subdivision to read: 
500.10     Subd. 7.  [ADULT FOSTER CARE; VARIANCE FOR ALTERNATE 
500.11  OVERNIGHT SUPERVISION.] (a) The commissioner may grant a 
500.12  variance under section 245A.04, subdivision 9, to rule parts 
500.13  requiring a caregiver to be present in an adult foster care home 
500.14  during normal sleeping hours to allow for alternative methods of 
500.15  overnight supervision.  The commissioner may grant the variance 
500.16  if the local county licensing agency recommends the variance and 
500.17  the county recommendation includes documentation verifying that: 
500.18     (1) the county has approved the license holder's plan for 
500.19  alternative methods of providing overnight supervision and 
500.20  determined the plan protects the residents' health, safety, and 
500.21  rights; 
500.22     (2) the license holder has obtained written and signed 
500.23  informed consent from each resident or each resident's legal 
500.24  representative documenting the resident's or legal 
500.25  representative's agreement with the alternative method of 
500.26  overnight supervision; and 
500.27     (3) the alternative method of providing overnight 
500.28  supervision is specified for each resident in the resident's: 
500.29  (i) individualized plan of care; (ii) individual service plan 
500.30  under section 256B.092, subdivision 1b, if required; or (iii) 
500.31  individual resident placement agreement under Minnesota Rules, 
500.32  part 9555.5105, subpart 19, if required. 
500.33     (b) To be eligible for a variance under paragraph (a), the 
500.34  adult foster care license holder must not have had a licensing 
500.35  action under section 245A.06 or 245A.07 during the prior 24 
500.36  months based on failure to provide adequate supervision, health 
501.1   care services, or resident safety in the adult foster care home. 
501.2      Sec. 13.  Minnesota Statutes 2002, section 245B.03, 
501.3   subdivision 2, is amended to read: 
501.4      Subd. 2.  [RELATIONSHIP TO OTHER STANDARDS GOVERNING 
501.5   SERVICES FOR PERSONS WITH MENTAL RETARDATION OR RELATED 
501.6   CONDITIONS.] (a) ICFs/MR are exempt from: 
501.7      (1) section 245B.04; 
501.8      (2) section 245B.06, subdivisions 4 and 6; and 
501.9      (3) section 245B.07, subdivisions 4, paragraphs (b) and 
501.10  (c); 7; and 8, paragraphs (1), clause (iv), and (2). 
501.11     (b) License holders also licensed under chapter 144 as a 
501.12  supervised living facility are exempt from section 245B.04. 
501.13     (c) Residential service sites controlled by license holders 
501.14  licensed under chapter 245B for home and community-based 
501.15  waivered services for four or fewer adults are exempt from 
501.16  compliance with Minnesota Rules, parts 9543.0040, subpart 2, 
501.17  item C; 9555.5505; 9555.5515, items B and G; 9555.5605; 
501.18  9555.5705; 9555.6125, subparts 3, item C, subitem (2), and 4 to 
501.19  6; 9555.6185; 9555.6225, subpart 8; 9555.6245; 9555.6255; and 
501.20  9555.6265; and as provided under section 245B.06, subdivision 2, 
501.21  the license holder is exempt from the program abuse prevention 
501.22  plans and individual abuse prevention plans otherwise required 
501.23  under sections 245A.65, subdivision 2, and 626.557, subdivision 
501.24  14.  The commissioner may approve alternative methods of 
501.25  providing overnight supervision using the process and criteria 
501.26  for granting a variance in section 245A.04, subdivision 9.  This 
501.27  chapter does not apply to foster care homes that do not provide 
501.28  residential habilitation services funded under the home and 
501.29  community-based waiver programs defined in section 256B.092. 
501.30     (d) Residential service sites controlled by license holders 
501.31  licensed under this chapter for home and community-based 
501.32  waivered services for four or fewer children are exempt from 
501.33  compliance with Minnesota Rules, parts 9545.0130; 9545.0140; 
501.34  9545.0150; 9545.0170; 9545.0220, subparts 1, items C, F, and I, 
501.35  and 3; and 9545.0230. 
501.36     (e) The commissioner may exempt license holders from 
502.1   applicable standards of this chapter when the license holder 
502.2   meets the standards under section 245A.09, subdivision 7.  
502.3   License holders that are accredited by an independent 
502.4   accreditation body shall continue to be licensed under this 
502.5   chapter. 
502.6      (e) (f) License holders governed by sections 245B.02 to 
502.7   245B.07 must also meet the licensure requirements in chapter 
502.8   245A.  
502.9      (f) (g) Nothing in this chapter prohibits license holders 
502.10  from concurrently serving consumers with and without mental 
502.11  retardation or related conditions provided this chapter's 
502.12  standards are met as well as other relevant standards. 
502.13     (g) (h) The documentation that sections 245B.02 to 245B.07 
502.14  require of the license holder meets the individual program plan 
502.15  required in section 256B.092 or successor provisions.  
502.16     Sec. 14.  Minnesota Statutes 2002, section 245B.03, is 
502.17  amended by adding a subdivision to read: 
502.18     Subd. 3.  [CONTINUITY OF CARE.] (a) When a consumer changes 
502.19  service to the same type of service provided under a different 
502.20  license held by the same license holder and the policies and 
502.21  procedures under section 245B.07, subdivision 8, are 
502.22  substantially similar, the license holder is exempt from the 
502.23  requirements in sections 245B.06, subdivisions 2, paragraphs (e) 
502.24  and (f), and 4; and 245B.07, subdivision 9, clause (2). 
502.25     (b) When a direct service staff person begins providing 
502.26  direct service under one or more licenses other than the license 
502.27  for which the staff person initially received the staff 
502.28  orientation requirements under section 245B.07, subdivision 5, 
502.29  the license holder is exempt from all staff orientation 
502.30  requirements under section 245B.07, subdivision 5, except that: 
502.31     (1) if the service provision location changes, the staff 
502.32  person must receive orientation regarding any policies or 
502.33  procedures under section 245B.07, subdivision 8, that are 
502.34  specific to the service provision location; and 
502.35     (2) if the staff person provides direct service to one or 
502.36  more consumers for whom the staff person has not previously 
503.1   provided direct service, the staff person must review each 
503.2   consumer's:  (i) service plans and risk management plan in 
503.3   accordance with section 245B.07, subdivision 5, paragraph (b), 
503.4   clause (1); and (ii) medication administration in accordance 
503.5   with section 245B.07, subdivision 5, paragraph (b), clause (6). 
503.6      Sec. 15.  Minnesota Statutes 2002, section 245B.04, 
503.7   subdivision 2, is amended to read: 
503.8      Subd. 2.  [SERVICE-RELATED RIGHTS.] A consumer's 
503.9   service-related rights include the right to: 
503.10     (1) refuse or terminate services and be informed of the 
503.11  consequences of refusing or terminating services; 
503.12     (2) know, in advance, limits to the services available from 
503.13  the license holder; 
503.14     (3) know conditions and terms governing the provision of 
503.15  services, including those related to initiation and termination; 
503.16     (4) know what the charges are for services, regardless of 
503.17  who will be paying for the services, and be notified upon 
503.18  request of changes in those charges; 
503.19     (5) know, in advance, whether services are covered by 
503.20  insurance, government funding, or other sources, and be told of 
503.21  any charges the consumer or other private party may have to pay; 
503.22  and 
503.23     (6) receive licensed services from individuals who are 
503.24  competent and trained, who have professional certification or 
503.25  licensure, as required, and who meet additional qualifications 
503.26  identified in the individual service plan. 
503.27     Sec. 16.  Minnesota Statutes 2002, section 245B.06, 
503.28  subdivision 2, is amended to read: 
503.29     Subd. 2.  [RISK MANAGEMENT PLAN.] (a) The license holder 
503.30  must develop and, document in writing, and implement a risk 
503.31  management plan that incorporates the individual abuse 
503.32  prevention plan as required in section 245A.65 meets the 
503.33  requirements of this subdivision.  License holders licensed 
503.34  under this chapter are exempt from sections 245A.65, subdivision 
503.35  2, and 626.557, subdivision 14, if the requirements of this 
503.36  subdivision are met.  
504.1      (b) The risk management plan must identify areas in which 
504.2   the consumer is vulnerable, based on an assessment, at a 
504.3   minimum, of the following areas: 
504.4      (1) an adult consumer's susceptibility to physical, 
504.5   emotional, and sexual abuse as defined in section 626.5572, 
504.6   subdivision 2, and financial exploitation as defined in section 
504.7   626.5572, subdivision 9; a minor consumer's susceptibility to 
504.8   sexual and physical abuse as defined in section 626.556, 
504.9   subdivision 2; and a consumer's susceptibility to self-abuse, 
504.10  regardless of age; 
504.11     (2) the consumer's health needs, considering the consumer's 
504.12  physical disabilities; allergies; sensory impairments; seizures; 
504.13  diet; need for medications; and ability to obtain medical 
504.14  treatment; 
504.15     (3) the consumer's safety needs, considering the consumer's 
504.16  ability to take reasonable safety precautions; community 
504.17  survival skills; water survival skills; ability to seek 
504.18  assistance or provide medical care; and access to toxic 
504.19  substances or dangerous items; 
504.20     (4) environmental issues, considering the program's 
504.21  location in a particular neighborhood or community; the type of 
504.22  grounds and terrain surrounding the building; and the consumer's 
504.23  ability to respond to weather-related conditions, open locked 
504.24  doors, and remain alone in any environment; and 
504.25     (5) the consumer's behavior, including behaviors that may 
504.26  increase the likelihood of physical aggression between consumers 
504.27  or sexual activity between consumers involving force or 
504.28  coercion, as defined under section 245B.02, subdivision 10, 
504.29  clauses (6) and (7). 
504.30     (c) When assessing a consumer's vulnerability, the license 
504.31  holder must consider only the consumer's skills and abilities, 
504.32  independent of staffing patterns, supervision plans, the 
504.33  environment, or other situational elements.  
504.34     (d) License holders jointly providing services to a 
504.35  consumer shall coordinate and use the resulting assessment of 
504.36  risk areas for the development of this each license holder's 
505.1   risk management or the shared risk management plan.  Upon 
505.2   initiation of services, the license holder will have in place an 
505.3   initial risk management plan that identifies areas in which the 
505.4   consumer is vulnerable, including health, safety, and 
505.5   environmental issues and the supports the provider will have in 
505.6   place to protect the consumer and to minimize these risks.  The 
505.7   plan must be changed based on the needs of the individual 
505.8   consumer and reviewed at least annually.  The license holder's 
505.9   plan must include the specific actions a staff person will take 
505.10  to protect the consumer and minimize risks for the identified 
505.11  vulnerability areas.  The specific actions must include the 
505.12  proactive measures being taken, training being provided, or a 
505.13  detailed description of actions a staff person will take when 
505.14  intervention is needed. 
505.15     (e) Prior to or upon initiating services, a license holder 
505.16  must develop an initial risk management plan that is, at a 
505.17  minimum, verbally approved by the consumer or consumer's legal 
505.18  representative and case manager.  The license holder must 
505.19  document the date the license holder receives the consumer's or 
505.20  consumer's legal representative's and case manager's verbal 
505.21  approval of the initial plan. 
505.22     (f) As part of the meeting held within 45 days of 
505.23  initiating service, as required under section 245B.06, 
505.24  subdivision 4, the license holder must review the initial risk 
505.25  management plan for accuracy and revise the plan if necessary.  
505.26  The license holder must give the consumer or consumer's legal 
505.27  representative and case manager an opportunity to participate in 
505.28  this plan review.  If the license holder revises the plan, or if 
505.29  the consumer or consumer's legal representative and case manager 
505.30  have not previously signed and dated the plan, the license 
505.31  holder must obtain dated signatures to document the plan's 
505.32  approval. 
505.33     (g) After plan approval, the license holder must review the 
505.34  plan at least annually and update the plan based on the 
505.35  individual consumer's needs and changes to the environment.  The 
505.36  license holder must give the consumer or consumer's legal 
506.1   representative and case manager an opportunity to participate in 
506.2   the ongoing plan development.  The license holder shall obtain 
506.3   dated signatures from the consumer or consumer's legal 
506.4   representative and case manager to document completion of the 
506.5   annual review and approval of plan changes. 
506.6      Sec. 17.  Minnesota Statutes 2002, section 245B.06, 
506.7   subdivision 5, is amended to read: 
506.8      Subd. 5.  [PROGRESS REVIEWS.] The license holder must 
506.9   participate in progress review meetings following stated time 
506.10  lines established in the consumer's individual service plan or 
506.11  as requested in writing by the consumer, the consumer's legal 
506.12  representative, or the case manager, at a minimum of once a 
506.13  year.  The license holder must summarize the progress toward 
506.14  achieving the desired outcomes and make recommendations in a 
506.15  written report sent to the consumer or the consumer's legal 
506.16  representative and case manager prior to the review meeting.  
506.17  For consumers under public guardianship, the license holder is 
506.18  required to provide quarterly written progress review reports to 
506.19  the consumer, designated family member, and case manager.  
506.20     Sec. 18.  Minnesota Statutes 2002, section 245B.07, 
506.21  subdivision 6, is amended to read: 
506.22     Subd. 6.  [STAFF TRAINING.] (a) The license holder shall 
506.23  ensure that direct service staff annually complete hours of 
506.24  training equal to two percent of the number of hours the staff 
506.25  person worked or one percent for license holders providing 
506.26  semi-independent living services.  Direct service staff who have 
506.27  worked for the license holder for an average of at least 30 
506.28  hours per week for 24 or more months must annually complete 
506.29  hours of training equal to one percent of the number of hours 
506.30  the staff person worked.  If direct service staff has received 
506.31  training from a license holder licensed under a program rule 
506.32  identified in this chapter or completed course work regarding 
506.33  disability-related issues from a post-secondary educational 
506.34  institute, that training may also count toward training 
506.35  requirements for other services and for other license holders. 
506.36     (b) The license holder must document the training completed 
507.1   by each employee. 
507.2      (c) Training shall address staff competencies necessary to 
507.3   address the consumer needs as identified in the consumer's 
507.4   individual service plan and ensure consumer health, safety, and 
507.5   protection of rights.  Training may also include other areas 
507.6   identified by the license holder. 
507.7      (d) For consumers requiring a 24-hour plan of care, the 
507.8   license holder shall provide training in cardiopulmonary 
507.9   resuscitation, from a qualified source determined by the 
507.10  commissioner, if the consumer's health needs as determined by 
507.11  the consumer's physician indicate trained staff would be 
507.12  necessary to the consumer. 
507.13     Sec. 19.  Minnesota Statutes 2002, section 245B.07, 
507.14  subdivision 9, is amended to read: 
507.15     Subd. 9.  [AVAILABILITY OF CURRENT WRITTEN POLICIES AND 
507.16  PROCEDURES.] The license holder shall: 
507.17     (1) review and update, as needed, the written policies and 
507.18  procedures in this chapter and inform all consumers or the 
507.19  consumer's legal representatives, case managers, and employees 
507.20  of the revised policies and procedures when they affect the 
507.21  service provision; 
507.22     (2) inform consumers or the consumer's legal 
507.23  representatives of the written policies and procedures in this 
507.24  chapter upon service initiation.  Copies must be available to 
507.25  consumers or the consumer's legal representatives, case 
507.26  managers, the county where services are located, and the 
507.27  commissioner upon request; and 
507.28     (3) provide all consumers or the consumers' legal 
507.29  representatives and case managers a copy and explanation of 
507.30  revisions to policies and procedures that affect consumers' 
507.31  service-related or protection-related rights under section 
507.32  245B.04.  Unless there is reasonable cause, the license holder 
507.33  must provide this notice at least 30 days before implementing 
507.34  the revised policy and procedure.  The license holder must 
507.35  document the reason for not providing the notice at least 30 
507.36  days before implementing the revisions; 
508.1      (4) annually notify all consumers or the consumers' legal 
508.2   representatives and case managers of any revised policies and 
508.3   procedures under this chapter, other than those in clause (3).  
508.4   Upon request, the license holder must provide the consumer or 
508.5   consumer's legal representative and case manager copies of the 
508.6   revised policies and procedures; 
508.7      (5) before implementing revisions to policies and 
508.8   procedures under this chapter, inform all employees of the 
508.9   revised policies and procedures; and 
508.10     (6) document and maintain relevant information related to 
508.11  the policies and procedures in this chapter. 
508.12     Sec. 20.  Minnesota Statutes 2002, section 245B.08, 
508.13  subdivision 1, is amended to read: 
508.14     Subdivision 1.  [ALTERNATIVE METHODS OF DETERMINING 
508.15  COMPLIANCE.] (a) In addition to methods specified in chapter 
508.16  245A, the commissioner may use alternative methods and new 
508.17  regulatory strategies to determine compliance with this 
508.18  section.  The commissioner may use sampling techniques to ensure 
508.19  compliance with this section.  Notwithstanding section 245A.09, 
508.20  subdivision 7, paragraph (d) (e), the commissioner may also 
508.21  extend periods of licensure, not to exceed five years, for 
508.22  license holders who have demonstrated substantial and consistent 
508.23  compliance with sections 245B.02 to 245B.07 and have 
508.24  consistently maintained the health and safety of consumers and 
508.25  have demonstrated by alternative methods in paragraph (b) that 
508.26  they meet or exceed the requirements of this section.  For 
508.27  purposes of this section, "substantial and consistent 
508.28  compliance" means that during the current licensing period: 
508.29     (1) the license holder's license has not been made 
508.30  conditional, suspended, or revoked; 
508.31     (2) there have been no substantiated allegations of 
508.32  maltreatment against the license holder; 
508.33     (3) there have been no program deficiencies that have been 
508.34  identified that would jeopardize the health or safety of 
508.35  consumers being served; and 
508.36     (4) the license holder is in substantial compliance with 
509.1   the other requirements of chapter 245A and other applicable laws 
509.2   and rules. 
509.3      (b) To determine the length of a license, the commissioner 
509.4   shall consider: 
509.5      (1) information from affected consumers, and the license 
509.6   holder's responsiveness to consumers' concerns and 
509.7   recommendations; 
509.8      (2) self assessments and peer reviews of the standards of 
509.9   this section, corrective actions taken by the license holder, 
509.10  and sharing the results of the inspections with consumers, the 
509.11  consumers' families, and others, as requested; 
509.12     (3) length of accreditation by an independent accreditation 
509.13  body, if applicable; 
509.14     (4) information from the county where the license holder is 
509.15  located; and 
509.16     (5) information from the license holder demonstrating 
509.17  performance that meets or exceeds the minimum standards of this 
509.18  chapter. 
509.19     (c) The commissioner may reduce the length of the license 
509.20  if the license holder fails to meet the criteria in paragraph 
509.21  (a) and the conditions specified in paragraph (b). 
509.22     Sec. 21.  Minnesota Statutes 2002, section 252.27, 
509.23  subdivision 2a, is amended to read: 
509.24     Subd. 2a.  [CONTRIBUTION AMOUNT.] (a) The natural or 
509.25  adoptive parents of a minor child, including a child determined 
509.26  eligible for medical assistance without consideration of 
509.27  parental income, must contribute monthly to the cost of 
509.28  services, unless the child is married or has been married, 
509.29  parental rights have been terminated, or the child's adoption is 
509.30  subsidized according to section 259.67 or through title IV-E of 
509.31  the Social Security Act. 
509.32     (b) For households with adjusted gross income equal to or 
509.33  greater than 100 percent of federal poverty guidelines, the 
509.34  parental contribution shall be the greater of a minimum monthly 
509.35  fee of $25 for households with adjusted gross income of $30,000 
509.36  and over, or an amount to be computed by applying the following 
510.1   schedule of rates to the adjusted gross income of the natural or 
510.2   adoptive parents that exceeds 150 percent of the federal poverty 
510.3   guidelines for the applicable household size, the following 
510.4   schedule of rates: 
510.5      (1) on the amount of adjusted gross income over 150 percent 
510.6   of poverty, but not over $50,000, ten percent if the adjusted 
510.7   gross income is equal to or greater than 100 percent of federal 
510.8   poverty guidelines and less than 175 percent of federal poverty 
510.9   guidelines, the parental contribution is $4 per month; 
510.10     (2) on if the amount of adjusted gross income over 150 
510.11  percent of poverty and over $50,000 but not over $60,000, 12 
510.12  percent is equal to or greater than 175 percent of federal 
510.13  poverty guidelines and less than or equal to 975 percent of 
510.14  federal poverty guidelines, the parental contribution shall be 
510.15  determined using a sliding fee scale established by the 
510.16  commissioner of human services which begins at one percent of 
510.17  adjusted gross income at 175 percent of federal poverty 
510.18  guidelines and increases to 16 percent of adjusted gross income 
510.19  for those with adjusted gross income up to 975 percent of 
510.20  federal poverty guidelines; 
510.21     (3) on the amount of adjusted gross income over 150 percent 
510.22  of poverty, and over $60,000 but not over $75,000, 14 percent; 
510.23  and 
510.24     (4) on all adjusted gross income amounts over 150 percent 
510.25  of poverty, and over $75,000, 15 percent. 
510.26     (3) if the adjusted gross income is equal to or greater 
510.27  than 975 percent of federal poverty guidelines, the parental 
510.28  contribution shall be 16 percent of adjusted gross income. 
510.29     If the child lives with the parent, the parental 
510.30  contribution annual adjusted gross income is reduced by $200, 
510.31  except that the parent must pay the minimum monthly $25 fee 
510.32  under this paragraph $4,800 prior to calculating the parental 
510.33  contribution.  If the child resides in an institution specified 
510.34  in section 256B.35, the parent is responsible for the personal 
510.35  needs allowance specified under that section in addition to the 
510.36  parental contribution determined under this section.  The 
511.1   parental contribution is reduced by any amount required to be 
511.2   paid directly to the child pursuant to a court order, but only 
511.3   if actually paid. 
511.4      (c) The household size to be used in determining the amount 
511.5   of contribution under paragraph (b) includes natural and 
511.6   adoptive parents and their dependents under age 21, including 
511.7   the child receiving services.  Adjustments in the contribution 
511.8   amount due to annual changes in the federal poverty guidelines 
511.9   shall be implemented on the first day of July following 
511.10  publication of the changes. 
511.11     (d) For purposes of paragraph (b), "income" means the 
511.12  adjusted gross income of the natural or adoptive parents 
511.13  determined according to the previous year's federal tax form. 
511.14     (e) The contribution shall be explained in writing to the 
511.15  parents at the time eligibility for services is being 
511.16  determined.  The contribution shall be made on a monthly basis 
511.17  effective with the first month in which the child receives 
511.18  services.  Annually upon redetermination or at termination of 
511.19  eligibility, if the contribution exceeded the cost of services 
511.20  provided, the local agency or the state shall reimburse that 
511.21  excess amount to the parents, either by direct reimbursement if 
511.22  the parent is no longer required to pay a contribution, or by a 
511.23  reduction in or waiver of parental fees until the excess amount 
511.24  is exhausted. 
511.25     (f) The monthly contribution amount must be reviewed at 
511.26  least every 12 months; when there is a change in household size; 
511.27  and when there is a loss of or gain in income from one month to 
511.28  another in excess of ten percent.  The local agency shall mail a 
511.29  written notice 30 days in advance of the effective date of a 
511.30  change in the contribution amount.  A decrease in the 
511.31  contribution amount is effective in the month that the parent 
511.32  verifies a reduction in income or change in household size. 
511.33     (g) Parents of a minor child who do not live with each 
511.34  other shall each pay the contribution required under paragraph 
511.35  (a), except that a.  An amount equal to the annual court-ordered 
511.36  child support payment actually paid on behalf of the child 
512.1   receiving services shall be deducted from the contribution 
512.2   adjusted gross income of the parent making the payment prior to 
512.3   calculating the parental contribution under paragraph (b). 
512.4      (h) The contribution under paragraph (b) shall be increased 
512.5   by an additional five percent if the local agency determines 
512.6   that insurance coverage is available but not obtained for the 
512.7   child.  For purposes of this section, "available" means the 
512.8   insurance is a benefit of employment for a family member at an 
512.9   annual cost of no more than five percent of the family's annual 
512.10  income.  For purposes of this section, "insurance" means health 
512.11  and accident insurance coverage, enrollment in a nonprofit 
512.12  health service plan, health maintenance organization, 
512.13  self-insured plan, or preferred provider organization. 
512.14     Parents who have more than one child receiving services 
512.15  shall not be required to pay more than the amount for the child 
512.16  with the highest expenditures.  There shall be no resource 
512.17  contribution from the parents.  The parent shall not be required 
512.18  to pay a contribution in excess of the cost of the services 
512.19  provided to the child, not counting payments made to school 
512.20  districts for education-related services.  Notice of an increase 
512.21  in fee payment must be given at least 30 days before the 
512.22  increased fee is due.  
512.23     (i) The contribution under paragraph (b) shall be reduced 
512.24  by $300 per fiscal year if, in the 12 months prior to July 1: 
512.25     (1) the parent applied for insurance for the child; 
512.26     (2) the insurer denied insurance; 
512.27     (3) the parents submitted a complaint or appeal, in writing 
512.28  to the insurer, submitted a complaint or appeal, in writing, to 
512.29  the commissioner of health or the commissioner of commerce, or 
512.30  litigated the complaint or appeal; and 
512.31     (4) as a result of the dispute, the insurer reversed its 
512.32  decision and granted insurance. 
512.33     For purposes of this section, "insurance" has the meaning 
512.34  given in paragraph (h). 
512.35     A parent who has requested a reduction in the contribution 
512.36  amount under this paragraph shall submit proof in the form and 
513.1   manner prescribed by the commissioner or county agency, 
513.2   including, but not limited to, the insurer's denial of 
513.3   insurance, the written letter or complaint of the parents, court 
513.4   documents, and the written response of the insurer approving 
513.5   insurance.  The determinations of the commissioner or county 
513.6   agency under this paragraph are not rules subject to chapter 14. 
513.7      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
513.8      Sec. 22.  Minnesota Statutes 2002, section 253B.04, 
513.9   subdivision 1, is amended to read: 
513.10     Subdivision 1.  [VOLUNTARY ADMISSION AND TREATMENT.] (a) 
513.11  Voluntary admission is preferred over involuntary commitment and 
513.12  treatment.  Any person 16 years of age or older may request to 
513.13  be admitted to a treatment facility as a voluntary patient for 
513.14  observation, evaluation, diagnosis, care and treatment without 
513.15  making formal written application.  Any person under the age of 
513.16  16 years may be admitted as a patient with the consent of a 
513.17  parent or legal guardian if it is determined by independent 
513.18  examination that there is reasonable evidence that (1) the 
513.19  proposed patient has a mental illness, or is mentally retarded 
513.20  or chemically dependent; and (2) the proposed patient is 
513.21  suitable for treatment.  The head of the treatment facility 
513.22  shall not arbitrarily refuse any person seeking admission as a 
513.23  voluntary patient.  In making decisions regarding admissions, 
513.24  the facility shall use clinical admission criteria consistent 
513.25  with the current applicable inpatient admission standards 
513.26  established by the American Psychiatric Association or the 
513.27  American Academy of Child and Adolescent Psychiatry.  These 
513.28  criteria must be no more restrictive than, and must be 
513.29  consistent with, the requirements of section 62Q.53.  The 
513.30  facility may not refuse to admit a person voluntarily solely 
513.31  because the person does not meet the criteria for involuntary 
513.32  holds under section 253B.05 or the definition of mental illness 
513.33  under section 253B.02, subdivision 13.  
513.34     (b) In addition to the consent provisions of paragraph (a), 
513.35  a person who is 16 or 17 years of age who refuses to consent 
513.36  personally to admission may be admitted as a patient for mental 
514.1   illness or chemical dependency treatment with the consent of a 
514.2   parent or legal guardian if it is determined by an independent 
514.3   examination that there is reasonable evidence that the proposed 
514.4   patient is chemically dependent or has a mental illness and is 
514.5   suitable for treatment.  The person conducting the examination 
514.6   shall notify the proposed patient and the parent or legal 
514.7   guardian of this determination. 
514.8      (c) A person who is voluntarily participating in treatment 
514.9   for a mental illness is not subject to civil commitment under 
514.10  this chapter if the person: 
514.11     (1) has given informed consent or, if lacking capacity, is 
514.12  a person for whom legally valid substitute consent has been 
514.13  given; and 
514.14     (2) is participating in a medically appropriate course of 
514.15  treatment, including clinically appropriate and lawful use of 
514.16  neuroleptic medication and electroconvulsive therapy.  The 
514.17  limitation on commitment in this paragraph does not apply if, 
514.18  based on clinical assessment, the court finds that it is 
514.19  unlikely that the person will remain in and cooperate with a 
514.20  medically appropriate course of treatment absent commitment and 
514.21  the standards for commitment are otherwise met.  This paragraph 
514.22  does not apply to a person for whom commitment proceedings are 
514.23  initiated pursuant to rule 20.01 or 20.02 of the Rules of 
514.24  Criminal Procedure, or a person found by the court to meet the 
514.25  requirements under section 253B.02, subdivision 17. 
514.26     Legally valid substitute consent may be provided by a proxy 
514.27  under a health care directive, a guardian or conservator with 
514.28  authority to consent to mental health treatment, or consent to 
514.29  admission under subdivision 1a or 1b.  
514.30     Sec. 23.  Minnesota Statutes 2002, section 253B.05, 
514.31  subdivision 3, is amended to read: 
514.32     Subd. 3.  [DURATION OF HOLD.] (a) Any person held pursuant 
514.33  to this section may be held up to 72 hours, exclusive of 
514.34  Saturdays, Sundays, and legal holidays after admission.  If a 
514.35  petition for the commitment of the person is filed in the 
514.36  district court in the county of the person's residence or of the 
515.1   county in which the treatment facility is located, the court may 
515.2   issue a judicial hold order pursuant to section 253B.07, 
515.3   subdivision 2b. 
515.4      (b) During the 72-hour hold period, a court may not release 
515.5   a person held under this section unless the court has received a 
515.6   written petition for release and held a summary hearing 
515.7   regarding the release.  The petition must include the name of 
515.8   the person being held, the basis for and location of the hold, 
515.9   and a statement as to why the hold is improper.  The petition 
515.10  also must include copies of any written documentation under 
515.11  subdivision 1 or 2 in support of the hold, unless the person 
515.12  holding the petitioner refuses to supply the documentation.  The 
515.13  hearing must be held as soon as practicable and may be conducted 
515.14  by means of a telephone conference call or similar method by 
515.15  which the participants are able to simultaneously hear each 
515.16  other.  If the court decides to release the person, the court 
515.17  shall direct the release and shall issue written findings 
515.18  supporting the decision.  The release may not be delayed pending 
515.19  the written order.  Before deciding to release the person, the 
515.20  court shall make every reasonable effort to provide notice of 
515.21  the proposed release to: 
515.22     (1) any specific individuals identified in a statement 
515.23  under subdivision 1 or 2 or individuals identified in the record 
515.24  who might be endangered if the person was not held; 
515.25     (2) the examiner whose written statement was a basis for a 
515.26  hold under subdivision 1; and 
515.27     (3) the peace or health officer who applied for a hold 
515.28  under subdivision 2. 
515.29     (c) If a person is intoxicated in public and held under 
515.30  this section for detoxification, a treatment facility may 
515.31  release the person without providing notice under paragraph (d) 
515.32  as soon as the treatment facility determines the person is no 
515.33  longer a danger to themselves or others. 
515.34     (c) (d) If a treatment facility releases a person during 
515.35  the 72-hour hold period, the head of the treatment facility 
515.36  shall immediately notify the agency which employs the peace or 
516.1   health officer who transported the person to the treatment 
516.2   facility under this section. 
516.3      (e) A person held under a 72-hour emergency hold must be 
516.4   released by the facility within 72 hours unless a court order to 
516.5   hold the person is obtained.  A consecutive emergency hold order 
516.6   under this section may not be issued. 
516.7      Sec. 24.  Minnesota Statutes 2002, section 256.012, is 
516.8   amended to read: 
516.9      256.012 [MINNESOTA MERIT SYSTEM.] 
516.10     Subdivision 1.  [PERSONNEL STANDARDS.] The commissioner of 
516.11  human services shall promulgate by rule personnel standards on a 
516.12  merit basis in accordance with federal standards for a merit 
516.13  system of personnel administration for all employees of county 
516.14  boards engaged in the administration of community social 
516.15  services or income maintenance programs, all employees of human 
516.16  services boards that have adopted the rules of the Minnesota 
516.17  merit system, and all employees of local social services 
516.18  agencies.  
516.19     Excluded from the rules are employees of institutions and 
516.20  hospitals under the jurisdiction of the aforementioned boards 
516.21  and agencies; employees of county personnel systems otherwise 
516.22  provided for by law that meet federal merit system requirements; 
516.23  duly appointed or elected members of the aforementioned boards 
516.24  and agencies; and the director of community social services and 
516.25  employees in positions that, upon the request of the appointing 
516.26  authority, the commissioner chooses to exempt, provided the 
516.27  exemption accords with the federal standards for a merit system 
516.28  of personnel administration.  
516.29     Subd. 2.  [PAYMENT FOR SERVICES PROVIDED.] (a) The cost of 
516.30  merit system operations shall be paid by counties and other 
516.31  entities that utilize merit system services.  Total costs shall 
516.32  be determined by the commissioner annually and must be set at a 
516.33  level that neither significantly over-recovers nor 
516.34  under-recovers the costs of providing the service.  The costs of 
516.35  merit system services shall be prorated among participating 
516.36  counties in accordance with an agreement between the 
517.1   commissioner and these counties.  Participating counties will be 
517.2   billed quarterly in advance and shall pay their share of the 
517.3   costs upon receipt of the billing. 
517.4      (b) This subdivision does not apply to counties with 
517.5   personnel systems otherwise provided by law that meet federal 
517.6   merit system requirements.  A county that applies to withdraw 
517.7   from the merit system must notify the commissioner of the 
517.8   county's intent to develop its own personnel system.  This 
517.9   notice must be provided in writing by December 31 of the year 
517.10  preceding the year of final participation in the merit system.  
517.11  The county may withdraw after the commissioner has certified 
517.12  that its personnel system meets federal merit system 
517.13  requirements. 
517.14     (c) A county merit system operations account is established 
517.15  in the special revenue fund.  Payments received by the 
517.16  commissioner for merit system costs must be deposited in the 
517.17  merit system operations account and must be used for the purpose 
517.18  of providing the services and administering the merit system. 
517.19     (d) County payment of merit system costs is effective July 
517.20  1, 2003, however payment for the period from July 1, 2003 
517.21  through December 31, 2003, shall be made no later than January 
517.22  31, 2004. 
517.23     Subd. 3.  [PARTICIPATING COUNTY CONSULTATION.] The 
517.24  commissioner shall ensure that participating counties are 
517.25  consulted regularly and offered the opportunity to provide input 
517.26  on the management of the merit system to ensure effective use of 
517.27  resources and to monitor system performance. 
517.28     Sec. 25.  Minnesota Statutes 2002, section 256.935, 
517.29  subdivision 1, is amended to read: 
517.30     Subdivision 1.  [FUNERAL BURIAL OR CREMATION EXPENSES.] On 
517.31  the death of any person receiving public assistance through 
517.32  MFIP, the county agency shall pay an amount for funeral burial 
517.33  or cremation expenses not exceeding the amount paid for 
517.34  comparable services under section 261.035 plus actual cemetery 
517.35  charges.  The county agency may pay for cremation instead of 
517.36  burial expenses being respectful of cultural and religious 
518.1   preferences of the decedent or the decedent's next of kin.  No 
518.2   funeral burial or cremation expenses shall be paid if the estate 
518.3   of the deceased is sufficient to pay such expenses or if the 
518.4   spouse, who was legally responsible for the support of the 
518.5   deceased while living, is able to pay such expenses; provided, 
518.6   that the additional payment or donation of the cost of cemetery 
518.7   lot, interment, religious service, or for the transportation of 
518.8   the body into or out of the community in which the deceased 
518.9   resided, shall not limit payment by the county agency as herein 
518.10  authorized.  Freedom of choice in the selection of a funeral 
518.11  director shall be granted to persons lawfully authorized to make 
518.12  arrangements for the burial of any such deceased recipient.  In 
518.13  determining the sufficiency of such estate, due regard shall be 
518.14  had for the nature and marketability of the assets of the 
518.15  estate.  The county agency may grant funeral burial or cremation 
518.16  expenses where the sale would cause undue loss to the estate.  
518.17  Any amount paid for funeral burial or cremation expenses shall 
518.18  be a prior claim against the estate, as provided in section 
518.19  524.3-805, and any amount recovered shall be reimbursed to the 
518.20  agency which paid the expenses.  The commissioner shall specify 
518.21  requirements for reports, including fiscal reports, according to 
518.22  section 256.01, subdivision 2, paragraph (17).  The state share 
518.23  shall pay the entire amount of county agency expenditures.  
518.24  Benefits shall be issued to recipients by the state or county 
518.25  subject to provisions of section 256.017. 
518.26     Sec. 26.  Minnesota Statutes 2002, section 256B.0911, 
518.27  subdivision 3, is amended to read: 
518.28     Subd. 3.  [LONG-TERM CARE CONSULTATION TEAM.] (a) A 
518.29  long-term care consultation team shall be established by the 
518.30  county board of commissioners.  Each local consultation team 
518.31  shall consist of at least one social worker and at least one 
518.32  public health nurse from their respective county agencies.  The 
518.33  board may designate public health or social services as the lead 
518.34  agency for long-term care consultation services.  If a county 
518.35  does not have a public health nurse available, it may request 
518.36  approval from the commissioner to assign a county registered 
519.1   nurse with at least one year experience in home care to 
519.2   participate on the team.  Two or more counties may collaborate 
519.3   to establish a joint local consultation team or teams. 
519.4      (b) The team is responsible for providing long-term care 
519.5   consultation services to all persons located in the county who 
519.6   request the services, regardless of eligibility for Minnesota 
519.7   health care programs. 
519.8      Sec. 27.  Minnesota Statutes 2002, section 256F.13, 
519.9   subdivision 1, is amended to read: 
519.10     Subdivision 1.  [FEDERAL REVENUE ENHANCEMENT.] (a) [DUTIES 
519.11  OF COMMISSIONER OF HUMAN SERVICES.] The commissioner of human 
519.12  services may enter into an agreement with one or more family 
519.13  services collaboratives to enhance federal reimbursement under 
519.14  Title IV-E of the Social Security Act and federal administrative 
519.15  reimbursement under Title XIX of the Social Security Act.  The 
519.16  commissioner may contract with the department of children, 
519.17  families, and learning for purposes of transferring the federal 
519.18  reimbursement to the commissioner of children, families, and 
519.19  learning to be distributed to the collaboratives according to 
519.20  clause (2).  The commissioner shall have the following authority 
519.21  and responsibilities regarding family services collaboratives: 
519.22     (1) the commissioner shall submit amendments to state plans 
519.23  and seek waivers as necessary to implement the provisions of 
519.24  this section; 
519.25     (2) the commissioner shall pay the federal reimbursement 
519.26  earned under this subdivision to each collaborative based on 
519.27  their earnings.  Payments to collaboratives for expenditures 
519.28  under this subdivision will only be made of federal earnings 
519.29  from services provided by the collaborative; 
519.30     (3) the commissioner shall review expenditures of family 
519.31  services collaboratives using reports specified in the agreement 
519.32  with the collaborative to ensure that the base level of 
519.33  expenditures is continued and new federal reimbursement is used 
519.34  to expand fund education, social, health, or health-related 
519.35  services to young children and their families; 
519.36     (4) the commissioner may reduce, suspend, or eliminate a 
520.1   family services collaborative's obligations to continue the base 
520.2   level of expenditures or expansion of services if the 
520.3   commissioner determines that one or more of the following 
520.4   conditions apply: 
520.5      (i) imposition of levy limits that significantly reduce 
520.6   available funds for social, health, or health-related services 
520.7   to families and children; 
520.8      (ii) reduction in the net tax capacity of the taxable 
520.9   property eligible to be taxed by the lead county or 
520.10  subcontractor that significantly reduces available funds for 
520.11  education, social, health, or health-related services to 
520.12  families and children; 
520.13     (iii) reduction in the number of children under age 19 in 
520.14  the county, collaborative service delivery area, subcontractor's 
520.15  district, or catchment area when compared to the number in the 
520.16  base year using the most recent data provided by the state 
520.17  demographer's office; or 
520.18     (iv) termination of the federal revenue earned under the 
520.19  family services collaborative agreement; 
520.20     (5) the commissioner shall not use the federal 
520.21  reimbursement earned under this subdivision in determining the 
520.22  allocation or distribution of other funds to counties or 
520.23  collaboratives; 
520.24     (6) (5) the commissioner may suspend, reduce, or terminate 
520.25  the federal reimbursement to a provider that does not meet the 
520.26  reporting or other requirements of this subdivision; 
520.27     (7) (6) the commissioner shall recover from the family 
520.28  services collaborative any federal fiscal disallowances or 
520.29  sanctions for audit exceptions directly attributable to the 
520.30  family services collaborative's actions in the integrated fund, 
520.31  or the proportional share if federal fiscal disallowances or 
520.32  sanctions are based on a statewide random sample; and 
520.33     (8) (7) the commissioner shall establish criteria for the 
520.34  family services collaborative for the accounting and financial 
520.35  management system that will support claims for federal 
520.36  reimbursement. 
521.1      (b) [FAMILY SERVICES COLLABORATIVE RESPONSIBILITIES.] The 
521.2   family services collaborative shall have the following authority 
521.3   and responsibilities regarding federal revenue enhancement: 
521.4      (1) the family services collaborative shall be the party 
521.5   with which the commissioner contracts.  A lead county shall be 
521.6   designated as the fiscal agency for reporting, claiming, and 
521.7   receiving payments; 
521.8      (2) the family services collaboratives may enter into 
521.9   subcontracts with other counties, school districts, special 
521.10  education cooperatives, municipalities, and other public and 
521.11  nonprofit entities for purposes of identifying and claiming 
521.12  eligible expenditures to enhance federal reimbursement, or to 
521.13  expand education, social, health, or health-related services to 
521.14  families and children; 
521.15     (3) the family services collaborative must continue the 
521.16  base level of expenditures for education, social, health, or 
521.17  health-related services to families and children from any state, 
521.18  county, federal, or other public or private funding source 
521.19  which, in the absence of the new federal reimbursement earned 
521.20  under this subdivision, would have been available for those 
521.21  services, except as provided in subdivision 1, paragraph (a), 
521.22  clause (4).  The base year for purposes of this subdivision 
521.23  shall be the four-quarter calendar year ending at least two 
521.24  calendar quarters before the first calendar quarter in which the 
521.25  new federal reimbursement is earned; 
521.26     (4) the family services collaborative must use all new 
521.27  federal reimbursement resulting from federal revenue enhancement 
521.28  to expand make expenditures for education, social, health, or 
521.29  health-related services to families and children beyond the base 
521.30  level, except as provided in subdivision 1, paragraph (a), 
521.31  clause (4); 
521.32     (5) the family services collaborative must ensure that 
521.33  expenditures submitted for federal reimbursement are not made 
521.34  from federal funds or funds used to match other federal funds.  
521.35  Notwithstanding section 256B.19, subdivision 1, for the purposes 
521.36  of family services collaborative expenditures under agreement 
522.1   with the department, the nonfederal share of costs shall be 
522.2   provided by the family services collaborative from sources other 
522.3   than federal funds or funds used to match other federal funds; 
522.4      (6) the family services collaborative must develop and 
522.5   maintain an accounting and financial management system adequate 
522.6   to support all claims for federal reimbursement, including a 
522.7   clear audit trail and any provisions specified in the agreement; 
522.8   and 
522.9      (7) the family services collaborative shall submit an 
522.10  annual report to the commissioner as specified in the agreement. 
522.11     Sec. 28.  Minnesota Statutes 2002, section 256F.13, 
522.12  subdivision 2, is amended to read: 
522.13     Subd. 2.  [AGREEMENTS WITH FAMILY SERVICES COLLABORATIVES.] 
522.14  At a minimum, the agreement between the commissioner and the 
522.15  family services collaborative shall include the following 
522.16  provisions: 
522.17     (1) specific documentation of the expenditures eligible for 
522.18  federal reimbursement; 
522.19     (2) the process for developing and submitting claims to the 
522.20  commissioner; 
522.21     (3) specific identification of the education, social, 
522.22  health, or health-related services to families and children 
522.23  which are to be expanded funded with the federal reimbursement; 
522.24     (4) reporting and review procedures ensuring that the 
522.25  family services collaborative must continue the base level of 
522.26  expenditures for the education, social, health, or 
522.27  health-related services for families and children as specified 
522.28  in subdivision 2, clause (3) that emphasize the minimum number 
522.29  of data elements necessary; 
522.30     (5) reporting and review procedures to ensure that federal 
522.31  revenue earned under this section is spent specifically to 
522.32  expand fund education, social, health, or health-related 
522.33  services for families and children as specified in subdivision 
522.34  2, clause (4); 
522.35     (6) the period of time, not to exceed three years, 
522.36  governing the terms of the agreement and provisions for 
523.1   amendments to, and renewal of the agreement; and 
523.2      (7) an annual report prepared by the family services 
523.3   collaborative. 
523.4      Sec. 29.  Minnesota Statutes 2002, section 261.035, is 
523.5   amended to read: 
523.6      261.035 [FUNERALS BURIAL AT EXPENSE OF COUNTY.] 
523.7      When a person dies in any county without apparent means to 
523.8   provide for that person's funeral or final disposition burial or 
523.9   cremation, the county board shall first investigate to determine 
523.10  whether that person had contracted for any prepaid funeral 
523.11  arrangements.  If arrangements have been made, the county shall 
523.12  authorize arrangements to be implemented in accord with the 
523.13  instructions of the deceased.  If it is determined that the 
523.14  person did not leave sufficient means to defray the necessary 
523.15  expenses of a funeral and final disposition burial or cremation, 
523.16  nor any spouse of sufficient ability to procure the burial or 
523.17  cremation, the county board shall provide for a funeral and 
523.18  final disposition burial or cremation, being respectful of 
523.19  cultural and religious preferences, of the person's remains to 
523.20  be made at the expense of the county.  Any funeral and final 
523.21  disposition burial or cremation provided at the expense of the 
523.22  county shall be in accordance with religious and moral beliefs 
523.23  of the decedent or the decedent's spouse or the decedent's next 
523.24  of kin.  If the wishes of the decedent are not known and the 
523.25  county has no information about the existence of or location of 
523.26  any next of kin, the county may determine the method of final 
523.27  disposition. 
523.28     Sec. 30.  Minnesota Statutes 2002, section 393.07, 
523.29  subdivision 1, is amended to read: 
523.30     Subdivision 1.  [PUBLIC CHILD WELFARE PROGRAM.] (a) To 
523.31  assist in carrying out the child protection, delinquency 
523.32  prevention and family assistance responsibilities of the state, 
523.33  the local social services agency shall administer a program of 
523.34  social services and financial assistance to be known as the 
523.35  public child welfare program.  The public child welfare program 
523.36  shall be supervised by the commissioner of human services and 
524.1   administered by the local social services agency in accordance 
524.2   with law and with rules of the commissioner. 
524.3      (b) The purpose of the public child welfare program is to 
524.4   assure protection for and financial assistance to children who 
524.5   are confronted with social, physical, or emotional problems 
524.6   requiring protection and assistance.  These problems include, 
524.7   but are not limited to the following: 
524.8      (1) mental, emotional, or physical handicap; 
524.9      (2) birth of a child to a mother who was not married to the 
524.10  child's father when the child was conceived nor when the child 
524.11  was born, including but not limited to costs of prenatal care, 
524.12  confinement and other care necessary for the protection of a 
524.13  child born to a mother who was not married to the child's father 
524.14  at the time of the child's conception nor at the birth; 
524.15     (3) dependency, neglect; 
524.16     (4) delinquency; 
524.17     (5) abuse or rejection of a child by its parents; 
524.18     (6) absence of a parent or guardian able and willing to 
524.19  provide needed care and supervision; 
524.20     (7) need of parents for assistance with child rearing 
524.21  problems, or in placing the child in foster care. 
524.22     (c) A local social services agency shall make the services 
524.23  of its public child welfare program available as required by 
524.24  law, by the commissioner, or by the courts and shall cooperate 
524.25  with other agencies, public or private, dealing with the 
524.26  problems of children and their parents as provided in this 
524.27  subdivision. 
524.28     The public child welfare program shall be available in 
524.29  divorce cases for investigations of children and home conditions 
524.30  and for supervision of children when directed by the court 
524.31  hearing the divorce. 
524.32     (d) A local social services agency may rent, lease, or 
524.33  purchase property, or in any other way approved by the 
524.34  commissioner, contract with individuals or agencies to provide 
524.35  needed facilities for foster care of children.  It may purchase 
524.36  services or child care from duly authorized individuals, 
525.1   agencies or institutions when in its judgment the needs of a 
525.2   child or the child's family can best be met in this way. 
525.3      Sec. 31.  Minnesota Statutes 2002, section 393.07, 
525.4   subdivision 5, is amended to read: 
525.5      Subd. 5.  [COMPLIANCE WITH FEDERAL SOCIAL SECURITY ACT; 
525.6   MERIT SYSTEM.] The commissioner of human services shall have 
525.7   authority to require such methods of administration as are 
525.8   necessary for compliance with requirements of the federal Social 
525.9   Security Act, as amended, and for the proper and efficient 
525.10  operation of all welfare programs.  This authority to require 
525.11  methods of administration includes methods relating to the 
525.12  establishment and maintenance of personnel standards on a merit 
525.13  basis as concerns all employees of local social services 
525.14  agencies except those employed in an institution, sanitarium, or 
525.15  hospital.  The commissioner of human services shall exercise no 
525.16  authority with respect to the selection, tenure of office, and 
525.17  compensation of any individual employed in accordance with such 
525.18  methods.  The adoption of methods relating to the establishment 
525.19  and maintenance of personnel standards on a merit basis of all 
525.20  such employees of the local social services agencies and the 
525.21  examination thereof, and the administration thereof shall be 
525.22  directed and controlled exclusively by the commissioner of human 
525.23  services. 
525.24     Notwithstanding the provisions of any other law to the 
525.25  contrary, every employee of every local social services agency 
525.26  who occupies a position which requires as prerequisite to 
525.27  eligibility therefor graduation from an accredited four year 
525.28  college or a certificate of registration as a registered nurse 
525.29  under section 148.231, must be employed in such position under 
525.30  the merit system established under authority of this 
525.31  subdivision.  Every such employee now employed by a local social 
525.32  services agency and who is not under said merit system is 
525.33  transferred, as of January 1, 1962, to a position of comparable 
525.34  classification in the merit system with the same status therein 
525.35  as the employee had in the county of employment prior thereto 
525.36  and every such employee shall be subject to and have the benefit 
526.1   of the merit system, including seniority within the local social 
526.2   services agency, as though the employee had served thereunder 
526.3   from the date of entry into the service of the local social 
526.4   services agency. 
526.5      By March 1, 1996, the commissioner of human services shall 
526.6   report to the chair of the senate health care and family 
526.7   services finance division and the chair of the house health and 
526.8   human services finance division on options for the delivery of 
526.9   merit-based employment services by entities other than the 
526.10  department of human services in order to reduce the 
526.11  administrative costs to the state while maintaining compliance 
526.12  with applicable federal regulations.  
526.13     Sec. 32.  Minnesota Statutes 2002, section 518.167, 
526.14  subdivision 1, is amended to read: 
526.15     Subdivision 1.  [COURT ORDER.] In contested custody 
526.16  proceedings, and in other custody proceedings if a parent or the 
526.17  child's custodian requests, the court may order an investigation 
526.18  and report concerning custodial arrangements for the child.  If 
526.19  the county elects to conduct an investigation, the county may 
526.20  charge a fee.  The investigation and report may be made by the 
526.21  county welfare agency or department of court services or a 
526.22  private vendor. 
526.23     Sec. 33.  Minnesota Statutes 2002, section 518.551, 
526.24  subdivision 7, is amended to read: 
526.25     Subd. 7.  [SERVICE FEE FEES AND COST RECOVERY FEES FOR IV-D 
526.26  SERVICES.] When the public agency responsible for child support 
526.27  enforcement provides child support collection services either to 
526.28  a public assistance recipient or to a party who does not receive 
526.29  public assistance, the public agency may upon written notice to 
526.30  the obligor charge a monthly collection fee equivalent to the 
526.31  full monthly cost to the county of providing collection 
526.32  services, in addition to the amount of the child support which 
526.33  was ordered by the court.  The fee shall be deposited in the 
526.34  county general fund.  The service fee assessed is limited to ten 
526.35  percent of the monthly court ordered child support and shall not 
526.36  be assessed to obligors who are current in payment of the 
527.1   monthly court ordered child support. (a) When a recipient of 
527.2   IV-D services is no longer receiving assistance under the 
527.3   state's title IV-A, IV-E foster care, medical assistance, or 
527.4   MinnesotaCare programs, the public authority responsible for 
527.5   child support enforcement must notify the recipient, within five 
527.6   working days of the notification of ineligibility, that IV-D 
527.7   services will be continued unless the public authority is 
527.8   notified to the contrary by the recipient.  The notice must 
527.9   include the implications of continuing to receive IV-D services, 
527.10  including the available services and fees, cost recovery fees, 
527.11  and distribution policies relating to fees. 
527.12     (b) An application fee of $25 shall be paid by the person 
527.13  who applies for child support and maintenance collection 
527.14  services, except persons who are receiving public assistance as 
527.15  defined in section 256.741 and, if enacted, the diversionary 
527.16  work program under section 256J.95, persons who transfer from 
527.17  public assistance to nonpublic assistance status, and minor 
527.18  parents and parents enrolled in a public secondary school, area 
527.19  learning center, or alternative learning program approved by the 
527.20  commissioner of children, families, and learning.  
527.21     (c) When the public authority provides full IV-D services 
527.22  to an obligee who has applied for those services, upon written 
527.23  notice to the obligee, the public authority must charge a cost 
527.24  recovery fee of two percent of the amount collected.  This fee 
527.25  must be deducted from the amount of the child support and 
527.26  maintenance collected and not assigned under section 256.741, 
527.27  before disbursement to the obligee.  This fee does not apply to 
527.28  an obligee who: 
527.29     (1) is currently receiving assistance under the state's 
527.30  title IV-A, IV-E foster care, medical assistance, or 
527.31  MinnesotaCare programs; or 
527.32     (2) has received assistance under the state's title IV-A or 
527.33  IV-E foster care programs, until the person has not received 
527.34  this assistance for 24 consecutive months.  
527.35     (d) When the public authority provides full IV-D services 
527.36  to an obligor who has applied for such services, upon written 
528.1   notice to the obligor, the public authority must charge a cost 
528.2   recovery fee of two percent of the monthly court ordered child 
528.3   support and maintenance obligation.  The fee may be collected 
528.4   through income withholding, as well as by any other enforcement 
528.5   remedy available to the public authority responsible for child 
528.6   support enforcement. 
528.7      (e) Fees assessed by state and federal tax agencies for 
528.8   collection of overdue support owed to or on behalf of a person 
528.9   not receiving public assistance must be imposed on the person 
528.10  for whom these services are provided.  The public authority upon 
528.11  written notice to the obligee shall assess a fee of $25 to the 
528.12  person not receiving public assistance for each successful 
528.13  federal tax interception.  The fee must be withheld prior to the 
528.14  release of the funds received from each interception and 
528.15  deposited in the general fund. 
528.16     (f) Cost recovery fees collected under paragraphs (c) and 
528.17  (d) shall be considered child support program income according 
528.18  to Code of Federal Regulations, title 45, section 304.50, and 
528.19  shall be deposited in the cost recovery fee account established 
528.20  under paragraph (h).  The commissioner of human services must 
528.21  elect to recover costs based on either actual or standardized 
528.22  costs. 
528.23     However, (g) The limitations of this subdivision on the 
528.24  assessment of fees shall not apply to the extent inconsistent 
528.25  with the requirements of federal law for receiving funds for the 
528.26  programs under Title IV-A and Title IV-D of the Social Security 
528.27  Act, United States Code, title 42, sections 601 to 613 and 
528.28  United States Code, title 42, sections 651 to 662.  
528.29     (h) The commissioner of human services is authorized to 
528.30  establish a special revenue fund account to receive child 
528.31  support cost recovery fees.  A portion of the nonfederal share 
528.32  of these fees may be retained for expenditures necessary to 
528.33  administer the fee, and must be transferred to the child support 
528.34  system special revenue account.  The remaining nonfederal share 
528.35  of the cost recovery fee must be retained by the commissioner 
528.36  and dedicated to the child support general fund county 
529.1   performance based grant account authorized under sections 
529.2   256.979 and 256.9791. 
529.3      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004, 
529.4   except paragraph (d) is effective July 1, 2005. 
529.5      Sec. 34.  Minnesota Statutes 2002, section 518.6111, 
529.6   subdivision 2, is amended to read: 
529.7      Subd. 2.  [APPLICATION.] This section applies to all 
529.8   support orders issued by a court or an administrative tribunal 
529.9   and orders for or notices of withholding issued by the public 
529.10  authority according to section 518.5513, subdivision 5, 
529.11  paragraph (a), clause (5). 
529.12     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
529.13     Sec. 35.  Minnesota Statutes 2002, section 518.6111, 
529.14  subdivision 3, is amended to read: 
529.15     Subd. 3.  [ORDER.] Every support order must address income 
529.16  withholding.  Whenever a support order is initially entered or 
529.17  modified, the full amount of the support order must be 
529.18  withheld subject to income withholding from the income of the 
529.19  obligor.  If the obligee or obligor applies for either full IV-D 
529.20  services or for income withholding only services from the public 
529.21  authority responsible for child support enforcement, the full 
529.22  amount of the support order must be withheld from the income of 
529.23  the obligor and forwarded to the public authority.  Every order 
529.24  for support or maintenance shall provide for a conspicuous 
529.25  notice of the provisions of this section that complies with 
529.26  section 518.68, subdivision 2.  An order without this notice 
529.27  remains subject to this section.  This section applies 
529.28  regardless of the source of income of the person obligated to 
529.29  pay the support or maintenance. 
529.30     A payor of funds shall implement income withholding 
529.31  according to this section upon receipt of an order for or notice 
529.32  of withholding.  The notice of withholding shall be on a form 
529.33  provided by the commissioner of human services. 
529.34     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
529.35     Sec. 36.  Minnesota Statutes 2002, section 518.6111, 
529.36  subdivision 4, is amended to read: 
530.1      Subd. 4.  [COLLECTION SERVICES.] (a) The commissioner of 
530.2   human services shall prepare and make available to the courts a 
530.3   notice of services that explains child support and maintenance 
530.4   collection services available through the public authority, 
530.5   including income withholding, and the fees for such services.  
530.6   Upon receiving a petition for dissolution of marriage or legal 
530.7   separation, the court administrator shall promptly send the 
530.8   notice of services to the petitioner and respondent at the 
530.9   addresses stated in the petition. 
530.10     (b) Either the obligee or obligor may at any time apply to 
530.11  the public authority for either full IV-D services or for income 
530.12  withholding only services. 
530.13     Upon receipt of a support order requiring income 
530.14  withholding, a petitioner or respondent, who is not a recipient 
530.15  of public assistance and does not receive child support services 
530.16  from the public authority, shall apply to the public authority 
530.17  for either full child support collection services or for income 
530.18  withholding only services. 
530.19     (c) For those persons applying for income withholding only 
530.20  services, a monthly service fee of $15 must be charged to the 
530.21  obligor.  This fee is in addition to the amount of the support 
530.22  order and shall be withheld through income withholding.  The 
530.23  public authority shall explain the service options in this 
530.24  section to the affected parties and encourage the application 
530.25  for full child support collection services. 
530.26     (d) If the obligee is not a current recipient of public 
530.27  assistance as defined in section 256.741, the person who applied 
530.28  for services may at any time choose to terminate either full 
530.29  IV-D services or income withholding only services regardless of 
530.30  whether income withholding is currently in place.  The obligee 
530.31  or obligor may reapply for either full IV-D services or income 
530.32  withholding only services at any time.  Unless the applicant is 
530.33  a recipient of public assistance as defined in section 256.741, 
530.34  a $25 application fee shall be charged at the time of each 
530.35  application.  
530.36     (e) When a person terminates IV-D services, if an arrearage 
531.1   for public assistance as defined in section 256.741 exists, the 
531.2   public authority may continue income withholding, as well as use 
531.3   any other enforcement remedy for the collection of child 
531.4   support, until all public assistance arrears are paid in full.  
531.5   Income withholding shall be in an amount equal to 20 percent of 
531.6   the support order in effect at the time the services terminated. 
531.7      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
531.8      Sec. 37.  Minnesota Statutes 2002, section 518.6111, 
531.9   subdivision 16, is amended to read: 
531.10     Subd. 16.  [WAIVER.] (a) If the public authority is 
531.11  providing child support and maintenance enforcement services and 
531.12  child support or maintenance is not assigned under section 
531.13  256.741, the court may waive the requirements of this section if 
531.14  the court finds there is no arrearage in child support and 
531.15  maintenance as of the date of the hearing and: 
531.16     (1) one party demonstrates and the court finds determines 
531.17  there is good cause to waive the requirements of this section or 
531.18  to terminate an order for or notice of income withholding 
531.19  previously entered under this section.  The court must make 
531.20  written findings to include the reasons income withholding would 
531.21  not be in the best interests of the child.  In cases involving a 
531.22  modification of support, the court must also make a finding that 
531.23  support payments have been timely made; or 
531.24     (2) all parties reach an the obligee and obligor sign a 
531.25  written agreement and the agreement providing for an alternative 
531.26  payment arrangement which is approved reviewed and entered in 
531.27  the record by the court after a finding that the agreement is 
531.28  likely to result in regular and timely payments.  The court's 
531.29  findings waiving the requirements of this paragraph shall 
531.30  include a written explanation of the reasons why income 
531.31  withholding would not be in the best interests of the child. 
531.32     In addition to the other requirements in this subdivision, 
531.33  if the case involves a modification of support, the court shall 
531.34  make a finding that support has been timely made. 
531.35     (b) If the public authority is not providing child support 
531.36  and maintenance enforcement services and child support or 
532.1   maintenance is not assigned under section 256.741, the court may 
532.2   waive the requirements of this section if the parties sign a 
532.3   written agreement.  
532.4      (c) If the court waives income withholding, the obligee or 
532.5   obligor may at any time request income withholding under 
532.6   subdivision 7. 
532.7      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
532.8      Sec. 38.  [MANDATE IDENTIFICATION; REPORT TO LEGISLATURE.] 
532.9      The commissioners of health and human services must 
532.10  identify required state services or programs in law or rule that 
532.11  are under each agency's respective jurisdictions, the 
532.12  administration or provision of which the state has delegated to 
532.13  the counties.  For each state-mandated service or program, the 
532.14  commissioner must describe: 
532.15     (1) the year enacted and the scope of the service or 
532.16  program; 
532.17     (2) the funding sources for the service or program; and 
532.18     (3) related federal requirements and support. 
532.19  The commissioners must seek the advice of the county officials 
532.20  knowledgeable about the state-mandated services and programs, 
532.21  county associations, consumer representatives, and service or 
532.22  program providers.  Each commissioner must submit a report to 
532.23  the house and senate committees with jurisdiction over the 
532.24  budget of departments of health and human services by January 
532.25  15, 2004. 
532.26     <b>[EFFECTIVE DATE; EXPIRATION DATE.]</b> This section is 
532.27  effective the day following final enactment and expires June 30, 
532.28  2005. 
532.29     Sec. 39.  [STATE-OPERATED SERVICES STUDY.] 
532.30     (a) Before restructuring state-operated services, 
532.31  redesigning the mental health safety net, or reducing reliance 
532.32  on large institutions, the commissioner shall review and study 
532.33  the President's New Freedom Commission on Mental Health final 
532.34  report.  The commissioner shall report on whether the 
532.35  commissioner's plan to restructure state-operated services is 
532.36  consistent with the recommendations in the final report and how 
533.1   the state can implement the recommendations in the final report. 
533.2      (b) The commissioner of human services shall study 
533.3   alternate methods of providing services to persons with 
533.4   developmental disabilities served by state-operated community 
533.5   services (SOCS) and other providers, including, but not limited 
533.6   to, the needs of the persons served, the cost effectiveness of 
533.7   the services provided, whether alternate populations can be 
533.8   served in SOCS, and if the services could be privatized.  The 
533.9   commissioner shall also study the Minnesota extended treatment 
533.10  options, including an analysis of the population served by the 
533.11  program and the effectiveness of the program.  The commissioner 
533.12  shall report on the results of the study under this section to 
533.13  the chairs of the house and senate committees with jurisdiction 
533.14  over state-operated services by January 15, 2004. 
533.15     Sec. 40.  [REDUCING DUPLICATIVE HEALTH AND HUMAN SERVICES 
533.16  LICENSING ACTIVITIES; REPORT TO LEGISLATURE.] 
533.17     (a) The commissioners of health and human services shall 
533.18  submit a report to the chairs of the house and senate committees 
533.19  with jurisdiction over health and human services licensing by 
533.20  December 15, 2003, regarding how to reduce duplicative licensing 
533.21  activities by the departments of health and human services. 
533.22     (b) The report must include draft legislation providing for:
533.23     (1) the licensure of intermediate care facilities for 
533.24  persons with mental retardation or related conditions or ICFs/MR 
533.25  by either the commissioner of health or human services.  In 
533.26  developing the draft legislation, the commissioners, in 
533.27  consultation with provider and advocacy organizations, shall 
533.28  review: 
533.29     (i) current state regulations enforced by the commissioner 
533.30  of human services under Minnesota Statutes, chapter 245B; the 
533.31  psychotropic medication use checklist under Minnesota Statutes, 
533.32  section 245B.02, subdivision 19; and Minnesota Rules, parts 
533.33  9525.2700 to 9525.2810, governing the use of aversive and 
533.34  deprivation procedures; and 
533.35     (ii) current state regulations enforced by the commissioner 
533.36  of health under Minnesota Statutes, chapter 144, and Minnesota 
534.1   Rules, chapter 4665. 
534.2      The draft legislation must codify the regulations and 
534.3   provisions listed in items (i) and (ii) in Minnesota Statutes, 
534.4   chapter 144 or 245B, depending upon which commissioner is 
534.5   recommended to license ICFs/MR.  The draft legislation also must 
534.6   repeal all rules made obsolete by the proposed codification of 
534.7   the regulations; and 
534.8      (2) the licensure of residential adult mental illness 
534.9   treatment programs and chemical dependency treatment programs by 
534.10  the commissioner of human services.  The commissioners, in 
534.11  consultation with provider and advocacy organizations, shall 
534.12  review current regulations enforced by the commissioner of 
534.13  health in nonhospital-based residential adult mental illness and 
534.14  chemical dependency treatment programs to determine whether the 
534.15  commissioner of human services should enforce the regulations.  
534.16  If the commissioners determine that the commissioner of human 
534.17  services should enforce the regulations, the draft legislation 
534.18  must address how the provisions in the regulations should be 
534.19  codified in Minnesota Statutes, chapter 245A. 
534.20     (c) The report also must include an analysis of: 
534.21     (1) whether the international fire and building codes, 
534.22  effective in calendar year 2003, provide comparable and adequate 
534.23  physical plant safeguards when compared to the supervised living 
534.24  facility class B licensing standards.  The commissioner must 
534.25  analyze whether a board and lodging license combined with a 
534.26  human services program license will maintain at least the 
534.27  current safety levels in supervised living facility class B 
534.28  facilities.  If the commissioners determine that there is likely 
534.29  no adverse effect on the health and safety of persons receiving 
534.30  services from the adult mental illness or chemical dependency 
534.31  programs or ICFs/MR, the draft legislation must repeal the 
534.32  supervised living facility regulations and require board and 
534.33  lodging licensure for these programs; and 
534.34     (2) the funding implications for any proposed change to the 
534.35  commissioners' responsibilities for licensing activities, 
534.36  including the impact on the general fund and the state 
535.1   government special revenue fund. 
535.2      Sec. 41.  [REVISOR'S INSTRUCTION.] 
535.3      For sections in Minnesota Statutes and Minnesota Rules 
535.4   affected by the repealed sections in this article, the revisor 
535.5   shall delete internal cross-references where appropriate and 
535.6   make changes necessary to correct the punctuation, grammar, or 
535.7   structure of the remaining text and preserve its meaning. 
535.8      Sec. 42.  [REPEALER.] 
535.9      (a) Minnesota Statutes 2002, sections 145A.17, subdivision 
535.10  9; 245.478; 245.4888; 245.714; 256B.0945, subdivisions 6, 7, 8, 
535.11  and 10; 256B.83; and 256F.10, subdivision 7, are repealed. 
535.12     (b) Minnesota Rules, parts 9545.2000; 9545.2010; 9545.2020; 
535.13  9545.2030; and 9545.2040, are repealed. 
535.14                             ARTICLE 8 
535.15                  HEALTH DEPARTMENT MISCELLANEOUS 
535.16     Section 1.  Minnesota Statutes 2002, section 62A.65, 
535.17  subdivision 7, is amended to read: 
535.18     Subd. 7.  [SHORT-TERM COVERAGE.] (a) For purposes of this 
535.19  section, "short-term coverage" means an individual health plan 
535.20  that: 
535.21     (1) is issued to provide coverage for a period of 185 days 
535.22  or less, except that the health plan may permit coverage to 
535.23  continue until the end of a period of hospitalization for a 
535.24  condition for which the covered person was hospitalized on the 
535.25  day that coverage would otherwise have ended; 
535.26     (2) is nonrenewable, provided that the health carrier may 
535.27  provide coverage for one or more subsequent periods that satisfy 
535.28  clause (1), if the total of the periods of coverage do not 
535.29  exceed a total of 185 555 days out of any 365-day 730-day 
535.30  period, plus any additional days covered as a result of 
535.31  hospitalization on the day that a period of coverage would 
535.32  otherwise have ended; 
535.33     (3) does not cover any preexisting conditions, including 
535.34  ones that originated during a previous identical policy or 
535.35  contract with the same health carrier where coverage was 
535.36  continuous between the previous and the current policy or 
536.1   contract; and 
536.2      (4) is available with an immediate effective date without 
536.3   underwriting upon receipt of a completed application indicating 
536.4   eligibility under the health carrier's eligibility requirements, 
536.5   provided that coverage that includes optional benefits may be 
536.6   offered on a basis that does not meet this requirement. 
536.7      (b) Short-term coverage is not subject to subdivisions 2 
536.8   and 5.  Short-term coverage may exclude as a preexisting 
536.9   condition any injury, illness, or condition for which the 
536.10  covered person had medical treatment, symptoms, or any 
536.11  manifestations before the effective date of the coverage, but 
536.12  dependent children born or placed for adoption during the policy 
536.13  period must not be subject to this provision.  
536.14     (c) Notwithstanding subdivision 3, and section 62A.021, a 
536.15  health carrier may combine short-term coverage with its most 
536.16  commonly sold individual qualified plan, as defined in section 
536.17  62E.02, other than short-term coverage, for purposes of 
536.18  complying with the loss ratio requirement. 
536.19     (d) The 185 555 day coverage limitation provided in 
536.20  paragraph (a) applies to the total number of days of short-term 
536.21  coverage that covers a person, regardless of the number of 
536.22  policies, contracts, or health carriers that provide the 
536.23  coverage.  A written application for short-term coverage must 
536.24  ask the applicant whether the applicant has been covered by 
536.25  short-term coverage by any health carrier within the 365 730 
536.26  days immediately preceding the effective date of the coverage 
536.27  being applied for.  Short-term coverage issued in violation of 
536.28  the 185-day 555-day limitation is valid until the end of its 
536.29  term and does not lose its status as short-term coverage, in 
536.30  spite of the violation.  A health carrier that knowingly issues 
536.31  short-term coverage in violation of the 185-day 555-day 
536.32  limitation is subject to the administrative penalties otherwise 
536.33  available to the commissioner of commerce or the commissioner of 
536.34  health, as appropriate. 
536.35     (e) Time spent under short-term coverage counts as time 
536.36  spent under a preexisting condition limitation for purposes of 
537.1   group or individual health plans, other than short-term 
537.2   coverage, subsequently issued to that person, or to cover that 
537.3   person, by any health carrier, if the person maintains 
537.4   continuous coverage as defined in section 62L.02.  Short-term 
537.5   coverage is a health plan and is qualifying coverage as defined 
537.6   in section 62L.02.  Notwithstanding any other law to the 
537.7   contrary, a health carrier is not required under any 
537.8   circumstances to provide a person covered by short-term coverage 
537.9   the right to obtain coverage on a guaranteed issue basis under 
537.10  another health plan offered by the health carrier, as a result 
537.11  of the person's enrollment in short-term coverage. 
537.12     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
537.13  following final enactment and applies to policies issued on or 
537.14  after that date. 
537.15     Sec. 2.  Minnesota Statutes 2002, section 62D.095, 
537.16  subdivision 2, is amended to read: 
537.17     Subd. 2.  [CO-PAYMENTS.] (a) A health maintenance contract 
537.18  may impose a co-payment as authorized under Minnesota Rules, 
537.19  part 4685.0801, or under this section.  
537.20     (b) A health maintenance contract may impose a flat fee 
537.21  co-payment on outpatient office visits and prescription drugs 
537.22  not to exceed 50 percent of the median provider's charges for 
537.23  similar services or goods received by enrollees as calculated 
537.24  under Minnesota Rules, part 4685.0801, subparts 3 and 4. 
537.25     (c) If a health maintenance contract is permitted to impose 
537.26  a co-payment for preexisting health status under sections 62D.01 
537.27  to 62D.30, these provisions may vary with respect to length of 
537.28  enrollment in the health plan.  
537.29     Sec. 3.  Minnesota Statutes 2002, section 62D.095, is 
537.30  amended by adding a subdivision to read: 
537.31     Subd. 6.  [PUBLIC PROGRAMS.] This section does not apply to 
537.32  the prepaid medical assistance program, the MinnesotaCare 
537.33  program, the prepaid general assistance program, the federal 
537.34  Medicare program, or the health plans provided through any of 
537.35  those programs. 
537.36     Sec. 4.  Minnesota Statutes 2002, section 62J.692, 
538.1   subdivision 4, is amended to read: 
538.2      Subd. 4.  [DISTRIBUTION OF FUNDS.] (a) The commissioner 
538.3   shall annually distribute medical education funds to all 
538.4   qualifying applicants based on the following criteria:  
538.5      (1) total medical education funds available for 
538.6   distribution; 
538.7      (2) total number of eligible trainee FTEs in each clinical 
538.8   medical education program; and 
538.9      (3) the statewide average cost per trainee as determined by 
538.10  the application information provided in the first year of the 
538.11  biennium, by type of trainee, in each clinical medical education 
538.12  program.  
538.13     (b) Funds distributed shall not be used to displace current 
538.14  funding appropriations from federal or state sources.  
538.15     (c) Funds shall be distributed to the sponsoring 
538.16  institutions indicating the amount to be distributed to each of 
538.17  the sponsor's clinical medical education programs based on the 
538.18  criteria in this subdivision and in accordance with the 
538.19  commissioner's approval letter.  Each clinical medical education 
538.20  program must distribute funds to the training sites as specified 
538.21  in the commissioner's approval letter.  Sponsoring institutions, 
538.22  which are accredited through an organization recognized by the 
538.23  department of education or the Centers for Medicare and Medicaid 
538.24  Services, may contract directly with training sites to provide 
538.25  clinical training.  To ensure the quality of clinical training, 
538.26  those accredited sponsoring institutions must: 
538.27     (1) develop contracts specifying the terms, expectations, 
538.28  and outcomes of the clinical training conducted at sites; and 
538.29     (2) take necessary action if the contract requirements are 
538.30  not met.  Action may include the withholding of payments under 
538.31  this section or the removal of students from the site.  
538.32     (d) Any funds not distributed in accordance with the 
538.33  commissioner's approval letter must be returned to the medical 
538.34  education and research fund within 30 days of receiving notice 
538.35  from the commissioner.  The commissioner shall distribute 
538.36  returned funds to the appropriate training sites in accordance 
539.1   with the commissioner's approval letter. 
539.2      (e) The commissioner shall distribute by June 30 of each 
539.3   year an amount equal to the funds transferred under section 
539.4   62J.694, subdivision 2a, paragraph (b) subdivision 10, plus five 
539.5   percent interest to the University of Minnesota board of regents 
539.6   for the costs of the academic health center as specified under 
539.7   section 62J.694, subdivision 2a, paragraph (a). instructional 
539.8   costs of health professional programs at the academic health 
539.9   center and for interdisciplinary academic initiatives within the 
539.10  academic health center. 
539.11     (f) A maximum of $150,000 of the funds dedicated to the 
539.12  commissioner under section 297F.10, subdivision 1, paragraph 
539.13  (b), clause (2), may be used by the commissioner for 
539.14  administrative expenses associated with implementing this 
539.15  section. 
539.16     Sec. 5.  Minnesota Statutes 2002, section 62J.692, is 
539.17  amended by adding a subdivision to read: 
539.18     Subd. 10.  [TRANSFERS FROM UNIVERSITY OF MINNESOTA.] Of the 
539.19  funds dedicated to the academic health center under section 
539.20  297F.10, subdivision 1, paragraph (b), clause (1), $4,850,000 
539.21  shall be transferred annually to the commissioner of health no 
539.22  later than April 15 of each year for distribution under 
539.23  subdivision 4, paragraph (e). 
539.24     Sec. 6.  Minnesota Statutes 2002, section 62Q.19, 
539.25  subdivision 1, is amended to read: 
539.26     Subdivision 1.  [DESIGNATION.] (a) The commissioner shall 
539.27  designate essential community providers.  The criteria for 
539.28  essential community provider designation shall be the following: 
539.29     (1) a demonstrated ability to integrate applicable 
539.30  supportive and stabilizing services with medical care for 
539.31  uninsured persons and high-risk and special needs populations, 
539.32  underserved, and other special needs populations; and 
539.33     (2) a commitment to serve low-income and underserved 
539.34  populations by meeting the following requirements: 
539.35     (i) has nonprofit status in accordance with chapter 317A; 
539.36     (ii) has tax exempt status in accordance with the Internal 
540.1   Revenue Service Code, section 501(c)(3); 
540.2      (iii) charges for services on a sliding fee schedule based 
540.3   on current poverty income guidelines; and 
540.4      (iv) does not restrict access or services because of a 
540.5   client's financial limitation; 
540.6      (3) status as a local government unit as defined in section 
540.7   62D.02, subdivision 11, a hospital district created or 
540.8   reorganized under sections 447.31 to 447.37, an Indian tribal 
540.9   government, an Indian health service unit, or a community health 
540.10  board as defined in chapter 145A; 
540.11     (4) a former state hospital that specializes in the 
540.12  treatment of cerebral palsy, spina bifida, epilepsy, closed head 
540.13  injuries, specialized orthopedic problems, and other disabling 
540.14  conditions; or 
540.15     (5) a rural hospital that has qualified for a sole 
540.16  community hospital financial assistance grant in the past three 
540.17  years under section 144.1484, subdivision 1.  For these rural 
540.18  hospitals, the essential community provider designation applies 
540.19  to all health services provided, including both inpatient and 
540.20  outpatient services.  For purposes of this section, "sole 
540.21  community hospital" means a rural hospital that: 
540.22     (i) is eligible to be classified as a sole community 
540.23  hospital according to Code of Federal Regulations, title 42, 
540.24  section 412.92, or is located in a community with a population 
540.25  of less than 5,000 and located more than 25 miles from a like 
540.26  hospital currently providing acute short-term services; 
540.27     (ii) has experienced net operating income losses in two of 
540.28  the previous three most recent consecutive hospital fiscal years 
540.29  for which audited financial information is available; and 
540.30     (iii) consists of 40 or fewer licensed beds. 
540.31     (b) Prior to designation, the commissioner shall publish 
540.32  the names of all applicants in the State Register.  The public 
540.33  shall have 30 days from the date of publication to submit 
540.34  written comments to the commissioner on the application.  No 
540.35  designation shall be made by the commissioner until the 30-day 
540.36  period has expired. 
541.1      (c) The commissioner may designate an eligible provider as 
541.2   an essential community provider for all the services offered by 
541.3   that provider or for specific services designated by the 
541.4   commissioner. 
541.5      (d) For the purpose of this subdivision, supportive and 
541.6   stabilizing services include at a minimum, transportation, child 
541.7   care, cultural, and linguistic services where appropriate. 
541.8      Sec. 7.  Minnesota Statutes 2002, section 144.1222, is 
541.9   amended by adding a subdivision to read: 
541.10     Subd. 1a.  [FEES.] All plans and specifications for public 
541.11  swimming pool and spa construction, installation, or alteration 
541.12  or requests for a variance that are submitted to the 
541.13  commissioner according to Minnesota Rules, part 4717.3975, shall 
541.14  be accompanied by the appropriate fees.  If the commissioner 
541.15  determines, upon review of the plans, that inadequate fees were 
541.16  paid, the necessary additional fees shall be paid before plan 
541.17  approval.  For purposes of determining fees, a project is 
541.18  defined as a proposal to construct or install a public pool, 
541.19  spa, special purpose pool, or wading pool and all associated 
541.20  water treatment equipment and drains, gutters, decks, water 
541.21  recreation features, spray pads, and those design and safety 
541.22  features that are within five feet of any pool or spa.  The 
541.23  commissioner shall charge the following fees for plan review and 
541.24  inspection of public pools and spas and for requests for 
541.25  variance from the public pool and spa rules:  
541.26     (1) each spa pool, $500; 
541.27     (2) projects valued at $250,000 or less, a minimum of $800 
541.28  per pool plus:  
541.29     (i) for each slide, an additional $400; and 
541.30     (ii) for each spa pool, an additional $500; 
541.31     (3) projects valued at $250,000 or more, 0.5 percent of 
541.32  documented estimated project cost to a maximum fee of $10,000; 
541.33     (4) alterations to an existing pool without changing the 
541.34  size or configuration of the pool, $400; 
541.35     (5) removal or replacement of pool disinfection equipment 
541.36  only, $75; and 
542.1      (6) request for variance from the public pool and spa 
542.2   rules, $500. 
542.3      Sec. 8.  Minnesota Statutes 2002, section 144.125, is 
542.4   amended to read: 
542.5      144.125 [TESTS OF INFANTS FOR INBORN METABOLIC ERRORS 
542.6   HERITABLE AND CONGENITAL DISORDERS.] 
542.7      Subdivision 1.  [DUTY TO PERFORM TESTING.] It is the duty 
542.8   of (1) the administrative officer or other person in charge of 
542.9   each institution caring for infants 28 days or less of age, (2) 
542.10  the person required in pursuance of the provisions of section 
542.11  144.215, to register the birth of a child, or (3) the nurse 
542.12  midwife or midwife in attendance at the birth, to arrange to 
542.13  have administered to every infant or child in its care tests for 
542.14  inborn errors of metabolism in accordance with heritable and 
542.15  congenital disorders according to subdivision 2 and rules 
542.16  prescribed by the state commissioner of health.  In determining 
542.17  which tests must be administered, the commissioner shall take 
542.18  into consideration the adequacy of laboratory methods to detect 
542.19  the inborn metabolic error, the ability to treat or prevent 
542.20  medical conditions caused by the inborn metabolic error, and the 
542.21  severity of the medical conditions caused by the inborn 
542.22  metabolic error.  Testing and the recording and reporting of 
542.23  test results shall be performed at the times and in the manner 
542.24  prescribed by the commissioner of health.  The commissioner 
542.25  shall charge laboratory service fees so that the total of fees 
542.26  collected will approximate the costs of conducting the tests and 
542.27  implementing and maintaining a system to follow-up infants with 
542.28  inborn metabolic errors heritable or congenital disorders.  The 
542.29  laboratory service fee is $61 per specimen.  Costs associated 
542.30  with capital expenditures and the development of new procedures 
542.31  may be prorated over a three-year period when calculating the 
542.32  amount of the fees. 
542.33     Subd. 2.  [DETERMINATION OF TESTS TO BE ADMINISTERED.] The 
542.34  commissioner shall periodically revise the list of tests to be 
542.35  administered for determining the presence of a heritable or 
542.36  congenital disorder.  Revisions to the list shall reflect 
543.1   advances in medical science, new and improved testing methods, 
543.2   or other factors that will improve the public health.  In 
543.3   determining whether a test must be administered, the 
543.4   commissioner shall take into consideration the adequacy of 
543.5   laboratory methods to detect the heritable or congenital 
543.6   disorder, the ability to treat or prevent medical conditions 
543.7   caused by the heritable or congenital disorder, and the severity 
543.8   of the medical conditions caused by the heritable or congenital 
543.9   disorder.  The list of tests to be performed may be revised if 
543.10  the changes are recommended by the advisory committee 
543.11  established under section 144.1255, approved by the 
543.12  commissioner, and published in the State Register.  The revision 
543.13  is exempt from the rulemaking requirements in chapter 14 and 
543.14  sections 14.385 and 14.386 do not apply.  
543.15     Subd. 3.  [OBJECTION OF PARENTS TO TEST.] Persons with a 
543.16  duty to perform testing under subdivision 1 shall advise parents 
543.17  of infants (1) that the blood or tissue samples used to perform 
543.18  testing thereunder as well as the results of such testing may be 
543.19  retained by the department of health and (2) that the following 
543.20  options are available to them with respect to the testing: 
543.21     (i) to decline to have the tests, or 
543.22     (ii) to elect to have the tests but to require that all 
543.23  blood samples and records of test results be destroyed within 24 
543.24  months of the testing.  If the parents of an infant object in 
543.25  writing to testing for heritable and congenital disorders or 
543.26  elect to require that blood samples and test results be 
543.27  destroyed, the objection or election shall be recorded on a form 
543.28  that is signed by a parent or legal guardian and made part of 
543.29  the infant's medical record.  A written objection exempts an 
543.30  infant from the requirements of this section and section 144.128.
543.31     Sec. 9.  [144.1255] [ADVISORY COMMITTEE ON HERITABLE AND 
543.32  CONGENITAL DISORDERS.] 
543.33     Subdivision 1.  [CREATION AND MEMBERSHIP.] (a) By July 1, 
543.34  2003, the commissioner of health shall appoint an advisory 
543.35  committee to provide advice and recommendations to the 
543.36  commissioner concerning tests and treatments for heritable and 
544.1   congenital disorders found in newborn children.  Membership of 
544.2   the committee shall include, but not be limited to, at least one 
544.3   member from each of the following representative groups:  
544.4      (1) parents and other consumers; 
544.5      (2) primary care providers; 
544.6      (3) clinicians and researchers specializing in newborn 
544.7   diseases and disorders; 
544.8      (4) genetic counselors; 
544.9      (5) birth hospital representatives; 
544.10     (6) newborn screening laboratory professionals; 
544.11     (7) nutritionists; and 
544.12     (8) other experts as needed representing related fields 
544.13  such as emerging technologies and health insurance. 
544.14     (b) The terms and removal of members are governed by 
544.15  section 15.059.  Members shall not receive per diems but shall 
544.16  be compensated for expenses.  Notwithstanding section 15.059, 
544.17  subdivision 5, the advisory committee does not expire. 
544.18     Subd. 2.  [FUNCTION AND OBJECTIVES.] The committee's 
544.19  activities include, but are not limited to:  
544.20     (1) collection of information on the efficacy and 
544.21  reliability of various tests for heritable and congenital 
544.22  disorders; 
544.23     (2) collection of information on the availability and 
544.24  efficacy of treatments for heritable and congenital disorders; 
544.25     (3) collection of information on the severity of medical 
544.26  conditions caused by heritable and congenital disorders; 
544.27     (4) discussion and assessment of the benefits of performing 
544.28  tests for heritable or congenital disorders as compared to the 
544.29  costs, treatment limitations, or other potential disadvantages 
544.30  of requiring the tests; 
544.31     (5) discussion and assessment of ethical considerations 
544.32  surrounding the testing, treatment, and handling of data and 
544.33  specimens generated by the testing requirements of sections 
544.34  144.125 to 144.128; and 
544.35     (6) providing advice and recommendations to the 
544.36  commissioner concerning tests and treatments for heritable and 
545.1   congenital disorders found in newborn children. 
545.2      <b>[EFFECTIVE DATE.]</b> This section is effective the day 
545.3   following final enactment. 
545.4      Sec. 10.  Minnesota Statutes 2002, section 144.128, is 
545.5   amended to read: 
545.6      144.128 [TREATMENT FOR POSITIVE DIAGNOSIS, REGISTRY OF 
545.7   CASES COMMISSIONER'S DUTIES.] 
545.8      The commissioner shall: 
545.9      (1) notify the physicians of newborns tested of the results 
545.10  of the tests performed; 
545.11     (1) (2) make arrangements referrals for the necessary 
545.12  treatment of diagnosed cases of hemoglobinopathy, 
545.13  phenylketonuria, and other inborn errors of metabolism heritable 
545.14  or congenital disorders when treatment is indicated and the 
545.15  family is uninsured and, because of a lack of available income, 
545.16  is unable to pay the cost of the treatment; 
545.17     (2) (3) maintain a registry of the cases of 
545.18  hemoglobinopathy, phenylketonuria, and other inborn errors of 
545.19  metabolism heritable and congenital disorders detected by the 
545.20  screening program for the purpose of follow-up services; and 
545.21     (3) (4) adopt rules to carry out section 144.126 and this 
545.22  section sections 144.125 to 144.128. 
545.23     Sec. 11.  Minnesota Statutes 2002, section 144.1483, is 
545.24  amended to read: 
545.25     144.1483 [RURAL HEALTH INITIATIVES.] 
545.26     The commissioner of health, through the office of rural 
545.27  health, and consulting as necessary with the commissioner of 
545.28  human services, the commissioner of commerce, the higher 
545.29  education services office, and other state agencies, shall: 
545.30     (1) develop a detailed plan regarding the feasibility of 
545.31  coordinating rural health care services by organizing individual 
545.32  medical providers and smaller hospitals and clinics into 
545.33  referral networks with larger rural hospitals and clinics that 
545.34  provide a broader array of services; 
545.35     (2) develop and implement a program to assist rural 
545.36  communities in establishing community health centers, as 
546.1   required by section 144.1486; 
546.2      (3) administer the program of financial assistance 
546.3   established under section 144.1484 for rural hospitals in 
546.4   isolated areas of the state that are in danger of closing 
546.5   without financial assistance, and that have exhausted local 
546.6   sources of support; 
546.7      (4) develop recommendations regarding health education and 
546.8   training programs in rural areas, including but not limited to a 
546.9   physician assistants' training program, continuing education 
546.10  programs for rural health care providers, and rural outreach 
546.11  programs for nurse practitioners within existing training 
546.12  programs; 
546.13     (5) (4) develop a statewide, coordinated recruitment 
546.14  strategy for health care personnel and maintain a database on 
546.15  health care personnel as required under section 144.1485; 
546.16     (6) (5) develop and administer technical assistance 
546.17  programs to assist rural communities in:  (i) planning and 
546.18  coordinating the delivery of local health care services; and 
546.19  (ii) hiring physicians, nurse practitioners, public health 
546.20  nurses, physician assistants, and other health personnel; 
546.21     (7) (6) study and recommend changes in the regulation of 
546.22  health care personnel, such as nurse practitioners and physician 
546.23  assistants, related to scope of practice, the amount of on-site 
546.24  physician supervision, and dispensing of medication, to address 
546.25  rural health personnel shortages; 
546.26     (8) (7) support efforts to ensure continued funding for 
546.27  medical and nursing education programs that will increase the 
546.28  number of health professionals serving in rural areas; 
546.29     (9) (8) support efforts to secure higher reimbursement for 
546.30  rural health care providers from the Medicare and medical 
546.31  assistance programs; 
546.32     (10) (9) coordinate the development of a statewide plan for 
546.33  emergency medical services, in cooperation with the emergency 
546.34  medical services advisory council; 
546.35     (11) (10) establish a Medicare rural hospital flexibility 
546.36  program pursuant to section 1820 of the federal Social Security 
547.1   Act, United States Code, title 42, section 1395i-4, by 
547.2   developing a state rural health plan and designating, consistent 
547.3   with the rural health plan, rural nonprofit or public hospitals 
547.4   in the state as critical access hospitals.  Critical access 
547.5   hospitals shall include facilities that are certified by the 
547.6   state as necessary providers of health care services to 
547.7   residents in the area.  Necessary providers of health care 
547.8   services are designated as critical access hospitals on the 
547.9   basis of being more than 20 miles, defined as official mileage 
547.10  as reported by the Minnesota department of transportation, from 
547.11  the next nearest hospital, being the sole hospital in the 
547.12  county, being a hospital located in a county with a designated 
547.13  medically underserved area or health professional shortage area, 
547.14  or being a hospital located in a county contiguous to a county 
547.15  with a medically underserved area or health professional 
547.16  shortage area.  A critical access hospital located in a county 
547.17  with a designated medically underserved area or a health 
547.18  professional shortage area or in a county contiguous to a county 
547.19  with a medically underserved area or health professional 
547.20  shortage area shall continue to be recognized as a critical 
547.21  access hospital in the event the medically underserved area or 
547.22  health professional shortage area designation is subsequently 
547.23  withdrawn; and 
547.24     (12) (11) carry out other activities necessary to address 
547.25  rural health problems. 
547.26     Sec. 12.  Minnesota Statutes 2002, section 144.1488, 
547.27  subdivision 4, is amended to read: 
547.28     Subd. 4.  [ELIGIBLE HEALTH PROFESSIONALS.] (a) To be 
547.29  eligible to apply to the commissioner for the loan repayment 
547.30  program, health professionals must be citizens or nationals of 
547.31  the United States, must not have any unserved obligations for 
547.32  service to a federal, state, or local government, or other 
547.33  entity, must have a current and unrestricted Minnesota license 
547.34  to practice, and must be ready to begin full-time clinical 
547.35  practice upon signing a contract for obligated service. 
547.36     (b) Eligible providers are those specified by the federal 
548.1   Bureau of Primary Health Care Health Professions in the policy 
548.2   information notice for the state's current federal grant 
548.3   application.  A health professional selected for participation 
548.4   is not eligible for loan repayment until the health professional 
548.5   has an employment agreement or contract with an eligible loan 
548.6   repayment site and has signed a contract for obligated service 
548.7   with the commissioner. 
548.8      Sec. 13.  Minnesota Statutes 2002, section 144.1491, 
548.9   subdivision 1, is amended to read: 
548.10     Subdivision 1.  [PENALTIES FOR BREACH OF CONTRACT.] A 
548.11  program participant who fails to complete two the required years 
548.12  of obligated service shall repay the amount paid, as well as a 
548.13  financial penalty based upon the length of the service 
548.14  obligation not fulfilled.  If the participant has served at 
548.15  least one year, the financial penalty is the number of unserved 
548.16  months multiplied by $1,000.  If the participant has served less 
548.17  than one year, the financial penalty is the total number of 
548.18  obligated months multiplied by $1,000 specified by the federal 
548.19  Bureau of Health Professions in the policy information notice 
548.20  for the state's current federal grant application.  The 
548.21  commissioner shall report to the appropriate health-related 
548.22  licensing board a participant who fails to complete the service 
548.23  obligation and fails to repay the amount paid or fails to pay 
548.24  any financial penalty owed under this subdivision. 
548.25     Sec. 14.  [144.1501] [HEALTH PROFESSIONAL EDUCATION LOAN 
548.26  FORGIVENESS PROGRAM.] 
548.27     Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
548.28  section, the following definitions apply.  
548.29     (b) "Designated rural area" means:  
548.30     (1) an area in Minnesota outside the counties of Anoka, 
548.31  Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 
548.32  excluding the cities of Duluth, Mankato, Moorhead, Rochester, 
548.33  and St. Cloud; or 
548.34     (2) a municipal corporation, as defined under section 
548.35  471.634, that is physically located, in whole or in part, in an 
548.36  area defined as a designated rural area under clause (1).  
549.1      (c) "Emergency circumstances" means those conditions that 
549.2   make it impossible for the participant to fulfill the service 
549.3   commitment, including death, total and permanent disability, or 
549.4   temporary disability lasting more than two years. 
549.5      (d) "Medical resident" means an individual participating in 
549.6   a medical residency in family practice, internal medicine, 
549.7   obstetrics and gynecology, pediatrics, or psychiatry.  
549.8      (e) "Midlevel practitioner" means a nurse practitioner, 
549.9   nurse-midwife, nurse anesthetist, advanced clinical nurse 
549.10  specialist, or physician assistant.  
549.11     (f) "Nurse" means an individual who has completed training 
549.12  and received all licensing or certification necessary to perform 
549.13  duties as a licensed practical nurse or registered nurse.  
549.14     (g) "Nurse-midwife" means a registered nurse who has 
549.15  graduated from a program of study designed to prepare registered 
549.16  nurses for advanced practice as nurse-midwives.  
549.17     (h) "Nurse practitioner" means a registered nurse who has 
549.18  graduated from a program of study designed to prepare registered 
549.19  nurses for advanced practice as nurse practitioners.  
549.20     (i) "Physician" means an individual who is licensed to 
549.21  practice medicine in the areas of family practice, internal 
549.22  medicine, obstetrics and gynecology, pediatrics, or psychiatry.  
549.23     (j) "Physician assistant" means a person registered under 
549.24  chapter 147A.  
549.25     (k) "Qualified educational loan" means a government, 
549.26  commercial, or foundation loan for actual costs paid for 
549.27  tuition, reasonable education expenses, and reasonable living 
549.28  expenses related to the graduate or undergraduate education of a 
549.29  health care professional.  
549.30     (l) "Underserved urban community" means a Minnesota urban 
549.31  area or population included in the list of designated primary 
549.32  medical care health professional shortage areas (HPSAs), 
549.33  medically underserved areas (MUAs), or medically underserved 
549.34  populations (MUPs) maintained and updated by the United States 
549.35  Department of Health and Human Services.  
549.36     Subd. 2.  [CREATION OF ACCOUNT.] A health professional 
550.1   education loan forgiveness program account is established.  The 
550.2   commissioner of health shall use money from the account to 
550.3   establish a loan forgiveness program for medical residents 
550.4   agreeing to practice in designated rural areas or underserved 
550.5   urban communities, for midlevel practitioners agreeing to 
550.6   practice in designated rural areas, and for nurses who agree to 
550.7   practice in a Minnesota nursing home or intermediate care 
550.8   facility for persons with mental retardation or related 
550.9   conditions.  Appropriations made to the account do not cancel 
550.10  and are available until expended, except that at the end of each 
550.11  biennium, any remaining balance in the account that is not 
550.12  committed by contract and not needed to fulfill existing 
550.13  commitments shall cancel to the fund. 
550.14     Subd. 3.  [ELIGIBILITY.] (a) To be eligible to participate 
550.15  in the loan forgiveness program, an individual must: 
550.16     (1) be a medical resident or be enrolled in a midlevel 
550.17  practitioner, registered nurse, or a licensed practical nurse 
550.18  training program; and 
550.19     (2) submit an application to the commissioner of health.  
550.20     (b) An applicant selected to participate must sign a 
550.21  contract to agree to serve a minimum three-year full-time 
550.22  service obligation according to subdivision 2, which shall begin 
550.23  no later than March 31 following completion of required training.
550.24     Subd. 4.  [LOAN FORGIVENESS.] The commissioner of health 
550.25  may select applicants each year for participation in the loan 
550.26  forgiveness program, within the limits of available funding.  
550.27  The commissioner shall distribute available funds for loan 
550.28  forgiveness proportionally among the eligible professions 
550.29  according to the vacancy rate for each profession in the 
550.30  required geographic area or facility type specified in 
550.31  subdivision 2.  The commissioner shall allocate funds for 
550.32  physician loan forgiveness so that 75 percent of the funds 
550.33  available are used for rural physician loan forgiveness and 25 
550.34  percent of the funds available are used for underserved urban 
550.35  communities loan forgiveness.  If the commissioner does not 
550.36  receive enough qualified applicants each year to use the entire 
551.1   allocation of funds for urban underserved communities, the 
551.2   remaining funds may be allocated for rural physician loan 
551.3   forgiveness.  Applicants are responsible for securing their own 
551.4   qualified educational loans.  The commissioner shall select 
551.5   participants based on their suitability for practice serving the 
551.6   required geographic area or facility type specified in 
551.7   subdivision 2, as indicated by experience or training.  The 
551.8   commissioner shall give preference to applicants closest to 
551.9   completing their training.  For each year that a participant 
551.10  meets the service obligation required under subdivision 3, up to 
551.11  a maximum of four years, the commissioner shall make annual 
551.12  disbursements directly to the participant equivalent to 15 
551.13  percent of the average educational debt for indebted graduates 
551.14  in their profession in the year closest to the applicant's 
551.15  selection for which information is available, not to exceed the 
551.16  balance of the participant's qualifying educational loans.  
551.17  Before receiving loan repayment disbursements and as requested, 
551.18  the participant must complete and return to the commissioner an 
551.19  affidavit of practice form provided by the commissioner 
551.20  verifying that the participant is practicing as required under 
551.21  subdivisions 2 and 3.  The participant must provide the 
551.22  commissioner with verification that the full amount of loan 
551.23  repayment disbursement received by the participant has been 
551.24  applied toward the designated loans.  After each disbursement, 
551.25  verification must be received by the commissioner and approved 
551.26  before the next loan repayment disbursement is made.  
551.27  Participants who move their practice remain eligible for loan 
551.28  repayment as long as they practice as required under subdivision 
551.29  2.  
551.30     Subd. 5.  [PENALTY FOR NONFULFILLMENT.] If a participant 
551.31  does not fulfill the required minimum commitment of service 
551.32  according to subdivision 3, the commissioner of health shall 
551.33  collect from the participant the total amount paid to the 
551.34  participant under the loan forgiveness program plus interest at 
551.35  a rate established according to section 270.75.  The 
551.36  commissioner shall deposit the money collected in the health 
552.1   care access fund to be credited to the health professional 
552.2   education loan forgiveness program account established in 
552.3   subdivision 2.  The commissioner shall allow waivers of all or 
552.4   part of the money owed the commissioner as a result of a 
552.5   nonfulfillment penalty if emergency circumstances prevented 
552.6   fulfillment of the minimum service commitment.  
552.7      Subd. 6.  [RULES.] The commissioner may adopt rules to 
552.8   implement this section.  
552.9      Sec. 15.  Minnesota Statutes 2002, section 144.1502, 
552.10  subdivision 4, is amended to read: 
552.11     Subd. 4.  [LOAN FORGIVENESS.] The commissioner of health 
552.12  may accept up to 14 applicants per each year for participation 
552.13  in the loan forgiveness program, within the limits of available 
552.14  funding.  Applicants are responsible for securing their own 
552.15  loans.  The commissioner shall select participants based on 
552.16  their suitability for practice serving public program patients, 
552.17  as indicated by experience or training.  The commissioner shall 
552.18  give preference to applicants who have attended a Minnesota 
552.19  dentistry educational institution and to applicants closest to 
552.20  completing their training.  For each year that a participant 
552.21  meets the service obligation required under subdivision 3, up to 
552.22  a maximum of four years, the commissioner shall make annual 
552.23  disbursements directly to the participant equivalent to $10,000 
552.24  per year of service, not to exceed $40,000 15 percent of the 
552.25  average educational debt for indebted dental school graduates in 
552.26  the year closest to the applicant's selection for which 
552.27  information is available or the balance of the qualifying 
552.28  educational loans, whichever is less.  Before receiving loan 
552.29  repayment disbursements and as requested, the participant must 
552.30  complete and return to the commissioner an affidavit of practice 
552.31  form provided by the commissioner verifying that the participant 
552.32  is practicing as required under subdivision 3.  The participant 
552.33  must provide the commissioner with verification that the full 
552.34  amount of loan repayment disbursement received by the 
552.35  participant has been applied toward the designated loans.  After 
552.36  each disbursement, verification must be received by the 
553.1   commissioner and approved before the next loan repayment 
553.2   disbursement is made.  Participants who move their practice 
553.3   remain eligible for loan repayment as long as they practice as 
553.4   required under subdivision 3. 
553.5      Sec. 16.  Minnesota Statutes 2002, section 144.551, 
553.6   subdivision 1, is amended to read: 
553.7      Subdivision 1.  [RESTRICTED CONSTRUCTION OR MODIFICATION.] 
553.8   (a) The following construction or modification may not be 
553.9   commenced:  
553.10     (1) any erection, building, alteration, reconstruction, 
553.11  modernization, improvement, extension, lease, or other 
553.12  acquisition by or on behalf of a hospital that increases the bed 
553.13  capacity of a hospital, relocates hospital beds from one 
553.14  physical facility, complex, or site to another, or otherwise 
553.15  results in an increase or redistribution of hospital beds within 
553.16  the state; and 
553.17     (2) the establishment of a new hospital.  
553.18     (b) This section does not apply to:  
553.19     (1) construction or relocation within a county by a 
553.20  hospital, clinic, or other health care facility that is a 
553.21  national referral center engaged in substantial programs of 
553.22  patient care, medical research, and medical education meeting 
553.23  state and national needs that receives more than 40 percent of 
553.24  its patients from outside the state of Minnesota; 
553.25     (2) a project for construction or modification for which a 
553.26  health care facility held an approved certificate of need on May 
553.27  1, 1984, regardless of the date of expiration of the 
553.28  certificate; 
553.29     (3) a project for which a certificate of need was denied 
553.30  before July 1, 1990, if a timely appeal results in an order 
553.31  reversing the denial; 
553.32     (4) a project exempted from certificate of need 
553.33  requirements by Laws 1981, chapter 200, section 2; 
553.34     (5) a project involving consolidation of pediatric 
553.35  specialty hospital services within the Minneapolis-St. Paul 
553.36  metropolitan area that would not result in a net increase in the 
554.1   number of pediatric specialty hospital beds among the hospitals 
554.2   being consolidated; 
554.3      (6) a project involving the temporary relocation of 
554.4   pediatric-orthopedic hospital beds to an existing licensed 
554.5   hospital that will allow for the reconstruction of a new 
554.6   philanthropic, pediatric-orthopedic hospital on an existing site 
554.7   and that will not result in a net increase in the number of 
554.8   hospital beds.  Upon completion of the reconstruction, the 
554.9   licenses of both hospitals must be reinstated at the capacity 
554.10  that existed on each site before the relocation; 
554.11     (7) the relocation or redistribution of hospital beds 
554.12  within a hospital building or identifiable complex of buildings 
554.13  provided the relocation or redistribution does not result in: 
554.14  (i) an increase in the overall bed capacity at that site; (ii) 
554.15  relocation of hospital beds from one physical site or complex to 
554.16  another; or (iii) redistribution of hospital beds within the 
554.17  state or a region of the state; 
554.18     (8) relocation or redistribution of hospital beds within a 
554.19  hospital corporate system that involves the transfer of beds 
554.20  from a closed facility site or complex to an existing site or 
554.21  complex provided that:  (i) no more than 50 percent of the 
554.22  capacity of the closed facility is transferred; (ii) the 
554.23  capacity of the site or complex to which the beds are 
554.24  transferred does not increase by more than 50 percent; (iii) the 
554.25  beds are not transferred outside of a federal health systems 
554.26  agency boundary in place on July 1, 1983; and (iv) the 
554.27  relocation or redistribution does not involve the construction 
554.28  of a new hospital building; 
554.29     (9) a construction project involving up to 35 new beds in a 
554.30  psychiatric hospital in Rice county that primarily serves 
554.31  adolescents and that receives more than 70 percent of its 
554.32  patients from outside the state of Minnesota; 
554.33     (10) a project to replace a hospital or hospitals with a 
554.34  combined licensed capacity of 130 beds or less if:  (i) the new 
554.35  hospital site is located within five miles of the current site; 
554.36  and (ii) the total licensed capacity of the replacement 
555.1   hospital, either at the time of construction of the initial 
555.2   building or as the result of future expansion, will not exceed 
555.3   70 licensed hospital beds, or the combined licensed capacity of 
555.4   the hospitals, whichever is less; 
555.5      (11) the relocation of licensed hospital beds from an 
555.6   existing state facility operated by the commissioner of human 
555.7   services to a new or existing facility, building, or complex 
555.8   operated by the commissioner of human services; from one 
555.9   regional treatment center site to another; or from one building 
555.10  or site to a new or existing building or site on the same 
555.11  campus; 
555.12     (12) the construction or relocation of hospital beds 
555.13  operated by a hospital having a statutory obligation to provide 
555.14  hospital and medical services for the indigent that does not 
555.15  result in a net increase in the number of hospital beds; 
555.16     (13) a construction project involving the addition of up to 
555.17  31 new beds in an existing nonfederal hospital in Beltrami 
555.18  county; or 
555.19     (14) a construction project involving the addition of up to 
555.20  eight new beds in an existing nonfederal hospital in Otter Tail 
555.21  county with 100 licensed acute care beds; 
555.22     (15) a construction project involving the addition of 20 
555.23  new hospital beds used for rehabilitation services in an 
555.24  existing hospital in Carver county serving the southwest 
555.25  suburban metropolitan area; or 
555.26     (16) a project for the construction or relocation of up to 
555.27  20 hospital beds for the operation of up to two psychiatric 
555.28  facilities or units for children provided that the operation of 
555.29  the facilities or units have received the approval of the 
555.30  commissioner of human services. 
555.31     Sec. 17.  [144.706] [CITATION.] 
555.32     Sections 144.706 to 144.7069 may be cited as the Minnesota 
555.33  Adverse Health Care Events Reporting Act of 2003. 
555.34     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2005, 
555.35  contingent upon obtaining independent funding. 
555.36     Sec. 18.  [144.7063] [DEFINITIONS.] 
556.1      Subdivision 1.  [SCOPE.] Unless the context clearly 
556.2   indicates otherwise, for the purposes of sections 144.706 to 
556.3   144.7069, the terms defined in this section have the meanings 
556.4   given them. 
556.5      Subd. 2.  [COMMISSIONER.] "Commissioner" means the 
556.6   commissioner of health. 
556.7      Subd. 3.  [FACILITY.] "Facility" means a hospital licensed 
556.8   under sections 144.50 to 144.58. 
556.9      Subd. 4.  [SERIOUS DISABILITY.] "Serious disability" means 
556.10  (1) a physical or mental impairment that substantially limits 
556.11  one or more of the major life activities of an individual or a 
556.12  loss of bodily function, if the impairment or loss lasts more 
556.13  than seven days or is still present at the time of discharge 
556.14  from an inpatient health care facility or (2) loss of a body 
556.15  part. 
556.16     Subd. 5.  [SURGERY.] "Surgery" means the treatment of 
556.17  disease, injury, or deformity by manual or operative methods.  
556.18  Surgery includes endoscopies and other invasive procedures. 
556.19     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2005, 
556.20  contingent upon obtaining independent funding. 
556.21     Sec. 19.  [144.7065] [FACILITY REQUIREMENTS TO REPORT, 
556.22  ANALYZE, AND CORRECT.] 
556.23     Subdivision 1.  [REPORTS OF ADVERSE HEALTH CARE EVENTS 
556.24  REQUIRED.] Each facility shall report to the commissioner the 
556.25  occurrence of any of the adverse health care events described in 
556.26  subdivisions 2 to 7 as soon as is reasonably and practically 
556.27  possible, but no later than 15 working days after discovery of 
556.28  the event.  The report shall be filed in a format specified by 
556.29  the commissioner and shall identify the facility but shall not 
556.30  identify any of the health care professionals, facility 
556.31  employees, or patients involved.  The report shall not contain 
556.32  the name, address, social security number, date of birth, 
556.33  telephone number, federal patient identification number, 
556.34  subscriber number, medical record number, or any other 
556.35  identifying information of the patient involved.  The report 
556.36  shall not contain the name, social security number, federal 
557.1   provider identification number, license number, or other 
557.2   identifying information of the health care professionals 
557.3   involved.  The report shall not contain the name, employee 
557.4   number, social security number, or any other identifying 
557.5   information of the facility employee involved.  The commissioner 
557.6   may consult with experts and organizations familiar with patient 
557.7   safety when developing the format for reporting and in further 
557.8   defining events in order to be consistent with industry 
557.9   standards. 
557.10     Subd. 2.  [SURGICAL EVENTS.] Events reportable under this 
557.11  subdivision are: 
557.12     (1) surgery performed on a wrong body part that is not 
557.13  consistent with the documented informed consent for that 
557.14  patient.  Reportable events under this clause do not include 
557.15  situations requiring prompt action that occur in the course of 
557.16  surgery or situations whose urgency precludes obtaining informed 
557.17  consent; 
557.18     (2) surgery performed on the wrong patient; 
557.19     (3) the wrong surgical procedure performed on a patient 
557.20  that is not consistent with the documented informed consent for 
557.21  that patient.  Reportable events under this clause do not 
557.22  include situations requiring prompt action that occur in the 
557.23  course of surgery or situations whose urgency precludes 
557.24  obtaining informed consent; 
557.25     (4) retention of a foreign object in a patient after 
557.26  surgery or other procedure, excluding objects intentionally 
557.27  implanted as part of a planned intervention and objects present 
557.28  prior to surgery that are intentionally retained; and 
557.29     (5) death during or immediately after surgery of a normal, 
557.30  healthy patient who has no organic, physiologic, biochemical, or 
557.31  psychiatric disturbance and for whom the pathologic processes 
557.32  for which the operation is to be performed are localized and do 
557.33  not entail a systemic disturbance. 
557.34     Subd. 3.  [PRODUCT OR DEVICE EVENTS.] Events reportable 
557.35  under this subdivision are: 
557.36     (1) patient death or serious disability associated with the 
558.1   use of contaminated drugs, devices, or biologics provided by the 
558.2   facility when the contamination is the result of generally 
558.3   detectable contaminants in drugs, devices, or biologics 
558.4   regardless of the source of the contamination or the product; 
558.5      (2) patient death or serious disability associated with the 
558.6   use or function of a device in patient care in which the device 
558.7   is used or functions other than as intended.  "Device" includes, 
558.8   but is not limited to, catheters, drains, and other specialized 
558.9   tubes, infusion pumps, and ventilators; and 
558.10     (3) patient death or serious disability associated with 
558.11  intravascular air embolism that occurs while being cared for in 
558.12  a facility, excluding deaths associated with neurosurgical 
558.13  procedures known to present a high risk of intravascular air 
558.14  embolism. 
558.15     Subd. 4.  [PATIENT PROTECTION EVENTS.] Events reportable 
558.16  under this subdivision are: 
558.17     (1) an infant discharged to the wrong person; 
558.18     (2) patient death or serious disability associated with 
558.19  patient disappearance for more than four hours, excluding events 
558.20  involving adults who have decision making capacity; and 
558.21     (3) patient suicide or attempted suicide resulting in 
558.22  serious disability while being cared for in a facility due to 
558.23  patient actions after admission to the facility, excluding 
558.24  deaths resulting from self-inflicted injuries that were the 
558.25  reason for admission to the facility. 
558.26     Subd. 5.  [CARE MANAGEMENT EVENTS.] Events reportable under 
558.27  this subdivision are: 
558.28     (1) patient death or serious disability associated with a 
558.29  medication error, including, but not limited to, errors 
558.30  involving the wrong drug, the wrong dose, the wrong patient, the 
558.31  wrong time, the wrong rate, the wrong preparation, or the wrong 
558.32  route of administration, excluding reasonable differences in 
558.33  clinical judgment on drug selection and dose; 
558.34     (2) patient death or serious disability associated with a 
558.35  hemolytic reaction due to the administration of ABO-incompatible 
558.36  blood or blood products; 
559.1      (3) maternal death or serious disability associated with 
559.2   labor or delivery in a low-risk pregnancy while being cared for 
559.3   in a facility, including events that occur within 42 days 
559.4   postdelivery and excluding deaths from pulmonary or amniotic 
559.5   fluid embolism, acute fatty liver of pregnancy, or 
559.6   cardiomyopathy; 
559.7      (4) patient death or serious disability directly related to 
559.8   hypoglycemia, the onset of which occurs while the patient is 
559.9   being cared for in a facility; 
559.10     (5) death or serious disability, including kernicterus, 
559.11  associated with failure to identify and treat hyperbilirubinemia 
559.12  in neonates during the first 28 days of life.  
559.13  "Hyperbilirubinemia" means bilirubin levels greater than 30 
559.14  milligrams per deciliter; 
559.15     (6) stage 3 or 4 ulcers acquired after admission to a 
559.16  facility, excluding progression from stage 2 to stage 3 if stage 
559.17  2 was recognized upon admission; and 
559.18     (7) patient death or serious disability due to spinal 
559.19  manipulative therapy. 
559.20     Subd. 6.  [ENVIRONMENTAL EVENTS.] Events reportable under 
559.21  this subdivision are: 
559.22     (1) patient death or serious disability associated with an 
559.23  electric shock while being cared for in a facility, excluding 
559.24  events involving planned treatments such as electric 
559.25  countershock; 
559.26     (2) any incident in which a line designated for oxygen or 
559.27  other gas to be delivered to a patient contains the wrong gas or 
559.28  is contaminated by toxic substances; 
559.29     (3) patient death or serious disability associated with a 
559.30  burn incurred from any source while being cared for in a 
559.31  facility; 
559.32     (4) patient death associated with a fall while being cared 
559.33  for in a facility; and 
559.34     (5) patient death or serious disability associated with the 
559.35  use or lack of restraints or bedrails while being cared for in a 
559.36  facility. 
560.1      Subd. 7.  [CRIMINAL EVENTS.] Events reportable under this 
560.2   subdivision are: 
560.3      (1) any instance of care ordered by or provided by someone 
560.4   impersonating a physician, nurse, pharmacist, or other licensed 
560.5   health care provider; 
560.6      (2) abduction of a patient of any age; 
560.7      (3) sexual assault on a patient within or on the grounds of 
560.8   a facility; and 
560.9      (4) death or significant injury of a patient or staff 
560.10  member resulting from a physical assault that occurs within or 
560.11  on the grounds of a facility. 
560.12     Subd. 8.  [ROOT CAUSE ANALYSIS; CORRECTIVE ACTION 
560.13  PLAN.] Following the occurrence of an adverse health care event, 
560.14  the facility must conduct a root cause analysis of the event.  
560.15  Following the analysis, the facility must:  (1) implement a 
560.16  corrective action plan to implement the findings of the 
560.17  analysis, or (2) report to the commissioner any reasons for not 
560.18  taking corrective action.  If the root cause analysis and the 
560.19  implementation of a corrective action plan are complete at the 
560.20  time an event must be reported, the findings of the analysis and 
560.21  the corrective action plan must be included in the report of the 
560.22  event.  The findings of the root cause analysis and a copy of 
560.23  the corrective action plan must otherwise be filed with the 
560.24  commissioner within 60 days of the event. 
560.25     Subd. 9.  [ELECTRONIC REPORTING.] The commissioner must 
560.26  design the reporting system so that a facility may file by 
560.27  electronic means the reports required under this section.  The 
560.28  commissioner shall encourage a facility to use the electronic 
560.29  filing option when that option is feasible for the facility. 
560.30     Subd. 10.  [RELATION TO OTHER LAW.] (a) Adverse health 
560.31  events described in subdivisions 2 to 6 do not constitute 
560.32  "maltreatment" or "a physical injury that is not reasonably 
560.33  explained" under section 626.557 and are excluded from the 
560.34  reporting requirements of section 626.557, provided the facility 
560.35  makes a determination within 24 hours of the discovery of the 
560.36  event that this section is applicable and the facility files the 
561.1   reports required under this section in a timely fashion. 
561.2      (b) A facility that has determined that an event described 
561.3   in subdivisions 2 to 6 has occurred must inform persons who are 
561.4   mandated reporters under section 626.5572, subdivision 16, of 
561.5   that determination.  A mandated reporter otherwise required to 
561.6   report under section 626.557, subdivision 3, paragraph (e), is 
561.7   relieved of the duty to report an event that the facility 
561.8   determines under paragraph (a) to be reportable under 
561.9   subdivisions 2 to 6. 
561.10     (c) The protections and immunities applicable to voluntary 
561.11  reports under section 626.557 are not affected by this section. 
561.12     (d) Notwithstanding section 626.557, a lead agency under 
561.13  section 626.5572, subdivision 13, is not required to conduct an 
561.14  investigation of an event described in subdivisions 2 to 6. 
561.15     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2005, 
561.16  contingent upon obtaining independent funding. 
561.17     Sec. 20.  [144.7067] [COMMISSIONER DUTIES AND 
561.18  RESPONSIBILITIES.] 
561.19     Subdivision 1.  [ESTABLISHMENT OF REPORTING SYSTEM.] (a) 
561.20  The commissioner shall establish an adverse health event 
561.21  reporting system designed to facilitate quality improvement in 
561.22  the health care system.  The reporting system shall not be 
561.23  designed to punish errors by health care practitioners or health 
561.24  care facility employees. 
561.25     (b) The reporting system shall consist of: 
561.26     (1) mandatory reporting by facilities of 27 adverse health 
561.27  care events; 
561.28     (2) mandatory completion of a root cause analysis and a 
561.29  corrective action plan by the facility and reporting of the 
561.30  findings of the analysis and the plan to the commissioner or 
561.31  reporting of reasons for not taking corrective action; 
561.32     (3) analysis of reported information by the commissioner to 
561.33  determine patterns of systemic failure in the health care system 
561.34  and successful methods to correct these failures; 
561.35     (4) sanctions against facilities for failure to comply with 
561.36  reporting system requirements; and 
562.1      (5) communication from the commissioner to facilities, 
562.2   health care purchasers, and the public to maximize the use of 
562.3   the reporting system to improve health care quality. 
562.4      (c) Reports, analyses, and corrective action plans 
562.5   submitted under section 144.7065, subdivisions 1 and 8, shall be 
562.6   considered aggregate data as contemplated by section 145.64, 
562.7   subdivision 1, paragraph (b), and afforded the protections and 
562.8   immunities provided in section 145.64. 
562.9      (d) Nothing in this section shall authorize the 
562.10  commissioner to select from or between competing alternative 
562.11  medical practices. 
562.12     Subd. 2.  [DUTY TO ANALYZE REPORTS; COMMUNICATE 
562.13  FINDINGS.] The commissioner shall: 
562.14     (1) analyze adverse event reports, corrective action plans, 
562.15  and the findings of the root cause analyses, to determine 
562.16  patterns of systemic failure in the health care system and 
562.17  successful methods to correct these failures; 
562.18     (2) communicate to individual facilities the commissioner's 
562.19  conclusions, if any, regarding an adverse event reported by the 
562.20  facility; 
562.21     (3) communicate with relevant health care facilities any 
562.22  recommendations for corrective action resulting from the 
562.23  commissioner's analysis of submissions from facilities; and 
562.24     (4) publish an annual report: 
562.25     (i) describing, by institution, adverse events reported; 
562.26     (ii) outlining, in aggregate, corrective action plans, and 
562.27  the findings of the root cause analyses; and 
562.28     (iii) making recommendations for modifications of state 
562.29  health care operations. 
562.30     Subd. 3.  [SANCTIONS.] (a) The commissioner shall take 
562.31  steps necessary to determine if adverse event reports, the 
562.32  findings of the root cause analyses, and corrective action plans 
562.33  are filed in a timely manner.  The commissioner may sanction a 
562.34  facility for: 
562.35     (1) failure to file a timely adverse event report under 
562.36  section 144.7065, subdivision 1; or 
563.1      (2) failure to conduct a root cause analysis, to implement 
563.2   a corrective action plan, or to provide the findings of a root 
563.3   cause analysis or corrective action plan in a timely fashion 
563.4   under section 144.7065, subdivision 8. 
563.5      (b) If a facility fails to develop and implement a 
563.6   corrective action plan or report to the commissioner why 
563.7   corrective action is not needed, the commissioner may suspend, 
563.8   revoke, fail to renew, or place conditions on the license under 
563.9   which the facility operates. 
563.10     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2005, 
563.11  contingent upon obtaining independent funding. 
563.12     Sec. 21.  [144.7069] [INTERSTATE COORDINATION; REPORTS.] 
563.13     The commissioner shall report the definitions and the list 
563.14  of reportable events adopted in this act to the National Quality 
563.15  Forum and, working in coordination with the National Quality 
563.16  Forum, to the other states.  The commissioner shall monitor 
563.17  discussions by the National Quality Forum of amendments to the 
563.18  forum's list of reportable events and shall report to the 
563.19  legislature whenever the list is modified.  The commissioner 
563.20  shall also monitor implementation efforts in other states to 
563.21  establish a list of reportable events and shall make 
563.22  recommendations to the legislature as necessary for 
563.23  modifications in the Minnesota list or in the other components 
563.24  of the Minnesota reporting system to keep the system as nearly 
563.25  uniform as possible with similar systems in other states. 
563.26     Sec. 22.  Minnesota Statutes 2002, section 147A.08, is 
563.27  amended to read: 
563.28     147A.08 [EXEMPTIONS.] 
563.29     (a) This chapter does not apply to, control, prevent, or 
563.30  restrict the practice, service, or activities of persons listed 
563.31  in section 147.09, clauses (1) to (6) and (8) to (13), persons 
563.32  regulated under section 214.01, subdivision 2, or persons 
563.33  defined in section 144.1495 144.1501, subdivision 1, 
563.34  paragraphs (a) to (d) (e), (g), and (h). 
563.35     (b) Nothing in this chapter shall be construed to require 
563.36  registration of: 
564.1      (1) a physician assistant student enrolled in a physician 
564.2   assistant or surgeon assistant educational program accredited by 
564.3   the Committee on Allied Health Education and Accreditation or by 
564.4   its successor agency approved by the board; 
564.5      (2) a physician assistant employed in the service of the 
564.6   federal government while performing duties incident to that 
564.7   employment; or 
564.8      (3) technicians, other assistants, or employees of 
564.9   physicians who perform delegated tasks in the office of a 
564.10  physician but who do not identify themselves as a physician 
564.11  assistant. 
564.12     Sec. 23.  Minnesota Statutes 2002, section 148.5194, 
564.13  subdivision 1, is amended to read: 
564.14     Subdivision 1.  [FEE PRORATION.] The commissioner shall 
564.15  prorate the registration fee for clinical fellowship, temporary, 
564.16  and first time registrants according to the number of months 
564.17  that have elapsed between the date registration is issued and 
564.18  the date registration expires or must be renewed under section 
564.19  148.5191, subdivision 4.  
564.20     Sec. 24.  Minnesota Statutes 2002, section 148.5194, 
564.21  subdivision 2, is amended to read: 
564.22     Subd. 2.  [BIENNIAL REGISTRATION FEE.] The fee for initial 
564.23  registration and biennial registration, clinical fellowship 
564.24  registration, temporary registration, or renewal is $200.  
564.25     Sec. 25.  Minnesota Statutes 2002, section 148.5194, 
564.26  subdivision 3, is amended to read: 
564.27     Subd. 3.  [BIENNIAL REGISTRATION FEE FOR DUAL 
564.28  REGISTRATION.] The fee for initial registration and biennial 
564.29  registration, clinical fellowship registration, temporary 
564.30  registration, or renewal is $200.  
564.31     Sec. 26.  Minnesota Statutes 2002, section 148.5194, is 
564.32  amended by adding a subdivision to read: 
564.33     Subd. 6.  [VERIFICATION OF CREDENTIAL.] The fee for written 
564.34  verification of credentialed status is $25. 
564.35     Sec. 27.  Minnesota Statutes 2002, section 148.6445, 
564.36  subdivision 7, is amended to read: 
565.1      Subd. 7.  [CERTIFICATION VERIFICATION TO OTHER STATES.] The 
565.2   fee for certification verification of licensure to other states 
565.3   is $25. 
565.4      Sec. 28.  [148C.12] [FEES.] 
565.5      Subdivision 1.  [APPLICATION.] The application fee for a 
565.6   license to practice alcohol and drug counseling is $295. 
565.7      Subd. 2.  [BIENNIAL RENEWAL.] The license renewal fee is 
565.8   $295.  If the commissioner changes the renewal schedule and the 
565.9   expiration date is less than two years, the fee must be prorated.
565.10     Subd. 3.  [TEMPORARY PRACTICE STATUS.] The initial fee for 
565.11  applicants under section 148C.04, subdivision 6, paragraph (a), 
565.12  clause (1), item (i), is $100.  The initial fee for applicants 
565.13  under section 148C.04, subdivision 6, paragraph (a), clause (1), 
565.14  item (ii) or (iii), is the license application fee under 
565.15  subdivision 1.  The fee for annual renewal of temporary practice 
565.16  status is $100.  
565.17     Subd. 4.  [EXAMINATION.] The examination fee is $95 for the 
565.18  written examination and $200 for the oral examination. 
565.19     Subd. 5.  [INACTIVE RENEWAL.] The inactive renewal fee is 
565.20  $150. 
565.21     Subd. 6.  [LATE FEE.] The late fee is 25 percent of the 
565.22  biennial renewal fee, the inactive renewal fee, or the annual 
565.23  fee for renewal of temporary practice status. 
565.24     Subd. 7.  [RENEWAL AFTER EXPIRATION.] The fee for renewal 
565.25  of a license that has expired is the total of the biennial 
565.26  renewal fee, the late fee, and a fee of $100 for review and 
565.27  approval of the continuing education report. 
565.28     Subd. 8.  [LICENSE VERIFICATION.] The fee for license 
565.29  verification to institutions and other jurisdictions is $25. 
565.30     Subd. 9.  [SURCHARGE.] Notwithstanding section 16A.1285, 
565.31  subdivision 2, a surcharge of $172 shall be paid at the time of 
565.32  application for or renewal of an alcohol and drug counseling 
565.33  license until June 30, 2009. 
565.34     Subd. 10.  [NONREFUNDABLE FEES.] All fees are nonrefundable.
565.35     Sec. 29.  Minnesota Statutes 2002, section 153A.17, is 
565.36  amended to read: 
566.1      153A.17 [EXPENSES; FEES.] 
566.2      The expenses for administering the certification 
566.3   requirements including the complaint handling system for hearing 
566.4   aid dispensers in sections 153A.14 and 153A.15 and the consumer 
566.5   information center under section 153A.18 must be paid from 
566.6   initial application and examination fees, renewal fees, 
566.7   penalties, and fines.  All fees are nonrefundable.  The 
566.8   certificate application fee is $165 for audiologists registered 
566.9   under section 148.511 and $490 for all others $350, the 
566.10  examination fee is $200 $250 for the written portion and 
566.11  $200 $250 for the practical portion each time one or the other 
566.12  is taken, and the trainee application fee 
566.13  is $100 $200.  Notwithstanding the policy set forth in section 
566.14  16A.1285, subdivision 2, a surcharge of $165 for audiologists 
566.15  registered under section 148.511 and $330 for all others shall 
566.16  be paid at the time of application or renewal until June 30, 
566.17  2003, to recover the commissioner's accumulated direct 
566.18  expenditures for administering the requirements of this 
566.19  chapter.  The penalty fee for late submission of a renewal 
566.20  application is $200.  The fee for verification of certification 
566.21  to other jurisdictions or entities is $25.  All fees, penalties, 
566.22  and fines received must be deposited in the state government 
566.23  special revenue fund.  The commissioner may prorate the 
566.24  certification fee for new applicants based on the number of 
566.25  quarters remaining in the annual certification period. 
566.26     Sec. 30.  Minnesota Statutes 2002, section 179A.03, 
566.27  subdivision 7, is amended to read: 
566.28     Subd. 7.  [ESSENTIAL EMPLOYEE.] "Essential employee" means 
566.29  firefighters, peace officers subject to licensure under sections 
566.30  626.84 to 626.863, 911 system and police and fire department 
566.31  public safety dispatchers, guards at correctional facilities, 
566.32  confidential employees, supervisory employees, assistant county 
566.33  attorneys, assistant city attorneys, principals, and assistant 
566.34  principals.  However, for state employees, "essential employee" 
566.35  means all employees in law enforcement, health care 
566.36  professionals, health care nonprofessionals, correctional 
567.1   guards, professional engineering, and supervisory collective 
567.2   bargaining units, irrespective of severance, and no other 
567.3   employees.  For University of Minnesota employees, "essential 
567.4   employee" means all employees in law enforcement, nursing 
567.5   professional and supervisory units, irrespective of severance, 
567.6   and no other employees.  "Firefighters" means salaried employees 
567.7   of a fire department whose duties include, directly or 
567.8   indirectly, controlling, extinguishing, preventing, detecting, 
567.9   or investigating fires.  Employees for whom the state court 
567.10  administrator is the negotiating employer are not essential 
567.11  employees. 
567.12     Sec. 31.  Minnesota Statutes 2002, section 295.55, 
567.13  subdivision 2, is amended to read: 
567.14     Subd. 2.  [ESTIMATED TAX; HOSPITALS; SURGICAL CENTERS.] (a) 
567.15  Each hospital or surgical center must make estimated payments of 
567.16  the taxes for the calendar year in monthly installments to the 
567.17  commissioner within 15 days after the end of the month. 
567.18     (b) Estimated tax payments are not required of hospitals or 
567.19  surgical centers if:  (1) the tax for the current calendar year 
567.20  is less than $500; or (2) the tax for the previous calendar year 
567.21  is less than $500, if the taxpayer had a tax liability and was 
567.22  doing business the entire year; or (3) if a hospital has been 
567.23  allowed a grant under section 144.1484, subdivision 2, for the 
567.24  year. 
567.25     (c) Underpayment of estimated installments bear interest at 
567.26  the rate specified in section 270.75, from the due date of the 
567.27  payment until paid or until the due date of the annual return 
567.28  whichever comes first.  An underpayment of an estimated 
567.29  installment is the difference between the amount paid and the 
567.30  lesser of (1) 90 percent of one-twelfth of the tax for the 
567.31  calendar year or (2) one-twelfth of the total tax for the 
567.32  previous calendar year if the taxpayer had a tax liability and 
567.33  was doing business the entire year. 
567.34     Sec. 32.  Minnesota Statutes 2002, section 326.42, is 
567.35  amended to read: 
567.36     326.42 [APPLICATIONS, FEES.] 
568.1      Subdivision 1.  [APPLICATION.] Applications for plumber's 
568.2   license shall be made to the state commissioner of health, with 
568.3   fee.  Unless the applicant is entitled to a renewal, the 
568.4   applicant shall be licensed by the state commissioner of health 
568.5   only after passing a satisfactory examination by the examiners 
568.6   showing fitness.  Examination fees for both journeyman and 
568.7   master plumbers shall be in an amount prescribed by the state 
568.8   commissioner of health pursuant to section 144.122.  Upon being 
568.9   notified that of having successfully passed the examination for 
568.10  original license the applicant shall submit an application, with 
568.11  the license fee herein provided.  License fees shall be in an 
568.12  amount prescribed by the state commissioner of health pursuant 
568.13  to section 144.122.  Licenses shall expire and be renewed as 
568.14  prescribed by the commissioner pursuant to section 144.122. 
568.15     Subd. 2.  [FEES.] Plumbing system plans and specifications 
568.16  that are submitted to the commissioner for review shall be 
568.17  accompanied by the appropriate plan examination fees.  If the 
568.18  commissioner determines, upon review of the plans, that 
568.19  inadequate fees were paid, the necessary additional fees shall 
568.20  be paid prior to plan approval.  The commissioner shall charge 
568.21  the following fees for plan reviews and audits of plumbing 
568.22  installations for public, commercial, and industrial buildings:  
568.23     (1) systems with both water distribution and drain, waste, 
568.24  and vent systems and having:  
568.25     (i) 25 or fewer drainage fixture units, $150; 
568.26     (ii) 26 to 50 drainage fixture units, $250; 
568.27     (iii) 51 to 150 drainage fixture units, $350; 
568.28     (iv) 151 to 249 drainage fixture units, $500; 
568.29     (v) 250 or more drainage fixture units, $3 per drainage 
568.30  fixture unit to a maximum of $4,000; and 
568.31     (vi) interceptors, separators, or catch basins, $70 per 
568.32  interceptor, separator, or catch basin; 
568.33     (2) building sewer service only, $150; 
568.34     (3) building water service only, $150; 
568.35     (4) building water distribution system only, no drainage 
568.36  system, $5 per supply fixture unit or $150, whichever is 
569.1   greater; 
569.2      (5) storm drainage system, a minimum fee of $150 or: 
569.3      (i) $50 per drain opening, up to a maximum of $500; and 
569.4      (ii) $70 per interceptor, separator, or catch basin; 
569.5      (6) manufactured home park or campground, 1 to 25 sites, 
569.6   $300; 
569.7      (7) manufactured home park or campground, 26 to 50 sites, 
569.8   $350; 
569.9      (8) manufactured home park or campground, 51 to 125 sites, 
569.10  $400; 
569.11     (9) manufactured home park or campground, more than 125 
569.12  sites, $500; 
569.13     (10) accelerated review, double the regular fee, one-half 
569.14  to be refunded if no response from the commissioner within 15 
569.15  business days; and 
569.16     (11) revision to previously reviewed or incomplete plans: 
569.17     (i) review of plans for which commissioner has issued two 
569.18  or more requests for additional information, per review, $100 or 
569.19  ten percent of the original fee, whichever is greater; 
569.20     (ii) proposer-requested revision with no increase in 
569.21  project scope, $50 or ten percent of original fee, whichever is 
569.22  greater; and 
569.23     (iii) proposer-requested revision with an increase in 
569.24  project scope, $50 plus the difference between the original 
569.25  project fee and the revised project fee. 
569.26     Sec. 33.  [AUTHORITY TO COLLECT CERTAIN FEES SUSPENDED.] 
569.27     (a) The commissioner's authority to collect the certificate 
569.28  application fee from hearing instrument dispensers under 
569.29  Minnesota Statutes, section 153A.17, is suspended for certified 
569.30  hearing instrument dispensers renewing certification in fiscal 
569.31  year 2004. 
569.32     (b) The commissioner's authority to collect the license 
569.33  renewal fee from occupational therapy practitioners under 
569.34  Minnesota Statutes, section 148.6445, subdivision 2, is 
569.35  suspended for fiscal years 2004 and 2005. 
569.36     Sec. 34.  [TRANSITION PERIOD.] 
570.1      From July 1, 2003, through June 30, 2005, facilities are 
570.2   required to report any adverse health care events as defined in 
570.3   Minnesota Statutes, section 144.7067, to the incident reporting 
570.4   system currently maintained by the Minnesota Hospital 
570.5   Association.  The commissioner of health will work with the 
570.6   Minnesota Hospital Association to obtain access to, or receive 
570.7   reports of, adverse health care events by category only.  The 
570.8   commissioner will not receive any identifying information from 
570.9   such access or reports.  The commissioner will work with 
570.10  organizations and experts familiar with patient safety to review 
570.11  reporting categories in Minnesota Statutes, section 144.7067, 
570.12  and will monitor discussions of the National Quality Forum, 
570.13  other states and the federal government in the area of patient 
570.14  safety.  The commissioner of health will submit reports to the 
570.15  legislature by January 15, 2004, and January 15, 2005, including 
570.16  a listing of the number of reported events by type and 
570.17  recommendations, if any, of additional categories of events that 
570.18  should be included.  From July 1, 2003, through June 30, 2005, 
570.19  the department of health shall not make a final disposition as 
570.20  defined in Minnesota Statutes, section 626.5572, subdivision 8, 
570.21  for investigations conducted in licensed hospitals under the 
570.22  provisions of Minnesota Statutes, section 626.557.  The 
570.23  department of health's findings in these cases shall identify 
570.24  noncompliance with federal certification or state licensure 
570.25  rules or laws.  From July 1, 2003, through June 30, 2005, the 
570.26  commissioner will solicit funds to provide for full 
570.27  implementation of the Minnesota Adverse Health Care Reporting 
570.28  Act of 2003 on a pilot or demonstration basis.  If funds are 
570.29  available, the commissioner will advise the legislature and 
570.30  recommend full implementation of the Act on an earlier date.  
570.31     <b>[EFFECTIVE DATE.]</b> This section is effective to the extent 
570.32  independent funds are obtained. 
570.33     Sec. 35.  [HOSPITAL MORATORIUM STUDY.] 
570.34     (a) Utilizing existing resources, the commissioner of 
570.35  health, working with the Minnesota Hospital Association and 
570.36  other affected parties, shall study and report to the 
571.1   legislature by January 1, 2005, on the moratorium on hospital 
571.2   beds.  The study and report shall: 
571.3      (1) evaluate the moratorium's impact on access, cost, and 
571.4   quality of care; 
571.5      (2) recommend appropriate criteria to be considered by the 
571.6   legislature in judging applications for moratorium exceptions; 
571.7      (3) assess the impact of "niche" and ambulatory services on 
571.8   a system of controlling capacity; 
571.9      (4) identify demographic and health care delivery changes 
571.10  that have occurred since the inception of the moratorium, 
571.11  projected future trends in technology, and their impact on 
571.12  future inpatient hospitals' utilization and future demand for 
571.13  inpatient services; and 
571.14     (5) include a comprehensive national survey of inpatient 
571.15  and outpatient capacity controls. 
571.16     (b) As an outcome of the study, the commissioner shall 
571.17  recommend: 
571.18     (1) criteria for judging exception requests; 
571.19     (2) processes to be used in considering exception requests; 
571.20  and 
571.21     (3) other changes in the moratorium law needed to work with 
571.22  future trends and demographic changes. 
571.23     (c) A progress report shall be presented to the legislature 
571.24  by March 15, 2004. 
571.25     Sec. 36.  [REVISOR'S INSTRUCTION.] 
571.26     (a) The revisor of statutes shall delete the reference to 
571.27  "144.1495" in Minnesota Statutes, section 62Q.145, and insert 
571.28  "144.1501." 
571.29     (b) For sections in Minnesota Statutes and Minnesota Rules 
571.30  affected by the repealed sections in this article, the revisor 
571.31  shall delete internal cross-references where appropriate and 
571.32  make changes necessary to correct the punctuation, grammar, or 
571.33  structure of the remaining text and preserve its meaning. 
571.34     Sec. 37.  [REPEALER; EXPENDITURE REPORTING.] 
571.35     Minnesota Statutes 2002, sections 16A.151, subdivision 5, 
571.36  and 62J.17, are repealed effective the day following final 
572.1   enactment.  Notwithstanding the repeal of section 62J.17, any 
572.2   prospective review imposed on a provider for violation of 
572.3   section 62J.17 shall continue until its scheduled expiration. 
572.4      Sec. 38.  [REPEALER.] 
572.5      (a) Minnesota Statutes 2002, sections 16A.87; 62J.694; 
572.6   144.126; 144.1484; 144.1494; 144.1495; 144.1496; 144.1497; 
572.7   144.395; 144.396; 144A.36; 144A.38; 148.5194, subdivision 3a; 
572.8   and 148.6445, subdivision 9, are repealed.  
572.9      (b) Minnesota Rules, parts 4763.0100; 4763.0110; 4763.0125; 
572.10  4763.0135; 4763.0140; 4763.0150; 4763.0160; 4763.0170; 
572.11  4763.0180; 4763.0190; 4763.0205; 4763.0215; 4763.0220; 
572.12  4763.0230; 4763.0240; 4763.0250; 4763.0260; 4763.0270; 
572.13  4763.0285; 4763.0295; and 4763.0300, are repealed. 
572.14                             ARTICLE 9 
572.15                     LOCAL PUBLIC HEALTH GRANTS
572.16     Section 1.  Minnesota Statutes 2002, section 144E.11, 
572.17  subdivision 6, is amended to read: 
572.18     Subd. 6.  [REVIEW CRITERIA.] When reviewing an application 
572.19  for licensure, the board and administrative law judge shall 
572.20  consider the following factors: 
572.21     (1) the relationship of the proposed service or expansion 
572.22  in primary service area to the current community health plan as 
572.23  approved by the commissioner of health under section 145A.12, 
572.24  subdivision 4; 
572.25     (2) the recommendations or comments of the governing bodies 
572.26  of the counties, municipalities, community health boards as 
572.27  defined under section 145A.09, subdivision 2, and regional 
572.28  emergency medical services system designated under section 
572.29  144E.50 in which the service would be provided; 
572.30     (3) (2) the deleterious effects on the public health from 
572.31  duplication, if any, of ambulance services that would result 
572.32  from granting the license; 
572.33     (4) (3) the estimated effect of the proposed service or 
572.34  expansion in primary service area on the public health; and 
572.35     (5) (4) whether any benefit accruing to the public health 
572.36  would outweigh the costs associated with the proposed service or 
573.1   expansion in primary service area.  The administrative law judge 
573.2   shall recommend that the board either grant or deny a license or 
573.3   recommend that a modified license be granted.  The reasons for 
573.4   the recommendation shall be set forth in detail.  The 
573.5   administrative law judge shall make the recommendations and 
573.6   reasons available to any individual requesting them.  
573.7      Sec. 2.  Minnesota Statutes 2002, section 145.88, is 
573.8   amended to read: 
573.9      145.88 [PURPOSE.] 
573.10     The legislature finds that it is in the public interest to 
573.11  assure:  
573.12     (a) statewide planning and coordination of maternal and 
573.13  child health services through the acquisition and analysis of 
573.14  population-based health data, provision of technical support and 
573.15  training, and coordination of the various public and private 
573.16  maternal and child health efforts; and 
573.17     (b) support for targeted maternal and child health services 
573.18  in communities with significant populations of high risk, low 
573.19  income families through a grants process.  
573.20     Federal money received by the Minnesota department of 
573.21  health, pursuant to United States Code, title 42, sections 701 
573.22  to 709, shall be expended to:  
573.23     (1) assure access to quality maternal and child health 
573.24  services for mothers and children, especially those of low 
573.25  income and with limited availability to health services and 
573.26  those children at risk of physical, neurological, emotional, and 
573.27  developmental problems arising from chemical abuse by a mother 
573.28  during pregnancy; 
573.29     (2) reduce infant mortality and the incidence of 
573.30  preventable diseases and handicapping conditions among children; 
573.31     (3) reduce the need for inpatient and long-term care 
573.32  services and to otherwise promote the health of mothers and 
573.33  children, especially by providing preventive and primary care 
573.34  services for low-income mothers and children and prenatal, 
573.35  delivery and postpartum care for low-income mothers; 
573.36     (4) provide rehabilitative services for blind and disabled 
574.1   children under age 16 receiving benefits under title XVI of the 
574.2   Social Security Act; and 
574.3      (5) provide and locate medical, surgical, corrective and 
574.4   other service for children who are crippled or who are suffering 
574.5   from conditions that lead to crippling.  
574.6      Sec. 3.  Minnesota Statutes 2002, section 145.881, 
574.7   subdivision 2, is amended to read: 
574.8      Subd. 2.  [DUTIES.] The advisory task force shall meet on a 
574.9   regular basis to perform the following duties:  
574.10     (a) review and report on the health care needs of mothers 
574.11  and children throughout the state of Minnesota; 
574.12     (b) review and report on the type, frequency and impact of 
574.13  maternal and child health care services provided to mothers and 
574.14  children under existing maternal and child health care programs, 
574.15  including programs administered by the commissioner of health; 
574.16     (c) establish, review, and report to the commissioner a 
574.17  list of program guidelines and criteria which the advisory task 
574.18  force considers essential to providing an effective maternal and 
574.19  child health care program to low income populations and high 
574.20  risk persons and fulfilling the purposes defined in section 
574.21  145.88; 
574.22     (d) review staff recommendations of the department of 
574.23  health regarding maternal and child health grant awards before 
574.24  the awards are made; 
574.25     (e) make recommendations to the commissioner for the use of 
574.26  other federal and state funds available to meet maternal and 
574.27  child health needs; 
574.28     (f) (e) make recommendations to the commissioner of health 
574.29  on priorities for funding the following maternal and child 
574.30  health services:  (1) prenatal, delivery and postpartum care, (2)
574.31  comprehensive health care for children, especially from birth 
574.32  through five years of age, (3) adolescent health services, (4) 
574.33  family planning services, (5) preventive dental care, (6) 
574.34  special services for chronically ill and handicapped children 
574.35  and (7) any other services which promote the health of mothers 
574.36  and children; and 
575.1      (g) make recommendations to the commissioner of health on 
575.2   the process to distribute, award and administer the maternal and 
575.3   child health block grant funds; and 
575.4      (h) review the measures that are used to define the 
575.5   variables of the funding distribution formula in section 
575.6   145.882, subdivision 4, every two years and make recommendations 
575.7   to the commissioner of health for changes based upon principles 
575.8   established by the advisory task force for this purpose.  
575.9      (f) establish, in consultation with the commissioner and 
575.10  the state community health advisory committee established under 
575.11  section 145A.10, subdivision 10, paragraph (a), statewide 
575.12  outcomes that will improve the health status of mothers and 
575.13  children as required in section 145A.12, subdivision 7. 
575.14     Sec. 4.  Minnesota Statutes 2002, section 145.882, 
575.15  subdivision 1, is amended to read: 
575.16     Subdivision 1.  [FUNDING LEVELS AND ADVISORY TASK FORCE 
575.17  REVIEW.] Any decrease in the amount of federal funding to the 
575.18  state for the maternal and child health block grant must be 
575.19  apportioned to reflect a proportional decrease for each 
575.20  recipient.  Any increase in the amount of federal funding to the 
575.21  state must be distributed under subdivisions 2, and 3, and 4. 
575.22     The advisory task force shall review and recommend the 
575.23  proportion of maternal and child health block grant funds to be 
575.24  expended for indirect costs, direct services and special 
575.25  projects.  
575.26     Sec. 5.  Minnesota Statutes 2002, section 145.882, 
575.27  subdivision 2, is amended to read: 
575.28     Subd. 2.  [ALLOCATION TO THE COMMISSIONER OF HEALTH.] 
575.29  Beginning January 1, 1986, up to one-third of the total maternal 
575.30  and child health block grant money may be retained by the 
575.31  commissioner of health for administrative and technical 
575.32  assistance services, projects of regional or statewide 
575.33  significance, direct services to children with handicaps, and 
575.34  other activities of the commissioner. to: 
575.35     (1) meet federal maternal and child block grant 
575.36  requirements of a statewide needs assessment every five years 
576.1   and prepare the annual federal block grant application and 
576.2   report; 
576.3      (2) collect and disseminate statewide data on the health 
576.4   status of mothers and children within one year of the end of the 
576.5   year; 
576.6      (3) provide technical assistance to community health boards 
576.7   in meeting statewide outcomes under section 145A.12, subdivision 
576.8   7; 
576.9      (4) evaluate the impact of maternal and child health 
576.10  activities on the health status of mothers and children; 
576.11     (5) provide services to children under age 16 receiving 
576.12  benefits under title XVI of the Social Security Act; and 
576.13     (6) perform other maternal and child health activities 
576.14  listed in section 145.88 and as deemed necessary by the 
576.15  commissioner. 
576.16     Sec. 6.  Minnesota Statutes 2002, section 145.882, 
576.17  subdivision 3, is amended to read: 
576.18     Subd. 3.  [ALLOCATION TO COMMUNITY HEALTH SERVICES 
576.19  AREAS BOARDS.] (a) The maternal and child health block grant 
576.20  money remaining after distributions made under subdivision 2 
576.21  must be allocated according to the formula in subdivision 4 to 
576.22  community health services areas section 145A.131, subdivision 2, 
576.23  for distribution by to community health boards. as defined in 
576.24  section 145A.02, subdivision 5, to qualified programs that 
576.25  provide essential services within the community health services 
576.26  area as long as:  
576.27     (1) the Minneapolis community health service area is 
576.28  allocated at least $1,626,215 per year; 
576.29     (2) the St. Paul community health service area is allocated 
576.30  at least $822,931 per year; and 
576.31     (3) all other community health service areas are allocated 
576.32  at least $30,000 per county per year or their 1988-1989 funding 
576.33  cycle award, whichever is less. 
576.34     (b) Notwithstanding paragraph (a), if the total amount of 
576.35  maternal and child health block grant funding decreases, the 
576.36  decrease must be apportioned to reflect a proportional decrease 
577.1   for each recipient, including recipients who would otherwise 
577.2   receive a guaranteed minimum allocation under paragraph (a). 
577.3      Sec. 7.  Minnesota Statutes 2002, section 145.882, is 
577.4   amended by adding a subdivision to read:  
577.5      Subd. 5a.  [NONPARTICIPATING COMMUNITY HEALTH BOARDS.] If a 
577.6   community health board decides not to participate in maternal 
577.7   and child health block grant activities under subdivision 3 or 
577.8   the commissioner determines under section 145A.131, subdivision 
577.9   7, not to fund the community health board, the commissioner is 
577.10  responsible for directing maternal and child health block grant 
577.11  activities in that community health board's geographic area.  
577.12  The commissioner may elect to directly provide public health 
577.13  activities to meet the statewide outcomes or to contract with 
577.14  other governmental units or nonprofit organizations. 
577.15     Sec. 8.  Minnesota Statutes 2002, section 145.882, 
577.16  subdivision 7, is amended to read: 
577.17     Subd. 7.  [USE OF BLOCK GRANT MONEY.] (a) Maternal and 
577.18  child health block grant money allocated to a community health 
577.19  board or community health services area under this section must 
577.20  be used for qualified programs for high risk and low-income 
577.21  individuals.  Block grant money must be used for programs that: 
577.22     (1) specifically address the highest risk populations, 
577.23  particularly low-income and minority groups with a high rate of 
577.24  infant mortality and children with low birth weight, by 
577.25  providing services, including prepregnancy family planning 
577.26  services, calculated to produce measurable decreases in infant 
577.27  mortality rates, instances of children with low birth weight, 
577.28  and medical complications associated with pregnancy and 
577.29  childbirth, including infant mortality, low birth rates, and 
577.30  medical complications arising from chemical abuse by a mother 
577.31  during pregnancy; 
577.32     (2) specifically target pregnant women whose age, medical 
577.33  condition, maternal history, or chemical abuse substantially 
577.34  increases the likelihood of complications associated with 
577.35  pregnancy and childbirth or the birth of a child with an 
577.36  illness, disability, or special medical needs; 
578.1      (3) specifically address the health needs of young children 
578.2   who have or are likely to have a chronic disease or disability 
578.3   or special medical needs, including physical, neurological, 
578.4   emotional, and developmental problems that arise from chemical 
578.5   abuse by a mother during pregnancy; 
578.6      (4) provide family planning and preventive medical care for 
578.7   specifically identified target populations, such as minority and 
578.8   low-income teenagers, in a manner calculated to decrease the 
578.9   occurrence of inappropriate pregnancy and minimize the risk of 
578.10  complications associated with pregnancy and childbirth; or 
578.11     (5) specifically address the frequency and severity of 
578.12  childhood and adolescent health issues, including injuries in 
578.13  high risk target populations by providing services calculated to 
578.14  produce measurable decreases in mortality and morbidity.; 
578.15  However, money may be used for this purpose only if the 
578.16  community health board's application includes program components 
578.17  for the purposes in clauses (1) to (4) in the proposed 
578.18  geographic service area and the total expenditure for 
578.19  injury-related programs under this clause does not exceed ten 
578.20  percent of the total allocation under subdivision 3. 
578.21     (b) Maternal and child health block grant money may be used 
578.22  for purposes other than the purposes listed in this subdivision 
578.23  only under the following conditions:  
578.24     (1) the community health board or community health services 
578.25  area can demonstrate that existing programs fully address the 
578.26  needs of the highest risk target populations described in this 
578.27  subdivision; or 
578.28     (2) the money is used to continue projects that received 
578.29  funding before creation of the maternal and child health block 
578.30  grant in 1981. 
578.31     (c) Projects that received funding before creation of the 
578.32  maternal and child health block grant in 1981, must be allocated 
578.33  at least the amount of maternal and child health special project 
578.34  grant funds received in 1989, unless (1) the local board of 
578.35  health provides equivalent alternative funding for the project 
578.36  from another source; or (2) the local board of health 
579.1   demonstrates that the need for the specific services provided by 
579.2   the project has significantly decreased as a result of changes 
579.3   in the demographic characteristics of the population, or other 
579.4   factors that have a major impact on the demand for services.  If 
579.5   the amount of federal funding to the state for the maternal and 
579.6   child health block grant is decreased, these projects must 
579.7   receive a proportional decrease as required in subdivision 1.  
579.8   Increases in allocation amounts to local boards of health under 
579.9   subdivision 4 may be used to increase funding levels for these 
579.10  projects. 
579.11     (6) specifically address preventing child abuse and 
579.12  neglect, reducing juvenile delinquency, promoting positive 
579.13  parenting and resiliency in children, and promoting family 
579.14  health and economic sufficiency through public health nurse home 
579.15  visits under section 145A.17; or 
579.16     (7) specifically address nutritional issues of women, 
579.17  infants, and young children through WIC clinic services. 
579.18     Sec. 9.  [145.8821] [ACCOUNTABILITY.] 
579.19     (a) Coordinating with the statewide outcomes established 
579.20  under section 145A.12, subdivision 7, and with accountability 
579.21  measures outlined in section 145A.131, subdivision 7, each 
579.22  community health board that receives money under section 
579.23  145.882, subdivision 3, shall select by February 1, 2005, and 
579.24  every five years thereafter, up to two statewide maternal and 
579.25  child health outcomes. 
579.26     (b) For the period January 1, 2004, to December 31, 2005, 
579.27  each community health board must work toward the Healthy People 
579.28  2010 goal to reduce the state's percentage of low birth weight 
579.29  infants.  
579.30     (c) The commissioner shall monitor and evaluate whether 
579.31  each community health board has made sufficient progress toward 
579.32  the selected outcomes established in paragraph (b) and under 
579.33  section 145A.12, subdivision 7. 
579.34     (d) Community health boards shall provide the commissioner 
579.35  with annual information necessary to evaluate progress toward 
579.36  selected statewide outcomes and to meet federal reporting 
580.1   requirements. 
580.2      Sec. 10.  Minnesota Statutes 2002, section 145.883, 
580.3   subdivision 1, is amended to read: 
580.4      Subdivision 1.  [SCOPE.] For purposes of sections 145.881 
580.5   to 145.888 145.883, the terms defined in this section shall have 
580.6   the meanings given them.  
580.7      Sec. 11.  Minnesota Statutes 2002, section 145.883, 
580.8   subdivision 9, is amended to read: 
580.9      Subd. 9.  [COMMUNITY HEALTH SERVICES AREA BOARD.] 
580.10  "Community health services area board" means a city, county, or 
580.11  multicounty area that is organized as a community health board 
580.12  under section 145A.09 and for which a state subsidy is received 
580.13  under sections 145A.09 to 145A.13 a board of health established, 
580.14  operating, and eligible for a local public health grant under 
580.15  sections 145A.09 to 145A.131. 
580.16     Sec. 12.  Minnesota Statutes 2002, section 145A.02, 
580.17  subdivision 5, is amended to read: 
580.18     Subd. 5.  [COMMUNITY HEALTH BOARD.] "Community health 
580.19  board" means a board of health established, operating, and 
580.20  eligible for a subsidy local public health grant under sections 
580.21  145A.09 to 145A.13 145A.131. 
580.22     Sec. 13.  Minnesota Statutes 2002, section 145A.02, 
580.23  subdivision 6, is amended to read: 
580.24     Subd. 6.  [COMMUNITY HEALTH SERVICES.] "Community health 
580.25  services" means activities designed to protect and promote the 
580.26  health of the general population within a community health 
580.27  service area by emphasizing the prevention of disease, injury, 
580.28  disability, and preventable death through the promotion of 
580.29  effective coordination and use of community resources, and by 
580.30  extending health services into the community.  Program 
580.31  categories of community health services include disease 
580.32  prevention and control, emergency medical care, environmental 
580.33  health, family health, health promotion, and home health care. 
580.34     Sec. 14.  Minnesota Statutes 2002, section 145A.02, 
580.35  subdivision 7, is amended to read: 
580.36     Subd. 7.  [COMMUNITY HEALTH SERVICE AREA.] "Community 
581.1   health service area" means a city, county, or multicounty area 
581.2   that is organized as a community health board under section 
581.3   145A.09 and for which a subsidy local public health grant is 
581.4   received under sections 145A.09 to 145A.13 145A.131. 
581.5      Sec. 15.  Minnesota Statutes 2002, section 145A.06, 
581.6   subdivision 1, is amended to read: 
581.7      Subdivision 1.  [GENERALLY.] In addition to other powers 
581.8   and duties provided by law, the commissioner has the powers 
581.9   listed in subdivisions 2 to 4 5. 
581.10     Sec. 16.  Minnesota Statutes 2002, section 145A.09, 
581.11  subdivision 2, is amended to read: 
581.12     Subd. 2.  [COMMUNITY HEALTH BOARD; ELIGIBILITY.] A board of 
581.13  health that meets the requirements of sections 145A.09 
581.14  to 145A.13 145A.131 is a community health board and is eligible 
581.15  for a community health subsidy local public health grant under 
581.16  section 145A.13 145A.131. 
581.17     Sec. 17.  Minnesota Statutes 2002, section 145A.09, 
581.18  subdivision 4, is amended to read: 
581.19     Subd. 4.  [CITIES.] A city that received a subsidy under 
581.20  section 145A.13 and that meets the requirements of sections 
581.21  145A.09 to 145A.13 145A.131 is eligible for a community health 
581.22  subsidy local public health grant under section 
581.23  145A.13 145A.131. 
581.24     Sec. 18.  Minnesota Statutes 2002, section 145A.09, 
581.25  subdivision 7, is amended to read: 
581.26     Subd. 7.  [WITHDRAWAL.] (a) A county or city that has 
581.27  established or joined a community health board may withdraw from 
581.28  the subsidy local public health grant program authorized by 
581.29  sections 145A.09 to 145A.13 145A.131 by resolution of its 
581.30  governing body in accordance with section 145A.03, subdivision 
581.31  3, and this subdivision. 
581.32     (b) A county or city may not withdraw from a joint powers 
581.33  community health board during the first two calendar years 
581.34  following that county's or city's initial adoption of the joint 
581.35  powers agreement.  
581.36     (c) The withdrawal of a county or city from a community 
582.1   health board does not affect the eligibility for the community 
582.2   health subsidy local public health grant of any remaining county 
582.3   or city for one calendar year following the effective date of 
582.4   withdrawal. 
582.5      (d) The amount of additional annual payment for calendar 
582.6   year 1985 made pursuant to Minnesota Statutes 1984, section 
582.7   145.921, subdivision 4, must be subtracted from the subsidy for 
582.8   a county that, due to withdrawal from a community health board, 
582.9   ceases to meet the terms and conditions under which that 
582.10  additional annual payment was made The local public health grant 
582.11  for a county that chooses to withdraw from a multicounty 
582.12  community health board shall be reduced by the amount of the 
582.13  local partnership incentive under section 145A.131, subdivision 
582.14  2, paragraph (c). 
582.15     Sec. 19.  Minnesota Statutes 2002, section 145A.10, 
582.16  subdivision 2, is amended to read: 
582.17     Subd. 2.  [PREEMPTION.] (a) Not later than 365 days after 
582.18  the approval of a community health plan by the 
582.19  commissioner formation of a community health board, any other 
582.20  board of health within the community health service area for 
582.21  which the plan has been prepared must cease operation, except as 
582.22  authorized in a joint powers agreement under section 145A.03, 
582.23  subdivision 2, or delegation agreement under section 145A.07, 
582.24  subdivision 2, or as otherwise allowed by this subdivision. 
582.25     (b) This subdivision does not preempt or otherwise change 
582.26  the powers and duties of any city or county eligible for subsidy 
582.27  a local public health grant under section 145A.09. 
582.28     (c) This subdivision does not preempt the authority to 
582.29  operate a community health services program of any city of the 
582.30  first or second class operating an existing program of community 
582.31  health services located within a county with a population of 
582.32  300,000 or more persons until the city council takes action to 
582.33  allow the county to preempt the city's powers and duties. 
582.34     Sec. 20.  Minnesota Statutes 2002, section 145A.10, is 
582.35  amended by adding a subdivision to read: 
582.36     Subd. 5a.  [DUTIES.] (a) Consistent with the guidelines and 
583.1   standards established under section 145A.12, and with input from 
583.2   the community, the community health board shall: 
583.3      (1) establish local public health priorities based on an 
583.4   assessment of community health needs and assets; and 
583.5      (2) determine the mechanisms by which the community health 
583.6   board will address the local public health priorities 
583.7   established under clause (1) and achieve the statewide outcomes 
583.8   established under sections 145.8821 and 145A.12, subdivision 7, 
583.9   within the limits of available funding.  In determining the 
583.10  mechanisms to address local public health priorities and achieve 
583.11  statewide outcomes, the community health board shall seek public 
583.12  input or consider the recommendations of the community health 
583.13  advisory committee and the following essential public health 
583.14  services: 
583.15     (i) monitor health status to identify community health 
583.16  problems; 
583.17     (ii) diagnose and investigate problems and health hazards 
583.18  in the community; 
583.19     (iii) inform, educate, and empower people about health 
583.20  issues; 
583.21     (iv) mobilize community partnerships to identify and solve 
583.22  health problems; 
583.23     (v) develop policies and plans that support individual and 
583.24  community health efforts; 
583.25     (vi) enforce laws and regulations that protect health and 
583.26  ensure safety; 
583.27     (vii) link people to needed personal health care services; 
583.28     (viii) ensure a competent public health and personal health 
583.29  care workforce; 
583.30     (ix) evaluate effectiveness, accessibility, and quality of 
583.31  personal and population-based health services; and 
583.32     (x) research for new insights and innovative solutions to 
583.33  health problems. 
583.34     (b) By February 1, 2005, and every five years thereafter, 
583.35  each community health board that receives a local public health 
583.36  grant under section 145A.131 shall notify the commissioner in 
584.1   writing of the statewide outcomes established under sections 
584.2   145.8821 and 145A.12, subdivision 7, that the board will address 
584.3   and the local priorities established under paragraph (a) that 
584.4   the board will address. 
584.5      (c) Each community health board receiving a local public 
584.6   health grant under section 145A.131 must submit an annual report 
584.7   to the commissioner documenting progress towards the achievement 
584.8   of statewide outcomes established under sections 145.8821 and 
584.9   145A.12, subdivision 7, and the local public health priorities 
584.10  established under paragraph (a), using reporting standards and 
584.11  procedures established by the commissioner and in compliance 
584.12  with all applicable federal requirements.  If a community health 
584.13  board has identified additional local priorities for use of the 
584.14  local public health grant since the last notification of 
584.15  outcomes and priorities under paragraph (b), the community 
584.16  health board shall notify the commissioner of the additional 
584.17  local public health priorities in the annual report. 
584.18     Sec. 21.  Minnesota Statutes 2002, section 145A.10, 
584.19  subdivision 10, is amended to read: 
584.20     Subd. 10.  [STATE AND LOCAL ADVISORY COMMITTEES.] (a) A 
584.21  state community health advisory committee is established to 
584.22  advise, consult with, and make recommendations to the 
584.23  commissioner on the development, maintenance, funding, and 
584.24  evaluation of community health services.  Each community health 
584.25  board may appoint a member to serve on the committee.  The 
584.26  committee must meet at least quarterly, and special meetings may 
584.27  be called by the committee chair or a majority of the members.  
584.28  Members or their alternates may receive a per diem and must be 
584.29  reimbursed for travel and other necessary expenses while engaged 
584.30  in their official duties.  
584.31     (b) The city councils or county boards that have 
584.32  established or are members of a community health board must may 
584.33  appoint a community health advisory committee to advise, consult 
584.34  with, and make recommendations to the community health board on 
584.35  matters relating to the development, maintenance, funding, and 
584.36  evaluation of community health services.  The committee must 
585.1   consist of at least five members and must be generally 
585.2   representative of the population and health care providers of 
585.3   the community health service area.  The committee must meet at 
585.4   least three times a year and at the call of the chair or a 
585.5   majority of the members.  Members may receive a per diem and 
585.6   reimbursement for travel and other necessary expenses while 
585.7   engaged in their official duties. 
585.8      (c) State and local advisory committees must adopt bylaws 
585.9   or operating procedures that specify the length of terms of 
585.10  membership, procedures for assuring that no more than half of 
585.11  these terms expire during the same year, and other matters 
585.12  relating to the conduct of committee business.  Bylaws or 
585.13  operating procedures may allow one alternate to be appointed for 
585.14  each member of a state or local advisory committee.  Alternates 
585.15  may be given full or partial powers and duties of members the 
585.16  duties under subdivision 5a. 
585.17     Sec. 22.  Minnesota Statutes 2002, section 145A.11, 
585.18  subdivision 2, is amended to read: 
585.19     Subd. 2.  [CONSIDERATION OF COMMUNITY HEALTH PLAN LOCAL 
585.20  PUBLIC HEALTH PRIORITIES AND STATEWIDE OUTCOMES IN TAX LEVY.] In 
585.21  levying taxes authorized under section 145A.08, subdivision 3, a 
585.22  city council or county board that has formed or is a member of a 
585.23  community health board must consider the income and expenditures 
585.24  required to meet the objectives of the community health plan for 
585.25  its area local public health priorities established under 
585.26  section 145A.10, subdivision 5a, and statewide outcomes 
585.27  established under section 145A.12, subdivision 7. 
585.28     Sec. 23.  Minnesota Statutes 2002, section 145A.11, 
585.29  subdivision 4, is amended to read: 
585.30     Subd. 4.  [ORDINANCES RELATING TO COMMUNITY HEALTH 
585.31  SERVICES.] A city council or county board that has established 
585.32  or is a member of a community health board may by ordinance 
585.33  adopt and enforce minimum standards for services provided 
585.34  according to sections 145A.02 and 145A.10, subdivision 5.  An 
585.35  ordinance must not conflict with state law or with more 
585.36  stringent standards established either by rule of an agency of 
586.1   state government or by the provisions of the charter or 
586.2   ordinances of any city organized under section 145A.09, 
586.3   subdivision 4. 
586.4      Sec. 24.  Minnesota Statutes 2002, section 145A.12, 
586.5   subdivision 1, is amended to read: 
586.6      Subdivision 1.  [ADMINISTRATIVE AND PROGRAM SUPPORT.] The 
586.7   commissioner must assist community health boards in the 
586.8   development, administration, and implementation of community 
586.9   health services.  This assistance may consist of but is not 
586.10  limited to: 
586.11     (1) informational resources, consultation, and training to 
586.12  help community health boards plan, develop, integrate, provide 
586.13  and evaluate community health services; and 
586.14     (2) administrative and program guidelines and standards, 
586.15  developed with the advice of the state community health advisory 
586.16  committee.  Adoption of these guidelines by a community health 
586.17  board is not a prerequisite for plan approval as prescribed in 
586.18  subdivision 4. 
586.19     Sec. 25.  Minnesota Statutes 2002, section 145A.12, 
586.20  subdivision 2, is amended to read: 
586.21     Subd. 2.  [PERSONNEL STANDARDS.] In accordance with chapter 
586.22  14, and in consultation with the state community health advisory 
586.23  committee, the commissioner may adopt rules to set standards for 
586.24  administrative and program personnel to ensure competence in 
586.25  administration and planning and in each program area defined in 
586.26  section 145A.02. 
586.27     Sec. 26.  Minnesota Statutes 2002, section 145A.12, is 
586.28  amended by adding a subdivision to read:  
586.29     Subd. 7.  [STATEWIDE OUTCOMES.] (a) The commissioner, in 
586.30  consultation with the state community health advisory committee 
586.31  established under section 145A.10, subdivision 10, paragraph 
586.32  (a), shall establish statewide outcomes for local public health 
586.33  grant funds allocated to community health boards between January 
586.34  1, 2004, and December 31, 2005. 
586.35     (b) At least one statewide outcome must be established in 
586.36  each of the following public health areas: 
587.1      (1) preventing diseases; 
587.2      (2) protecting against environmental hazards; 
587.3      (3) preventing injuries; 
587.4      (4) promoting healthy behavior; 
587.5      (5) responding to disasters; and 
587.6      (6) ensuring access to health services. 
587.7      (c) The commissioner shall use Minnesota's public health 
587.8   goals established under section 62J.212 and the essential public 
587.9   health services under section 145A.10, subdivision 5a, as a 
587.10  basis for the development of statewide outcomes. 
587.11     (d) The statewide maternal and child health outcomes 
587.12  established under section 145.8821 shall be included as 
587.13  statewide outcomes under this section. 
587.14     (e) By December 31, 2004, and every five years thereafter, 
587.15  the commissioner, in consultation with the state community 
587.16  health advisory committee established under section 145A.10, 
587.17  subdivision 10, paragraph (a), and the maternal and child health 
587.18  advisory task force established under section 145.881, shall 
587.19  develop statewide outcomes for the local public health grant 
587.20  established under section 145A.131, based on state and local 
587.21  assessment data regarding the health of Minnesota residents, the 
587.22  essential public health services under section 145A.10, and 
587.23  current Minnesota public health goals established under section 
587.24  62J.212. 
587.25     Sec. 27.  Minnesota Statutes 2002, section 145A.13, is 
587.26  amended by adding a subdivision to read: 
587.27     Subd. 4.  [EXPIRATION.] This section expires January 1, 
587.28  2004. 
587.29     Sec. 28.  [145A.131] [LOCAL PUBLIC HEALTH GRANT.] 
587.30     Subdivision 1.  [FUNDING FORMULA FOR COMMUNITY HEALTH 
587.31  BOARDS] (a) The state community health advisory committee shall 
587.32  recommend a formula to the commissioner to use in distributing 
587.33  state and federal funds to community health boards organized and 
587.34  operating under sections 145A.09 to 145A.131 to achieve locally 
587.35  identified priorities under section 145A.10, subdivision 5a, and 
587.36  selected statewide outcomes under section 145A.12, subdivision 
588.1   7, by July 1, 2004, for use of distributing funds to community 
588.2   health boards beginning January 1, 2006, and thereafter. 
588.3      (b) This paragraph and paragraph (c) create base funding 
588.4   for the local public health grant formula.  A community health 
588.5   board eligible for a local public health grant under section 
588.6   145A.09, subdivision 2, shall receive no less for any calendar 
588.7   year than 50 percent of the board's 2002-2003 fiscal year 
588.8   allocations, prior to unallotment in fiscal year 2003, of the 
588.9   following awards:  community health services subsidy; maternal 
588.10  and child health special projects grants; and state allocations 
588.11  of women, infants, and children. 
588.12     (c) A community health board eligible for a local public 
588.13  health grant under section 145A.09, subdivision 2, shall receive 
588.14  no less for any calendar year than a combination of 50 percent 
588.15  of the board's 2002-2003 fiscal year award for family home 
588.16  visiting and 50 percent of the board's anticipated 2004-2005 
588.17  fiscal year award for family home visiting. 
588.18     (d) Base funding for a community health board eligible for 
588.19  a local public health grant under section 145A.09, subdivision 
588.20  2, shall be reduced or increased equally among all community 
588.21  health boards. 
588.22     (e) Multicounty community health boards shall receive a 
588.23  local partnership base of up to $15,000 per year for each county 
588.24  included in the community health board.  The multicounty base 
588.25  will be limited in fiscal years 2004 and 2005 so as not to 
588.26  exceed a community health board's allocations as defined in 
588.27  paragraphs (b) and (c). 
588.28     Subd. 2.  [LOCAL MATCH.] (a) A community health board that 
588.29  receives a local public health grant shall provide a 50 percent 
588.30  match for the local public health grant funds described in 
588.31  paragraph (b), subject to paragraphs (b) to (e). 
588.32     (b) Eligible funds must be used to meet match requirements. 
588.33  Eligible funds include funds from local property taxes, 
588.34  reimbursements from third parties, fees, other state funds, and 
588.35  donations or nonfederal grants that are used for community 
588.36  health services described in section 145A.02, subdivision 6. 
589.1      (c) Community health boards must provide documentation that 
589.2   the 50 percent match for funds received under United States 
589.3   Code, title 42, sections 701 to 709, is used for maternal and 
589.4   child health activities as described in section 145.882, 
589.5   subdivision 7. 
589.6      (d) When the amount of local matching funds for a community 
589.7   health board is less than the amount required under paragraph 
589.8   (a), the local public health grant provided for that community 
589.9   health board under this section shall be reduced proportionally. 
589.10     (e) A city organized under the provision of sections 
589.11  145A.09 to 145A.131 that levies a tax for provision of community 
589.12  health services is exempt from any county levy for the same 
589.13  services to the extent of the levy imposed by the city. 
589.14     Subd. 3.  [ADDITIONAL FUNDS.] Additional state or federal 
589.15  funds distributed to community health boards to achieve specific 
589.16  outcomes shall be distributed as part of the local public health 
589.17  grant established in subdivision 1.  Additional outcomes for 
589.18  these funds, if not specified by federal or state law, shall be 
589.19  developed by the commissioner in consultation with the state 
589.20  community health advisory committee established under section 
589.21  145A.10, subdivision 10, and the maternal and child health 
589.22  advisory task force established under section 145.881. 
589.23     Subd. 4.  [SPECIAL PROJECT GRANTS.] Notwithstanding other 
589.24  requirements of this section, the commissioner in consultation 
589.25  with the state community health advisory committee may choose to 
589.26  fund noncompetitive special project grants for projects by 
589.27  select community health boards, according to state or federal 
589.28  law.  These special project grant funds shall be distributed as 
589.29  a part of a community health board's local public health grant 
589.30  established in subdivision 1. 
589.31     Subd. 5.  [RESPONSIBILITY OF COMMISSIONER TO ENSURE A 
589.32  STATEWIDE PUBLIC HEALTH SYSTEM.] If a county withdraws from a 
589.33  community health board and operates as a board of health or if a 
589.34  community health board elects not to accept the local public 
589.35  health grant, the commissioner may retain the amount of funding 
589.36  that would have been allocated to the community health board 
590.1   using the formula described in subdivision 1 and assume 
590.2   responsibility for public health activities to meet the 
590.3   statewide outcomes in the geographic area served by the board of 
590.4   health or community health board.  The commissioner may elect to 
590.5   directly provide public health activities to meet the statewide 
590.6   outcomes or contract with other units of government or with 
590.7   community-based organizations.  If a city that is currently a 
590.8   community health board withdraws from a community health board 
590.9   or elects not to accept the local public health grant, the local 
590.10  public health grant funds that would have been allocated to that 
590.11  city shall be distributed to the county in which the city is 
590.12  located, if the county is part of a community health board.  
590.13     Subd. 6.  [ACCOUNTABILITY.] (a) Community health boards 
590.14  accepting local public health grants must document progress 
590.15  towards the selected statewide outcomes established in section 
590.16  145A.12, subdivision 7, to maintain eligibility to receive the 
590.17  local public health grant. 
590.18     (b) If the commissioner determines that a community health 
590.19  board has not by the applicable deadline documented progress in 
590.20  one or more of the statewide outcomes established under section 
590.21  145.8821 or 145A.12, subdivision 7, then the commissioner may 
590.22  determine not to distribute future funds to the community health 
590.23  board under subdivision 1.  If the commissioner determines not 
590.24  to distribute future funds, the commissioner must give the 
590.25  community health board written notice of this determination.  In 
590.26  determining whether or not to distribute future funds to the 
590.27  community health board, the commissioner shall consider the 
590.28  following factors with respect to the statewide outcomes for 
590.29  which the community health board did not demonstrate sufficient 
590.30  progress: 
590.31     (1) the difficulty of meeting the statewide outcome; 
590.32     (2) the effort put forth by the community health board to 
590.33  meet the statewide outcome; 
590.34     (3) the number of statewide outcomes that the community 
590.35  health board did not meet; 
590.36     (4) whether the community health board has previously 
591.1   failed to meet statewide outcomes under this section; 
591.2      (5) the amount of funding received by the community health 
591.3   board to address the statewide outcomes; and 
591.4      (6) other factors as justice may require, if the 
591.5   commissioner specifically identifies the additional factors in 
591.6   the commissioner's written notice of determination. 
591.7      (c) If a community health board does not document progress 
591.8   towards the selected statewide outcomes, the commissioner may 
591.9   retain local public health grant funds and assume responsibility 
591.10  for directly carrying out activities to meet the statewide 
591.11  outcomes or contract with other units of government or 
591.12  community-based organizations to assume responsibility for the 
591.13  statewide outcomes.  If the community health board that does not 
591.14  document progress towards the selected statewide outcomes is a 
591.15  city, the commissioner shall distribute the local public health 
591.16  grant funds that would have been allocated to that city to the 
591.17  county in which the city is located, if the county is part of a 
591.18  community health board. 
591.19     (d) The commissioner shall establish a reporting system for 
591.20  community health boards to report their progress.  The system 
591.21  shall be developed in consultation with the state community 
591.22  health advisory committee established under section 145A.10, 
591.23  subdivision 10, paragraph (a), and the maternal and child health 
591.24  advisory task force established under section 145.881. 
591.25     Subd. 7.  [LOCAL PUBLIC HEALTH PRIORITIES.] Community 
591.26  health boards may use their local public health grant to address 
591.27  local public health priorities identified under section 145A.10, 
591.28  subdivision 5a. 
591.29     Sec. 29.  Minnesota Statutes 2002, section 145A.14, 
591.30  subdivision 2, is amended to read: 
591.31     Subd. 2.  [INDIAN HEALTH GRANTS.] (a) The commissioner may 
591.32  make special grants to community health boards to establish, 
591.33  operate, or subsidize clinic facilities and services to furnish 
591.34  health services for American Indians who reside off reservations.
591.35     (b) To qualify for a grant under this subdivision the 
591.36  community health plan submitted by the community health board 
592.1   must contain a proposal for the delivery of the services and 
592.2   documentation that representatives of the Indian community 
592.3   affected by the plan were involved in its development. 
592.4      (c) Applicants must submit for approval a plan and budget 
592.5   for the use of the funds in the form and detail specified by the 
592.6   commissioner. 
592.7      (d) (c) Applicants must keep records, including records of 
592.8   expenditures to be audited, as the commissioner specifies. 
592.9      Sec. 30.  Minnesota Statutes 2002, section 145A.14, is 
592.10  amended by adding a subdivision to read: 
592.11     Subd. 2a.  [TRIBAL GOVERNMENTS.] (a) Of the funding 
592.12  available for local public health grants, $2,000,000 per year is 
592.13  available to tribal governments for: 
592.14     (1) maternal and child health activities under section 
592.15  145.882, subdivision 7; 
592.16     (2) activities to reduce health disparities under section 
592.17  145.928, subdivision 10; and 
592.18     (3) emergency preparedness. 
592.19     (b) The commissioner, in consultation with tribal 
592.20  governments, shall establish a formula for distributing the 
592.21  funds and developing the outcomes to be measured. 
592.22     Sec. 31.  [REVISOR'S INSTRUCTION.] 
592.23     (a) The revisor of statutes shall delete "145A.13" and 
592.24  insert "145A.131" in Minnesota Statutes, sections 145A.03, 
592.25  subdivision 1; 145A.04, subdivision 4; 145A.10, subdivision 1; 
592.26  256E.03, subdivision 2; 383B.221, subdivision 2; and 402.02, 
592.27  subdivision 2. 
592.28     (b) For sections in Minnesota Statutes and Minnesota Rules 
592.29  affected by the repealed sections in this article, the revisor 
592.30  shall delete internal cross-references where appropriate and 
592.31  make changes necessary to correct the punctuation, grammar, or 
592.32  structure of the remaining text and preserve its meaning. 
592.33     Sec. 32.  [REPEALER.] 
592.34     (a) Minnesota Statutes 2002, sections 144.401; 144.9507, 
592.35  subdivision 3; 145.56, subdivision 2; 145.882, subdivisions 4, 
592.36  5, 6, and 8; 145.883, subdivisions 4 and 7; 145.884; 145.885; 
593.1   145.886; 145.888; 145.889; 145.890; 145.9266, subdivisions 2, 4, 
593.2   5, 6, and 7; 145.928, subdivision 9; 145A.02, subdivisions 9, 
593.3   10, 11, 12, 13, and 14; 145A.09, subdivision 6; 145A.10, 
593.4   subdivisions 5, 6, and 8; 145A.11, subdivision 3; 145A.12, 
593.5   subdivisions 3, 4, and 5; 145A.14, subdivisions 3 and 4; and 
593.6   145A.17, subdivision 2, are repealed. 
593.7      (b) Minnesota Rules, parts 4736.0010; 4736.0020; 4736.0030; 
593.8   4736.0040; 4736.0050; 4736.0060; 4736.0070; 4736.0080; 
593.9   4736.0090; 4736.0120; and 4736.0130, are repealed effective 
593.10  January 1, 2004. 
593.11     (c) Minnesota Rules, parts 4705.0100; 4705.0200; 4705.0300; 
593.12  4705.0400; 4705.0500; 4705.0600; 4705.0700; 4705.0800; 
593.13  4705.0900; 4705.1000; 4705.1100; 4705.1200; 4705.1300; 
593.14  4705.1400; 4705.1500; and 4705.1600, are repealed effective June 
593.15  30, 2004. 
593.16                            ARTICLE  10 
593.17              CHILD CARE AND MISCELLANEOUS PROVISIONS 
593.18     Section 1.  Minnesota Statutes 2002, section 119B.011, 
593.19  subdivision 5, is amended to read: 
593.20     Subd. 5.  [CHILD CARE.] "Child care" means the care of a 
593.21  child by someone other than a parent or, stepparent, legal 
593.22  guardian, eligible relative caregiver, or the spouses of any of 
593.23  the foregoing in or outside the child's own home for gain or 
593.24  otherwise, on a regular basis, for any part of a 24-hour day. 
593.25     Sec. 2.  Minnesota Statutes 2002, section 119B.011, 
593.26  subdivision 6, is amended to read: 
593.27     Subd. 6.  [CHILD CARE FUND.] "Child care fund" means a 
593.28  program under this chapter providing:  
593.29     (1) financial assistance for child care to parents engaged 
593.30  in employment, job search, or education and training leading to 
593.31  employment, or an at-home infant care subsidy; and 
593.32     (2) grants to develop, expand, and improve the access and 
593.33  availability of child care services statewide. 
593.34     Sec. 3.  Minnesota Statutes 2002, section 119B.011, 
593.35  subdivision 15, is amended to read: 
593.36     Subd. 15.  [INCOME.] "Income" means earned or unearned 
594.1   income received by all family members, including public 
594.2   assistance cash benefits and at-home infant care subsidy 
594.3   payments, unless specifically excluded and child support and 
594.4   maintenance distributed to the family under section 256.741, 
594.5   subdivision 15.  The following are excluded from income:  funds 
594.6   used to pay for health insurance premiums for family members, 
594.7   Supplemental Security Income, scholarships, work-study income, 
594.8   and grants that cover costs or reimbursement for tuition, fees, 
594.9   books, and educational supplies; student loans for tuition, 
594.10  fees, books, supplies, and living expenses; state and federal 
594.11  earned income tax credits; assistance specifically excluded as 
594.12  income by law; in-kind income such as food stamps, energy 
594.13  assistance, foster care assistance, medical assistance, child 
594.14  care assistance, and housing subsidies; earned income of 
594.15  full-time or part-time students up to the age of 19, who have 
594.16  not earned a high school diploma or GED high school equivalency 
594.17  diploma including earnings from summer employment; grant awards 
594.18  under the family subsidy program; nonrecurring lump sum income 
594.19  only to the extent that it is earmarked and used for the purpose 
594.20  for which it is paid; and any income assigned to the public 
594.21  authority according to section 256.741. 
594.22     Sec. 4.  Minnesota Statutes 2002, section 119B.011, 
594.23  subdivision 19, is amended to read: 
594.24     Subd. 19.  [PROVIDER.] "Provider" means:  (1) an individual 
594.25  or child care center or facility, either licensed or unlicensed, 
594.26  providing legal child care services as defined under section 
594.27  245A.03; or (2) an individual or child care center or facility 
594.28  holding a valid child care license issued by another state or a 
594.29  tribe and providing child care services in the licensing state 
594.30  or in the area under the licensing tribe's jurisdiction.  A 
594.31  legally unlicensed registered family child care provider must be 
594.32  at least 18 years of age, and not a member of the MFIP 
594.33  assistance unit or a member of the family receiving child care 
594.34  assistance to be authorized under this chapter.  
594.35     Sec. 5.  Minnesota Statutes 2002, section 119B.011, is 
594.36  amended by adding a subdivision to read: 
595.1      Subd. 19a.  [REGISTRATION.] "Registration" means the 
595.2   process used by a county to determine whether the provider 
595.3   selected by a family applying for or receiving child care 
595.4   assistance to care for that family's children meets the 
595.5   requirements necessary for payment of child care assistance for 
595.6   care provided by that provider. 
595.7      Sec. 6.  Minnesota Statutes 2002, section 119B.011, 
595.8   subdivision 21, is amended to read: 
595.9      Subd. 21.  [RECOUPMENT OF OVERPAYMENTS.] "Recoupment of 
595.10  overpayments" means the reduction of child care assistance 
595.11  payments to an eligible family or a child care provider in order 
595.12  to correct an overpayment to the family even when the 
595.13  overpayment is due to agency error or other circumstances 
595.14  outside the responsibility or control of the family of child 
595.15  care assistance. 
595.16     Sec. 7.  Minnesota Statutes 2002, section 119B.011, is 
595.17  amended by adding a subdivision to read: 
595.18     Subd. 23.  [FEDERAL POVERTY GUIDELINES.] "Federal poverty 
595.19  guidelines" means the annual poverty guidelines for a family of 
595.20  four, adjusted for family size, published annually by the United 
595.21  States Department of Health and Human Services in the Federal 
595.22  Register. 
595.23     Sec. 8.  Minnesota Statutes 2002, section 119B.011, is 
595.24  amended by adding a subdivision to read: 
595.25     Subd. 24.  [UNSAFE CARE.] "Unsafe care" means any provider 
595.26  or care arrangement that meets any of the criteria listed in 
595.27  sections 119B.125, subdivision 2, 245A.04, subdivisions 3b and 
595.28  3d, or any other conduct or condition determined to be injurious 
595.29  or potentially harmful to a child. 
595.30     Sec. 9.  Minnesota Statutes 2002, section 119B.02, 
595.31  subdivision 1, is amended to read: 
595.32     Subdivision 1.  [CHILD CARE SERVICES.] The commissioner 
595.33  shall develop standards for county and human services boards to 
595.34  provide child care services to enable eligible families to 
595.35  participate in employment, training, or education programs.  
595.36  Within the limits of available appropriations, the commissioner 
596.1   shall distribute money to counties to reduce the costs of child 
596.2   care for eligible families.  The commissioner shall adopt rules 
596.3   to govern the program in accordance with this section.  The 
596.4   rules must establish a sliding schedule of fees for parents 
596.5   receiving child care services.  The rules shall provide that 
596.6   funds received as a lump sum payment of child support arrearages 
596.7   shall not be counted as income to a family in the month received 
596.8   but shall be prorated over the 12 months following receipt and 
596.9   added to the family income during those months.  In the rules 
596.10  adopted under this section, county and human services boards 
596.11  shall be authorized to establish policies for payment of child 
596.12  care spaces for absent children, when the payment is required by 
596.13  the child's regular provider.  The rules shall not set a maximum 
596.14  number of days for which absence payments can be made, but 
596.15  instead shall direct the county agency to set limits and pay for 
596.16  absences according to the prevailing market practice in the 
596.17  county.  County policies for payment of absences shall be 
596.18  subject to the approval of the commissioner.  The commissioner 
596.19  shall maximize the use of federal money under title I and title 
596.20  IV of Public Law Number 104-193, the Personal Responsibility and 
596.21  Work Opportunity Reconciliation Act of 1996, and other programs 
596.22  that provide federal or state reimbursement for child care 
596.23  services for low-income families who are in education, training, 
596.24  job search, or other activities allowed under those programs.  
596.25  Money appropriated under this section must be coordinated with 
596.26  the programs that provide federal reimbursement for child care 
596.27  services to accomplish this purpose.  Federal reimbursement 
596.28  obtained must be allocated to the county that spent money for 
596.29  child care that is federally reimbursable under programs that 
596.30  provide federal reimbursement for child care services.  The 
596.31  counties shall use the federal money to expand child care 
596.32  services.  The commissioner may adopt rules under chapter 14 to 
596.33  implement and coordinate federal program requirements. 
596.34     Sec. 10.  [119B.025] [DUTIES OF COUNTIES.] 
596.35     Subdivision 1.  [FACTORS WHICH MUST BE VERIFIED.] (a) The 
596.36  county shall verify the following at all initial child care 
597.1   applications using the universal application: 
597.2      (1) identity of adults; 
597.3      (2) presence of the minor child in the home, if 
597.4   questionable; 
597.5      (3) relationship of minor child to caregivers; 
597.6      (4) age; 
597.7      (5) immigration status, if related to eligibility; 
597.8      (6) social security number, if given; 
597.9      (7) income; 
597.10     (8) spousal support and child support payments made to 
597.11  persons outside the household; 
597.12     (9) residence; 
597.13     (10) inconsistent information, if related to eligibility; 
597.14  and 
597.15     (11) any other information the county deems necessary to 
597.16  determine eligibility. 
597.17     (b) If a family did not use the universal application to 
597.18  apply for child care assistance, the family must complete the 
597.19  universal application at its next eligibility redetermination 
597.20  and the county must verify the factors listed in paragraph (a) 
597.21  as part of that redetermination.  Once a family has completed a 
597.22  universal application, the county shall use the redetermination 
597.23  form described in paragraph (c) for that family's subsequent 
597.24  redeterminations.  
597.25     (c) The commissioner shall develop a recertification form 
597.26  to redetermine eligibility that minimizes paperwork for the 
597.27  county and the participant. 
597.28     Subd. 2.  [SOCIAL SECURITY NUMBERS.] The county must 
597.29  request social security numbers from all applicants for child 
597.30  care assistance under this chapter.  A county may not deny child 
597.31  care assistance solely on the basis of failure of an applicant 
597.32  to report a social security number. 
597.33     Sec. 11.  Minnesota Statutes 2002, section 119B.03, 
597.34  subdivision 9, is amended to read: 
597.35     Subd. 9.  [PORTABILITY POOL.] (a) The commissioner shall 
597.36  establish a pool of up to five percent of the annual 
598.1   appropriation for the basic sliding fee program to provide 
598.2   continuous child care assistance for eligible families who move 
598.3   between Minnesota counties.  At the end of each allocation 
598.4   period, any unspent funds in the portability pool must be used 
598.5   for assistance under the basic sliding fee program.  If 
598.6   expenditures from the portability pool exceed the amount of 
598.7   money available, the reallocation pool must be reduced to cover 
598.8   these shortages. 
598.9      (b) To be eligible for portable basic sliding fee 
598.10  assistance, a family that has moved from a county in which it 
598.11  was receiving basic sliding fee assistance to a county with a 
598.12  waiting list for the basic sliding fee program must: 
598.13     (1) meet the income and eligibility guidelines for the 
598.14  basic sliding fee program; and 
598.15     (2) notify the new county of residence within 30 60 days of 
598.16  moving and apply for basic sliding fee assistance in submit 
598.17  information to the new county of residence to verify eligibility 
598.18  for the basic sliding fee program. 
598.19     (c) The receiving county must: 
598.20     (1) accept administrative responsibility for applicants for 
598.21  portable basic sliding fee assistance at the end of the two 
598.22  months of assistance under the Unitary Residency Act; 
598.23     (2) continue basic sliding fee assistance for the lesser of 
598.24  six months or until the family is able to receive assistance 
598.25  under the county's regular basic sliding program; and 
598.26     (3) notify the commissioner through the quarterly reporting 
598.27  process of any family that meets the criteria of the portable 
598.28  basic sliding fee assistance pool. 
598.29     Sec. 12.  Minnesota Statutes 2002, section 119B.05, 
598.30  subdivision 1, is amended to read: 
598.31     Subdivision 1.  [ELIGIBLE PARTICIPANTS.] Families eligible 
598.32  for child care assistance under the MFIP child care program are: 
598.33     (1) MFIP participants who are employed or in job search and 
598.34  meet the requirements of section 119B.10; 
598.35     (2) persons who are members of transition year families 
598.36  under section 119B.011, subdivision 20, and meet the 
599.1   requirements of section 119B.10; 
599.2      (3) families who are participating in employment 
599.3   orientation or job search, or other employment or training 
599.4   activities that are included in an approved employability 
599.5   development plan under chapter 256K; 
599.6      (4) MFIP families who are participating in work job search, 
599.7   job support, employment, or training activities as required in 
599.8   their job search support or employment plan, or in appeals, 
599.9   hearings, assessments, or orientations according to chapter 
599.10  256J; 
599.11     (5) MFIP families who are participating in social services 
599.12  activities under chapter 256J or 256K as required in their 
599.13  employment plan approved according to chapter 256J or 256K; and 
599.14     (6) families who are participating in programs as required 
599.15  in tribal contracts under section 119B.02, subdivision 2, or 
599.16  256.01, subdivision 2. 
599.17     Sec. 13.  Minnesota Statutes 2002, section 119B.08, 
599.18  subdivision 3, is amended to read: 
599.19     Subd. 3.  [CHILD CARE FUND PLAN.] The county and designated 
599.20  administering agency shall submit a biennial child care fund 
599.21  plan to the commissioner an annual child care fund plan in its 
599.22  biennial community social services plan.  The commissioner shall 
599.23  establish the dates by which the county must submit the plans.  
599.24  The plan shall include: 
599.25     (1) a narrative of the total program for child care 
599.26  services, including all policies and procedures that affect 
599.27  eligible families and are used to administer the child care 
599.28  funds; 
599.29     (2) the methods used by the county to inform eligible 
599.30  families of the availability of child care assistance and 
599.31  related services; 
599.32     (3) the provider rates paid for all children with special 
599.33  needs by provider type; 
599.34     (4) the county prioritization policy for all eligible 
599.35  families under the basic sliding fee program; and 
599.36     (5) other a description of strategies to coordinate and 
600.1   maximize public and private community resources, including 
600.2   school districts, health care facilities, government agencies, 
600.3   neighborhood organizations, and other resources knowledgeable in 
600.4   early childhood development, in particular to coordinate child 
600.5   care assistance with existing community-based programs and 
600.6   service providers including child care resource and referral 
600.7   programs, early childhood family education, school readiness, 
600.8   Head Start, local interagency early intervention committees, 
600.9   special education services, early childhood screening, and other 
600.10  early childhood care and education services and programs to the 
600.11  extent possible, to foster collaboration among agencies and 
600.12  other community-based programs that provide flexible, 
600.13  family-focused services to families with young children and to 
600.14  facilitate transition into kindergarten.  The county must 
600.15  describe a method by which to share information, responsibility, 
600.16  and accountability among service and program providers; 
600.17     (2) a description of procedures and methods to be used to 
600.18  make copies of the proposed state plan reasonably available to 
600.19  the public, including members of the public particularly 
600.20  interested in child care policies such as parents, child care 
600.21  providers, culturally specific service organizations, child care 
600.22  resource and referral programs, interagency early intervention 
600.23  committees, potential collaborative partners and agencies 
600.24  involved in the provision of care and education to young 
600.25  children, and allowing sufficient time for public review and 
600.26  comment; and 
600.27     (3) information as requested by the department to ensure 
600.28  compliance with the child care fund statutes and rules 
600.29  promulgated by the commissioner. 
600.30     The commissioner shall notify counties within 60 90 days of 
600.31  the date the plan is submitted whether the plan is approved or 
600.32  the corrections or information needed to approve the plan.  The 
600.33  commissioner shall withhold a county's allocation until it has 
600.34  an approved plan.  Plans not approved by the end of the second 
600.35  quarter after the plan is due may result in a 25 percent 
600.36  reduction in allocation.  Plans not approved by the end of the 
601.1   third quarter after the plan is due may result in a 100 percent 
601.2   reduction in the allocation to the county.  Counties are to 
601.3   maintain services despite any reduction in their allocation due 
601.4   to plans not being approved. 
601.5      Sec. 14.  Minnesota Statutes 2002, section 119B.09, 
601.6   subdivision 1, is amended to read: 
601.7      Subdivision 1.  [GENERAL ELIGIBILITY REQUIREMENTS FOR ALL 
601.8   APPLICANTS FOR CHILD CARE ASSISTANCE.] (a) Child care services 
601.9   must be available to families who need child care to find or 
601.10  keep employment or to obtain the training or education necessary 
601.11  to find employment and who: 
601.12     (1) meet the requirements of section 119B.05; receive MFIP 
601.13  assistance; and are participating in employment and training 
601.14  services under chapter 256J or 256K; 
601.15     (2) have household income below the eligibility levels for 
601.16  MFIP; or 
601.17     (3) have household income within a range established by the 
601.18  commissioner less than 250 percent of the federal poverty 
601.19  guidelines, adjusted for family size. 
601.20     (b) Child care services must be made available as in-kind 
601.21  services.  
601.22     (c) All applicants for child care assistance and families 
601.23  currently receiving child care assistance must be assisted and 
601.24  required to cooperate in establishment of paternity and 
601.25  enforcement of child support obligations for all children in the 
601.26  family as a condition of program eligibility.  For purposes of 
601.27  this section, a family is considered to meet the requirement for 
601.28  cooperation when the family complies with the requirements of 
601.29  section 256.741. 
601.30     Sec. 15.  Minnesota Statutes 2002, section 119B.09, 
601.31  subdivision 2, is amended to read: 
601.32     Subd. 2.  [SLIDING FEE.] Child care services to 
601.33  families with incomes in the commissioner's established range 
601.34  must be made available on a sliding fee basis.  The upper limit 
601.35  of the range must be neither less than 70 percent nor more than 
601.36  90 percent of the state median income for a family of four, 
602.1   adjusted for family size.  
602.2      Sec. 16.  Minnesota Statutes 2002, section 119B.09, 
602.3   subdivision 7, is amended to read: 
602.4      Subd. 7.  [DATE OF ELIGIBILITY FOR ASSISTANCE.] (a) The 
602.5   date of eligibility for child care assistance under this chapter 
602.6   is the later of the date the application was signed; the 
602.7   beginning date of employment, education, or training; or the 
602.8   date a determination has been made that the applicant is a 
602.9   participant in employment and training services under Minnesota 
602.10  Rules, part 3400.0080, subpart 2a, or chapter 256J or 256K.  The 
602.11  date of eligibility for the basic sliding fee at-home infant 
602.12  child care program is the later of the date the infant is born 
602.13  or, in a county with a basic sliding fee waiting list, the date 
602.14  the family applies for at-home infant child care.  
602.15     (b) Payment ceases for a family under the at-home infant 
602.16  child care program when a family has used a total of 12 months 
602.17  of assistance as specified under section 119B.061.  Payment of 
602.18  child care assistance for employed persons on MFIP is effective 
602.19  the date of employment or the date of MFIP eligibility, 
602.20  whichever is later.  Payment of child care assistance for MFIP 
602.21  or work first participants in employment and training services 
602.22  is effective the date of commencement of the services or the 
602.23  date of MFIP or work first eligibility, whichever is later.  
602.24  Payment of child care assistance for transition year child care 
602.25  must be made retroactive to the date of eligibility for 
602.26  transition year child care. 
602.27     Sec. 17.  Minnesota Statutes 2002, section 119B.09, is 
602.28  amended by adding a subdivision to read: 
602.29     Subd. 9.  [LICENSED AND LEGAL NONLICENSED FAMILY CHILD CARE 
602.30  PROVIDERS; ASSISTANCE.] Licensed and legal nonlicensed family 
602.31  child care providers are not eligible to receive child care 
602.32  assistance subsidies under this chapter for their own children 
602.33  or children in their custody. 
602.34     Sec. 18.  Minnesota Statutes 2002, section 119B.09, is 
602.35  amended by adding a subdivision to read: 
602.36     Subd. 10.  [PAYMENT OF FUNDS.] All federal, state, and 
603.1   local child care funds must be paid directly to the parent when 
603.2   a provider cares for children in the children's own home.  In 
603.3   all other cases, all federal, state, and local child care funds 
603.4   must be paid directly to the child care provider, either 
603.5   licensed or legal nonlicensed, on behalf of the eligible family. 
603.6      Sec. 19.  Minnesota Statutes 2002, section 119B.11, 
603.7   subdivision 2a, is amended to read: 
603.8      Subd. 2a.  [RECOVERY OF OVERPAYMENTS.] (a) An amount of 
603.9   child care assistance paid to a recipient in excess of the 
603.10  payment due is recoverable by the county agency under paragraphs 
603.11  (b) and (c), even when the overpayment was caused by agency 
603.12  error or circumstances outside the responsibility and control of 
603.13  the family or provider.  
603.14     (b) An overpayment must be recouped or recovered from the 
603.15  family if the overpayment benefited the family by causing the 
603.16  family to pay less for child care expenses than the family 
603.17  otherwise would have been required to pay under child care 
603.18  assistance program requirements.  If the family remains eligible 
603.19  for child care assistance, the overpayment must be recovered 
603.20  through recoupment as identified in Minnesota Rules, 
603.21  part 3400.0140, subpart 19 3400.0187, except that the 
603.22  overpayments must be calculated and collected on a service 
603.23  period basis.  If the family no longer remains eligible for 
603.24  child care assistance, the county may choose to initiate efforts 
603.25  to recover overpayments from the family for overpayment less 
603.26  than $50.  If the overpayment is greater than or equal to $50, 
603.27  the county shall seek voluntary repayment of the overpayment 
603.28  from the family.  If the county is unable to recoup the 
603.29  overpayment through voluntary repayment, the county shall 
603.30  initiate civil court proceedings to recover the overpayment 
603.31  unless the county's costs to recover the overpayment will exceed 
603.32  the amount of the overpayment.  A family with an outstanding 
603.33  debt under this subdivision is not eligible for child care 
603.34  assistance until:  (1) the debt is paid in full; or (2) 
603.35  satisfactory arrangements are made with the county to retire the 
603.36  debt consistent with the requirements of this chapter and 
604.1   Minnesota Rules, chapter 3400, and the family is in compliance 
604.2   with the arrangements. 
604.3      (c) The county must recover an overpayment from a provider 
604.4   if the overpayment did not benefit the family by causing it to 
604.5   receive more child care assistance or to pay less for child care 
604.6   expenses than the family otherwise would have been eligible to 
604.7   receive or required to pay under child care assistance program 
604.8   requirements, and benefited the provider by causing the provider 
604.9   to receive more child care assistance than otherwise would have 
604.10  been paid on the family's behalf under child care assistance 
604.11  program requirements.  If the provider continues to care for 
604.12  children receiving child care assistance, the overpayment must 
604.13  be recovered through reductions in child care assistance 
604.14  payments for services as described in an agreement with the 
604.15  county.  The provider may not charge families using that 
604.16  provider more to cover the cost of recouping the overpayment.  
604.17  If the provider no longer cares for children receiving child 
604.18  care assistance, the county may choose to initiate efforts to 
604.19  recover overpayments of less than $50 from the provider.  If the 
604.20  overpayment is greater than or equal to $50, the county shall 
604.21  seek voluntary repayment of the overpayment from the provider.  
604.22  If the county is unable to recoup the overpayment through 
604.23  voluntary repayment, the county shall initiate civil court 
604.24  proceedings to recover the overpayment unless the county's costs 
604.25  to recover the overpayment will exceed the amount of the 
604.26  overpayment.  A provider with an outstanding debt under this 
604.27  subdivision is not eligible to care for children receiving child 
604.28  care assistance until:  (1) the debt is paid in full; or (2) 
604.29  satisfactory arrangements are made with the county to retire the 
604.30  debt consistent with the requirements of this chapter and 
604.31  Minnesota Rules, chapter 3400, and the provider is in compliance 
604.32  with the arrangements. 
604.33     (d) When both the family and the provider acted together to 
604.34  intentionally cause the overpayment, both the family and the 
604.35  provider are jointly liable for the overpayment regardless of 
604.36  who benefited from the overpayment.  The county must recover the 
605.1   overpayment as provided in paragraphs (b) and (c).  When the 
605.2   family or the provider is in compliance with a repayment 
605.3   agreement, the party in compliance is eligible to receive child 
605.4   care assistance or to care for children receiving child care 
605.5   assistance despite the other party's noncompliance with 
605.6   repayment arrangements. 
605.7      Sec. 20.  Minnesota Statutes 2002, section 119B.12, 
605.8   subdivision 2, is amended to read: 
605.9      Subd. 2.  [PARENT FEE.] A family must be assessed a parent 
605.10  fee for each service period.  A family's monthly parent fee must 
605.11  be a fixed percentage of its annual gross income.  Parent fees 
605.12  must apply to families eligible for child care assistance under 
605.13  sections 119B.03 and 119B.05.  Income must be as defined in 
605.14  section 119B.011, subdivision 15.  The fixed percent is based on 
605.15  the relationship of the family's annual gross income to 100 250 
605.16  percent of state median income the federal poverty 
605.17  guidelines.  Beginning January 1, 1998, parent fees must begin 
605.18  at 75 percent of the poverty level.  The minimum parent fees for 
605.19  families between 75 percent and 100 percent of poverty level 
605.20  must be $5 per month.  Parent fees must be established in rule 
605.21  and must provide for graduated movement to full payment. 
605.22     Sec. 21.  [119B.125] [PROVIDER REQUIREMENTS.] 
605.23     Subdivision 1.  [AUTHORIZATION.] Except as provided in 
605.24  subdivision 5, a county must authorize a provider to receive 
605.25  child care assistance payments before the county makes payment 
605.26  for care provided by that provider.  The commissioner must 
605.27  establish the requirements necessary for authorization of 
605.28  providers. 
605.29     Subd. 2.  [PERSONS WHO CANNOT BE AUTHORIZED.] (a) A person 
605.30  who meets any of the conditions under paragraphs (b) to (n) must 
605.31  not be authorized as a legal nonlicensed family child care 
605.32  provider.  For purposes of this subdivision, a finding that a 
605.33  delinquency petition is proven in juvenile court must be 
605.34  considered a conviction in state district court. 
605.35     (b) The person has been convicted of one of the following 
605.36  offenses or has admitted to committing or a preponderance of the 
606.1   evidence indicates that the person has committed an act that 
606.2   meets the definition of one of the following offenses:  sections 
606.3   609.185 to 609.195, murder in the first, second, or third 
606.4   degree; 609.2661 to 609.2663, murder of an unborn child in the 
606.5   first, second, or third degree; 609.322, solicitation, 
606.6   inducement, or promotion of prostitution; 609.323, receiving 
606.7   profit from prostitution; 609.342 to 609.345, criminal sexual 
606.8   conduct in the first, second, third, or fourth degree; 609.352, 
606.9   solicitation of children to engage in sexual conduct; 609.365, 
606.10  incest; 609.377, felony malicious punishment of a child; 
606.11  617.246, use of minors in sexual performance; 617.247, 
606.12  possession of pictorial representation of a minor; 609.2242 to 
606.13  609.2243, felony domestic assault; a felony offense of spousal 
606.14  abuse; a felony offense of child abuse or neglect; a felony 
606.15  offense of a crime against children; or an attempt or conspiracy 
606.16  to commit any of these offenses as defined in Minnesota 
606.17  Statutes; or an offense in any other state or country where the 
606.18  elements are substantially similar to any of the offenses listed 
606.19  in this paragraph. 
606.20     (c) Less than 15 years have passed since the discharge of 
606.21  the sentence imposed for the offense and the person has received 
606.22  a felony conviction for one of the following offenses, or the 
606.23  person has admitted to committing or a preponderance of the 
606.24  evidence indicates that the person has committed an act that 
606.25  meets the definition of a felony conviction for one of the 
606.26  following offenses:  sections 609.20 to 609.205, manslaughter in 
606.27  the first or second degree; 609.21, criminal vehicular homicide; 
606.28  609.215, aiding suicide or aiding attempted suicide; 609.221 to 
606.29  609.2231, assault in the first, second, third, or fourth degree; 
606.30  609.224, repeat offenses of fifth degree assault; 609.228, great 
606.31  bodily harm caused by distribution of drugs; 609.2325, criminal 
606.32  abuse of a vulnerable adult; 609.2335, financial exploitation of 
606.33  a vulnerable adult; 609.235, use of drugs to injure or 
606.34  facilitate a crime; 609.24, simple robbery; 617.241, repeat 
606.35  offenses of obscene materials and performances; 609.245, 
606.36  aggravated robbery; 609.25, kidnapping; 609.255, false 
607.1   imprisonment; 609.2664 to 609.2665, manslaughter of an unborn 
607.2   child in the first or second degree; 609.267 to 609.2672, 
607.3   assault of an unborn child in the first, second, or third 
607.4   degree; 609.268, injury or death of an unborn child in the 
607.5   commission of a crime; 609.27, coercion; 609.275, attempt to 
607.6   coerce; 609.324, subdivision 1, other prohibited acts, minor 
607.7   engaged in prostitution; 609.3451, repeat offenses of criminal 
607.8   sexual conduct in the fifth degree; 609.378, neglect or 
607.9   endangerment of a child; 609.52, theft; 609.521, possession of 
607.10  shoplifting gear; 609.561 to 609.563, arson in the first, 
607.11  second, or third degree; 609.582, burglary in the first, second, 
607.12  third, or fourth degree; 609.625, aggravated forgery; 609.63, 
607.13  forgery; 609.631, check forgery, offering a forged check; 
607.14  609.635, obtaining signature by false pretenses; 609.66, 
607.15  dangerous weapon; 609.665, setting a spring gun; 609.67, 
607.16  unlawfully owning, possessing, or operating a machine gun; 
607.17  609.687, adulteration; 609.71, riot; 609.713, terrorist threats; 
607.18  609.749, harassment, stalking; 260.221, grounds for termination 
607.19  of parental rights; 152.021 to 152.022, controlled substance 
607.20  crime in the first or second degree; 152.023, subdivision 1, 
607.21  clause (3) or (4), or 152.023, subdivision 2, clause (4), 
607.22  controlled substance crime in third degree; 152.024, subdivision 
607.23  1, clause (2), (3), or (4), controlled substance crime in fourth 
607.24  degree; 617.23, repeat offenses of indecent exposure; an attempt 
607.25  or conspiracy to commit any of these offenses as defined in 
607.26  Minnesota Statutes; or an offense in any other state or country 
607.27  where the elements are substantially similar to any of the 
607.28  offenses listed in this paragraph. 
607.29     (d) Less than ten years have passed since the discharge of 
607.30  the sentence imposed for the offense and the person has received 
607.31  a gross misdemeanor conviction for one of the following offenses 
607.32  or the person has admitted to committing or a preponderance of 
607.33  the evidence indicates that the person has committed an act that 
607.34  meets the definition of a gross misdemeanor conviction for one 
607.35  of the following offenses:  sections 609.224, fifth degree 
607.36  assault; 609.2242 to 609.2243, domestic assault; 518B.01, 
608.1   subdivision 14, violation of an order for protection; 609.3451, 
608.2   fifth degree criminal sexual conduct; 609.746, repeat offenses 
608.3   of interference with privacy; 617.23, repeat offenses of 
608.4   indecent exposure; 617.241, obscene materials and performances; 
608.5   617.243, indecent literature, distribution; 617.293, 
608.6   disseminating or displaying harmful material to minors; 609.71, 
608.7   riot; 609.66, dangerous weapons; 609.749, harassment, stalking; 
608.8   609.224, subdivision 2, paragraph (c), fifth degree assault 
608.9   against a vulnerable adult by a caregiver; 609.23, mistreatment 
608.10  of persons confined; 609.231, mistreatment of residents or 
608.11  patients; 609.2325, criminal abuse of a vulnerable adult; 
608.12  609.2335, financial exploitation of a vulnerable adult; 609.233, 
608.13  criminal neglect of a vulnerable adult; 609.234, failure to 
608.14  report maltreatment of a vulnerable adult; 609.72, subdivision 
608.15  3, disorderly conduct against a vulnerable adult; 609.265, 
608.16  abduction; 609.378, neglect or endangerment of a child; 609.377, 
608.17  malicious punishment of a child; 609.324, subdivision 1a, other 
608.18  prohibited acts, minor engaged in prostitution; 609.33, 
608.19  disorderly house; 609.52, theft; 609.582, burglary in the first, 
608.20  second, third, or fourth degree; 609.631, check forgery, 
608.21  offering a forged check; 609.275, attempt to coerce; an attempt 
608.22  or conspiracy to commit any of these offenses as defined in 
608.23  Minnesota Statutes; or an offense in any other state or country 
608.24  where the elements are substantially similar to any of the 
608.25  offenses listed in this paragraph. 
608.26     (e) Less than seven years have passed since the discharge 
608.27  of the sentence imposed for the offense and the person has 
608.28  received a misdemeanor conviction for one of the following 
608.29  offenses or the person has admitted to committing or a 
608.30  preponderance of the evidence indicates that the person has 
608.31  committed an act that meets the definition of a misdemeanor 
608.32  conviction for one of the following offenses:  sections 609.224, 
608.33  fifth degree assault; 609.2242, domestic assault; 518B.01, 
608.34  violation of an order for protection; 609.3232, violation of an 
608.35  order for protection; 609.746, interference with privacy; 
608.36  609.79, obscene or harassing telephone calls; 609.795, letter, 
609.1   telegram, or package, opening, harassment; 617.23, indecent 
609.2   exposure; 609.2672, assault of an unborn child, third degree; 
609.3   617.293, dissemination and display of harmful materials to 
609.4   minors; 609.66, dangerous weapons; 609.665, spring guns; an 
609.5   attempt or conspiracy to commit any of these offenses as defined 
609.6   in Minnesota Statutes; or an offense in any other state or 
609.7   country where the elements are substantially similar to any of 
609.8   the offenses listed in this paragraph. 
609.9      (f) The person has been identified by the county's child 
609.10  protection agency or by the statewide child protection database 
609.11  as the person allegedly responsible for physical or sexual abuse 
609.12  of a child within the last seven years. 
609.13     (g) The person has been identified by the county's adult 
609.14  protection agency or by the statewide adult protection database 
609.15  as the person responsible for abuse or neglect of a vulnerable 
609.16  adult within the last seven years. 
609.17     (h) The person has refused to give written consent for 
609.18  disclosure of criminal history records. 
609.19     (i) The person has been denied a family child care license 
609.20  or has received a fine or a sanction as a licensed child care 
609.21  provider that has not been reversed on appeal. 
609.22     (j) The person has a family child care licensing 
609.23  disqualification that has not been set aside. 
609.24     (k) The person has admitted or a county has found that 
609.25  there is a preponderance of evidence that fraudulent information 
609.26  was given to the county for application purposes or was used in 
609.27  submitting bills for payment. 
609.28     (l) The person has been convicted or there is a 
609.29  preponderance of evidence of the crime of theft by wrongfully 
609.30  obtaining public assistance. 
609.31     (m) The person has a household member age 13 or older who 
609.32  has access to children during the hours that care is provided 
609.33  and who meets one of the conditions listed in paragraphs (b) to 
609.34  (l). 
609.35     (n) The person has a household member ages ten to 12 who 
609.36  has access to children during the hours that care is provided; 
610.1   information or circumstances exist which provide the county with 
610.2   articulable suspicion that further pertinent information may 
610.3   exist showing the household member meets one of the conditions 
610.4   listed in paragraphs (b) to (l); and the household member 
610.5   actually meets one of the conditions listed in paragraphs (b) to 
610.6   (l). 
610.7      Subd. 3.  [AUTHORIZATION EXCEPTION.] When a county denies a 
610.8   person authorization as a legal nonlicensed family child care 
610.9   provider under subdivision 2, the county later may authorize 
610.10  that person as a provider if the following conditions are met: 
610.11     (1) after receiving notice of the denial of the 
610.12  authorization, the person applies for and obtains a valid child 
610.13  care license issued under chapter 245A, issued by a tribe, or 
610.14  issued by another state; 
610.15     (2) the person maintains the valid child care license; and 
610.16     (3) the person is providing child care in the state of 
610.17  licensure or in the area under the jurisdiction of the licensing 
610.18  tribe. 
610.19     Subd. 4.  [UNSAFE CARE.] A county may deny authorization as 
610.20  a child care provider to any applicant or rescind authorization 
610.21  of any provider when the county knows or has reason to believe 
610.22  that the provider is unsafe or that the circumstances of the 
610.23  chosen child care arrangement are unsafe, even when the grounds 
610.24  supporting this determination are not listed in subdivision 2. 
610.25     Subd. 5.  [RETROACTIVE PAYMENT.] Once a provider receives 
610.26  county authorization, the county may issue retroactive payment 
610.27  to the provider for child care services provided during the time 
610.28  between the county's receipt of the completed application and 
610.29  final authorization of the provider. 
610.30     Subd. 6.  [RECORD KEEPING REQUIREMENT.] All providers must 
610.31  keep daily attendance records for children receiving child care 
610.32  assistance and must make those records available immediately to 
610.33  the county upon request.  The daily attendance records must be 
610.34  retained for six years after the date of service.  A county may 
610.35  deny authorization as a child care provider to any applicant or 
610.36  rescind authorization of any provider when the county knows or 
611.1   has reason to believe that the provider has not complied with 
611.2   the record keeping requirement in this subdivision. 
611.3      Sec. 22.  Minnesota Statutes 2002, section 119B.13, 
611.4   subdivision 1, is amended to read: 
611.5      Subdivision 1.  [SUBSIDY RESTRICTIONS.] The maximum rate 
611.6   paid for child care assistance under the child care fund may not 
611.7   exceed the 75th 60th percentile rate for like-care arrangements 
611.8   in the county as surveyed by the commissioner.  A rate which 
611.9   includes a provider bonus paid under subdivision 2 or a special 
611.10  needs rate paid under subdivision 3 may be in excess of the 
611.11  maximum rate allowed under this subdivision.  The department 
611.12  shall monitor the effect of this paragraph on provider rates.  
611.13  The county shall pay the provider's full charges for every child 
611.14  in care up to the maximum established.  The commissioner shall 
611.15  determine the maximum rate for each type of care on an hourly, 
611.16  full-day, and weekly basis, including special needs and 
611.17  handicapped care.  Not less than once every two years, the 
611.18  commissioner shall evaluate market practices for payment of 
611.19  absences and shall establish policies for payment of absent days 
611.20  that reflect current market practice. 
611.21     When the provider charge is greater than the maximum 
611.22  provider rate allowed, the parent is responsible for payment of 
611.23  the difference in the rates in addition to must pay any family 
611.24  copayment fee but the provider cannot require the parent to pay 
611.25  the difference between the maximum rate allowed and the provider 
611.26  charge. 
611.27     Sec. 23.  Minnesota Statutes 2002, section 119B.13, is 
611.28  amended by adding a subdivision to read: 
611.29     Subd. 1a.  [CHILD CARE PROVIDERS; HOURLY RATES.] When a 
611.30  family receiving child care assistance is authorized to receive 
611.31  seven hours of care or less per day, child care assistance 
611.32  payments for that care must be made on an hourly basis but may 
611.33  not exceed the maximum full-day rate. 
611.34     Sec. 24.  Minnesota Statutes 2002, section 119B.13, is 
611.35  amended by adding a subdivision to read: 
611.36     Subd. 1b.  [LEGAL NONLICENSED FAMILY CHILD CARE PROVIDER 
612.1   RATES.] (a) Legal nonlicensed family child care providers 
612.2   receiving reimbursement under this chapter must be paid on an 
612.3   hourly basis for care provided to families receiving assistance. 
612.4      (b) The maximum rate paid to legal nonlicensed family child 
612.5   care providers must be 90 percent of the county maximum hourly 
612.6   rate for licensed family child care providers.  In counties 
612.7   where the maximum hourly rate for licensed family child care 
612.8   providers is higher than the maximum weekly rate for those 
612.9   providers divided by 50, the maximum hourly rate that may be 
612.10  paid to legal nonlicensed family child care providers is the 
612.11  rate equal to the maximum weekly rate for licensed family child 
612.12  care providers divided by 50 and then multiplied by 0.90. 
612.13     (c) A rate which includes a provider bonus paid under 
612.14  subdivision 2 or a special needs rate paid under subdivision 3 
612.15  may be in excess of the maximum rate allowed under this 
612.16  subdivision. 
612.17     (d) Legal nonlicensed family child care providers receiving 
612.18  reimbursement under this chapter may not be paid registration 
612.19  fees for families receiving assistance. 
612.20     Sec. 25.  Minnesota Statutes 2002, section 119B.13, 
612.21  subdivision 2, is amended to read: 
612.22     Subd. 2.  [PROVIDER RATE BONUS FOR ACCREDITATION.] A family 
612.23  child care provider or child care center shall be paid a 
612.24  ten five percent bonus above the maximum rate established in 
612.25  subdivision 1, 1a, or 1b, if the provider or center holds a 
612.26  current early childhood development credential approved by the 
612.27  commissioner, up to the actual provider rate.  
612.28     Sec. 26.  Minnesota Statutes 2002, section 119B.13, 
612.29  subdivision 6, is amended to read: 
612.30     Subd. 6.  [PROVIDER PAYMENTS.] (a) Counties or the state 
612.31  shall make vendor payments to the child care provider or pay the 
612.32  parent directly for eligible child care expenses, except when a 
612.33  provider cares for children in the children's own home.  When a 
612.34  provider cares for children in the children's own home, the 
612.35  county or the state shall make child care assistance payments 
612.36  directly to the parent.  
613.1      (b) If payments for child care assistance are made to 
613.2   providers, the child care facility is a center and has the 
613.3   ability to bill electronically or keeps a detailed sign in/sign 
613.4   out log, then the parent or guardian is not required to sign the 
613.5   bill.  If the provider does not keep detailed log sheets, both 
613.6   the parent or guardian and the provider must sign the bill for 
613.7   services rendered before payment is issued.  For licensed family 
613.8   child care and legal nonlicensed child care providers, both the 
613.9   parent or guardian and the provider must sign the bill.  The 
613.10  provider shall bill the county for services provided within ten 
613.11  days of the end of the month of service period.  If bills are 
613.12  submitted in accordance with the provisions of this 
613.13  subdivision within ten days of the end of the service period, a 
613.14  county or the state shall issue payment to the provider of child 
613.15  care under the child care fund within 30 days of receiving an 
613.16  invoice a bill from the provider.  Counties or the state may 
613.17  establish policies that make payments on a more frequent basis.  
613.18     (c) All bills must be submitted within 90 days of the last 
613.19  date of service on the bill.  A county may pay a bill submitted 
613.20  more than 90 days after the last date of service if the provider 
613.21  shows good cause why the bill was not submitted within 90 days.  
613.22  Good cause must be defined in the county's child care fund plan 
613.23  under section 119B.08, subdivision 3, and the definition of good 
613.24  cause must include county error.  A county may not pay any bill 
613.25  submitted more than one year after the last date of service on 
613.26  the bill, unless the delay in payment is due to county error. 
613.27     (d) A county may stop payment issued to a provider or may 
613.28  refuse to pay a bill submitted by a provider if: 
613.29     (1) the provider admits to intentionally providing the 
613.30  county with false information on the provider's billing forms; 
613.31  or 
613.32     (2) a county finds by a preponderance of the evidence that 
613.33  the provider intentionally gave the county false information on 
613.34  the provider's billing forms. 
613.35     (e) A county's payment policies must be included in the 
613.36  county's child care plan under section 119B.08, subdivision 3.  
614.1   If payments are made by the state, in addition to being in 
614.2   compliance with this subdivision, the payments must be made in 
614.3   compliance with section 16A.124. 
614.4      Sec. 27.  Minnesota Statutes 2002, section 119B.16, is 
614.5   amended by adding a subdivision to read: 
614.6      Subd. 1a.  [FAIR HEARING ALLOWED FOR PROVIDERS.] (a) This 
614.7   subdivision applies to providers caring for children receiving 
614.8   child care assistance. 
614.9      (b) A provider to whom a county agency has assigned 
614.10  responsibility for an overpayment may request a fair hearing in 
614.11  accordance with section 256.045 for the limited purpose of 
614.12  challenging the assignment of responsibility for the overpayment 
614.13  and the amount of the overpayment.  The scope of the fair 
614.14  hearing does not include the issues of whether the provider 
614.15  wrongfully obtained public assistance in violation of section 
614.16  256.98 or was properly disqualified under section 256.98, 
614.17  subdivision 8, paragraph (c), unless the fair hearing has been 
614.18  combined with an administrative disqualification hearing brought 
614.19  against the provider under section 256.046. 
614.20     Sec. 28.  Minnesota Statutes 2002, section 119B.16, is 
614.21  amended by adding a subdivision to read: 
614.22     Subd. 1b.  [JOINT FAIR HEARINGS.] When a provider requests 
614.23  a fair hearing under subdivision 1a, the family in whose case 
614.24  the overpayment was created must be made a party to the fair 
614.25  hearing.  All other issues raised by the family must be resolved 
614.26  in the same proceeding.  When a family requests a fair hearing 
614.27  and claims that the county should have assigned responsibility 
614.28  for an overpayment to a provider, the provider must be made a 
614.29  party to the fair hearing.  The referee assigned to a fair 
614.30  hearing may join a family or a provider as a party to the fair 
614.31  hearing whenever joinder of that party is necessary to fully and 
614.32  fairly resolve overpayment issues raised in the appeal. 
614.33     Sec. 29.  Minnesota Statutes 2002, section 119B.16, 
614.34  subdivision 2, is amended to read: 
614.35     Subd. 2.  [INFORMAL CONFERENCE.] The county agency shall 
614.36  offer an informal conference to applicants and recipients 
615.1   adversely affected by an agency action to attempt to resolve the 
615.2   dispute.  The county agency shall offer an informal conference 
615.3   to providers to whom the county agency has assigned 
615.4   responsibility for an overpayment in an attempt to resolve the 
615.5   dispute.  The county agency or the provider may ask the family 
615.6   in whose case the overpayment arose to participate in the 
615.7   informal conference, but the family may refuse to do so.  The 
615.8   county agency shall advise adversely affected applicants and, 
615.9   recipients, and providers that a request for a conference with 
615.10  the agency is optional and does not delay or replace the right 
615.11  to a fair hearing. 
615.12     Sec. 30.  Minnesota Statutes 2002, section 119B.19, 
615.13  subdivision 7, is amended to read: 
615.14     Subd. 7.  [CHILD CARE RESOURCE AND REFERRAL PROGRAMS.] 
615.15  Within each region, a child care resource and referral program 
615.16  must: 
615.17     (1) maintain one database of all existing child care 
615.18  resources and services and one database of family referrals; 
615.19     (2) provide a child care referral service for families; 
615.20     (3) develop resources to meet the child care service needs 
615.21  of families; 
615.22     (4) increase the capacity to provide culturally responsive 
615.23  child care services; 
615.24     (5) coordinate professional development opportunities for 
615.25  child care and school-age care providers; 
615.26     (6) administer and award child care services grants; 
615.27     (7) administer and provide loans for child development 
615.28  education and training; and 
615.29     (8) cooperate with the Minnesota Child Care Resource and 
615.30  Referral Network and its member programs to develop effective 
615.31  child care services and child care resources; and 
615.32     (9) assist in fostering coordination, collaboration, and 
615.33  planning among child care programs and community programs such 
615.34  as school readiness, Head Start, early childhood family 
615.35  education, local interagency early intervention committees, 
615.36  early childhood screening, special education services, and other 
616.1   early childhood care and education services and programs that 
616.2   provide flexible, family-focused services to families with young 
616.3   children to the extent possible. 
616.4      Sec. 31.  Minnesota Statutes 2002, section 119B.21, 
616.5   subdivision 11, is amended to read: 
616.6      Subd. 11.  [STATEWIDE ADVISORY TASK FORCE.] The 
616.7   commissioner may convene a statewide advisory task force to 
616.8   advise the commissioner on statewide grants or other child care 
616.9   issues.  The following groups must be represented:  family child 
616.10  care providers, child care center programs, school-age care 
616.11  providers, parents who use child care services, health services, 
616.12  social services, Head Start, public schools, school-based early 
616.13  childhood programs, special education programs, employers, and 
616.14  other citizens with demonstrated interest in child care issues.  
616.15  Additional members may be appointed by the commissioner.  The 
616.16  commissioner may compensate members for their travel, child 
616.17  care, and child care provider substitute expenses for attending 
616.18  task force meetings.  The commissioner may also pay a stipend to 
616.19  parent representatives for participating in task force meetings. 
616.20     Sec. 32.  Minnesota Statutes 2002, section 119B.23, 
616.21  subdivision 3, is amended to read: 
616.22     Subd. 3.  [BIENNIAL PLAN.] The county board shall 
616.23  biennially develop a plan for the distribution of money for 
616.24  child care services as part of the community social services 
616.25  plan described in section 256E.09 child care fund plan under 
616.26  section 119B.08.  All licensed child care programs shall be 
616.27  given written notice concerning the availability of money and 
616.28  the application process. 
616.29     Sec. 33.  Minnesota Statutes 2002, section 256.046, 
616.30  subdivision 1, is amended to read: 
616.31     Subdivision 1.  [HEARING AUTHORITY.] A local agency must 
616.32  initiate an administrative fraud disqualification hearing for 
616.33  individuals, including child care providers caring for children 
616.34  receiving child care assistance, accused of wrongfully obtaining 
616.35  assistance or intentional program violations, in lieu of a 
616.36  criminal action when it has not been pursued, in the aid to 
617.1   families with dependent children program formerly codified in 
617.2   sections 256.72 to 256.87, MFIP, child care assistance programs, 
617.3   general assistance, family general assistance program formerly 
617.4   codified in section 256D.05, subdivision 1, clause (15), 
617.5   Minnesota supplemental aid, medical care, or food stamp 
617.6   programs.  The hearing is subject to the requirements of section 
617.7   256.045 and the requirements in Code of Federal Regulations, 
617.8   title 7, section 273.16, for the food stamp program and title 
617.9   45, section 235.112, as of September 30, 1995, for the cash 
617.10  grant and, medical care programs, and child care assistance 
617.11  under chapter 119B. 
617.12     Sec. 34.  Minnesota Statutes 2002, section 256.0471, 
617.13  subdivision 1, is amended to read: 
617.14     Subdivision 1.  [QUALIFYING OVERPAYMENT.] Any overpayment 
617.15  for assistance granted under section 119B.05 chapter 119B, the 
617.16  MFIP program formerly codified under sections 256.031 to 
617.17  256.0361, and the AFDC program formerly codified under sections 
617.18  256.72 to 256.871; chapters 256B, 256D, 256I, 256J, and 256K; 
617.19  and the food stamp program, except agency error claims, become a 
617.20  judgment by operation of law 90 days after the notice of 
617.21  overpayment is personally served upon the recipient in a manner 
617.22  that is sufficient under rule 4.03(a) of the Rules of Civil 
617.23  Procedure for district courts, or by certified mail, return 
617.24  receipt requested.  This judgment shall be entitled to full 
617.25  faith and credit in this and any other state. 
617.26     Sec. 35.  Minnesota Statutes 2002, section 256.98, 
617.27  subdivision 8, is amended to read: 
617.28     Subd. 8.  [DISQUALIFICATION FROM PROGRAM.] (a) Any person 
617.29  found to be guilty of wrongfully obtaining assistance by a 
617.30  federal or state court or by an administrative hearing 
617.31  determination, or waiver thereof, through a disqualification 
617.32  consent agreement, or as part of any approved diversion plan 
617.33  under section 401.065, or any court-ordered stay which carries 
617.34  with it any probationary or other conditions, in the Minnesota 
617.35  family investment program, the food stamp program, the general 
617.36  assistance program, the group residential housing program, or 
618.1   the Minnesota supplemental aid program shall be disqualified 
618.2   from that program.  In addition, any person disqualified from 
618.3   the Minnesota family investment program shall also be 
618.4   disqualified from the food stamp program.  The needs of that 
618.5   individual shall not be taken into consideration in determining 
618.6   the grant level for that assistance unit:  
618.7      (1) for one year after the first offense; 
618.8      (2) for two years after the second offense; and 
618.9      (3) permanently after the third or subsequent offense.  
618.10     The period of program disqualification shall begin on the 
618.11  date stipulated on the advance notice of disqualification 
618.12  without possibility of postponement for administrative stay or 
618.13  administrative hearing and shall continue through completion 
618.14  unless and until the findings upon which the sanctions were 
618.15  imposed are reversed by a court of competent jurisdiction.  The 
618.16  period for which sanctions are imposed is not subject to 
618.17  review.  The sanctions provided under this subdivision are in 
618.18  addition to, and not in substitution for, any other sanctions 
618.19  that may be provided for by law for the offense involved.  A 
618.20  disqualification established through hearing or waiver shall 
618.21  result in the disqualification period beginning immediately 
618.22  unless the person has become otherwise ineligible for 
618.23  assistance.  If the person is ineligible for assistance, the 
618.24  disqualification period begins when the person again meets the 
618.25  eligibility criteria of the program from which they were 
618.26  disqualified and makes application for that program. 
618.27     (b) A family receiving assistance through child care 
618.28  assistance programs under chapter 119B with a family member who 
618.29  is found to be guilty of wrongfully obtaining child care 
618.30  assistance by a federal court, state court, or an administrative 
618.31  hearing determination or waiver, through a disqualification 
618.32  consent agreement, as part of an approved diversion plan under 
618.33  section 401.065, or a court-ordered stay with probationary or 
618.34  other conditions, is disqualified from child care assistance 
618.35  programs.  The disqualifications must be for periods of three 
618.36  months, six months, and two years for the first, second, and 
619.1   third offenses respectively.  Subsequent violations must result 
619.2   in permanent disqualification.  During the disqualification 
619.3   period, disqualification from any child care program must extend 
619.4   to all child care programs and must be immediately applied. 
619.5      (c) A provider caring for children receiving assistance 
619.6   through child care assistance programs under chapter 119B is 
619.7   disqualified from receiving payment for child care services from 
619.8   the child care assistance program under chapter 119B when the 
619.9   provider is found to have wrongfully obtained child care 
619.10  assistance by a federal court, state court, or an administrative 
619.11  hearing determination or waiver under section 256.046, through a 
619.12  disqualification consent agreement, as part of an approved 
619.13  diversion plan under section 401.065, or a court-ordered stay 
619.14  with probationary or other conditions.  The disqualifications 
619.15  must be for periods of one year and two years for the first and 
619.16  second offenses respectively.  Any subsequent violation must 
619.17  result in permanent disqualification.  The disqualification 
619.18  period must be imposed immediately after a determination is made 
619.19  under this paragraph.  During the disqualification period, the 
619.20  provider is disqualified from receiving payment from any child 
619.21  care assistance program under chapter 119B. 
619.22     Sec. 36.  Minnesota Statutes 2002, section 466.03, 
619.23  subdivision 6d, is amended to read: 
619.24     Subd. 6d.  [LICENSING AND AUTHORIZATION OF PROVIDERS.] A 
619.25  claim against a municipality based on the failure of a provider 
619.26  to meet the standards needed for a license to operate a day care 
619.27  facility under chapter 245A for children, unless the 
619.28  municipality had actual knowledge of a failure to meet licensing 
619.29  standards that resulted in a dangerous condition that 
619.30  foreseeably threatened the plaintiff or to meet the standards 
619.31  needed for authorization as a provider for the child care 
619.32  assistance program under chapter 119B.  A municipality shall be 
619.33  immune from liability for a claim arising out of a provider's 
619.34  use of a swimming pool located at a family day care or group 
619.35  family day care home under section 245A.14, subdivision 10, 
619.36  unless the municipality had actual knowledge of a provider's 
620.1   failure to meet the licensing standards under section 245A.14, 
620.2   subdivision 10, paragraph (a), clauses (1) to (3), that resulted 
620.3   in a dangerous condition that foreseeably threatened the 
620.4   plaintiff. 
620.5      Sec. 37.  [DIRECTION TO COMMISSIONER; PROVIDER RATES.] 
620.6      The provider rates determined under Minnesota Statutes, 
620.7   section 119B.13, for fiscal year 2003 and implemented on July 1, 
620.8   2002, are to be continued in effect through June 30, 2005.  The 
620.9   commissioner of human services is directed to evaluate the costs 
620.10  of child care in Minnesota, to examine the differences in the 
620.11  cost of child care in rural and metropolitan areas, and to make 
620.12  recommendations to the legislature for containing future cost 
620.13  increases in the child care program under Minnesota Statutes, 
620.14  chapter 119B, in a manner that complies with federal child care 
620.15  and development block grant requirements for promoting parental 
620.16  choice and permits the department to track the effect of rate 
620.17  changes on child care assistance program costs, the availability 
620.18  of different types of care throughout the state, the length of 
620.19  waiting lists, and the care options available to program 
620.20  participants.  The commissioner shall also examine the 
620.21  allocation formula under Minnesota Statutes, section 119B.03, 
620.22  and make recommendations to the legislature in order to create a 
620.23  more equitable formula.  The commissioner shall consider the 
620.24  impact any recommendations might have on work incentives for low 
620.25  and middle income families and possible changes to MFIP child 
620.26  care, basic sliding fee child care, and the dependent care tax 
620.27  credit.  The commissioner shall make recommendations to the 
620.28  legislature by January 15, 2005. 
620.29     Sec. 38.  [CHILD CARE WAITING LIST.] 
620.30     Notwithstanding Minnesota Statutes, section 119B.03, 
620.31  subdivision 6, the commissioner may manage the child care 
620.32  assistance waiting list under Minnesota Statutes, section 
620.33  119B.03, subdivision 2, on a regional or statewide basis in 
620.34  order to ensure that families listed under higher priority 
620.35  categories, as determined by Minnesota Statutes, section 
620.36  119B.03, subdivision 4, are served before families listed under 
621.1   lower priority categories. 
621.2      Sec. 39.  [CHILD CARE ASSISTANCE PARENT FEE SCHEDULE.] 
621.3      Notwithstanding Minnesota Rules, part 3400.0100, subpart 4, 
621.4   the parent fee schedule is as follows: 
621.5        Income Range                  Co-payment (as a percentage of
621.6        (as a percentage of the       adjusted gross income)
621.7        federal poverty guidelines)
621.8        0-74.99%                      $15/month
621.9        75.00-99.99%                  $25/month
621.10       100.00-104.99%                2.50%
621.11       105.00-109.99%                2.60%
621.12       110.00-114.99%                3.00%
621.13       115.00-119.99%                4.25%
621.14       120.00-124.99%                6.00%
621.15       125.00-139.99%                8.00%
621.16       140.00-144.99%                8.50%
621.17       145.00-149.99%                9.00%
621.18       150.00-154.99%                9.25%
621.19       155.00-159.99%                9.50%
621.20       160.00-164.99%                10.00%
621.21       165.00-169.99%                10.25%
621.22       170.00-174.99%                10.50%
621.23       175.00-179.99%                10.75%
621.24       180.00-184.99%                11.00%
621.25       185.00-189.99%                11.25%
621.26       190.00-194.99%                12.00%
621.27       195.00-199.99%                12.50%
621.28       200.00-209.99%                13.20%
621.29       210.00-224.99%                13.30%
621.30       225.00-229.99%                13.40%
621.31       230.00-234.99%                13.70%
621.32       235.00-239.99%                14.10%
621.33       240.00-244.99%                14.20%
621.34       245.00-249.99%                15.40%
621.35       250%                          ineligible
621.36     A family's monthly co-payment fee is the fixed percentage 
622.1   established for the income range multiplied by the highest 
622.2   possible income within that income range. 
622.3      Sec. 40.  [REPEALER.] 
622.4      (a) Minnesota Statutes 2002, section 119B.061, is repealed. 
622.5      (b) Laws 2001, First Special Session chapter 3, article 1, 
622.6   section 16, is repealed. 
622.7                             ARTICLE 11A 
622.8            HEALTH AND HUMAN SERVICES FORECAST ADJUSTMENTS 
622.9   Section 1.  [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 
622.10     The dollar amounts shown in the columns marked 
622.11  "APPROPRIATIONS" are added to or, if shown in parentheses, are 
622.12  subtracted from the appropriations in Laws 2001, First Special 
622.13  Session chapter 9, as amended by Laws 2002, chapter 220, and 
622.14  Laws 2002, chapter 374, and are appropriated from the general 
622.15  fund, or any other fund named, to the agencies and for the 
622.16  purposes specified in this article, to be available for the 
622.17  fiscal year indicated for each purpose.  The figure "2003" used 
622.18  in this article means that the appropriation or appropriations 
622.19  listed under them are available for the fiscal year ending June 
622.20  30, 2003. 
622.21                          SUMMARY BY FUND
622.22                                                         2003 
622.23  General                                            $103,756,000
622.24  Health Care Access                                   (1,492,000) 
622.25  Federal TANF                                         20,419,000 
622.26                                             APPROPRIATIONS 
622.27                                         Available for the Year 
622.28                                          Ending June 30, 2003
622.29  Sec. 2.  COMMISSIONER OF 
622.30  HUMAN SERVICES
622.31  Subdivision 1.  Total 
622.32  Appropriation                                      $128,203,000 
622.33                Summary by Fund
622.34  General                           109,276,000
622.35  Health Care Access                 (1,492,000)
622.36  Federal TANF                       20,419,000
622.37  Subd. 2.  Administrative 
622.38  Reimbursement/Pass-through                             1,180,000
623.1   Subd. 3.  Basic Health Care 
623.2   Grants 
623.3   General                                              59,364,000
623.4   Health Care Access                                   (1,492,000)
623.5   The amounts that may be spent from this 
623.6   appropriation for each purpose are as 
623.7   follows: 
623.8   (a) MinnesotaCare Grants 
623.9   Health Care Access                                   (1,492,000) 
623.10  (b) MA Basic Health Care Grants - 
623.11  Families and Children 
623.12  General                                              14,708,000 
623.13  (c) MA Basic Health Care Grants - 
623.14  Elderly and Disabled 
623.15  General                                              15,137,000 
623.16  (d) General Assistance Medical Care 
623.17  Grants 
623.18  General                                              29,519,000 
623.19  Subd. 4.  Continuing Care Grants 
623.20  General                                              56,615,000 
623.21  The amounts that may be spent from this 
623.22  appropriation for each purpose are as 
623.23  follows: 
623.24  (a) Medical Assistance Long-Term Care 
623.25  Waivers and Home Care Grants 
623.26  General                                              57,388,000 
623.27  (b) Medical Assistance Long-Term Care 
623.28  Facilities Grants 
623.29  General                                                 678,000 
623.30  (c) Group Residential Housing Grants 
623.31  General                                              (1,451,000) 
623.32  Subd. 5.  Economic Support Grants 
623.33  General                                              (6,703,000)
623.34  Federal TANF                                         19,239,000 
623.35  The amounts that may be spent from the 
623.36  appropriation for each purpose are as 
623.37  follows: 
623.38  (a) Assistance to Families Grants 
623.39  General                                              (9,306,000) 
623.40  Federal TANF                                         19,239,000 
623.41  (b) General Assistance Grants 
623.42  General                                               3,491,000 
624.1   (c) Minnesota Supplemental Aid Grants 
624.2   General                                                (888,000) 
624.3   Sec. 3.  COMMISSIONER OF HEALTH
624.4   Subdivision 1.  Total Appropriation                  (5,520,000)
624.5                 Summary by Fund
624.6   General                                              (5,520,000) 
624.7   Subd. 2.  Access and Quality Improvement             (5,520,000)
624.8      Sec. 4.  [EFFECTIVE DATE.] 
624.9      Sections 1 to 3 are effective the day following final 
624.10  enactment. 
624.11                            ARTICLE 11B 
624.12           DEPARTMENT OF CHILDREN, FAMILIES, AND LEARNING 
624.13                        FORECAST ADJUSTMENT 
624.14  Section 1.  The dollar amounts shown are added to or, if shown 
624.15  in parentheses, are subtracted from the appropriations in Laws 
624.16  2001, First Special Session chapter 6, as amended by Laws 2002, 
624.17  chapter 220, and Laws 2002, chapter 374, or other law, and are 
624.18  appropriated from the general fund to the department of 
624.19  children, families, and learning for the purposes specified in 
624.20  this article, to be available for the fiscal year indicated for 
624.21  each purpose.  The figure "2003" used in this article means that 
624.22  the appropriation or appropriations listed are available for the 
624.23  fiscal year ending June 30, 2003. 
624.24                                                         2003 
624.25                                             APPROPRIATION CHANGE
624.26  Sec. 2.  APPROPRIATIONS; EARLY CHILDHOOD
624.27  AND FAMILY EDUCATION 
624.28  MFIP Child Care                                       6,817,000 
624.31                            ARTICLE 11C 
624.32                           APPROPRIATIONS 
624.33  Section 1.  [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 
624.34     The sums shown in the columns marked "APPROPRIATIONS" are 
624.35  appropriated from the general fund, or any other fund named, to 
624.36  the agencies and for the purposes specified in the sections of 
624.37  this article, to be available for the fiscal years indicated for 
625.1   each purpose.  The figures "2004" and "2005" where used in this 
625.2   article, mean that the appropriation or appropriations listed 
625.3   under them are available for the fiscal year ending June 30, 
625.4   2004, or June 30, 2005, respectively.  Where a dollar amount 
625.5   appears in parentheses, it means a reduction of an appropriation.
625.6                           SUMMARY BY FUND
625.7                                                        BIENNIAL
625.8                              2004          2005           TOTAL
625.9   General            $3,623,751,000 $3,535,232,000 $7,158,983,000
625.10  State Government
625.11  Special Revenue        45,162,000     44,899,000     90,061,000
625.12  Health Care 
625.13  Access                262,386,000    328,686,000    591,072,000
625.14  Federal TANF          267,482,000    267,161,000    534,643,000
625.15  Lottery Prize 
625.16  Fund                    1,306,000      1,306,000      2,612,000
625.17  TOTAL              $4,200,087,000 $4,177,284,000 $8,377,371,000
625.18                                             APPROPRIATIONS 
625.19                                         Available for the Year 
625.20                                             Ending June 30 
625.21                                            2004         2005 
625.22  Sec. 2.  COMMISSIONER OF
625.23  HUMAN SERVICES
625.24  Subdivision 1.  Total
625.25  Appropriation                     $4,071,756,000 $4,059,974,000
625.26                Summary by Fund
625.27  General           3,552,321,000 3,474,560,000
625.28  State Government 
625.29  Special Revenue         534,000       534,000
625.30  Health Care
625.31  Access              256,113,000   322,413,000
625.32  Federal TANF        261,482,000   261,161,000
625.33  Lottery Cash
625.34  Flow                  1,306,000     1,306,000
625.35  [RECEIPTS FOR SYSTEMS PROJECTS.] 
625.36  Appropriations and federal receipts for 
625.37  information system projects for MAXIS, 
625.38  PRISM, MMIS, and SSIS must be deposited 
625.39  in the state system account authorized 
625.40  in Minnesota Statutes, section 
625.41  256.014.  Money appropriated for 
625.42  computer projects approved by the 
625.43  Minnesota office of technology, funded 
625.44  by the legislature, and approved by the 
625.45  commissioner of finance may be 
625.46  transferred from one project to another 
625.47  and from development to operations as 
625.48  the commissioner of human services 
625.49  considers necessary.  Any unexpended 
626.1   balance in the appropriation for these 
626.2   projects does not cancel but is 
626.3   available for ongoing development and 
626.4   operations. 
626.5   [GIFTS.] Notwithstanding Minnesota 
626.6   Statutes, chapter 7, the commissioner 
626.7   may accept on behalf of the state 
626.8   additional funding from sources other 
626.9   than state funds for the purpose of 
626.10  financing the cost of assistance 
626.11  program grants or nongrant 
626.12  administration.  All additional funding 
626.13  is appropriated to the commissioner for 
626.14  use as designated by the grantor of 
626.15  funding. 
626.16  [SYSTEMS CONTINUITY.] In the event of 
626.17  disruption of technical systems or 
626.18  computer operations, the commissioner 
626.19  may use available grant appropriations 
626.20  to ensure continuity of payments for 
626.21  maintaining the health, safety, and 
626.22  well-being of clients served by 
626.23  programs administered by the department 
626.24  of human services.  Grant funds must be 
626.25  used in a manner consistent with the 
626.26  original intent of the appropriation. 
626.27  [NONFEDERAL SHARE TRANSFERS.] The 
626.28  nonfederal share of activities for 
626.29  which federal administrative 
626.30  reimbursement is appropriated to the 
626.31  commissioner may be transferred to the 
626.32  special revenue fund. 
626.33  [TANF FUNDS APPROPRIATED TO OTHER 
626.34  ENTITIES.] Any expenditures from the 
626.35  TANF block grant shall be expended in 
626.36  accordance with the requirements and 
626.37  limitations of part A of title IV of 
626.38  the Social Security Act, as amended, 
626.39  and any other applicable federal 
626.40  requirement or limitation.  Prior to 
626.41  any expenditure of these funds, the 
626.42  commissioner shall assure that funds 
626.43  are expended in compliance with the 
626.44  requirements and limitations of federal 
626.45  law and that any reporting requirements 
626.46  of federal law are met.  It shall be 
626.47  the responsibility of any entity to 
626.48  which these funds are appropriated to 
626.49  implement a memorandum of understanding 
626.50  with the commissioner that provides the 
626.51  necessary assurance of compliance prior 
626.52  to any expenditure of funds.  The 
626.53  commissioner shall receipt TANF funds 
626.54  appropriated to other state agencies 
626.55  and coordinate all related interagency 
626.56  accounting transactions necessary to 
626.57  implement these appropriations.  
626.58  Unexpended TANF funds appropriated to 
626.59  any state, local, or nonprofit entity 
626.60  cancel at the end of the state fiscal 
626.61  year unless appropriating language 
626.62  permits otherwise. 
626.63  [TANF FUNDS TRANSFERRED TO OTHER 
626.64  FEDERAL GRANTS.] The commissioner must 
626.65  authorize transfers from TANF to other 
626.66  federal block grants so that funds are 
627.1   available to meet the annual 
627.2   expenditure needs as appropriated.  
627.3   Transfers may be authorized prior to 
627.4   the expenditure year with the agreement 
627.5   of the receiving entity.  Transferred 
627.6   funds must be expended in the year for 
627.7   which the funds were appropriated 
627.8   unless appropriation language permits 
627.9   otherwise.  In accelerating transfer 
627.10  authorizations, the commissioner must 
627.11  aim to preserve the future potential 
627.12  transfer capacity from TANF to other 
627.13  block grants. 
627.14  [TANF MAINTENANCE OF EFFORT.] (a) In 
627.15  order to meet the basic maintenance of 
627.16  effort (MOE) requirements of the TANF 
627.17  block grant specified under Code of 
627.18  Federal Regulations, title 45, section 
627.19  263.1, the commissioner may only report 
627.20  nonfederal money expended for allowable 
627.21  activities listed in the following 
627.22  clauses as TANF/MOE expenditures: 
627.23  (1) MFIP cash, diversionary work 
627.24  program, and food assistance benefits 
627.25  under Minnesota Statutes, chapter 256J; 
627.26  (2) the child care assistance programs 
627.27  under Minnesota Statutes, sections 
627.28  119B.03 and 119B.05, and county child 
627.29  care administrative costs under 
627.30  Minnesota Statutes, section 119B.15; 
627.31  (3) state and county MFIP 
627.32  administrative costs under Minnesota 
627.33  Statutes, chapters 256J and 256K; 
627.34  (4) state, county, and tribal MFIP 
627.35  employment services under Minnesota 
627.36  Statutes, chapters 256J and 256K; 
627.37  (5) expenditures made on behalf of 
627.38  noncitizen MFIP recipients who qualify 
627.39  for the medical assistance without 
627.40  federal financial participation program 
627.41  under Minnesota Statutes, section 
627.42  256B.06, subdivision 4, paragraphs (d), 
627.43  (e), and (j). 
627.44  (6) qualifying working family credit 
627.45  expenditures under Minnesota Statutes, 
627.46  section 290.0671. 
627.47  (b) The commissioner shall ensure that 
627.48  sufficient qualified nonfederal 
627.49  expenditures are made each year to meet 
627.50  the state's TANF/MOE requirements.  For 
627.51  the activities listed in paragraph (a), 
627.52  clauses (2) to (6), the commissioner 
627.53  may only report expenditures that are 
627.54  excluded from the definition of 
627.55  assistance under Code of Federal 
627.56  Regulations, title 45, section 260.31. 
627.57  (c) By August 31 of each year, the 
627.58  commissioner shall make a preliminary 
627.59  calculation to determine the likelihood 
627.60  that the state will meet its annual 
627.61  federal work participation requirement 
627.62  under Code of Federal Regulations, 
628.1   title 45, sections 261.21 and 261.23, 
628.2   after adjustment for any caseload 
628.3   reduction credit under Code of Federal 
628.4   Regulations, title 45, section 261.41.  
628.5   If the commissioner determines that the 
628.6   state will meet its federal work 
628.7   participation rate for the federal 
628.8   fiscal year ending that September, the 
628.9   commissioner may reduce the expenditure 
628.10  under paragraph (a), clause (1), to the 
628.11  extent allowed under Code of Federal 
628.12  Regulations, title 45, section 
628.13  263.1(a)(2). 
628.14  (d) For fiscal years beginning with 
628.15  state fiscal year 2003, the 
628.16  commissioner shall assure that the 
628.17  maintenance of effort used by the 
628.18  commissioner of finance for the 
628.19  February and November forecasts 
628.20  required under Minnesota Statutes, 
628.21  section 16A.103, contains expenditures 
628.22  under paragraph (a), clause (1), equal 
628.23  to at least 25 percent of the total 
628.24  required under Code of Federal 
628.25  Regulations, title 45, section 263.1. 
628.26  (e) If nonfederal expenditures for the 
628.27  programs and purposes listed in 
628.28  paragraph (a) are insufficient to meet 
628.29  the state's TANF/MOE requirements, the 
628.30  commissioner shall recommend additional 
628.31  allowable sources of nonfederal 
628.32  expenditures to the legislature, if the 
628.33  legislature is or will be in session to 
628.34  take action to specify additional 
628.35  sources of nonfederal expenditures for 
628.36  TANF/MOE before a federal penalty is 
628.37  imposed.  The commissioner shall 
628.38  otherwise provide notice to the 
628.39  legislative commission on planning and 
628.40  fiscal policy under paragraph (g). 
628.41  (f) If the commissioner uses authority 
628.42  granted under section 11, or similar 
628.43  authority granted by a subsequent 
628.44  legislature, to meet the state's 
628.45  TANF/MOE requirement in a reporting 
628.46  period, the commissioner shall inform 
628.47  the chairs of the appropriate 
628.48  legislative committees about all 
628.49  transfers made under that authority for 
628.50  this purpose. 
628.51  (g) If the commissioner determines that 
628.52  nonfederal expenditures under paragraph 
628.53  (a) are insufficient to meet TANF/MOE 
628.54  expenditure requirements, and if the 
628.55  legislature is not or will not be in 
628.56  session to take timely action to avoid 
628.57  a federal penalty, the commissioner may 
628.58  report nonfederal expenditures from 
628.59  other allowable sources as TANF/MOE 
628.60  expenditures after the requirements of 
628.61  this paragraph are met.  The 
628.62  commissioner may report nonfederal 
628.63  expenditures in addition to those 
628.64  specified under paragraph (a) as 
628.65  nonfederal TANF/MOE expenditures, but 
628.66  only ten days after the commissioner of 
628.67  finance has first submitted the 
629.1   commissioner's recommendations for 
629.2   additional allowable sources of 
629.3   nonfederal TANF/MOE expenditures to the 
629.4   members of the legislative commission 
629.5   on planning and fiscal policy for their 
629.6   review. 
629.7   (h) The commissioner of finance shall 
629.8   not incorporate any changes in federal 
629.9   TANF expenditures or nonfederal 
629.10  expenditures for TANF/MOE that may 
629.11  result from reporting additional 
629.12  allowable sources of nonfederal 
629.13  TANF/MOE expenditures under the interim 
629.14  procedures in paragraph (g) into the 
629.15  February or November forecasts required 
629.16  under Minnesota Statutes, section 
629.17  16A.103, unless the commissioner of 
629.18  finance has approved the additional 
629.19  sources of expenditures under paragraph 
629.20  (g). 
629.21  (i) Minnesota Statutes, section 
629.22  256.011, subdivision 3, which requires 
629.23  that federal grants or aids secured or 
629.24  obtained under that subdivision be used 
629.25  to reduce any direct appropriations 
629.26  provided by law, do not apply if the 
629.27  grants or aids are federal TANF funds. 
629.28  (j) Notwithstanding section 14, 
629.29  paragraph (a), clauses (1) to (5), and 
629.30  paragraphs (b) to (j) expire June 30, 
629.31  2007. 
629.32  [SHIFT COUNTY PAYMENT.] The 
629.33  commissioner shall make up to 100 
629.34  percent of the calendar year 2005 
629.35  payments to counties for developmental 
629.36  disabilities semi-independent living 
629.37  services grants, developmental 
629.38  disabilities family support grants, and 
629.39  adult mental health grants from fiscal 
629.40  year 2006 appropriations.  This is a 
629.41  onetime payment shift.  Calendar year 
629.42  2006 and future payments for these 
629.43  grants are not affected by this shift.  
629.44  This provision expires June 30, 2006. 
629.45  [CAPITATION RATE INCREASE.] Of the 
629.46  health care access fund appropriations 
629.47  to the University of Minnesota in the 
629.48  higher education omnibus appropriation 
629.49  bill, $2,157,000 in fiscal year 2004 
629.50  and $2,157,000 in fiscal year 2005 are 
629.51  to be used to increase the capitation 
629.52  payments under Minnesota Statutes, 
629.53  section 256B.69.  Notwithstanding the 
629.54  provisions of section 14, this 
629.55  provision shall not expire. 
629.56  Subd. 2.  Agency Management        
629.57                Summary by Fund
629.58  General              41,534,000    27,868,000
629.59  State Government                             
629.60  Special Revenue         415,000       415,000
629.61  Health Care Access    3,673,000     3,673,000
630.1   Federal TANF            320,000       320,000
630.2   The amounts that may be spent from the 
630.3   appropriation for each purpose are as 
630.4   follows: 
630.5   (a) Financial Operations 
630.6   General               8,751,000     9,056,000
630.7   Health Care Access      828,000       828,000
630.8   Federal TANF            220,000       220,000
630.9   (b) Legal and
630.10  Regulation Operations 
630.11  General               7,957,000     8,168,000
630.12  State Government                             
630.13  Special Revenue         415,000       415,000
630.14  Health Care Access      244,000       244,000
630.15  Federal TANF            100,000       100,000
630.16  (c) Management Operations 
630.17  General              17,373,000     3,076,000
630.18  Health Care Access    1,623,000     1,623,000
630.19  (d) Information Technology
630.20  Operations 
630.21  General               7,453,000     7,568,000
630.22  Health Care Access      978,000       978,000
630.23  Subd. 3.  Revenue and Pass-Through 
630.24  Federal TANF         54,845,000    51,221,000
630.25  [TANF TRANSFER TO SOCIAL SERVICES BLOCK 
630.26  GRANT.] $6,000,000 in fiscal year 2004 
630.27  and $9,272,000 in fiscal year 2005 are 
630.28  appropriated to the commissioner for 
630.29  the purposes of providing services for 
630.30  families with children whose incomes 
630.31  are at or below 200 percent of the 
630.32  federal poverty guidelines.  The 
630.33  commissioner shall authorize a 
630.34  sufficient transfer of funds from the 
630.35  state's federal TANF block grant to the 
630.36  state's federal social services block 
630.37  grant to meet this appropriation.  The 
630.38  funds shall be distributed to counties 
630.39  for the children and community services 
630.40  grant according to the formula for the 
630.41  state appropriations in Minnesota 
630.42  Statutes, chapter 256M. 
630.43  [TANF FUNDS FOR FISCAL YEAR 2006 AND 
630.44  FISCAL YEAR 2007 REFINANCING.] 
630.45  $16,724,000 in fiscal year 2006 and 
630.46  $16,827,000 in fiscal year 2007 in TANF 
630.47  funds are available to the commissioner 
630.48  to replace general funds in the amount 
630.49  of $16,724,000 in fiscal year 2006 and 
630.50  $16,827,000 in fiscal year 2007 in 
630.51  expenditures that may be counted toward 
631.1   TANF maintenance of effort requirements 
631.2   or as an allowable TANF expenditure. 
631.3   [REDUCTION IN TANF TRANSFER TO CHILD 
631.4   CARE AND DEVELOPMENT FUND.] Transfers 
631.5   of TANF to the child care development 
631.6   fund for the purposes of MFIP child 
631.7   care assistance shall be reduced by 
631.8   $1,126,000 in fiscal year 2004 and 
631.9   $118,000 in fiscal year 2005. 
631.10  Subd. 4.  Children's Services Grants 
631.11                Summary by Fund
631.12  General             105,760,000    92,165,000
631.13  Federal TANF          6,000,000     9,272,000
631.14  [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 
631.15  Federal funds available during fiscal 
631.16  year 2004 and fiscal year 2005, for 
631.17  adoption incentive grants are 
631.18  appropriated to the commissioner for 
631.19  these purposes. 
631.20  [ADOPTION ASSISTANCE AND RELATIVE 
631.21  CUSTODY ASSISTANCE.] The commissioner 
631.22  may transfer unencumbered appropriation 
631.23  balances for adoption assistance and 
631.24  relative custody assistance between 
631.25  fiscal years and between programs. 
631.26  Subd. 5.  Children's Services Management 
631.27  General               5,221,000     5,283,000
631.28  Subd. 6.  Basic Health Care Grants 
631.29                Summary by Fund
631.30  General           1,501,432,000 1,457,549,000
631.31  Health Care Access  236,638,000   303,184,000
631.32  [UPDATING FEDERAL POVERTY GUIDELINES.] 
631.33  Annual updates to the federal poverty 
631.34  guidelines are effective each July 1, 
631.35  following publication by the United 
631.36  States Department of Health and Human 
631.37  Services for health care programs under 
631.38  Minnesota Statutes, chapters 256, 256B, 
631.39  256D, and 256L. 
631.40  The amounts that may be spent from this 
631.41  appropriation for each purpose are as 
631.42  follows: 
631.43  (a) MinnesotaCare Grants 
631.44  Health Care Access 232,634,000   299,083,000
631.45  [MINNESOTACARE FEDERAL RECEIPTS.] 
631.46  Receipts received as a result of 
631.47  federal participation pertaining to 
631.48  administrative costs of the Minnesota 
631.49  health care reform waiver shall be 
631.50  deposited as nondedicated revenue in 
631.51  the health care access fund.  Receipts 
631.52  received as a result of federal 
631.53  participation pertaining to grants 
632.1   shall be deposited in the federal fund 
632.2   and shall offset health care access 
632.3   funds for payments to providers. 
632.4   [MINNESOTACARE FUNDING.] The 
632.5   commissioner may expend money 
632.6   appropriated from the health care 
632.7   access fund for MinnesotaCare in either 
632.8   fiscal year of the biennium. 
632.9   [MINNESOTACARE NOT AN ENTITLEMENT.] The 
632.10  MinnesotaCare program is not an 
632.11  entitlement.  Enrollment in the 
632.12  program, eligibility criteria, and 
632.13  covered services are subject to the 
632.14  availability of funding, and may be 
632.15  modified by the commissioner of human 
632.16  services to maintain program 
632.17  expenditures within the level of 
632.18  funding.  Notwithstanding section 14, 
632.19  this provision does not expire. 
632.20  (b) MA Basic Health Care Grants - 
632.21  Families and Children 
632.22  General             560,143,000   575,614,000
632.23  (c) MA Basic Health Care Grants - Elderly 
632.24  and Disabled 
632.25  General             696,413,000   750,033,000
632.26  [DELAY MA FEE FOR SERVICE - ACUTE 
632.27  CARE.] The last payment in fiscal year 
632.28  2005 from the Medicaid Management 
632.29  Information System that would otherwise 
632.30  have been made to providers for medical 
632.31  assistance and general assistance 
632.32  medical care services shall be delayed 
632.33  and included in the first payment in 
632.34  fiscal year 2006.  This payment delay 
632.35  shall not include payments to skilled 
632.36  nursing facilities, intermediate care 
632.37  facilities for mental retardation, 
632.38  prepaid health plans, home health 
632.39  agencies, personal care nursing 
632.40  providers, and providers of only waiver 
632.41  services.  The provisions of Minnesota 
632.42  Statutes, section 16A.124, shall not 
632.43  apply to these delayed payments.  
632.44  Notwithstanding section 14, this 
632.45  provision shall not expire. 
632.46  (d) General Assistance Medical Care 
632.47  Grants 
632.48  General             232,650,000   119,904,000
632.49  (e) Health Care Grants - Other 
632.50  Assistance 
632.51  General               2,660,000     2,472,000
632.52  Health Care Access    4,004,000     4,101,000
632.53  (f) Prescription Drug Program 
632.54  General               9,566,000     9,526,000
632.55  [TRANSFER FOR THE PRESCRIPTION DRUG 
632.56  ASSISTANCE PROGRAM.] Of the 
633.1   appropriation from the general fund for 
633.2   the prescription drug program under 
633.3   Minnesota Statutes, section 256.955, 
633.4   for the biennium beginning July 1, 2003 
633.5   $1,739,000 is for the commissioner of 
633.6   human services to establish and 
633.7   administer the prescription drug 
633.8   assistance program through the 
633.9   Minnesota board on aging. 
633.10  [MINNESOTA PRESCRIPTION DRUG DEDICATED 
633.11  FUND.] Of this appropriation, 
633.12  $7,200,000 is appropriated from the 
633.13  health care access fund to the 
633.14  commissioner of human services for the 
633.15  fiscal year beginning July 1, 2003, for 
633.16  the Minnesota prescription drug 
633.17  dedicated fund established under the 
633.18  prescription drug discount program.  
633.19  This is a onetime appropriation. 
633.20  Subd. 7.  Health Care Management 
633.21                Summary by Fund
633.22  General              24,452,000    24,517,000
633.23  Health Care Access   14,453,000    14,207,000
633.24  The amounts that may be spent from this 
633.25  appropriation for each purpose are as 
633.26  follows: 
633.27  (a) Health Care Policy Administration 
633.28  General               4,222,000     5,466,000
633.29  Health Care Access      846,000       846,000
633.30  [MINNESOTACARE OUTREACH REIMBURSEMENT.] 
633.31  Federal administrative reimbursement 
633.32  resulting from MinnesotaCare outreach 
633.33  is appropriated to the commissioner for 
633.34  this activity. 
633.35  [MINNESOTA SENIOR HEALTH OPTIONS 
633.36  REIMBURSEMENT.] Federal administrative 
633.37  reimbursement resulting from the 
633.38  Minnesota senior health options project 
633.39  is appropriated to the commissioner for 
633.40  this activity. 
633.41  [UTILIZATION REVIEW.] Federal 
633.42  administrative reimbursement resulting 
633.43  from prior authorization and inpatient 
633.44  admission certification by a 
633.45  professional review organization shall 
633.46  be dedicated to the commissioner for 
633.47  these purposes.  A portion of these 
633.48  funds must be used for activities to 
633.49  decrease unnecessary pharmaceutical 
633.50  costs in medical assistance. 
633.51  (b) Health Care Options 
633.52  General              20,230,000    20,051,000
633.53  Health Care Access   13,607,000    13,361,000
633.54  [PREPAID MEDICAL PROGRAMS.] For all 
633.55  counties in which the PMAP program has 
634.1   been operating for 12 or more months, 
634.2   state funding for the nonfederal share 
634.3   of prepaid medical assistance program 
634.4   administration costs for county managed 
634.5   care advocacy and enrollment operations 
634.6   is eliminated.  State funding will 
634.7   continue for these activities for 
634.8   counties and tribes establishing new 
634.9   PMAP programs for a maximum of 16 
634.10  months (four months prior to beginning 
634.11  PMAP enrollment and through the first 
634.12  12 months of their PMAP program 
634.13  operation).  Those counties operating 
634.14  PMAP programs for less than 12 months 
634.15  can continue to receive state funding 
634.16  for advocacy and enrollment activities 
634.17  through their first year of operation. 
634.18  Subd. 8.  State-operated Services 
634.19  General             195,062,000   186,775,000
634.20  [MITIGATION RELATED TO STATE-OPERATED 
634.21  SERVICES RESTRUCTURING.] Money 
634.22  appropriated to finance mitigation 
634.23  expenses related to restructuring 
634.24  state-operated services programs and 
634.25  administrative services may be 
634.26  transferred between fiscal years within 
634.27  the biennium. 
634.28  [STATE-OPERATED SERVICES 
634.29  RESTRUCTURING.] For purposes of 
634.30  restructuring state-operated services, 
634.31  any state-operated services employee 
634.32  whose position is to be eliminated 
634.33  shall be afforded the options provided 
634.34  in applicable collective bargaining 
634.35  agreements.  All salary and mitigation 
634.36  allocations from fiscal year 2004 shall 
634.37  be carried forward into fiscal year 
634.38  2005.  Provided there is no conflict 
634.39  with any collective bargaining 
634.40  agreement, any state-operated services 
634.41  position reduction must only be 
634.42  accomplished through mitigation, 
634.43  attrition, transfer, and other measures 
634.44  as provided in state or applicable 
634.45  collective bargaining agreements and in 
634.46  Minnesota Statutes, section 252.50, 
634.47  subdivision 11, and not through layoff. 
634.48  [REPAIRS AND BETTERMENTS.] The 
634.49  commissioner may transfer unencumbered 
634.50  appropriation balances between fiscal 
634.51  years within the biennium for the state 
634.52  residential facilities repairs and 
634.53  betterments account and special 
634.54  equipment. 
634.55  Subd. 9.  Continuing Care Grants 
634.56                Summary by Fund
634.57  General           1,504,983,000 1,503,331,000
634.58  Lottery Prize Fund    1,158,000     1,158,000
634.59  The amounts that may be spent from this 
634.60  appropriation for each purpose are as 
634.61  follows: 
635.1   (a) Aging and Adult Service Grant 
635.2   General              12,259,000    13,212,000
635.3   [LONG-TERM CARE PROGRAM REDUCTIONS.] 
635.4   For the biennium ending June 30, 2005, 
635.5   state funding for the following state 
635.6   long-term care programs is reduced by 
635.7   15 percent from the level of state 
635.8   funding provided on June 30, 2003:  
635.9   SAIL project grants under Minnesota 
635.10  Statutes, section 256B.0917; 
635.11  independent living demonstration 
635.12  project for persons with epilepsy 
635.13  established under Laws 1988, chapter 
635.14  689, article 2, section 251; the 
635.15  congregate meals portion of senior 
635.16  nutrition programs under Minnesota 
635.17  Statutes, section 256.9752; foster 
635.18  grandparents program under Minnesota 
635.19  Statutes, section 256.976; retired 
635.20  senior volunteer program under 
635.21  Minnesota Statutes, section 256.9753; 
635.22  and the senior companion program under 
635.23  Minnesota Statutes, section 256.977. 
635.24  (b) Deaf and Hard-of-hearing 
635.25  Service Grants 
635.26  General               1,725,000     1,498,000
635.27  (c) Mental Health Grants 
635.28  General              53,744,000    34,955,000
635.29  Lottery Prize Fund    1,158,000     1,158,000
635.30  [RESTRUCTURING OF ADULT MENTAL HEALTH 
635.31  SERVICES.] The commissioner may make 
635.32  budget neutral transfers to effectively 
635.33  implement the restructuring of adult 
635.34  mental health services.  "Budget 
635.35  neutral transfers" means transfers 
635.36  which do not increase the state share 
635.37  of costs.  
635.38  (d) Community Support Grants 
635.39  General               13,022,000   10,091,000
635.40  (e) Medical Assistance Long-Term 
635.41  Care Waivers and Home Care Grants 
635.42  General              666,828,000  729,808,000
635.43  [REDUCE GROWTH IN MR/RC WAIVER.] The 
635.44  commissioner shall reduce the growth in 
635.45  the MR/RC waiver by not allocating the 
635.46  300 additional diversion allocations 
635.47  that are included in the February 2003 
635.48  forecast for the fiscal years that 
635.49  begin on July 1, 2003, and July 1, 2004.
635.50  [MANAGE THE GROWTH IN THE TBI WAIVER.] 
635.51  During the fiscal years beginning on 
635.52  July 1, 2003, and July 1, 2004, the 
635.53  commissioner shall allocate money for 
635.54  home and community-based programs 
635.55  covered under Minnesota Statutes, 
635.56  section 256B.49, to assure a reduction 
635.57  in state spending that is equivalent to 
636.1   limiting the caseload growth of the TBI 
636.2   waiver to 150 in each year of the 
636.3   biennium.  Priorities for the 
636.4   allocation of funds shall be for 
636.5   individuals anticipated to be 
636.6   discharged from institutional settings 
636.7   or who are at imminent risk of a 
636.8   placement in an institutional setting. 
636.9   [TARGETED CASE MANAGEMENT FOR HOME CARE 
636.10  RECIPIENTS.] Implementation of the 
636.11  targeted case management benefit for 
636.12  home care recipients, according to 
636.13  Minnesota Statutes, section 256B.0621, 
636.14  subdivisions 2, 3, 5, 6, 7, 9, and 10, 
636.15  will be delayed until July 1, 2005. 
636.16  [COMMON SERVICE MENU.] Implementation 
636.17  of the common service menu option 
636.18  within the home and community-based 
636.19  waivers, according to Minnesota 
636.20  Statutes, section 256B.49, subdivision 
636.21  16, will be delayed until July 1, 2005. 
636.22  (f) Medical Assistance Long-term 
636.23  Care Facilities Grants 
636.24  General             540,712,000   521,251,000
636.25  (g) Alternative Care Grants 
636.26  General              71,382,000    59,885,000
636.27  [ALTERNATIVE CARE TRANSFER.] Any money 
636.28  allocated to the alternative care 
636.29  program that is not spent for the 
636.30  purposes indicated does not cancel but 
636.31  shall be transferred to the medical 
636.32  assistance account. 
636.33  [ALTERNATIVE CARE APPROPRIATION.] The 
636.34  commissioner may expend the money 
636.35  appropriated for the alternative care 
636.36  program for that purpose in either year 
636.37  of the biennium. 
636.38  [ALTERNATIVE CARE IMPLEMENTATION OF 
636.39  CHANGES TO PREMIUMS AND ELIGIBILITY.] 
636.40  Changes to Minnesota Statutes, section 
636.41  256B.0913, subdivision 4, paragraph 
636.42  (d), and subdivision 12, are effective 
636.43  July 1, 2003, for all persons found 
636.44  eligible for the alternative care 
636.45  program on or after July 1, 2003.  All 
636.46  recipients of alternative care funding 
636.47  as of June 30, 2003, shall be subject 
636.48  to Minnesota Statutes, section 
636.49  256B.0913, subdivision 4, paragraph 
636.50  (d), and subdivision 12, on the annual 
636.51  reassessment and review of their 
636.52  eligibility after July 1, 2003, but no 
636.53  later than January 1, 2004. 
636.54  (h) Group Residential Housing Grants 
636.55  General              94,583,000    80,728,000
636.56  [GROUP RESIDENTIAL HOUSING COSTS 
636.57  REFINANCED.] Effective July 1, 2004, 
636.58  the commissioner shall increase the 
636.59  home and community-based service rates 
637.1   and county allocations provided to 
637.2   programs established under section 
637.3   1915(c) of the Social Security Act to 
637.4   the extent that these programs will be 
637.5   paying for the costs above the rate 
637.6   established in Minnesota Statutes, 
637.7   section 256I.05, subdivision 1. 
637.8   (i) Chemical Dependency
637.9   Entitlement Grants 
637.10  General              49,673,000    50,848,000
637.11  (j) Chemical Dependency Nonentitlement 
637.12  Grants 
637.13  General               1,055,000     1,055,000
637.14  Subd. 10.  Continuing Care Management 
637.15                Summary by Fund
637.16  General              21,427,000    21,258,000
637.17  State Government 
637.18  Special Revenue         119,000       119,000
637.19  Lottery Prize Fund      148,000       148,000
637.20  Subd. 11.  Economic Support Grants 
637.21                Summary by Fund
637.22  General             113,422,000   116,511,000
637.23  Federal TANF        199,816,000   199,856,000
637.24  The amounts that may be spent from this 
637.25  appropriation for each purpose are as 
637.26  follows: 
637.27  (a) Minnesota Family Investment Program 
637.28  General              50,947,000    38,938,000
637.29  Federal TANF        104,756,000    98,170,000
637.30  (b) Work Grants 
637.31  General                 666,000    14,678,000
637.32  Federal TANF         94,800,000   101,426,000
637.33  [MFIP SUPPORT SERVICES COUNTY AND 
637.34  TRIBAL ALLOCATION.] When determining 
637.35  the funds available for the 
637.36  consolidated MFIP support services 
637.37  grant in the 18-month period ending 
637.38  December 31, 2004, the commissioner 
637.39  shall apportion the funds appropriated 
637.40  for fiscal year 2005 in such manner as 
637.41  necessary to provide $14,000,000 more 
637.42  to counties and tribes for the period 
637.43  ending December 31, 2004, than would 
637.44  have been available had the funds been 
637.45  evenly divided within the fiscal year 
637.46  between the period before December 31, 
637.47  2004, and the period after December 31, 
637.48  2004. 
637.49  For allocations for the calendar years 
638.1   starting January 1, 2005, the 
638.2   commissioner shall apportion the funds 
638.3   appropriated for each fiscal year in 
638.4   such manner as necessary to provide 
638.5   $14,000,000 more to counties and tribes 
638.6   for the period ending December 31 of 
638.7   that year than would have been 
638.8   available had the funds been evenly 
638.9   divided within the fiscal year between 
638.10  the period before December 31 and the 
638.11  period after December 31. 
638.12  (c) Economic Support Grants - Other 
638.13  Assistance 
638.14  General               3,358,000     3,463,000
638.15  (d) Child Support Enforcement Grants 
638.16  General               3,571,000     3,503,000
638.17  Federal TANF            260,000       260,000
638.18  (e) General Assistance Grants
638.19  General              24,651,000    24,482,000
638.20  [GENERAL ASSISTANCE STANDARD.] The 
638.21  commissioner shall set the monthly 
638.22  standard of assistance for general 
638.23  assistance units consisting of an adult 
638.24  recipient who is childless and 
638.25  unmarried or living apart from parents 
638.26  or a legal guardian at $203.  The 
638.27  commissioner may reduce this amount 
638.28  according to Laws 1997, chapter 85, 
638.29  article 3, section 54. 
638.30  [EMERGENCY GENERAL ASSISTANCE.] The 
638.31  amount appropriated for emergency 
638.32  general assistance funds is limited to 
638.33  no more than $7,889,812 in each fiscal 
638.34  year of 2004 and 2005.  Funds to 
638.35  counties shall be allocated by the 
638.36  commissioner using the allocation 
638.37  method specified in Minnesota Statutes, 
638.38  section 256D.06. 
638.39  (f) Minnesota Supplemental Aid Grants 
638.40  General              30,229,000    31,447,000
638.41  [EMERGENCY MINNESOTA SUPPLEMENTAL AID 
638.42  FUNDS.] The amount appropriated for 
638.43  emergency Minnesota supplemental aid 
638.44  funds is limited to no more than 
638.45  $1,138,707 in fiscal year 2004 and 
638.46  $1,017,000 in fiscal year 2005.  Funds 
638.47  to counties shall be allocated by the 
638.48  commissioner using the allocation 
638.49  method specified in Minnesota Statutes, 
638.50  section 256D.46. 
638.51  Subd. 12.  Economic Support
638.52  Management 
638.53                Summary by Fund
638.54  General              39,028,000    39,303,000
638.55  Health Care Access    1,349,000     1,349,000
639.1   Federal TANF            368,000       368,000
639.2   The amounts that may be spent from this 
639.3   appropriation for each purpose are as 
639.4   follows: 
639.5   (a) Economic Support 
639.6   Policy Administration
639.7   General               5,360,000     5,587,000
639.8   Federal TANF            368,000       368,000
639.9   (b) Economic Support 
639.10  Operations 
639.11  General              33,668,000    33,716,000
639.12  Health Care Access    1,349,000     1,349,000
639.13  [CHILD SUPPORT PAYMENT CENTER.] 
639.14  Payments to the commissioner from other 
639.15  governmental units, private 
639.16  enterprises, and individuals for 
639.17  services performed by the child support 
639.18  payment center must be deposited in the 
639.19  state systems account authorized under 
639.20  Minnesota Statutes, section 256.014.  
639.21  These payments are appropriated to the 
639.22  commissioner for the operation of the 
639.23  child support payment center or system, 
639.24  according to Minnesota Statutes, 
639.25  section 256.014. 
639.26  [CHILD SUPPORT COST RECOVERY FEES.] The 
639.27  commissioner shall transfer $247,000 of 
639.28  child support cost recovery fees 
639.29  collected in fiscal year 2005 to the 
639.30  PRISM special revenue account to offset 
639.31  PRISM system costs of implementing the 
639.32  fee. 
639.33  [FINANCIAL INSTITUTION DATA MATCH AND 
639.34  PAYMENT OF FEES.] The commissioner is 
639.35  authorized to allocate up to $310,000 
639.36  each year in fiscal year 2004 and 
639.37  fiscal year 2005 from the PRISM special 
639.38  revenue account to make payments to 
639.39  financial institutions in exchange for 
639.40  performing data matches between account 
639.41  information held by financial 
639.42  institutions and the public authority's 
639.43  database of child support obligors as 
639.44  authorized by Minnesota Statutes, 
639.45  section 13B.06, subdivision 7. 
639.46  Sec. 3.  COMMISSIONER OF HEALTH
639.47  Subdivision 1.  Total
639.48  Appropriation                        101,714,000    101,980,000
639.49                Summary by Fund
639.50  General              56,561,000    57,090,000
639.51  State Government
639.52  Special Revenue      32,880,000    32,617,000
639.53  Health Care Access    6,273,000     6,273,000
639.54  Federal TANF          6,000,000     6,000,000
640.1   Subd. 2.  Health Improvement 
640.2                 Summary by Fund
640.3   General              42,584,000    42,178,000
640.4   State Government
640.5   Special Revenue       1,987,000     1,987,000
640.6   Health Care Access    3,510,000     3,510,000
640.7   Federal TANF          6,000,000     6,000,000
640.8   [TOBACCO PREVENTION ENDOWMENT FUND 
640.9   TRANSFERS.] (a) On July 1, 2003, the 
640.10  commissioner of finance shall transfer 
640.11  $4,000,000 from the tobacco use 
640.12  prevention and local public health 
640.13  endowment expendable trust fund to the 
640.14  general fund. 
640.15  (b) Notwithstanding Minnesota Statutes, 
640.16  section 16A.62, any remaining 
640.17  unexpended balance in the fund after 
640.18  the transfer in paragraph (a) shall be 
640.19  transferred to the miscellaneous 
640.20  special revenue fund and dedicated to 
640.21  the commissioner of health for a youth 
640.22  tobacco prevention program.  These 
640.23  funds are available until expended. 
640.24  [TANF APPROPRIATIONS.] TANF funds 
640.25  appropriated to the commissioner are 
640.26  available for home visiting and 
640.27  nutritional activities listed under 
640.28  Minnesota Statutes, section 145.882, 
640.29  subdivision 7, clauses (6) and (7), and 
640.30  eliminating health disparities 
640.31  activities under Minnesota Statutes, 
640.32  section 145.928, subdivision 10.  
640.33  Funding shall be distributed to 
640.34  community health boards and tribal 
640.35  governments based on the formula in 
640.36  Minnesota Statutes, section 145A.131, 
640.37  subdivisions 1 and 2. 
640.38  [TANF CARRYFORWARD.] Any unexpended 
640.39  balance of the TANF appropriation in 
640.40  the first year of the biennium does not 
640.41  cancel but is available for the second 
640.42  year. 
640.43  [IGT MEDICARE UPPER PAYMENT LIMIT.] If 
640.44  variations in intergovernmental 
640.45  transfer revenue occur resulting from 
640.46  adjustments to medical assistance and 
640.47  general assistance medical care 
640.48  payments for inpatient and outpatient 
640.49  hospital services, then appropriations 
640.50  for community clinic grants and rural 
640.51  hospital capital improvement grants 
640.52  shall be adjusted accordingly. 
640.53  [FAMILY PLANNING GRANTS.] On June 30, 
640.54  2005, family planning grants are 
640.55  reduced by $4,478,000.  Base level 
640.56  funding in each year of the fiscal year 
640.57  2006-2007 biennium is $2,618,000.  
640.58  Subd. 3.  Health Quality and 
640.59  Access 
641.1                 Summary by Fund
641.2   General                 873,000       814,000
641.3   State Government
641.4   Special Revenue       8,888,000     8,888,000
641.5   Health Care Access    2,763,000     2,763,000
641.6   [STATE GOVERNMENT SPECIAL REVENUE FUND 
641.7   TRANSFERS.] On July 1, 2003, the 
641.8   commissioner of finance shall transfer 
641.9   $3,000,000 from the state government 
641.10  special revenue fund to the general 
641.11  fund.  On July 1, 2004, the 
641.12  commissioner of finance shall transfer 
641.13  $1,000,000 from the state government 
641.14  special revenue fund to the general 
641.15  fund. 
641.16  [NURSING PROVIDERS WORK GROUP.] 
641.17  Notwithstanding the provisions of 
641.18  Minnesota Statutes, section 144A.10, 
641.19  during the next biennium, the 
641.20  commissioner of health shall not 
641.21  conduct surveys under the provisions of 
641.22  Minnesota Rules, chapter 4655, and 
641.23  chapter 4658, parts 4658.0010 to 
641.24  4658.2090 in nursing homes or boarding 
641.25  care homes that are certified for 
641.26  participation in the federal Medicaid 
641.27  or Medicare program.  During the next 
641.28  biennium, the commissioner of health 
641.29  shall establish a working group 
641.30  consisting of nursing home and boarding 
641.31  care home providers, representatives of 
641.32  nursing home residents, and other 
641.33  health care providers to review current 
641.34  licensure provisions and evaluate the 
641.35  continued appropriateness of these 
641.36  provisions.  The commissioner shall 
641.37  present recommendations to the 
641.38  legislature by January 1, 2005. 
641.39  [MEDICAL EDUCATION ENDOWMENT FUND 
641.40  TRANSFERS.] Notwithstanding Minnesota 
641.41  Statutes, section 16A.62, any remaining 
641.42  unexpended balances in the medical 
641.43  education expendable trust fund shall 
641.44  be transferred to the miscellaneous 
641.45  special revenue fund and dedicated to 
641.46  the commissioner for the purposes 
641.47  identified in Minnesota Statutes, 
641.48  section 62J.692.  These funds are 
641.49  available until expended. 
641.50  [MEDICAL EDUCATION AND RESEARCH COSTS.] 
641.51  $8,660,000 in fiscal year 2004 and 
641.52  $8,616,000 in fiscal year 2005 are 
641.53  appropriated from the medical education 
641.54  and research costs account in the 
641.55  special revenue fund for medical 
641.56  education and research funding.  In the 
641.57  event that the balance in the account 
641.58  is less than the appropriation, the 
641.59  appropriation is reduced accordingly. 
641.60  Subd. 4.  Health Protection 
641.61                Summary by Fund
642.1   General               8,855,000     8,855,000
642.2   State Government
642.3   Special Revenue      22,005,000    21,742,000
642.4   Subd. 5.  Management and Support 
642.5   Services 
642.6   General               5,249,000     5,243,000
642.7   [STATE GOVERNMENT SPECIAL REVENUE FUND 
642.8   TRANSFERS.] On July 1, 2003, the 
642.9   commissioner of finance shall transfer 
642.10  $4,000,000 from the state government 
642.11  special revenue fund to the general 
642.12  fund. 
642.13  Sec. 4.  VETERANS HOME BOARD 
642.14  General              30,030,000    30,030,000
642.15  [VETERANS HOMES SPECIAL REVENUE 
642.16  ACCOUNT.] The general fund 
642.17  appropriations made to the board may be 
642.18  transferred to a veterans homes special 
642.19  revenue account in the special revenue 
642.20  fund in the same manner as other 
642.21  receipts are deposited according to 
642.22  Minnesota Statutes, section 198.34, and 
642.23  are appropriated to the board for the 
642.24  operation of board facilities and 
642.25  programs. 
642.26  Sec. 5.  HEALTH-RELATED BOARDS 
642.27  Subdivision 1.  Total
642.28  Appropriation                         11,266,000     11,266,000 
642.29  [STATE GOVERNMENT SPECIAL REVENUE 
642.30  FUND.] The appropriations in this 
642.31  section are from the state government 
642.32  special revenue fund, except where 
642.33  noted. 
642.34  [NO SPENDING IN EXCESS OF REVENUES.] 
642.35  The commissioner of finance shall not 
642.36  permit the allotment, encumbrance, or 
642.37  expenditure of money appropriated in 
642.38  this section in excess of the 
642.39  anticipated biennial revenues or 
642.40  accumulated surplus revenues from fees 
642.41  collected by the boards.  Neither this 
642.42  provision nor Minnesota Statutes, 
642.43  section 214.06, applies to transfers 
642.44  from the general contingent account. 
642.45  [STATE GOVERNMENT SPECIAL REVENUE FUND 
642.46  TRANSFERS.] On July 1, 2003, the 
642.47  commissioner of finance shall transfer 
642.48  $3,500,000 from the state government 
642.49  special revenue fund to the general 
642.50  fund. 
642.51  Subd. 2.  Board of Chiropractic
642.52  Examiners                                384,000        384,000 
642.53  Subd. 3.  Board of Dentistry                                    
642.54  State Government Special    
642.55  Revenue Fund                             858,000        858,000 
643.1   Health Care                 
643.2   Access Fund                               64,000         64,000 
643.3   Subd. 4.  Board of Dietetic and 
643.4   Nutrition Practice                       101,000        101,000 
643.5   Subd. 5.  Board of Marriage and
643.6   Family Therapy                           118,000        118,000 
643.7   Subd. 6.  Board of Medical
643.8   Practice                               3,498,000      3,498,000 
643.9   Subd. 7.  Board of Nursing             2,405,000      2,405,000 
643.10  Subd. 8.  Board of Nursing
643.11  Home Administrators                      198,000        198,000 
643.12  Subd. 9.  Board of Optometry              96,000         96,000 
643.13  Subd. 10.  Board of Pharmacy           1,386,000      1,386,000 
643.14  [ADMINISTRATIVE SERVICES UNIT.] Of this 
643.15  appropriation, $359,000 the first year 
643.16  and $359,000 the second year are for 
643.17  the health boards administrative 
643.18  services unit.  The administrative 
643.19  services unit may receive and expend 
643.20  reimbursements for services performed 
643.21  for other agencies. 
643.22  Subd. 11.  Board of Physical
643.23  Therapy                                  197,000        197,000 
643.24  Subd. 12.  Board of Podiatry              45,000         45,000 
643.25  Subd. 13.  Board of Psychology           680,000        680,000 
643.26  Subd. 14.  Board of Social 
643.27  Work                                   1,073,000      1,073,000 
643.28  Subd. 15.  Board of Veterinary
643.29  Medicine                                 163,000        163,000 
643.30  Sec. 6.  EMERGENCY MEDICAL SERVICES BOARD 
643.31  Subdivision 1.  Total
643.32  Appropriation                          2,850,000      2,850,000
643.33                Summary by Fund
643.34  General               2,304,000     2,304,000
643.35  State Government
643.36  Special Revenue         546,000       546,000
643.37  [HEALTH PROFESSIONAL SERVICES 
643.38  ACTIVITY.] $546,000 each year from the 
643.39  state government special revenue fund 
643.40  is for the health professional services 
643.41  activity. 
643.42  Sec. 7.  COUNCIL ON DISABILITY 
643.43  General                                  500,000        500,000
643.44  Sec. 8.  OMBUDSMAN FOR MENTAL HEALTH 
643.45  AND MENTAL RETARDATION                                          
643.46  General                                1,243,000      1,242,000 
643.47  Sec. 9.  OMBUDSMAN FOR 
644.1   FAMILIES                                                        
644.2   General                                  170,000        170,000 
644.3   Sec. 10.  DEPARTMENT OF CHILDREN, 
644.4    FAMILIES, AND LEARNING 
644.5   Subdivision 1.  Total 
644.6   Appropriation                     $  122,906,000 $  117,307,000
644.7                 Summary by Fund
644.8   General              95,431,000    93,318,000
644.9   Federal TANF         24,135,000    20,649,000
644.10  State Special 
644.11  Revenue               3,340,000     3,340,000 
644.12  Subd. 2.  Child Care 
644.13  [BASIC SLIDING FEE CHILD CARE.] Of this 
644.14  appropriation, $23,561,000 in fiscal 
644.15  year 2004, and $18,984,000 in fiscal 
644.16  year 2005 are for child care assistance 
644.17  according to Minnesota Statutes, 
644.18  section 119B.03.  These appropriations 
644.19  are available to be spent either year. 
644.20  [MFIP CHILD CARE.] Of this 
644.21  appropriation, $66,752,000 in fiscal 
644.22  year 2004, and $67,416,000 in fiscal 
644.23  year 2005 are for MFIP child care. 
644.24  [CHILD CARE PROGRAM INTEGRITY.] Of this 
644.25  appropriation, $425,000 in fiscal year 
644.26  2004, and $376,000 in fiscal year 2005 
644.27  are for the administrative costs of 
644.28  program integrity and fraud prevention 
644.29  for child care assistance under 
644.30  Minnesota Statutes, chapter 119B. 
644.31  [CHILD CARE DEVELOPMENT.] Of this 
644.32  appropriation, $1,115,000 in fiscal 
644.33  year 2004, and $1,164,000 in fiscal 
644.34  year 2005 are for child care 
644.35  development grants according to 
644.36  Minnesota Statutes, section 119B.21. 
644.37  Subd. 3.  Child Care Assistance
644.38  Special Revenue Account                3,340,000 $    3,340,000
644.39  [CHILD SUPPORT SPECIAL REVENUE 
644.40  ACCOUNT.] Appropriations and transfers 
644.41  in this subdivision are from the child 
644.42  support collection payments in the 
644.43  special revenue fund, pursuant to 
644.44  Minnesota Statutes, section 119B.074.  
644.45  The sums indicated are appropriated to 
644.46  the department of children, families, 
644.47  and learning for the fiscal years 
644.48  designated. 
644.49  [CHILD CARE ASSISTANCE.] Of this 
644.50  appropriation, $3,340,000 in fiscal 
644.51  year 2004, and $3,340,000 in fiscal 
644.52  year 2005 are for child care assistance 
644.53  according to Minnesota Statutes, 
644.54  section 119B.03. 
644.55  [SPECIAL REVENUE ACCOUNT UNOBLIGATED 
645.1   FUND TRANSFER.] On July 1, 2003, the 
645.2   commissioner of finance shall transfer 
645.3   $1,800,000 from the special revenue 
645.4   fund to the general fund. 
645.5   Subd. 4.  Child Care
645.6   Assistance TANF Funds
645.7   [FEDERAL TANF TRANSFERS.] The sums 
645.8   indicated in this section are 
645.9   transferred from the federal TANF fund 
645.10  to the child care and development fund 
645.11  and are appropriated to the department 
645.12  of children, families, and learning for 
645.13  the fiscal years indicated.  The 
645.14  commissioner shall ensure that all 
645.15  transferred funds are expended 
645.16  according to the child care and 
645.17  development fund regulations and that 
645.18  maximum allowable transferred funds are 
645.19  used for the following programs: 
645.20  (a) For basic sliding fee child care, 
645.21  $17,819,000 in fiscal year 2004 and 
645.22  $17,824,000 in fiscal year 2005, are 
645.23  for child care assistance under 
645.24  Minnesota Statutes, section 119B.03. 
645.25  (b) For MFIP/TY, $6,302,000 in fiscal 
645.26  year 2004 and $2,825,000 in fiscal year 
645.27  2005 are for child care assistance 
645.28  under Minnesota Statutes, section 
645.29  119B.05. 
645.30  (c) For child care development grants 
645.31  under Minnesota Statutes, section 
645.32  119B.21, $14,000 is available in fiscal 
645.33  year 2004. 
645.34   Subd. 5.  Self-Sufficiency Programs
645.35  General        5,378,000     5,378,000 
645.36  [MINNESOTA ECONOMIC OPPORTUNITY 
645.37  GRANTS.] Of this appropriation, 
645.38  $4,000,000 in fiscal year 2004 and 
645.39  $4,000,000 in fiscal year 2005 are for 
645.40  Minnesota economic opportunity grants. 
645.41  [FOOD SHELF PROGRAMS.] Of this 
645.42  appropriation, $1,278,000 in fiscal 
645.43  year 2004 and $1,278,000 in fiscal year 
645.44  2005 are for food shelf programs under 
645.45  Minnesota Statutes, section 119A.44. 
645.46  [LEAD ABATEMENT.] Of this 
645.47  appropriation, $100,000 in fiscal year 
645.48  2004 and $100,000 in fiscal year 2005 
645.49  are for lead abatement according to 
645.50  Minnesota Statutes, section 119A.46. 
645.51  Any balance in the first year does not 
645.52  cancel but is available in the second 
645.53  year. 
645.54     Sec. 11.  [TRANSFERS.] 
645.55     Subdivision 1.  [GRANTS.] The commissioner of human 
645.56  services, with the approval of the commissioner of finance, and 
645.57  after notification of the chair of the senate health, human 
646.1   services and corrections budget division and the chair of the 
646.2   house health and human services finance committee, may transfer 
646.3   unencumbered appropriation balances for the biennium ending June 
646.4   30, 2005, within fiscal years among the MFIP, general 
646.5   assistance, general assistance medical care, medical assistance, 
646.6   Minnesota supplemental aid, and group residential housing 
646.7   programs, and the entitlement portion of the chemical dependency 
646.8   consolidated treatment fund, and between fiscal years of the 
646.9   biennium. 
646.10     Subd. 2.  [ADMINISTRATION.] Positions, salary money, and 
646.11  nonsalary administrative money may be transferred within the 
646.12  departments of human services and health and within the programs 
646.13  operated by the veterans nursing homes board as the 
646.14  commissioners and the board consider necessary, with the advance 
646.15  approval of the commissioner of finance.  The commissioner or 
646.16  the board shall inform the chairs of the house health and human 
646.17  services finance committee and the senate health, human services 
646.18  and corrections budget division quarterly about transfers made 
646.19  under this provision. 
646.20     Subd. 3.  [PROHIBITED TRANSFERS.] Grant money shall not be 
646.21  transferred to operations within the departments of human 
646.22  services and health and within the programs operated by the 
646.23  veterans nursing homes board without the approval of the 
646.24  legislature. 
646.25     Sec. 12.  [INDIRECT COSTS NOT TO FUND PROGRAMS.] 
646.26     The commissioners of health and of human services shall not 
646.27  use indirect cost allocations to pay for the operational costs 
646.28  of any program for which they are responsible. 
646.29     Sec. 13.  [CARRYOVER LIMITATION.] 
646.30     The appropriations in this article which are allowed to be 
646.31  carried forward from fiscal year 2004 to fiscal year 2005 shall 
646.32  not become part of the base level funding for the 2006-2007 
646.33  biennial budget, unless specifically directed by the legislature.
646.34     Sec. 14.  [SUNSET OF UNCODIFIED LANGUAGE.] 
646.35     All uncodified language contained in this article expires 
646.36  on June 30, 2005, unless a different expiration date is explicit.
647.1      Sec. 15.  [REPEALER.] 
647.2      Laws 2002, chapter 374, article 9, section 8, is repealed 
647.3   effective upon final enactment. 
647.4      Sec. 16.  [EFFECTIVE DATE.] 
647.5      The provisions in this article are effective July 1, 2003, 
647.6   unless a different effective date is specified.