1.1                          A bill for an act 
  1.2             relating to human services; allowing the ombudsman for 
  1.3             corrections to apply for or receive certain grants; 
  1.4             making changes to continuing care programs; modifying 
  1.5             case manager continuing education requirements; adding 
  1.6             an exemption from preadmission screening requirements; 
  1.7             modifying targeted case management client contact 
  1.8             requirements; requiring a case management services 
  1.9             study; modifying planned closure rate adjustment 
  1.10            provisions; correcting inconsistencies in mental 
  1.11            health services coverage in border states; requiring 
  1.12            plumbers to be licensed; establishing inspection 
  1.13            requirements for new plumbing installations; allowing 
  1.14            the commissioner to charge fees to hire staff; 
  1.15            licensing restricted plumbing contractors; requiring 
  1.16            rulemaking; expanding MFIP hardship extensions; 
  1.17            amending Minnesota Statutes 2000, sections 241.44, by 
  1.18            adding a subdivision; 245.462, subdivision 4; 
  1.19            245.4871, subdivision 4; 245.50, subdivisions 1, 2, 5; 
  1.20            326.01, by adding a subdivision; 326.37, subdivision 
  1.21            1, by adding a subdivision; 326.40, subdivision 1; 
  1.22            Minnesota Statutes 2001 Supplement, sections 144.122; 
  1.23            144.148, subdivision 2; 256B.0627, subdivision 10; 
  1.24            256B.0911, subdivisions 4b, 4d; 256B.0913, subdivision 
  1.25            5; 256B.0915, subdivision 3; 256B.0924, subdivision 6; 
  1.26            256B.0951, subdivisions 7, 8; 256B.437, subdivision 6; 
  1.27            256J.425, subdivisions 3, 4, 5, 6, by adding a 
  1.28            subdivision; 326.38; proposing coding for new law in 
  1.29            Minnesota Statutes, chapter 326; repealing Minnesota 
  1.30            Statutes 2000, section 326.45. 
  1.31  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.32                             ARTICLE 1
  1.33                   HUMAN SERVICES AND CORRECTIONS
  1.34     Section 1.  Minnesota Statutes 2001 Supplement, section 
  1.35  144.122, is amended to read: 
  1.36     144.122 [LICENSE, PERMIT, AND SURVEY FEES.] 
  1.37     (a) The state commissioner of health, by rule, may 
  1.38  prescribe reasonable procedures and fees for filing with the 
  2.1   commissioner as prescribed by statute and for the issuance of 
  2.2   original and renewal permits, licenses, registrations, and 
  2.3   certifications issued under authority of the commissioner.  The 
  2.4   expiration dates of the various licenses, permits, 
  2.5   registrations, and certifications as prescribed by the rules 
  2.6   shall be plainly marked thereon.  Fees may include application 
  2.7   and examination fees and a penalty fee for renewal applications 
  2.8   submitted after the expiration date of the previously issued 
  2.9   permit, license, registration, and certification.  The 
  2.10  commissioner may also prescribe, by rule, reduced fees for 
  2.11  permits, licenses, registrations, and certifications when the 
  2.12  application therefor is submitted during the last three months 
  2.13  of the permit, license, registration, or certification period.  
  2.14  Fees proposed to be prescribed in the rules shall be first 
  2.15  approved by the department of finance.  All fees proposed to be 
  2.16  prescribed in rules shall be reasonable.  The fees shall be in 
  2.17  an amount so that the total fees collected by the commissioner 
  2.18  will, where practical, approximate the cost to the commissioner 
  2.19  in administering the program.  All fees collected shall be 
  2.20  deposited in the state treasury and credited to the state 
  2.21  government special revenue fund unless otherwise specifically 
  2.22  appropriated by law for specific purposes. 
  2.23     (b) The commissioner shall adopt reasonable rules 
  2.24  establishing criteria and procedures for refusal to grant or 
  2.25  renew licenses and registrations, and for suspension and 
  2.26  revocation of licenses and registrations. 
  2.27     (c) The commissioner may refuse to grant or renew licenses 
  2.28  and registrations, or suspend or revoke licenses and 
  2.29  registrations, in accordance with the commissioner's criteria 
  2.30  and procedures as adopted by rule. 
  2.31     (d) The commissioner may charge a fee for voluntary 
  2.32  certification of medical laboratories and environmental 
  2.33  laboratories, and for environmental and medical laboratory 
  2.34  services provided by the department, without complying with 
  2.35  paragraph (a) or chapter 14.  Fees charged for environment and 
  2.36  medical laboratory services provided by the department must be 
  3.1   approximately equal to the costs of providing the services.  
  3.2      ~~(c)~~ (e) The commissioner may develop a schedule of fees for 
  3.3   diagnostic evaluations conducted at clinics held by the services 
  3.4   for children with handicaps program.  All receipts generated by 
  3.5   the program are annually appropriated to the commissioner for 
  3.6   use in the maternal and child health program. 
  3.7      ~~(d)~~ (f) The commissioner shall set license fees for 
  3.8   hospitals and nursing homes that are not boarding care homes at 
  3.9   the following levels: 
  3.10  Joint Commission on Accreditation of Healthcare 
  3.11  Organizations (JCAHO hospitals)  $7,055
  3.12  Non-JCAHO hospitals              $4,680 plus $234 per bed
  3.13  Nursing home                     $183 plus $91 per bed
  3.14     The commissioner shall set license fees for outpatient 
  3.15  surgical centers, boarding care homes, and supervised living 
  3.16  facilities at the following levels: 
  3.17  Outpatient surgical centers      $1,512
  3.18  Boarding care homes              $183 plus $91 per bed
  3.19  Supervised living facilities     $183 plus $91 per bed.
  3.20     ~~(e)~~ (g) Unless prohibited by federal law, the commissioner 
  3.21  of health shall charge applicants the following fees to cover 
  3.22  the cost of any initial certification surveys required to 
  3.23  determine a provider's eligibility to participate in the 
  3.24  Medicare or Medicaid program: 
  3.25  Prospective payment surveys for          $  900
  3.26  hospitals
  3.28  Swing bed surveys for nursing homes      $1,200
  3.30  Psychiatric hospitals                    $1,400
  3.32  Rural health facilities                  $1,100
  3.34  Portable X-ray providers                 $  500
  3.36  Home health agencies                     $1,800
  3.38  Outpatient therapy agencies              $  800
  3.40  End stage renal dialysis providers       $2,100
  3.42  Independent therapists                   $  800
  3.44  Comprehensive rehabilitation             $1,200
  3.45  outpatient facilities
  3.47  Hospice providers                        $1,700
  4.2   Ambulatory surgical providers            $1,800
  4.4   Hospitals                                $4,200
  4.6   Other provider categories or             Actual surveyor costs:
  4.7   additional resurveys required            average surveyor cost x
  4.8   to complete initial certification        number of hours for the
  4.9                                            survey process.
  4.10     These fees shall be submitted at the time of the 
  4.11  application for federal certification and shall not be 
  4.12  refunded.  All fees collected after the date that the imposition 
  4.13  of fees is not prohibited by federal law shall be deposited in 
  4.14  the state treasury and credited to the state government special 
  4.15  revenue fund. 
  4.16     (h) The commissioner shall charge the following fees for 
  4.17  examinations, registrations, licenses, plan reviews, and 
  4.18  inspections: 
  4.19  Plumbing examination                         $ 50
  4.20  Water conditioning examination               $ 50
  4.21  Plumbing bond registration fee               $ 40
  4.22  Water conditioning bond registration fee     $ 40
  4.23  Master plumber's license                     $120
  4.24  Restricted plumbing contractor license       $ 90
  4.25  Journeyman plumber's license                 $ 55
  4.26  Apprentice registration                      $ 25
  4.27  Water conditioning contractor license        $ 70
  4.28  Water conditioning installer license         $ 35
  4.29  Residential inspection fee (each visit)      $ 50
  4.30  Public, commercial, and    Plan review fee   Inspection fee
  4.31  industrial inspections
  4.32     25 or fewer drainage
  4.33     fixture units              $ 50              $  300
  4.34     26 to 50 drainage
  4.35     fixture units              $150              $  900
  4.36     51 to 150 drainage
  4.37     fixture units              $200              $1,200
  4.38     151 to 249 drainage
  4.39     fixture units              $250              $1,500
  4.40     250 or more drainage
  4.41     fixture units              $300              $1,800
  4.42     Callback fee (each visit)                    $  100
  4.43     Plumbing installations that require only fixture 
  5.1   installation or replacement require a minimum of one 
  5.2   inspection.  Residence remodeling involving plumbing 
  5.3   installations requires a minimum of two inspections.  New 
  5.4   residential plumbing installations require a minimum of three 
  5.5   inspections.  For purposes of this paragraph, residences of more 
  5.6   than four units are considered commercial.  
  5.7      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
  5.8      Sec. 2.  Minnesota Statutes 2001 Supplement, section 
  5.9   144.148, subdivision 2, is amended to read: 
  5.10     Subd. 2.  [PROGRAM.] (a) The commissioner of health shall 
  5.11  award rural hospital capital improvement grants to eligible 
  5.12  rural hospitals.  Except as provided in paragraph (b), a grant 
  5.13  shall not exceed $500,000 per hospital.  Prior to the receipt of 
  5.14  any grant, the hospital must certify to the commissioner that at 
  5.15  least one-quarter of the grant amount, which may include in-kind 
  5.16  services, is available for the same purposes from nonstate 
  5.17  resources.  Notwithstanding any law to the contrary, funds 
  5.18  awarded to grantees in a grant agreement do not lapse until 
  5.19  expended by the grantee.  
  5.20     (b) A grant shall not exceed $1,500,000 per eligible rural 
  5.21  hospital that also satisfies the following criteria: 
  5.22     (1) is the only hospital in a county; 
  5.23     (2) has 25 or fewer licensed hospital beds with a net 
  5.24  hospital operating margin not greater than an average of two 
  5.25  percent over the three fiscal years prior to application; 
  5.26     (3) is located in a medically underserved community (MUC) 
  5.27  or a health professional shortage area (HPSA); 
  5.28     (4) is located near a migrant worker employment site and 
  5.29  regularly treats significant numbers of migrant workers and 
  5.30  their families; and 
  5.31     (5) has not previously received a grant under this section 
  5.32  prior to July 1, 1999. 
  5.33     Sec. 3.  Minnesota Statutes 2000, section 241.44, is 
  5.34  amended by adding a subdivision to read: 
  5.35     Subd. 5.  [GRANTS.] The ombudsman may apply for and receive 
  5.36  grants from public and private entities for purposes of carrying 
  6.1   out the ombudsman's powers and duties under sections 241.41 to 
  6.2   241.45.  
  6.3      Sec. 4.  Minnesota Statutes 2000, section 245.462, 
  6.4   subdivision 4, is amended to read: 
  6.5      Subd. 4.  [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 
  6.6   management service provider" means a case manager or case 
  6.7   manager associate employed by the county or other entity 
  6.8   authorized by the county board to provide case management 
  6.9   services specified in section 245.4711.  
  6.10     (b) A case manager must: 
  6.11     (1) be skilled in the process of identifying and assessing 
  6.12  a wide range of client needs; 
  6.13     (2) be knowledgeable about local community resources and 
  6.14  how to use those resources for the benefit of the client; 
  6.15     (3) have a bachelor's degree in one of the behavioral 
  6.16  sciences or related fields including, but not limited to, social 
  6.17  work, psychology, or nursing from an accredited college or 
  6.18  university or meet the requirements of paragraph (c); and 
  6.19     (4) meet the supervision and continuing education 
  6.20  requirements described in paragraphs (d), (e), and (f), as 
  6.21  applicable.  
  6.22     (c) Case managers without a bachelor's degree must meet one 
  6.23  of the requirements in clauses (1) to (3):  
  6.24     (1) have three or four years of experience as a case 
  6.25  manager associate as defined in this section; 
  6.26     (2) be a registered nurse without a bachelor's degree and 
  6.27  have a combination of specialized training in psychiatry and 
  6.28  work experience consisting of community interaction and 
  6.29  involvement or community discharge planning in a mental health 
  6.30  setting totaling three years; or 
  6.31     (3) be a person who qualified as a case manager under the 
  6.32  1998 department of human service waiver provision and meet the 
  6.33  continuing education and mentoring requirements in this section. 
  6.34     (d) A case manager with at least 2,000 hours of supervised 
  6.35  experience in the delivery of services to adults with mental 
  6.36  illness must receive regular ongoing supervision and clinical 
  7.1   supervision totaling 38 hours per year of which at least one 
  7.2   hour per month must be clinical supervision regarding individual 
  7.3   service delivery with a case management supervisor.  The 
  7.4   remaining 26 hours of supervision may be provided by a case 
  7.5   manager with two years of experience.  Group supervision may not 
  7.6   constitute more than one-half of the required supervision 
  7.7   hours.  Clinical supervision must be documented in the client 
  7.8   record. 
  7.9      (e) A case manager without 2,000 hours of supervised 
  7.10  experience in the delivery of services to adults with mental 
  7.11  illness must: 
  7.12     (1) receive clinical supervision regarding individual 
  7.13  service delivery from a mental health professional at least one 
  7.14  hour per week until the requirement of 2,000 hours of experience 
  7.15  is met; and 
  7.16     (2) complete 40 hours of training approved by the 
  7.17  commissioner in case management skills and the characteristics 
  7.18  and needs of adults with serious and persistent mental illness.  
  7.19     (f) A case manager who is not licensed, registered, or 
  7.20  certified by a health-related licensing board must receive 30 
  7.21  hours of continuing education and training in mental illness and 
  7.22  mental health services ~~annually~~ every two years. 
  7.23     (g) A case manager associate (CMA) must: 
  7.24     (1) work under the direction of a case manager or case 
  7.25  management supervisor; 
  7.26     (2) be at least 21 years of age; 
  7.27     (3) have at least a high school diploma or its equivalent; 
  7.28  and 
  7.29     (4) meet one of the following criteria: 
  7.30     (i) have an associate of arts degree in one of the 
  7.31  behavioral sciences or human services; 
  7.32     (ii) be a registered nurse without a bachelor's degree; 
  7.33     (iii) within the previous ten years, have three years of 
  7.34  life experience with serious and persistent mental illness as 
  7.35  defined in section 245.462, subdivision 20; or as a child had 
  7.36  severe emotional disturbance as defined in section 245.4871, 
  8.1   subdivision 6; or have three years life experience as a primary 
  8.2   caregiver to an adult with serious and persistent mental illness 
  8.3   within the previous ten years; 
  8.4      (iv) have 6,000 hours work experience as a nondegreed state 
  8.5   hospital technician; or 
  8.6      (v) be a mental health practitioner as defined in section 
  8.7   245.462, subdivision 17, clause (2). 
  8.8      Individuals meeting one of the criteria in items (i) to 
  8.9   (iv), may qualify as a case manager after four years of 
  8.10  supervised work experience as a case manager associate.  
  8.11  Individuals meeting the criteria in item (v), may qualify as a 
  8.12  case manager after three years of supervised experience as a 
  8.13  case manager associate. 
  8.14     (h) A case management associate must meet the following 
  8.15  supervision, mentoring, and continuing education requirements:  
  8.16     (1) have 40 hours of preservice training described under 
  8.17  paragraph (e), clause (2); 
  8.18     (2) receive at least 40 hours of continuing education in 
  8.19  mental illness and mental health services annually; and 
  8.20     (3) receive at least five hours of mentoring per week from 
  8.21  a case management mentor.  
  8.22  A "case management mentor" means a qualified, practicing case 
  8.23  manager or case management supervisor who teaches or advises and 
  8.24  provides intensive training and clinical supervision to one or 
  8.25  more case manager associates.  Mentoring may occur while 
  8.26  providing direct services to consumers in the office or in the 
  8.27  field and may be provided to individuals or groups of case 
  8.28  manager associates.  At least two mentoring hours per week must 
  8.29  be individual and face-to-face. 
  8.30     (i) A case management supervisor must meet the criteria for 
  8.31  mental health professionals, as specified in section 245.462, 
  8.32  subdivision 18. 
  8.33     (j) An immigrant who does not have the qualifications 
  8.34  specified in this subdivision may provide case management 
  8.35  services to adult immigrants with serious and persistent mental 
  8.36  illness who are members of the same ethnic group as the case 
  9.1   manager if the person:  
  9.2      (1) is currently enrolled in and is actively pursuing 
  9.3   credits toward the completion of a bachelor's degree in one of 
  9.4   the behavioral sciences or a related field including, but not 
  9.5   limited to, social work, psychology, or nursing from an 
  9.6   accredited college or university; 
  9.7      (2) completes 40 hours of training as specified in this 
  9.8   subdivision; and 
  9.9      (3) receives clinical supervision at least once a week 
  9.10  until the requirements of this subdivision are met. 
  9.11     Sec. 5.  Minnesota Statutes 2000, section 245.4871, 
  9.12  subdivision 4, is amended to read: 
  9.13     Subd. 4.  [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 
  9.14  management service provider" means a case manager or case 
  9.15  manager associate employed by the county or other entity 
  9.16  authorized by the county board to provide case management 
  9.17  services specified in subdivision 3 for the child with severe 
  9.18  emotional disturbance and the child's family.  
  9.19     (b) A case manager must: 
  9.20     (1) have experience and training in working with children; 
  9.21     (2) have at least a bachelor's degree in one of the 
  9.22  behavioral sciences or a related field including, but not 
  9.23  limited to, social work, psychology, or nursing from an 
  9.24  accredited college or university or meet the requirements of 
  9.25  paragraph (d); 
  9.26     (3) have experience and training in identifying and 
  9.27  assessing a wide range of children's needs; 
  9.28     (4) be knowledgeable about local community resources and 
  9.29  how to use those resources for the benefit of children and their 
  9.30  families; and 
  9.31     (5) meet the supervision and continuing education 
  9.32  requirements of paragraphs (e), (f), and (g), as applicable. 
  9.33     (c) A case manager may be a member of any professional 
  9.34  discipline that is part of the local system of care for children 
  9.35  established by the county board. 
  9.36     (d) A case manager without a bachelor's degree must meet 
 10.1   one of the requirements in clauses (1) to (3):  
 10.2      (1) have three or four years of experience as a case 
 10.3   manager associate; 
 10.4      (2) be a registered nurse without a bachelor's degree who 
 10.5   has a combination of specialized training in psychiatry and work 
 10.6   experience consisting of community interaction and involvement 
 10.7   or community discharge planning in a mental health setting 
 10.8   totaling three years; or 
 10.9      (3) be a person who qualified as a case manager under the 
 10.10  1998 department of human services waiver provision and meets the 
 10.11  continuing education, supervision, and mentoring requirements in 
 10.12  this section. 
 10.13     (e) A case manager with at least 2,000 hours of supervised 
 10.14  experience in the delivery of mental health services to children 
 10.15  must receive regular ongoing supervision and clinical 
 10.16  supervision totaling 38 hours per year, of which at least one 
 10.17  hour per month must be clinical supervision regarding individual 
 10.18  service delivery with a case management supervisor.  The other 
 10.19  26 hours of supervision may be provided by a case manager with 
 10.20  two years of experience.  Group supervision may not constitute 
 10.21  more than one-half of the required supervision hours. 
 10.22     (f) A case manager without 2,000 hours of supervised 
 10.23  experience in the delivery of mental health services to children 
 10.24  with emotional disturbance must: 
 10.25     (1) begin 40 hours of training approved by the commissioner 
 10.26  of human services in case management skills and in the 
 10.27  characteristics and needs of children with severe emotional 
 10.28  disturbance before beginning to provide case management 
 10.29  services; and 
 10.30     (2) receive clinical supervision regarding individual 
 10.31  service delivery from a mental health professional at least one 
 10.32  hour each week until the requirement of 2,000 hours of 
 10.33  experience is met. 
 10.34     (g) A case manager who is not licensed, registered, or 
 10.35  certified by a health-related licensing board must receive 30 
 10.36  hours of continuing education and training in severe emotional 
 11.1   disturbance and mental health services ~~annually~~ every two years. 
 11.2      (h) Clinical supervision must be documented in the child's 
 11.3   record.  When the case manager is not a mental health 
 11.4   professional, the county board must provide or contract for 
 11.5   needed clinical supervision. 
 11.6      (i) The county board must ensure that the case manager has 
 11.7   the freedom to access and coordinate the services within the 
 11.8   local system of care that are needed by the child. 
 11.9      (j) A case manager associate (CMA) must: 
 11.10     (1) work under the direction of a case manager or case 
 11.11  management supervisor; 
 11.12     (2) be at least 21 years of age; 
 11.13     (3) have at least a high school diploma or its equivalent; 
 11.14  and 
 11.15     (4) meet one of the following criteria: 
 11.16     (i) have an associate of arts degree in one of the 
 11.17  behavioral sciences or human services; 
 11.18     (ii) be a registered nurse without a bachelor's degree; 
 11.19     (iii) have three years of life experience as a primary 
 11.20  caregiver to a child with serious emotional disturbance as 
 11.21  defined in section 245.4871, subdivision 6, within the previous 
 11.22  ten years; 
 11.23     (iv) have 6,000 hours work experience as a nondegreed state 
 11.24  hospital technician; or 
 11.25     (v) be a mental health practitioner as defined in 
 11.26  subdivision 26, clause (2). 
 11.27     Individuals meeting one of the criteria in items (i) to 
 11.28  (iv) may qualify as a case manager after four years of 
 11.29  supervised work experience as a case manager associate.  
 11.30  Individuals meeting the criteria in item (v) may qualify as a 
 11.31  case manager after three years of supervised experience as a 
 11.32  case manager associate. 
 11.33     (k) Case manager associates must meet the following 
 11.34  supervision, mentoring, and continuing education requirements; 
 11.35     (1) have 40 hours of preservice training described under 
 11.36  paragraph (f), clause (1); 
 12.1      (2) receive at least 40 hours of continuing education in 
 12.2   severe emotional disturbance and mental health service annually; 
 12.3   and 
 12.4      (3) receive at least five hours of mentoring per week from 
 12.5   a case management mentor.  A "case management mentor" means a 
 12.6   qualified, practicing case manager or case management supervisor 
 12.7   who teaches or advises and provides intensive training and 
 12.8   clinical supervision to one or more case manager associates.  
 12.9   Mentoring may occur while providing direct services to consumers 
 12.10  in the office or in the field and may be provided to individuals 
 12.11  or groups of case manager associates.  At least two mentoring 
 12.12  hours per week must be individual and face-to-face. 
 12.13     (l) A case management supervisor must meet the criteria for 
 12.14  a mental health professional as specified in section 245.4871, 
 12.15  subdivision 27. 
 12.16     (m) An immigrant who does not have the qualifications 
 12.17  specified in this subdivision may provide case management 
 12.18  services to child immigrants with severe emotional disturbance 
 12.19  of the same ethnic group as the immigrant if the person:  
 12.20     (1) is currently enrolled in and is actively pursuing 
 12.21  credits toward the completion of a bachelor's degree in one of 
 12.22  the behavioral sciences or related fields at an accredited 
 12.23  college or university; 
 12.24     (2) completes 40 hours of training as specified in this 
 12.25  subdivision; and 
 12.26     (3) receives clinical supervision at least once a week 
 12.27  until the requirements of obtaining a bachelor's degree and 
 12.28  2,000 hours of supervised experience are met. 
 12.29     Sec. 6.  Minnesota Statutes 2000, section 245.50, 
 12.30  subdivision 1, is amended to read: 
 12.31     Subdivision 1.  [DEFINITIONS.] For purposes of this 
 12.32  section, the following terms have the meanings given them. 
 12.33     (a) "Bordering state" means Iowa, North Dakota, South 
 12.34  Dakota, or Wisconsin. 
 12.35     (b) "Receiving agency ~~or facility~~" means a public or 
 12.36  private hospital, mental health center, or other person or 
 13.1   organization ~~authorized by a state to provide~~ which provides 
 13.2   mental health services under this section to individuals from a 
 13.3   state other than the state in which the agency is located. 
 13.4      (c) "Receiving state" means the state in which a receiving 
 13.5   agency is located. 
 13.6      (d) "Sending agency" means a state or county agency which 
 13.7   sends an individual to a bordering state for treatment under 
 13.8   this section. 
 13.9      (e) "Sending state" means the state in which the sending 
 13.10  agency is located. 
 13.11     Sec. 7.  Minnesota Statutes 2000, section 245.50, 
 13.12  subdivision 2, is amended to read: 
 13.13     Subd. 2.  [PURPOSE AND AUTHORITY.] (a) The purpose of this 
 13.14  section is to enable appropriate treatment to be provided to 
 13.15  individuals, across state lines from the individual's state of 
 13.16  residence, in qualified facilities that are closer to the homes 
 13.17  of individuals than are facilities available in the individual's 
 13.18  home state. 
 13.19     (b) Unless prohibited by another law and subject to the 
 13.20  exceptions listed in subdivision 3, a county board or the 
 13.21  commissioner of human services may contract with an agency or 
 13.22  facility in a bordering state for mental health services for 
 13.23  residents of Minnesota, and a Minnesota mental health agency or 
 13.24  facility may contract to provide services to residents of 
 13.25  bordering states.  Except as provided in subdivision 5, a person 
 13.26  who receives services in another state under this section is 
 13.27  subject to the laws of the state in which services are 
 13.28  provided.  A person who will receive services in another state 
 13.29  under this section must be informed of the consequences of 
 13.30  receiving services in another state, including the implications 
 13.31  of the differences in state laws, to the extent the individual 
 13.32  will be subject to the laws of the receiving state. 
 13.33     Sec. 8.  Minnesota Statutes 2000, section 245.50, 
 13.34  subdivision 5, is amended to read: 
 13.35     Subd. 5.  [SPECIAL CONTRACTS; ~~WISCONSIN~~ BORDERING 
 13.36  STATES.] ~~The commissioner of the Minnesota department of human~~ 
 14.1   ~~services must enter into negotiations with appropriate personnel~~ 
 14.2   ~~at the Wisconsin department of health and social services and~~ 
 14.3   ~~must develop an agreement that conforms to the requirements of~~ 
 14.4   ~~subdivision 4, to enable the placement in Minnesota of patients~~ 
 14.5   ~~who are on emergency holds or who have been involuntarily~~ 
 14.6   ~~committed as mentally ill or chemically dependent in Wisconsin~~ 
 14.7   ~~and to enable the temporary placement in Wisconsin of patients~~ 
 14.8   ~~who are on emergency holds in Minnesota under section 253B.05,~~ 
 14.9   ~~provided that the Minnesota courts retain jurisdiction over~~ 
 14.10  ~~Minnesota patients, and the state of Wisconsin affords to~~ 
 14.11  ~~Minnesota patients the rights under Minnesota law.  Persons~~ 
 14.12  ~~committed by the Wisconsin courts and placed in Minnesota~~ 
 14.13  ~~facilities shall continue to be in the legal custody of~~ 
 14.14  ~~Wisconsin and Wisconsin's laws governing length of commitment,~~ 
 14.15  ~~reexaminations, and extension of commitment shall continue to~~ 
 14.16  ~~apply to these residents.  In all other respects, Wisconsin~~ 
 14.17  ~~residents placed in Minnesota facilities are subject to~~ 
 14.18  ~~Minnesota laws.  The agreement must specify that responsibility~~ 
 14.19  ~~for payment for the cost of care of Wisconsin residents shall~~ 
 14.20  ~~remain with the state of Wisconsin and the cost of care of~~ 
 14.21  ~~Minnesota residents shall remain with the state of Minnesota.~~  
 14.22  ~~The commissioner shall be assisted by attorneys from the~~ 
 14.23  ~~Minnesota attorney general's office in negotiating and~~ 
 14.24  ~~finalizing this agreement.  The agreement shall be completed so~~ 
 14.25  ~~as to permit placement of Wisconsin residents in Minnesota~~ 
 14.26  ~~facilities and Minnesota residents in Wisconsin facilities~~ 
 14.27  ~~beginning July 1, 1994.~~ (a) An individual who is detained, 
 14.28  committed, or placed on an involuntary basis under chapter 253B 
 14.29  may be confined or treated in a bordering state pursuant to a 
 14.30  contract under this section.  An individual who is detained, 
 14.31  committed, or placed on an involuntary basis under the civil law 
 14.32  of a bordering state may be confined or treated in Minnesota 
 14.33  pursuant to a contract under this section.  A peace or health 
 14.34  officer who is acting under the authority of the sending state 
 14.35  may transport an individual to a receiving agency that provides 
 14.36  services pursuant to a contract under this section, and may 
 15.1   transport the individual back to the sending state under the 
 15.2   laws of the sending state.  Court orders valid under the law of 
 15.3   the sending state are granted recognition and reciprocity in the 
 15.4   receiving state for individuals covered by a contract under this 
 15.5   section to the extent that the court orders relate to 
 15.6   confinement for treatment or care of mental illness.  Such 
 15.7   treatment or care may address other conditions that may be 
 15.8   co-occurring with the mental illness.  These court orders are 
 15.9   not subject to legal challenge in the courts of the receiving 
 15.10  state.  Individuals who are detained, committed, or placed under 
 15.11  the law of a sending state and who are transferred to a 
 15.12  receiving state under this section continue to be in the legal 
 15.13  custody of the authority responsible for them under the law of 
 15.14  the sending state.  Except in emergencies, those individuals may 
 15.15  not be transferred, removed, or furloughed from a receiving 
 15.16  agency without the specific approval of the authority 
 15.17  responsible for them under the law of the sending state. 
 15.18     (b) While in the receiving state pursuant to a contract 
 15.19  under this section, an individual shall be subject to the 
 15.20  sending state's laws and rules relating to length of 
 15.21  confinement, reexaminations, and extensions of confinement.  No 
 15.22  individual may be sent to another state pursuant to a contract 
 15.23  under this section until the receiving state has enacted a law 
 15.24  recognizing the validity and applicability of this section. 
 15.25     (c) If an individual receiving services pursuant to a 
 15.26  contract under this section leaves the receiving agency without 
 15.27  permission and the individual is subject to involuntary 
 15.28  confinement under the law of the sending state, the receiving 
 15.29  agency shall use all reasonable means to return the individual 
 15.30  to the receiving agency.  The receiving agency shall immediately 
 15.31  report the absence to the sending agency.  The receiving state 
 15.32  has the primary responsibility for, and the authority to direct, 
 15.33  the return of these individuals within its borders and is liable 
 15.34  for the cost of the action to the extent that it would be liable 
 15.35  for costs of its own resident. 
 15.36     (d) Responsibility for payment for the cost of care remains 
 16.1   with the sending agency. 
 16.2      (e) This subdivision also applies to county contracts under 
 16.3   subdivision 2 which include emergency care and treatment 
 16.4   provided to a county resident in a bordering state. 
 16.5      Sec. 9.  Minnesota Statutes 2001 Supplement, section 
 16.6   256B.0627, subdivision 10, is amended to read: 
 16.7      Subd. 10.  [FISCAL INTERMEDIARY OPTION AVAILABLE FOR 
 16.8   PERSONAL CARE ASSISTANT SERVICES.] (a) The commissioner may 
 16.9   allow a recipient of personal care assistant services to use a 
 16.10  fiscal intermediary to assist the recipient in paying and 
 16.11  accounting for medically necessary covered personal care 
 16.12  assistant services authorized in subdivision 4 and within the 
 16.13  payment parameters of subdivision 5.  Unless otherwise provided 
 16.14  in this subdivision, all other statutory and regulatory 
 16.15  provisions relating to personal care assistant services apply to 
 16.16  a recipient using the fiscal intermediary option. 
 16.17     (b) The recipient or responsible party shall: 
 16.18     (1) recruit, hire, and terminate a qualified professional, 
 16.19  if a qualified professional is requested by the recipient or 
 16.20  responsible party; 
 16.21     (2) verify and document the credentials of the qualified 
 16.22  professional, if a qualified professional is requested by the 
 16.23  recipient or responsible party; 
 16.24     (3) develop a service plan based on physician orders and 
 16.25  public health nurse assessment with the assistance of a 
 16.26  qualified professional, if a qualified professional is requested 
 16.27  by the recipient or responsible party, that addresses the health 
 16.28  and safety of the recipient; 
 16.29     (4) recruit, hire, and terminate the personal care 
 16.30  assistant; 
 16.31     (5) orient and train the personal care assistant with 
 16.32  assistance as needed from the qualified professional; 
 16.33     (6) supervise and evaluate the personal care assistant with 
 16.34  assistance as needed from the recipient's physician or the 
 16.35  qualified professional; 
 16.36     (7) monitor and verify in writing and report to the fiscal 
 17.1   intermediary the number of hours worked by the personal care 
 17.2   assistant and the qualified professional; and 
 17.3      (8) enter into a written agreement, as specified in 
 17.4   paragraph (f). 
 17.5      (c) The duties of the fiscal intermediary shall be to: 
 17.6      (1) bill the medical assistance program for personal care 
 17.7   assistant and qualified professional services; 
 17.8      (2) request and secure background checks on personal care 
 17.9   assistants and qualified professionals according to section 
 17.10  245A.04; 
 17.11     (3) pay the personal care assistant and qualified 
 17.12  professional based on actual hours of services provided; 
 17.13     (4) withhold and pay all applicable federal and state 
 17.14  taxes; 
 17.15     (5) verify and keep records of hours worked by the personal 
 17.16  care assistant and qualified professional; 
 17.17     (6) make the arrangements and pay unemployment insurance, 
 17.18  taxes, workers' compensation, liability insurance, and other 
 17.19  benefits, if any; 
 17.20     (7) enroll in the medical assistance program as a fiscal 
 17.21  intermediary; and 
 17.22     (8) enter into a written agreement as specified in 
 17.23  paragraph (f) before services are provided. 
 17.24     (d) The fiscal intermediary: 
 17.25     (1) may not be related to the recipient, qualified 
 17.26  professional, or the personal care assistant; 
 17.27     (2) must ensure arm's length transactions with the 
 17.28  recipient and personal care assistant; and 
 17.29     (3) shall be considered a joint employer of the personal 
 17.30  care assistant and qualified professional to the extent 
 17.31  specified in this section. 
 17.32     The fiscal intermediary or owners of the entity that 
 17.33  provides fiscal intermediary services under this subdivision 
 17.34  must pass a criminal background check as required in section 
 17.35  256B.0627, subdivision 1, paragraph (e). 
 17.36     (e) If the recipient or responsible party requests a 
 18.1   qualified professional, the qualified professional providing 
 18.2   assistance to the recipient shall meet the qualifications 
 18.3   specified in section 256B.0625, subdivision 19c.  The qualified 
 18.4   professional shall assist the recipient in developing and 
 18.5   revising a plan to meet the recipient's needs, as assessed by 
 18.6   the public health nurse.  In performing this function, the 
 18.7   qualified professional must visit the recipient in the 
 18.8   recipient's home at least once annually.  The qualified 
 18.9   professional must report any suspected abuse, neglect, or 
 18.10  financial exploitation of the recipient to the appropriate 
 18.11  authorities.  
 18.12     (f) The fiscal intermediary, recipient or responsible 
 18.13  party, personal care assistant, and qualified professional shall 
 18.14  enter into a written agreement before services are started.  The 
 18.15  agreement shall include: 
 18.16     (1) the duties of the recipient, qualified professional, 
 18.17  personal care assistant, and fiscal agent based on paragraphs 
 18.18  (a) to (e); 
 18.19     (2) the salary and benefits for the personal care assistant 
 18.20  and the qualified professional; 
 18.21     (3) the administrative fee of the fiscal intermediary and 
 18.22  services paid for with that fee, including background check 
 18.23  fees; 
 18.24     (4) procedures to respond to billing or payment complaints; 
 18.25  and 
 18.26     (5) procedures for hiring and terminating the personal care 
 18.27  assistant and the qualified professional. 
 18.28     (g) The rates paid for personal care assistant 
 18.29  services, shared care services, qualified professional services, 
 18.30  and fiscal intermediary services under this subdivision shall be 
 18.31  the same rates paid for personal care assistant services and 
 18.32  qualified professional services under subdivision 2 
 18.33  respectively.  Except for the administrative fee of the fiscal 
 18.34  intermediary specified in paragraph (f), the remainder of the 
 18.35  rates paid to the fiscal intermediary must be used to pay for 
 18.36  the salary and benefits for the personal care assistant or the 
 19.1   qualified professional. 
 19.2      (h) As part of the assessment defined in subdivision 1, the 
 19.3   following conditions must be met to use or continue use of a 
 19.4   fiscal intermediary: 
 19.5      (1) the recipient must be able to direct the recipient's 
 19.6   own care, or the responsible party for the recipient must be 
 19.7   readily available to direct the care of the personal care 
 19.8   assistant; 
 19.9      (2) the recipient or responsible party must be 
 19.10  knowledgeable of the health care needs of the recipient and be 
 19.11  able to effectively communicate those needs; 
 19.12     (3) a face-to-face assessment must be conducted by the 
 19.13  local county public health nurse at least annually, or when 
 19.14  there is a significant change in the recipient's condition or 
 19.15  change in the need for personal care assistant services; 
 19.16     (4) ~~the recipient cannot select the shared services option~~ 
 19.17  recipients who choose to use the shared care option as specified 
 19.18  in subdivision 8 must utilize the same fiscal intermediary; and 
 19.19     (5) parties must be in compliance with the written 
 19.20  agreement specified in paragraph (f). 
 19.21     (i) The commissioner shall deny, revoke, or suspend the 
 19.22  authorization to use the fiscal intermediary option if: 
 19.23     (1) it has been determined by the qualified professional or 
 19.24  local county public health nurse that the use of this option 
 19.25  jeopardizes the recipient's health and safety; 
 19.26     (2) the parties have failed to comply with the written 
 19.27  agreement specified in paragraph (f); or 
 19.28     (3) the use of the option has led to abusive or fraudulent 
 19.29  billing for personal care assistant services.  
 19.30     The recipient or responsible party may appeal the 
 19.31  commissioner's action according to section 256.045.  The denial, 
 19.32  revocation, or suspension to use the fiscal intermediary option 
 19.33  shall not affect the recipient's authorized level of personal 
 19.34  care assistant services as determined in subdivision 5. 
 19.35     Sec. 10.  Minnesota Statutes 2001 Supplement, section 
 19.36  256B.0911, subdivision 4b, is amended to read: 
 20.1      Subd. 4b.  [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 
 20.2   Exemptions from the federal screening requirements outlined in 
 20.3   subdivision 4a, paragraphs (b) and (c), are limited to: 
 20.4      (1) a person who, having entered an acute care facility 
 20.5   from a certified nursing facility, is returning to a certified 
 20.6   nursing facility; ~~and~~ 
 20.7      (2) a person transferring from one certified nursing 
 20.8   facility in Minnesota to another certified nursing facility in 
 20.9   Minnesota; and 
 20.10     (3) a person, 21 years of age or older, who satisfies the 
 20.11  following criteria, as specified in the Code of Federal 
 20.12  Regulations, title 42, section 483.106(b)(2): 
 20.13     (i) the person is admitted to a nursing facility directly 
 20.14  from a hospital after receiving acute inpatient care at the 
 20.15  hospital; 
 20.16     (ii) the person requires nursing facility services for the 
 20.17  same condition for which care was provided in the hospital; and 
 20.18     (iii) the attending physician has certified before the 
 20.19  nursing facility admission that the person is likely to receive 
 20.20  less than 30 days of nursing facility services. 
 20.21     (b) Persons who are exempt from preadmission screening for 
 20.22  purposes of level of care determination include: 
 20.23     (1) persons described in paragraph (a); 
 20.24     (2) an individual who has a contractual right to have 
 20.25  nursing facility care paid for indefinitely by the veterans' 
 20.26  administration; 
 20.27     (3) an individual enrolled in a demonstration project under 
 20.28  section 256B.69, subdivision 8, at the time of application to a 
 20.29  nursing facility; 
 20.30     (4) an individual currently being served under the 
 20.31  alternative care program or under a home and community-based 
 20.32  services waiver authorized under section 1915(c) of the federal 
 20.33  Social Security Act; and 
 20.34     (5) individuals admitted to a certified nursing facility 
 20.35  for a short-term stay, which is expected to be 14 days or less 
 20.36  in duration based upon a physician's certification, and who have 
 21.1   been assessed and approved for nursing facility admission within 
 21.2   the previous six months.  This exemption applies only if the 
 21.3   consultation team member determines at the time of the initial 
 21.4   assessment of the six-month period that it is appropriate to use 
 21.5   the nursing facility for short-term stays and that there is an 
 21.6   adequate plan of care for return to the home or community-based 
 21.7   setting.  If a stay exceeds 14 days, the individual must be 
 21.8   referred no later than the first county working day following 
 21.9   the 14th resident day for a screening, which must be completed 
 21.10  within five working days of the referral.  The payment 
 21.11  limitations in subdivision 7 apply to an individual found at 
 21.12  screening to not meet the level of care criteria for admission 
 21.13  to a certified nursing facility. 
 21.14     (c) Persons admitted to a Medicaid-certified nursing 
 21.15  facility from the community on an emergency basis as described 
 21.16  in paragraph (d) or from an acute care facility on a nonworking 
 21.17  day must be screened the first working day after admission. 
 21.18     (d) Emergency admission to a nursing facility prior to 
 21.19  screening is permitted when all of the following conditions are 
 21.20  met: 
 21.21     (1) a person is admitted from the community to a certified 
 21.22  nursing or certified boarding care facility during county 
 21.23  nonworking hours; 
 21.24     (2) a physician has determined that delaying admission 
 21.25  until preadmission screening is completed would adversely affect 
 21.26  the person's health and safety; 
 21.27     (3) there is a recent precipitating event that precludes 
 21.28  the client from living safely in the community, such as 
 21.29  sustaining an injury, sudden onset of acute illness, or a 
 21.30  caregiver's inability to continue to provide care; 
 21.31     (4) the attending physician has authorized the emergency 
 21.32  placement and has documented the reason that the emergency 
 21.33  placement is recommended; and 
 21.34     (5) the county is contacted on the first working day 
 21.35  following the emergency admission. 
 21.36  Transfer of a patient from an acute care hospital to a nursing 
 22.1   facility is not considered an emergency except for a person who 
 22.2   has received hospital services in the following situations: 
 22.3   hospital admission for observation, care in an emergency room 
 22.4   without hospital admission, or following hospital 24-hour bed 
 22.5   care. 
 22.6      (e) A nursing facility must provide a written notice to 
 22.7   persons who satisfy the criteria in paragraph (a), clause (3), 
 22.8   regarding the person's right to request and receive long-term 
 22.9   care consultation services as defined in subdivision 1a.  The 
 22.10  notice must be provided prior to the person's discharge from the 
 22.11  facility and in a format specified by the commissioner. 
 22.12     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
 22.13  following final enactment. 
 22.14     Sec. 11.  Minnesota Statutes 2001 Supplement, section 
 22.15  256B.0911, subdivision 4d, is amended to read: 
 22.16     Subd. 4d.  [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 
 22.17  YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 
 22.18  ensure that individuals with disabilities or chronic illness are 
 22.19  served in the most integrated setting appropriate to their needs 
 22.20  and have the necessary information to make informed choices 
 22.21  about home and community-based service options. 
 22.22     (b) Individuals under 65 years of age who are admitted to a 
 22.23  nursing facility from a hospital must be screened prior to 
 22.24  admission as outlined in subdivisions 4a through 4c. 
 22.25     (c) Individuals under 65 years of age who are admitted to 
 22.26  nursing facilities with only a telephone screening must receive 
 22.27  a face-to-face assessment from the long-term care consultation 
 22.28  team member of the county in which the facility is located or 
 22.29  from the recipient's county case manager within 20 working days 
 22.30  of admission. 
 22.31     (d) Individuals under 65 years of age who are admitted to a 
 22.32  nursing facility without preadmission screening according to the 
 22.33  exemption described in subdivision 4b, paragraph (a), clause 
 22.34  (3), and who remain in the facility longer than 30 days must 
 22.35  receive a face-to-face assessment within 40 days of admission. 
 22.36     ~~(d)~~ (e) At the face-to-face assessment, the long-term care 
 23.1   consultation team member or county case manager must perform the 
 23.2   activities required under subdivision 3b. 
 23.3      ~~(e)~~ (f) For individuals under 21 years of age, a screening 
 23.4   interview which recommends nursing facility admission must be 
 23.5   face-to-face and approved by the commissioner before the 
 23.6   individual is admitted to the nursing facility. 
 23.7      ~~(f)~~ (g) In the event that an individual under 65 years of 
 23.8   age is admitted to a nursing facility on an emergency basis, the 
 23.9   county must be notified of the admission on the next working 
 23.10  day, and a face-to-face assessment as described in paragraph (c) 
 23.11  must be conducted within 20 working days of admission. 
 23.12     ~~(g)~~ (h) At the face-to-face assessment, the long-term care 
 23.13  consultation team member or the case manager must present 
 23.14  information about home and community-based options so the 
 23.15  individual can make informed choices.  If the individual chooses 
 23.16  home and community-based services, the long-term care 
 23.17  consultation team member or case manager must complete a written 
 23.18  relocation plan within 20 working days of the visit.  The plan 
 23.19  shall describe the services needed to move out of the facility 
 23.20  and a time line for the move which is designed to ensure a 
 23.21  smooth transition to the individual's home and community. 
 23.22     ~~(h)~~ (i) An individual under 65 years of age residing in a 
 23.23  nursing facility shall receive a face-to-face assessment at 
 23.24  least every 12 months to review the person's service choices and 
 23.25  available alternatives unless the individual indicates, in 
 23.26  writing, that annual visits are not desired.  In this case, the 
 23.27  individual must receive a face-to-face assessment at least once 
 23.28  every 36 months for the same purposes. 
 23.29     ~~(i)~~ (j) Notwithstanding the provisions of subdivision 6, 
 23.30  the commissioner may pay county agencies directly for 
 23.31  face-to-face assessments for individuals under 65 years of age 
 23.32  who are being considered for placement or residing in a nursing 
 23.33  facility. 
 23.34     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
 23.35  following final enactment. 
 23.36     Sec. 12.  Minnesota Statutes 2001 Supplement, section 
 24.1   256B.0913, subdivision 5, is amended to read: 
 24.2      Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
 24.3   Alternative care funding may be used for payment of costs of: 
 24.4      (1) adult foster care; 
 24.5      (2) adult day care; 
 24.6      (3) home health aide; 
 24.7      (4) homemaker services; 
 24.8      (5) personal care; 
 24.9      (6) case management; 
 24.10     (7) respite care; 
 24.11     (8) assisted living; 
 24.12     (9) residential care services; 
 24.13     (10) care-related supplies and equipment; 
 24.14     (11) meals delivered to the home; 
 24.15     (12) transportation; 
 24.16     (13) skilled nursing; 
 24.17     (14) chore services; 
 24.18     (15) companion services; 
 24.19     (16) nutrition services; 
 24.20     (17) training for direct informal caregivers; 
 24.21     (18) telemedicine devices to monitor recipients in their 
 24.22  own homes as an alternative to hospital care, nursing home care, 
 24.23  or home visits; 
 24.24     (19) other services which includes discretionary funds and 
 24.25  direct cash payments to clients, following approval by the 
 24.26  commissioner, subject to the provisions of paragraph (j).  Total 
 24.27  annual payments for "other services" for all clients within a 
 24.28  county may not exceed ~~either ten~~ 25 percent of that county's 
 24.29  annual alternative care program base allocation ~~or $5,000,~~ 
 24.30  ~~whichever is greater.  In no case shall this amount exceed the~~ 
 24.31  ~~county's total annual alternative care program base allocation~~; 
 24.32  and 
 24.33     (20) environmental modifications. 
 24.34     (b) The county agency must ensure that the funds are not 
 24.35  used to supplant services available through other public 
 24.36  assistance or services programs. 
 25.1      (c) Unless specified in statute, the service definitions 
 25.2   and standards for alternative care services shall be the same as 
 25.3   the service definitions and standards specified in the federally 
 25.4   approved elderly waiver plan.  Except for the county agencies' 
 25.5   approval of direct cash payments to clients as described in 
 25.6   paragraph (j) or for a provider of supplies and equipment when 
 25.7   the monthly cost of the supplies and equipment is less than 
 25.8   $250, persons or agencies must be employed by or under a 
 25.9   contract with the county agency or the public health nursing 
 25.10  agency of the local board of health in order to receive funding 
 25.11  under the alternative care program.  Supplies and equipment may 
 25.12  be purchased from a vendor not certified to participate in the 
 25.13  Medicaid program if the cost for the item is less than that of a 
 25.14  Medicaid vendor.  
 25.15     (d) The adult foster care rate shall be considered a 
 25.16  difficulty of care payment and shall not include room and 
 25.17  board.  The adult foster care rate shall be negotiated between 
 25.18  the county agency and the foster care provider.  The alternative 
 25.19  care payment for the foster care service in combination with the 
 25.20  payment for other alternative care services, including case 
 25.21  management, must not exceed the limit specified in subdivision 
 25.22  4, paragraph (a), clause (6). 
 25.23     (e) Personal care services must meet the service standards 
 25.24  defined in the federally approved elderly waiver plan, except 
 25.25  that a county agency may contract with a client's relative who 
 25.26  meets the relative hardship waiver requirement as defined in 
 25.27  section 256B.0627, subdivision 4, paragraph (b), clause (10), to 
 25.28  provide personal care services if the county agency ensures 
 25.29  supervision of this service by a registered nurse or mental 
 25.30  health practitioner.  
 25.31     (f) For purposes of this section, residential care services 
 25.32  are services which are provided to individuals living in 
 25.33  residential care homes.  Residential care homes are currently 
 25.34  licensed as board and lodging establishments and are registered 
 25.35  with the department of health as providing special services 
 25.36  under section 157.17 and are not subject to registration under 
 26.1   chapter 144D.  Residential care services are defined as 
 26.2   "supportive services" and "health-related services."  
 26.3   "Supportive services" means the provision of up to 24-hour 
 26.4   supervision and oversight.  Supportive services includes:  (1) 
 26.5   transportation, when provided by the residential care home only; 
 26.6   (2) socialization, when socialization is part of the plan of 
 26.7   care, has specific goals and outcomes established, and is not 
 26.8   diversional or recreational in nature; (3) assisting clients in 
 26.9   setting up meetings and appointments; (4) assisting clients in 
 26.10  setting up medical and social services; (5) providing assistance 
 26.11  with personal laundry, such as carrying the client's laundry to 
 26.12  the laundry room.  Assistance with personal laundry does not 
 26.13  include any laundry, such as bed linen, that is included in the 
 26.14  room and board rate.  "Health-related services" are limited to 
 26.15  minimal assistance with dressing, grooming, and bathing and 
 26.16  providing reminders to residents to take medications that are 
 26.17  self-administered or providing storage for medications, if 
 26.18  requested.  Individuals receiving residential care services 
 26.19  cannot receive homemaking services funded under this section.  
 26.20     (g) For the purposes of this section, "assisted living" 
 26.21  refers to supportive services provided by a single vendor to 
 26.22  clients who reside in the same apartment building of three or 
 26.23  more units which are not subject to registration under chapter 
 26.24  144D and are licensed by the department of health as a class A 
 26.25  home care provider or a class E home care provider.  Assisted 
 26.26  living services are defined as up to 24-hour supervision, and 
 26.27  oversight, supportive services as defined in clause (1), 
 26.28  individualized home care aide tasks as defined in clause (2), 
 26.29  and individualized home management tasks as defined in clause 
 26.30  (3) provided to residents of a residential center living in 
 26.31  their units or apartments with a full kitchen and bathroom.  A 
 26.32  full kitchen includes a stove, oven, refrigerator, food 
 26.33  preparation counter space, and a kitchen utensil storage 
 26.34  compartment.  Assisted living services must be provided by the 
 26.35  management of the residential center or by providers under 
 26.36  contract with the management or with the county. 
 27.1      (1) Supportive services include:  
 27.2      (i) socialization, when socialization is part of the plan 
 27.3   of care, has specific goals and outcomes established, and is not 
 27.4   diversional or recreational in nature; 
 27.5      (ii) assisting clients in setting up meetings and 
 27.6   appointments; and 
 27.7      (iii) providing transportation, when provided by the 
 27.8   residential center only.  
 27.9      (2) Home care aide tasks means:  
 27.10     (i) preparing modified diets, such as diabetic or low 
 27.11  sodium diets; 
 27.12     (ii) reminding residents to take regularly scheduled 
 27.13  medications or to perform exercises; 
 27.14     (iii) household chores in the presence of technically 
 27.15  sophisticated medical equipment or episodes of acute illness or 
 27.16  infectious disease; 
 27.17     (iv) household chores when the resident's care requires the 
 27.18  prevention of exposure to infectious disease or containment of 
 27.19  infectious disease; and 
 27.20     (v) assisting with dressing, oral hygiene, hair care, 
 27.21  grooming, and bathing, if the resident is ambulatory, and if the 
 27.22  resident has no serious acute illness or infectious disease.  
 27.23  Oral hygiene means care of teeth, gums, and oral prosthetic 
 27.24  devices.  
 27.25     (3) Home management tasks means:  
 27.26     (i) housekeeping; 
 27.27     (ii) laundry; 
 27.28     (iii) preparation of regular snacks and meals; and 
 27.29     (iv) shopping.  
 27.30     Individuals receiving assisted living services shall not 
 27.31  receive both assisted living services and homemaking services.  
 27.32  Individualized means services are chosen and designed 
 27.33  specifically for each resident's needs, rather than provided or 
 27.34  offered to all residents regardless of their illnesses, 
 27.35  disabilities, or physical conditions.  Assisted living services 
 27.36  as defined in this section shall not be authorized in boarding 
 28.1   and lodging establishments licensed according to sections 
 28.2   157.011 and 157.15 to 157.22. 
 28.3      (h) For establishments registered under chapter 144D, 
 28.4   assisted living services under this section means either the 
 28.5   services described in paragraph (g) and delivered by a class E 
 28.6   home care provider licensed by the department of health or the 
 28.7   services described under section 144A.4605 and delivered by an 
 28.8   assisted living home care provider or a class A home care 
 28.9   provider licensed by the commissioner of health. 
 28.10     (i) Payment for assisted living services and residential 
 28.11  care services shall be a monthly rate negotiated and authorized 
 28.12  by the county agency based on an individualized service plan for 
 28.13  each resident and may not cover direct rent or food costs.  
 28.14     (1) The individualized monthly negotiated payment for 
 28.15  assisted living services as described in paragraph (g) or (h), 
 28.16  and residential care services as described in paragraph (f), 
 28.17  shall not exceed the nonfederal share in effect on July 1 of the 
 28.18  state fiscal year for which the rate limit is being calculated 
 28.19  of the greater of either the statewide or any of the geographic 
 28.20  groups' weighted average monthly nursing facility payment rate 
 28.21  of the case mix resident class to which the alternative care 
 28.22  eligible client would be assigned under Minnesota Rules, parts 
 28.23  9549.0050 to 9549.0059, less the maintenance needs allowance as 
 28.24  described in section 256B.0915, subdivision 1d, paragraph (a), 
 28.25  until the first day of the state fiscal year in which a resident 
 28.26  assessment system, under section 256B.437, of nursing home rate 
 28.27  determination is implemented.  Effective on the first day of the 
 28.28  state fiscal year in which a resident assessment system, under 
 28.29  section 256B.437, of nursing home rate determination is 
 28.30  implemented and the first day of each subsequent state fiscal 
 28.31  year, the individualized monthly negotiated payment for the 
 28.32  services described in this clause shall not exceed the limit 
 28.33  described in this clause which was in effect on the last day of 
 28.34  the previous state fiscal year and which has been adjusted by 
 28.35  the greater of any legislatively adopted home and 
 28.36  community-based services cost-of-living percentage increase or 
 29.1   any legislatively adopted statewide percent rate increase for 
 29.2   nursing facilities. 
 29.3      (2) The individualized monthly negotiated payment for 
 29.4   assisted living services described under section 144A.4605 and 
 29.5   delivered by a provider licensed by the department of health as 
 29.6   a class A home care provider or an assisted living home care 
 29.7   provider and provided in a building that is registered as a 
 29.8   housing with services establishment under chapter 144D and that 
 29.9   provides 24-hour supervision in combination with the payment for 
 29.10  other alternative care services, including case management, must 
 29.11  not exceed the limit specified in subdivision 4, paragraph (a), 
 29.12  clause (6). 
 29.13     (j) A county agency may make payment from their alternative 
 29.14  care program allocation for "other services" which include use 
 29.15  of "discretionary funds" for services that are not otherwise 
 29.16  defined in this section and direct cash payments to the client 
 29.17  for the purpose of purchasing the services.  The following 
 29.18  provisions apply to payments under this paragraph: 
 29.19     (1) a cash payment to a client under this provision cannot 
 29.20  exceed ~~80 percent of~~ the monthly payment limit for that client 
 29.21  as specified in subdivision 4, paragraph (a), clause (6); 
 29.22     (2) a county may not approve any cash payment for a client 
 29.23  who meets either of the following: 
 29.24     (i) has been assessed as having a dependency in 
 29.25  orientation, unless the client has an authorized 
 29.26  representative.  An "authorized representative" means an 
 29.27  individual who is at least 18 years of age and is designated by 
 29.28  the person or the person's legal representative to act on the 
 29.29  person's behalf.  This individual may be a family member, 
 29.30  guardian, representative payee, or other individual designated 
 29.31  by the person or the person's legal representative, if any, to 
 29.32  assist in purchasing and arranging for supports; or 
 29.33     (ii) is concurrently receiving adult foster care, 
 29.34  residential care, or assisted living services; 
 29.35     (3) cash payments to a person or a person's family will be 
 29.36  provided through a monthly payment and be in the form of cash, 
 30.1   voucher, or direct county payment to a vendor.  Fees or premiums 
 30.2   assessed to the person for eligibility for health and human 
 30.3   services are not reimbursable through this service option.  
 30.4   Services and goods purchased through cash payments must be 
 30.5   identified in the person's individualized care plan and must 
 30.6   meet all of the following criteria: 
 30.7      (i) they must be over and above the normal cost of caring 
 30.8   for the person if the person did not have functional 
 30.9   limitations; 
 30.10     (ii) they must be directly attributable to the person's 
 30.11  functional limitations; 
 30.12     (iii) they must have the potential to be effective at 
 30.13  meeting the goals of the program; 
 30.14     (iv) they must be consistent with the needs identified in 
 30.15  the individualized service plan.  The service plan shall specify 
 30.16  the needs of the person and family, the form and amount of 
 30.17  payment, the items and services to be reimbursed, and the 
 30.18  arrangements for management of the individual grant; and 
 30.19     (v) the person, the person's family, or the legal 
 30.20  representative shall be provided sufficient information to 
 30.21  ensure an informed choice of alternatives.  The local agency 
 30.22  shall document this information in the person's care plan, 
 30.23  including the type and level of expenditures to be reimbursed; 
 30.24     (4) the county, lead agency under contract, or tribal 
 30.25  government under contract to administer the alternative care 
 30.26  program shall not be liable for damages, injuries, or 
 30.27  liabilities sustained through the purchase of direct supports or 
 30.28  goods by the person, the person's family, or the authorized 
 30.29  representative with funds received through the cash payments 
 30.30  under this section.  Liabilities include, but are not limited 
 30.31  to, workers' compensation, the Federal Insurance Contributions 
 30.32  Act (FICA), or the Federal Unemployment Tax Act (FUTA); 
 30.33     (5) persons receiving grants under this section shall have 
 30.34  the following responsibilities: 
 30.35     (i) spend the grant money in a manner consistent with their 
 30.36  individualized service plan with the local agency; 
 31.1      (ii) notify the local agency of any necessary changes in 
 31.2   the grant expenditures; 
 31.3      (iii) arrange and pay for supports; and 
 31.4      (iv) inform the local agency of areas where they have 
 31.5   experienced difficulty securing or maintaining supports; and 
 31.6      (6) the county shall report client outcomes, services, and 
 31.7   costs under this paragraph in a manner prescribed by the 
 31.8   commissioner. 
 31.9      (k) Upon implementation of direct cash payments to clients 
 31.10  under this section, any person determined eligible for the 
 31.11  alternative care program who chooses a cash payment approved by 
 31.12  the county agency shall receive the cash payment under this 
 31.13  section and not under section 256.476 unless the person was 
 31.14  receiving a consumer support grant under section 256.476 before 
 31.15  implementation of direct cash payments under this section. 
 31.16     Sec. 13.  Minnesota Statutes 2001 Supplement, section 
 31.17  256B.0915, subdivision 3, is amended to read: 
 31.18     Subd. 3.  [LIMITS OF CASES, RATES, PAYMENTS, AND 
 31.19  FORECASTING.] (a) The number of medical assistance waiver 
 31.20  recipients that a county may serve must be allocated according 
 31.21  to the number of medical assistance waiver cases open on July 1 
 31.22  of each fiscal year.  Additional recipients may be served with 
 31.23  the approval of the commissioner. 
 31.24     (b) The monthly limit for the cost of waivered services to 
 31.25  an individual elderly waiver client shall be the weighted 
 31.26  average monthly nursing facility rate of the case mix resident 
 31.27  class to which the elderly waiver client would be assigned under 
 31.28  Minnesota Rules, parts 9549.0050 to 9549.0059, less the 
 31.29  recipient's maintenance needs allowance as described in 
 31.30  subdivision 1d, paragraph (a), until the first day of the state 
 31.31  fiscal year in which the resident assessment system as described 
 31.32  in section 256B.437 for nursing home rate determination is 
 31.33  implemented.  Effective on the first day of the state fiscal 
 31.34  year in which the resident assessment system as described in 
 31.35  section 256B.437 for nursing home rate determination is 
 31.36  implemented and the first day of each subsequent state fiscal 
 32.1   year, the monthly limit for the cost of waivered services to an 
 32.2   individual elderly waiver client shall be the rate of the case 
 32.3   mix resident class to which the waiver client would be assigned 
 32.4   under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect 
 32.5   on the last day of the previous state fiscal year, adjusted by 
 32.6   the greater of any legislatively adopted home and 
 32.7   community-based services cost-of-living percentage increase or 
 32.8   any legislatively adopted statewide percent rate increase for 
 32.9   nursing facilities. 
 32.10     (c) If extended medical supplies and equipment or 
 32.11  environmental modifications are or will be purchased for an 
 32.12  elderly waiver client, the costs may be prorated for up to 12 
 32.13  consecutive months beginning with the month of purchase.  If the 
 32.14  monthly cost of a recipient's waivered services exceeds the 
 32.15  monthly limit established in paragraph (b), the annual cost of 
 32.16  all waivered services shall be determined.  In this event, the 
 32.17  annual cost of all waivered services shall not exceed 12 times 
 32.18  the monthly limit of waivered services as described in paragraph 
 32.19  (b).  
 32.20     (d) For a person who is a nursing facility resident at the 
 32.21  time of requesting a determination of eligibility for elderly 
 32.22  waivered services, a monthly conversion limit for the cost of 
 32.23  elderly waivered services may be requested.  The monthly 
 32.24  conversion limit for the cost of elderly waiver services shall 
 32.25  be the resident class assigned under Minnesota Rules, parts 
 32.26  9549.0050 to 9549.0059, for that resident in the nursing 
 32.27  facility where the resident currently resides until July 1 of 
 32.28  the state fiscal year in which the resident assessment system as 
 32.29  described in section 256B.437 for nursing home rate 
 32.30  determination is implemented.  Effective on July 1 of the state 
 32.31  fiscal year in which the resident assessment system as described 
 32.32  in section 256B.437 for nursing home rate determination is 
 32.33  implemented, the monthly conversion limit for the cost of 
 32.34  elderly waiver services shall be the per diem nursing facility 
 32.35  rate as determined by the resident assessment system as 
 32.36  described in section 256B.437 for that resident in the nursing 
 33.1   facility where the resident currently resides multiplied by 365 
 33.2   and divided by 12, less the recipient's maintenance needs 
 33.3   allowance as described in subdivision 1d.  The initially 
 33.4   approved conversion rate may be adjusted by the greater of any 
 33.5   subsequent legislatively adopted home and community-based 
 33.6   services cost-of-living percentage increase or any subsequent 
 33.7   legislatively adopted statewide percentage rate increase for 
 33.8   nursing facilities.  The limit under this clause only applies to 
 33.9   persons discharged from a nursing facility after a minimum 
 33.10  30-day stay and found eligible for waivered services on or after 
 33.11  July 1, 1997.  The following costs must be included in 
 33.12  determining the total monthly costs for the waiver client: 
 33.13     (1) cost of all waivered services, including extended 
 33.14  medical supplies and equipment and environmental modifications; 
 33.15  and 
 33.16     (2) cost of skilled nursing, home health aide, and personal 
 33.17  care services reimbursable by medical assistance.  
 33.18     (e) Medical assistance funding for skilled nursing 
 33.19  services, private duty nursing, home health aide, and personal 
 33.20  care services for waiver recipients must be approved by the case 
 33.21  manager and included in the individual care plan. 
 33.22     (f) A county is not required to contract with a provider of 
 33.23  supplies and equipment if the monthly cost of the supplies and 
 33.24  equipment is less than $250.  
 33.25     (g) The adult foster care rate shall be considered a 
 33.26  difficulty of care payment and shall not include room and 
 33.27  board.  The adult foster care service rate shall be negotiated 
 33.28  between the county agency and the foster care provider.  The 
 33.29  elderly waiver payment for the foster care service in 
 33.30  combination with the payment for all other elderly waiver 
 33.31  services, including case management, must not exceed the limit 
 33.32  specified in paragraph (b). 
 33.33     (h) Payment for assisted living service shall be a monthly 
 33.34  rate negotiated and authorized by the county agency based on an 
 33.35  individualized service plan for each resident and may not cover 
 33.36  direct rent or food costs. 
 34.1      (1) The individualized monthly negotiated payment for 
 34.2   assisted living services as described in section 256B.0913, 
 34.3   subdivision 5, paragraph (g) or (h), and residential care 
 34.4   services as described in section 256B.0913, subdivision 5, 
 34.5   paragraph (f), shall not exceed the nonfederal share, in effect 
 34.6   on July 1 of the state fiscal year for which the rate limit is 
 34.7   being calculated, of the greater of either the statewide or any 
 34.8   of the geographic groups' weighted average monthly nursing 
 34.9   facility rate of the case mix resident class to which the 
 34.10  elderly waiver eligible client would be assigned under Minnesota 
 34.11  Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 
 34.12  allowance as described in subdivision 1d, paragraph (a), until 
 34.13  the July 1 of the state fiscal year in which the resident 
 34.14  assessment system as described in section 256B.437 for nursing 
 34.15  home rate determination is implemented.  Effective on July 1 of 
 34.16  the state fiscal year in which the resident assessment system as 
 34.17  described in section 256B.437 for nursing home rate 
 34.18  determination is implemented and July 1 of each subsequent state 
 34.19  fiscal year, the individualized monthly negotiated payment for 
 34.20  the services described in this clause shall not exceed the limit 
 34.21  described in this clause which was in effect on June 30 of the 
 34.22  previous state fiscal year and which has been adjusted by the 
 34.23  greater of any legislatively adopted home and community-based 
 34.24  services cost-of-living percentage increase or any legislatively 
 34.25  adopted statewide percent rate increase for nursing facilities. 
 34.26     (2) The individualized monthly negotiated payment for 
 34.27  assisted living services described in section 144A.4605 and 
 34.28  delivered by a provider licensed by the department of health as 
 34.29  a class A home care provider or an assisted living home care 
 34.30  provider and provided in a building that is registered as a 
 34.31  housing with services establishment under chapter 144D and that 
 34.32  provides 24-hour supervision in combination with the payment for 
 34.33  other elderly waiver services, including case management, must 
 34.34  not exceed the limit specified in paragraph (b). 
 34.35     (i) The county shall negotiate individual service rates 
 34.36  with vendors and may authorize payment for actual costs up to 
 35.1   the county's current approved rate.  Persons or agencies must be 
 35.2   employed by or under a contract with the county agency or the 
 35.3   public health nursing agency of the local board of health in 
 35.4   order to receive funding under the elderly waiver program, 
 35.5   except as a provider of supplies and equipment when the monthly 
 35.6   cost of the supplies and equipment is less than $250.  
 35.7      (j) Reimbursement for the medical assistance recipients 
 35.8   under the approved waiver shall be made from the medical 
 35.9   assistance account through the invoice processing procedures of 
 35.10  the department's Medicaid Management Information System (MMIS), 
 35.11  only with the approval of the client's case manager.  The budget 
 35.12  for the state share of the Medicaid expenditures shall be 
 35.13  forecasted with the medical assistance budget, and shall be 
 35.14  consistent with the approved waiver.  
 35.15     (k) To improve access to community services and eliminate 
 35.16  payment disparities between the alternative care program and the 
 35.17  elderly waiver, the commissioner shall establish statewide 
 35.18  maximum service rate limits and eliminate county-specific 
 35.19  service rate limits. 
 35.20     (1) Effective July 1, 2001, for service rate limits, except 
 35.21  those described or defined in paragraphs (g) and (h), the rate 
 35.22  limit for each service shall be the greater of the alternative 
 35.23  care statewide maximum rate or the elderly waiver statewide 
 35.24  maximum rate. 
 35.25     (2) Counties may negotiate individual service rates with 
 35.26  vendors for actual costs up to the statewide maximum service 
 35.27  rate limit. 
 35.28     (l) Beginning July 1, 1991, the state shall reimburse 
 35.29  counties according to the payment schedule in section 256.025 
 35.30  for the county share of costs incurred under this subdivision on 
 35.31  or after January 1, 1991, for individuals who are receiving 
 35.32  medical assistance. 
 35.33     Sec. 14.  Minnesota Statutes 2001 Supplement, section 
 35.34  256B.0924, subdivision 6, is amended to read: 
 35.35     Subd. 6.  [PAYMENT FOR TARGETED CASE MANAGEMENT.] (a) 
 35.36  Medical assistance and MinnesotaCare payment for targeted case 
 36.1   management shall be made on a monthly basis.  In order to 
 36.2   receive payment for an eligible adult, the provider must 
 36.3   document at least one contact per month and not more than two 
 36.4   consecutive months without a face-to-face contact with the adult 
 36.5   or the adult's legal representative, family, primary caregiver, 
 36.6   or other relevant persons identified as necessary to the 
 36.7   development or implementation of the goals of the personal 
 36.8   service plan. 
 36.9      (b) Payment for targeted case management provided by county 
 36.10  staff under this subdivision shall be based on the monthly rate 
 36.11  methodology under section 256B.094, subdivision 6, paragraph 
 36.12  (b), calculated as one combined average rate together with adult 
 36.13  mental health case management under section 256B.0625, 
 36.14  subdivision 20, except for calendar year 2002.  In calendar year 
 36.15  2002, the rate for case management under this section shall be 
 36.16  the same as the rate for adult mental health case management in 
 36.17  effect as of December 31, 2001.  Billing and payment must 
 36.18  identify the recipient's primary population group to allow 
 36.19  tracking of revenues. 
 36.20     (c) Payment for targeted case management provided by 
 36.21  county-contracted vendors shall be based on a monthly rate 
 36.22  negotiated by the host county.  The negotiated rate must not 
 36.23  exceed the rate charged by the vendor for the same service to 
 36.24  other payers.  If the service is provided by a team of 
 36.25  contracted vendors, the county may negotiate a team rate with a 
 36.26  vendor who is a member of the team.  The team shall determine 
 36.27  how to distribute the rate among its members.  No reimbursement 
 36.28  received by contracted vendors shall be returned to the county, 
 36.29  except to reimburse the county for advance funding provided by 
 36.30  the county to the vendor. 
 36.31     (d) If the service is provided by a team that includes 
 36.32  contracted vendors and county staff, the costs for county staff 
 36.33  participation on the team shall be included in the rate for 
 36.34  county-provided services.  In this case, the contracted vendor 
 36.35  and the county may each receive separate payment for services 
 36.36  provided by each entity in the same month.  In order to prevent 
 37.1   duplication of services, the county must document, in the 
 37.2   recipient's file, the need for team targeted case management and 
 37.3   a description of the different roles of the team members. 
 37.4      (e) Notwithstanding section 256B.19, subdivision 1, the 
 37.5   nonfederal share of costs for targeted case management shall be 
 37.6   provided by the recipient's county of responsibility, as defined 
 37.7   in sections 256G.01 to 256G.12, from sources other than federal 
 37.8   funds or funds used to match other federal funds. 
 37.9      (f) The commissioner may suspend, reduce, or terminate 
 37.10  reimbursement to a provider that does not meet the reporting or 
 37.11  other requirements of this section.  The county of 
 37.12  responsibility, as defined in sections 256G.01 to 256G.12, is 
 37.13  responsible for any federal disallowances.  The county may share 
 37.14  this responsibility with its contracted vendors. 
 37.15     (g) The commissioner shall set aside five percent of the 
 37.16  federal funds received under this section for use in reimbursing 
 37.17  the state for costs of developing and implementing this section. 
 37.18     (h) Notwithstanding section 256.025, subdivision 2, 
 37.19  payments to counties for targeted case management expenditures 
 37.20  under this section shall only be made from federal earnings from 
 37.21  services provided under this section.  Payments to contracted 
 37.22  vendors shall include both the federal earnings and the county 
 37.23  share. 
 37.24     (i) Notwithstanding section 256B.041, county payments for 
 37.25  the cost of case management services provided by county staff 
 37.26  shall not be made to the state treasurer.  For the purposes of 
 37.27  targeted case management services provided by county staff under 
 37.28  this section, the centralized disbursement of payments to 
 37.29  counties under section 256B.041 consists only of federal 
 37.30  earnings from services provided under this section. 
 37.31     (j) If the recipient is a resident of a nursing facility, 
 37.32  intermediate care facility, or hospital, and the recipient's 
 37.33  institutional care is paid by medical assistance, payment for 
 37.34  targeted case management services under this subdivision is 
 37.35  limited to the last 180 days of the recipient's residency in 
 37.36  that facility and may not exceed more than six months in a 
 38.1   calendar year. 
 38.2      (k) Payment for targeted case management services under 
 38.3   this subdivision shall not duplicate payments made under other 
 38.4   program authorities for the same purpose. 
 38.5      (l) Any growth in targeted case management services and 
 38.6   cost increases under this section shall be the responsibility of 
 38.7   the counties. 
 38.8      Sec. 15.  Minnesota Statutes 2001 Supplement, section 
 38.9   256B.0951, subdivision 7, is amended to read: 
 38.10     Subd. 7.  [WAIVER OF RULES.] If a federal waiver is 
 38.11  approved under subdivision 8, the commissioner of health may 
 38.12  exempt residents of intermediate care facilities for persons 
 38.13  with mental retardation (ICFs/MR) who participate in the 
 38.14  ~~three-year~~ alternative quality assurance ~~pilot~~ project 
 38.15  established in section 256B.095 from the requirements of 
 38.16  Minnesota Rules, chapter 4665~~, upon approval by the federal~~ 
 38.17  ~~government of a waiver of federal certification requirements for~~ 
 38.18  ~~ICFs/MR~~.  
 38.19     Sec. 16.  Minnesota Statutes 2001 Supplement, section 
 38.20  256B.0951, subdivision 8, is amended to read: 
 38.21     Subd. 8.  [FEDERAL WAIVER.] The commissioner of human 
 38.22  services shall seek ~~federal authority to waive provisions of~~ 
 38.23  ~~intermediate care facilities for persons with mental retardation~~ 
 38.24  ~~(ICFs/MR) regulations to enable the demonstration and evaluation~~ 
 38.25  ~~of the alternative quality assurance system for ICFs/MR under~~ 
 38.26  ~~the project.  The commissioner of human services shall apply for~~ 
 38.27  ~~any necessary waivers as soon as practicable.~~ a federal waiver 
 38.28  to allow intermediate care facilities for persons with mental 
 38.29  retardation (ICFs/MR) in region 10 of Minnesota to participate 
 38.30  in the alternative licensing system.  If it is necessary for 
 38.31  purposes of participation in this alternative licensing system 
 38.32  for a facility to be decertified as an ICF/MR facility according 
 38.33  to the terms of the federal waiver, when the facility seeks 
 38.34  recertification under the provisions of ICF/MR regulations at 
 38.35  the end of the demonstration project, it will not be considered 
 38.36  a new ICF/MR as defined under section 252.291 provided the 
 39.1   licensed capacity of the facility did not increase during its 
 39.2   participation in the alternative licensing system.  The 
 39.3   provisions of sections 252.82, 252.292, and 256B.5011 to 
 39.4   256B.5015 will remain applicable for counties in region 10 of 
 39.5   Minnesota and the ICFs/MR located within those counties 
 39.6   notwithstanding a county's participation in the alternative 
 39.7   licensing system. 
 39.8      Sec. 17.  Minnesota Statutes 2001 Supplement, section 
 39.9   256B.437, subdivision 6, is amended to read: 
 39.10     Subd. 6.  [PLANNED CLOSURE RATE ADJUSTMENT.] (a) The 
 39.11  commissioner of human services shall calculate the amount of the 
 39.12  planned closure rate adjustment available under subdivision 3, 
 39.13  paragraph (b), for up to 5,140 beds according to clauses (1) to 
 39.14  (4): 
 39.15     (1) the amount available is the net reduction of nursing 
 39.16  facility beds multiplied by $2,080; 
 39.17     (2) the total number of beds in the nursing facility or 
 39.18  facilities receiving the planned closure rate adjustment must be 
 39.19  identified; 
 39.20     (3) capacity days are determined by multiplying the number 
 39.21  determined under clause (2) by 365; and 
 39.22     (4) the planned closure rate adjustment is the amount 
 39.23  available in clause (1), divided by capacity days determined 
 39.24  under clause (3). 
 39.25     (b) A planned closure rate adjustment under this section is 
 39.26  effective on the first day of the month following completion of 
 39.27  closure of the facility designated for closure in the 
 39.28  application and becomes part of the nursing facility's total 
 39.29  operating payment rate. 
 39.30     (c) Applicants may use the planned closure rate adjustment 
 39.31  to allow for a property payment for a new nursing facility or an 
 39.32  addition to an existing nursing facility or as an operating 
 39.33  payment rate adjustment.  Applications approved under this 
 39.34  subdivision are exempt from other requirements for moratorium 
 39.35  exceptions under section 144A.073, subdivisions 2 and 3. 
 39.36     (d) Upon the request of a closing facility, the 
 40.1   commissioner must allow the facility a closure rate adjustment 
 40.2   as provided under section 144A.161, subdivision 10. 
 40.3      (e) A facility that has received a planned closure rate 
 40.4   adjustment may reassign it to another facility that is under the 
 40.5   same ownership at any time within three years of its effective 
 40.6   date.  The amount of the adjustment shall be computed according 
 40.7   to paragraph (a). 
 40.8      (f) If the per bed dollar amount specified in paragraph 
 40.9   (a), clause (1), is increased, the commissioner shall 
 40.10  recalculate planned closure rate adjustments for facilities that 
 40.11  delicense beds under this section on or after July 1, 2001, to 
 40.12  reflect the increase in the per bed dollar amount.  The 
 40.13  recalculated planned closure rate adjustment shall be effective 
 40.14  from the date the per bed dollar amount is increased. 
 40.15     Sec. 18.  Minnesota Statutes 2000, section 326.01, is 
 40.16  amended by adding a subdivision to read: 
 40.17     Subd. 9a.  [RESTRICTED PLUMBING CONTRACTOR.] A "restricted 
 40.18  plumbing contractor" is any person skilled in the planning, 
 40.19  superintending, and practical installation of plumbing who is 
 40.20  otherwise lawfully qualified to contract for plumbing and 
 40.21  installations and to conduct the business of plumbing, who is 
 40.22  familiar with the laws and rules governing the business of 
 40.23  plumbing, and who performs the plumbing trade in cities and 
 40.24  towns with a population of fewer than 5,000 according to federal 
 40.25  census. 
 40.26     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003.  
 40.27     Sec. 19.  Minnesota Statutes 2000, section 326.37, 
 40.28  subdivision 1, is amended to read: 
 40.29     Subdivision 1.  [RULES.] The state commissioner of 
 40.30  health ~~may~~ shall, by rule, prescribe minimum uniform standards 
 40.31  ~~which shall be uniform, and which standards shall thereafter be~~ 
 40.32  effective for all new plumbing installations, including 
 40.33  additions, extensions, alterations, and replacements ~~connected~~ 
 40.34  ~~with any water or sewage disposal system owned or operated by or~~ 
 40.35  ~~for any municipality, institution, factory, office building,~~ 
 40.36  ~~hotel, apartment building, or any other place of business~~ 
 41.1   ~~regardless of location or the population of the city or town in~~ 
 41.2   ~~which located~~.  Notwithstanding the provisions of Minnesota 
 41.3   Rules, part 4715.3130, as they apply to review of plans and 
 41.4   specifications, the commissioner may allow plumbing 
 41.5   construction, alteration, or extension to proceed without 
 41.6   approval of the plans or specifications by the commissioner. 
 41.7      The commissioner shall administer the provisions of 
 41.8   sections 326.37 to ~~326.45~~ 326.451 and for such purposes may 
 41.9   employ plumbing inspectors and other assistants. 
 41.10     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003.  
 41.11     Sec. 20.  Minnesota Statutes 2000, section 326.37, is 
 41.12  amended by adding a subdivision to read: 
 41.13     Subd. 1a.  [INSPECTION.] All new plumbing installations, 
 41.14  including additions, extensions, alterations, and replacements, 
 41.15  shall be inspected by the commissioner for compliance with 
 41.16  accepted standards of construction for health, safety to life 
 41.17  and property, and compliance with applicable codes.  The 
 41.18  department of health shall have full implementation of its 
 41.19  inspections plan in place and operational July 1, 2005.  This 
 41.20  subdivision does not apply where a political subdivision 
 41.21  requires, by ordinance, plumbing inspections similar to the 
 41.22  requirements of this subdivision. 
 41.23     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003.  
 41.24     Sec. 21.  Minnesota Statutes 2001 Supplement, section 
 41.25  326.38, is amended to read: 
 41.26     326.38 [LOCAL REGULATIONS.] 
 41.27     Any city having a system of waterworks or sewerage, or any 
 41.28  town in which reside over 5,000 people exclusive of any 
 41.29  statutory cities located therein, or the metropolitan airports 
 41.30  commission, may, by ordinance, adopt local regulations providing 
 41.31  for plumbing permits, bonds, approval of plans, and inspections 
 41.32  of plumbing, which regulations are not in conflict with the 
 41.33  plumbing standards on the same subject prescribed by the state 
 41.34  commissioner of health.  No city or such town shall prohibit 
 41.35  plumbers licensed by the state commissioner of health from 
 41.36  engaging in or working at the business, except cities and 
 42.1   statutory cities which, prior to April 21, 1933, by ordinance 
 42.2   required the licensing of plumbers.  No city or such town shall 
 42.3   require a license for persons performing building sewer or water 
 42.4   service installation who have completed pipe laying training as 
 42.5   prescribed by the state commissioner of health.  Any city by 
 42.6   ordinance may prescribe regulations, reasonable standards, and 
 42.7   inspections and grant permits to any person, firm, or 
 42.8   corporation engaged in the business of installing water 
 42.9   softeners, who is not licensed as a master plumber or journeyman 
 42.10  plumber by the state commissioner of health, to connect water 
 42.11  softening and water filtering equipment to private residence 
 42.12  water distribution systems, where provision has been previously 
 42.13  made therefor and openings left for that purpose or by use of 
 42.14  cold water connections to a domestic water heater; where it is 
 42.15  not necessary to rearrange, make any extension or alteration of, 
 42.16  or addition to any pipe, fixture or plumbing connected with the 
 42.17  water system except to connect the water softener, and provided 
 42.18  the connections so made comply with minimum standards prescribed 
 42.19  by the state commissioner of health. 
 42.20     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003.  
 42.21     Sec. 22.  Minnesota Statutes 2000, section 326.40, 
 42.22  subdivision 1, is amended to read: 
 42.23     Subdivision 1.  [~~PLUMBERS MUST BE LICENSED IN CERTAIN~~ 
 42.24  ~~CITIES; MASTER AND JOURNEYMAN PLUMBERS~~ MASTER, JOURNEYMAN, AND 
 42.25  RESTRICTED PLUMBING CONTRACTORS; PLUMBING ON ONE'S OWN PREMISES; 
 42.26  RULES FOR EXAMINATION.] ~~In any city now or hereafter having~~ 
 42.27  ~~5,000 or more population, according to the last federal census,~~ 
 42.28  ~~and having a system of waterworks or sewerage, no person, firm,~~ 
 42.29  ~~or corporation shall engage in or work at the business of a~~ 
 42.30  ~~master plumber or journeyman plumber unless licensed to do so by~~ 
 42.31  ~~the state commissioner of health.~~  No person, firm, or 
 42.32  corporation shall engage in or work at the business of a master 
 42.33  plumber, restricted plumbing contractor, or journeyman plumber 
 42.34  unless licensed to do so by the state commissioner of health 
 42.35  under sections 326.37 to 326.451.  A license is not required for:
 42.36     (1) persons performing building sewer or water service 
 43.1   installation who have completed pipe laying training as 
 43.2   prescribed by the commissioner of health; or 
 43.3      (2) persons selling an appliance plumbing installation 
 43.4   service at point of sale if the installation work is performed 
 43.5   by a plumber licensed under sections 326.37 to 326.451.  
 43.6      A master plumber may also work as a journeyman plumber.  
 43.7   Anyone not so licensed may do plumbing work which complies with 
 43.8   the provisions of the minimum standard prescribed by the state 
 43.9   commissioner of health on premises or that part of premises 
 43.10  owned and actually occupied by the worker as a residence, unless 
 43.11  otherwise forbidden to do so by a local ordinance. 
 43.12     ~~In any such city~~ No person, firm, or corporation shall 
 43.13  engage in the business of installing plumbing nor install 
 43.14  plumbing in connection with the dealing in and selling of 
 43.15  plumbing material and supplies unless at all times a licensed 
 43.16  master plumber or restricted plumbing contractor, who shall be 
 43.17  responsible for proper installation, is in charge of the 
 43.18  plumbing work of the person, firm, or corporation. 
 43.19     The department of health shall prescribe rules, not 
 43.20  inconsistent herewith, for the examination and licensing of 
 43.21  plumbers. 
 43.22     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003.  
 43.23     Sec. 23.  [326.402] [RESTRICTED PLUMBING CONTRACTOR 
 43.24  LICENSE.] 
 43.25     Subdivision 1.  [LICENSURE.] The commissioner shall grant a 
 43.26  restricted plumbing contractor license to any person who applies 
 43.27  to the commissioner and provides evidence of having at least two 
 43.28  years of practical plumbing experience in the plumbing trade 
 43.29  preceding application for licensure. 
 43.30     Subd. 2.  [USE OF LICENSE.] A restricted plumbing 
 43.31  contractor may engage in the plumbing trade only in cities and 
 43.32  towns with a population of fewer than 5,000 according to federal 
 43.33  census. 
 43.34     Subd. 3.  [APPLICATION PERIOD.] Applications for restricted 
 43.35  plumbing contractor licenses must be submitted to the 
 43.36  commissioner prior to January 1, 2004. 
 44.1      Subd. 4.  [USE PERIOD FOR RESTRICTED PLUMBING CONTRACTOR 
 44.2   LICENSE.] A restricted plumbing contractor license does not 
 44.3   expire and remains in effect for as long as that person engages 
 44.4   in the plumbing trade. 
 44.5      Subd. 5.  [PROHIBITION OF TRANSFERENCE.] A restricted 
 44.6   plumbing contractor license must not be transferred or sold to 
 44.7   any other person. 
 44.8      Subd. 6.  [RESTRICTED PLUMBING CONTRACTOR LICENSE RENEWAL.] 
 44.9   The commissioner shall adopt rules for renewal of the restricted 
 44.10  plumbing contractor license. 
 44.11     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003.  
 44.12     Sec. 24.  [326.451] [INSPECTORS.] 
 44.13     (a) The commissioner shall set all reasonable criteria and 
 44.14  procedures by rule for inspector certification, certification 
 44.15  period, examinations, examination fees, certification fees, and 
 44.16  renewal of certifications. 
 44.17     (b) The commissioner shall adopt reasonable rules 
 44.18  establishing criteria and procedures for refusal to grant or 
 44.19  renew inspector certifications, and for suspension and 
 44.20  revocation of inspector certifications. 
 44.21     (c) The commissioner shall refuse to renew or grant 
 44.22  inspector certifications, or suspend or revoke inspector 
 44.23  certifications, in accordance with the commissioner's criteria 
 44.24  and procedures as adopted by rule.  
 44.25     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
 44.26     Sec. 25.  [CASE MANAGEMENT STUDY.] 
 44.27     The commissioner of human services, in consultation with 
 44.28  consumers, providers, consumer advocates, and local social 
 44.29  service agencies, shall study case management services for 
 44.30  persons with disabilities.  The commissioner must report to the 
 44.31  chairs and ranking minority members of the senate and the house 
 44.32  of representatives committees having jurisdiction over human 
 44.33  services issues by January 15, 2003, on strategies that: 
 44.34     (1) streamline administration; 
 44.35     (2) improve case management service availability across the 
 44.36  state; 
 45.1      (3) enhance consumer access to needed services and 
 45.2   supports; 
 45.3      (4) improve accountability and the use of performance 
 45.4   measures; 
 45.5      (5) provide for consumer choice of vendor; and 
 45.6      (6) improve the financing of case management services. 
 45.7      <b>[EFFECTIVE DATE.]</b> This section is effective the day 
 45.8   following final enactment. 
 45.9      Sec. 26.  [REVISOR INSTRUCTION.] 
 45.10     The revisor of statutes shall change all references to 
 45.11  section 326.45 to section 326.451 in Minnesota Statutes, 
 45.12  sections 144.99, 326.44, 326.61, and 326.65. 
 45.13     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003.  
 45.14     Sec. 27.  [REPEALER.] 
 45.15     Minnesota Statutes 2000, section 326.45, is repealed. 
 45.16     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
 45.17                             ARTICLE 2 
 45.18                                TANF
 45.19     Section 1.  Minnesota Statutes 2001 Supplement, section 
 45.20  256J.425, is amended by adding a subdivision to read: 
 45.21     Subd. 1b.  [TEMPORARY EXTENSION.] (a) A temporary extension 
 45.22  on assistance applies to participants who are: 
 45.23     (i) not in sanction status in the 60th month of receiving 
 45.24  assistance and are following the work search and other 
 45.25  requirements in their plan; and 
 45.26     (ii) have not obtained sufficient employment that results 
 45.27  in a wage that is equal to or exceeds 120 percent of the federal 
 45.28  poverty guidelines for a family of the same size. 
 45.29     (b) All notices and information provided to participants 
 45.30  under this chapter related to the 60-month time limit must 
 45.31  include an explanation of the extension of the 60-month time 
 45.32  limit under paragraph (a). 
 45.33     (c) This subdivision expires on June 30, 2004. 
 45.34     Sec. 2.  Minnesota Statutes 2001 Supplement, section 
 45.35  256J.425, subdivision 3, is amended to read: 
 45.36     Subd. 3.  [HARD-TO-EMPLOY PARTICIPANTS.] An assistance unit 
 46.1   subject to the time limit in section 256J.42, subdivision 1, in 
 46.2   which any participant has received 60 counted months of 
 46.3   assistance, is eligible to receive months of assistance under a 
 46.4   hardship extension if the participant belongs to any of the 
 46.5   following groups: 
 46.6      (1) a person who is diagnosed by a licensed physician, 
 46.7   psychological practitioner, or other qualified professional, as 
 46.8   mentally retarded or mentally ill, and that condition prevents 
 46.9   the person from obtaining or retaining unsubsidized employment; 
 46.10     (2) a person who: 
 46.11     (i) has been assessed by a vocational specialist or the 
 46.12  county agency to be unemployable for purposes of this 
 46.13  subdivision; or 
 46.14     (ii) has an IQ below 80 who has been assessed by a 
 46.15  vocational specialist or a county agency to be employable, but 
 46.16  not at a level that makes the participant eligible for an 
 46.17  extension under subdivision 4 or, in the case of a 
 46.18  non-English-speaking person for whom it is not possible to 
 46.19  provide a determination due to language barriers or absence of 
 46.20  culturally appropriate assessment tools, is determined by a 
 46.21  qualified professional to have an IQ below 80.  A person is 
 46.22  considered employable if positions of employment in the local 
 46.23  labor market exist, regardless of the current availability of 
 46.24  openings for those positions, that the person is capable of 
 46.25  performing; ~~or~~ 
 46.26     (3) a person who is determined by the county agency to be 
 46.27  learning disabled or, in the case of a non-English-speaking 
 46.28  person for whom it is not possible to provide a medical 
 46.29  diagnosis due to language barriers or absence of culturally 
 46.30  appropriate assessment tools, is determined by a qualified 
 46.31  professional to have a learning disability.  If a rehabilitation 
 46.32  plan for the person is developed or approved by the county 
 46.33  agency, the plan must be incorporated into the employment plan.  
 46.34  However, a rehabilitation plan does not replace the requirement 
 46.35  to develop and comply with an employment plan under section 
 46.36  256J.52.  For purposes of this section, "learning disabled" 
 47.1   means the applicant or recipient has a disorder in one or more 
 47.2   of the psychological processes involved in perceiving, 
 47.3   understanding, or using concepts through verbal language or 
 47.4   nonverbal means.  The disability must severely limit the 
 47.5   applicant or recipient in obtaining, performing, or maintaining 
 47.6   suitable employment.  Learning disabled does not include 
 47.7   learning problems that are primarily the result of visual, 
 47.8   hearing, or motor handicaps; mental retardation; emotional 
 47.9   disturbance; or due to environmental, cultural, or economic 
 47.10  disadvantage~~.~~; or 
 47.11     (4) a person who is a victim of family violence as defined 
 47.12  in section 256J.49, subdivision 2, and who is participating in 
 47.13  an alternative employment plan under section 256J.49, 
 47.14  subdivision 1a.  
 47.15     Sec. 3.  Minnesota Statutes 2001 Supplement, section 
 47.16  256J.425, subdivision 4, is amended to read: 
 47.17     Subd. 4.  [EMPLOYED PARTICIPANTS.] (a) An assistance unit 
 47.18  subject to the time limit under section 256J.42, subdivision 1, 
 47.19  in which any participant has received 60 months of assistance, 
 47.20  is eligible to receive assistance under a hardship extension if 
 47.21  the participant belongs to: 
 47.22     (1) a one-parent assistance unit in which the participant 
 47.23  is participating in work activities for at least 30 hours per 
 47.24  week, of which an average of at least 25 hours per week every 
 47.25  month are spent participating in employment; ~~or~~ 
 47.26     (2) a two-parent assistance unit in which the participants 
 47.27  are participating in work activities for at least 55 hours per 
 47.28  week, of which an average of at least 45 hours per week every 
 47.29  month are spent participating in employment~~.~~; or 
 47.30     (3) an assistance unit in which a participant is 
 47.31  participating in employment for fewer hours than those specified 
 47.32  in clause (1), provided the participant submits verification 
 47.33  from a health care provider, in a form acceptable to the 
 47.34  commissioner, stating that the number of hours the participant 
 47.35  may work is limited due to illness or disability, as long as the 
 47.36  participant is participating in employment for at least the 
 48.1   number of hours specified by the health care provider.  The 
 48.2   participant must be following the treatment recommendations of 
 48.3   the health care provider providing the verification.  The 
 48.4   commissioner shall develop a form to be completed and signed by 
 48.5   the health care provider, documenting the diagnosis and any 
 48.6   additional information necessary to document the functional 
 48.7   limitations of the participant that limit work hours.  If the 
 48.8   participant is part of a two-parent assistance unit, the other 
 48.9   parent must be treated as a one-parent assistance unit for 
 48.10  purposes of meeting the work requirements under this subdivision.
 48.11     For purposes of this section, employment means: 
 48.12     (1) unsubsidized employment under section 256J.49, 
 48.13  subdivision 13, clause (1); 
 48.14     (2) subsidized employment under section 256J.49, 
 48.15  subdivision 13, clause (2); 
 48.16     (3) on-the-job training under section 256J.49, subdivision 
 48.17  13, clause (4); 
 48.18     (4) an apprenticeship under section 256J.49, subdivision 
 48.19  13, clause (19); 
 48.20     (5) supported work.  For purposes of this section, 
 48.21  "supported work" means services supporting a participant on the 
 48.22  job which include, but are not limited to, supervision, job 
 48.23  coaching, and subsidized wages; 
 48.24     (6) a combination of (1) to (5); or 
 48.25     (7) child care under section 256J.49, subdivision 13, 
 48.26  clause (25), if it is in combination with paid employment. 
 48.27     (b) If a participant is complying with a child protection 
 48.28  plan under chapter 260C, the number of hours required under the 
 48.29  child protection plan count toward the number of hours required 
 48.30  under this subdivision.  
 48.31     (c) The county shall provide the opportunity for subsidized 
 48.32  employment to participants needing that type of employment 
 48.33  within available appropriations. 
 48.34     (d) To be eligible for a hardship extension for employed 
 48.35  participants under this subdivision, a participant in a 
 48.36  one-parent assistance unit or both parents in a two-parent 
 49.1   assistance unit must be in compliance for at least ten out of 
 49.2   the 12 months immediately preceding the participant's 61st month 
 49.3   on assistance.  If only one parent in a two-parent assistance 
 49.4   unit fails to be in compliance ten out of the 12 months 
 49.5   immediately preceding the participant's 61st month, the county 
 49.6   shall give the assistance unit the option of disqualifying the 
 49.7   noncompliant parent.  If the noncompliant participant is 
 49.8   disqualified, the assistance unit must be treated as a 
 49.9   one-parent assistance unit for the purposes of meeting the work 
 49.10  requirements under this subdivision and the assistance unit's 
 49.11  MFIP grant shall be calculated using the shared household 
 49.12  standard under section 256J.08, subdivision 82a. 
 49.13     (e) The employment plan developed under section 256J.52, 
 49.14  subdivision 5, for participants under this subdivision must 
 49.15  contain the number of hours specified in paragraph (a) related 
 49.16  to employment and work activities.  The job counselor and the 
 49.17  participant must sign the employment plan to indicate agreement 
 49.18  between the job counselor and the participant on the contents of 
 49.19  the plan. 
 49.20     (f) Participants who fail to meet the requirements in 
 49.21  paragraph (a), without good cause under section 256J.57, shall 
 49.22  be sanctioned or permanently disqualified under subdivision 6.  
 49.23  Good cause may only be granted for that portion of the month for 
 49.24  which the good cause reason applies.  Participants must meet all 
 49.25  remaining requirements in the approved employment plan or be 
 49.26  subject to sanction or permanent disqualification.  
 49.27     (g) If the noncompliance with an employment plan is due to 
 49.28  the involuntary loss of employment, the participant is exempt 
 49.29  from the hourly employment requirement under this subdivision 
 49.30  for one month.  Participants must meet all remaining 
 49.31  requirements in the approved employment plan or be subject to 
 49.32  sanction or permanent disqualification.  This exemption is 
 49.33  available to one-parent assistance units two times in a 12-month 
 49.34  period, and two-parent assistance units, two times per parent in 
 49.35  a 12-month period. 
 49.36     (h) This subdivision expires on June 30, 2004. 
 50.1      Sec. 4.  Minnesota Statutes 2001 Supplement, section 
 50.2   256J.425, subdivision 5, is amended to read: 
 50.3      Subd. 5.  [ACCRUAL OF CERTAIN EXEMPT MONTHS.] (a) A 
 50.4   participant who received TANF assistance that counted towards 
 50.5   the federal 60-month time limit while the participant was exempt 
 50.6   under section 256J.56, paragraph (a), clause (7), from 
 50.7   employment and training services requirements and who is no 
 50.8   longer eligible for assistance under a hardship extension under 
 50.9   subdivision 2, paragraph (a), clause (3), is eligible for 
 50.10  assistance under a hardship extension for a period of time equal 
 50.11  to the number of months that were counted toward the federal 
 50.12  60-month time limit while the participant was exempt under 
 50.13  section 256J.56, paragraph (a), clause (7), from the employment 
 50.14  and training services requirements. 
 50.15     (b) A participant who received TANF assistance that counted 
 50.16  towards the federal 60-month time limit while the participant 
 50.17  met the state time limit exemption criteria under section 
 50.18  256J.42, subdivision 4 or 5, is eligible for assistance under a 
 50.19  hardship extension for a period of time equal to the number of 
 50.20  months that were counted toward the federal 60-month time limit 
 50.21  while the participant met the state time limit exemption 
 50.22  criteria under section 256J.42, subdivision 5. 
 50.23     (c) A participant who received TANF assistance that counted 
 50.24  towards the federal 60-month time limit while the participant 
 50.25  was exempt under section 256J.56, paragraph (a), clause (3), 
 50.26  from employment and training services requirements, who 
 50.27  demonstrates at the time of the case review required under 
 50.28  section 256J.42, subdivision 6, that the participant met the 
 50.29  criteria for exemption from employment and training services 
 50.30  requirements listed under section 256J.56, paragraph (a), clause 
 50.31  (7), during one or more months the participant was exempt under 
 50.32  section 256J.56, paragraph (a), clause (3), before or after July 
 50.33  1, 2000, is eligible for assistance under a hardship extension 
 50.34  for a period of time equal to the number of months that were 
 50.35  counted toward the federal 60-month time limit during the time 
 50.36  the participant met the criteria of section 256J.56, paragraph 
 51.1   (a), clause (7).  At the time of the case review required under 
 51.2   section 256J.42, subdivision 6, a county agency or job counselor 
 51.3   must explain to the participant the basis for receiving a 
 51.4   hardship extension based on the accrual of exempt months.  The 
 51.5   participant must document the information necessary to enable 
 51.6   the county agency or job counselor to determine whether the 
 51.7   participant is eligible to receive a hardship extension based on 
 51.8   the accrual of exempt months or authorize the county agency to 
 51.9   verify the information. 
 51.10     Sec. 5.  Minnesota Statutes 2001 Supplement, section 
 51.11  256J.425, subdivision 6, is amended to read: 
 51.12     Subd. 6.  [SANCTIONS FOR EXTENDED CASES.] (a) If one or 
 51.13  both participants in an assistance unit receiving assistance 
 51.14  under subdivision 1b, 3, or 4 are not in compliance with the 
 51.15  employment and training service requirements in sections 256J.52 
 51.16  to 256J.55, the sanctions under this subdivision apply.  For a 
 51.17  first occurrence of noncompliance, an assistance unit must be 
 51.18  sanctioned under section 256J.46, subdivision 1, paragraph (d), 
 51.19  clause (1).  For a second or third occurrence of noncompliance, 
 51.20  the assistance unit must be sanctioned under section 256J.46, 
 51.21  subdivision 1, paragraph (d), clause (2).  ~~For~~ 
 51.22     (b) Beginning July 1, 2004, and for fourth occurrences of 
 51.23  noncompliance that occur on or after July 1, 2004, a fourth 
 51.24  occurrence of noncompliance~~,~~ results in the assistance unit ~~is~~ 
 51.25  being disqualified from MFIP.  If a participant is determined to 
 51.26  be out of compliance, the participant may claim a good cause 
 51.27  exception under section 256J.57, however, the participant may 
 51.28  not claim an exemption under section 256J.56.  
 51.29     ~~(b)~~ (c) If both participants in a two-parent assistance 
 51.30  unit are out of compliance at the same time, it is considered 
 51.31  one occurrence of noncompliance. 
 51.32     Sec. 6.  [HEALTH AND HUMAN SERVICES WORKER PROGRAM.] 
 51.33     The unobliged balance for the health care and human 
 51.34  services worker training and retention program under Minnesota 
 51.35  Statutes, section 116L.10, as of January 1, 2002, is canceled. 
 51.36     Notwithstanding Laws 2000, chapter 488, article 1, section 
 52.1   16, paragraph (c), unexpended TANF funds appropriated for the 
 52.2   health care and human services worker training and retention 
 52.3   program cancel at the end of each biennium. 
 52.4      Sec. 7.  [PATHWAYS PROGRAM.] 
 52.5      Temporary assistance to needy families funding for the 
 52.6   pathways program under Laws 1999, chapter 223, article 1, 
 52.7   section 2, subdivision 2, and Laws 2000, chapter 488, article 1, 
 52.8   section 16, subdivision (b), is eliminated as of July 1, 2002. 
 52.9      Sec. 8.  [FISCAL 2003 TANF MAINTENANCE OF EFFORT.] 
 52.10     The commissioner of human services must assure that the 
 52.11  maintenance of effort amount used in the MFIP forecast of 
 52.12  November 2002 and February 2003 is not less than $188,937,000 
 52.13  with respect to fiscal year 2003.  
 52.14     Sec. 9.  [APPROPRIATION.] 
 52.15     (a) $6,095,000 is appropriated from the federal TANF fund 
 52.16  to the commissioner of human services for the biennium ending 
 52.17  June 30, 2003, for purposes of sections 1 to 4.  Of this 
 52.18  appropriation, $2,137,000 is for child care costs associated 
 52.19  with sections 1 to 4.  The commissioner of human services shall 
 52.20  transfer 80 percent of the child care funds, or $1,710,000, to 
 52.21  the federal child care and development fund block grant, and the 
 52.22  remaining funds shall be transferred to the federal child care 
 52.23  and development fund block grant based on a demonstrated need by 
 52.24  the commissioner of children, families, and learning. 
 52.25     (b) $1,450,000 is appropriated from the federal TANF fund 
 52.26  to the commissioner of human services for fiscal year 2003 to 
 52.27  increase the amount of funds available for reallocation under 
 52.28  Minnesota Statutes, section 256J.76, subdivision 4.  If funds 
 52.29  available for reallocation are insufficient to reimburse those 
 52.30  counties that have eligible expenditures in excess of their 
 52.31  allocations, the funds available for reallocation must be 
 52.32  apportioned among those counties with excess expenditures in 
 52.33  proportion to their share of the excess expenditures.  These 
 52.34  funds must become part of the fiscal year 2004-2005 base.