1.1                          A bill for an act 
  1.2             relating to human services; providing comprehensively 
  1.3             for senior care with the Community Care Options for 
  1.4             Older Adults Act; appropriating money; amending 
  1.5             Minnesota Statutes 2000, sections 43A.24, by adding a 
  1.6             subdivision; 43A.318, subdivision 1; 119B.09, 
  1.7             subdivision 4; 144.057; 144A.071, subdivisions 1, 1a, 
  1.8             2, and 4a; 144A.073, subdivisions 2, 4, and by adding 
  1.9             a subdivision; 144A.62, subdivisions 1, 2, 3, and 4; 
  1.10            245A.04, subdivisions 3, 3a, 3b, and 3d; 256B.056, 
  1.11            subdivision 4; 256B.431, subdivision 17; 256B.434, 
  1.12            subdivision 10; 256D.44, subdivision 5; and 290.0672, 
  1.13            subdivision 2; Laws 1999, chapter 245, article 3, 
  1.14            section 45; proposing coding for new law as Minnesota 
  1.15            Statutes, chapter 256M; repealing Minnesota Statutes 
  1.16            2000, sections 256B.431, subdivisions 2e and 3f; 
  1.17            256B.434, subdivision 4; 256B.435; and 256B.69, 
  1.18            subdivision 6a. 
  1.19  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.20                             ARTICLE 1
  1.21             COMMUNITY ACCESS AND SUPPORTS FOR SENIORS
  1.22     Section 1.  Minnesota Statutes 2000, section 256B.056, 
  1.23  subdivision 4, is amended to read: 
  1.24     Subd. 4.  [INCOME.] To be eligible for medical assistance, 
  1.25  a person eligible under section 256B.055, subdivision 7, not 
  1.26  receiving supplemental security income program payments, may 
  1.27  have an income up to 100 percent of the federal poverty 
  1.28  guidelines, and families and children may have an income up to 
  1.29  133-1/3 percent of the AFDC income standard in effect under the 
  1.30  July 16, 1996, AFDC state plan.  Effective July 1, 2000, the 
  1.31  base AFDC standard in effect on July 16, 1996, shall be 
  1.32  increased by three percent. Effective January 1, 2000, and each 
  2.1   successive January, recipients of supplemental security income 
  2.2   may have an income up to the supplemental security income 
  2.3   standard in effect on that date.  In computing income to 
  2.4   determine eligibility of persons who are not residents of 
  2.5   long-term care facilities, the commissioner shall disregard 
  2.6   increases in income as required by Public Law Numbers 94-566, 
  2.7   section 503; 99-272; and 99-509.  Veterans aid and attendance 
  2.8   benefits and Veterans Administration unusual medical expense 
  2.9   payments are considered income to the recipient. 
  2.10     Sec. 2.  Minnesota Statutes 2000, section 256D.44, 
  2.11  subdivision 5, is amended to read: 
  2.12     Subd. 5.  [SPECIAL NEEDS.] In addition to the state 
  2.13  standards of assistance established in subdivisions 1 to 4, 
  2.14  payments are allowed for the following special needs of 
  2.15  recipients of Minnesota supplemental aid who are not residents 
  2.16  of a nursing home, a regional treatment center, or a group 
  2.17  residential housing facility. 
  2.18     (a) The county agency shall pay a monthly allowance for 
  2.19  medically prescribed diets payable under the Minnesota family 
  2.20  investment program if the cost of those additional dietary needs 
  2.21  cannot be met through some other maintenance benefit.  
  2.22     (b) Payment for nonrecurring special needs must be allowed 
  2.23  for necessary home repairs or necessary repairs or replacement 
  2.24  of household furniture and appliances using the payment standard 
  2.25  of the AFDC program in effect on July 16, 1996, for these 
  2.26  expenses, as long as other funding sources are not available.  
  2.27     (c) A fee for guardian or conservator service is allowed at 
  2.28  a reasonable rate negotiated by the county or approved by the 
  2.29  court.  This rate shall not exceed five percent of the 
  2.30  assistance unit's gross monthly income up to a maximum of $100 
  2.31  per month.  If the guardian or conservator is a member of the 
  2.32  county agency staff, no fee is allowed. 
  2.33     (d) The county agency shall continue to pay a monthly 
  2.34  allowance of $68 for restaurant meals for a person who was 
  2.35  receiving a restaurant meal allowance on June 1, 1990, and who 
  2.36  eats two or more meals in a restaurant daily.  The allowance 
  3.1   must continue until the person has not received Minnesota 
  3.2   supplemental aid for one full calendar month or until the 
  3.3   person's living arrangement changes and the person no longer 
  3.4   meets the criteria for the restaurant meal allowance, whichever 
  3.5   occurs first. 
  3.6      (e) A fee of ten percent of the recipient's gross income or 
  3.7   $25, whichever is less, is allowed for representative payee 
  3.8   services provided by an agency that meets the requirements under 
  3.9   SSI regulations to charge a fee for representative payee 
  3.10  services.  This special need is available to all recipients of 
  3.11  Minnesota supplemental aid regardless of their living 
  3.12  arrangement. 
  3.13     (f) Notwithstanding the language in this subdivision, an 
  3.14  amount equal to the maximum allotment authorized by the federal 
  3.15  Food Stamp Program for a single individual which is in effect on 
  3.16  the first day of January each year will be added to the standard 
  3.17  of assistance established in subdivisions 1 to 4 for applicants 
  3.18  as well as current recipients of benefits from the alternative 
  3.19  care program under section 256B.0913 or the elderly waiver 
  3.20  program under section 256B.0915, who are shelter needy.  
  3.21  "Shelter needy" means the assistance unit incurs monthly shelter 
  3.22  costs that exceed 40 percent of the assistance unit's gross 
  3.23  income before the application of this special needs standard.  
  3.24  "Gross income" in this section is the applicant's or recipient's 
  3.25  income as defined in section 256D.35, subdivision 10, or the 
  3.26  standard defined in subdivision 3, whichever is greater.  A 
  3.27  recipient of a federal housing subsidy, including Section 8 
  3.28  program assistance, cannot be considered shelter needy for 
  3.29  purposes of this provision. 
  3.30     Sec. 3.  [256M.01] [COMMUNITY SERVICES DEVELOPMENT GRANTS 
  3.31  PROGRAM.] 
  3.32     Subdivision 1.  [DEFINITIONS.] For purposes of this 
  3.33  section, the following terms have the meanings given. 
  3.34     (a) "Community" means a town, township, city, or targeted 
  3.35  neighborhood within a city, or a consortium of towns, townships, 
  3.36  cities, or targeted neighborhoods within cities. 
  4.1      (b) "Older adult services" means any services available 
  4.2   under the elderly waiver program or alternative care grant 
  4.3   programs; nursing facility services; transportation services; 
  4.4   respite services; and other community-based services identified 
  4.5   as necessary either to maintain lifestyle choices for older 
  4.6   Minnesotans, or to promote independence. 
  4.7      (c) "Older adult" refers to individuals 65 years of age and 
  4.8   older. 
  4.9      Subd. 2.  [CREATION.] The community services development 
  4.10  grants program is created under the administration of the 
  4.11  commissioner of human services.  
  4.12     Subd. 3.  [PURPOSE.] Grants are available to communities 
  4.13  and to providers of older adult services identified in 
  4.14  subdivision 1, or to a consortium of providers of older adult 
  4.15  services from the community services development grants program 
  4.16  to establish new older adult services.  Grants may be provided 
  4.17  for capital and other costs including, but not limited to, 
  4.18  start-up and training costs, equipment, and supplies related to 
  4.19  the establishment of new older adult services or other living or 
  4.20  service alternatives to nursing facility care.  Grants may also 
  4.21  be made for the purpose of new renovation of current buildings, 
  4.22  transportation services, or the expansion of state-funded 
  4.23  programs in the area. 
  4.24     Subd. 4.  [ELIGIBILITY.] Grants may only be released to 
  4.25  communities and providers or to a consortium of providers that 
  4.26  have a local match of 50 percent of the costs for the project in 
  4.27  the form of donations, local tax increases, or fundraising. 
  4.28     Subd. 5.  [GRANT PREFERENCE.] The commissioner of human 
  4.29  services may award grants to the extent grant funds are 
  4.30  available and to the extent applications are approved by the 
  4.31  commissioner.  Denial of approval of an application in one year 
  4.32  does not preclude submission of an application in a subsequent 
  4.33  year.  The maximum grant amount is limited to $750,000. 
  4.34     Sec. 4.  [256M.02] [TRANSITION PLANNING GRANTS.] 
  4.35     Subdivision 1.  [DEFINITIONS.] "Eligible nursing home" 
  4.36  means any nursing home licensed under sections 144A.01 to 
  5.1   144A.16 and certified by the appropriate authority under United 
  5.2   States Code, title 42, sections 1396-1396p, to participate as a 
  5.3   vendor in the medical assistance program established under 
  5.4   chapter 256B. 
  5.5      Subd. 2.  [GRANTS AUTHORIZED.] (a) The commissioner shall 
  5.6   establish a program of grants to assist eligible nursing homes 
  5.7   implement the provisions in paragraphs (b) to (d).  
  5.8      (b) Planning grants may be used by nursing homes to develop 
  5.9   strategic plans which identify the appropriate institutional and 
  5.10  noninstitutional settings necessary to meet the older adult 
  5.11  service needs of the community.  
  5.12     (c) At a minimum, a strategic plan must consist of: 
  5.13     (1) a needs assessment to determine what older adult 
  5.14  services are needed and desired by the community; 
  5.15     (2) an assessment of the appropriate settings in which to 
  5.16  provide needed older adult services; 
  5.17     (3) an assessment identifying currently available services 
  5.18  and their settings in the community; and 
  5.19     (4) a transition plan to achieve the needed outcome 
  5.20  identified by the assessment. 
  5.21     (d) Transition grants may be used by eligible nursing homes 
  5.22  to implement transition projects identified in a strategic 
  5.23  plan.  The purposes for which the grants may be used may include 
  5.24  capital improvements or the elimination of existing financing 
  5.25  barriers. 
  5.26     Subd. 3.  [ALLOCATION OF GRANTS.] (a) Eligible nursing 
  5.27  homes must apply to the commissioner no later than September 1 
  5.28  of each fiscal year for grants awarded in that fiscal year.  A 
  5.29  grant shall be awarded upon signing of a grant contract. 
  5.30     (b) The commissioner must make a final decision on the 
  5.31  funding of each application within 60 days of the deadline for 
  5.32  receiving applications. 
  5.33     (c) In determining which nursing homes will receive grants 
  5.34  under this section, the commissioner shall consider the 
  5.35  following factors: 
  5.36     (1) description of the problem, description of the project, 
  6.1   and the likelihood of the project meeting identified needs.  The 
  6.2   applicant should describe achievable objectives, a timetable, 
  6.3   and the roles and capabilities of the responsible individuals 
  6.4   and organizations; 
  6.5      (2) the extent of community support for the nursing home 
  6.6   and the proposed project, including other local long-term care 
  6.7   providers and local community and government leaders; 
  6.8      (3) a balanced distribution of grants among geographic 
  6.9   regions and among small and large nursing homes; and 
  6.10     (4) the financial condition of the nursing home. 
  6.11     (d) A transition planning grant, as described in 
  6.12  subdivision 2, given to a nursing home, including nursing homes 
  6.13  that submit applications as a consortium, may not exceed 
  6.14  $100,000. 
  6.15     Subd. 5.  [EVALUATION.] The commissioner shall evaluate the 
  6.16  overall effectiveness of the grant program.  The commissioner 
  6.17  may collect, from the nursing homes receiving grants, the 
  6.18  information necessary to evaluate the grant program.  
  6.19  Information related to the financial condition of individual 
  6.20  nursing homes shall be classified as nonpublic data. 
  6.21     Sec. 5.  [256M.03] [ESTABLISHMENT AND PURPOSE OF MEDICAL 
  6.22  ASSISTANCE PILOT PROJECT ON SENIOR SERVICES.] 
  6.23     Subdivision 1.  [ESTABLISHMENT AND PURPOSE.] The 
  6.24  commissioner of human services shall establish a medical 
  6.25  assistance pilot project on senior services to determine how 
  6.26  converting the delivery of housing, supportive services, and 
  6.27  health care for seniors into a flexible voucher program will 
  6.28  impact public expenditures for older adult service care and 
  6.29  provide an alternative way to purchase services based on 
  6.30  consumer choice. 
  6.31     Subd. 2.  [FEDERAL WAIVER AUTHORITY.] The commissioner 
  6.32  shall apply for any necessary federal waivers or approvals to 
  6.33  implement this pilot project.  The commissioner shall submit the 
  6.34  waiver request no later than April 15, 2002.  The medical 
  6.35  assistance pilot project on senior services shall be implemented 
  6.36  January 1, 2003, or upon federal approval. 
  7.1      Subd. 3.  [REPORT.] Participating communities and the 
  7.2   commissioner of human services shall collaborate to prepare and 
  7.3   issue an annual report beginning December 2003, to the 
  7.4   appropriate committee chairs in the senate and house on:  (1) 
  7.5   the use of state resources, including other funds leveraged for 
  7.6   this initiative; (2) the status of individuals being served in 
  7.7   the pilot project; and (3) the cost-effectiveness of the pilot 
  7.8   project.  The commissioner shall provide data that may be needed 
  7.9   to evaluate the pilot project to communities that request the 
  7.10  data. 
  7.11     Subd. 4.  [SUNSET.] The pilot project in subdivision 1 
  7.12  shall sunset June 30, 2008. 
  7.13     Sec. 6.  [256M.04] [SENIOR INFORMATION SOURCE PROGRAM 
  7.14  ESTABLISHED.] 
  7.15     Subdivision 1.  [PROGRAM ESTABLISHED.] (a) The Minnesota 
  7.16  board on aging shall develop a senior information source to 
  7.17  provide free telephone and Internet information and assistance 
  7.18  service for seniors and their families.  The program may be 
  7.19  funded, in part, from federal funds made available under the 
  7.20  Older Americans Act.  The senior information source shall:  
  7.21     (1) alleviate critical information needs of consumers 
  7.22  confronting specific health care, supportive services, and human 
  7.23  services needs in all geographic regions of the state; 
  7.24     (2) identify specific options for consumers when local 
  7.25  providers are not currently offering sufficient health care or 
  7.26  human services options and are unable to do so because of the 
  7.27  limited capacity, economic circumstances, or other limiting 
  7.28  factors described in the request for proposal and verified by 
  7.29  the Minnesota board on aging; and 
  7.30     (3) increase opportunities for current and potential senior 
  7.31  consumers to qualify for health care services and human service 
  7.32  funding programs or housing subsidies through the development of 
  7.33  a comprehensive, singular information source for seniors. 
  7.34     (b) The Minnesota board on aging, through the development 
  7.35  of the senior information source, shall act as a catalyst to 
  7.36  bring together consumers, the business community, and state 
  8.1   government agencies to design a single information source for 
  8.2   seniors on statewide services, financing for health care 
  8.3   services, and quality measures of community services.  The 
  8.4   program shall work closely with interested stakeholders to 
  8.5   develop a comprehensive and timely information service. 
  8.6      (c) An individual, entity, or qualified consortium may 
  8.7   apply to the Minnesota board on aging to design, implement, and 
  8.8   manage the senior information source.  The Minnesota board on 
  8.9   aging must contract with an individual, entity, or qualified 
  8.10  consortium for this purpose by January 2002. 
  8.11     Subd. 2.  [REQUESTS FOR PROPOSALS.] The Minnesota board on 
  8.12  aging shall publish in the State Register a request for 
  8.13  proposals to create the senior information source described in 
  8.14  subdivision 1.  The request for proposal process shall be open 
  8.15  to any individual, entity, or qualified consortium, except for 
  8.16  public institutions, who must be part of a consortium to 
  8.17  participate.  An individual, entity, or qualifying consortium 
  8.18  shall apply to the commissioner of human services in the manner 
  8.19  specified by the department.  If the Minnesota board on aging 
  8.20  rejects a proposal of an individual, entity, or qualified 
  8.21  consortium, the board must provide written notice to the 
  8.22  individual, entity, or qualified consortium of the reason for 
  8.23  the rejection, including the factors and evidence upon which the 
  8.24  rejection was based. 
  8.25     Subd. 3.  [QUALIFIED CONSORTIUM.] "Qualified consortium" 
  8.26  means an entity that may include a public or private 
  8.27  institution, health care provider, county, association, or one 
  8.28  or more employers. 
  8.29     Subd. 4.  [FISCAL REQUIREMENTS.] The request for proposal 
  8.30  respondents must specify how the individual, entity, or 
  8.31  qualified consortium will make maximum use of available federal 
  8.32  and state funds to support the single information source.  The 
  8.33  individual, entity, or qualified consortium must designate a 
  8.34  lead agency as the fiscal agent for reporting, claiming, and 
  8.35  receiving payments.  A private institution or entity may be 
  8.36  designated as a lead agency. 
  9.1      Subd. 5.  [INFORMATION SOURCE TARGETS.] The request for 
  9.2   proposal must require a description of how the respondent will 
  9.3   meet the specific information needs addressed in subdivision 1.  
  9.4   An individual, entity, or qualified consortium submitting a 
  9.5   response to the request for proposal must outline how they will 
  9.6   implement a marketing and outreach strategy to increase program 
  9.7   awareness and use of the service. 
  9.8      Subd. 6.  [LOCAL MATCH REQUIREMENTS.] The selected 
  9.9   individual, entity, or qualified consortium must provide at 
  9.10  least a 50 percent match from local resources for money 
  9.11  appropriated under this section.  In-kind services and 
  9.12  expenditures under this section may be used to meet this local 
  9.13  match requirement.  The request for proposal application must 
  9.14  specify the financial contribution from each member of the 
  9.15  consortium. 
  9.16     Subd. 7.  [EVALUATION.] The Minnesota board on aging shall 
  9.17  evaluate the success of the selected individual, entity, or 
  9.18  qualified consortium that receives the request for proposal for 
  9.19  the contract for the senior information source service in 
  9.20  achieving expected outcomes and shall report to the legislature 
  9.21  annually.  The report must examine overall program costs, costs 
  9.22  per client, and other outcome measurements established in the 
  9.23  request for proposal process.  The first report shall be due on 
  9.24  January 15, 2003, and on each January 15 thereafter.  The report 
  9.25  shall include any recommendations from the board to modify the 
  9.26  senior information source service program. 
  9.27     Sec. 7.  [256M.05] [EXPANSION OF BED DISTRIBUTION STUDY AND 
  9.28  CREATION OF CRITICAL ACCESS SITES.] 
  9.29     Subdivision 1.  [OLDER ADULT SERVICES DISTRIBUTION 
  9.30  STUDY.] Beginning July 1, 2001, the commissioner of health, in 
  9.31  coordination with the commissioner of human services, shall 
  9.32  implement mechanisms to monitor and analyze the distribution of 
  9.33  older adult services, including, but not limited to, nursing 
  9.34  home beds, senior housing, elderly housing with services units, 
  9.35  and home and community-based services in the different 
  9.36  geographic areas of the state.  The study shall include an 
 10.1   analysis of the impact of amendments to the nursing home 
 10.2   moratorium law which would allow for transfers of nursing home 
 10.3   beds within the state.  The commissioner of health shall submit 
 10.4   to the legislature, no later than January 15, 2002, and annually 
 10.5   thereafter, an assessment of the impact of the distribution of 
 10.6   long-term health care services by geographic area, with 
 10.7   particular attention to service deficits or problems, 
 10.8   designating critical access service sites and a corrective 
 10.9   action plan. 
 10.10     Subd. 2.  [CRITICAL ACCESS SERVICE SITE.] "Critical access 
 10.11  service site" shall include nursing homes, senior housing, and 
 10.12  home and community-based services that are certified by the 
 10.13  state as necessary health care services to a specific geographic 
 10.14  area.  Necessary providers of health care services are 
 10.15  designated as critical access service sites on the basis of 
 10.16  being more than 20 miles, defined as official mileage as 
 10.17  reported by the Minnesota department of transportation, from the 
 10.18  next nearest long-term health care provider or being the sole 
 10.19  long-term health care provider in the county or being a 
 10.20  long-term health care provider located in a medically 
 10.21  underserved area or health professional shortage area. 
 10.22     Subd. 3.  [IDENTIFICATION OF CRITICAL ACCESS SERVICE 
 10.23  SITES.] Based on the results of the analysis completed in 
 10.24  subdivision 1, the commissioners of health and human services 
 10.25  shall identify and designate specific geographic areas as 
 10.26  critical access service sites. 
 10.27     Subd. 4.  [CRITICAL ACCESS SERVICE SITES.] The commissioner 
 10.28  of health, with the commissioner of human services, shall: 
 10.29     (1) develop and implement specific waivers to regulation 
 10.30  governing health care personnel scope of duties, physical plant 
 10.31  requirements, and location of community-based services, to 
 10.32  address critical access service site older adult service needs; 
 10.33     (2) give priority to grant requests under section 256M.01, 
 10.34  the community services development grants program for 
 10.35  establishment of new senior services in designated communities, 
 10.36  and transition planning grants under section 256M.02; and 
 11.1      (3) identify payment barriers to the continued operation of 
 11.2   older adult services in critical access service site, and 
 11.3   provide recommendations on changes to reimbursement rates to 
 11.4   facilitate the continued operation of these services. 
 11.5                              ARTICLE 2
 11.6                          CAREGIVER SUPPORT
 11.7      Section 1.  Minnesota Statutes 2000, section 43A.24, is 
 11.8   amended by adding a subdivision to read: 
 11.9      Subd. 2a.  [EMPLOYEES OF LICENSED NURSING 
 11.10  FACILITIES.] Employees of licensed nursing facilities are 
 11.11  eligible for hospital, medical, and dental benefits offered to 
 11.12  eligible persons under subdivision 2.  The state is not 
 11.13  obligated to pay for such benefits, but shall make the state 
 11.14  insurance benefit programs available to nursing facility 
 11.15  employers to purchase on behalf of their employees. 
 11.16     Sec. 2.  Minnesota Statutes 2000, section 119B.09, 
 11.17  subdivision 4, is amended to read: 
 11.18     Subd. 4.  [ELIGIBILITY; ANNUAL INCOME; CALCULATION.] Annual 
 11.19  income of the applicant family is the current monthly income of 
 11.20  the family multiplied by 12 or the income for the 12-month 
 11.21  period immediately preceding the date of application, or income 
 11.22  calculated by the method which provides the most accurate 
 11.23  assessment of income available to the family.  Self-employment 
 11.24  income must be calculated based on gross receipts less operating 
 11.25  expenses.  Income must be redetermined when the family's income 
 11.26  changes, but no less often than every six months.  Income must 
 11.27  be verified with documentary evidence.  If the applicant does 
 11.28  not have sufficient evidence of income, verification must be 
 11.29  obtained from the source of the income.  Wage increases received 
 11.30  by long-term care workers as a result of direct mandate by the 
 11.31  legislature, such as increases received under section 256B.431, 
 11.32  subdivision 28, paragraph (c), clause (2), shall not be included 
 11.33  in annual income for the purpose of determining eligibility. 
 11.34     Sec. 3.  Minnesota Statutes 2000, section 144.057, is 
 11.35  amended to read: 
 11.36     144.057 [BACKGROUND STUDIES ON LICENSEES AND TEMPORARY POOL 
 12.1   AGENCY PERSONNEL.] 
 12.2      Subdivision 1.  [BACKGROUND STUDIES REQUIRED.] The 
 12.3   commissioner of health shall contract with the commissioner of 
 12.4   human services to conduct background studies of: 
 12.5      (1) individuals providing services which have direct 
 12.6   contact, as defined under section 245A.04, subdivision 3, with 
 12.7   patients and residents in hospitals, boarding care homes, 
 12.8   outpatient surgical centers licensed under sections 144.50 to 
 12.9   144.58; nursing homes and home care agencies licensed under 
 12.10  chapter 144A; residential care homes licensed under chapter 
 12.11  144B, and board and lodging establishments that are registered 
 12.12  to provide supportive or health supervision services under 
 12.13  section 157.17; and 
 12.14     (2) beginning July 1, 1999, all other employees in nursing 
 12.15  homes licensed under chapter 144A, and boarding care homes 
 12.16  licensed under sections 144.50 to 144.58.  A disqualification of 
 12.17  an individual in this section shall disqualify the individual 
 12.18  from positions allowing direct contact or access to patients or 
 12.19  residents receiving services; 
 12.20     (3) individuals employed by temporary employment agencies 
 12.21  who are providing services in health care facilities under 
 12.22  contract with a temporary employment agency registered under 
 12.23  chapter 144F; and 
 12.24     (4) controlling persons of temporary employment agencies, 
 12.25  as defined in section 4. 
 12.26     If a facility or program is licensed by the department of 
 12.27  human services and subject to the background study provisions of 
 12.28  chapter 245A and is also licensed by the department of health, 
 12.29  the department of human services is solely responsible for the 
 12.30  background studies of individuals in the jointly licensed 
 12.31  programs. 
 12.32     Subd. 2.  [RESPONSIBILITIES OF DEPARTMENT OF HUMAN 
 12.33  SERVICES.] The department of human services shall conduct the 
 12.34  background studies required by subdivision 1 in compliance with 
 12.35  the provisions of chapter 245A and Minnesota Rules, parts 
 12.36  9543.3000 to 9543.3090.  For the purpose of this section, the 
 13.1   term "residential program" shall include all facilities 
 13.2   described in subdivision 1.  The department of human services 
 13.3   shall provide necessary forms and instructions, shall conduct 
 13.4   the necessary background studies of individuals, and shall 
 13.5   provide notification of the results of the studies to the 
 13.6   facilities, temporary employment agencies, individuals, and the 
 13.7   commissioner of health.  Individuals shall be disqualified under 
 13.8   the provisions of chapter 245A and Minnesota Rules, parts 
 13.9   9543.3000 to 9543.3090.  If an individual is disqualified, the 
 13.10  department of human services shall notify the facility, the 
 13.11  temporary employment agency, and the individual and shall inform 
 13.12  the individual of the right to request a reconsideration of the 
 13.13  disqualification by submitting the request to the department of 
 13.14  health. 
 13.15     Subd. 3.  [RECONSIDERATIONS.] The commissioner of health 
 13.16  shall review and decide reconsideration requests, including the 
 13.17  granting of variances, in accordance with the procedures and 
 13.18  criteria contained in chapter 245A and Minnesota Rules, parts 
 13.19  9543.3000 to 9543.3090.  The commissioner's decision shall be 
 13.20  provided to the individual and to the department of human 
 13.21  services.  The commissioner's decision to grant or deny a 
 13.22  reconsideration of disqualification is the final administrative 
 13.23  agency action. 
 13.24     Subd. 4.  [RESPONSIBILITIES OF FACILITIES AND AGENCIES.] 
 13.25  Facilities and temporary employment agencies described in 
 13.26  subdivision 1 shall be responsible for cooperating with the 
 13.27  departments in implementing the provisions of this section.  The 
 13.28  responsibilities imposed on applicants and licensees under 
 13.29  chapter 245A and Minnesota Rules, parts 9543.3000 to 9543.3090, 
 13.30  shall apply to these facilities and temporary employment 
 13.31  agencies.  The provision of section 245A.04, subdivision 3, 
 13.32  paragraph (e), shall apply to applicants, 
 13.33  licensees, registrants, or an individual's refusal to cooperate 
 13.34  with the completion of the background studies.  Temporary 
 13.35  employment agencies subject to the registration requirements in 
 13.36  section 256M.20 must maintain records verifying compliance with 
 14.1   the background study requirements under this section. 
 14.2      Sec. 4.  Minnesota Statutes 2000, section 144A.62, 
 14.3   subdivision 1, is amended to read: 
 14.4      Subdivision 1.  [ASSISTANCE WITH EATING AND DRINKING.] (a) 
 14.5   Upon federal approval, a nursing home may employ resident 
 14.6   attendants to assist with the activities authorized under 
 14.7   subdivision 2.  The resident attendant will not be counted in 
 14.8   the minimum staffing requirements under section 144A.04, 
 14.9   subdivision 7. 
 14.10     (b) The commissioner shall submit by May July 15, 2000 
 14.11  2001, a new request for a federal waiver necessary to implement 
 14.12  this section. 
 14.13     Sec. 5.  Minnesota Statutes 2000, section 144A.62, 
 14.14  subdivision 2, is amended to read: 
 14.15     Subd. 2.  [DEFINITION.] "Resident attendant" means an 
 14.16  individual who assists residents in a nursing home with the one 
 14.17  or more of the following activities of eating and drinking: 
 14.18     (1) eating and drinking; and 
 14.19     (2) transporting. 
 14.20  A resident attendant does not include an individual who: 
 14.21     (1) is a licensed health professional or a registered 
 14.22  dietitian; 
 14.23     (2) volunteers without monetary compensation; or 
 14.24     (3) is a registered nursing assistant. 
 14.25     Sec. 6.  Minnesota Statutes 2000, section 144A.62, 
 14.26  subdivision 3, is amended to read: 
 14.27     Subd. 3.  [REQUIREMENTS.] (a) A nursing home may not use on 
 14.28  a full-time or other paid basis any individual as a resident 
 14.29  attendant in the nursing home unless the individual: 
 14.30     (1) has completed a training and competency evaluation 
 14.31  program encompassing the tasks activities in subdivision 2 that 
 14.32  the individual provides; 
 14.33     (2) is competent to provide feeding and hydration services 
 14.34  those activities; and 
 14.35     (3) is under the supervision of the director of nursing. 
 14.36     (b) A nursing home may not use a current employee as a 
 15.1   resident attendant unless the employee satisfies the 
 15.2   requirements of paragraph (a) and volunteers to be used in that 
 15.3   capacity. 
 15.4      Sec. 7.  Minnesota Statutes 2000, section 144A.62, 
 15.5   subdivision 4, is amended to read: 
 15.6      Subd. 4.  [EVALUATION.] The training and competency 
 15.7   evaluation program may be facility based.  It must include, at a 
 15.8   minimum, the training and competency standards for eating and 
 15.9   drinking assistance the specific activities the attendant will 
 15.10  be conducting contained in the nursing assistant training 
 15.11  curriculum. 
 15.12     Sec. 8.  Minnesota Statutes 2000, section 245A.04, 
 15.13  subdivision 3, is amended to read: 
 15.14     Subd. 3.  [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 
 15.15  (a) Before the commissioner issues a license, the commissioner 
 15.16  shall conduct a study of the individuals specified in paragraph 
 15.17  (c), clauses (1) to (5), according to rules of the commissioner. 
 15.18     Beginning January 1, 1997, the commissioner shall also 
 15.19  conduct a study of employees providing direct contact services 
 15.20  for nonlicensed personal care provider organizations described 
 15.21  in paragraph (c), clause (5). 
 15.22     The commissioner shall recover the cost of these background 
 15.23  studies through a fee of no more than $12 per study charged to 
 15.24  the personal care provider organization.  
 15.25     Beginning August 1, 1997, the commissioner shall conduct 
 15.26  all background studies required under this chapter for adult 
 15.27  foster care providers who are licensed by the commissioner of 
 15.28  human services and registered under chapter 144D.  The 
 15.29  commissioner shall conduct these background studies in 
 15.30  accordance with this chapter.  The commissioner shall initiate a 
 15.31  pilot project to conduct up to 5,000 background studies under 
 15.32  this chapter in programs with joint licensure as home and 
 15.33  community-based services and adult foster care for people with 
 15.34  developmental disabilities when the license holder does not 
 15.35  reside in the foster care residence. 
 15.36     (b) Beginning July 1, 1998, the commissioner shall conduct 
 16.1   a background study on individuals specified in paragraph (c), 
 16.2   clauses (1) to (5), who perform direct contact services in a 
 16.3   nursing home or a home care agency licensed under chapter 144A 
 16.4   or a boarding care home licensed under sections 144.50 to 
 16.5   144.58, when the subject of the study resides outside Minnesota; 
 16.6   the study must be at least as comprehensive as that of a 
 16.7   Minnesota resident and include a search of information from the 
 16.8   criminal justice data communications network in the state where 
 16.9   the subject of the study resides. 
 16.10     (c) Beginning August 1, 2001, the commissioner shall 
 16.11  conduct all background studies required under this chapter and 
 16.12  initiated by temporary employment agencies registered under 
 16.13  chapter 144F for individuals providing services in health care 
 16.14  facilities.  The commissioner shall conduct these background 
 16.15  studies according to this chapter.  The commissioner shall 
 16.16  recover the cost of these background studies through a fee 
 16.17  charged to the temporary pool agency. 
 16.18     (d) The applicant, license holder, registrant, the bureau 
 16.19  of criminal apprehension, the commissioner of health and county 
 16.20  agencies, after written notice to the individual who is the 
 16.21  subject of the study, shall help with the study by giving the 
 16.22  commissioner criminal conviction data and reports about the 
 16.23  maltreatment of adults substantiated under section 626.557 and 
 16.24  the maltreatment of minors in licensed programs substantiated 
 16.25  under section 626.556.  The individuals to be studied shall 
 16.26  include: 
 16.27     (1) the applicant; 
 16.28     (2) persons over the age of 13 living in the household 
 16.29  where the licensed program will be provided; 
 16.30     (3) current employees or contractors of the applicant who 
 16.31  will have direct contact with persons served by the facility, 
 16.32  agency, or program; 
 16.33     (4) volunteers or student volunteers who have direct 
 16.34  contact with persons served by the program to provide program 
 16.35  services, if the contact is not directly supervised by the 
 16.36  individuals listed in clause (1) or (3); and 
 17.1      (5) any person who, as an individual or as a member of an 
 17.2   organization, exclusively offers, provides, or arranges for 
 17.3   personal care assistant services under the medical assistance 
 17.4   program as authorized under sections 256B.04, subdivision 16, 
 17.5   and 256B.0625, subdivision 19a. 
 17.6      The juvenile courts shall also help with the study by 
 17.7   giving the commissioner existing juvenile court records on 
 17.8   individuals described in clause (2) relating to delinquency 
 17.9   proceedings held within either the five years immediately 
 17.10  preceding the application or the five years immediately 
 17.11  preceding the individual's 18th birthday, whichever time period 
 17.12  is longer.  The commissioner shall destroy juvenile records 
 17.13  obtained pursuant to this subdivision when the subject of the 
 17.14  records reaches age 23.  
 17.15     For purposes of this section and Minnesota Rules, part 
 17.16  9543.3070, a finding that a delinquency petition is proven in 
 17.17  juvenile court shall be considered a conviction in state 
 17.18  district court. 
 17.19     For purposes of this subdivision, "direct contact" means 
 17.20  providing face-to-face care, training, supervision, counseling, 
 17.21  consultation, or medication assistance to persons served by a 
 17.22  program.  For purposes of this subdivision, "directly supervised"
 17.23  means an individual listed in clause (1), (3), or (5) is within 
 17.24  sight or hearing of a volunteer to the extent that the 
 17.25  individual listed in clause (1), (3), or (5) is capable at all 
 17.26  times of intervening to protect the health and safety of the 
 17.27  persons served by the program who have direct contact with the 
 17.28  volunteer. 
 17.29     A study of an individual in clauses (1) to (5) shall be 
 17.30  conducted at least upon application for initial license or 
 17.31  registration, and reapplication for a license or registration.  
 17.32  The commissioner is not required to conduct a study of an 
 17.33  individual at the time of reapplication for a license or if the 
 17.34  individual has been continuously affiliated with a foster care 
 17.35  provider licensed by the commissioner of human services and 
 17.36  registered under chapter 144D, other than a family day care or 
 18.1   foster care license, if:  (i) a study of the individual was 
 18.2   conducted either at the time of initial licensure or when the 
 18.3   individual became affiliated with the license holder; (ii) the 
 18.4   individual has been continuously affiliated with the license 
 18.5   holder since the last study was conducted; and (iii) the 
 18.6   procedure described in paragraph (d) has been implemented and 
 18.7   was in effect continuously since the last study was conducted.  
 18.8   For the purposes of this section, a physician licensed under 
 18.9   chapter 147 is considered to be continuously affiliated upon the 
 18.10  license holder's receipt from the commissioner of health or 
 18.11  human services of the physician's background study results.  For 
 18.12  individuals who are required to have background studies under 
 18.13  clauses (1) to (5) and who have been continuously affiliated 
 18.14  with a foster care provider that is licensed in more than one 
 18.15  county, criminal conviction data may be shared among those 
 18.16  counties in which the foster care programs are licensed.  A 
 18.17  county agency's receipt of criminal conviction data from another 
 18.18  county agency shall meet the criminal data background study 
 18.19  requirements of this section. 
 18.20     The commissioner may must also conduct studies on 
 18.21  individuals specified in clauses (3) and (4) when the studies 
 18.22  are initiated by: 
 18.23     (i) personnel pool agencies; 
 18.24     (ii) temporary personnel agencies; 
 18.25     (iii) educational programs that train persons by providing 
 18.26  direct contact services in licensed programs; and 
 18.27     (iv) professional services agencies that are not licensed 
 18.28  and which contract with licensed programs to provide direct 
 18.29  contact services or individuals who provide direct contact 
 18.30  services. 
 18.31     Studies on individuals in items (i) to (iv) must be 
 18.32  initiated annually by these agencies, programs, and 
 18.33  individuals.  Except for personal care provider 
 18.34  organizations and temporary employment agencies, no applicant, 
 18.35  license holder, or individual who is the subject of the study 
 18.36  shall pay any fees required to conduct the study. 
 19.1      (1) At the option of the licensed facility, rather than 
 19.2   initiating another background study on an individual required to 
 19.3   be studied who has indicated to the licensed facility that a 
 19.4   background study by the commissioner was previously completed, 
 19.5   the facility may make a request to the commissioner for 
 19.6   documentation of the individual's background study status, 
 19.7   provided that: 
 19.8      (i) the facility makes this request using a form provided 
 19.9   by the commissioner; 
 19.10     (ii) in making the request the facility informs the 
 19.11  commissioner that either: 
 19.12     (A) the individual has been continuously affiliated with a 
 19.13  licensed facility since the individual's previous background 
 19.14  study was completed, or since October 1, 1995, whichever is 
 19.15  shorter; or 
 19.16     (B) the individual is affiliated only with a personnel pool 
 19.17  agency, a temporary personnel agency, an educational program 
 19.18  that trains persons by providing direct contact services in 
 19.19  licensed programs, or a professional services agency that is not 
 19.20  licensed and which contracts with licensed programs to provide 
 19.21  direct contact services or individuals who provide direct 
 19.22  contact services; and 
 19.23     (iii) the facility provides notices to the individual as 
 19.24  required in paragraphs (a) to (d), and that the facility is 
 19.25  requesting written notification of the individual's background 
 19.26  study status from the commissioner.  
 19.27     (2) The commissioner shall respond to each request under 
 19.28  paragraph (1) with a written or electronic notice to the 
 19.29  facility and the study subject.  If the commissioner determines 
 19.30  that a background study is necessary, the study shall be 
 19.31  completed without further request from a licensed agency or 
 19.32  notifications to the study subject.  
 19.33     (3) When a background study is being initiated by a 
 19.34  licensed facility or a foster care provider that is also 
 19.35  registered under chapter 144D, a study subject affiliated with 
 19.36  multiple licensed facilities may attach to the background study 
 20.1   form a cover letter indicating the additional facilities' names, 
 20.2   addresses, and background study identification numbers.  When 
 20.3   the commissioner receives such notices, each facility identified 
 20.4   by the background study subject shall be notified of the study 
 20.5   results.  The background study notice sent to the subsequent 
 20.6   agencies shall satisfy those facilities' responsibilities for 
 20.7   initiating a background study on that individual. 
 20.8      (d) (e) If an individual who is affiliated with a program 
 20.9   or facility regulated by the department of human services or 
 20.10  department of health or who is affiliated with a nonlicensed 
 20.11  personal care provider organization, is convicted of a crime 
 20.12  constituting a disqualification under subdivision 3d, the 
 20.13  probation officer or corrections agent shall notify the 
 20.14  commissioner of the conviction.  The commissioner, in 
 20.15  consultation with the commissioner of corrections, shall develop 
 20.16  forms and information necessary to implement this paragraph and 
 20.17  shall provide the forms and information to the commissioner of 
 20.18  corrections for distribution to local probation officers and 
 20.19  corrections agents.  The commissioner shall inform individuals 
 20.20  subject to a background study that criminal convictions for 
 20.21  disqualifying crimes will be reported to the commissioner by the 
 20.22  corrections system.  A probation officer, corrections agent, or 
 20.23  corrections agency is not civilly or criminally liable for 
 20.24  disclosing or failing to disclose the information required by 
 20.25  this paragraph.  Upon receipt of disqualifying information, the 
 20.26  commissioner shall provide the notifications required in 
 20.27  subdivision 3a, as appropriate to agencies on record as having 
 20.28  initiated a background study or making a request for 
 20.29  documentation of the background study status of the individual.  
 20.30  This paragraph does not apply to family day care and child 
 20.31  foster care programs. 
 20.32     (e) (f) The individual who is the subject of the study must 
 20.33  provide the applicant or license holder with sufficient 
 20.34  information to ensure an accurate study including the 
 20.35  individual's first, middle, and last name; home address, city, 
 20.36  county, and state of residence for the past five years; zip 
 21.1   code; sex; date of birth; and driver's license number.  The 
 21.2   applicant or license holder shall provide this information about 
 21.3   an individual in paragraph (c), clauses (1) to (5), on forms 
 21.4   prescribed by the commissioner.  By January 1, 2000, for 
 21.5   background studies conducted by the department of human 
 21.6   services, the commissioner shall implement a system for the 
 21.7   electronic transmission of:  (1) background study information to 
 21.8   the commissioner; and (2) background study results to the 
 21.9   license holder.  The commissioner may request additional 
 21.10  information of the individual, which shall be optional for the 
 21.11  individual to provide, such as the individual's social security 
 21.12  number or race. 
 21.13     (f) (g) Except for child foster care, adult foster care, 
 21.14  and family day care homes, a study must include information 
 21.15  related to names of substantiated perpetrators of maltreatment 
 21.16  of vulnerable adults that has been received by the commissioner 
 21.17  as required under section 626.557, subdivision 9c, paragraph 
 21.18  (i), and the commissioner's records relating to the maltreatment 
 21.19  of minors in licensed programs, information from juvenile courts 
 21.20  as required in paragraph (c) for persons listed in paragraph 
 21.21  (c), clause (2), and information from the bureau of criminal 
 21.22  apprehension.  For child foster care, adult foster care, and 
 21.23  family day care homes, the study must include information from 
 21.24  the county agency's record of substantiated maltreatment of 
 21.25  adults, and the maltreatment of minors, information from 
 21.26  juvenile courts as required in paragraph (c) for persons listed 
 21.27  in paragraph (c), clause (2), and information from the bureau of 
 21.28  criminal apprehension.  The commissioner may also review arrest 
 21.29  and investigative information from the bureau of criminal 
 21.30  apprehension, the commissioner of health, a county attorney, 
 21.31  county sheriff, county agency, local chief of police, other 
 21.32  states, the courts, or the Federal Bureau of Investigation if 
 21.33  the commissioner has reasonable cause to believe the information 
 21.34  is pertinent to the disqualification of an individual listed in 
 21.35  paragraph (c), clauses (1) to (5).  The commissioner is not 
 21.36  required to conduct more than one review of a subject's records 
 22.1   from the Federal Bureau of Investigation if a review of the 
 22.2   subject's criminal history with the Federal Bureau of 
 22.3   Investigation has already been completed by the commissioner and 
 22.4   there has been no break in the subject's affiliation with the 
 22.5   license holder who initiated the background studies. 
 22.6      When the commissioner has reasonable cause to believe that 
 22.7   further pertinent information may exist on the subject, the 
 22.8   subject shall provide a set of classifiable fingerprints 
 22.9   obtained from an authorized law enforcement agency.  For 
 22.10  purposes of requiring fingerprints, the commissioner shall be 
 22.11  considered to have reasonable cause under, but not limited to, 
 22.12  the following circumstances: 
 22.13     (1) information from the bureau of criminal apprehension 
 22.14  indicates that the subject is a multistate offender; 
 22.15     (2) information from the bureau of criminal apprehension 
 22.16  indicates that multistate offender status is undetermined; or 
 22.17     (3) the commissioner has received a report from the subject 
 22.18  or a third party indicating that the subject has a criminal 
 22.19  history in a jurisdiction other than Minnesota. 
 22.20     (g) (h) An applicant's or, license holder's, or 
 22.21  registrant's failure or refusal to cooperate with the 
 22.22  commissioner is reasonable cause to disqualify a subject, deny a 
 22.23  license application or immediately suspend, suspend, or revoke a 
 22.24  license or registration.  Failure or refusal of an individual to 
 22.25  cooperate with the study is just cause for denying or 
 22.26  terminating employment of the individual if the individual's 
 22.27  failure or refusal to cooperate could cause the applicant's 
 22.28  application to be denied or the license holder's license to be 
 22.29  immediately suspended, suspended, or revoked. 
 22.30     (h) (i) The commissioner shall not consider an application 
 22.31  to be complete until all of the information required to be 
 22.32  provided under this subdivision has been received.  
 22.33     (i) (j) No person in paragraph (c), clause (1), (2), (3), 
 22.34  (4), or (5) who is disqualified as a result of this section may 
 22.35  be retained by the agency in a position involving direct contact 
 22.36  with persons served by the program. 
 23.1      (j) (k) Termination of persons in paragraph (c), clause 
 23.2   (1), (2), (3), (4), or (5), made in good faith reliance on a 
 23.3   notice of disqualification provided by the commissioner shall 
 23.4   not subject the applicant or license holder to civil liability. 
 23.5      (k) (l) The commissioner may establish records to fulfill 
 23.6   the requirements of this section. 
 23.7      (l) (m) The commissioner may not disqualify an individual 
 23.8   subject to a study under this section because that person has, 
 23.9   or has had, a mental illness as defined in section 245.462, 
 23.10  subdivision 20. 
 23.11     (m) (n) An individual subject to disqualification under 
 23.12  this subdivision has the applicable rights in subdivision 3a, 
 23.13  3b, or 3c. 
 23.14     (n) (o) For the purposes of background studies completed by 
 23.15  tribal organizations performing licensing activities otherwise 
 23.16  required of the commissioner under this chapter, after obtaining 
 23.17  consent from the background study subject, tribal licensing 
 23.18  agencies shall have access to criminal history data in the same 
 23.19  manner as county licensing agencies and private licensing 
 23.20  agencies under this chapter. 
 23.21     Sec. 9.  Minnesota Statutes 2000, section 245A.04, 
 23.22  subdivision 3a, is amended to read: 
 23.23     Subd. 3a.  [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 
 23.24  STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 
 23.25  commissioner shall notify the applicant or, license holder, or 
 23.26  registrant and the individual who is the subject of the study, 
 23.27  in writing or by electronic transmission, of the results of the 
 23.28  study.  When the study is completed, a notice that the study was 
 23.29  undertaken and completed shall be maintained in the personnel 
 23.30  files of the program.  For studies on individuals pertaining to 
 23.31  a license to provide family day care or group family day care, 
 23.32  foster care for children in the provider's own home, or foster 
 23.33  care or day care services for adults in the provider's own home, 
 23.34  the commissioner is not required to provide a separate notice of 
 23.35  the background study results to the individual who is the 
 23.36  subject of the study unless the study results in a 
 24.1   disqualification of the individual. 
 24.2      The commissioner shall notify the individual studied if the 
 24.3   information in the study indicates the individual is 
 24.4   disqualified from direct contact with persons served by the 
 24.5   program.  The commissioner shall disclose the information 
 24.6   causing disqualification and instructions on how to request a 
 24.7   reconsideration of the disqualification to the individual 
 24.8   studied.  An applicant or license holder who is not the subject 
 24.9   of the study shall be informed that the commissioner has found 
 24.10  information that disqualifies the subject from direct contact 
 24.11  with persons served by the program.  However, only the 
 24.12  individual studied must be informed of the information contained 
 24.13  in the subject's background study unless the only basis for the 
 24.14  disqualification is failure to cooperate, the Data Practices Act 
 24.15  provides for release of the information, or the individual 
 24.16  studied authorizes the release of the information. 
 24.17     (b) If the commissioner determines that the individual 
 24.18  studied has a disqualifying characteristic, the commissioner 
 24.19  shall review the information immediately available and make a 
 24.20  determination as to the subject's immediate risk of harm to 
 24.21  persons served by the program where the individual studied will 
 24.22  have direct contact.  The commissioner shall consider all 
 24.23  relevant information available, including the following factors 
 24.24  in determining the immediate risk of harm:  the recency of the 
 24.25  disqualifying characteristic; the recency of discharge from 
 24.26  probation for the crimes; the number of disqualifying 
 24.27  characteristics; the intrusiveness or violence of the 
 24.28  disqualifying characteristic; the vulnerability of the victim 
 24.29  involved in the disqualifying characteristic; and the similarity 
 24.30  of the victim to the persons served by the program where the 
 24.31  individual studied will have direct contact.  The commissioner 
 24.32  may determine that the evaluation of the information immediately 
 24.33  available gives the commissioner reason to believe one of the 
 24.34  following: 
 24.35     (1) The individual poses an imminent risk of harm to 
 24.36  persons served by the program where the individual studied will 
 25.1   have direct contact.  If the commissioner determines that an 
 25.2   individual studied poses an imminent risk of harm to persons 
 25.3   served by the program where the individual studied will have 
 25.4   direct contact, the individual and the license holder must be 
 25.5   sent a notice of disqualification.  The commissioner shall order 
 25.6   the license holder to immediately remove the individual studied 
 25.7   from direct contact.  The notice to the individual studied must 
 25.8   include an explanation of the basis of this determination. 
 25.9      (2) The individual poses a risk of harm requiring 
 25.10  continuous supervision while providing direct contact services 
 25.11  during the period in which the subject may request a 
 25.12  reconsideration.  If the commissioner determines that an 
 25.13  individual studied poses a risk of harm that requires continuous 
 25.14  supervision, the individual and the license holder must be sent 
 25.15  a notice of disqualification.  The commissioner shall order the 
 25.16  license holder to immediately remove the individual studied from 
 25.17  direct contact services or assure that the individual studied is 
 25.18  within sight or hearing of another staff person when providing 
 25.19  direct contact services during the period in which the 
 25.20  individual may request a reconsideration of the 
 25.21  disqualification.  If the individual studied does not submit a 
 25.22  timely request for reconsideration, or the individual submits a 
 25.23  timely request for reconsideration, but the disqualification is 
 25.24  not set aside for that license holder, the license holder will 
 25.25  be notified of the disqualification and ordered to immediately 
 25.26  remove the individual from any position allowing direct contact 
 25.27  with persons receiving services from the license holder. 
 25.28     (3) The individual does not pose an imminent risk of harm 
 25.29  or a risk of harm requiring continuous supervision while 
 25.30  providing direct contact services during the period in which the 
 25.31  subject may request a reconsideration.  If the commissioner 
 25.32  determines that an individual studied does not pose a risk of 
 25.33  harm that requires continuous supervision, only the individual 
 25.34  must be sent a notice of disqualification.  The license holder 
 25.35  must be sent a notice that more time is needed to complete the 
 25.36  individual's background study.  If the individual studied 
 26.1   submits a timely request for reconsideration, and if the 
 26.2   disqualification is set aside for that license holder, the 
 26.3   license holder will receive the same notification received by 
 26.4   license holders in cases where the individual studied has no 
 26.5   disqualifying characteristic.  If the individual studied does 
 26.6   not submit a timely request for reconsideration, or the 
 26.7   individual submits a timely request for reconsideration, but the 
 26.8   disqualification is not set aside for that license holder, the 
 26.9   license holder will be notified of the disqualification and 
 26.10  ordered to immediately remove the individual from any position 
 26.11  allowing direct contact with persons receiving services from the 
 26.12  license holder.  
 26.13     (c) County licensing agencies performing duties under this 
 26.14  subdivision may develop an alternative system for determining 
 26.15  the subject's immediate risk of harm to persons served by the 
 26.16  program, providing the notices under paragraph (b), and 
 26.17  documenting the action taken by the county licensing agency.  
 26.18  Each county licensing agency's implementation of the alternative 
 26.19  system is subject to approval by the commissioner.  
 26.20  Notwithstanding this alternative system, county licensing 
 26.21  agencies shall complete the requirements of paragraph (a). 
 26.22     Sec. 10.  Minnesota Statutes 2000, section 245A.04, 
 26.23  subdivision 3b, is amended to read: 
 26.24     Subd. 3b.  [RECONSIDERATION OF DISQUALIFICATION.] (a) The 
 26.25  individual who is the subject of the disqualification may 
 26.26  request a reconsideration of the disqualification.  
 26.27     The individual must submit the request for reconsideration 
 26.28  to the commissioner in writing.  A request for reconsideration 
 26.29  for an individual who has been sent a notice of disqualification 
 26.30  under subdivision 3a, paragraph (b), clause (1) or (2), must be 
 26.31  submitted within 30 calendar days of the disqualified 
 26.32  individual's receipt of the notice of disqualification.  A 
 26.33  request for reconsideration for an individual who has been sent 
 26.34  a notice of disqualification under subdivision 3a, paragraph 
 26.35  (b), clause (3), must be submitted within 15 calendar days of 
 26.36  the disqualified individual's receipt of the notice of 
 27.1   disqualification.  Removal of a disqualified individual from 
 27.2   direct contact shall be ordered if the individual does not 
 27.3   request reconsideration within the prescribed time, and for an 
 27.4   individual who submits a timely request for reconsideration, if 
 27.5   the disqualification is not set aside.  The individual must 
 27.6   present information showing that: 
 27.7      (1) the information the commissioner relied upon is 
 27.8   incorrect or inaccurate.  If the basis of a reconsideration 
 27.9   request is that a maltreatment determination or disposition 
 27.10  under section 626.556 or 626.557 is incorrect, and the 
 27.11  commissioner has issued a final order in an appeal of that 
 27.12  determination or disposition under section 256.045, the 
 27.13  commissioner's order is conclusive on the issue of maltreatment; 
 27.14  or 
 27.15     (2) the subject of the study does not pose a risk of harm 
 27.16  to any person served by the applicant or, license holder, or 
 27.17  registrant. 
 27.18     (b) The commissioner may set aside the disqualification 
 27.19  under this section if the commissioner finds that the 
 27.20  information the commissioner relied upon is incorrect or the 
 27.21  individual does not pose a risk of harm to any person served by 
 27.22  the applicant or, license holder, or registrant.  In determining 
 27.23  that an individual does not pose a risk of harm, the 
 27.24  commissioner shall consider the consequences of the event or 
 27.25  events that lead to disqualification, whether there is more than 
 27.26  one disqualifying event, the vulnerability of the victim at the 
 27.27  time of the event, the time elapsed without a repeat of the same 
 27.28  or similar event, documentation of successful completion by the 
 27.29  individual studied of training or rehabilitation pertinent to 
 27.30  the event, and any other information relevant to 
 27.31  reconsideration.  In reviewing a disqualification under this 
 27.32  section, the commissioner shall give preeminent weight to the 
 27.33  safety of each person to be served by the license holder or, 
 27.34  applicant, or registrant over the interests of the license 
 27.35  holder or, applicant, or registrant. 
 27.36     (c) Unless the information the commissioner relied on in 
 28.1   disqualifying an individual is incorrect, the commissioner may 
 28.2   not set aside the disqualification of an individual in 
 28.3   connection with a license to provide family day care for 
 28.4   children, foster care for children in the provider's own home, 
 28.5   or foster care or day care services for adults in the provider's 
 28.6   own home if: 
 28.7      (1) less than ten years have passed since the discharge of 
 28.8   the sentence imposed for the offense; and the individual has 
 28.9   been convicted of a violation of any offense listed in sections 
 28.10  609.20 (manslaughter in the first degree), 609.205 (manslaughter 
 28.11  in the second degree), criminal vehicular homicide under 609.21 
 28.12  (criminal vehicular homicide and injury), 609.215 (aiding 
 28.13  suicide or aiding attempted suicide), felony violations under 
 28.14  609.221 to 609.2231 (assault in the first, second, third, or 
 28.15  fourth degree), 609.713 (terroristic threats), 609.235 (use of 
 28.16  drugs to injure or to facilitate crime), 609.24 (simple 
 28.17  robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 
 28.18  609.255 (false imprisonment), 609.561 or 609.562 (arson in the 
 28.19  first or second degree), 609.71 (riot), burglary in the first or 
 28.20  second degree under 609.582 (burglary), 609.66 (dangerous 
 28.21  weapon), 609.665 (spring guns), 609.67 (machine guns and 
 28.22  short-barreled shotguns), 609.749 (harassment; stalking), 
 28.23  152.021 or 152.022 (controlled substance crime in the first or 
 28.24  second degree), 152.023, subdivision 1, clause (3) or (4), or 
 28.25  subdivision 2, clause (4) (controlled substance crime in the 
 28.26  third degree), 152.024, subdivision 1, clause (2), (3), or (4) 
 28.27  (controlled substance crime in the fourth degree), 609.224, 
 28.28  subdivision 2, paragraph (c) (fifth-degree assault by a 
 28.29  caregiver against a vulnerable adult), 609.228 (great bodily 
 28.30  harm caused by distribution of drugs), 609.23 (mistreatment of 
 28.31  persons confined), 609.231 (mistreatment of residents or 
 28.32  patients), 609.2325 (criminal abuse of a vulnerable adult), 
 28.33  609.233 (criminal neglect of a vulnerable adult), 609.2335 
 28.34  (financial exploitation of a vulnerable adult), 609.234 (failure 
 28.35  to report), 609.265 (abduction), 609.2664 to 609.2665 
 28.36  (manslaughter of an unborn child in the first or second degree), 
 29.1   609.267 to 609.2672 (assault of an unborn child in the first, 
 29.2   second, or third degree), 609.268 (injury or death of an unborn 
 29.3   child in the commission of a crime), 617.293 (disseminating or 
 29.4   displaying harmful material to minors), a gross misdemeanor 
 29.5   offense under 609.324, subdivision 1 (other prohibited acts), a 
 29.6   gross misdemeanor offense under 609.378 (neglect or endangerment 
 29.7   of a child), a gross misdemeanor offense under 609.377 
 29.8   (malicious punishment of a child), 609.72, subdivision 3 
 29.9   (disorderly conduct against a vulnerable adult); or an attempt 
 29.10  or conspiracy to commit any of these offenses, as each of these 
 29.11  offenses is defined in Minnesota Statutes; or an offense in any 
 29.12  other state, the elements of which are substantially similar to 
 29.13  the elements of any of the foregoing offenses; 
 29.14     (2) regardless of how much time has passed since the 
 29.15  discharge of the sentence imposed for the offense, the 
 29.16  individual was convicted of a violation of any offense listed in 
 29.17  sections 609.185 to 609.195 (murder in the first, second, or 
 29.18  third degree), 609.2661 to 609.2663 (murder of an unborn child 
 29.19  in the first, second, or third degree), a felony offense under 
 29.20  609.377 (malicious punishment of a child), a felony offense 
 29.21  under 609.324, subdivision 1 (other prohibited acts), a felony 
 29.22  offense under 609.378 (neglect or endangerment of a child), 
 29.23  609.322 (solicitation, inducement, and promotion of 
 29.24  prostitution), 609.342 to 609.345 (criminal sexual conduct in 
 29.25  the first, second, third, or fourth degree), 609.352 
 29.26  (solicitation of children to engage in sexual conduct), 617.246 
 29.27  (use of minors in a sexual performance), 617.247 (possession of 
 29.28  pictorial representations of a minor), 609.365 (incest), a 
 29.29  felony offense under sections 609.2242 and 609.2243 (domestic 
 29.30  assault), a felony offense of spousal abuse, a felony offense of 
 29.31  child abuse or neglect, a felony offense of a crime against 
 29.32  children, or an attempt or conspiracy to commit any of these 
 29.33  offenses as defined in Minnesota Statutes, or an offense in any 
 29.34  other state, the elements of which are substantially similar to 
 29.35  any of the foregoing offenses; 
 29.36     (3) within the seven years preceding the study, the 
 30.1   individual committed an act that constitutes maltreatment of a 
 30.2   child under section 626.556, subdivision 10e, and that resulted 
 30.3   in substantial bodily harm as defined in section 609.02, 
 30.4   subdivision 7a, or substantial mental or emotional harm as 
 30.5   supported by competent psychological or psychiatric evidence; or 
 30.6      (4) within the seven years preceding the study, the 
 30.7   individual was determined under section 626.557 to be the 
 30.8   perpetrator of a substantiated incident of maltreatment of a 
 30.9   vulnerable adult that resulted in substantial bodily harm as 
 30.10  defined in section 609.02, subdivision 7a, or substantial mental 
 30.11  or emotional harm as supported by competent psychological or 
 30.12  psychiatric evidence. 
 30.13     In the case of any ground for disqualification under 
 30.14  clauses (1) to (4), if the act was committed by an individual 
 30.15  other than the applicant or license holder residing in the 
 30.16  applicant's or license holder's home, the applicant or, license 
 30.17  holder, or registrant may seek reconsideration when the 
 30.18  individual who committed the act no longer resides in the home.  
 30.19     The disqualification periods provided under clauses (1), 
 30.20  (3), and (4) are the minimum applicable disqualification 
 30.21  periods.  The commissioner may determine that an individual 
 30.22  should continue to be disqualified from licensure because the 
 30.23  license holder or applicant poses a risk of harm to a person 
 30.24  served by that individual after the minimum disqualification 
 30.25  period has passed. 
 30.26     (d) The commissioner shall respond in writing or by 
 30.27  electronic transmission to all reconsideration requests for 
 30.28  which the basis for the request is that the information relied 
 30.29  upon by the commissioner to disqualify is incorrect or 
 30.30  inaccurate within 30 working days of receipt of a request and 
 30.31  all relevant information.  If the basis for the request is that 
 30.32  the individual does not pose a risk of harm, the commissioner 
 30.33  shall respond to the request within 15 working days after 
 30.34  receiving the request for reconsideration and all relevant 
 30.35  information.  If the disqualification is set aside, the 
 30.36  commissioner shall notify the applicant or license holder in 
 31.1   writing or by electronic transmission of the decision. 
 31.2      (e) Except as provided in subdivision 3c, the 
 31.3   commissioner's decision to disqualify an individual, including 
 31.4   the decision to grant or deny a rescission or set aside a 
 31.5   disqualification under this section, is the final administrative 
 31.6   agency action and shall not be subject to further review in a 
 31.7   contested case under chapter 14 involving a negative licensing 
 31.8   appeal taken in response to the disqualification or involving an 
 31.9   accuracy and completeness appeal under section 13.04. 
 31.10     Sec. 11.  Minnesota Statutes 2000, section 245A.04, 
 31.11  subdivision 3d, is amended to read: 
 31.12     Subd. 3d.  [DISQUALIFICATION.] (a) Except as provided in 
 31.13  paragraph (b), when a background study completed under 
 31.14  subdivision 3 shows any of the following:  a conviction of one 
 31.15  or more crimes listed in clauses (1) to (4); the individual has 
 31.16  admitted to or a preponderance of the evidence indicates the 
 31.17  individual has committed an act or acts that meet the definition 
 31.18  of any of the crimes listed in clauses (1) to (4); or an 
 31.19  administrative determination listed under clause (4), the 
 31.20  individual shall be disqualified from any position allowing 
 31.21  direct contact with persons receiving services from the license 
 31.22  holder or registrant: 
 31.23     (1) regardless of how much time has passed since the 
 31.24  discharge of the sentence imposed for the offense, and unless 
 31.25  otherwise specified, regardless of the level of the conviction, 
 31.26  the individual was convicted of any of the following offenses:  
 31.27  sections 609.185 (murder in the first degree); 609.19 (murder in 
 31.28  the second degree); 609.195 (murder in the third degree); 
 31.29  609.2661 (murder of an unborn child in the first degree); 
 31.30  609.2662 (murder of an unborn child in the second degree); 
 31.31  609.2663 (murder of an unborn child in the third degree); 
 31.32  609.322 (solicitation, inducement, and promotion of 
 31.33  prostitution); 609.342 (criminal sexual conduct in the first 
 31.34  degree); 609.343 (criminal sexual conduct in the second degree); 
 31.35  609.344 (criminal sexual conduct in the third degree); 609.345 
 31.36  (criminal sexual conduct in the fourth degree); 609.352 
 32.1   (solicitation of children to engage in sexual conduct); 609.365 
 32.2   (incest); felony offense under 609.377 (malicious punishment of 
 32.3   a child); a felony offense under 609.378 (neglect or 
 32.4   endangerment of a child); a felony offense under 609.324, 
 32.5   subdivision 1 (other prohibited acts); 617.246 (use of minors in 
 32.6   sexual performance prohibited); 617.247 (possession of pictorial 
 32.7   representations of minors); a felony offense under sections 
 32.8   609.2242 and 609.2243 (domestic assault), a felony offense of 
 32.9   spousal abuse, a felony offense of child abuse or neglect, a 
 32.10  felony offense of a crime against children; or attempt or 
 32.11  conspiracy to commit any of these offenses as defined in 
 32.12  Minnesota Statutes, or an offense in any other state or country, 
 32.13  where the elements are substantially similar to any of the 
 32.14  offenses listed in this clause; 
 32.15     (2) if less than 15 years have passed since the discharge 
 32.16  of the sentence imposed for the offense; and the individual has 
 32.17  received a felony conviction for a violation of any of these 
 32.18  offenses:  sections 609.20 (manslaughter in the first degree); 
 32.19  609.205 (manslaughter in the second degree); 609.21 (criminal 
 32.20  vehicular homicide and injury); 609.215 (suicide); 609.221 to 
 32.21  609.2231 (assault in the first, second, third, or fourth 
 32.22  degree); repeat offenses under 609.224 (assault in the fifth 
 32.23  degree); repeat offenses under 609.3451 (criminal sexual conduct 
 32.24  in the fifth degree); 609.713 (terroristic threats); 609.235 
 32.25  (use of drugs to injure or facilitate crime); 609.24 (simple 
 32.26  robbery); 609.245 (aggravated robbery); 609.25 (kidnapping); 
 32.27  609.255 (false imprisonment); 609.561 (arson in the first 
 32.28  degree); 609.562 (arson in the second degree); 609.563 (arson in 
 32.29  the third degree); repeat offenses under 617.23 (indecent 
 32.30  exposure; penalties); repeat offenses under 617.241 (obscene 
 32.31  materials and performances; distribution and exhibition 
 32.32  prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 
 32.33  609.67 (machine guns and short-barreled shotguns); 609.749 
 32.34  (harassment; stalking; penalties); 609.228 (great bodily harm 
 32.35  caused by distribution of drugs); 609.2325 (criminal abuse of a 
 32.36  vulnerable adult); 609.2664 (manslaughter of an unborn child in 
 33.1   the first degree); 609.2665 (manslaughter of an unborn child in 
 33.2   the second degree); 609.267 (assault of an unborn child in the 
 33.3   first degree); 609.2671 (assault of an unborn child in the 
 33.4   second degree); 609.268 (injury or death of an unborn child in 
 33.5   the commission of a crime); 609.52 (theft); 609.2335 (financial 
 33.6   exploitation of a vulnerable adult); 609.521 (possession of 
 33.7   shoplifting gear); 609.582 (burglary); 609.625 (aggravated 
 33.8   forgery); 609.63 (forgery); 609.631 (check forgery; offering a 
 33.9   forged check); 609.635 (obtaining signature by false pretense); 
 33.10  609.27 (coercion); 609.275 (attempt to coerce); 609.687 
 33.11  (adulteration); 260C.301 (grounds for termination of parental 
 33.12  rights); and chapter 152 (drugs; controlled substance).  An 
 33.13  attempt or conspiracy to commit any of these offenses, as each 
 33.14  of these offenses is defined in Minnesota Statutes; or an 
 33.15  offense in any other state or country, the elements of which are 
 33.16  substantially similar to the elements of the offenses in this 
 33.17  clause.  If the individual studied is convicted of one of the 
 33.18  felonies listed in this clause, but the sentence is a gross 
 33.19  misdemeanor or misdemeanor disposition, the lookback period for 
 33.20  the conviction is the period applicable to the disposition, that 
 33.21  is the period for gross misdemeanors or misdemeanors; 
 33.22     (3) if less than ten years have passed since the discharge 
 33.23  of the sentence imposed for the offense; and the individual has 
 33.24  received a gross misdemeanor conviction for a violation of any 
 33.25  of the following offenses:  sections 609.224 (assault in the 
 33.26  fifth degree); 609.2242 and 609.2243 (domestic assault); 
 33.27  violation of an order for protection under 518B.01, subdivision 
 33.28  14; 609.3451 (criminal sexual conduct in the fifth degree); 
 33.29  repeat offenses under 609.746 (interference with privacy); 
 33.30  repeat offenses under 617.23 (indecent exposure); 617.241 
 33.31  (obscene materials and performances); 617.243 (indecent 
 33.32  literature, distribution); 617.293 (harmful materials; 
 33.33  dissemination and display to minors prohibited); 609.71 (riot); 
 33.34  609.66 (dangerous weapons); 609.749 (harassment; stalking; 
 33.35  penalties); 609.224, subdivision 2, paragraph (c) (assault in 
 33.36  the fifth degree by a caregiver against a vulnerable adult); 
 34.1   609.23 (mistreatment of persons confined); 609.231 (mistreatment 
 34.2   of residents or patients); 609.2325 (criminal abuse of a 
 34.3   vulnerable adult); 609.233 (criminal neglect of a vulnerable 
 34.4   adult); 609.2335 (financial exploitation of a vulnerable adult); 
 34.5   609.234 (failure to report maltreatment of a vulnerable adult); 
 34.6   609.72, subdivision 3 (disorderly conduct against a vulnerable 
 34.7   adult); 609.265 (abduction); 609.378 (neglect or endangerment of 
 34.8   a child); 609.377 (malicious punishment of a child); 609.324, 
 34.9   subdivision 1a (other prohibited acts; minor engaged in 
 34.10  prostitution); 609.33 (disorderly house); 609.52 (theft); 
 34.11  609.582 (burglary); 609.631 (check forgery; offering a forged 
 34.12  check); 609.275 (attempt to coerce); or an attempt or conspiracy 
 34.13  to commit any of these offenses, as each of these offenses is 
 34.14  defined in Minnesota Statutes; or an offense in any other state 
 34.15  or country, the elements of which are substantially similar to 
 34.16  the elements of any of the offenses listed in this clause.  If 
 34.17  the defendant is convicted of one of the gross misdemeanors 
 34.18  listed in this clause, but the sentence is a misdemeanor 
 34.19  disposition, the lookback period for the conviction is the 
 34.20  period applicable to misdemeanors; or 
 34.21     (4) if less than seven years have passed since the 
 34.22  discharge of the sentence imposed for the offense; and the 
 34.23  individual has received a misdemeanor conviction for a violation 
 34.24  of any of the following offenses:  sections 609.224 (assault in 
 34.25  the fifth degree); 609.2242 (domestic assault); violation of an 
 34.26  order for protection under 518B.01 (Domestic Abuse Act); 
 34.27  violation of an order for protection under 609.3232 (protective 
 34.28  order authorized; procedures; penalties); 609.746 (interference 
 34.29  with privacy); 609.79 (obscene or harassing phone calls); 
 34.30  609.795 (letter, telegram, or package; opening; harassment); 
 34.31  617.23 (indecent exposure; penalties); 609.2672 (assault of an 
 34.32  unborn child in the third degree); 617.293 (harmful materials; 
 34.33  dissemination and display to minors prohibited); 609.66 
 34.34  (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 
 34.35  exploitation of a vulnerable adult); 609.234 (failure to report 
 34.36  maltreatment of a vulnerable adult); 609.52 (theft); 609.27 
 35.1   (coercion); or an attempt or conspiracy to commit any of these 
 35.2   offenses, as each of these offenses is defined in Minnesota 
 35.3   Statutes; or an offense in any other state or country, the 
 35.4   elements of which are substantially similar to the elements of 
 35.5   any of the offenses listed in this clause; failure to make 
 35.6   required reports under section 626.556, subdivision 3, or 
 35.7   626.557, subdivision 3, for incidents in which:  (i) the final 
 35.8   disposition under section 626.556 or 626.557 was substantiated 
 35.9   maltreatment, and (ii) the maltreatment was recurring or 
 35.10  serious; or substantiated serious or recurring maltreatment of a 
 35.11  minor under section 626.556 or of a vulnerable adult under 
 35.12  section 626.557 for which there is a preponderance of evidence 
 35.13  that the maltreatment occurred, and that the subject was 
 35.14  responsible for the maltreatment. 
 35.15     For the purposes of this section, "serious maltreatment" 
 35.16  means sexual abuse; maltreatment resulting in death; or 
 35.17  maltreatment resulting in serious injury which reasonably 
 35.18  requires the care of a physician whether or not the care of a 
 35.19  physician was sought; or abuse resulting in serious injury.  For 
 35.20  purposes of this section, "abuse resulting in serious injury" 
 35.21  means:  bruises, bites, skin laceration or tissue damage; 
 35.22  fractures; dislocations; evidence of internal injuries; head 
 35.23  injuries with loss of consciousness; extensive second-degree or 
 35.24  third-degree burns and other burns for which complications are 
 35.25  present; extensive second-degree or third-degree frostbite, and 
 35.26  others for which complications are present; irreversible 
 35.27  mobility or avulsion of teeth; injuries to the eyeball; 
 35.28  ingestion of foreign substances and objects that are harmful; 
 35.29  near drowning; and heat exhaustion or sunstroke.  For purposes 
 35.30  of this section, "care of a physician" is treatment received or 
 35.31  ordered by a physician, but does not include diagnostic testing, 
 35.32  assessment, or observation.  For the purposes of this section, 
 35.33  "recurring maltreatment" means more than one incident of 
 35.34  maltreatment for which there is a preponderance of evidence that 
 35.35  the maltreatment occurred, and that the subject was responsible 
 35.36  for the maltreatment. 
 36.1      (b) If the subject of a background study is licensed by a 
 36.2   health-related licensing board, the board shall make the 
 36.3   determination regarding a disqualification under this 
 36.4   subdivision based on a finding of substantiated maltreatment 
 36.5   under section 626.556 or 626.557.  The commissioner shall notify 
 36.6   the health-related licensing board if a background study shows 
 36.7   that a licensee would be disqualified because of substantiated 
 36.8   maltreatment and the board shall make a determination under 
 36.9   section 214.104. 
 36.10     Sec. 12.  [256M.20] [REGISTRATION OF TEMPORARY EMPLOYMENT 
 36.11  AGENCIES SERVING HEALTH CARE INDUSTRY.] 
 36.12     Subdivision 1.  [SCOPE.] As used in sections 256M.20 to 
 36.13  256M.29, the following terms have the meanings given them. 
 36.14     Subd. 2.  [COMMISSIONER.] "Commissioner" means the 
 36.15  commissioner of health or the commissioner's designee. 
 36.16     Subd. 3.  [TEMPORARY EMPLOYMENT AGENCY SERVING HEALTH CARE 
 36.17  INDUSTRY.] A "temporary employment agency serving the health 
 36.18  care industry" or "temporary employment agency" means a 
 36.19  personnel pool or temporary pool agency providing individuals 
 36.20  for direct contact services as defined in section 245A.04 in 
 36.21  health care settings licensed by the department of health or 
 36.22  human services.  A temporary employment agency does not include 
 36.23  direct contact services provided by or coordinated by health 
 36.24  care facilities. 
 36.25     Subd. 4.  [HEALTH CARE FACILITY.] "Health care facility" 
 36.26  means hospitals, boarding care homes, outpatient surgical 
 36.27  centers licensed under sections 144.50 to 144.58; and nursing 
 36.28  homes, boarding care homes, and home care agencies licensed 
 36.29  under chapter 144A. 
 36.30     Sec. 13.  [256M.21] [REGISTRATION REQUIRED.] 
 36.31     Effective January 1, 2001, no entity may establish, 
 36.32  operate, conduct, or maintain a temporary employment agency in 
 36.33  this state without registering and operating as required in this 
 36.34  section.  Each application for a temporary employment agency 
 36.35  registration, or for a renewal of a registration, shall be 
 36.36  accompanied by a fee to be set by the commissioner. 
 37.1      Sec. 14.  [256M.22] [ENFORCEMENT.] 
 37.2      (a) The commissioner may refuse to grant or renew a 
 37.3   registration, or may suspend or revoke a registration, for 
 37.4   violation of statutes or rules relating to temporary employment 
 37.5   agencies or for conduct detrimental to the welfare of the 
 37.6   consumer.  Prior to any suspension, revocation, or refusal to 
 37.7   renew a registration, the temporary employment agency shall be 
 37.8   entitled to notice and a hearing as provided by sections 14.57 
 37.9   to 14.69.  In addition to any other remedy provided by law, the 
 37.10  commissioner may, without a prior contested case hearing, 
 37.11  temporarily suspend a registration or prohibit delivery of 
 37.12  services by a temporary employment agency for no more than 60 
 37.13  days if the commissioner determines that the health or safety of 
 37.14  a consumer is in imminent danger, provided: 
 37.15     (1) advance notice is given to the temporary employment 
 37.16  agency; 
 37.17     (2) after notice, the provider fails to correct the 
 37.18  problem; 
 37.19     (3) the commissioner has reason to believe that other 
 37.20  administrative remedies are not likely to be effective; and 
 37.21     (4) there is an opportunity for a contested case hearing 
 37.22  within the 60 days. 
 37.23     (b) The owner and managerial officials, as defined in this 
 37.24  section of a temporary employment agency whose Minnesota 
 37.25  registration has not been renewed or has been revoked because of 
 37.26  noncompliance with applicable law or rule, shall not be eligible 
 37.27  to apply for nor will be granted a registration for five years 
 37.28  following the effective date of the nonrenewal or revocation. 
 37.29     (c) The commissioner shall not issue a registration to a 
 37.30  temporary employment agency if an owner or managerial official 
 37.31  includes any individual who was an owner or managerial official 
 37.32  of a temporary employment agency whose Minnesota registration 
 37.33  was not renewed or was revoked as described in paragraph (b) for 
 37.34  five years following the effective date of nonrenewal or 
 37.35  revocation. 
 37.36     (d) Notwithstanding the provisions of paragraph (a), the 
 38.1   commissioner may not renew and shall suspend or revoke the 
 38.2   registration of any temporary employment agency which includes 
 38.3   any individual as an owner or managerial official who was an 
 38.4   owner or managerial official of a temporary employment agency 
 38.5   whose Minnesota registration was not renewed or was revoked as 
 38.6   described in paragraph (b) for five years following the 
 38.7   effective date of the nonrenewal or revocation.  The 
 38.8   commissioner must notify the temporary employment agency 30 days 
 38.9   in advance of the date of nonrenewal, suspension, or revocation 
 38.10  of the license.  Within ten days after the receipt of this 
 38.11  notification, the temporary employment agency may request in 
 38.12  writing that the commissioner stay the nonrenewal, revocation, 
 38.13  or suspension of the registration.  The temporary employment 
 38.14  agency must specify the reasons for requesting the stay; the 
 38.15  steps that will be taken to attain or maintain compliance with 
 38.16  the registration requirements; any limits on the authority or 
 38.17  responsibility of the owners or managerial officials whose 
 38.18  actions resulted in the notice of nonrenewal, revocation, or 
 38.19  suspension; and any other information to establish that the 
 38.20  continuing affiliation with these individuals will not 
 38.21  jeopardize client health, safety, or well-being.  The 
 38.22  commissioner must determine whether the stay will be granted 
 38.23  within 30 days of receiving the agency's request.  The 
 38.24  commissioner may propose additional restrictions or limitations 
 38.25  on the agency's registration and require that the granting of 
 38.26  the stay be contingent upon compliance with those provisions.  
 38.27  The commissioner must take into consideration the following 
 38.28  factors when determining whether the stay should be granted: 
 38.29     (1) the threat that continued involvement of the owners or 
 38.30  managerial officials in the temporary employment agency poses to 
 38.31  client health, safety, and well-being; 
 38.32     (2) the compliance history of the temporary employment 
 38.33  agency; and 
 38.34     (3) the appropriateness of any limits suggested by the 
 38.35  temporary employment agency. 
 38.36  If the commissioner grants the stay, the order must include any 
 39.1   restrictions or limitation on the agency's registration.  The 
 39.2   failure of the provider to comply with any restrictions or 
 39.3   limitations shall result in the immediate removal of the stay 
 39.4   and the commissioner must take immediate action to suspend, 
 39.5   revoke, or not renew the registration. 
 39.6      (e) The provisions contained in paragraphs (b) and (c) 
 39.7   apply to any nonrenewal or revocation of a temporary employment 
 39.8   agency registration occurring after January 1, 2001. 
 39.9      (f) In this subdivision, owners of a temporary employment 
 39.10  agency are those individuals whose ownership interest provides 
 39.11  sufficient authority or control to affect or change decisions 
 39.12  related to the operation of the temporary employment agency.  An 
 39.13  owner includes a sole proprietor, a general partner, or any 
 39.14  other individual whose individual ownership interest can affect 
 39.15  the management and direction of the policies of the temporary 
 39.16  employment agency.  For the purposes of this subdivision, 
 39.17  managerial officials are those individuals who were responsible 
 39.18  for the ongoing management or direction of the policies, 
 39.19  services, or employees of the temporary employment agency 
 39.20  relating to the areas of noncompliance which resulted in the 
 39.21  registration revocation or nonrenewal. 
 39.22     Sec. 15.  [256M.23] [INJUNCTIVE RELIEF.] 
 39.23     In addition to any other remedy provided by law, the 
 39.24  commissioner may bring an action in district court to enjoin a 
 39.25  person who is involved in the management, operation, or control 
 39.26  of a temporary employment agency, or an employee of the 
 39.27  temporary employment agency from illegally engaging in 
 39.28  activities regulated by this chapter.  The commissioner may 
 39.29  bring an action under this subdivision in the district court in 
 39.30  Ramsey county or in the district in which a temporary employment 
 39.31  agency is providing services.  The court may grant a temporary 
 39.32  restraining order in the proceeding if continued activity by the 
 39.33  person who is involved in the management, operation, or control 
 39.34  of a temporary employment agency, or by an employee of the 
 39.35  temporary employment agency, would create an imminent risk of 
 39.36  harm to a recipient of agency services. 
 40.1      Sec. 16.  [256M.24] [SUBPOENA.] 
 40.2      In matters pending before the commissioner under this 
 40.3   chapter, the commissioner may issue subpoenas and compel the 
 40.4   attendance of witnesses and the production of all necessary 
 40.5   papers, books, records, documents, and other evidentiary 
 40.6   material.  If a person fails or refuses to comply with a 
 40.7   subpoena or order of the commissioner to appear or testify 
 40.8   regarding any matter about which the person may be lawfully 
 40.9   questioned or to produce any papers, books, records, documents, 
 40.10  or evidentiary materials in the matter to be heard, the 
 40.11  commissioner may apply to the district court in any district, 
 40.12  and the court shall order the person to comply with the 
 40.13  commissioner's order or subpoena.  The commissioner of health 
 40.14  may administer oaths to witnesses, or take their affirmation.  
 40.15  Depositions may be taken in or outside the state in a manner 
 40.16  provided by law for taking of depositions in civil actions.  A 
 40.17  subpoena or other process or paper may be served upon a named 
 40.18  person anywhere within the state by an officer authorized to 
 40.19  serve subpoenas in civil actions, with the same fees and mileage 
 40.20  and in the same manner as prescribed by law for process issued 
 40.21  out of a district court.  A person subpoenaed under this 
 40.22  subdivision shall receive the same fees, mileage, and other 
 40.23  costs that are paid in proceedings in district court. 
 40.24     Sec. 17.  [256M.25] [PRIOR CRIMINAL CONVICTIONS.] 
 40.25     (a) Before the commissioner issues an initial or renewal 
 40.26  registration, an owner or managerial official shall be required 
 40.27  to complete a background study under section 144.057.  No person 
 40.28  may be involved in the management, operation, or control of a 
 40.29  provider if the person has been disqualified under chapter 
 40.30  245A.  An individual disqualified under chapter 245A may request 
 40.31  a reconsideration, and if the disqualification is set aside the 
 40.32  individual is then eligible to be involved in the management, 
 40.33  operation, or control of the provider. 
 40.34     (b) In this section, owners of a temporary employment 
 40.35  agency subject to the background check requirement are those 
 40.36  individuals whose ownership interest provides sufficient 
 41.1   authority or control to affect or change decisions related to 
 41.2   the operation of the temporary employment agency.  An owner 
 41.3   includes a sole proprietor, a general partner, or any other 
 41.4   individual whose individual ownership interest can affect the 
 41.5   management and direction of the policies of the home care 
 41.6   provider.  
 41.7      (c) In this section, managerial officials subject to the 
 41.8   background check requirement are those individuals who provide 
 41.9   "direct contact" as defined in section 245A.04 or those 
 41.10  individuals who have the responsibility for the ongoing 
 41.11  management or direction of the policies, services, or employees 
 41.12  of the temporary employment agency.  Data collected under this 
 41.13  subdivision shall be classified as private data under section 
 41.14  13.02, subdivision 12. 
 41.15     (d) Employees and contractors of a temporary employment 
 41.16  agency are subject to the background study required by section 
 41.17  144.057.  These individuals shall be disqualified under the 
 41.18  provisions of chapter 245A and Minnesota Rules, parts 9543.3000 
 41.19  to 9543.3090. 
 41.20     (e) Termination of an employee in good faith reliance on 
 41.21  information or records obtained under paragraphs (a) to (d) 
 41.22  regarding a confirmed conviction does not subject the employee 
 41.23  and contractors of a temporary employment agency to civil 
 41.24  liability or liability for unemployment benefits. 
 41.25     Sec. 18.  [256M.26] [REGISTRATION.] 
 41.26     Subdivision 1.  [REGISTRATION PROCEDURES.] The commissioner 
 41.27  shall establish forms and procedures for annual registration of 
 41.28  temporary employment agencies.  The commissioner shall charge an 
 41.29  annual registration fee that is based on revenues of each 
 41.30  temporary employment agency that will cover the ongoing costs of 
 41.31  the registration program.  No fee shall be refunded.  A 
 41.32  registered temporary employment agency shall notify the 
 41.33  commissioner within 30 days of the date the agency is no longer 
 41.34  required to be registered under this chapter or of any change in 
 41.35  the business name or address of the establishment, the name or 
 41.36  mailing address of the owner or owners, or the name or mailing 
 42.1   address of the managing agent.  There shall be no fee for 
 42.2   submission of the notice. 
 42.3      Subd. 2.  [REGISTRATION INFORMATION.] The temporary 
 42.4   employment agency must provide the following information to the 
 42.5   commissioner in order to be registered: 
 42.6      (1) the business name, street address, and mailing address 
 42.7   of the establishment; 
 42.8      (2) the name and mailing address of the owner or owners of 
 42.9   the establishment and, if the owner or owners are not natural 
 42.10  persons, identification of the type of business entity of the 
 42.11  owner or owners, and the names and addresses of the officers and 
 42.12  members of the governing body, or comparable persons for 
 42.13  partnerships, limited liability corporations, or other types of 
 42.14  business organizations of the owner or owners; 
 42.15     (3) the name and mailing address of the managing agent, 
 42.16  whether through management agreement or lease agreement, of the 
 42.17  temporary employment agency, if different from the owner or 
 42.18  owners, and the name of the on-site manager, if any; 
 42.19     (4) verification that the temporary employment agency has 
 42.20  entered into a contract, as required in section 144.04, with 
 42.21  each facility; 
 42.22     (5) the name and address of at least one natural person who 
 42.23  shall be responsible for dealing with the commissioner on all 
 42.24  matters provided for in this chapter, and on whom personal 
 42.25  service of all notices and orders shall be made, and who is 
 42.26  authorized to accept service on behalf of the owner or owners 
 42.27  and the managing agent, if any; and 
 42.28     (6) the signature of the authorized representative of the 
 42.29  owner or owners or, if the owner or owners are not natural 
 42.30  persons, signatures of at least two authorized representatives 
 42.31  of each owner, one of which shall be an officer of the owner. 
 42.32  Personal service on the person identified under clause (5) by 
 42.33  the owner or owners in the registration shall be considered 
 42.34  service on the owner or owners, and it shall not be a defense to 
 42.35  any action that personal service was not made on each individual 
 42.36  or entity.  The designation of one or more individuals under 
 43.1   this subdivision shall not affect the legal responsibility of 
 43.2   owners under this chapter. 
 43.3      Sec. 19.  [256M.27] [TEMPORARY EMPLOYMENT AGENCY 
 43.4   CONTRACTS.] 
 43.5      Subdivision 1.  [CONTRACT REQUIRED.] No temporary 
 43.6   employment agency may operate in this state unless a written 
 43.7   temporary employment agency contract, as defined in subdivision 
 43.8   2, is executed between the temporary employment agency and each 
 43.9   facility and unless the temporary employment agency operates 
 43.10  according to the terms of the contract.  The facility shall be 
 43.11  given a complete copy of the contract and all supporting 
 43.12  documents and attachments and any changes that are made. 
 43.13     Subd. 2.  [CONTENTS OF CONTRACT.] A temporary employment 
 43.14  agency contract, which need not be named as such to comply with 
 43.15  this section, shall include at least the following elements in 
 43.16  the body of the contract or through supporting documents or 
 43.17  attachments: 
 43.18     (1) name, street address, and mailing address of the 
 43.19  agency; 
 43.20     (2) the name and mailing address of the owner or owners of 
 43.21  the agency and, if the owner or owners are not natural persons, 
 43.22  identification of the type of business entity of the owner or 
 43.23  owners; 
 43.24     (3) the name and mailing address of the managing agent, 
 43.25  through management agreement or lease agreement, of the 
 43.26  temporary employment agency, if different from the owner or 
 43.27  owners; 
 43.28     (4) the name and address of at least one natural person who 
 43.29  is authorized to accept service on behalf of the owner or owners 
 43.30  and managing agent; 
 43.31     (5) a statement describing the registration and licensure 
 43.32  status of the temporary employment agency; 
 43.33     (6) term of the contract; 
 43.34     (7) description of the services to be provided to the 
 43.35  facility in the base rate charged to the facility; 
 43.36     (8) description of the process through which the contract 
 44.1   may be modified, amended, or terminated; 
 44.2      (9) description of the temporary employment agency's 
 44.3   complaint resolution process available to facilities; 
 44.4      (10) the facility's designated contact, if any; 
 44.5      (11) criteria used by the temporary employment agency to 
 44.6   determine who may continue to be employed in a facility; 
 44.7      (12) billing and payment procedures and requirements; 
 44.8      (13) a statement that the temporary employment agency 
 44.9   conducts all required background checks on all employees working 
 44.10  in health care facilities, and will provide documented proof of 
 44.11  satisfactory completion of a background study required by 
 44.12  sections 144.057 and 245A.04, and is responsible for all 
 44.13  employee actions; and 
 44.14     (14) a statement that the temporary employment agency only 
 44.15  places employees in nursing assistant or nurse aide positions 
 44.16  who are on the state nursing assistant registry. 
 44.17     Subd. 3.  [CONTRACTS IN PERMANENT FILES.] Temporary 
 44.18  employment agency contracts and related documents executed by 
 44.19  the agency shall be maintained by the temporary employment 
 44.20  agency in files from the date of execution until three years 
 44.21  after the contract is terminated.  The contracts shall be made 
 44.22  available for on site inspection by the commissioner upon 
 44.23  request at any time. 
 44.24     Sec. 20.  [256M.28] [AUTHORITY OF COMMISSIONER.] 
 44.25     (a) The commissioner shall, upon receipt of information 
 44.26  which may indicate the failure of the temporary employment 
 44.27  agency to comply with a legal requirement, make appropriate 
 44.28  referrals to other governmental agencies and entities having 
 44.29  jurisdiction over the subject matter.  The commissioner may also 
 44.30  make referrals to any public or private agency the commissioner 
 44.31  considers available for appropriate assistance to those involved.
 44.32     (b) The commissioner may bring an action for injunctive 
 44.33  relief in the district court in which an establishment is 
 44.34  located to compel the temporary employment agency to meet the 
 44.35  requirements of this chapter or other requirements of the state 
 44.36  or of any county or local governmental unit to which the 
 45.1   temporary employment agency is otherwise subject.  Proceedings 
 45.2   for securing an injunction may be brought by the commissioner 
 45.3   through the attorney general.  The sanctions in this section do 
 45.4   not restrict other sanctions available. 
 45.5      Sec. 21.  [256M.29] [TEMPORARY AGENCY CHARGES.] 
 45.6      (a) The department of human services shall establish 
 45.7   maximum rates of payment for services provided by a temporary 
 45.8   employment agency required to register under section 6.  
 45.9   Effective July 1, 2001, a temporary employment agency must not 
 45.10  bill or receive payments from health care facilities at a rate 
 45.11  greater than the rate established under this section.  The rate 
 45.12  shall take into consideration the reasonable administrative 
 45.13  expenses of the agency, the wages and benefits paid by the 
 45.14  agency to the medical personnel supplied to a health care 
 45.15  facility, and an allowance that provides a reasonable return on 
 45.16  equity. 
 45.17     (b) Temporary employment agencies that charge a rate in 
 45.18  violation of this subdivision are subject to an action by the 
 45.19  state of Minnesota or any of its subdivisions or agencies for 
 45.20  civil damages. 
 45.21     Sec. 22.  [256M.30] [LOAN FORGIVENESS PROGRAM FOR LICENSED 
 45.22  PROFESSIONAL STAFF.] 
 45.23     Subdivision 1.  [COORDINATION OF EXISTING PROGRAMS.] (a) 
 45.24  The commissioner of health shall coordinate all loan 
 45.25  forgiveness, grant, tuition waiver programs, and training 
 45.26  programs available for licensed and unlicensed health care 
 45.27  workers who work or pledge to work in long-term health care 
 45.28  settings. 
 45.29     (b) Loan forgiveness, grant, tuition waiver programs, and 
 45.30  training programs include, but are not limited to: 
 45.31     (1) national health services corps state loan repayment 
 45.32  program; 
 45.33     (2) state rural health network reform initiative; 
 45.34     (3) nursing grant program; 
 45.35     (4) rural physicians loan forgiveness loan program; 
 45.36     (5) rural midlevel practitioner loan forgiveness program; 
 46.1      (6) nurses in nursing homes or ICFs/MRs program; 
 46.2      (7) rural clinic sites for nurse practitioner education; 
 46.3      (8) health care and human services worker training and 
 46.4   retention program; 
 46.5      (9) health care and human services tuition waiver program; 
 46.6      (10) worker development fund; and 
 46.7      (11) tuition payback program established under subdivision 
 46.8   2. 
 46.9      (c) The department of health shall also serve as a 
 46.10  clearinghouse on available programs through the dissemination of 
 46.11  information to interested individuals and through the 
 46.12  development and performance of public education activities and 
 46.13  outreach. 
 46.14     Subd. 2.  [ESTABLISHMENT OF TUITION PAYBACK PROGRAM.] The 
 46.15  commissioner of health shall establish a health care worker 
 46.16  tuition payback program, with grants made available to health 
 46.17  care facilities for the purpose of either:  (1) reimbursing 
 46.18  employees' costs of tuition for education needed to perform 
 46.19  their current job functions; (2) reimbursing employees' cost of 
 46.20  tuition to further their career development in the long-term 
 46.21  care field; or (3) payment for past tuition debts in exchange 
 46.22  for pledges to work within the facility for a period of time. 
 46.23                             ARTICLE 3
 46.24                 PAYMENT AND QUALITY SYSTEM REFORM
 46.25     Section 1.  [256M.40] [QUALITY AND PAYMENT REVIEW 
 46.26  COMMISSION.] 
 46.27     Subdivision 1.  [PURPOSE.] A quality and payment review 
 46.28  commission is established to review long-term care payment 
 46.29  policies and submit financial and quality assurance 
 46.30  recommendations and reports to the legislature. 
 46.31     Subd. 2.  [DUTIES.] The commission must review and make 
 46.32  recommendations to the legislature concerning: 
 46.33     (1) the methodology of nursing facility payments; 
 46.34     (2) mechanisms used to adjust payment rates and the need to 
 46.35  adjust the mechanisms; 
 46.36     (3) the development and implementation of mechanisms for 
 47.1   quality assurance on a statewide and program-specific basis; 
 47.2      (4) the impact of the payment systems on access to nursing 
 47.3   facility care and other long-term care services, including 
 47.4   subacute care; 
 47.5      (5) implications of the prepaid medical assistance program 
 47.6   and Minnesota senior health options program on access, service 
 47.7   delivery, and expenditures; 
 47.8      (6) infrastructure barriers and capital needs of nursing 
 47.9   facilities; and 
 47.10     (7) general interaction of long-term care payment policies 
 47.11  with general health care access and delivery, reviewing the 
 47.12  spectrum of long- and short-term care service delivery. 
 47.13     Subd. 3.  [MEMBERSHIP.] The commission shall consist of 
 47.14  nine members.  The governor shall appoint one commissioner from 
 47.15  each congressional district obtaining the advice and consent of 
 47.16  the house and senate.  The governor shall appoint the ninth 
 47.17  commission member from any congressional district, who shall 
 47.18  serve as chair.  No more than five commissioners shall belong to 
 47.19  the same political party.  The governor, when selecting 
 47.20  commissioners, shall give consideration to persons active in 
 47.21  health care, aging services, health care finance, or economics.  
 47.22  Commission members may employ an executive director and other 
 47.23  personnel, enter into contracts or make other necessary 
 47.24  arrangements, and establish other policies when necessary. 
 47.25     Subd. 4.  [CHAIR.] The governor shall select one of the 
 47.26  commissioners to serve as the chair for a term concurrent with 
 47.27  that of the governor.  If a vacancy occurs in the position of 
 47.28  chair, the governor shall select a new chair to complete the 
 47.29  expired term.  
 47.30     Subd. 5.  [POWERS.] Members may obtain official data, carry 
 47.31  out or award grants or contracts for original research, and 
 47.32  adopt procedures allowing interested parties to submit 
 47.33  information for the commission's use in making reports and 
 47.34  recommendations. 
 47.35     Subd. 6.  [VACANCIES.] Members serve five-year terms except 
 47.36  that three of the initial appointments are for one year, three 
 48.1   are for three years, and three are for five years.  Any member 
 48.2   appointed by the governor to fill a vacancy occurring before the 
 48.3   expiration of the term will be appointed only for the remainder 
 48.4   of that term. 
 48.5      Subd. 7.  [QUORUM.] A majority of the commissioners present 
 48.6   constitutes a quorum, and any act or decision by a majority of 
 48.7   the commissioners present, when a quorum is present, constitutes 
 48.8   the act or decision of the commission.  If a vacancy exists on 
 48.9   the commission, a majority of the remaining commissioners 
 48.10  constitutes a quorum. 
 48.11     Subd. 8.  [COMPENSATION.] Commission members are entitled 
 48.12  to a per diem and expenses reimbursed as provided in section 
 48.13  15.0575.  Travel expenses must be authorized by the chair of the 
 48.14  commission. 
 48.15     Subd. 9.  [AGENDAS AND REVIEWS.] The commission will 
 48.16  consult periodically with the chair of the committee on ways and 
 48.17  means in the house and the finance committee in the senate, 
 48.18  regarding the commission's agenda and progress toward achieving 
 48.19  the agenda. 
 48.20     Subd. 10.  [AGENCY REPORTS.] A report submitted by the 
 48.21  department of health or the department of human services to the 
 48.22  legislature relating to long-term care quality or payment 
 48.23  policies must also be submitted to the commission.  The 
 48.24  commission must review the report and submit comments or 
 48.25  recommendations to the legislature. 
 48.26     Sec. 2.  [256M.41] [DETERMINATION OF PAYMENT SYSTEM FOR 
 48.27  NURSING FACILITIES.] 
 48.28     Subdivision 1.  [CHARGE TO THE COMMISSION.] The quality and 
 48.29  payment review commission established under section 256M.40 
 48.30  shall make recommendations, by February 15, 2002, to the 
 48.31  legislature on a new operating payment system for nursing 
 48.32  facilities receiving medical assistance payment.  The new system 
 48.33  is effective July 1, 2002. 
 48.34     Subd. 2.  [SYSTEM COMPONENTS.] In establishing new 
 48.35  operating payment rates, the commission must: 
 48.36     (1) conduct, or contract for, a time study to determine how 
 49.1   much nursing and nonnursing time is currently being spent on the 
 49.2   various case mix categories, to include all nursing positions as 
 49.3   well as facility-wide staffing such as activities and social 
 49.4   services; 
 49.5      (2) recommend adjustments to the case mix weights based on 
 49.6   time study data; 
 49.7      (3) recommend changes to current laws, regulations, and 
 49.8   reimbursement practices that encourage the development and use 
 49.9   of private rooms in nursing facilities; 
 49.10     (4) determine whether the current staffing standard is 
 49.11  adequate for providing quality care and subacute level of 
 49.12  services; and if not, determine an appropriate staffing standard 
 49.13  for the various case mix categories or specialization; and the 
 49.14  financial implications of phasing into this standard over the 
 49.15  next five years; 
 49.16     (5) calculate adjustment factors to the cost base for 
 49.17  facilities in effect on July 1, 2001, that will: 
 49.18     (i) increase the staffing levels and pay rates of facility 
 49.19  staff; 
 49.20     (ii) provide a geographic differential that will increase 
 49.21  the lower rate facilities a greater percentage than higher rate 
 49.22  facilities, and establish an operating payment floor; 
 49.23     (iii) provide an inflationary adjustment index appropriate 
 49.24  for long-term care service increases; and 
 49.25     (iv) provide a mechanism for facility payment for loan 
 49.26  forgiveness and tuition payment for facility staff; 
 49.27     (6) recommend methodology within the payment system to 
 49.28  adjust rates in response to new legislative or regulatory 
 49.29  mandates, addressing the issue of unfunded mandates; 
 49.30     (7) recommend appropriate thresholds or levels for 
 49.31  operating margins or return on investment and mechanisms for 
 49.32  building the levels into future rate setting; 
 49.33     (8) analyze the value of continuing the prohibited 
 49.34  practices provisions under section 256B.48, subdivision 1; 
 49.35     (9) establish a standard for equal rates for nursing 
 49.36  facility residents, regardless of payment source, in terms of 
 50.1   costs to the system, impact on private room development, and 
 50.2   medical assistance spenddown rates; and 
 50.3      (10) recommend a rate appeals process for nursing 
 50.4   facilities impacted by the new payment system. 
 50.5      Sec. 3.  [256M.42] [RATE ADJUSTMENTS EFFECTIVE JULY 1, 
 50.6   2001.] 
 50.7      Subdivision 1.  [NURSING FACILITY RATES.] (a) For the rate 
 50.8   years beginning after June 30, 2001, the commissioner shall make 
 50.9   available to each nursing facility reimbursed under this section 
 50.10  or section 256B.434, an adjustment to the total operating 
 50.11  payment rate.  Operating payment rate increases under this 
 50.12  subdivision must be applied to each facility's operating payment 
 50.13  rate as of the last day before the beginning of the rate year.  
 50.14  The prior operating payment rate must include the increases 
 50.15  under section 256B.431, subdivision 28, and the salary 
 50.16  adjustment in section 256B.431, subdivision 2i. 
 50.17     (b) The operating rate adjustment for each year must be 
 50.18  calculated as follows: 
 50.19     (1) an increase equal to the operating payment rate at the 
 50.20  end of the prior year times the Data Resources, Inc. forecast of 
 50.21  the nursing home market basket index in the fourth quarter of 
 50.22  the calendar year preceding the rate year, based on the 12-month 
 50.23  period from the midpoint of the previous rate year to the 
 50.24  midpoint of the rate year for which the rate is being 
 50.25  determined, plus three percent; 
 50.26     (2) an additional increase equal to $1 times all of the 
 50.27  compensated hours, including nursing pool hours, reported on the 
 50.28  most recent cost report.  Facilities reimbursed under section 
 50.29  256B.434, which do not file a cost report, must report their 
 50.30  compensated hours for each cost report year on a form specified 
 50.31  by the commissioner. 
 50.32     (c) The increase described in paragraph (b), clause (2), 
 50.33  must be used only for the compensation, either salary or 
 50.34  benefits, of employees.  The funds in paragraph (b), clause (2), 
 50.35  may be used to hire additional employees.  The funds in 
 50.36  paragraph (b), clause (2), may be applied to increases 
 51.1   previously agreed to between a nursing home and an exclusive 
 51.2   bargaining representative.  The commissioner may request from 
 51.3   each facility a report on how funds provided in paragraph (b), 
 51.4   clause (2), are spent.  
 51.5      (d) The increases identified in paragraphs (a) to (c), 
 51.6   shall continue each subsequent rate year until the payment 
 51.7   system established under section 256M.41 is implemented. 
 51.8      Subd. 2.  [ADDITIONAL INCREASES FOR LOW RATE 
 51.9   FACILITIES.] Before the calculation of the increases in 
 51.10  subdivision 1, paragraphs (a) to (d), the commissioner must 
 51.11  provide for special increases to facilities determined to be the 
 51.12  lowest rate facilities in the state.  The commissioner shall 
 51.13  place all nursing facilities under section 256B.431 or 256B.434 
 51.14  into one of the state development regions designated under 
 51.15  section 462.385.  Within each of the development regions, the 
 51.16  commissioner shall identify the median nursing facility rates by 
 51.17  case mix category.  Nursing home rates that are below the median 
 51.18  must be adjusted to the greater of their current rates or 98 
 51.19  percent of the region median.  Certified boarding care home 
 51.20  rates that are below the median must be adjusted to the greater 
 51.21  of their current rates or 90 percent of the region median. 
 51.22     Subd. 3.  [CONTRACTS FOR SERVICES FOR VENTILATOR DEPENDENT 
 51.23  PERSONS.] (a) The commissioner may contract with a nursing 
 51.24  facility eligible to receive medical assistance payments to 
 51.25  provide services to a ventilator dependent person identified by 
 51.26  the commissioner according to criteria developed by the 
 51.27  commissioner, including:  
 51.28     (1) when nursing facility care has been recommended for the 
 51.29  person by a preadmission screening team; 
 51.30     (2) when the person has been assessed at case mix 
 51.31  classification K; 
 51.32     (3) when the person no longer requires inpatient acute care 
 51.33  hospital services; and 
 51.34     (4) when the commissioner has determined that necessary 
 51.35  services for the person cannot be provided under existing 
 51.36  nursing facility rates.  
 52.1      (b) The commissioner may issue a request for proposals to 
 52.2   provide services to a ventilator dependent person to nursing 
 52.3   facilities eligible to receive medical assistance payments and 
 52.4   shall select nursing facilities from among respondents according 
 52.5   to criteria developed by the commissioner, including:  
 52.6      (1) the cost-effectiveness and appropriateness of services; 
 52.7      (2) the nursing facility's compliance with federal and 
 52.8   state licensing and certification standards; and 
 52.9      (3) the proximity of the nursing facility to a 
 52.10  ventilator-dependent person identified by the commissioner who 
 52.11  requires nursing facility placement.  
 52.12     (c) The commissioner may negotiate an adjustment to the 
 52.13  operating cost payment rate for a nursing facility selected by 
 52.14  the commissioner from among respondents to the request for 
 52.15  proposals.  The negotiated adjustment must reflect only the 
 52.16  actual additional cost of meeting the specialized care needs of 
 52.17  a ventilator-dependent person identified by the commissioner for 
 52.18  whom necessary services cannot be provided under existing 
 52.19  nursing facility rates and which are not otherwise covered under 
 52.20  Minnesota Rules, parts 9549.0010 to 9549.0080 or 9505.0170 to 
 52.21  9505.0475.  The negotiated payment rate must be set at a minimum 
 52.22  of 200 percent of the most recent highest multiple bedroom 
 52.23  payment rate for the nursing facility requesting a negotiated 
 52.24  rate. 
 52.25     Subd. 4.  [PROPERTY COSTS AFTER JULY 1, 1988.] (a) 
 52.26  [INVESTMENT PER BED LIMIT.] For the rate year beginning July 1, 
 52.27  1988, the replacement-cost-new per bed limit must be $32,571 per 
 52.28  licensed bed in multiple bedrooms and $48,857 per licensed bed 
 52.29  in a single bedroom.  For the rate year beginning July 1, 1989, 
 52.30  the replacement-cost-new per bed limit for a single bedroom must 
 52.31  be $49,907 adjusted according to Minnesota Rules, part 
 52.32  9549.0060, subpart 4, item A, subitem (1).  Beginning January 1, 
 52.33  1990, the replacement-cost-new per bed limits must be adjusted 
 52.34  annually as specified in Minnesota Rules, part 9549.0060, 
 52.35  subpart 4, item A, subitem (1).  Beginning January 1, 1991, the 
 52.36  replacement-cost-new per bed limits will be adjusted annually as 
 53.1   specified in Minnesota Rules, part 9549.0060, subpart 4, item A, 
 53.2   subitem (1), except that the index utilized will be the Bureau 
 53.3   of the Census:  Composite fixed-weighted price index as 
 53.4   published in the C30 Report, Value of New Construction Put in 
 53.5   Place plus ten percent. 
 53.6      (b) [RENTAL FACTOR.] For the rate year beginning July 1, 
 53.7   1988, the commissioner shall increase the rental factor as 
 53.8   established in Minnesota Rules, part 9549.0060, subpart 8, item 
 53.9   A, by 6.2 percent rounded to the nearest 100th percent for the 
 53.10  purpose of reimbursing nursing facilities for soft costs and 
 53.11  entrepreneurial profits not included in the cost valuation 
 53.12  services used by the state's contracted appraisers.  For rate 
 53.13  years beginning on or after July 1, 1989, the rental factor is 
 53.14  the amount determined under this paragraph for the rate year 
 53.15  beginning July 1, 1988. 
 53.16     (c) [OCCUPANCY FACTOR.] For rate years beginning on or 
 53.17  after July 1, 1988, in order to determine property-related 
 53.18  payment rates under Minnesota Rules, part 9549.0060, for all 
 53.19  nursing facilities except those whose average length of stay in 
 53.20  a skilled level of care within a nursing facility is 180 days or 
 53.21  less, the commissioner shall use 95 percent of capacity days.  
 53.22  For a nursing facility whose average length of stay in a skilled 
 53.23  level of care within a nursing facility is 180 days or less, the 
 53.24  commissioner shall use the greater of resident days or 80 
 53.25  percent of capacity days but the divisor must not exceed 95 
 53.26  percent of capacity days. 
 53.27     (d) [EQUIPMENT ALLOWANCE.] For rate years beginning on July 
 53.28  1, 1988, and July 1, 1989, the commissioner shall add ten cents 
 53.29  per resident per day to each nursing facility's property-related 
 53.30  payment rate.  The ten-cent property-related payment rate 
 53.31  increase is not cumulative from rate year to rate year.  For the 
 53.32  rate year beginning July 1, 1990, the commissioner shall 
 53.33  increase each nursing facility's equipment allowance as 
 53.34  established in Minnesota Rules, part 9549.0060, subpart 10, by 
 53.35  ten cents per resident per day.  For rate years beginning after 
 53.36  June 30, 1991, the adjusted equipment allowance must be adjusted 
 54.1   annually for inflation as in Minnesota Rules, part 9549.0060, 
 54.2   subpart 10, item E.  For the rate period beginning October 1, 
 54.3   1992, the equipment allowance for each nursing facility shall be 
 54.4   increased by 28 percent.  For rate years beginning after June 
 54.5   30, 1993, the allowance must be adjusted annually for inflation. 
 54.6      (e) [POST CHAPTER 199 RELATED-ORGANIZATION DEBTS AND 
 54.7   INTEREST EXPENSE.] For rate years beginning after June 30, 1990, 
 54.8   Minnesota Rules, part 9549.0060, subpart 5, item E, does not 
 54.9   apply to outstanding related organization debt incurred before 
 54.10  May 23, 1983, provided that the debt was an allowable debt under 
 54.11  Minnesota Rules, parts 9510.0010 to 9510.0480, the debt is 
 54.12  subject to repayment through annual principal payments, and the 
 54.13  nursing facility demonstrates to the commissioner's satisfaction 
 54.14  that the interest rate on the debt was less than market interest 
 54.15  rates for similar arms-length transactions at the time the debt 
 54.16  was incurred.  If the debt was incurred due to a sale between 
 54.17  family members, the nursing facility must also demonstrate that 
 54.18  the seller no longer participates in the management or operation 
 54.19  of the nursing facility.  Debts meeting the conditions of this 
 54.20  paragraph are subject to all other provisions of Minnesota 
 54.21  Rules, parts 9549.0010 to 9549.0080. 
 54.22     (f) [BUILDING CAPITAL ALLOWANCE FOR NURSING FACILITIES WITH 
 54.23  OPERATING LEASES.] For rate years beginning on or after July 1, 
 54.24  1990, a nursing facility with operating lease costs incurred for 
 54.25  the nursing facility's buildings shall receive a building 
 54.26  capital allowance computed according to Minnesota Rules, part 
 54.27  9549.0060, subpart 8.  If an operating lease provides that the 
 54.28  lessee's rent is adjusted to recognize improvements made by the 
 54.29  lessor and related debt, the costs for capital improvements and 
 54.30  related debt shall be allowed in the computation of the lessee's 
 54.31  building capital allowance, but the reimbursement for these 
 54.32  costs under an operating lease must not exceed the rate 
 54.33  otherwise paid. 
 54.34     Subd. 5.  [ALTERNATE RATES FOR NURSING FACILITIES.] (a) The 
 54.35  commissioner shall establish a rate under this subdivision for 
 54.36  nursing facilities that have their payment rates determined 
 55.1   under this section rather than section 256B.431.  The nursing 
 55.2   facility must enter into a written contract with the 
 55.3   commissioner. 
 55.4      (b) A nursing facility's case mix payment rate for the 
 55.5   first rate year of a facility's contract under this section is 
 55.6   the payment rate the facility would have received under section 
 55.7   256B.431. 
 55.8      (c) A nursing facility's case mix payment rate for the 
 55.9   second and later years of a facility's contract under this 
 55.10  section are the previous rate year's contract payment rates plus 
 55.11  increases established under subdivision 1.  A nursing facility's 
 55.12  property payment rate is increased annually by an inflation 
 55.13  adjustment.  The index for the inflation adjustment must be 
 55.14  based on the change in the Consumer Price Index-All Items 
 55.15  (United States City average) (CPI-U) forecasted by Data 
 55.16  Resources, Inc., as forecasted in the fourth quarter of the last 
 55.17  calendar year before the rate year.  The inflation adjustment 
 55.18  must be based on the 12-month period from the midpoint of the 
 55.19  last rate year to the midpoint of the rate year for which the 
 55.20  rate is being determined.  In determining the amount of the 
 55.21  property-related payment rate adjustment under this paragraph, 
 55.22  the commissioner shall determine the proportion of the 
 55.23  facility's rates that are property-related based on the 
 55.24  facility's most recent cost report. 
 55.25     (d) The commissioner shall develop additional 
 55.26  incentive-based payments of up to five percent above the 
 55.27  standard contract rate for achieving outcomes specified in each 
 55.28  contract.  The specified facility-specific outcomes must be 
 55.29  measurable and approved by the commissioner.  The commissioner 
 55.30  may establish, for each contract, various levels of achievement 
 55.31  within an outcome.  After the outcomes have been specified the 
 55.32  commissioner shall assign various levels of payment associated 
 55.33  with achieving the outcome.  Any incentive-based payment cancels 
 55.34  if there is a termination of the contract.  In establishing the 
 55.35  specified outcomes and related criteria the commissioner shall 
 55.36  consider the following state policy objectives: 
 56.1      (1) improved cost effectiveness and quality of life as 
 56.2   measured by improved clinical outcomes; 
 56.3      (2) successful diversion or discharge to community 
 56.4   alternatives; 
 56.5      (3) decreased acute care costs; 
 56.6      (4) improved consumer satisfaction; 
 56.7      (5) the achievement of quality; or 
 56.8      (6) any additional outcomes proposed by a nursing facility 
 56.9   that the commissioner finds desirable. 
 56.10     Subd. 6.  [OTHER PROVIDER INCREASES.] (a) The commissioner 
 56.11  shall increase reimbursement rates by 12 percent in the first 
 56.12  and second years of the biennium for the providers listed in 
 56.13  paragraph (b).  The increases are effective for services 
 56.14  rendered after June 30 of each year. 
 56.15     (b) The rate increases described in this section must be 
 56.16  provided to home and community-based waivered services for the 
 56.17  elderly under section 256B.0915; nursing services and home 
 56.18  health services under section 256B.0625, subdivision 6a; 
 56.19  personal care services and nursing supervision of personal care 
 56.20  services under section 256B.0625, subdivision 19a; private-duty 
 56.21  nursing services under section 256B.0625, subdivision 7; 
 56.22  alternative care services under section 256B.0913; and group 
 56.23  residential housing supplementary service rate under section 
 56.24  256I.05, subdivision 1a. 
 56.25     Sec. 4.  [256M.43] [ESTABLISHMENT OF LONG-TERM CARE 
 56.26  REVOLVING FUND.] 
 56.27     At the end of each state fiscal year, any unspent and 
 56.28  unencumbered state general fund appropriations for long-term 
 56.29  care for the elderly, including nursing facility, elderly 
 56.30  waiver, alternative care, and home care services, must be 
 56.31  deposited in the long-term care enhancement fund, which is 
 56.32  established.  Money in the long-term care enhancement fund may 
 56.33  be used only to enhance long-term care services in the state 
 56.34  through capital or other one-time investment projects or through 
 56.35  provider rate increases that are greater than the rate of 
 56.36  inflation, measured by the Data Resources, Inc. forecast of the 
 57.1   nursing home market basket index in the fourth quarter of the 
 57.2   calendar year preceding the rate year, based on the 12-month 
 57.3   period from the midpoint of the last rate year to the midpoint 
 57.4   of the rate year for which funds are being appropriated.  Each 
 57.5   year that the long-term care enhancement fund is forecast to 
 57.6   have a balance, the commission created under section 2 shall 
 57.7   designate the use of the funds. 
 57.8      Sec. 5.  [256M.44] [REGULATORY IMPACT REVIEW.] 
 57.9      State agencies proposing new regulations or new 
 57.10  interpretations of existing regulations in the area of housing 
 57.11  and service delivery for older adults must submit a copy of the 
 57.12  proposed changes to the quality and payment review commission 
 57.13  for a regulatory financial impact statement and approval.  If 
 57.14  the commission determines the proposed regulation or new 
 57.15  interpretation has a financial impact on the programs or 
 57.16  consumers receiving the service and approves adoption of the 
 57.17  rule, the commission shall provide recommendations on how to 
 57.18  fund the new mandate. 
 57.19                             ARTICLE 4 
 57.20                     INFRASTRUCTURE CONVERSION 
 57.21     Section 1.  Minnesota Statutes 2000, section 144A.071, 
 57.22  subdivision 1, is amended to read: 
 57.23     144A.071 [MORATORIUM ON CERTIFICATION OF NURSING HOME 
 57.24  BEDS.] 
 57.25     Subdivision 1.  [FINDINGS.] The legislature declares that a 
 57.26  moratorium on the licensure and medical assistance certification 
 57.27  of new nursing home beds and construction projects that 
 57.28  exceed $750,000 $1,000,000 or 25 percent of the facility's 
 57.29  appraised value, whichever is greater, is necessary to control 
 57.30  nursing home expenditure growth and enable the state to meet the 
 57.31  needs of its elderly by providing high quality services in the 
 57.32  most appropriate manner along a continuum of care.  
 57.33     Sec. 2.  Minnesota Statutes 2000, section 144A.071, 
 57.34  subdivision 1a, is amended to read: 
 57.35     Subd. 1a.  [DEFINITIONS.] For purposes of sections 144A.071 
 57.36  to 144A.073, the following terms have the meanings given them: 
 58.1      (a) "attached fixtures" has the meaning given in Minnesota 
 58.2   Rules, part 9549.0020, subpart 6. 
 58.3      (b) "buildings" has the meaning given in Minnesota Rules, 
 58.4   part 9549.0020, subpart 7. 
 58.5      (c) "capital assets" has the meaning given in section 
 58.6   256B.421, subdivision 16. 
 58.7      (d) "commenced construction" means that all of the 
 58.8   following conditions were met:  the final working drawings and 
 58.9   specifications were approved by the commissioner of health; the 
 58.10  construction contracts were let; a timely construction schedule 
 58.11  was developed, stipulating dates for beginning, achieving 
 58.12  various stages, and completing construction; and all zoning and 
 58.13  building permits were applied for. 
 58.14     (e) "completion date" means the date on which a certificate 
 58.15  of occupancy is issued for a construction project, or if a 
 58.16  certificate of occupancy is not required, the date on which the 
 58.17  construction project is available for facility use. 
 58.18     (f) "construction" means any erection, building, 
 58.19  alteration, reconstruction, modernization, or improvement 
 58.20  necessary to comply with the nursing home licensure rules. 
 58.21     (g) "construction project" means: 
 58.22     (1) a capital asset addition to, or replacement of a 
 58.23  nursing home or certified boarding care home that results in new 
 58.24  space or the remodeling of or renovations to existing facility 
 58.25  space; 
 58.26     (2) the remodeling or renovation of existing facility space 
 58.27  the use of which is modified as a result of the project 
 58.28  described in clause (1).  This existing space and the project 
 58.29  described in clause (1) must be used for the functions as 
 58.30  designated on the construction plans on completion of the 
 58.31  project described in clause (1) for a period of not less than 24 
 58.32  months; or 
 58.33     (3) capital asset additions or replacements that are 
 58.34  completed within 12 months before or after the completion date 
 58.35  of the project described in clause (1). 
 58.36     (h) "new licensed" or "new certified beds" means: 
 59.1      (1) newly constructed beds in a facility or the 
 59.2   construction of a new facility that would increase the total 
 59.3   number of licensed nursing home beds or certified boarding care 
 59.4   or nursing home beds in the state; or 
 59.5      (2) newly licensed nursing home beds or newly certified 
 59.6   boarding care or nursing home beds that result from remodeling 
 59.7   of the facility that involves relocation of beds but does not 
 59.8   result in an increase in the total number of beds, except when 
 59.9   the project involves the upgrade of boarding care beds to 
 59.10  nursing home beds, as defined in section 144A.073, subdivision 
 59.11  1.  "Remodeling" includes any of the type of conversion, 
 59.12  renovation, replacement, or upgrading projects as defined in 
 59.13  section 144A.073, subdivision 1. 
 59.14     (i) "project construction costs" means the cost of the 
 59.15  facility capital asset additions, replacements, renovations, or 
 59.16  remodeling projects, construction site preparation costs, and 
 59.17  related soft costs.  Project construction costs also include the 
 59.18  cost of any remodeling or renovation of existing facility space 
 59.19  which is modified as a result of the construction 
 59.20  project.  Project construction costs also includes the cost of 
 59.21  new technology implemented as part of the construction project. 
 59.22     (j) "technology" means information systems or devices that 
 59.23  make documentation, charting, and staff time more efficient or 
 59.24  encourage and allow for care through alternative settings 
 59.25  including, but not limited to, touch screens, monitors, 
 59.26  hand-helds, swipe cards, motion detectors, pagers, telemedicine, 
 59.27  medication dispensers, and equipment to monitor vital signs and 
 59.28  self-injections, and to observe skin and other conditions. 
 59.29     Sec. 3.  Minnesota Statutes 2000, section 144A.071, 
 59.30  subdivision 2, is amended to read: 
 59.31     Subd. 2.  [MORATORIUM.] The commissioner of health, in 
 59.32  coordination with the commissioner of human services, shall deny 
 59.33  each request for new licensed or certified nursing home or 
 59.34  certified boarding care beds except as provided in subdivision 3 
 59.35  or 4a, or section 144A.073.  "Certified bed" means a nursing 
 59.36  home bed or a boarding care bed certified by the commissioner of 
 60.1   health for the purposes of the medical assistance program, under 
 60.2   United States Code, title 42, sections 1396 et seq.  
 60.3      The commissioner of human services, in coordination with 
 60.4   the commissioner of health, shall deny any request to issue a 
 60.5   license under section 252.28 and chapter 245A to a nursing home 
 60.6   or boarding care home, if that license would result in an 
 60.7   increase in the medical assistance reimbursement amount.  
 60.8      In addition, the commissioner of health must not approve 
 60.9   any construction project whose cost exceeds $750,000 $1,000,000 
 60.10  or 25 percent of the facility's appraised value is greater, 
 60.11  unless: 
 60.12     (a) any construction costs exceeding $750,000 $1,000,000 or 
 60.13  25 percent of the facility's appraised value, whichever is 
 60.14  greater, are not added to the facility's appraised value and are 
 60.15  not included in the facility's payment rate for reimbursement 
 60.16  under the medical assistance program; or 
 60.17     (b) the project: 
 60.18     (1) has been approved through the process described in 
 60.19  section 144A.073; 
 60.20     (2) meets an exception in subdivision 3 or 4a; 
 60.21     (3) is necessary to correct violations of state or federal 
 60.22  law issued by the commissioner of health; 
 60.23     (4) is necessary to repair or replace a portion of the 
 60.24  facility that was damaged by fire, lightning, groundshifts, or 
 60.25  other such hazards, including environmental hazards, provided 
 60.26  that the provisions of subdivision 4a, clause (a), are met; 
 60.27     (5) as of May 1, 1992, the facility has submitted to the 
 60.28  commissioner of health written documentation evidencing that the 
 60.29  facility meets the "commenced construction" definition as 
 60.30  specified in subdivision 1a, clause (d), or that substantial 
 60.31  steps have been taken prior to April 1, 1992, relating to the 
 60.32  construction project.  "Substantial steps" require that the 
 60.33  facility has made arrangements with outside parties relating to 
 60.34  the construction project and include the hiring of an architect 
 60.35  or construction firm, submission of preliminary plans to the 
 60.36  department of health or documentation from a financial 
 61.1   institution that financing arrangements for the construction 
 61.2   project have been made; or 
 61.3      (6) is being proposed by a licensed nursing facility that 
 61.4   is not certified to participate in the medical assistance 
 61.5   program and will not result in new licensed or certified beds. 
 61.6      Prior to the final plan approval of any construction 
 61.7   project, the commissioner of health shall be provided with an 
 61.8   itemized cost estimate for the project construction costs.  If a 
 61.9   construction project is anticipated to be completed in phases, 
 61.10  the total estimated cost of all phases of the project shall be 
 61.11  submitted to the commissioner and shall be considered as one 
 61.12  construction project.  Once the construction project is 
 61.13  completed and prior to the final clearance by the commissioner, 
 61.14  the total project construction costs for the construction 
 61.15  project shall be submitted to the commissioner.  If the final 
 61.16  project construction cost exceeds the dollar threshold in this 
 61.17  subdivision, the commissioner of human services shall not 
 61.18  recognize any of the project construction costs or the related 
 61.19  financing costs in excess of this threshold in establishing the 
 61.20  facility's property-related payment rate. 
 61.21     The dollar thresholds for construction projects are as 
 61.22  follows:  for construction projects other than those authorized 
 61.23  in clauses (1) to (6), the dollar threshold 
 61.24  is $750,000 $1,000,000 or 25 percent of the facility's appraised 
 61.25  value, whichever is greater.  For projects authorized after July 
 61.26  1, 1993, under clause (1), the dollar threshold is the cost 
 61.27  estimate submitted with a proposal for an exception under 
 61.28  section 144A.073, plus inflation as calculated according to 
 61.29  section 256B.431, subdivision 3f, paragraph (a).  For projects 
 61.30  authorized under clauses (2) to (4), the dollar threshold is the 
 61.31  itemized estimate project construction costs submitted to the 
 61.32  commissioner of health at the time of final plan approval, plus 
 61.33  inflation as calculated according to section 256B.431, 
 61.34  subdivision 3f, paragraph (a). 
 61.35     The commissioner of health shall adopt rules to implement 
 61.36  this section or to amend the emergency rules for granting 
 62.1   exceptions to the moratorium on nursing homes under section 
 62.2   144A.073.  
 62.3      Sec. 4.  Minnesota Statutes 2000, section 144A.071, 
 62.4   subdivision 4a, is amended to read: 
 62.5      Subd. 4a.  [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 
 62.6   best interest of the state to ensure that nursing homes and 
 62.7   boarding care homes continue to meet the physical plant 
 62.8   licensing and certification requirements by permitting certain 
 62.9   construction projects.  Facilities should be maintained in 
 62.10  condition to satisfy the physical and emotional needs of 
 62.11  residents while allowing the state to maintain control over 
 62.12  nursing home expenditure growth. 
 62.13     The commissioner of health in coordination with the 
 62.14  commissioner of human services, may approve the renovation, 
 62.15  replacement, upgrading, or relocation of a nursing home or 
 62.16  boarding care home, under the following conditions: 
 62.17     (a) to license or certify beds in a new facility 
 62.18  constructed to replace a facility or to make repairs in an 
 62.19  existing facility that was destroyed or damaged after June 30, 
 62.20  1987, by fire, lightning, or other hazard provided:  
 62.21     (i) destruction was not caused by the intentional act of or 
 62.22  at the direction of a controlling person of the facility; 
 62.23     (ii) at the time the facility was destroyed or damaged the 
 62.24  controlling persons of the facility maintained insurance 
 62.25  coverage for the type of hazard that occurred in an amount that 
 62.26  a reasonable person would conclude was adequate; 
 62.27     (iii) the net proceeds from an insurance settlement for the 
 62.28  damages caused by the hazard are applied to the cost of the new 
 62.29  facility or repairs; 
 62.30     (iv) the new facility is constructed on the same site as 
 62.31  the destroyed facility or on another site subject to the 
 62.32  restrictions in section 144A.073, subdivision 5; 
 62.33     (v) the number of licensed and certified beds in the new 
 62.34  facility does not exceed the number of licensed and certified 
 62.35  beds in the destroyed facility; and 
 62.36     (vi) the commissioner determines that the replacement beds 
 63.1   are needed to prevent an inadequate supply of beds. 
 63.2   Project construction costs incurred for repairs authorized under 
 63.3   this clause shall not be considered in the dollar threshold 
 63.4   amount defined in subdivision 2; 
 63.5      (b) to license or certify beds that are moved from one 
 63.6   location to another within a nursing home facility, provided the 
 63.7   total costs of remodeling performed in conjunction with the 
 63.8   relocation of beds does not exceed $750,000 $1,000,000 or 25 
 63.9   percent of appraised value, whichever is greater; 
 63.10     (c) to license or certify beds in a project recommended for 
 63.11  approval under section 144A.073; 
 63.12     (d) to license or certify beds that are moved from an 
 63.13  existing state nursing home to a different state facility, 
 63.14  provided there is no net increase in the number of state nursing 
 63.15  home beds; 
 63.16     (e) to certify and license as nursing home beds boarding 
 63.17  care beds in a certified boarding care facility if the beds meet 
 63.18  the standards for nursing home licensure, or in a facility that 
 63.19  was granted an exception to the moratorium under section 
 63.20  144A.073, and if the cost of any remodeling of the facility does 
 63.21  not exceed $750,000 $1,000,000 or 25 percent of appraised value, 
 63.22  whichever is greater.  If boarding care beds are licensed as 
 63.23  nursing home beds, the number of boarding care beds in the 
 63.24  facility must not increase beyond the number remaining at the 
 63.25  time of the upgrade in licensure.  The provisions contained in 
 63.26  section 144A.073 regarding the upgrading of the facilities do 
 63.27  not apply to facilities that satisfy these requirements; 
 63.28     (f) to license and certify up to 40 beds transferred from 
 63.29  an existing facility owned and operated by the Amherst H. Wilder 
 63.30  Foundation in the city of St. Paul to a new unit at the same 
 63.31  location as the existing facility that will serve persons with 
 63.32  Alzheimer's disease and other related disorders.  The transfer 
 63.33  of beds may occur gradually or in stages, provided the total 
 63.34  number of beds transferred does not exceed 40.  At the time of 
 63.35  licensure and certification of a bed or beds in the new unit, 
 63.36  the commissioner of health shall delicense and decertify the 
 64.1   same number of beds in the existing facility.  As a condition of 
 64.2   receiving a license or certification under this clause, the 
 64.3   facility must make a written commitment to the commissioner of 
 64.4   human services that it will not seek to receive an increase in 
 64.5   its property-related payment rate as a result of the transfers 
 64.6   allowed under this paragraph; 
 64.7      (g) to license and certify nursing home beds to replace 
 64.8   currently licensed and certified boarding care beds which may be 
 64.9   located either in a remodeled or renovated boarding care or 
 64.10  nursing home facility or in a remodeled, renovated, newly 
 64.11  constructed, or replacement nursing home facility within the 
 64.12  identifiable complex of health care facilities in which the 
 64.13  currently licensed boarding care beds are presently located, 
 64.14  provided that the number of boarding care beds in the facility 
 64.15  or complex are decreased by the number to be licensed as nursing 
 64.16  home beds and further provided that, if the total costs of new 
 64.17  construction, replacement, remodeling, or renovation exceed ten 
 64.18  percent of the appraised value of the facility or $200,000, 
 64.19  whichever is less, the facility makes a written commitment to 
 64.20  the commissioner of human services that it will not seek to 
 64.21  receive an increase in its property-related payment rate by 
 64.22  reason of the new construction, replacement, remodeling, or 
 64.23  renovation.  The provisions contained in section 144A.073 
 64.24  regarding the upgrading of facilities do not apply to facilities 
 64.25  that satisfy these requirements; 
 64.26     (h) to license as a nursing home and certify as a nursing 
 64.27  facility a facility that is licensed as a boarding care facility 
 64.28  but not certified under the medical assistance program, but only 
 64.29  if the commissioner of human services certifies to the 
 64.30  commissioner of health that licensing the facility as a nursing 
 64.31  home and certifying the facility as a nursing facility will 
 64.32  result in a net annual savings to the state general fund of 
 64.33  $200,000 or more; 
 64.34     (i) to certify, after September 30, 1992, and prior to July 
 64.35  1, 1993, existing nursing home beds in a facility that was 
 64.36  licensed and in operation prior to January 1, 1992; 
 65.1      (j) to license and certify new nursing home beds to replace 
 65.2   beds in a facility acquired by the Minneapolis community 
 65.3   development agency as part of redevelopment activities in a city 
 65.4   of the first class, provided the new facility is located within 
 65.5   three miles of the site of the old facility.  Operating and 
 65.6   property costs for the new facility must be determined and 
 65.7   allowed under section 256B.431 or 256B.434; 
 65.8      (k) to license and certify up to 20 new nursing home beds 
 65.9   in a community-operated hospital and attached convalescent and 
 65.10  nursing care facility with 40 beds on April 21, 1991, that 
 65.11  suspended operation of the hospital in April 1986.  The 
 65.12  commissioner of human services shall provide the facility with 
 65.13  the same per diem property-related payment rate for each 
 65.14  additional licensed and certified bed as it will receive for its 
 65.15  existing 40 beds; 
 65.16     (l) to license or certify beds in renovation, replacement, 
 65.17  or upgrading projects as defined in section 144A.073, 
 65.18  subdivision 1, so long as the cumulative total costs of the 
 65.19  facility's remodeling projects do not exceed $750,000 $1,000,000 
 65.20  or 25 percent of appraised value, whichever is greater; 
 65.21     (m) to license and certify beds that are moved from one 
 65.22  location to another for the purposes of converting up to five 
 65.23  four-bed wards to single or double occupancy rooms in a nursing 
 65.24  home that, as of January 1, 1993, was county-owned and had a 
 65.25  licensed capacity of 115 beds; 
 65.26     (n) to allow a facility that on April 16, 1993, was a 
 65.27  106-bed licensed and certified nursing facility located in 
 65.28  Minneapolis to layaway all of its licensed and certified nursing 
 65.29  home beds.  These beds may be relicensed and recertified in a 
 65.30  newly-constructed teaching nursing home facility affiliated with 
 65.31  a teaching hospital upon approval by the legislature.  The 
 65.32  proposal must be developed in consultation with the interagency 
 65.33  committee on long-term care planning.  The beds on layaway 
 65.34  status shall have the same status as voluntarily delicensed and 
 65.35  decertified beds, except that beds on layaway status remain 
 65.36  subject to the surcharge in section 256.9657.  This layaway 
 66.1   provision expires July 1, 1998; 
 66.2      (o) to allow a project which will be completed in 
 66.3   conjunction with an approved moratorium exception project for a 
 66.4   nursing home in southern Cass county and which is directly 
 66.5   related to that portion of the facility that must be repaired, 
 66.6   renovated, or replaced, to correct an emergency plumbing problem 
 66.7   for which a state correction order has been issued and which 
 66.8   must be corrected by August 31, 1993; 
 66.9      (p) to allow a facility that on April 16, 1993, was a 
 66.10  368-bed licensed and certified nursing facility located in 
 66.11  Minneapolis to layaway, upon 30 days prior written notice to the 
 66.12  commissioner, up to 30 of the facility's licensed and certified 
 66.13  beds by converting three-bed wards to single or double 
 66.14  occupancy.  Beds on layaway status shall have the same status as 
 66.15  voluntarily delicensed and decertified beds except that beds on 
 66.16  layaway status remain subject to the surcharge in section 
 66.17  256.9657, remain subject to the license application and renewal 
 66.18  fees under section 144A.07 and shall be subject to a $100 per 
 66.19  bed reactivation fee.  In addition, at any time within three 
 66.20  years of the effective date of the layaway, the beds on layaway 
 66.21  status may be: 
 66.22     (1) relicensed and recertified upon relocation and 
 66.23  reactivation of some or all of the beds to an existing licensed 
 66.24  and certified facility or facilities located in Pine River, 
 66.25  Brainerd, or International Falls; provided that the total 
 66.26  project construction costs related to the relocation of beds 
 66.27  from layaway status for any facility receiving relocated beds 
 66.28  may not exceed the dollar threshold provided in subdivision 2 
 66.29  unless the construction project has been approved through the 
 66.30  moratorium exception process under section 144A.073; 
 66.31     (2) relicensed and recertified, upon reactivation of some 
 66.32  or all of the beds within the facility which placed the beds in 
 66.33  layaway status, if the commissioner has determined a need for 
 66.34  the reactivation of the beds on layaway status. 
 66.35     The property-related payment rate of a facility placing 
 66.36  beds on layaway status must be adjusted by the incremental 
 67.1   change in its rental per diem after recalculating the rental per 
 67.2   diem as provided in section 256B.431, subdivision 3a, paragraph 
 67.3   (c).  The property-related payment rate for a facility 
 67.4   relicensing and recertifying beds from layaway status must be 
 67.5   adjusted by the incremental change in its rental per diem after 
 67.6   recalculating its rental per diem using the number of beds after 
 67.7   the relicensing to establish the facility's capacity day 
 67.8   divisor, which shall be effective the first day of the month 
 67.9   following the month in which the relicensing and recertification 
 67.10  became effective.  Any beds remaining on layaway status more 
 67.11  than three years after the date the layaway status became 
 67.12  effective must be removed from layaway status and immediately 
 67.13  delicensed and decertified; 
 67.14     (q) to license and certify beds in a renovation and 
 67.15  remodeling project to convert 12 four-bed wards into 24 two-bed 
 67.16  rooms, expand space, and add improvements in a nursing home 
 67.17  that, as of January 1, 1994, met the following conditions:  the 
 67.18  nursing home was located in Ramsey county; had a licensed 
 67.19  capacity of 154 beds; and had been ranked among the top 15 
 67.20  applicants by the 1993 moratorium exceptions advisory review 
 67.21  panel.  The total project construction cost estimate for this 
 67.22  project must not exceed the cost estimate submitted in 
 67.23  connection with the 1993 moratorium exception process; 
 67.24     (r) to license and certify up to 117 beds that are 
 67.25  relocated from a licensed and certified 138-bed nursing facility 
 67.26  located in St. Paul to a hospital with 130 licensed hospital 
 67.27  beds located in South St. Paul, provided that the nursing 
 67.28  facility and hospital are owned by the same or a related 
 67.29  organization and that prior to the date the relocation is 
 67.30  completed the hospital ceases operation of its inpatient 
 67.31  hospital services at that hospital.  After relocation, the 
 67.32  nursing facility's status under section 256B.431, subdivision 
 67.33  2j, shall be the same as it was prior to relocation.  The 
 67.34  nursing facility's property-related payment rate resulting from 
 67.35  the project authorized in this paragraph shall become effective 
 67.36  no earlier than April 1, 1996.  For purposes of calculating the 
 68.1   incremental change in the facility's rental per diem resulting 
 68.2   from this project, the allowable appraised value of the nursing 
 68.3   facility portion of the existing health care facility physical 
 68.4   plant prior to the renovation and relocation may not exceed 
 68.5   $2,490,000; 
 68.6      (s) to license and certify two beds in a facility to 
 68.7   replace beds that were voluntarily delicensed and decertified on 
 68.8   June 28, 1991; 
 68.9      (t) to allow 16 licensed and certified beds located on July 
 68.10  1, 1994, in a 142-bed nursing home and 21-bed boarding care home 
 68.11  facility in Minneapolis, notwithstanding the licensure and 
 68.12  certification after July 1, 1995, of the Minneapolis facility as 
 68.13  a 147-bed nursing home facility after completion of a 
 68.14  construction project approved in 1993 under section 144A.073, to 
 68.15  be laid away upon 30 days' prior written notice to the 
 68.16  commissioner.  Beds on layaway status shall have the same status 
 68.17  as voluntarily delicensed or decertified beds except that they 
 68.18  shall remain subject to the surcharge in section 256.9657.  The 
 68.19  16 beds on layaway status may be relicensed as nursing home beds 
 68.20  and recertified at any time within five years of the effective 
 68.21  date of the layaway upon relocation of some or all of the beds 
 68.22  to a licensed and certified facility located in Watertown, 
 68.23  provided that the total project construction costs related to 
 68.24  the relocation of beds from layaway status for the Watertown 
 68.25  facility may not exceed the dollar threshold provided in 
 68.26  subdivision 2 unless the construction project has been approved 
 68.27  through the moratorium exception process under section 144A.073. 
 68.28     The property-related payment rate of the facility placing 
 68.29  beds on layaway status must be adjusted by the incremental 
 68.30  change in its rental per diem after recalculating the rental per 
 68.31  diem as provided in section 256B.431, subdivision 3a, paragraph 
 68.32  (c).  The property-related payment rate for the facility 
 68.33  relicensing and recertifying beds from layaway status must be 
 68.34  adjusted by the incremental change in its rental per diem after 
 68.35  recalculating its rental per diem using the number of beds after 
 68.36  the relicensing to establish the facility's capacity day 
 69.1   divisor, which shall be effective the first day of the month 
 69.2   following the month in which the relicensing and recertification 
 69.3   became effective.  Any beds remaining on layaway status more 
 69.4   than five years after the date the layaway status became 
 69.5   effective must be removed from layaway status and immediately 
 69.6   delicensed and decertified; 
 69.7      (u) to license and certify beds that are moved within an 
 69.8   existing area of a facility or to a newly constructed addition 
 69.9   which is built for the purpose of eliminating three- and 
 69.10  four-bed rooms and adding space for dining, lounge areas, 
 69.11  bathing rooms, and ancillary service areas in a nursing home 
 69.12  that, as of January 1, 1995, was located in Fridley and had a 
 69.13  licensed capacity of 129 beds; 
 69.14     (v) to relocate 36 beds in Crow Wing county and four beds 
 69.15  from Hennepin county to a 160-bed facility in Crow Wing county, 
 69.16  provided all the affected beds are under common ownership; 
 69.17     (w) to license and certify a total replacement project of 
 69.18  up to 49 beds located in Norman county that are relocated from a 
 69.19  nursing home destroyed by flood and whose residents were 
 69.20  relocated to other nursing homes.  The operating cost payment 
 69.21  rates for the new nursing facility shall be determined based on 
 69.22  the interim and settle-up payment provisions of Minnesota Rules, 
 69.23  part 9549.0057, and the reimbursement provisions of section 
 69.24  256B.431, except that subdivision 26, paragraphs (a) and (b), 
 69.25  shall not apply until the second rate year after the settle-up 
 69.26  cost report is filed.  Property-related reimbursement rates 
 69.27  shall be determined under section 256B.431, taking into account 
 69.28  any federal or state flood-related loans or grants provided to 
 69.29  the facility; 
 69.30     (x) to license and certify a total replacement project of 
 69.31  up to 129 beds located in Polk county that are relocated from a 
 69.32  nursing home destroyed by flood and whose residents were 
 69.33  relocated to other nursing homes.  The operating cost payment 
 69.34  rates for the new nursing facility shall be determined based on 
 69.35  the interim and settle-up payment provisions of Minnesota Rules, 
 69.36  part 9549.0057, and the reimbursement provisions of section 
 70.1   256B.431, except that subdivision 26, paragraphs (a) and (b), 
 70.2   shall not apply until the second rate year after the settle-up 
 70.3   cost report is filed.  Property-related reimbursement rates 
 70.4   shall be determined under section 256B.431, taking into account 
 70.5   any federal or state flood-related loans or grants provided to 
 70.6   the facility; 
 70.7      (y) to license and certify beds in a renovation and 
 70.8   remodeling project to convert 13 three-bed wards into 13 two-bed 
 70.9   rooms and 13 single-bed rooms, expand space, and add 
 70.10  improvements in a nursing home that, as of January 1, 1994, met 
 70.11  the following conditions:  the nursing home was located in 
 70.12  Ramsey county, was not owned by a hospital corporation, had a 
 70.13  licensed capacity of 64 beds, and had been ranked among the top 
 70.14  15 applicants by the 1993 moratorium exceptions advisory review 
 70.15  panel.  The total project construction cost estimate for this 
 70.16  project must not exceed the cost estimate submitted in 
 70.17  connection with the 1993 moratorium exception process; 
 70.18     (z) to license and certify up to 150 nursing home beds to 
 70.19  replace an existing 285 bed nursing facility located in St. 
 70.20  Paul.  The replacement project shall include both the renovation 
 70.21  of existing buildings and the construction of new facilities at 
 70.22  the existing site.  The reduction in the licensed capacity of 
 70.23  the existing facility shall occur during the construction 
 70.24  project as beds are taken out of service due to the construction 
 70.25  process.  Prior to the start of the construction process, the 
 70.26  facility shall provide written information to the commissioner 
 70.27  of health describing the process for bed reduction, plans for 
 70.28  the relocation of residents, and the estimated construction 
 70.29  schedule.  The relocation of residents shall be in accordance 
 70.30  with the provisions of law and rule; 
 70.31     (aa) to allow the commissioner of human services to license 
 70.32  an additional 36 beds to provide residential services for the 
 70.33  physically handicapped under Minnesota Rules, parts 9570.2000 to 
 70.34  9570.3400, in a 198-bed nursing home located in Red Wing, 
 70.35  provided that the total number of licensed and certified beds at 
 70.36  the facility does not increase; 
 71.1      (bb) to license and certify a new facility in St. Louis 
 71.2   county with 44 beds constructed to replace an existing facility 
 71.3   in St. Louis county with 31 beds, which has resident rooms on 
 71.4   two separate floors and an antiquated elevator that creates 
 71.5   safety concerns for residents and prevents nonambulatory 
 71.6   residents from residing on the second floor.  The project shall 
 71.7   include the elimination of three- and four-bed rooms; 
 71.8      (cc) to license and certify four beds in a 16-bed certified 
 71.9   boarding care home in Minneapolis to replace beds that were 
 71.10  voluntarily delicensed and decertified on or before March 31, 
 71.11  1992.  The licensure and certification is conditional upon the 
 71.12  facility periodically assessing and adjusting its resident mix 
 71.13  and other factors which may contribute to a potential 
 71.14  institution for mental disease declaration.  The commissioner of 
 71.15  human services shall retain the authority to audit the facility 
 71.16  at any time and shall require the facility to comply with any 
 71.17  requirements necessary to prevent an institution for mental 
 71.18  disease declaration, including delicensure and decertification 
 71.19  of beds, if necessary; or 
 71.20     (dd) to license and certify 72 beds in an existing facility 
 71.21  in Mille Lacs county with 80 beds as part of a renovation 
 71.22  project.  The renovation must include construction of an 
 71.23  addition to accommodate ten residents with beginning and 
 71.24  midstage dementia in a self-contained living unit; creation of 
 71.25  three resident households where dining, activities, and support 
 71.26  spaces are located near resident living quarters; designation of 
 71.27  four beds for rehabilitation in a self-contained area; 
 71.28  designation of 30 private rooms; and other improvements. 
 71.29     Sec. 5.  Minnesota Statutes 2000, section 144A.073, 
 71.30  subdivision 2, is amended to read: 
 71.31     Subd. 2.  [REQUEST FOR PROPOSALS.] At the authorization by 
 71.32  the legislature of additional medical assistance expenditures 
 71.33  for exceptions to the moratorium on nursing homes, the 
 71.34  interagency committee shall publish in the State Register a 
 71.35  request for proposals for nursing home projects to be licensed 
 71.36  or certified under section 144A.071, subdivision 4a, clause 
 72.1   (c).  The public notice of this funding and the request for 
 72.2   proposals must specify how the approval criteria will be 
 72.3   prioritized by the advisory review panel, the interagency 
 72.4   long-term care planning committee, and the commissioner.  The 
 72.5   notice must describe the information that must accompany a 
 72.6   request and state that proposals must be submitted to the 
 72.7   interagency committee within 90 days of the date of 
 72.8   publication.  The notice must include the amount of the 
 72.9   legislative appropriation available for the additional costs to 
 72.10  the medical assistance program of projects approved under this 
 72.11  section.  If no money is appropriated for a year, the 
 72.12  interagency committee shall publish a notice to that effect, and 
 72.13  no proposals shall be requested.  If money is appropriated, the 
 72.14  interagency committee shall initiate the application and review 
 72.15  process described in this section at least twice each biennium 
 72.16  and up to four times each biennium, according to dates 
 72.17  established by rule.  Authorized funds shall be allocated 
 72.18  proportionally to the number of processes.  Funds not encumbered 
 72.19  by an earlier process within a biennium shall carry forward to 
 72.20  subsequent iterations of the process.  Authorization for 
 72.21  expenditures does not carry forward into the following 
 72.22  biennium.  To be considered for approval, a proposal must 
 72.23  include the following information: 
 72.24     (1) whether the request is for renovation, replacement, 
 72.25  upgrading, conversion, or relocation; 
 72.26     (2) a description of the problem the project is designed to 
 72.27  address; 
 72.28     (3) a description of the proposed project; 
 72.29     (4) an analysis of projected costs of the nursing facility 
 72.30  proposal, which are not required to exceed the cost threshold 
 72.31  referred to in section 144A.071, subdivision 1, to be considered 
 72.32  under this section, including initial construction and 
 72.33  remodeling costs; site preparation costs; technology costs; 
 72.34  financing costs, including the current estimated long-term 
 72.35  financing costs of the proposal, which consists of estimates of 
 72.36  the amount and sources of money, reserves if required under the 
 73.1   proposed funding mechanism, annual payments schedule, interest 
 73.2   rates, length of term, closing costs and fees, insurance costs, 
 73.3   and any completed marketing study or underwriting review; and 
 73.4   estimated operating costs during the first two years after 
 73.5   completion of the project; 
 73.6      (5) for proposals involving replacement of all or part of a 
 73.7   facility, the proposed location of the replacement facility and 
 73.8   an estimate of the cost of addressing the problem through 
 73.9   renovation; 
 73.10     (6) for proposals involving renovation, an estimate of the 
 73.11  cost of addressing the problem through replacement; 
 73.12     (7) the proposed timetable for commencing construction and 
 73.13  completing the project; 
 73.14     (8) a statement of any licensure or certification issues, 
 73.15  such as certification survey deficiencies; 
 73.16     (9) the proposed relocation plan for current residents if 
 73.17  beds are to be closed so that the department of human services 
 73.18  can estimate the total costs of a proposal; and 
 73.19     (10) other information required by permanent rule of the 
 73.20  commissioner of health in accordance with subdivisions 4 and 8. 
 73.21     Sec. 6.  Minnesota Statutes 2000, section 144A.073, 
 73.22  subdivision 4, is amended to read: 
 73.23     Subd. 4.  [CRITERIA FOR REVIEW.] The following criteria 
 73.24  shall be used in a consistent manner to compare, evaluate, and 
 73.25  rank all proposals submitted.  Except for the criteria specified 
 73.26  in clause (3), the application of criteria listed under this 
 73.27  subdivision shall not reflect any distinction based on the 
 73.28  geographic location of the proposed project: 
 73.29     (1) the extent to which the proposal furthers state 
 73.30  long-term care goals, including the goals stated in section 
 73.31  144A.31, and including the goal of enhancing the availability 
 73.32  and use of alternative care services and the goal of reducing 
 73.33  the number of long-term care resident rooms with more than two 
 73.34  beds; 
 73.35     (2) the proposal's long-term effects on state costs 
 73.36  including the cost estimate of the project according to section 
 74.1   144A.071, subdivision 5a; 
 74.2      (3) the extent to which the proposal promotes equitable 
 74.3   access to long-term care services in nursing homes through 
 74.4   redistribution of the nursing home bed supply, as measured by 
 74.5   the number of beds relative to the population 85 or older, 
 74.6   projected to the year 2000 by the state demographer, and 
 74.7   according to items (i) to (iv): 
 74.8      (i) reduce beds in counties where the supply is high, 
 74.9   relative to the statewide mean, and increase beds in counties 
 74.10  where the supply is low, relative to the statewide mean; 
 74.11     (ii) adjust the bed supply so as to create the greatest 
 74.12  benefits in improving the distribution of beds; 
 74.13     (iii) adjust the existing bed supply in counties so that 
 74.14  the bed supply in a county moves toward the statewide mean; and 
 74.15     (iv) adjust the existing bed supply so that the 
 74.16  distribution of beds as projected for the year 2020 would be 
 74.17  consistent with projected need, based on the methodology 
 74.18  outlined in the interagency long-term care committee's 1993 
 74.19  nursing home bed distribution study; 
 74.20     (4) the extent to which the project improves conditions 
 74.21  that affect the health or safety of residents, such as narrow 
 74.22  corridors, narrow door frames, unenclosed fire exits, and wood 
 74.23  frame construction, and similar provisions contained in fire and 
 74.24  life safety codes and licensure and certification rules; 
 74.25     (5) the extent to which the project improves conditions 
 74.26  that affect the comfort or quality of life of residents in a 
 74.27  facility or the ability of the facility to provide efficient 
 74.28  care, such as a relatively high number of residents in a room; 
 74.29  inadequate lighting or ventilation; poor access to bathing or 
 74.30  toilet facilities; a lack of available ancillary space for 
 74.31  dining rooms, day rooms, or rooms used for other activities; 
 74.32  problems relating to heating, cooling, or energy efficiency; 
 74.33  inefficient location of nursing stations; narrow corridors; or 
 74.34  other provisions contained in the licensure and certification 
 74.35  rules; 
 74.36     (6) the extent to which the applicant demonstrates the 
 75.1   delivery of quality care, as defined in state and federal 
 75.2   statutes and rules, to residents as evidenced by the two most 
 75.3   recent state agency certification surveys and the applicants' 
 75.4   response to those surveys; 
 75.5      (7) the extent to which the project removes the need for 
 75.6   waivers or variances previously granted by either the licensing 
 75.7   agency, certifying agency, fire marshal, or local government 
 75.8   entity; and 
 75.9      (8) the extent to which the project increases the number of 
 75.10  private or single bed rooms; and 
 75.11     (9) other factors that may be developed in permanent rule 
 75.12  by the commissioner of health that evaluate and assess how the 
 75.13  proposed project will further promote or protect the health, 
 75.14  safety, comfort, treatment, or well-being of the facility's 
 75.15  residents. 
 75.16     Sec. 7.  Minnesota Statutes 2000, section 144A.073, is 
 75.17  amended by adding a subdivision to read: 
 75.18     Subd. 9a.  [CARRY FORWARD.] Funds appropriated for the 
 75.19  nursing home moratorium exception process that are not 
 75.20  authorized or have expired or are unused by the end of the 
 75.21  biennium are carried forward to the next biennium. 
 75.22     Sec. 8.  Minnesota Statutes 2000, section 256B.431, 
 75.23  subdivision 17, is amended to read: 
 75.24     Subd. 17.  [SPECIAL PROVISIONS FOR MORATORIUM EXCEPTIONS.] 
 75.25  (a) Notwithstanding Minnesota Rules, part 9549.0060, subpart 3, 
 75.26  for rate periods beginning on October 1, 1992, and for rate 
 75.27  years beginning after June 30, 1993, a nursing facility that (1) 
 75.28  has completed a construction project approved under section 
 75.29  144A.071, subdivision 4a, clause (m); (2) has completed a 
 75.30  construction project approved under section 144A.071, 
 75.31  subdivision 4a, and effective after June 30, 1995; or (3) has 
 75.32  completed a renovation, replacement, or upgrading project 
 75.33  approved under the moratorium exception process in section 
 75.34  144A.073 shall be reimbursed for costs directly identified to 
 75.35  that project as provided in subdivision 16 and this subdivision. 
 75.36     (b) Notwithstanding Minnesota Rules, part 9549.0060, 
 76.1   subparts 5, item A, subitems (1) and (3), and 7, item D, 
 76.2   allowable interest expense on debt shall include: 
 76.3      (1) interest expense on debt related to the cost of 
 76.4   purchasing or replacing depreciable equipment, excluding 
 76.5   vehicles, not to exceed six percent of the total historical cost 
 76.6   of the project; and 
 76.7      (2) interest expense on debt related to financing or 
 76.8   refinancing costs, including costs related to points, loan 
 76.9   origination fees, financing charges, legal fees, and title 
 76.10  searches; and issuance costs including bond discounts, bond 
 76.11  counsel, underwriter's counsel, corporate counsel, printing, and 
 76.12  financial forecasts.  Allowable debt related to items in this 
 76.13  clause shall not exceed seven percent of the total historical 
 76.14  cost of the project.  To the extent these costs are financed, 
 76.15  the straight-line amortization of the costs in this clause is 
 76.16  not an allowable cost; and 
 76.17     (3) interest on debt incurred for the establishment of a 
 76.18  debt reserve fund, net of the interest earned on the debt 
 76.19  reserve fund. 
 76.20     (c) Debt incurred for costs under paragraph (b) is not 
 76.21  subject to Minnesota Rules, part 9549.0060, subpart 5, item A, 
 76.22  subitem (5) or (6). 
 76.23     (d) The incremental increase in a nursing facility's rental 
 76.24  rate, determined under Minnesota Rules, parts 9549.0010 to 
 76.25  9549.0080, and this section, resulting from the acquisition of 
 76.26  allowable capital assets, and allowable debt and interest 
 76.27  expense under this subdivision shall be added to its 
 76.28  property-related payment rate and shall be effective on the 
 76.29  first day of the month following the month in which the 
 76.30  moratorium project was completed. 
 76.31     (e) Notwithstanding subdivision 3f, paragraph (a), for rate 
 76.32  periods beginning on October 1, 1992, and for rate years 
 76.33  beginning after June 30, 1993, the replacement-costs-new per bed 
 76.34  limit to be used in Minnesota Rules, part 9549.0060, subpart 4, 
 76.35  item B, for a nursing facility that has completed a renovation, 
 76.36  replacement, or upgrading project that has been approved under 
 77.1   the moratorium exception process in section 144A.073, or that 
 77.2   has completed an addition to or replacement of buildings, 
 77.3   attached fixtures, or land improvements for which the total 
 77.4   historical cost exceeds the lesser of $150,000 or ten percent of 
 77.5   the most recent appraised value, must be $47,500 per licensed 
 77.6   bed in multiple-bed rooms and $71,250 per licensed bed in a 
 77.7   single-bed room.  These amounts must be adjusted annually as 
 77.8   specified in subdivision 3f, paragraph (a), beginning January 1, 
 77.9   1993. 
 77.10     (f) For purposes of this paragraph, a total replacement 
 77.11  means the complete replacement of the nursing facility's 
 77.12  physical plant through the construction of a new physical plant, 
 77.13  the transfer of the nursing facility's license from one physical 
 77.14  plant location to another, or a new building addition to 
 77.15  relocate beds from three- and four-bed wards.  For total 
 77.16  replacement projects completed on or after July 1, 1992, the 
 77.17  commissioner shall compute the incremental change in the nursing 
 77.18  facility's rental per diem, for rate years beginning on or after 
 77.19  July 1, 1995, by replacing its appraised value, including the 
 77.20  historical capital asset costs, and the capital debt and 
 77.21  interest costs with the new nursing facility's allowable capital 
 77.22  asset costs and the related allowable capital debt and interest 
 77.23  costs.  If the new nursing facility has decreased its licensed 
 77.24  capacity, the aggregate investment per bed limit in subdivision 
 77.25  3a, paragraph (c), shall apply.  If the new nursing facility has 
 77.26  retained a portion of the original physical plant for nursing 
 77.27  facility usage, then a portion of the appraised value prior to 
 77.28  the replacement must be retained and included in the calculation 
 77.29  of the incremental change in the nursing facility's rental per 
 77.30  diem.  For purposes of this part, the original nursing facility 
 77.31  means the nursing facility prior to the total replacement 
 77.32  project.  The portion of the appraised value to be retained 
 77.33  shall be calculated according to clauses (1) to (3): 
 77.34     (1) The numerator of the allocation ratio shall be the 
 77.35  square footage of the area in the original physical plant which 
 77.36  is being retained for nursing facility usage. 
 78.1      (2) The denominator of the allocation ratio shall be the 
 78.2   total square footage of the original nursing facility physical 
 78.3   plant. 
 78.4      (3) Each component of the nursing facility's allowable 
 78.5   appraised value prior to the total replacement project shall be 
 78.6   multiplied by the allocation ratio developed by dividing clause 
 78.7   (1) by clause (2). 
 78.8      In the case of either type of total replacement as 
 78.9   authorized under section 144A.071 or 144A.073, the provisions of 
 78.10  this subdivision shall also apply.  For purposes of the 
 78.11  moratorium exception authorized under section 144A.071, 
 78.12  subdivision 4a, paragraph (s), if the total replacement involves 
 78.13  the renovation and use of an existing health care facility 
 78.14  physical plant, the new allowable capital asset costs and 
 78.15  related debt and interest costs shall include first the 
 78.16  allowable capital asset costs and related debt and interest 
 78.17  costs of the renovation, to which shall be added the allowable 
 78.18  capital asset costs of the existing physical plant prior to the 
 78.19  renovation, and if reported by the facility, the related 
 78.20  allowable capital debt and interest costs. 
 78.21     (g) Notwithstanding Minnesota Rules, part 9549.0060, 
 78.22  subpart 11, item C, subitem (2), for a total replacement, as 
 78.23  defined in paragraph (f), authorized under section 144A.071 or 
 78.24  144A.073 after July 1, 1999, or any building project that is a 
 78.25  relocation, renovation, upgrading, or conversion authorized 
 78.26  under section 144A.073, after July 1, 2001, the 
 78.27  replacement-costs-new per bed limit shall be $74,280 per 
 78.28  licensed bed in multiple-bed rooms, $92,850 per licensed bed in 
 78.29  semiprivate rooms with a fixed partition separating the resident 
 78.30  beds, and $111,420 per licensed bed in single rooms.  Minnesota 
 78.31  Rules, part 9549.0060, subpart 11, item C, subitem (2), does not 
 78.32  apply.  These amounts must be adjusted annually as specified in 
 78.33  subdivision 3f, paragraph (a), beginning January 1, 2000.  
 78.34     (h) For a total replacement, as defined in paragraph (f), 
 78.35  authorized under section 144A.073 for a 96-bed nursing home in 
 78.36  Carlton county, the replacement-costs-new per bed limit shall be 
 79.1   $74,280 per licensed bed in multiple-bed rooms, $92,850 per 
 79.2   licensed bed in semiprivate rooms with a fixed partition 
 79.3   separating the resident's beds, and $111,420 per licensed bed in 
 79.4   a single room.  Minnesota Rules, part 9549.0060, subpart 11, 
 79.5   item C, subitem (2), does not apply.  The resulting maximum 
 79.6   allowable replacement-costs-new multiplied by 1.25 shall 
 79.7   constitute the project's dollar threshold for purposes of 
 79.8   application of the limit set forth in section 144A.071, 
 79.9   subdivision 2.  The commissioner of health may waive the 
 79.10  requirements of section 144A.073, subdivision 3b, paragraph (b), 
 79.11  clause (2), on the condition that the other requirements of that 
 79.12  paragraph are met. 
 79.13     (i) For a renovation authorized under section 144A.073 for 
 79.14  a 65-bed nursing home in St. Louis county, the incremental 
 79.15  increase in rental rate for purposes of paragraph (d) shall be 
 79.16  $8.16, and the total replacement cost, allowable appraised 
 79.17  value, allowable debt, and allowable interest shall be increased 
 79.18  according to the incremental increase. 
 79.19     (j) For a total replacement, as defined in paragraph (f), 
 79.20  authorized under section 144A.073 involving a new building 
 79.21  addition that relocates beds from three-bed wards for an 80-bed 
 79.22  nursing home in Redwood county, the replacement-costs-new per 
 79.23  bed limit shall be $74,280 per licensed bed for multiple-bed 
 79.24  rooms; $92,850 per licensed bed for semiprivate rooms with a 
 79.25  fixed partition separating the beds; and $111,420 per licensed 
 79.26  bed for single rooms.  These amounts shall be adjusted annually, 
 79.27  beginning January 1, 2001.  Minnesota Rules, part 9549.0060, 
 79.28  subpart 11, item C, subitem (2), does not apply.  The resulting 
 79.29  maximum allowable replacement-costs-new multiplied by 1.25 shall 
 79.30  constitute the project's dollar threshold for purposes of 
 79.31  application of the limit set forth in section 144A.071, 
 79.32  subdivision 2.  The commissioner of health may waive the 
 79.33  requirements of section 144A.073, subdivision 3b, paragraph (b), 
 79.34  clause (2), on the condition that the other requirements of that 
 79.35  paragraph are met. 
 79.36     Sec. 9.  Minnesota Statutes 2000, section 256B.434, 
 80.1   subdivision 10, is amended to read: 
 80.2      Subd. 10.  [EXEMPTIONS.] (a) To the extent permitted by 
 80.3   federal law, (1) a facility that has entered into a contract 
 80.4   under this section is not required to file a cost report, as 
 80.5   defined in Minnesota Rules, part 9549.0020, subpart 13, for any 
 80.6   year after the base year that is the basis for the calculation 
 80.7   of the contract payment rate for the first rate year of the 
 80.8   alternative payment demonstration project contract; and (2) a 
 80.9   facility under contract is not subject to audits of historical 
 80.10  costs or revenues, or paybacks or retroactive adjustments based 
 80.11  on these costs or revenues, except audits, paybacks, or 
 80.12  adjustments relating to the cost report that is the basis for 
 80.13  calculation of the first rate year under the contract. 
 80.14     (b) A facility that is under contract with the commissioner 
 80.15  under this section is not subject to the moratorium on licensure 
 80.16  or certification of new nursing home beds in section 144A.071, 
 80.17  unless the project results in a net increase in bed capacity or 
 80.18  involves relocation of beds from one site to another.  Contract 
 80.19  payment rates must not be adjusted to reflect any additional 
 80.20  costs that a nursing facility incurs as a result of a 
 80.21  construction project undertaken under this paragraph.  In 
 80.22  addition, as a condition of entering into a contract under this 
 80.23  section, a nursing facility must agree that any future medical 
 80.24  assistance payments for nursing facility services will not 
 80.25  reflect any additional costs attributable to the sale of a 
 80.26  nursing facility under this section and to construction 
 80.27  undertaken under this paragraph that otherwise would not be 
 80.28  authorized under the moratorium in section 144A.073.  Nothing in 
 80.29  this section prevents a nursing facility participating in the 
 80.30  alternative payment demonstration project under this section 
 80.31  from seeking approval of an exception to the moratorium through 
 80.32  the process established in section 144A.073, and if approved the 
 80.33  facility's rates shall be adjusted to reflect the cost of the 
 80.34  project.  Nothing in this section prevents a nursing facility 
 80.35  participating in the alternative payment demonstration project 
 80.36  from seeking legislative approval of an exception to the 
 81.1   moratorium under section 144A.071, and, if enacted, the 
 81.2   facility's rates shall be adjusted to reflect the cost of the 
 81.3   project. 
 81.4      (c) Notwithstanding section 256B.48, subdivision 6, 
 81.5   paragraphs (c), (d), and (e), and pursuant to any terms and 
 81.6   conditions contained in the facility's contract, a nursing 
 81.7   facility that is under contract with the commissioner under this 
 81.8   section is in compliance with section 256B.48, subdivision 6, 
 81.9   paragraph (b), if the facility is Medicare certified. 
 81.10     (d) (c) Notwithstanding paragraph (a), if by April 1, 1996, 
 81.11  the health care financing administration has not approved a 
 81.12  required waiver, or the health care financing administration 
 81.13  otherwise requires cost reports to be filed prior to the 
 81.14  waiver's approval, the commissioner shall require a cost report 
 81.15  for the rate year. 
 81.16     (e) (d) A facility that is under contract with the 
 81.17  commissioner under this section shall be allowed to change 
 81.18  therapy arrangements from an unrelated vendor to a related 
 81.19  vendor during the term of the contract.  The commissioner may 
 81.20  develop reasonable requirements designed to prevent an increase 
 81.21  in therapy utilization for residents enrolled in the medical 
 81.22  assistance program. 
 81.23     Sec. 10.  [256M.50] [CONSTRUCTION PROJECTS FOR ALTERNATIVE 
 81.24  PAYMENT SYSTEM NURSING FACILITIES.] 
 81.25     (a) Beginning July 1, 2001, facilities reimbursed under 
 81.26  section 256B.434 shall receive reimbursement for projects as 
 81.27  provided in this section. 
 81.28     (b) Facilities reimbursed under section 256B.434 that 
 81.29  complete a project as defined in section 256B.431, subdivision 
 81.30  17, paragraph (e), shall receive an add-on to the total payment 
 81.31  rate as defined in Minnesota Rules, part 9549.0070, subpart 1. 
 81.32     (c) The department of human services shall use the 
 81.33  facility's most recently submitted cost report, project cost 
 81.34  information, and rate setting processes used for projects 
 81.35  defined in section 256B.431, subdivision 17, paragraph (e), to 
 81.36  calculate the rate add-on. 
 82.1      (d) For the rate year beginning July 1, 2001, the 
 82.2   replacement-cost-new per bed limit must be $59,570 per licensed 
 82.3   bed in multiple bedrooms and $89,354 per licensed bed in a 
 82.4   single bedroom.  The replacement-cost-new per bed limits must be 
 82.5   adjusted annually as specified in Minnesota Rules, part 
 82.6   9549.0060, subpart 4, item A, subitem (1), except that the index 
 82.7   that must be used is the Bureau of the Census:  Composite 
 82.8   fixed-weighted price index as published in the C30 Report, Value 
 82.9   of New Construction Put in Place plus ten percent. 
 82.10     Sec. 11.  [256M.60] [PRIVATE ROOMS.] 
 82.11     Subdivision 1.  [FEDERAL WAIVER.] The commissioner of human 
 82.12  services shall apply for any necessary waiver of federal 
 82.13  Medicaid regulations or change in state plan to allow the state 
 82.14  to cover the payment for a private or single bed room for 
 82.15  medical assistance recipients, regardless of the medical 
 82.16  necessity status of the recipient.  If a federal waiver is 
 82.17  required, the commissioner of human services shall allow 
 82.18  residents or family members to supplement the medical assistance 
 82.19  case mix payment to pay a private or single bed room payment, in 
 82.20  cases where the resident does not meet the medical necessity 
 82.21  threshold. 
 82.22     Subd. 2.  [PRIVATE ROOM INCENTIVE/CAPACITY DAYS 
 82.23  REFORM.] (a) After June 30, 2001, the commissioner of human 
 82.24  services shall use the following definition of capacity days to 
 82.25  adjust nursing facility property rates for facilities reimbursed 
 82.26  under sections 256B.431 and 256B.434.  Capacity days are 
 82.27  determined by multiplying the number of licensed beds in the 
 82.28  nursing facility by the number of days in the nursing facility's 
 82.29  reporting period. 
 82.30     (b) Once capacity days are determined, rates must be 
 82.31  established as follows: 
 82.32     (1) Use established capacity days based on the number of 
 82.33  beds on June 30, 2001, and the number of beds on July 1, 2001. 
 82.34     (2) On July 1, 2001, the commissioner shall increase the 
 82.35  facility's property payment rate by the incremental increase in 
 82.36  the rental per diem resulting from the recalculation of the 
 83.1   facility's rental per diem applying only the changes resulting 
 83.2   from change in the definition of capacity days and clauses (1) 
 83.3   to (3). 
 83.4      (3) If a facility reimbursed under section 256B.434 
 83.5   completes a moratorium exception project after its base year, 
 83.6   the base year property rate is the moratorium project property 
 83.7   rate.  The base year rate must be inflated by the factors in 
 83.8   section 256B.434, subdivision 4, paragraph (c). 
 83.9      (4) Single bed election options established under Minnesota 
 83.10  Rules, part 9549.0060, subpart 11, is not applicable for rates 
 83.11  established after June 30, 2001. 
 83.12     (5) Effective July 1, 2001, a private room payment rate of 
 83.13  130 percent of the established total payment rate for a resident 
 83.14  must be allowed if the resident is a medical assistance 
 83.15  recipient, subject to any limits determined under subdivision 1. 
 83.16     Sec. 12.  [256M.70] [NURSING HOME FACILITY CONVERSION 
 83.17  PROGRAM.] 
 83.18     Subdivision 1.  [CREATION.] (a) The nursing home facility 
 83.19  conversion program is established to be administered by the 
 83.20  commissioner of Minnesota housing finance agency.  The nursing 
 83.21  home facility conversion account is established for this 
 83.22  purpose.  The commissioner may make funds available to nursing 
 83.23  home facilities from the nursing home facility conversion 
 83.24  account for capital and other costs related to the conversion of 
 83.25  a nursing home facility to an assisted living facility or other 
 83.26  affordable housing for seniors.  The commissioner must seek the 
 83.27  advisory recommendation of the interagency committee established 
 83.28  by section 144A.31 before authorizing funds under this section. 
 83.29     (b) Funding may not be used to expand a current building 
 83.30  except: 
 83.31     (1) for additional space required to accommodate related 
 83.32  supportive services, such as dining rooms, kitchen and 
 83.33  recreation areas, or other community use areas; or 
 83.34     (2) if new construction of assisted living units, which 
 83.35  would expand parameters of the existing building, is more cost 
 83.36  effective than the conversion of existing space. 
 84.1      (c) A facility seeking expansion must agree that a 
 84.2   specified number of existing nursing facility beds will not 
 84.3   continue to be licensed. 
 84.4      (d) The commissioner shall establish an application process 
 84.5   for funds that may use other application processes administered 
 84.6   by the commissioner.  Denial of approval of an application in 
 84.7   one year does not preclude submission of an application in a 
 84.8   later year. 
 84.9      Subd. 2.  [ELIGIBILITY.] A nursing home facility that is 
 84.10  currently enrolled as a nursing home facility provider with the 
 84.11  Medicaid program is eligible to apply for nursing home facility 
 84.12  conversion funds. 
 84.13     Subd. 3.  [ALLOCATION.] In determining which nursing home 
 84.14  facilities must receive funds under this section, the 
 84.15  commissioner must consider the following factors: 
 84.16     (1) the extent to which the conversion results in 
 84.17  affordable housing for seniors; and 
 84.18     (2) the extent to which the conversion results in the 
 84.19  reduction of licensed nursing home facility beds. 
 84.20     Subd. 4.  [MEDICAL ASSISTANCE COSTS.] In approving funds, 
 84.21  the commissioner shall ensure that conversion projects do not 
 84.22  increase medical assistance costs for nursing facility 
 84.23  reimbursement. 
 84.24     Subd. 5.  [APPROPRIATION.] Funds appropriated in fiscal 
 84.25  year 2001 from the general fund to the commissioner of the 
 84.26  Minnesota housing finance agency for the housing development 
 84.27  fund created under this section shall carry over into later 
 84.28  fiscal years and must not convert back to the general fund. 
 84.29                             ARTICLE 5 
 84.30                        QUALITY IMPROVEMENT 
 84.31     Section 1.  [256M.80] [ALTERNATIVE NURSING HOME SURVEY 
 84.32  PROCESS.] 
 84.33     Subdivision 1.  [ALTERNATIVE NURSING HOME SURVEY 
 84.34  SCHEDULES.] (a) The commissioner of health shall implement 
 84.35  alternative procedures for the nursing home survey process as 
 84.36  authorized under this section.  
 85.1      (b) These alternative survey process procedures seek to:  
 85.2   (1) use department resources more effectively and efficiently to 
 85.3   target problem areas; (2) use other existing or new mechanisms 
 85.4   to provide objective assessments of quality and to measure 
 85.5   quality improvement; (3) provide for frequent collaborative 
 85.6   interaction of facility staff and surveyors rather than a 
 85.7   punitive approach; and (4) reward a nursing home that has 
 85.8   performed very well by extending intervals between full surveys. 
 85.9      (c) The commissioner shall pursue changes to federal law 
 85.10  necessary to accomplish this process and shall apply for any 
 85.11  necessary federal waivers or approval.  If a federal waiver is 
 85.12  required, the commissioner shall submit a formal waiver request 
 85.13  no later than June 15, 2001.  The commissioner shall also pursue 
 85.14  any necessary federal law changes during the 107th Congress. 
 85.15     (d) The alternative nursing home survey schedule shall be 
 85.16  implemented January 1, 2002, or upon federal approval. 
 85.17     Subd. 2.  [SURVEY INTERVALS.] The commissioner of health 
 85.18  must extend the time period between standard surveys up to 30 
 85.19  months based on the criteria established in subdivision 4.  In 
 85.20  using the alternative survey schedule, the requirement for the 
 85.21  statewide average to not exceed 12 months does not apply. 
 85.22     Subd. 3.  [COMPLIANCE HISTORY.] The commissioner shall 
 85.23  develop a process for identifying the survey cycles for skilled 
 85.24  nursing facilities based upon the compliance history of the 
 85.25  facility.  This process can use a range of months for survey 
 85.26  intervals.  At a minimum, the process must be based on 
 85.27  information from the last two survey cycles and shall take into 
 85.28  consideration any deficiencies issued as the result of a survey 
 85.29  or a complaint investigation during the interval.  A skilled 
 85.30  nursing facility with a finding of substandard quality of care 
 85.31  or a funding of immediate jeopardy is not entitled to a survey 
 85.32  interval greater than 12 months.  The commissioner shall alter 
 85.33  the survey cycle for a specific skilled nursing facility based 
 85.34  on findings identified through the completion of a survey, a 
 85.35  monitoring visit, or a complaint investigation.  The 
 85.36  commissioner must also take into consideration information other 
 86.1   than the facility's compliance history. 
 86.2      Subd. 4.  [CRITERIA FOR SURVEY INTERVAL 
 86.3   CLASSIFICATION.] (a) The commissioner shall provide public 
 86.4   notice of the classification process and shall identify the 
 86.5   selected survey cycles for each skilled nursing facility.  The 
 86.6   classification system must be based on an analysis of the 
 86.7   findings made during the past two standard survey intervals, but 
 86.8   it only takes one survey or complaint finding to modify the 
 86.9   interval. 
 86.10     (b) The commissioner shall also take into consideration 
 86.11  information obtained from residents and family members in each 
 86.12  skilled nursing facility and from other sources such as 
 86.13  employees and ombudsmen in determining the appropriate survey 
 86.14  intervals for facilities. 
 86.15     Subd. 5.  [REQUIRED MONITORING.] (a) The commissioner shall 
 86.16  conduct at least one monitoring visit on an annual basis for 
 86.17  every skilled nursing facility, which has been selected for a 
 86.18  survey cycle greater than 12 months.  The commissioner shall 
 86.19  develop protocols for the monitoring visits which shall be less 
 86.20  extensive than the requirements for a standard survey.  The 
 86.21  commissioner shall use the following criteria to determine 
 86.22  whether additional monitoring visits to a facility will be 
 86.23  required.  
 86.24     (b) The criteria shall include, but not be limited to, the 
 86.25  following: 
 86.26     (1) changes in ownership, administration of the facility, 
 86.27  or direction of the facility's nursing service; 
 86.28     (2) changes in the facility's quality indicators which 
 86.29  might evidence a decline in the facility's quality of care; 
 86.30     (3) reductions in staffing or an increase in the 
 86.31  utilization of temporary nursing personnel; and 
 86.32     (4) complaint information or other information that 
 86.33  identifies potential concerns for the quality of the care and 
 86.34  services provided in the skilled nursing facility. 
 86.35     Subd. 6.  [SURVEY REQUIREMENTS FOR FACILITIES NOT APPROVED 
 86.36  FOR EXTENDED SURVEY INTERVALS.] The commissioner shall establish 
 87.1   a process for the surveying an monitoring of facilities which 
 87.2   require a survey interval less than 15 months.  This information 
 87.3   shall identify the steps that the commissioner must take to 
 87.4   monitor the facility in addition to the standard survey. 
 87.5      Subd. 7.  [IMPACT ON SURVEY AGENCY'S BUDGET.] The 
 87.6   implementation of an alternative survey process for the state 
 87.7   must not result in any reduction of funding that would have been 
 87.8   provided to the state survey agency for survey and enforcement 
 87.9   activity based upon the completion of full standard surveys for 
 87.10  each skilled nursing facility in the state. 
 87.11     Subd. 8.  [EDUCATIONAL ACTIVITIES.] The commissioner shall 
 87.12  expand the state survey agency's ability to conduct training and 
 87.13  educational efforts for skilled nursing facilities, residents 
 87.14  and family members, residents and family councils, long-term 
 87.15  care ombudsman programs, and the general public. 
 87.16     Subd. 9.  [EVALUATION.] The commissioner shall develop a 
 87.17  process for the evaluation of the effectiveness of an 
 87.18  alternative survey process conducted under this section. 
 87.19     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
 87.20  following final enactment. 
 87.21     Sec. 2.  [256M.85] [INNOVATIONS IN QUALITY DEMONSTRATION 
 87.22  GRANTS.] 
 87.23     Subdivision 1.  [PROGRAM ESTABLISHED.] The commissioner of 
 87.24  health shall establish a long-term care grant program that 
 87.25  demonstrates best practices and innovation for long-term care 
 87.26  service delivery and housing.  The grants must fund 
 87.27  demonstrations that create new means and models for servicing 
 87.28  the elderly or demonstrate creativity in service provision 
 87.29  through the scope of their program or service. 
 87.30     Subd. 2.  [ELIGIBILITY.] Grants may only be made to those 
 87.31  who provide direct service or housing to the elderly within the 
 87.32  state.  Grants may only be made for projects that show 
 87.33  innovations and measurable improvement in resident care, quality 
 87.34  of life, use of technology, or customer satisfaction. 
 87.35     Subd. 3.  [AWARDING OF GRANTS.] (a) Applications for grants 
 87.36  must be made to the commissioner on forms prescribed by the 
 88.1   commissioner. 
 88.2      (b) The applications must be reviewed, ranked, and 
 88.3   recommended by a review panel.  The review panel shall consist 
 88.4   of two representatives from long-term care providers, two 
 88.5   citizen members, two representatives from business, one member 
 88.6   representing academia, and one state agency representative.  The 
 88.7   members shall be appointed by the governor. 
 88.8      (c) The review panel shall rank applications according to 
 88.9   the following criteria: 
 88.10     (1) improvement in direct care to residents; 
 88.11     (2) increase in efficiency through the use of technology; 
 88.12     (3) increase in quality of care through the use of 
 88.13  technology; 
 88.14     (4) increase in the access and delivery of service; 
 88.15     (5) enhancement of nursing staff training; 
 88.16     (6) the effectiveness of the project as a demonstration; 
 88.17  and 
 88.18     (7) the immediate transferability of the project to scale. 
 88.19     (d) The commissioner shall award grants based on the 
 88.20  recommendations of the panel.  Grants for eligible projects may 
 88.21  not exceed $100,000. 
 88.22                             ARTICLE 6 
 88.23                      PERSONAL RESPONSIBILITY 
 88.24     Section 1.  Minnesota Statutes 2000, section 43A.318, 
 88.25  subdivision 1, is amended to read: 
 88.26     Subdivision 1.  [DEFINITIONS.] (a)  [SCOPE.] For the 
 88.27  purposes of this section, the terms defined have the meaning 
 88.28  given them. 
 88.29     (b)  [ADVISORY COMMITTEE; COMMITTEE.] "Advisory committee" 
 88.30  or "committee" means the committee created under subdivision 3. 
 88.31     (c)  [COMMITTEE MEMBER; MEMBER.] "Committee member" or 
 88.32  "member" means a person serving on the advisory committee 
 88.33  created under subdivision 3. 
 88.34     (d)  [ELIGIBLE PERSON.] "Eligible person" means: 
 88.35     (1) an active a member of a public pension plan of the 
 88.36  state; 
 89.1      (2) an employee or elected official of the state who is not 
 89.2   eligible for participation in a public employee pension plan of 
 89.3   the state; or 
 89.4      (3) a spouse or parent of a person described in clause (1) 
 89.5   or (2), regardless of the enrollment status in the program of 
 89.6   the person described in clause (1) or (2). 
 89.7      (e)  [PROGRAM.] "Program" means the statewide public 
 89.8   employees long-term care insurance program created under 
 89.9   subdivision 2. 
 89.10     (f)  [PUBLIC EMPLOYEE PENSION PLAN.] "Public employee 
 89.11  pension plan" means any Minnesota public pension plan or fund 
 89.12  that provides pension or retirement coverage for state employees.
 89.13     (g)  [QUALIFIED VENDOR.] "Qualified vendor" means an entity 
 89.14  licensed or authorized to underwrite, provide, or administer 
 89.15  group long-term care insurance benefits in this state. 
 89.16     Sec. 2.  [256M.90] [LONG-TERM CARE PARTNERSHIP.] 
 89.17     Subdivision 1.  [DEFINITIONS.] For purposes of this 
 89.18  section, the following terms have the meanings given. 
 89.19     (a) "Home care service" means care described in section 
 89.20  144A.43. 
 89.21     (b) "Long-term care insurance" means a policy described in 
 89.22  section 62S.01. 
 89.23     (c) "Medical assistance" means the program of medical 
 89.24  assistance established under section 256B.01. 
 89.25     (d) "Nursing home" means nursing home as described in 
 89.26  Minnesota Statutes, section 144A.01. 
 89.27     (e) "Partnership policy" means a long-term care insurance 
 89.28  policy that meets the requirements under chapter 62S. 
 89.29     (f) "Partnership program" means the Minnesota partnership 
 89.30  for long-term care program established under this section. 
 89.31     Subd. 2.  [PARTNERSHIP PROGRAM.] (a) Subject to federal 
 89.32  waiver approval, the commissioner of human services, with the 
 89.33  commissioner of commerce, shall establish the Minnesota 
 89.34  partnership for long-term care program to provide for the 
 89.35  financing of long-term care through a combination of private 
 89.36  insurance and medical assistance. 
 90.1      (b) An individual who meets all of the requirements in 
 90.2   paragraph (c) is eligible to participate in the partnership 
 90.3   program: 
 90.4      (c) The individual must: 
 90.5      (1) be a Minnesota resident; 
 90.6      (2) purchase a partnership policy that is delivered, issued 
 90.7   for delivery, or renewed on or after the effective date of this 
 90.8   section, and maintains the partnership policy in effect 
 90.9   throughout the period of participation in the partnership 
 90.10  program; and 
 90.11     (3) exhaust the minimum benefits under the partnership 
 90.12  policy as described in this section.  Benefits received under a 
 90.13  long-term care insurance policy before the effective date of 
 90.14  this section do not count toward the exhaustion of benefits 
 90.15  required in this subdivision. 
 90.16     Subd. 3.  [MEDICAL ASSISTANCE ELIGIBILITY.] Upon 
 90.17  application of an individual who meets the requirements 
 90.18  described in subdivision 2, the commissioner of human services 
 90.19  shall determine the individual's eligibility for medical 
 90.20  assistance according to paragraphs (a) and (b). 
 90.21     (a) After disregarding financial assets exempted under 
 90.22  medical assistance eligibility requirements, the department 
 90.23  shall disregard an additional amount of financial assets equal 
 90.24  to the dollar amount of coverage under the partnership policy.  
 90.25     (b) The department shall consider the individual's income 
 90.26  according to medical assistance eligibility requirements. 
 90.27     Subd. 4.  [FEDERAL APPROVAL.] (a) The commissioner of human 
 90.28  services shall seek appropriate amendments to the medical 
 90.29  assistance state plan and shall apply for any necessary waiver 
 90.30  of medical assistance requirements by the federal Health Care 
 90.31  Financing Administration to implement the partnership program.  
 90.32  The state shall not implement the partnership program unless the 
 90.33  provisions in paragraphs (b) and (c) apply. 
 90.34     (b) The commissioner shall seek any necessary federal 
 90.35  waiver of medical assistance requirements. 
 90.36     (c) Individuals who receive medical assistance under this 
 91.1   section are exempt from estate recovery requirements under 
 91.2   section 1917, title XIX of the federal Social Security Act, 
 91.3   United States Code, title 42, section 1396p. 
 91.4      Subd. 5.  [APPROVED POLICIES.] A partnership policy must 
 91.5   meet all of the requirements in paragraphs (a) to (g). 
 91.6      (a) Minimum coverage shall be for a period of not less than 
 91.7   three years and for a dollar amount equal to 36 months of 
 91.8   nursing home care at the minimum daily benefit rate determined 
 91.9   and adjusted under paragraph (b).  The policy shall provide for 
 91.10  home health care benefits to be substituted for nursing home 
 91.11  care benefits on the basis of two home health care days for one 
 91.12  nursing home care day. 
 91.13     (b) Minimum daily benefits shall be $130 for nursing home 
 91.14  care or $65 for home care.  These minimum daily benefit amounts 
 91.15  shall be adjusted by the department on October 1 of each year, 
 91.16  based on the health care index used under medical assistance for 
 91.17  nursing home rate setting.  Adjusted minimum daily benefit 
 91.18  amounts shall be rounded to the nearest whole dollar. 
 91.19     (c) A third party designated by the insured shall be 
 91.20  entitled to receive notice if the policy is about to lapse for 
 91.21  nonpayment of premium, and an additional 30-day grace period for 
 91.22  payment of premium shall be granted following notification to 
 91.23  that person. 
 91.24     (d) The policy must cover all of the following services: 
 91.25     (1) nursing home stay; 
 91.26     (2) home care service; 
 91.27     (3) care management; and 
 91.28     (4) up to 14 days of nursing care in a hospital while the 
 91.29  individual is waiting for long-term care placement.  
 91.30     (e) Payment for service under paragraph (d), clause (4), 
 91.31  must not exceed the daily benefit amount for nursing home care. 
 91.32     (f) A partnership policy must offer both options in 
 91.33  paragraph (g) for an adjusted premium. 
 91.34     (g) The options are: 
 91.35     (1) an elimination period of not more than 100 days; and 
 91.36     (2) nonforfeiture benefits for applicants between the ages 
 92.1   of 18 and 75. 
 92.2      Sec. 3.  Minnesota Statutes 2000, section 290.0672, 
 92.3   subdivision 2, is amended to read: 
 92.4      Subd. 2.  [CREDIT.] A taxpayer is allowed a credit against 
 92.5   the tax imposed by this chapter for long-term care insurance 
 92.6   policy premiums paid during the tax year.  The credit for each 
 92.7   policy equals 25 percent of premiums paid to the extent not 
 92.8   deducted in determining federal taxable income.  A taxpayer may 
 92.9   claim a credit for only one policy for each qualified 
 92.10  beneficiary.  A maximum of $100 $250 applies to each qualified 
 92.11  beneficiary.  The maximum total credit allowed per year 
 92.12  is $200 $500 for married couples filing joint returns 
 92.13  and $100 $250 for all other filers.  For a nonresident or 
 92.14  part-year resident, the credit determined under this section 
 92.15  must be allocated based on the percentage calculated under 
 92.16  section 290.06, subdivision 2c, paragraph (e). 
 92.17                             ARTICLE 7 
 92.18                      MISCELLANEOUS PROVISIONS 
 92.19     Section 1.  Laws 1999, chapter 245, article 3, section 45, 
 92.20  is amended to read: 
 92.21     Sec. 45.  [STATE LICENSURE CONFLICTS WITH FEDERAL 
 92.22  REGULATIONS.] 
 92.23     (a) Notwithstanding the provisions of Minnesota Rules, part 
 92.24  4658.0520, an incontinent resident must be checked according to 
 92.25  a specific time interval written in the resident's care plan.  
 92.26  The resident's attending physician must authorize in writing any 
 92.27  interval longer than two hours. 
 92.28     (b) This section expires July 1, 2001 2003. 
 92.29     Sec. 2.  [REPEALER.] 
 92.30     Minnesota Statutes 2000, sections 256B.431, subdivisions 2e 
 92.31  and 3f; 256B.434, subdivision 4; 256B.435, and 256B.69, 
 92.32  subdivision 6a, are repealed. 
 92.33                             ARTICLE 8 
 92.34                           APPROPRIATIONS 
 92.35     Section 1.  [COMMUNITY SERVICES DEVELOPMENT GRANTS.] 
 92.36     $20,000,000 is appropriated from the general fund to the 
 93.1   commissioner of human services for the biennium beginning July 
 93.2   1, 2001, for community services development grants under article 
 93.3   1, section 3.  Unused funds for these grants must be carried 
 93.4   forward into later fiscal years and must not be directed back to 
 93.5   the general fund. 
 93.6      Sec. 2.  [TRANSITION PLANNING GRANTS.] 
 93.7      $5,000,000 is appropriated from the general fund to the 
 93.8   commissioner of human services for the biennium beginning June 
 93.9   1, 2001, to implement the transition grant program under article 
 93.10  1, section 4.  
 93.11     Sec. 3.  [MEDICAL ASSISTANCE PILOT PROJECT.] 
 93.12     $250,000 is appropriated from the general fund to the 
 93.13  commissioner of human services for administration of the medical 
 93.14  assistance pilot project under article 1, section 5. 
 93.15     Sec. 4.  [SENIOR INFORMATION SOURCE PROGRAM.] 
 93.16     $1,000,000 is appropriated from the general fund to the 
 93.17  Minnesota board on aging for the biennium beginning January 1, 
 93.18  2001, for the development and operation of the senior 
 93.19  information source under article 1, section 6. 
 93.20     Sec. 5.  [IDENTIFICATION OF CRITICAL ACCESS SERVICE SITES.] 
 93.21     $250,000 is appropriated from the general fund to the 
 93.22  commissioner of health for the implementation of article 1, 
 93.23  section 7. 
 93.24     Sec. 6.  [COORDINATION OF TUITION ASSISTANCE PROGRAMS.] 
 93.25     $250,000 is appropriated from the general fund to the 
 93.26  commissioner of health for the coordination of tuition 
 93.27  assistance programs under article 2, section 22. 
 93.28     Sec. 7.  [LOAN FORGIVENESS.] 
 93.29     $2,000,000 is appropriated from the general fund to the 
 93.30  commissioner of health for implementation of the loan 
 93.31  forgiveness program under article 2, section 22. 
 93.32     Sec. 8.  [QUALITY AND PAYMENT REVIEW COMMISSION.] 
 93.33     $1,000,000 is appropriated from the general fund to the 
 93.34  quality and payment review commission under article 3, section 
 93.35  1.  $750,000 is appropriated from the general fund to the 
 93.36  quality and payment review commission for the time study under 
 94.1   article 3, section 2, subdivision 2. 
 94.2      Sec. 9.  [VENTILATOR DEPENDENT RATES.] 
 94.3      $500,000 is appropriated from the general fund to the 
 94.4   commissioner of human services for the purpose of rate 
 94.5   negotiations under article 3, section 3. 
 94.6      Sec. 10.  [MORATORIUM EXCEPTION PROCESS.] 
 94.7      $20,000,000 is appropriated in fiscal year 2001 from the 
 94.8   general fund to the commissioner of human services for the 
 94.9   nursing home moratorium exception process. 
 94.10     Sec. 11.  [NURSING HOME FACILITY CONVERSION PROGRAM.] 
 94.11     $50,000,000 is appropriated from the general fund to the 
 94.12  Minnesota housing finance agency for the administration of the 
 94.13  nursing home conversion program under article 4, section 12. 
 94.14     Sec. 12.  [ALTERNATIVE SURVEY PROCESS.] 
 94.15     $250,000 is appropriated from the general fund to the 
 94.16  commissioner of health for the fiscal year ending June 30, 2002, 
 94.17  for implementation of the alternative survey schedule under 
 94.18  article 5, section 1.  
 94.19     Sec. 13.  [PROVIDER EDUCATION.] 
 94.20     $250,000 is appropriated from the general fund to the 
 94.21  commissioner of health for fiscal year ending June 30, 2002, to 
 94.22  implement consultation and technical assistance to nursing 
 94.23  facilities with compliance problems described under article 5, 
 94.24  section 1.  The pool of money established through civil monetary 
 94.25  penalties imposed upon nursing facilities to abate any 
 94.26  deficiencies identified in a nursing facility's plan of 
 94.27  correction may be used for this purpose. 
 94.28     Sec. 14.  [QUALITY DEMONSTRATION GRANTS.] 
 94.29     $3,000,000 is appropriated from the general fund to the 
 94.30  commissioner of health for the innovations in quality 
 94.31  demonstration grants under article 5, section 2. 
 94.32     Sec. 15.  [STATE LONG-TERM CARE INSURANCE BENEFIT.] 
 94.33     $100,000 is appropriated from the general fund to the 
 94.34  commissioner of employee relations for the purpose of promoting 
 94.35  the expansion of the state benefit under article 6. 
 94.36     Sec. 16.  [LONG-TERM CARE PARTNERSHIP PROGRAM.] 
 95.1      $200,000 is appropriated from the general fund to the 
 95.2   commissioner of human services for federal waiver development 
 95.3   and application under article 6, section 3.