Minnesota Legislature
SF 2225
2nd Engrossment - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am
KEY: stricken = removed, old language.
underscored = added, new language.
1.1 A bill for an act 1.2 relating to human services; appropriating money for 1.3 the departments of human services and health, the 1.4 veterans nursing homes board, the health-related 1.5 boards, the emergency medical services board, the 1.6 council on disability, the ombudsman for mental health 1.7 and mental retardation, and the ombudsman for 1.8 families; establishing the state board of physical 1.9 therapy; amending Minnesota Statutes 1998, sections 1.10 13.99, subdivision 38a, and by adding a subdivision; 1.11 16A.76, subdivision 2; 16C.10, subdivision 5; 60A.15, 1.12 subdivision 1; 62A.045; 62E.11, by adding a 1.13 subdivision; 62J.69; 116L.02; 125A.08; 125A.21, 1.14 subdivision 1; 125A.74, subdivisions 1 and 2; 144.065; 1.15 144.148; 144.1761, subdivision 1; 144.99, subdivision 1.16 1, and by adding a subdivision; 144A.073, subdivision 1.17 5; 144A.10, by adding subdivisions; 144A.46, 1.18 subdivision 2; 144D.01, subdivision 4; 144E.001, by 1.19 adding subdivisions; 144E.10, subdivision 1; 144E.11, 1.20 by adding a subdivision; 144E.16, subdivision 4; 1.21 144E.18; 144E.27, by adding subdivisions; 144E.50, by 1.22 adding a subdivision; 145.924; 145.9255, subdivisions 1.23 1 and 4; 145A.02, subdivision 10; 145.9255, 1.24 subdivisions 1 and 4; 148.5194, subdivisions 2, 3, 4, 1.25 and by adding a subdivision; 148.66; 148.67; 148.70; 1.26 148.705; 148.71; 148.72, subdivisions 1, 2, and 4; 1.27 148.73; 148.74; 148.75; 148.76; 148.78; 148B.32, 1.28 subdivision 1; 150A.10, subdivision 1; 214.01, 1.29 subdivision 2; 245.462, subdivisions 4 and 17; 1.30 245.4711, subdivision 1; 245.4712, subdivision 2; 1.31 245.4871, subdivisions 4 and 26; 245.4881, subdivision 1.32 1; 245A.04, subdivision 3a; 245A.08, subdivision 5; 1.33 245A.30; 245B.05, subdivision 7; 245B.07, subdivisions 1.34 5, 8, and 10; 246.18, subdivision 6; 252.28, 1.35 subdivision 1; 252.291, by adding a subdivision; 1.36 252.32, subdivision 3a; 252.46, subdivision 6; 1.37 253B.045, by adding subdivisions; 253B.07, subdivision 1.38 1; 253B.185, by adding a subdivision; 254B.01, by 1.39 adding a subdivision; 254B.03, subdivision 2; 254B.04, 1.40 subdivision 1; 254B.05, subdivision 1; 256.01, 1.41 subdivision 2; 256.015, subdivisions 1 and 3; 256.87, 1.42 subdivision 1a; 256.955, subdivisions 3, 4, 7, 8, and 1.43 9; 256.9685, subdivision 1a; 256.969, subdivision 1; 1.44 256B.04, subdivision 16, and by adding a subdivision; 1.45 256B.042, subdivisions 1, 2, and 3; 256B.055, 1.46 subdivision 3a; 256B.056, subdivision 4; 256B.057, 2.1 subdivision 3, and by adding a subdivision; 256B.0575; 2.2 256B.061; 256B.0625, subdivisions 6a, 8, 8a, 13, 19c, 2.3 20, 26, 28, 30, 32, 35, and by adding subdivisions; 2.4 256B.0627, subdivisions 1, 2, 4, 5, 8, and by adding 2.5 subdivisions; 256B.0635, subdivision 3; 256B.064, 2.6 subdivisions 1a, 1b, 1c, 2, and by adding a 2.7 subdivision; 256B.0911, subdivision 6; 256B.0913, 2.8 subdivisions 5, 10, 12, and 16; 256B.0917, subdivision 2.9 8; 256B.094, subdivisions 3, 5, and 6; 256B.37, 2.10 subdivision 2; 256B.431, subdivisions 2i, 17, 26, and 2.11 by adding a subdivision; 256B.434, subdivisions 3, 4, 2.12 13, and by adding a subdivision; 256B.435; 256B.48, 2.13 subdivisions 1, 1a, 1b, and 6; 256B.50, subdivision 2.14 1e; 256B.501, subdivision 8a, and by adding a 2.15 subdivision; 256B.5011, subdivisions 1 and 2; 256B.69, 2.16 subdivisions 3a, 5b, 6a, 6b, and by adding 2.17 subdivisions; 256B.692, subdivision 2; 256B.75; 2.18 256B.76; 256B.77, subdivisions 7a, 8, and by adding 2.19 subdivisions; 256D.03, subdivisions 3, 4, and 8; 2.20 256D.051, subdivision 2a, and by adding a subdivision; 2.21 256D.053, subdivision 1; 256D.06, subdivision 5; 2.22 256F.03, subdivision 5; 256F.05, subdivision 8; 2.23 256F.10, subdivisions 1, 4, 6, 7, 8, 9, and 10; 2.24 256I.04, subdivision 3; 256I.05, subdivisions 1 and 2.25 1a; 256J.08, subdivisions 11, 24, 65, 82, 83, 86a, and 2.26 by adding subdivisions; 256J.11, subdivisions 2 and 3; 2.27 256J.12, subdivisions 1a and 2; 256J.14; 256J.20, 2.28 subdivision 3; 256J.21, subdivisions 2, 3, and 4; 2.29 256J.24, subdivisions 2, 3, 7, 8, 9, and by adding a 2.30 subdivision; 256J.26, subdivision 1; 256J.30, 2.31 subdivisions 2, 7, 8, and 9; 256J.31, subdivisions 5 2.32 and 12; 256J.32, subdivisions 4 and 6; 256J.33; 2.33 256J.34, subdivisions 1, 3, and 4; 256J.35; 256J.36; 2.34 256J.37, subdivisions 1, 1a, 2, 9, and 10; 256J.38, 2.35 subdivision 4; 256J.42, subdivisions 1, 5, and by 2.36 adding a subdivision; 256J.43; 256J.45, subdivision 1; 2.37 256J.46, subdivisions 1, 2, and 2a; 256J.47, 2.38 subdivision 4; 256J.48, subdivisions 2 and 3; 256J.50, 2.39 subdivision 1; 256J.515; 256J.52, subdivisions 1, 4, 2.40 8, and by adding a subdivision; 256J.55, subdivision 2.41 4; 256J.56; 256J.57, subdivision 1; 256J.62, 2.42 subdivisions 1, 6, 7, 8, 9, and by adding a 2.43 subdivision; 256J.67, subdivision 4; 256J.74, 2.44 subdivision 2; 256J.76, subdivisions 1, 2, and 4; 2.45 256L.03, subdivisions 5 and 6; 256L.04, subdivisions 2.46 2, 7, 8, 11, and 13; 256L.05, subdivision 4, and by 2.47 adding a subdivision; 256L.06, subdivision 3; 256L.07; 2.48 256L.15, subdivisions 1, 1b, 2, and 3; 257.071, 2.49 subdivisions 1, 1a, 1c, 1d, 1e, 3, and 4; 257.66, 2.50 subdivision 3; 257.75, subdivision 2; 257.85, 2.51 subdivisions 2, 3, 4, 5, 6, 7, 9, and 11; 259.29, 2.52 subdivision 2; 259.67, subdivisions 6 and 7; 259.73; 2.53 259.85, subdivisions 2, 3, and 5; 259.89, by adding a 2.54 subdivision; 260.011, subdivision 2; 260.012; 260.015, 2.55 subdivisions 2a, 13, and 29; 260.131, subdivision 1a; 2.56 260.133, subdivisions 1 and 2; 260.135, by adding a 2.57 subdivision; 260.172, subdivision 1, and by adding a 2.58 subdivision; 260.181, subdivision 3; 260.191, 2.59 subdivisions 1, 1a, 1b, and 3b; 260.192; 260.221, 2.60 subdivisions 1, 1a, 1b, 1c, 3, and 5; 326.40, 2.61 subdivisions 2, 4, and 5; 518.10; 518.158, 2.62 subdivisions 1 and 2; 518.551, by adding a 2.63 subdivision; 518.5853, by adding a subdivision; 2.64 626.556, subdivisions 2, 3, 4, 7, 10, 10b, 10d, 10e, 2.65 10f, 10i, 10j, 11, 11b, 11c, and by adding a 2.66 subdivision; and 626.558, subdivision 1; Laws 1995, 2.67 chapter 178, article 2, section 46, subdivision 10; 2.68 chapter 207, article 8, section 41, as amended; Laws 2.69 1997, chapter 203, article 9, section 19; Laws 1998, 2.70 chapter 407, article 7, section 2, subdivision 3; 2.71 proposing coding for new law in Minnesota Statutes, 3.1 chapters 10; 62J; 116L; 137; 144; 144A; 144E; 148; 3.2 214; 245; 246; 252; 254A; 256; 256B; 256J; and 626; 3.3 proposing coding for new law as Minnesota Statutes, 3.4 chapter 256M; repealing Minnesota Statutes 1998, 3.5 sections 62J.77; 62J.78; 62J.79; 144.0723; 144E.16, 3.6 subdivisions 1, 2, 3, and 6; 144E.17; 144E.25; 3.7 144E.30, subdivisions 1, 2, and 6; 145.46; 256B.434, 3.8 subdivision 17; 256B.501, subdivision 3g; 256B.5011, 3.9 subdivision 3; 256B.74, subdivisions 2 and 5; 3.10 256D.051, subdivisions 6 and 19; 256D.053, subdivision 3.11 4; 256J.03; 256J.30, subdivision 6; 256J.53, 3.12 subdivision 4; 256J.62, subdivisions 2, 3, and 5; 3.13 257.071, subdivisions 8 and 10; and 462A.208; Laws 3.14 1997, chapter 85, article 1, section 63; chapter 203, 3.15 article 4, section 55; chapter 225, article 6, section 3.16 8; Laws 1998, chapter 407, article 2, section 104; 3.17 Minnesota Rules, parts 4690.0100, subparts 4, 13, 15, 3.18 19, 20, 21, 22, 23, 24, 26, 27, and 29; 4690.0300; 3.19 4690.0400; 4690.0500; 4690.0600; 4690.0700; 4690.0800, 3.20 subparts 1 and 2; 4690.0900; 4690.1000; 4690.1100; 3.21 4690.1200; 4690.1300; 4690.1600; 4690.1700; 4690.2100; 3.22 4690.2200, subparts 1, 3, 4, and 5; 4690.2300; 3.23 4690.2400, subparts 1, 2, and 3; 4690.2500; 4690.2900; 3.24 4690.3000; 4690.3700; 4690.3900; 4690.4000; 4690.4100; 3.25 4690.4200; 4690.4300; 4690.4400; 4690.4500; 4690.4600; 3.26 4690.4700; 4690.4800; 4690.4900; 4690.5000; 4690.5100; 3.27 4690.5200; 4690.5300; 4690.5400; 4690.5500; 4690.5700; 3.28 4690.5800; 4690.5900; 4690.6000; 4690.6100; 4690.6200; 3.29 4690.6300; 4690.6400; 4690.6500; 4690.6600; 4690.6700; 3.30 4690.6800; 4690.7000; 4690.7100; 4690.7200; 4690.7300; 3.31 4690.7400; 4690.7500; 4690.7600; 4690.7700; 4690.7800; 3.32 4690.8300, subparts 1, 2, 3, 4, and 5; and 4735.5000. 3.33 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.34 ARTICLE 1 3.35 APPROPRIATIONS 3.36 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 3.37 The sums shown in the columns marked "APPROPRIATIONS" are 3.38 appropriated from the general fund, or any other fund named, to 3.39 the agencies and for the purposes specified in the following 3.40 sections of this article, to be available for the fiscal years 3.41 indicated for each purpose. The figures "2000" and "2001" where 3.42 used in this article, mean that the appropriation or 3.43 appropriations listed under them are available for the fiscal 3.44 year ending June 30, 2000, or June 30, 2001, respectively. 3.45 Where a dollar amount appears in parentheses, it means a 3.46 reduction of an appropriation. 3.47 SUMMARY BY FUND 3.48 APPROPRIATIONS BIENNIAL 3.49 2000 2001 TOTAL 3.50 General $2,648,495,000 $2,777,133,000 $5,425,628,000 3.51 State Government 3.52 Special Revenue 36,447,000 36,158,000 72,605,000 4.1 Health Care 4.2 Access 149,417,000 188,885,000 338,302,000 4.3 Metropolitan 4.4 Landfill Contingency 4.5 Action Fund 196,000 199,000 395,000 4.6 Trunk Highway 1,726,000 1,773,000 3,499,000 4.7 Lottery Prize 1,660,000 1,550,000 3,210,000 4.8 TOTAL $2,837,941,000 $3,005,698,000 $5,843,639,000 4.9 [SPENDING TAILS CAP.] (a) The 4.10 commissioner of finance shall make 4.11 transfers and base reductions described 4.12 in clauses (1) and (2) below to reduce 4.13 the recognized fund balance 4.14 expenditures including planning 4.15 estimates, if any, for fiscal years 4.16 2002 and 2003 to $6,247,197,000, 4.17 provided that the reductions shall not 4.18 exceed $42,000,000: 4.19 (1) Notwithstanding any contrary 4.20 provision in section 2, subdivision 10, 4.21 paragraph (a), of this article, 4.22 $12,000,000 in fiscal year 2002 and 4.23 $12,000,000 in fiscal year 2003 shall 4.24 be transferred from the federal TANF 4.25 block grant to the state's federal 4.26 Title XX block grant to be allocated 4.27 according to the community social 4.28 services aids formula in Minnesota 4.29 Statutes, section 256E.06, and the base 4.30 funding level for the community social 4.31 services block grant shall be reduced 4.32 by $12,000,000 in fiscal year 2002 and 4.33 fiscal year 2003. 4.34 (2) If full implementation of clause 4.35 (1) does not produce sufficient 4.36 reductions, notwithstanding any 4.37 contrary provision in article 10, 4.38 section 7, of this act, in fiscal year 4.39 2002 the first $6,000,000 in earnings 4.40 credited to the tobacco prevention 4.41 endowment fund shall be appropriated to 4.42 the commissioner of finance and 4.43 transferred to the general fund, and in 4.44 fiscal year 2003 the first $12,000,000 4.45 in earnings credited to the tobacco 4.46 prevention endowment fund shall be 4.47 appropriated to the commissioner of 4.48 finance and transferred to the general 4.49 fund. 4.50 (b) The spending cap of $6,247,197,000 4.51 shall be adjusted upward by an amount 4.52 equivalent to additional spending and 4.53 applicable planning estimates, if any, 4.54 approved after December 31, 1999, for 4.55 activities funded in this article. 4.56 (c) This provision shall not take 4.57 effect if the recognized fund balance 4.58 expenditures including planning 4.59 estimates, if any, for the activities 4.60 referenced in paragraph (b) are 4.61 determined by the commissioner of 4.62 finance at any time between May 1, 5.1 1999, and March 31, 2001, to be below 5.2 $6,247,197,000. 5.3 APPROPRIATIONS 5.4 Available for the Year 5.5 Ending June 30 5.6 2000 2001 5.7 Sec. 2. COMMISSIONER OF 5.8 HUMAN SERVICES 5.9 Subdivision 1. Total 5.10 Appropriation $2,696,741,000 $2,863,722,000 5.11 Summary by Fund 5.12 General 2,555,853,000 2,683,303,000 5.13 State Government 5.14 Special Revenue 485,000 507,000 5.15 Health Care 5.16 Access 138,743,000 178,362,000 5.17 Lottery Prize 1,660,000 1,550,000 5.18 Subd. 2. Agency Management 5.19 General 28,661,000 28,961,000 5.20 State Government 5.21 Special Revenue 371,000 392,000 5.22 Health Care 5.23 Access 3,268,000 3,321,000 5.24 The amounts that may be spent from the 5.25 appropriation for each purpose are as 5.26 follows: 5.27 (a) Financial Operations 5.28 General 7,433,000 7,569,000 5.29 Health Care 5.30 Access 691,000 702,000 5.31 [RECEIPTS FOR SYSTEMS PROJECTS.] 5.32 Appropriations and federal receipts for 5.33 information system projects for MAXIS, 5.34 electronic benefit system, social 5.35 services information system, child 5.36 support enforcement, and Minnesota 5.37 Medicaid information system (MMIS II) 5.38 must be deposited in the state system 5.39 account authorized in Minnesota 5.40 Statutes, section 256.014. Money 5.41 appropriated for computer projects 5.42 approved by the information policy 5.43 office, funded by the legislature, and 5.44 approved by the commissioner of finance 5.45 may be transferred from one project to 5.46 another and from development to 5.47 operations as the commissioner of human 5.48 services considers necessary. Any 5.49 unexpended balance in the appropriation 5.50 for these projects does not cancel but 5.51 is available for ongoing development 5.52 and operations. 5.53 (b) Legal & Regulation Operations 6.1 General 6,579,000 6,671,000 6.2 State Government 6.3 Special Revenue 371,000 392,000 6.4 Health Care 6.5 Access 141,000 145,000 6.6 [REIMBURSEMENT OF COUNTY COSTS.] Of the 6.7 general fund appropriation, $10,000 is 6.8 for the commissioner for the biennium 6.9 beginning July 1, 1999, to reimburse 6.10 counties for the legal and related 6.11 costs of contesting through the 6.12 administrative and judicial systems 6.13 decisions that affect state spending 6.14 but not county spending on programs 6.15 administered or financed by the 6.16 commissioner. The commissioner may 6.17 reimburse expenses that occurred on or 6.18 after January 1, 1998. 6.19 (c) Management Operations 6.20 General 14,649,000 14,721,000 6.21 Health Care 6.22 Access 2,436,000 2,474,000 6.23 [COMMUNICATION COSTS.] The commissioner 6.24 shall continue to operate the 6.25 department of human services 6.26 communication systems account 6.27 established in Laws 1993, First Special 6.28 Session chapter 1, article 1, section 6.29 2, subdivision 2, to manage shared 6.30 communication costs necessary for the 6.31 operation of the programs the 6.32 commissioner supervises. A 6.33 communications account may also be 6.34 established for each regional treatment 6.35 center which operates communication 6.36 systems. Each account shall be used to 6.37 manage shared communication costs 6.38 necessary for the operation of programs 6.39 the commissioner supervises. The 6.40 commissioner may distribute the costs 6.41 of operating and maintaining 6.42 communication systems to participants 6.43 in a manner that reflects actual 6.44 usage. Costs may include acquisition, 6.45 licensing, insurance, maintenance, 6.46 repair, staff time, and other costs as 6.47 determined by the commissioner. 6.48 Nonprofit organizations and state, 6.49 county, and local government agencies 6.50 involved in the operation of programs 6.51 the commissioner supervises may 6.52 participate in the use of the 6.53 department's communication technology 6.54 and share in the cost of operation. 6.55 The commissioner may accept on behalf 6.56 of the state any gift, bequest, devise, 6.57 or personal property of any kind, or 6.58 money tendered to the state for any 6.59 lawful purpose pertaining to the 6.60 communication activities of the 6.61 department. Any money received for 6.62 this purpose must be deposited in the 6.63 department of human services 6.64 communication systems accounts. Money 7.1 collected by the commissioner for the 7.2 use of communication systems must be 7.3 deposited in the state communication 7.4 systems account and is appropriated to 7.5 the commissioner for purposes of this 7.6 section. 7.7 [ISSUANCE OPERATIONS CENTER.] Payments 7.8 to the commissioner from other 7.9 governmental units and private 7.10 enterprises for (1) services performed 7.11 by the issuance operations center, or 7.12 (2) reports generated by the payment 7.13 and eligibility systems must be 7.14 deposited in the state systems account 7.15 authorized in Minnesota Statutes, 7.16 section 256.014. These payments are 7.17 appropriated to the commissioner for 7.18 the operation of the issuance center or 7.19 system, in accordance with Minnesota 7.20 Statutes, section 256.014. 7.21 Subd. 3. Children's Grants 7.22 General 52,845,000 54,931,000 7.23 Subd. 4. Children's Services Management 7.24 General 3,350,000 3,140,000 7.25 Subd. 5. Basic Health Care Grants 7.26 Summary by Fund 7.27 General 869,070,000 919,566,000 7.28 Health Care 7.29 Access 117,877,000 155,573,000 7.30 The amounts that may be spent from this 7.31 appropriation for each purpose are as 7.32 follows: 7.33 (a) Minnesota Care Grants- 7.34 Health Care 7.35 Access 117,877,000 155,573,000 7.36 [MINNESOTACARE PROGRAM EXPANSION.] Of 7.37 this appropriation, $5,442,000 in 7.38 fiscal year 2001 is from the health 7.39 care access fund to the commissioner 7.40 for the eligibility expansion of the 7.41 MinnesotaCare program up to 275 percent 7.42 of the federal poverty guidelines for 7.43 single adults and households without 7.44 children. 7.45 [SUBSIDIZED EMPLOYER HEALTH COVERAGE.] 7.46 Of this appropriation, $4,059,000 in 7.47 the biennium is from the health care 7.48 access fund to the commissioner for the 7.49 subsidized employer health coverage 7.50 program described in Minnesota 7.51 Statutes, chapter 256M, if enacted. 7.52 [MINNESOTACARE OUTREACH FEDERAL 7.53 MATCHING FUNDS.] Any federal matching 7.54 funds received as a result of the 7.55 MinnesotaCare outreach activities 7.56 authorized by Laws 1997, chapter 225, 7.57 article 7, section 2, subdivision 1, 8.1 shall be deposited in the health care 8.2 access fund and dedicated to the 8.3 commissioner to be used for those 8.4 outreach purposes. 8.5 [FEDERAL RECEIPTS FOR ADMINISTRATION.] 8.6 Receipts received as a result of 8.7 federal participation pertaining to 8.8 administrative costs of the Minnesota 8.9 health care reform waiver shall be 8.10 deposited as nondedicated revenue in 8.11 the health care access fund. Receipts 8.12 received as a result of federal 8.13 participation pertaining to grants 8.14 shall be deposited in the federal fund 8.15 and shall offset health care access 8.16 funds for payments to providers. 8.17 [HEALTH CARE ACCESS FUND.] The 8.18 commissioner may expend money 8.19 appropriated from the health care 8.20 access fund for MinnesotaCare in either 8.21 fiscal year of the biennium. 8.22 (b) MA Basic Health Care Grants- 8.23 Families and Children 8.24 General 307,413,000 321,562,000 8.25 (c) MA Basic Health Care Grants- 8.26 Elderly & Disabled 8.27 General 405,535,000 452,901,000 8.28 [PUBLIC HEALTH NURSE ASSESSMENT.] The 8.29 reimbursement for public health nurse 8.30 visits relating to the provision of 8.31 personal care services under Minnesota 8.32 Statutes, sections 256B.0625, 8.33 subdivision 19a, and 256B.0627, is 8.34 $210.50 for a face-to-face assessment 8.35 visit, $105.25 for each service update, 8.36 and $105.25 for each request for a 8.37 temporary service increase. These 8.38 rates shall be adjusted based on rate 8.39 increases approved by the legislature 8.40 for cost-of-living or wage enhancements 8.41 for personal care assistant services. 8.42 [SURCHARGE COMPLIANCE.] In the event 8.43 that federal financial participation in 8.44 the Minnesota medical assistance 8.45 program is reduced as a result of a 8.46 determination that the surcharge and 8.47 intergovernmental transfers governed by 8.48 Minnesota Statutes, sections 256.9657 8.49 and 256B.19 are out of compliance with 8.50 United States Code, title 42, section 8.51 1396b(w), or its implementing 8.52 regulations or with any other federal 8.53 law designed to restrict provider tax 8.54 programs or intergovernmental 8.55 transfers, the commissioner shall 8.56 appeal the determination to the fullest 8.57 extent permitted by law and may ratably 8.58 reduce all medical assistance and 8.59 general assistance medical care 8.60 payments to providers other than the 8.61 state of Minnesota in order to 8.62 eliminate any shortfall resulting from 8.63 the reduced federal funding. Any 9.1 amount later recovered through the 9.2 appeals process shall be used to 9.3 reimburse providers for any ratable 9.4 reductions taken. 9.5 [BLOOD PRODUCTS LITIGATION.] To the 9.6 extent permitted by federal law, 9.7 Minnesota Statutes, section 256.015, 9.8 256B.042, and 256B.15, are waived as 9.9 necessary for the limited purpose of 9.10 resolving the state's claims in 9.11 connection with In re Factor VIII or IX 9.12 Concentrate Blood Products Litigation, 9.13 MDL-986, No. 93-C7452 (N.D.III.). 9.14 (d) General Assistance Medical Care 9.15 General 142,502,000 128,921,000 9.16 (e) Basic Health Care - Nonentitlement 9.17 General 13,620,000 16,182,000 9.18 [DENTAL ACCESS GRANT.] Of this 9.19 appropriation, $75,000 is from the 9.20 general fund to the commissioner in 9.21 fiscal year 2000 for a grant to a 9.22 nonprofit dental provider group 9.23 operating a dental clinic in Clay 9.24 county. The grant must be used to 9.25 increase access to dental services for 9.26 recipients of medical assistance, 9.27 general assistance medical care, and 9.28 the MinnesotaCare program in the 9.29 northwest area of the state. This 9.30 appropriation is available the day 9.31 following final enactment. 9.32 [SENIOR DRUG PROGRAM PREMIUM 9.33 REIMBURSEMENT.] Of this appropriation, 9.34 $118,000 in fiscal year 2000 is to the 9.35 commissioner to refund to current 9.36 enrollees the balance of their annual 9.37 premiums on a pro rata basis for the 9.38 months remaining in their first 9.39 12-month annual enrollment cycle. 9.40 Subd. 6. Basic Health Care Management 9.41 General 23,360,000 23,576,000 9.42 Health Care 9.43 Access 16,285,000 18,150,000 9.44 The amounts that may be spent from this 9.45 appropriation for each purpose are as 9.46 follows: 9.47 (a) Health Care Policy Administration 9.48 General 3,076,000 3,157,000 9.49 Health Care 9.50 Access 570,000 582,000 9.51 [CONSUMER SATISFACTION SURVEY.] Any 9.52 federal matching money received through 9.53 the medical assistance program for the 9.54 consumer satisfaction survey is 9.55 appropriated to the commissioner for 9.56 this purpose. The commissioner may 10.1 expend the federal money received for 10.2 the consumer satisfaction survey in 10.3 either year of the biennium. 10.4 (b) Health Care Operations 10.5 General 20,284,000 20,419,000 10.6 Health Care 10.7 Access 15,715,000 17,568,000 10.8 [MINNESOTACARE STAFF.] Of this 10.9 appropriation, $2,121,000 for fiscal 10.10 year 2000 and $1,465,000 for fiscal 10.11 year 2001 is from the health care 10.12 access fund to the commissioner for 10.13 staff and other administrative services 10.14 associated with improving MinnesotaCare 10.15 processing and caseload management. Of 10.16 this appropriation, $965,000 shall 10.17 become part of the base. 10.18 [PREPAID MEDICAL PROGRAMS.] The 10.19 nonfederal share of the prepaid medical 10.20 assistance program fund, which has been 10.21 appropriated to fund county managed 10.22 care advocacy and enrollment operating 10.23 costs, shall be disbursed as grants 10.24 using either a reimbursement or block 10.25 grant mechanism and may also be 10.26 transferred between grants and nongrant 10.27 administration costs with approval of 10.28 the commissioner of finance. 10.29 Subd. 7. State-Operated Services 10.30 General 206,785,000 211,902,000 10.31 The amounts that may be spent from this 10.32 appropriation for each purpose are as 10.33 follows: 10.34 (a) SOS-Campus Based Programs 10.35 General 185,552,000 190,043,000 10.36 [DAY TRAINING SERVICES.] In order to 10.37 ensure eligible individuals have access 10.38 to day training and habilitation 10.39 services, the regional treatment 10.40 centers, the Minnesota extended 10.41 treatment options program, and 10.42 state-operated community services 10.43 operating according to Minnesota 10.44 Statutes, section 252.50, are exempt 10.45 from the provisions of Minnesota 10.46 Statutes, section 252.41, subdivision 10.47 9, clause (2). Notwithstanding section 10.48 13, this provision shall not expire. 10.49 [MITIGATION RELATED TO DEVELOPMENTAL 10.50 DISABILITIES DOWNSIZING.] Money 10.51 appropriated to finance mitigation 10.52 expenses related to the downsizing of 10.53 regional treatment center developmental 10.54 disabilities programs may be 10.55 transferred between fiscal years within 10.56 the biennium. 10.57 [REGIONAL TREATMENT CENTER CHEMICAL 10.58 DEPENDENCY PROGRAMS.] When the 11.1 operations of the regional treatment 11.2 center chemical dependency fund created 11.3 in Minnesota Statutes, section 246.18, 11.4 subdivision 2, are impeded by projected 11.5 cash deficiencies resulting from delays 11.6 in the receipt of grants, dedicated 11.7 income, or other similar receivables, 11.8 and when the deficiencies would be 11.9 corrected within the budget period 11.10 involved, the commissioner of finance 11.11 may transfer general fund cash reserves 11.12 into this account as necessary to meet 11.13 cash demands. The cash flow transfers 11.14 must be returned to the general fund in 11.15 the fiscal year that the transfer was 11.16 made. Any interest earned on general 11.17 fund cash flow transfers accrues to the 11.18 general fund and not the regional 11.19 treatment center chemical dependency 11.20 fund. 11.21 [LEAVE LIABILITIES.] The accrued leave 11.22 liabilities of state employees 11.23 transferred to state-operated community 11.24 services programs may be paid from the 11.25 appropriation in this subdivision for 11.26 state-operated services. Funds set 11.27 aside for this purpose shall not exceed 11.28 the amount of the actual leave 11.29 liability calculated as of June 30, 11.30 2000, and shall be available until 11.31 expended. 11.32 [REGIONAL TREATMENT CENTER 11.33 RESTRUCTURING.] For purposes of 11.34 restructuring the regional treatment 11.35 centers and state nursing homes, any 11.36 regional treatment center or state 11.37 nursing home employee whose position is 11.38 to be eliminated shall be afforded the 11.39 options provided in applicable 11.40 collective bargaining agreements. All 11.41 salary and mitigation allocations from 11.42 fiscal year 2000 shall be carried 11.43 forward into fiscal year 2001. 11.44 Provided there is no conflict with any 11.45 collective bargaining agreement, any 11.46 regional treatment center or state 11.47 nursing home position reduction must 11.48 only be accomplished through 11.49 mitigation, attrition, transfer, and 11.50 other measures as provided in state or 11.51 applicable collective bargaining 11.52 agreements and in Minnesota Statutes, 11.53 section 252.50, subdivision 11, and not 11.54 through layoff. 11.55 [REGIONAL TREATMENT CENTER POPULATION.] 11.56 If the resident population at the 11.57 regional treatment centers is projected 11.58 to be higher than the estimates upon 11.59 which the medical assistance forecast 11.60 and budget recommendations for the 11.61 2000-2001 biennium is based, the amount 11.62 of the medical assistance appropriation 11.63 that is attributable to the cost of 11.64 services that would have been provided 11.65 as an alternative to regional treatment 11.66 center services, including resources 11.67 for community placements and waivered 11.68 services for persons with mental 12.1 retardation and related conditions, is 12.2 transferred to the residential 12.3 facilities appropriation. 12.4 [REPAIRS AND BETTERMENTS.] The 12.5 commissioner may transfer unencumbered 12.6 appropriation balances between fiscal 12.7 years for the state residential 12.8 facilities repairs and betterments 12.9 account and special equipment. 12.10 [PROJECT LABOR.] Wages for project 12.11 labor may be paid by the commissioner 12.12 out of repairs and betterments money if 12.13 the individual is to be engaged in a 12.14 construction project or a repair 12.15 project of short-term and nonrecurring 12.16 nature. Compensation for project labor 12.17 shall be based on the prevailing wage 12.18 rates, as defined in Minnesota 12.19 Statutes, section 177.42, subdivision 12.20 6. Project laborers are excluded from 12.21 the provisions of Minnesota Statutes, 12.22 sections 43A.22 to 43A.30, and shall 12.23 not be eligible for state-paid 12.24 insurance and benefits. 12.25 [DEVELOPMENTAL DISABILITIES CRISIS 12.26 UNIT.] The commissioner shall establish 12.27 a 16-bed developmental disabilities 12.28 crisis unit at the Brainerd regional 12.29 treatment center to provide short-term 12.30 crisis services to community-based 12.31 residents of state and private programs 12.32 for persons with mental retardation or 12.33 related conditions. 12.34 [LOCAL FIRE DEPARTMENT FUNDING.] (a) 12.35 The St. Peter Human Services Center 12.36 shall continue funding for fiscal year 12.37 2000 to the local fire department in an 12.38 amount equal to the funding provided to 12.39 the local fire department in the 1999 12.40 fiscal year. 12.41 (b) The Moose Lake Sexual Psychopathic 12.42 Personality Treatment Center shall 12.43 resume funding for fiscal year 2000 to 12.44 the local fire department in an amount 12.45 equal to one-half of the amount paid in 12.46 the last fiscal year the former Moose 12.47 Lake Human Services Center provided 12.48 funding to the local fire department. 12.49 (c) The commissioner of human services, 12.50 in consultation with the St. Peter and 12.51 Moose Lake fire departments, shall 12.52 report to the legislature by January 12.53 15, 2000, on the fiscal impact, and any 12.54 other relevant impact on the local 12.55 communities, of continuing or 12.56 discontinuing the funding to the local 12.57 fire departments. 12.58 (b) State-Operated Community 12.59 Services - Northeast Minnesota 12.60 Mental Health Services 12.61 General 3,983,000 4,055,000 12.62 (c) State-Operated Community 13.1 Services - Statewide DD Supports 13.2 General 15,493,000 16,047,000 13.3 (d) State-Operated Services - 13.4 Enterprise Activities 13.5 General 1,757,000 1,757,000 13.6 Subd. 8. Continuing Care and 13.7 Community Support Grants 13.8 General 1,171,727,000 1,253,915,000 13.9 Lottery Prize 1,518,000 1,408,000 13.10 The amounts that may be spent from this 13.11 appropriation for each purpose are as 13.12 follows: 13.13 (a) Community Social Services 13.14 Block Grants 13.15 42,597,000 43,498,000 13.16 [CSSA TRADITIONAL APPROPRIATION.] 13.17 Notwithstanding Minnesota Statutes, 13.18 section 256E.06, subdivisions 1 and 2, 13.19 the appropriations available under that 13.20 section in fiscal years 2000 and 2001 13.21 must be distributed to each county 13.22 proportionately to the aid received by 13.23 the county in calendar year 1998. The 13.24 commissioner, in consultation with 13.25 counties, shall study the formula 13.26 limitations in subdivision 2 of that 13.27 section, and report findings and any 13.28 recommendations for revision of the 13.29 CSSA formula and its formula limitation 13.30 provisions to the legislature by 13.31 January 15, 2000. 13.32 (b) Consumer Support Grants 13.33 1,123,000 1,123,000 13.34 (c) Aging Adult Service Grants 13.35 8,134,000 7,745,000 13.36 [LIVING-AT-HOME/BLOCK NURSE PROGRAM.] 13.37 Of the general fund appropriation, 13.38 $60,000 in fiscal year 2000 and $60,000 13.39 in fiscal year 2001 is for the 13.40 commissioner to provide funding to 13.41 three additional living-at-home/block 13.42 nurse programs. This appropriation 13.43 shall become part of the base for the 13.44 2002-2003 biennium. 13.45 [AREA AGENCIES ON AGING.] Of this 13.46 appropriation, $70,000 in fiscal year 13.47 2000 and $70,000 in fiscal year 2001 is 13.48 from the general fund to the 13.49 commissioner to be distributed to area 13.50 agencies on aging to provide technical 13.51 support and planning services to enable 13.52 older adults to remain living in the 13.53 community. The appropriation shall be 13.54 disbursed among area agencies in 13.55 proportion to the number of citizens 14.1 over 60 years of age living in each 14.2 region. This appropriation shall 14.3 become part of the base for the 14.4 2002-2003 biennium. 14.5 [MINNESOTA SENIOR SERVICE CORPS.] Of 14.6 this appropriation, $160,000 for the 14.7 biennium is from the general fund to 14.8 the commissioner for the following 14.9 purposes: 14.10 (a) $40,000 in fiscal year 2000 and 14.11 $40,000 in fiscal year 2001 is to 14.12 increase the hourly stipend by ten 14.13 cents per hour in the foster 14.14 grandparent program, the retired and 14.15 senior volunteer program, and the 14.16 senior companion program. 14.17 (b) $40,000 in fiscal year 2000 and 14.18 $40,000 in fiscal year 2001 is for a 14.19 grant to the tri-valley opportunity 14.20 council in Crookston to expand services 14.21 in the ten-county area of northwestern 14.22 Minnesota. 14.23 (c) This appropriation shall become 14.24 part of the base for the 2002-2003 14.25 biennium. 14.26 [SUPPLEMENTAL NUTRITION FUNDING.] Of 14.27 this appropriation, $150,000 in fiscal 14.28 year 2000 is to the commissioner for 14.29 grants to three counties that financed 14.30 congregate and home-delivered meals 14.31 locally prior to county participation 14.32 in the nutrition program of the Older 14.33 Americans Act. 14.34 [HEALTH INSURANCE COUNSELING.] Of this 14.35 appropriation, $100,000 in fiscal year 14.36 2000 and $100,000 in fiscal year 2001 14.37 is from the general fund to the 14.38 commissioner to transfer to the board 14.39 on aging for the purpose of awarding 14.40 health insurance counseling and 14.41 assistance grants to the area agencies 14.42 on aging providing state-funded health 14.43 insurance counseling services. Access 14.44 to health insurance counseling programs 14.45 shall be provided by the senior linkage 14.46 line service of the board on aging and 14.47 the area agencies on aging. The board 14.48 on aging shall explore opportunities 14.49 for obtaining alternative funding from 14.50 nonstate sources, including 14.51 contributions from individuals seeking 14.52 health insurance counseling services. 14.53 (d) Deaf and Hard-of-Hearing 14.54 Services Grants 14.55 1,949,000 1,970,000 14.56 [DEAF AND HARD-OF-HEARING ADULTS WITH 14.57 MENTAL ILLNESS.] Of this appropriation, 14.58 $200,000 in fiscal year 2000 and 14.59 $200,000 in fiscal year 2001 is from 14.60 the general fund to the commissioner 14.61 for the following purposes: 15.1 (a) $100,000 in fiscal year 2000 and 15.2 $100,000 in fiscal year 2001 is for a 15.3 grant to a nonprofit agency that 15.4 currently serves deaf and 15.5 hard-of-hearing adults with mental 15.6 illness through residential programs 15.7 and supported housing outreach to 15.8 operate a community-support program for 15.9 persons with mental illness that is 15.10 communicatively accessible for persons 15.11 who are deaf or hard-of-hearing. 15.12 (b) $100,000 in fiscal year 2000 and 15.13 $100,000 in fiscal year 2001 is for 15.14 grants to provide specialized 15.15 community-based mental health services 15.16 for the deaf and hard-of-hearing 15.17 residing outside the seven-county 15.18 metropolitan area. Services provided 15.19 under these grants may use remote 15.20 access technology for delivering mental 15.21 health services via teleconferencing 15.22 from a centralized site. 15.23 (c) These appropriations shall become 15.24 part of the base for the 2002-2003 15.25 biennium. 15.26 [MOBILITY SPECIALIST FOR DEAF-BLIND 15.27 PEOPLE.] Of this appropriation, $60,000 15.28 in fiscal year 2000 and $60,000 in 15.29 fiscal year 2001 is from the general 15.30 fund to the commissioner for a grant to 15.31 DeafBlind Services Minnesota to hire an 15.32 orientation and mobility specialist to 15.33 work with deaf-blind people. The 15.34 specialist shall provide services to 15.35 deaf-blind Minnesotans and training to 15.36 teachers and rehabilitation counselors 15.37 statewide. Any amount of this 15.38 appropriation that is not expended in 15.39 the first year shall not cancel but 15.40 shall be available for the second year. 15.41 This appropriation shall not become 15.42 part of the base for the 2002-2003 15.43 biennium. 15.44 [MINNESOTA COMMISSION SERVING DEAF AND 15.45 HARD-OF-HEARING.] Of this 15.46 appropriation, $50,000 in fiscal year 15.47 2000 and $50,000 in fiscal year 2001 is 15.48 from the general fund to the 15.49 commissioner for the Minnesota 15.50 commission serving deaf and 15.51 hard-of-hearing people. This 15.52 appropriation may be used for 15.53 communication access, printing, travel, 15.54 supplies, and equipment, but shall not 15.55 be used for staff compensation. This 15.56 appropriation shall become part of the 15.57 base for the 2002-2003 biennium. 15.58 (e) Mental Health Grants 15.59 General 45,154,000 46,537,000 15.60 Lottery Prize 1,518,000 1,408,000 15.61 [CRISIS HOUSING.] Of the general fund 15.62 appropriation, $126,000 in fiscal year 15.63 2000 and $174,000 in fiscal year 2001 16.1 is to the commissioner for the adult 16.2 mental illness crisis housing 16.3 assistance program. This appropriation 16.4 shall become part of the base for the 16.5 2002-2003 biennium. 16.6 Of this appropriation, $250,000 in 16.7 fiscal year 2000 and $250,000 in fiscal 16.8 year 2001 is from the lottery prize 16.9 fund to the commissioner for purposes 16.10 of the compulsive gambling program. 16.11 This shall become part of the base 16.12 level appropriation. 16.13 With the funds appropriated for the 16.14 compulsive gambling program, the 16.15 commissioner of human services shall 16.16 ensure that a continuum of therapeutic 16.17 services is available throughout the 16.18 state through a fee-for-service model 16.19 integrated with, and maintaining, the 16.20 existing network of grant-supported 16.21 group treatment centers. The 16.22 commissioner shall also ensure the 16.23 continuation of the toll-free hotline, 16.24 public awareness and education, 16.25 gambling assessments, and appropriate 16.26 prevalence studies and research. The 16.27 commissioner shall ensure that the 16.28 compulsive gambling program provides 16.29 for prevention, intervention, and 16.30 treatment for underserved populations 16.31 and high-risk or vulnerable populations. 16.32 [ADOLESCENT COMPULSIVE GAMBLING GRANT.] 16.33 $150,000 in fiscal year 2000 and 16.34 $150,000 in fiscal year 2001 is 16.35 appropriated from the lottery prize 16.36 fund created under Minnesota Statutes, 16.37 section 349A.10, subdivision 2, to the 16.38 commissioner for the purposes of a 16.39 grant to a compulsive gambling council 16.40 located in St. Louis county for a 16.41 statewide compulsive gambling 16.42 prevention and education project for 16.43 adolescents. 16.44 [COMPULSIVE GAMBLING INPATIENT 16.45 TREATMENT.] $110,000 the first year is 16.46 from the lottery prize fund for a grant 16.47 to Project Turnabout in Granite Falls 16.48 to provide compulsive gambling 16.49 treatment and education. The 16.50 appropriation is available until June 16.51 30, 2001, and must not become part of 16.52 the base appropriation. 16.53 (f) Developmental Disabilities 16.54 Community Support Grants 16.55 8,323,000 9,458,000 16.56 [CRISIS INTERVENTION PROJECT.] Of this 16.57 appropriation, $40,000 in fiscal year 16.58 2000 is to the commissioner for the 16.59 action, support, and prevention project 16.60 of southeastern Minnesota. 16.61 (g) Medical Assistance Long-Term 16.62 Care Waivers and Home Care 17.1 347,130,000 409,142,000 17.2 [PROVIDER RATE INCREASES.] (a) The 17.3 commissioner shall increase 17.4 reimbursement rates by four percent the 17.5 first year of the biennium and by three 17.6 percent the second year for the 17.7 providers listed in paragraph (b). The 17.8 increases shall be effective for 17.9 services rendered on or after July 1 of 17.10 each year. 17.11 (b) The rate increases described in 17.12 this section shall be provided to home 17.13 and community-based waivered services 17.14 for persons with mental retardation or 17.15 related conditions under Minnesota 17.16 Statutes, section 256B.501; home and 17.17 community-based waivered services for 17.18 the elderly under Minnesota Statutes, 17.19 section 256B.0915; waivered services 17.20 under community alternatives for 17.21 disabled individuals under Minnesota 17.22 Statutes, section 256B.49; community 17.23 alternative care waivered services 17.24 under Minnesota Statutes, section 17.25 256B.49; traumatic brain injury 17.26 waivered services under Minnesota 17.27 Statutes, section 256B.49; nursing 17.28 services and home health services under 17.29 Minnesota Statutes, section 256B.0625, 17.30 subdivision 6a; personal care services 17.31 and nursing supervision of personal 17.32 care services under Minnesota Statutes, 17.33 section 256B.0625, subdivision 19a; 17.34 private-duty nursing services under 17.35 Minnesota Statutes, section 256B.0625, 17.36 subdivision 7; day training and 17.37 habilitation services for adults with 17.38 mental retardation or related 17.39 conditions under Minnesota Statutes, 17.40 sections 252.40 to 252.46; alternative 17.41 care services under Minnesota Statutes, 17.42 section 256B.0913; adult residential 17.43 program grants under Minnesota Rules, 17.44 parts 9535.2000 to 9535.3000; adult and 17.45 family community support grants under 17.46 Minnesota Rules, parts 9535.1700 to 17.47 9535.1760; semi-independent living 17.48 services under Minnesota Statutes, 17.49 section 252.275, including SILS funding 17.50 under county social services grants 17.51 formerly funded under Minnesota 17.52 Statutes, chapter 256I; community 17.53 support services for deaf and 17.54 hard-of-hearing adults with mental 17.55 illness who use or wish to use sign 17.56 language as their primary means of 17.57 communication; and the group 17.58 residential housing supplementary 17.59 service rate under Minnesota Statutes, 17.60 section 256I.05, subdivision 1a. 17.61 (c) Providers that receive a rate 17.62 increase under this section shall use 17.63 at least 90 percent of the additional 17.64 revenue to increase the wages paid to 17.65 employees other than the administrator 17.66 and central office staff and for 17.67 payroll taxes associated with these 17.68 wage increases. 18.1 (d) A copy of the provider's plan for 18.2 complying with paragraph (c) must be 18.3 made available to all employees. This 18.4 must be done by giving each employee a 18.5 copy or by posting it in an area of the 18.6 provider's operation to which all 18.7 employees have access. If an employee 18.8 does not receive the salary adjustment 18.9 described in the plan and is unable to 18.10 resolve the problem with the provider, 18.11 the employee may contact the employee's 18.12 union representative. If the employee 18.13 is not covered by a collective 18.14 bargaining agreement, the employee may 18.15 contact the commissioner at a phone 18.16 number provided by the commissioner and 18.17 included in the provider's plan. 18.18 (e) Section 13, sunset of uncodified 18.19 language, does not apply to this 18.20 provision. 18.21 [COUNTY WAIVERED SERVICES RESERVE.] 18.22 Notwithstanding the provisions of 18.23 Minnesota Statutes, section 256B.092, 18.24 subdivision 4, and Minnesota Rules, 18.25 part 9525.1830, subpart 2, the 18.26 commissioner may approve written 18.27 procedures and criteria for the 18.28 allocation of home and community-based 18.29 waivered services funding for persons 18.30 with mental retardation or related 18.31 conditions which enables a county to 18.32 maintain a reserve resource account. 18.33 The reserve resource account may not 18.34 exceed five percent of the county 18.35 agency's total annual allocation of 18.36 home and community-based waivered 18.37 services funds. The reserve may be 18.38 utilized to ensure the county's ability 18.39 to meet the changing needs of current 18.40 recipients, to ensure the health and 18.41 safety needs of current recipients, or 18.42 to provide short-term emergency 18.43 intervention care to eligible waiver 18.44 recipients. 18.45 (h) Medical Assistance Long-Term 18.46 Care Facilities 18.47 545,560,000 557,620,000 18.48 [MORATORIUM EXCEPTIONS.] Of this 18.49 appropriation, $250,000 in fiscal year 18.50 2000 and $250,000 in fiscal year 2001 18.51 is from the general fund to the 18.52 commissioner for the medical assistance 18.53 costs of moratorium exceptions approved 18.54 by the commissioner of health under 18.55 Minnesota Statutes, section 144A.073. 18.56 Unexpended money appropriated for 18.57 fiscal year 2000 shall not cancel but 18.58 shall be available for fiscal year 2001. 18.59 [NURSING FACILITY OPERATED BY THE RED 18.60 LAKE BAND OF CHIPPEWA INDIANS.] (1) The 18.61 medical assistance payment rates for 18.62 the 47-bed nursing facility operated by 18.63 the Red Lake Band of Chippewa Indians 18.64 must be calculated according to 18.65 allowable reimbursement costs under the 19.1 medical assistance program, as 19.2 specified in Minnesota Statutes, 19.3 section 246.50, and are subject to the 19.4 facility-specific Medicare upper limits. 19.5 (2) In addition, the commissioner shall 19.6 make available a salary adjustment 19.7 effective July 1, 1999, that is equal 19.8 to four percent of total salaries, 19.9 related payroll taxes, and fringe 19.10 benefits, excluding general and 19.11 administrative costs, divided by the 19.12 number of total resident days and a 19.13 salary adjustment effective July 1, 19.14 2000, that is equal to three percent of 19.15 total salaries, related payroll taxes, 19.16 and fringe benefits, excluding general 19.17 and administrative costs, divided by 19.18 the number of total resident days. The 19.19 commissioner must use the facility's 19.20 final 1998 and 1999 Medicare cost 19.21 reports, respectively, to calculate the 19.22 rate adjustment. The rate adjustment 19.23 shall be available based on a plan 19.24 submitted and approved according to 19.25 Minnesota Statutes, section 256B.431, 19.26 subdivision 28. Section 13, sunset of 19.27 uncodified language, does not apply to 19.28 this paragraph. 19.29 (i) Alternative Care Grants 19.30 General 60,873,000 59,981,000 19.31 [ALTERNATIVE CARE TRANSFER.] Any money 19.32 allocated to the alternative care 19.33 program that is not spent for the 19.34 purposes indicated does not cancel but 19.35 shall be transferred to the medical 19.36 assistance account. 19.37 [PREADMISSION SCREENING AMOUNT.] The 19.38 preadmission screening payment to all 19.39 counties shall continue at the payment 19.40 amount in effect for fiscal year 1999. 19.41 [ALTERNATIVE CARE APPROPRIATION.] The 19.42 commissioner may expend the money 19.43 appropriated for the alternative care 19.44 program for that purpose in either year 19.45 of the biennium. 19.46 (j) Group Residential Housing 19.47 General 67,131,000 71,491,000 19.48 [GROUP RESIDENTIAL FACILITY FOR WOMEN 19.49 IN RAMSEY COUNTY.] (a) Notwithstanding 19.50 Minnesota Statutes 1998, section 19.51 256I.05, subdivision 1d, the new group 19.52 residential facility for women in 19.53 Ramsey county, with approval by the 19.54 county agency, may negotiate a 19.55 supplementary service rate in addition 19.56 to the board and lodging rate for 19.57 facilities licensed and registered by 19.58 the Minnesota department of health 19.59 under Minnesota Statutes, section 19.60 15.17. The supplementary service rate 19.61 shall not exceed $564 per person per 19.62 month and the total rate may not exceed 20.1 $1,177 per person per month. 20.2 (b) Of the general fund appropriation, 20.3 $19,000 in fiscal year 2000 and $38,000 20.4 in fiscal year 2001 is to the 20.5 commissioner for the costs associated 20.6 with paragraph (a). This appropriation 20.7 shall become part of the base for the 20.8 2002-2003 biennium. 20.9 [ELDERLY HOUSING AND SERVICES NEEDS 20.10 STUDY.] The commissioner shall study 20.11 and report to the legislature by 20.12 January 15, 2000, with a comprehensive 20.13 plan for the provision of housing and 20.14 services to low-income elderly 20.15 persons. The plan must incorporate 20.16 existing state and county programs and 20.17 funding options and identify unmet 20.18 needs for arrangements that provide 20.19 seniors with a combination of housing 20.20 and services. The report must analyze 20.21 the impact the plan may have on 20.22 existing institutional health care 20.23 providers and on state and county 20.24 budgets. The study shall be conducted 20.25 in cooperation with the commissioner of 20.26 housing finance and with local public 20.27 housing authorities and housing and 20.28 redevelopment officials. 20.29 (k) Chemical Dependency 20.30 Entitlement Grants 20.31 General 37,250,000 38,847,000 20.32 (l) Chemical Dependency 20.33 Nonentitlement Grants 20.34 General 6,503,000 6,503,000 20.35 [CHEMICAL DEPENDENCY SERVICES.] Of this 20.36 appropriation, $499,000 in fiscal year 20.37 2000 is to the commissioner for 20.38 chemical dependency services to persons 20.39 who qualify under Minnesota Statutes, 20.40 section 254B.04, subdivision 1, 20.41 paragraph (b). 20.42 [REPEAT DWI OFFENDER PROGRAM.] Of this 20.43 appropriation, $100,000 in fiscal year 20.44 2000 and $100,000 in fiscal year 2001 20.45 is for the commissioner to pay for 20.46 chemical dependency treatment for 20.47 participants in the Camp Ripley repeat 20.48 DWI offender program at Brainerd 20.49 regional human services center. 20.50 Payment to the Brainerd regional human 20.51 services center may only be authorized 20.52 from this appropriation after all 20.53 potential public and private 20.54 third-party payers have been billed and 20.55 a determination made that the 20.56 participant is not eligible for 20.57 reimbursement of the treatment costs. 20.58 This appropriation shall not become 20.59 part of the base for the 2002-2003 20.60 biennium. 20.61 Subd. 9. Continuing Care and 20.62 Community Support Management 21.1 General 17,084,000 17,384,000 21.2 Lottery Prize 142,000 142,000 21.3 State Government 21.4 Special Revenue 114,000 115,000 21.5 [MINNESOTA SENIOR HEALTH OPTIONS 21.6 PROJECT.] Of this appropriation, up to 21.7 $200,000 may be transferred to the 21.8 Minnesota senior health options project 21.9 special revenue account during the 21.10 biennium ending June 30, 2001, to serve 21.11 as matching funds. 21.12 [PERSONS WITH BRAIN INJURIES.] (a) The 21.13 commissioner shall study and report to 21.14 the legislature by January 15, 2000, on 21.15 the status of persons with brain 21.16 injuries residing in public and private 21.17 institutions. The report shall include 21.18 information on lengths of stay, ages of 21.19 institutionalized persons, and on the 21.20 supports and services needed to allow 21.21 these persons to return to their 21.22 communities. 21.23 (b) The commissioner shall apply to the 21.24 Health Care Financing Administration 21.25 for a grant to carry out a 21.26 demonstration project to transition 21.27 disabled persons out of nursing homes. 21.28 The project must: 21.29 (1) identify persons with brain 21.30 injuries and other disabled persons 21.31 residing in nursing homes who could 21.32 live successfully in the community with 21.33 appropriate supports; 21.34 (2) develop community-based services 21.35 and supports for institutionalized 21.36 persons; 21.37 (3) eliminate incentives to keep these 21.38 persons in institutions; 21.39 (4) foster the independence of 21.40 institutionalized persons by involving 21.41 them in the selection and management of 21.42 community-based services, such as 21.43 personal care assistance; 21.44 (5) develop innovative funding 21.45 arrangements to enable funding to 21.46 follow the individual; and 21.47 (6) empower disabled persons, families, 21.48 and advocacy groups by including them 21.49 in the design and implementation of 21.50 service delivery models that maximize 21.51 consumer choice and direction. 21.52 (c) Paragraph (b) is effective the day 21.53 following final enactment. 21.54 Subd. 10. Economic Support Grants 21.55 General 144,124,000 127,674,000 22.1 [GIFTS.] Notwithstanding Minnesota 22.2 Statutes, chapter 7, the commissioner 22.3 may accept on behalf of the state 22.4 additional funding from sources other 22.5 than state funds for the purpose of 22.6 financing the cost of assistance 22.7 program grants or nongrant 22.8 administration. All additional funding 22.9 is appropriated to the commissioner for 22.10 use as designated by the grantee of 22.11 funding. 22.12 [CHILD SUPPORT PAYMENT CENTER 22.13 RECOUPMENT ACCOUNT.] The child support 22.14 payment center is authorized to 22.15 establish an account to cover checks 22.16 issued in error or in cases where 22.17 insufficient funds are available to pay 22.18 the checks. All recoupments against 22.19 payments from the account must be 22.20 deposited in the child support payment 22.21 center recoupment account and are 22.22 appropriated to the commissioner for 22.23 the purposes of the account. Any 22.24 unexpended balance in the account does 22.25 not cancel, but is available until 22.26 expended. 22.27 The amounts that may be spent from this 22.28 appropriation for each purpose are as 22.29 follows: 22.30 (a) Assistance to Families Grants 22.31 General 64,870,000 66,117,000 22.32 [FEDERAL TANF FUNDS.] (1) Federal 22.33 Temporary Assistance for Needy Families 22.34 block grant funds authorized under 22.35 title I, Public Law Number 104-193, the 22.36 Personal Responsibility and Work 22.37 Opportunity Reconciliation Act of 1996, 22.38 and awarded in federal fiscal years 22.39 1997 to 2002 are appropriated to the 22.40 commissioner in amounts up to 22.41 $307,140,000 is fiscal year 2000 and 22.42 $306,974,000 in fiscal year 2001. 22.43 (2) Of the amounts in clause (1), 22.44 $45,700,000 the first year and 22.45 $45,125,000 the second year is 22.46 transferred to the state's federal 22.47 child care and development fund block 22.48 grant, and is appropriated to the 22.49 commissioner of children, families, and 22.50 learning. Of these amounts, 22.51 $45,000,000 in each year is for the 22.52 purposes of Minnesota Statutes, section 22.53 119B.03, and $700,000 the first year 22.54 and $125,000 the second year is for 22.55 child care development activities 22.56 required under the federal child care 22.57 and development fund. In fiscal years 22.58 2002 and 2003 the transfer shall be 22.59 $15,000,000 per year for the purposes 22.60 of Minnesota Statutes, section 119B.03. 22.61 (3) Of the amounts in clause (1), 22.62 $15,000,000 is transferred each year of 22.63 the biennium to the state's federal 22.64 Title XX block grant. Notwithstanding 23.1 the provisions of Minnesota Statutes, 23.2 section 256E.07, in each year of the 23.3 biennium the commissioner shall 23.4 allocate $15,000,000 of the state's 23.5 Title XX block grant funds based on the 23.6 community social services aids formula 23.7 in Minnesota Statutes, section 23.8 256E.06. The commissioner shall ensure 23.9 that money allocated to counties under 23.10 this provision is used according to the 23.11 requirements of United States Code, 23.12 title 42, section 604(d)(3)(B). Any 23.13 reductions to the amount of the 23.14 community social services block grant 23.15 in fiscal year 2000 or 2001 as a result 23.16 of these actions are one-time 23.17 reductions and shall not reduce the 23.18 base for the CSSA block grant for the 23.19 2002-2003 biennial budget. 23.20 (4) Of the amounts in clause (1), 23.21 $10,000,000 is transferred each year 23.22 from the state's federal TANF block 23.23 grant to the state's federal Title XX 23.24 block grant. In each year $140,000 is 23.25 for grants according to Minnesota 23.26 Statutes, section 257.3571, subdivision 23.27 2a, to the Indian child welfare defense 23.28 corporation to promote statewide 23.29 compliance with the Indian Child 23.30 Welfare Act of 1978; $4,650,000 is for 23.31 grants to counties for concurrent 23.32 permanency planning; and $5,210,000 is 23.33 for the commissioner to distribute 23.34 according to the formula in Minnesota 23.35 Statutes, section 256E.07. The 23.36 commissioner shall ensure that money 23.37 allocated under this clause is used 23.38 according to the requirements of United 23.39 States Code, title 42, section 23.40 604(d)(3)(B). In fiscal years 2002 and 23.41 2003, $9,860,000 per year is for the 23.42 commissioner to distribute according to 23.43 the formula in Minnesota Statutes, 23.44 section 256E.07, and $140,000 per year 23.45 is for grants according to Minnesota 23.46 Statutes, section 257.3571, subdivision 23.47 2a, to the Indian child welfare defense 23.48 corporation to promote statewide 23.49 compliance with the Indian Child 23.50 Welfare Act of 1978. 23.51 (5) Of the amounts in clause (1), 23.52 $20,000,000 each year is for increased 23.53 employment and training efforts and 23.54 shall be expended as follows: 23.55 (a) $5,000,000 each year is for the 23.56 commissioner to provide employment 23.57 services to MFIP participants who face 23.58 serious and multiple barriers to 23.59 employment. 23.60 (b) $140,000 each year is for a grant 23.61 to the new chance program. The new 23.62 chance program shall provide 23.63 comprehensive services through a 23.64 private, nonprofit agency to young 23.65 parents in Hennepin county who have 23.66 dropped out of school and are receiving 23.67 public assistance. The program 24.1 administrator shall report annually to 24.2 the commissioner on skills development, 24.3 education, job training, and job 24.4 placement outcomes for program 24.5 participants. This appropriation is 24.6 available for either year of the 24.7 biennium. 24.8 (c) $400,000 each year is for grants to 24.9 counties to operate the parents fair 24.10 share program to assist unemployed, 24.11 noncustodial parents with job search 24.12 and parenting skills. 24.13 (d) $1,500,000 each year is to be 24.14 transferred to the job skills 24.15 partnership board for the health care 24.16 and human services worker training and 24.17 retention program. 24.18 (e) $12,960,000 each year is to 24.19 increase employment and training 24.20 services grants for MFIP. 24.21 (f) These appropriations shall become 24.22 part of the base for the 2002-2003 24.23 biennium. 24.24 (6) Of the amounts in clause (1), 24.25 $1,094,000 in fiscal year 2000 and 24.26 $1,676,000 in fiscal year 2001 is 24.27 transferred from the state's federal 24.28 TANF block grant to the state's federal 24.29 child care and development fund block 24.30 grant, and is appropriated to the 24.31 commissioner of children, families, and 24.32 learning for the purposes of Minnesota 24.33 Statutes, section 119B.05. 24.34 (7) Of the amounts in clause (1), 24.35 $1,500,000 for the biennium is for the 24.36 purposes of creating and expanding 24.37 adult-supervised supportive living 24.38 arrangements under Minnesota Statutes, 24.39 section 256J.14. The commissioner 24.40 shall request proposals from interested 24.41 parties that have knowledge and 24.42 experience in the area of adolescent 24.43 housing, and award grants for the 24.44 purpose of either expanding existing 24.45 living arrangements or creating new 24.46 living arrangements. Minor parents who 24.47 are MFIP participants shall be given 24.48 priority for housing, and excess living 24.49 arrangements may be used by minor 24.50 parents who are not MFIP participants. 24.51 [EMPLOYMENT SERVICES CARRYOVER.] 24.52 General fund and federal TANF block 24.53 grant appropriations for employment 24.54 services that remain unexpended 24.55 subsequent to the reallocation process 24.56 required in Minnesota Statutes, section 24.57 256J.62, do not cancel but are 24.58 available for these purposes in fiscal 24.59 year 2001. 24.60 [CASH BENEFITS IN ADVANCE.] The 24.61 commissioner, with the advance approval 24.62 of the commissioner of finance, is 24.63 authorized to issue cash assistance 25.1 benefits up to three days before the 25.2 first day of each month, including 25.3 three days before the start of each 25.4 state fiscal year. Of the money 25.5 appropriated for cash assistance grants 25.6 for each fiscal year, up to three 25.7 percent of the annual state 25.8 appropriation is available to the 25.9 commissioner in the previous fiscal 25.10 year. If that amount is insufficient 25.11 for the costs incurred, an additional 25.12 amount of the appropriation as needed 25.13 may be transferred with the advance 25.14 approval of the commissioner of 25.15 finance. This paragraph is effective 25.16 the day following final enactment. 25.17 (b) Work Grants 25.18 General 12,031,000 12,031,000 25.19 (c) Aid to Families With 25.20 Dependent Children and Other 25.21 Assistance 25.22 General 1,053,000 1,119,000 25.23 (d) Child Support Enforcement 25.24 General 5,371,000 5,455,000 25.25 [CHILD SUPPORT PAYMENT CENTER.] 25.26 Payments to the commissioner from other 25.27 governmental units, private 25.28 enterprises, and individuals for 25.29 services performed by the child support 25.30 payment center must be deposited in the 25.31 state systems account authorized under 25.32 Minnesota Statutes, section 256.014. 25.33 These payments are appropriated to the 25.34 commissioner for the operation of the 25.35 child support payment center or system, 25.36 according to Minnesota Statutes, 25.37 section 256.014. 25.38 [EXPEDITED PROCESS.] Appropriations 25.39 relating to the operation of the 25.40 administrative process under Minnesota 25.41 Statutes 1998, section 518.5511, may be 25.42 used for the expedited child support 25.43 hearing process. Appropriations for 25.44 the second year of the biennium are 25.45 available in the first year, but only 25.46 to the extent that the costs of the 25.47 expedited child support hearing process 25.48 exceed the base budget for the 25.49 administrative process because of an 25.50 increase in the number of orders in the 25.51 process. The commissioner shall 25.52 include cost reimbursement claims for 25.53 the child support expedited process in 25.54 the department's federal cost 25.55 reimbursement claim process according 25.56 to federal law. Federal dollars earned 25.57 under these claims are appropriated to 25.58 the commissioner and shall be disbursed 25.59 according to department procedures and 25.60 schedules. 25.61 [FATHER PROJECT.] (a) The commissioner 25.62 shall waive the enforcement of any 26.1 existing specific statutory program 26.2 requirements, administrative rules, and 26.3 standards, including the relevant 26.4 provisions of the following sections of 26.5 Minnesota Statutes: 26.6 (1) 256.741, subdivision 2, paragraph 26.7 (a); 26.8 (2) 256J.30, subdivision 11; 26.9 (3) 256J.33, subdivision 4, clause (5); 26.10 and 26.11 (4) 256J.34, subdivision 1, paragraph 26.12 (d). 26.13 The waivers permitted under this 26.14 paragraph are for the limited purposes 26.15 of allowing the entire amount of child 26.16 support payments to be passed through 26.17 for the children of individuals 26.18 participating in the FATHER project and 26.19 excluding child support payments paid 26.20 by FATHER participants as income for 26.21 MFIP participants who receive the child 26.22 support payments. The waiver authority 26.23 granted by this section sunsets on July 26.24 1, 2002. 26.25 (b) Of this appropriation, $12,000 in 26.26 fiscal year 2000 and $96,000 in fiscal 26.27 year 2001 is to offset the increased 26.28 costs to the state for reimbursing the 26.29 federal government for their share of 26.30 child support collections relating to 26.31 the implementation of the waivers under 26.32 paragraph (a). This appropriation is 26.33 available until expended and is 26.34 available only to the extent that it is 26.35 completely reimbursed by money provided 26.36 by the private philanthropical 26.37 community. 26.38 (e) General Assistance 26.39 General 33,927,000 14,973,000 26.40 [TRANSFERS FROM STATE TANF RESERVE.] 26.41 $4,666,000 in fiscal year 2000 is 26.42 transferred from the state TANF reserve 26.43 account to the general fund. 26.44 [GENERAL ASSISTANCE STANDARD.] The 26.45 commissioner shall set the monthly 26.46 standard of assistance for general 26.47 assistance units consisting of an adult 26.48 recipient who is childless and 26.49 unmarried or living apart from his or 26.50 her parents or a legal guardian at 26.51 $203. The commissioner may reduce this 26.52 amount in accordance with Laws 1997, 26.53 chapter 85, article 3, section 54. 26.54 (f) Minnesota Supplemental Aid 26.55 General 25,767,000 26,874,000 26.56 (g) Refugee Services 26.57 General 1,105,000 1,105,000 27.1 Subd. 11. Economic Support 27.2 Management 27.3 General 38,847,000 42,254,000 27.4 Health Care 27.5 Access 1,313,000 1,318,000 27.6 The amounts that may be spent from this 27.7 appropriation for each purpose are as 27.8 follows: 27.9 (a) Economic Support Policy 27.10 Administration 27.11 General 7,100,000 6,951,000 27.12 [FOOD STAMP ADMINISTRATIVE 27.13 REIMBURSEMENT.] The commissioner shall 27.14 reduce quarterly food stamp 27.15 administrative reimbursement to 27.16 counties in fiscal years 1999, 2000, 27.17 and 2001 by the amount that the United 27.18 States Department of Health and Human 27.19 Services determines to be the county 27.20 random moment study share of the food 27.21 stamp adjustment under Public Law 27.22 Number 105-185. The reductions shall 27.23 be allocated to each county in 27.24 proportion to each county's 27.25 contribution, if any, to the amount of 27.26 the adjustment. Any adjustment to 27.27 medical assistance administrative 27.28 reimbursement that is based on the 27.29 United States Department of Health and 27.30 Human Services' determinations under 27.31 Public Law Number 105-185 shall be 27.32 distributed to counties in the same 27.33 manner. This provision is effective 27.34 the day following final enactment. 27.35 [SPENDING AUTHORITY FOR FOOD STAMP 27.36 ENHANCED FUNDING.] In the event that 27.37 Minnesota qualifies for United States 27.38 Department of Agriculture Food and 27.39 Nutrition Services Food Stamp Program 27.40 enhanced funding beginning in federal 27.41 fiscal year 1998, the money is 27.42 appropriated to the commissioner for 27.43 the purposes of the program. The 27.44 commissioner may retain 25 percent of 27.45 the enhanced funding, with the 27.46 remaining 75 percent divided among the 27.47 counties according to a formula that 27.48 takes into account each county's impact 27.49 on the statewide food stamp error rate. 27.50 [ELIGIBILITY DETERMINATION FUNDING.] 27.51 Increased federal funds for the costs 27.52 of eligibility determination and other 27.53 permitted activities that are available 27.54 to the state through section 114 of the 27.55 Personal Responsibility and Work 27.56 Opportunity Reconciliation Act, Public 27.57 Law Number 104-193, are appropriated to 27.58 the commissioner. 27.59 (b) Economic Support Operations 27.60 General 31,747,000 35,303,000 28.1 Health Care 28.2 Access 1,303,000 1,318,000 28.3 [FRAUD PREVENTION AND CONTROL FUNDING.] 28.4 Unexpended funds appropriated for the 28.5 provision of program integrity 28.6 activities for fiscal year 2000 are 28.7 also available to the commissioner to 28.8 fund fraud prevention and control 28.9 initiatives, and do not cancel but are 28.10 available to the commissioner for these 28.11 purposes for fiscal year 2001. 28.12 Unexpended funds may be transferred 28.13 between the fraud prevention 28.14 investigation program and fraud control 28.15 programs to promote the provisions of 28.16 Minnesota Statutes, sections 256.983 28.17 and 256.9861. 28.18 Sec. 3. COMMISSIONER OF HEALTH 28.19 Subdivision 1. Total 28.20 Appropriation 100,129,000 99,611,000 28.21 Summary by Fund 28.22 General 63,673,000 63,814,000 28.23 Metropolitan 28.24 Landfill Contingency 28.25 Action Fund 196,000 199,000 28.26 State Government 28.27 Special Revenue 25,586,000 25,075,000 28.28 Health Care 28.29 Access 10,674,000 10,523,000 28.30 [LANDFILL CONTINGENCY.] The 28.31 appropriation from the metropolitan 28.32 landfill contingency action fund is for 28.33 monitoring well water supplies and 28.34 conducting health assessments in the 28.35 metropolitan area. 28.36 [MINIMUM GRANT LEVELS.] The total level 28.37 of grants awarded by the commissioner 28.38 to local public health boards or 28.39 authorities under the community health 28.40 services act and under the maternal and 28.41 child health program shall not be less 28.42 than the amount awarded by the 28.43 commissioner in calendar year 1998. On 28.44 January 15 of each year, the 28.45 commissioner of finance shall report to 28.46 the chairs of the house health and 28.47 human services finance committee and 28.48 the senate health and family security 28.49 budget division and give assurances 28.50 that the awards under these programs 28.51 meet this test. 28.52 Subd. 2. Health Systems 28.53 and Special Populations 67,453,000 66,577,000 28.54 Summary by Fund 28.55 General 46,673,000 46,499,000 28.56 State Government 28.57 Special Revenue 10,202,000 9,653,000 29.1 Health Care 29.2 Access 10,578,000 10,425,000 29.3 [STATE VITAL STATISTICS REDESIGN 29.4 PROJECT ACCOUNT.] The amount 29.5 appropriated from the state government 29.6 special revenue fund in Laws 1997, 29.7 chapter 203, article 1, section 3, 29.8 subdivision 2, for the vital records 29.9 redesign project is available for 29.10 development and implementation costs 29.11 until expended. 29.12 [WIC TRANSFERS.] The general fund 29.13 appropriation for the women, infants, 29.14 and children (WIC) food supplement 29.15 program is available for either year of 29.16 the biennium. Transfers of these funds 29.17 between fiscal years must either be to 29.18 maximize federal funds or to minimize 29.19 fluctuations in the number of program 29.20 participants. 29.21 [MINNESOTA CHILDREN WITH SPECIAL HEALTH 29.22 NEEDS CARRYOVER.] General fund 29.23 appropriations for treatment services 29.24 in the services for Minnesota children 29.25 with special health needs program are 29.26 available for either year of the 29.27 biennium. 29.28 [FAMILY PLANNING GRANTS.] The 29.29 commissioner must allocate to each 29.30 organization receiving funds under 29.31 Minnesota Statutes, section 145.925, on 29.32 July 1, 1999, the same proportion of 29.33 grant funds for the 2000 to 2001 grant 29.34 funding cycle as the organization 29.35 received for the 1998 to 1999 grant 29.36 funding cycle, not to exceed the amount 29.37 received for the 1998 to 1999 grant 29.38 cycle, provided that the organization 29.39 submits revised goals, objectives, 29.40 methodologies, and budgets. 29.41 [FEE CHANGES.] When setting fees for 29.42 the speech language pathologist and 29.43 audiologist registration system 29.44 established under Minnesota Statutes, 29.45 sections 148.511 to 148.5196, the 29.46 commissioner is exempt from Minnesota 29.47 Statutes, section 16A.1285, subdivision 29.48 2. 29.49 [SUICIDE PREVENTION PROGRAM.] Of this 29.50 appropriation, $50,000 in fiscal year 29.51 2000 and $50,000 in fiscal year 2001 is 29.52 from the general fund to the 29.53 commissioner for the establishment of a 29.54 suicide prevention program. 29.55 [FAMILY PRACTICE RESIDENCY PROGRAM.] Of 29.56 the general fund appropriation, 29.57 $300,000 in fiscal year 2000 is to the 29.58 commissioner to make a grant to the 29.59 city of Duluth for a family practice 29.60 residency program for northeastern 29.61 Minnesota. 29.62 [UNCOMPENSATED CARE.] The commissioner 30.1 shall study and report to the 30.2 legislature by January 15, 2000, with: 30.3 (1) statistical information on the 30.4 amount of uncompensated health care 30.5 provided in Minnesota, the types of 30.6 care provided, the settings in which 30.7 the care is provided, and, if known, 30.8 the most common reasons why the care is 30.9 uncompensated; and 30.10 (2) recommendations for reducing the 30.11 level of uncompensated care, including, 30.12 but not limited to, methods to enroll 30.13 eligible persons in public health care 30.14 programs through simplification of the 30.15 application process and other efforts. 30.16 [RURAL AREA PHARMACY FINANCIAL 30.17 ASSISTANCE.] (a) Of this appropriation, 30.18 $500,000 in fiscal year 2000 and 30.19 $500,000 in fiscal year 2001 is from 30.20 the health care access fund to the 30.21 commissioner to award financial 30.22 assistance grants to pharmacies in 30.23 rural areas designated as sole 30.24 community pharmacies. 30.25 (b) A pharmacy advisory committee shall 30.26 be established jointly by the 30.27 commissioner, the University of 30.28 Minnesota college of pharmacy, and a 30.29 statewide pharmacist association 30.30 representing all pharmacy practice 30.31 settings. The advisory committee shall 30.32 establish criteria for determining sole 30.33 community pharmacies in rural areas. 30.34 (c) In selecting pharmacies to receive 30.35 grants, the commissioner shall take 30.36 into account the extent of local 30.37 support for the pharmacy. Evidence of 30.38 local support may include statements 30.39 issued by a local government entity, 30.40 such as a city or county, and loans, 30.41 grants, or donations to the pharmacy 30.42 from local government entities, private 30.43 organizations, or individuals. 30.44 (d) The commissioner shall determine 30.45 the amount of the award to be given to 30.46 each eligible pharmacy based on the 30.47 pharmacy's total operating losses as a 30.48 percentage of total operating revenue 30.49 for two of the previous three most 30.50 recent consecutive fiscal years. For 30.51 purposes of calculating a pharmacy's 30.52 operating loss margin, total operating 30.53 revenue does not include grant funding 30.54 provided under this section. The 30.55 available funds shall be disbursed 30.56 proportionately based on the operating 30.57 loss margins of all eligible pharmacies. 30.58 (e) This appropriation shall not become 30.59 part of the base for the 2002-2003 30.60 biennium. 30.61 [RURAL HOSPITAL CAPITAL IMPROVEMENT 30.62 GRANT PROGRAM.] Of this appropriation, 30.63 $2,867,000 for each fiscal year is from 31.1 the health care access fund to the 31.2 commissioner for the rural hospital 31.3 capital improvement grant program 31.4 described in Minnesota Statutes, 31.5 section 144.148. This appropriation 31.6 shall not become part of the base for 31.7 the 2002-2003 biennium. 31.8 [MINIMUM DATA SET ACCESS.] The 31.9 commissioner, in cooperation with the 31.10 commissioner of administration, shall 31.11 attempt to obtain access to information 31.12 from the Health Care Financing 31.13 Administration that is provided by 31.14 nursing facilities to the federal 31.15 minimum data set database. If access 31.16 is obtained, the commissioner shall 31.17 make minimum data set data available on 31.18 a quarterly basis to industry trade 31.19 associations for use in quality 31.20 improvement efforts and comparative 31.21 analysis. Minimum data set data shall 31.22 be provided to the associations in 31.23 summary aggregate form without patient 31.24 identifiers to protect resident 31.25 privacy. The commissioner may charge a 31.26 fee for the actual cost of accessing 31.27 and reproducing these documents. 31.28 [REPORT ON SIDE RAIL USE AND NONUSE IN 31.29 NURSING HOMES.] The commissioner shall 31.30 report to the chairs of the house 31.31 health and human services committee and 31.32 the senate health and family security 31.33 committee by December 15, 1999, with 31.34 information from all available data 31.35 gathered on the incidence of patient 31.36 deaths, serious injuries, and falls 31.37 involving the use or nonuse of side 31.38 rails and alternative interventions in 31.39 long-term care facilities during the 31.40 last five years for which data is 31.41 available. The report shall include, 31.42 but not be limited to, an analysis of: 31.43 (1) data on the number of deaths 31.44 arising from side rail entanglements 31.45 and information about bed, mattress, 31.46 and rail combinations used; the form of 31.47 monitoring device used; and resident 31.48 characteristics and conditions; and 31.49 (2) data on the incidence of resident 31.50 falls, serious injury, or death and the 31.51 prevalence of physical restraint use in 31.52 resident and patient care practice to 31.53 determine if there is a correlation 31.54 between resident falls, serious 31.55 injuries, or deaths and the use or 31.56 nonuse of physical restraints. 31.57 The commissioner shall work 31.58 cooperatively with the long-term care 31.59 industry to share and utilize the 31.60 information and analysis in the report 31.61 to identify and promote best care 31.62 practices. 31.63 [NURSING FACILITY DEFICIENCY FINES.] 31.64 The commissioner, in cooperation with 31.65 the commissioner of human services, 32.1 shall apply to the federal government 32.2 for a waiver to allow the use of fines 32.3 collected for nursing facility 32.4 deficiencies to train nursing facility 32.5 staff regarding health department 32.6 expectations and inspection standards. 32.7 [NURSING HOME MORATORIUM REPORT.] In 32.8 preparing the report required by 32.9 Minnesota Statutes, section 144A.071, 32.10 subdivision 5, the commissioner and the 32.11 commissioner of human services shall 32.12 analyze the adequacy of the supply of 32.13 nursing home beds by measuring the 32.14 ability of hospitals to promptly 32.15 discharge patients to a nursing home 32.16 within the hospital's primary service 32.17 area. If it is determined that a 32.18 shortage of beds exists, the report 32.19 shall present a plan to correct the 32.20 service deficits. The report shall 32.21 also analyze the impact of assisted 32.22 living services on the medical 32.23 assistance utilization of nursing homes. 32.24 Subd. 3. Health Protection 27,795,000 28,028,000 32.25 Summary by Fund 32.26 General 12,396,000 12,592,000 32.27 Metro Landfill 32.28 Contingency 196,000 199,000 32.29 State Government 32.30 Special Revenue 15,203,000 15,237,000 32.31 [OCCUPATIONAL RESPIRATORY DISEASE 32.32 INFORMATION SYSTEM.] Unexpended funds 32.33 appropriated in Laws 1998, chapter 407, 32.34 article 1, section 3, subdivision 3, to 32.35 design an occupational respiratory 32.36 disease information system do not 32.37 cancel but are available until 32.38 expended. This provision is effective 32.39 the day following final enactment. 32.40 [HIV/STD.] Of the general fund 32.41 appropriation, $150,000 in fiscal year 32.42 2000 and $150,000 in fiscal year 2001 32.43 is to the commissioner for activities 32.44 described under Minnesota Statutes, 32.45 sections 144.065 and 144.066, of which 32.46 no less than 65 percent shall be 32.47 distributed as grants under Minnesota 32.48 Statutes, section 144.066, to 32.49 demonstrate effective integration of 32.50 STD and HIV prevention education to 32.51 reach adolescents with the highest 32.52 health risks, including youth of 32.53 color. This appropriation shall become 32.54 part of the base for the 2002-2003 32.55 biennium. 32.56 [STD SCREENING.] Of this appropriation, 32.57 $125,000 in fiscal year 2000 and 32.58 $125,000 in fiscal year 2001 is from 32.59 the general fund to the commissioner 32.60 for grants to boards of health, state 32.61 agencies, state councils, and nonprofit 32.62 corporations to expand access to free 33.1 STD screening. When making grants, the 33.2 commissioner shall give priority to 33.3 grantees that provide services to 33.4 youth. This appropriation shall become 33.5 part of the base for the 2002-2003 33.6 biennium. 33.7 Subd. 4. Management and 33.8 Support Services 4,881,000 5,006,000 33.9 Summary by Fund 33.10 General 4,604,000 4,723,000 33.11 State Government 33.12 Special Revenue 181,000 185,000 33.13 Health Care 33.14 Access 96,000 98,000 33.15 [AT-RISK POPULATIONS.] Of the general 33.16 fund appropriation, $400,000 in fiscal 33.17 year 2000 and $400,000 in fiscal year 33.18 2001 is for grants to local health 33.19 agencies to conduct a health needs 33.20 assessment that is specific to 33.21 populations of color or other at-risk 33.22 populations. This appropriation shall 33.23 not become part of the base for the 33.24 2002-2003 biennium. 33.25 Sec. 4. VETERANS NURSING 33.26 HOMES BOARD 26,121,000 27,103,000 33.27 [ALLOWANCE FOR FOOD.] The allowance for 33.28 food may be adjusted annually to 33.29 reflect changes in the producer price 33.30 index, as prepared by the United States 33.31 Bureau of Labor Statistics, with the 33.32 approval of the commissioner of 33.33 finance. Adjustments for fiscal year 33.34 2000 and fiscal year 2001 must be based 33.35 on the June 1998 and June 1999 producer 33.36 price index respectively, but the 33.37 adjustment must be prorated if it would 33.38 require money in excess of the 33.39 appropriation. 33.40 [IMPROVEMENTS USING DONATED MONEY.] 33.41 Notwithstanding Minnesota Statutes, 33.42 section 16B.30, the board may make and 33.43 maintain the following improvements to 33.44 the veterans homes using money donated 33.45 for those purposes: 33.46 (1) a picnic pavilion at the 33.47 Minneapolis veterans home; 33.48 (2) walking trails at the Hastings 33.49 veterans home; 33.50 (3) walking trails and landscaping at 33.51 the Silver Bay veterans home; 33.52 (4) an entrance canopy at the Fergus 33.53 Falls veterans home; and 33.54 (5) a suspended wooden dining deck at 33.55 the Luverne veterans home. 33.56 [ASSET PRESERVATION; FACILITY REPAIR.] 34.1 Of the general fund appropriation, 34.2 $1,190,000 each year is for asset 34.3 preservation and facility repair. The 34.4 appropriations are available in either 34.5 year of the biennium and may be used 34.6 for abatement and repair at the Luverne 34.7 home. This appropriation shall become 34.8 part of the board's base level funding 34.9 for the 2002-2003 biennium. 34.10 [VETERANS HOMES SPECIAL REVENUE 34.11 ACCOUNT.] The general fund 34.12 appropriations made to the board shall 34.13 be transferred to a veterans homes 34.14 special revenue account in the special 34.15 revenue fund in the same manner as 34.16 other receipts are deposited according 34.17 to Minnesota Statutes, section 198.34, 34.18 and are appropriated to the board for 34.19 the operation of board facilities and 34.20 programs. 34.21 [SETTING COST OF CARE.] (a) The board 34.22 may set the cost of care at the Fergus 34.23 Falls facility for fiscal year 2000 34.24 based on the cost of average skilled 34.25 nursing care provided to residents of 34.26 the Minneapolis veterans home for 34.27 fiscal year 2000. 34.28 (b) The cost of care for the 34.29 domiciliary residents at the 34.30 Minneapolis veterans home and the 34.31 skilled nursing care residents at the 34.32 Luverne nursing home for fiscal year 34.33 2000 and fiscal year 2001 shall be 34.34 calculated based on 100 percent 34.35 occupancy at each facility. 34.36 [LICENSED BED CAPACITY FOR MINNEAPOLIS 34.37 VETERANS HOME.] The commissioner of 34.38 health shall not reduce the licensed 34.39 bed capacity for the Minneapolis 34.40 veterans home pending completion of the 34.41 project authorized by Laws 1990, 34.42 chapter 610, article 1, section 9, 34.43 subdivision 3. 34.44 [LUVERNE ENVIRONMENTAL QUALITY.] Of 34.45 this appropriation, $591,000 in fiscal 34.46 year 2000 is from the general fund to 34.47 the board to ensure an adequate 34.48 staffing complement during the repairs 34.49 at the Luverne home. Of that amount, 34.50 $229,000 is available the day following 34.51 final enactment. 34.52 Sec. 5. HEALTH-RELATED BOARDS 34.53 Subdivision 1. Total 34.54 Appropriation 10,376,000 10,576,000 34.55 [STATE GOVERNMENT SPECIAL REVENUE 34.56 FUND.] The appropriations in this 34.57 section are from the state government 34.58 special revenue fund. 34.59 [NO SPENDING IN EXCESS OF REVENUES.] 34.60 The commissioner of finance shall not 34.61 permit the allotment, encumbrance, or 34.62 expenditure of money appropriated in 35.1 this section in excess of the 35.2 anticipated biennial revenues or 35.3 accumulated surplus revenues from fees 35.4 collected by the boards. Neither this 35.5 provision nor Minnesota Statutes, 35.6 section 214.06, applies to transfers 35.7 from the general contingent account. 35.8 [CENTRALIZED LICENSING FUNCTION.] The 35.9 health-related licensing boards shall 35.10 develop a plan to centralize their 35.11 licensing functions within the 35.12 administrative services unit and report 35.13 to the legislature by January 15, 35.14 2000. If the plan is not submitted: 35.15 (1) the appropriations in this section 35.16 to the board of medical practice and 35.17 the board of nursing for licensing and 35.18 disciplinary systems for fiscal year 35.19 2001 shall not be expended; and 35.20 (2) three percent of the appropriations 35.21 in this section for fiscal year 2001 35.22 for the board of chiropractic 35.23 examiners, the board of dietetic and 35.24 nutrition practice, the board of 35.25 marriage and family therapy, the board 35.26 of nursing home administrators, the 35.27 board of optometry, the board of 35.28 pharmacy, the board of podiatry, the 35.29 board of psychology, the board of 35.30 social work, and the board of 35.31 veterinary medicine, shall not be 35.32 expended. 35.33 Subd. 2. Board of Chiropractic 35.34 Examiners 350,000 361,000 35.35 Subd. 3. Board of Dentistry 783,000 806,000 35.36 Subd. 4. Board of Dietetic 35.37 and Nutrition Practice 92,000 95,000 35.38 Subd. 5. Board of Marriage and 35.39 Family Therapy 107,000 111,000 35.40 Subd. 6. Board of Medical 35.41 Practice 3,696,000 3,778,000 35.42 Subd. 7. Board of Nursing 2,202,000 2,245,000 35.43 Subd. 8. Board of Nursing 35.44 Home Administrators 548,000 566,000 35.45 [HEALTH PROFESSIONAL SERVICES 35.46 ACTIVITY.] Of these appropriations, 35.47 $368,000 the first year and $380,000 35.48 the second year are for the Health 35.49 Professional Services Activity. 35.50 Subd. 9. Board of Optometry 87,000 90,000 35.51 Subd. 10. Board of Pharmacy 1,125,000 1,137,000 35.52 [ADMINISTRATIVE SERVICES UNIT.] Of this 35.53 appropriation, $259,000 the first year 35.54 and $270,000 the second year are for 35.55 the health boards administrative 35.56 services unit. The administrative 35.57 services unit may receive and expend 36.1 reimbursements for services performed 36.2 for other agencies. 36.3 Subd. 11. Board of Podiatry 41,000 42,000 36.4 Subd. 12. Board of Psychology 556,000 534,000 36.5 [PART-TIME POSITIONS FUNDING.] Of this 36.6 appropriation, $34,000 in fiscal year 36.7 2000 is from the special revenue fund 36.8 to the board to fund two part-time 36.9 positions previously funded through the 36.10 legislative advisory commission and for 36.11 a budget shortage due to position 36.12 reallocations. This appropriation is 36.13 available the day following final 36.14 enactment. 36.15 Subd. 13. Board of Social Work 641,000 658,000 36.16 Subd. 14. Board of Veterinary 36.17 Medicine 148,000 153,000 36.18 Sec. 6. EMERGENCY MEDICAL 36.19 SERVICES BOARD 2,420,000 2,467,000 36.20 Summary by Fund 36.21 General 694,000 694,000 36.22 Trunk Highway 1,726,000 1,773,000 36.23 [COMPREHENSIVE ADVANCED LIFE SUPPORT.] 36.24 Of the general fund appropriation, 36.25 $108,000 in fiscal year 2000 and 36.26 $108,000 in fiscal year 2001 is to the 36.27 board to establish a comprehensive 36.28 advanced life support educational 36.29 program to train rural medical 36.30 personnel, including physicians, 36.31 physician assistants, nurses, and 36.32 allied health care providers, in a team 36.33 approach to anticipate, recognize, and 36.34 treat life-threatening emergencies 36.35 before serious injury or cardiac arrest 36.36 occurs. This appropriation shall 36.37 become part of the base for the 36.38 2002-2003 biennium. 36.39 [EMERGENCY MEDICAL SERVICES GRANTS.] Of 36.40 the appropriation from the trunk 36.41 highway fund, $18,000 in fiscal year 36.42 2000 and $36,000 in fiscal year 2001 is 36.43 to the board for grants to regional 36.44 emergency medical services programs. 36.45 This appropriation shall become part of 36.46 the base for the 2002-2003 biennium. 36.47 Sec. 7. COUNCIL ON DISABILITY 650,000 670,000 36.48 Sec. 8. OMBUDSMAN FOR MENTAL 36.49 HEALTH AND MENTAL RETARDATION 1,338,000 1,378,000 36.50 Sec. 9. OMBUDSMAN 36.51 FOR FAMILIES 166,000 171,000 36.52 Sec. 10. TRANSFERS 36.53 Subdivision 1. Grant Programs 36.54 The commissioner of human services, 37.1 with the approval of the commissioner 37.2 of finance, and after notification of 37.3 the chair of the senate health and 37.4 family security budget division and the 37.5 chair of the house health and human 37.6 services finance committee, may 37.7 transfer unencumbered appropriation 37.8 balances for the biennium ending June 37.9 30, 2001, within fiscal years among the 37.10 MFIP, general assistance, general 37.11 assistance medical care, medical 37.12 assistance, Minnesota supplemental aid, 37.13 and group residential housing programs, 37.14 and the entitlement portion of the 37.15 chemical dependency consolidated 37.16 treatment fund, and between fiscal 37.17 years of the biennium. 37.18 Subd. 2. Approval Required 37.19 Positions, salary money, and nonsalary 37.20 administrative money may be transferred 37.21 within the departments of human 37.22 services and health and within the 37.23 programs operated by the veterans 37.24 nursing homes board as the 37.25 commissioners and the board consider 37.26 necessary, with the advance approval of 37.27 the commissioner of finance. The 37.28 commissioner or the board shall inform 37.29 the chairs of the house health and 37.30 human services finance committee and 37.31 the senate health and family security 37.32 budget division quarterly about 37.33 transfers made under this provision. 37.34 Sec. 11. PROVISIONS 37.35 (a) Money appropriated to the 37.36 commissioner of human services for the 37.37 purchase of provisions must be used 37.38 solely for that purpose. Money 37.39 provided and not used for the purchase 37.40 of provisions must be canceled into the 37.41 fund from which appropriated, except 37.42 that money provided and not used for 37.43 the purchase of provisions because of 37.44 population decreases may be transferred 37.45 and used for the purchase of drugs and 37.46 medical and hospital supplies and 37.47 equipment with the approval of the 37.48 commissioner of finance after 37.49 notification of the chairs of the house 37.50 health and human services finance 37.51 committee and the senate health and 37.52 family security budget division. 37.53 (b) For fiscal year 2000, the allowance 37.54 for food may be adjusted to the 37.55 equivalent of the 75th percentile of 37.56 the comparable raw food costs for 37.57 community nursing homes as reported to 37.58 the commissioner of human services. 37.59 For fiscal year 2001, an adjustment may 37.60 be made to reflect the annual change in 37.61 the United States Bureau of Labor 37.62 Statistics producer price index as of 37.63 June 2000 with the approval of the 37.64 commissioner of finance. The 37.65 adjustments for either year must be 37.66 prorated if they would require money in 38.1 excess of this appropriation. 38.2 Sec. 12. CARRYOVER LIMITATION 38.3 None of the appropriations in this act 38.4 which are allowed to be carried forward 38.5 from fiscal year 2000 to fiscal year 38.6 2001 shall become part of the base 38.7 level funding for the 2002-2003 38.8 biennial budget, unless specifically 38.9 directed by the legislature. 38.10 Sec. 13. SUNSET OF UNCODIFIED LANGUAGE 38.11 All uncodified language contained in 38.12 this article expires on June 30, 2001, 38.13 unless a different expiration date is 38.14 explicit. 38.15 Sec. 14. [REPEALER.] 38.16 Minnesota Statutes 1998, section 256J.03, is repealed 38.17 effective July 2, 1999. Section 13, sunset of uncodified 38.18 language, does not apply to this section. 38.19 ARTICLE 2 38.20 HEALTH DEPARTMENT 38.21 Section 1. [62J.535] [UNIFORM BILLING REQUIREMENTS.] 38.22 Subdivision 1. [DEVELOPMENT OF UNIFORM BILLING 38.23 TRANSACTIONS.] The commissioners of commerce and health shall 38.24 adopt uniform billing standards that comply with Public Law 38.25 Number 104-91 enacted by Congress on August 21, 1996. The 38.26 uniform billing standards shall apply to all paper and 38.27 electronic claim transactions and shall apply to all Minnesota 38.28 payers, including government programs. 38.29 Subd. 2. [COMPLIANCE.] Concurrent with the effective dates 38.30 established under Public Law Number 104-91 for uniform 38.31 electronic billing standards, all health care providers must 38.32 conform to the uniform billing standards developed by the 38.33 commissioners of commerce and health. 38.34 Sec. 2. Minnesota Statutes 1998, section 144.065, is 38.35 amended to read: 38.36 144.065 [VENEREAL DISEASE TREATMENT CENTERSPREVENTION AND 38.37 TREATMENT OF SEXUALLY TRANSMITTED INFECTIONS.] 38.38 The state commissioner of health shall assist local health 38.39 agencies and organizations throughout the state with the 38.40 development and maintenance of services for the detection and 39.1 treatment ofvenereal diseasessexually transmitted infections. 39.2 These services shall provide for research, screening and 39.3 diagnosis, treatment, case finding, investigation, and the 39.4 dissemination of appropriate educational information. The state 39.5 commissioner of health shallpromulgate rules relative to39.6 determine the composition of such services and shall establish a 39.7 method of providing funds tolocal health agenciesboards of 39.8 health as defined in section 145A.02, subdivision 2, state 39.9 agencies, state councils, andorganizationsnonprofit 39.10 corporations, which offer such services. The state commissioner 39.11 of health shall provide technical assistance to such agencies 39.12 and organizations in accordance with the needs of the local 39.13 area. Planning and implementation of services, and technical 39.14 assistance may be conducted in collaboration with boards of 39.15 health; state agencies, including the University of Minnesota 39.16 and the department of children, families, and learning; state 39.17 councils; nonprofit organizations; and representatives of 39.18 affected populations. 39.19 Sec. 3. [144.066] [SEXUALLY TRANSMITTED INFECTIONS 39.20 PREVENTION AND TREATMENT GRANTS.] 39.21 The commissioner may award grants to boards of health as 39.22 defined in section 145A.02, subdivision 2, state agencies, state 39.23 councils, or nonprofit corporations to provide services 39.24 described in section 144.065 to populations most vulnerable to 39.25 sexually transmitted infections as determined by current 39.26 epidemiological research. 39.27 Sec. 4. [144.1201] [DEFINITIONS.] 39.28 Subdivision 1. [APPLICABILITY.] For purposes of sections 39.29 144.1201 to 144.1204, the terms defined in this section have the 39.30 meanings given to them. 39.31 Subd. 2. [BY-PRODUCT NUCLEAR MATERIAL.] "By-product 39.32 nuclear material" means a radioactive material, other than 39.33 special nuclear material, yielded in or made radioactive by 39.34 exposure to radiation created incident to the process of 39.35 producing or utilizing special nuclear material. 39.36 Subd. 3. [RADIATION.] "Radiation" means ionizing radiation 40.1 and includes alpha rays; beta rays; gamma rays; x-rays; high 40.2 energy neutrons, protons, or electrons; and other atomic 40.3 particles. 40.4 Subd. 4. [RADIOACTIVE MATERIAL.] "Radioactive material" 40.5 means a matter that emits radiation. Radioactive material 40.6 includes special nuclear material, source nuclear material, and 40.7 by-product nuclear material. 40.8 Subd. 5. [SOURCE NUCLEAR MATERIAL.] "Source nuclear 40.9 material" means uranium or thorium, or a combination thereof, in 40.10 any physical or chemical form; or ores that contain by weight 40.11 1/20 of one percent (0.05 percent) or more of uranium, thorium, 40.12 or a combination thereof. Source nuclear material does not 40.13 include special nuclear material. 40.14 Subd. 6. [SPECIAL NUCLEAR MATERIAL.] "Special nuclear 40.15 material" means: 40.16 (1) plutonium, uranium enriched in the isotope 233 or in 40.17 the isotope 235, and any other material that the Nuclear 40.18 Regulatory Commission determines to be special nuclear material 40.19 according to United States Code, title 42, section 2071, except 40.20 that source nuclear material is not included; and 40.21 (2) a material artificially enriched by any of the 40.22 materials listed in clause (1), except that source nuclear 40.23 material is not included. 40.24 Sec. 5. [144.1202] [UNITED STATES NUCLEAR REGULATORY 40.25 COMMISSION AGREEMENT.] 40.26 Subdivision 1. [AGREEMENT AUTHORIZED.] In order to have a 40.27 comprehensive program to protect the public from radiation 40.28 hazards, the governor, on behalf of the state, is authorized to 40.29 enter into agreements with the United States Nuclear Regulatory 40.30 Commission under the Atomic Energy Act of 1954, section 274b, as 40.31 amended. The agreement shall provide for the discontinuance of 40.32 portions of the Nuclear Regulatory Commission's licensing and 40.33 related regulatory authority over by-product, source, and 40.34 special nuclear materials, and the assumption of regulatory 40.35 authority over these materials by the state. 40.36 Subd. 2. [HEALTH DEPARTMENT DESIGNATED LEAD.] The 41.1 department of health is designated as the lead agency to pursue 41.2 an agreement on behalf of the governor and for any assumption of 41.3 specified licensing and regulatory authority from the Nuclear 41.4 Regulatory Commission under an agreement with the commission. 41.5 The commissioner of health shall establish an advisory group to 41.6 assist in preparing the state to meet the requirements for 41.7 reaching an agreement. The commissioner may adopt rules to 41.8 allow the state to assume regulatory authority under an 41.9 agreement under this section, including the licensing and 41.10 regulation of radioactive materials. Any regulatory authority 41.11 assumed by the state includes the ability to set and collect 41.12 fees. 41.13 Subd. 3. [TRANSITION.] A person who, on the effective date 41.14 of an agreement under this section, possesses a Nuclear 41.15 Regulatory Commission license that is subject to the agreement 41.16 is deemed to possess a similar license issued by the department 41.17 of health. A department of health license obtained under this 41.18 subdivision expires on the expiration date specified in the 41.19 federal license. 41.20 Subd. 4. [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 41.21 agreement entered into before August 2, 2002, must remain in 41.22 effect until terminated under the Atomic Energy Act of 1954, 41.23 United States Code, title 42, section 2021, paragraph (j). The 41.24 governor may not enter into an initial agreement with the 41.25 Nuclear Regulatory Commission after August 1, 2002. If an 41.26 agreement is not entered into by August 1, 2002, any rules 41.27 adopted under this section are repealed effective August 1, 2002. 41.28 (b) An agreement authorized under subdivision 1 must be 41.29 approved by law before it may be implemented. 41.30 Sec. 6. [144.1203] [TRAINING; RULEMAKING.] 41.31 The commissioner shall adopt rules to ensure that 41.32 individuals handling or utilizing radioactive materials under 41.33 the terms of a license issued by the commissioner under section 41.34 144.1202 have proper training and qualifications to do so. The 41.35 rules adopted must be at least as stringent as federal 41.36 regulations on proper training and qualifications adopted by the 42.1 Nuclear Regulatory Commission. Rules adopted under this section 42.2 may incorporate federal regulations by reference. 42.3 Sec. 7. [144.1204] [SURETY REQUIREMENTS.] 42.4 Subdivision 1. [FINANCIAL ASSURANCE REQUIRED.] The 42.5 commissioner may require an applicant for a license under 42.6 section 144.1202, or a person who was formerly licensed by the 42.7 Nuclear Regulatory Commission and is now subject to sections 42.8 144.1201 to 144.1204, to post financial assurances to ensure the 42.9 completion of all requirements established by the commissioner 42.10 for the decontamination, closure, decommissioning, and 42.11 reclamation of sites, structures, and equipment used in 42.12 conjunction with activities related to licensure. The financial 42.13 assurances posted must be sufficient to restore the site to 42.14 unrestricted future use and must be sufficient to provide for 42.15 surveillance and care when radioactive materials remain at the 42.16 site after the licensed activities cease. The commissioner may 42.17 establish financial assurance criteria by rule. In establishing 42.18 such criteria, the commissioner may consider: 42.19 (1) the chemical and physical form of the licensed 42.20 radioactive material; 42.21 (2) the quantity of radioactive material authorized; 42.22 (3) the particular radioisotopes authorized and their 42.23 subsequent radiotoxicity; 42.24 (4) the method in which the radioactive material is held, 42.25 used, stored, processed, transferred, or disposed of; and 42.26 (5) the potential costs of decontamination, treatment, or 42.27 disposal of a licensee's equipment and facilities. 42.28 Subd. 2. [ACCEPTABLE FINANCIAL ASSURANCES.] The 42.29 commissioner may, by rule, establish types of financial 42.30 assurances that meet the requirements of this section. Such 42.31 financial assurances may include bank letters of credit, 42.32 deposits of cash, or deposits of government securities. 42.33 Subd. 3. [TRUST AGREEMENTS.] Financial assurances must be 42.34 established together with trust agreements. Both the financial 42.35 assurances and the trust agreements must be in a form and 42.36 substance that meet requirements established by the commissioner. 43.1 Subd. 4. [EXEMPTIONS.] The commissioner is authorized to 43.2 exempt from the requirements of this section, by rule, any 43.3 category of licensee upon a determination by the commissioner 43.4 that an exemption does not result in a significant risk to the 43.5 public health or safety or to the environment and does not pose 43.6 a financial risk to the state. 43.7 Subd. 5. [OTHER REMEDIES UNAFFECTED.] Nothing in this 43.8 section relieves a licensee of a civil liability incurred, nor 43.9 may this section be construed to relieve the licensee of 43.10 obligations to prevent or mitigate the consequences of improper 43.11 handling or abandonment of radioactive materials. 43.12 Sec. 8. Minnesota Statutes 1998, section 144.148, is 43.13 amended to read: 43.14 144.148 [RURAL HOSPITAL CAPITAL IMPROVEMENT GRANTAND LOAN43.15 PROGRAM.] 43.16 Subdivision 1. [DEFINITION.] (a) For purposes of this 43.17 section, the following definitions apply. 43.18 (b) "Eligible rural hospital" meansaany nonfederal, 43.19 general acute care hospital that: 43.20 (1) is either located in a rural area, as defined in the 43.21 federal Medicare regulations, Code of Federal Regulations, title 43.22 42, section 405.1041, or located in a community with a 43.23 population of less than 5,000, according to United States Census 43.24 Bureau Statistics, outside the seven-county metropolitan area; 43.25 (2) has 50 or fewerlicensed hospitalbedswith a net43.26hospital operating margin not greater than two percent in the43.27two fiscal years prior to application; and 43.28 (3) is25 miles or more from another hospitalnot for 43.29 profit. 43.30 (c) "Eligible project" means a modernization project to 43.31 update, remodel, or replace aging hospital facilities and 43.32 equipment necessary to maintain the operations of a hospital. 43.33 Subd. 2. [PROGRAM.] The commissioner of health shall award 43.34 rural hospital capital improvement grantsor loansto eligible 43.35 rural hospitals. A grantor loanshall not exceed 43.36$1,500,000$300,000 per hospital.Grants or loans shall be44.1interest free. An eligible rural hospital may apply the funds44.2retroactively to capital improvements made during the two fiscal44.3years preceding the fiscal year in which the grant or loan was44.4received, provided the hospital met the eligibility criteria44.5during that time periodPrior to the receipt of any grant, the 44.6 hospital must certify to the commissioner that at least 44.7 one-quarter of the grant amount, which may include in-kind 44.8 services, is available for the same purposes from nonstate 44.9 resources. 44.10 Subd. 3. [APPLICATIONS.] Eligible hospitals seeking a 44.11 grantor loanshall apply to the commissioner. Applications 44.12 must include a description of the problem that the proposed 44.13 project will address, a description of the project including 44.14 construction and remodeling drawings or specifications, sources 44.15 of funds for the project, uses of funds for the project, the 44.16 results expected, and a plan to maintain or operate any facility 44.17 or equipment included in the project. The applicant must 44.18 describe achievable objectives, a timetable, and roles and 44.19 capabilities of responsible individuals and organization. 44.20 Applicants must submit to the commissioner evidence that 44.21 competitive bidding was used to select contractors for the 44.22 project. 44.23 Subd. 4. [CONSIDERATION OF APPLICATIONS.] The commissioner 44.24 shall review each application to determine whether or not the 44.25 hospital's application is complete and whether the hospital and 44.26 the project are eligible for a grantor loan. In evaluating 44.27 applications, the commissioner shall score each application on a 44.28 100 point scale, assigning: a maximum of 40 points for an 44.29 applicant's clarity and thoroughness in describing the problem 44.30 and the project; a maximum of 40 points for the extent to which 44.31 the applicant has demonstrated that it has made adequate 44.32 provisions to assure proper and efficient operation of the 44.33 facility once the project is completed; and a maximum of 20 44.34 points for the extent to which the proposed project is 44.35 consistent with the hospital's capital improvement plan or 44.36 strategic plan. The commissioner may also take into account 45.1 other relevant factors. During application review, the 45.2 commissioner may request additional information about a proposed 45.3 project, including information on project cost. Failure to 45.4 provide the information requested disqualifiesa loanan 45.5 applicant. 45.6 Subd. 5. [PROGRAM OVERSIGHT.]The commissioner of health45.7shall review audited financial information of the hospital to45.8assess eligibility.The commissioner shall determine the amount 45.9 of a grantor loanto be given to an eligible rural hospital 45.10 based on the relative score of each eligible hospital's 45.11 application and the funds available to the commissioner. The 45.12 grantor loanshall be used to update, remodel, or replace aging 45.13 facilities and equipment necessary to maintain the operations of 45.14 the hospital. The commissioner may collect, from the hospitals 45.15 receiving grants, any information necessary to evaluate the 45.16 program. 45.17Subd. 6. [LOAN PAYMENT.] Loans shall be repaid as provided45.18in this subdivision over a period of 15 years. In those years45.19when an eligible rural hospital experiences a positive net45.20operating margin in excess of two percent, the eligible rural45.21hospital shall pay to the state one-half of the excess above two45.22percent, up to the yearly payment amount based upon a loan45.23period of 15 years. If the amount paid back in any year is less45.24than the yearly payment amount, or if no payment is required45.25because the eligible rural hospital does not experience a45.26positive net operating margin in excess of two percent, the45.27amount unpaid for that year shall be forgiven by the state45.28without any financial penalty. As a condition of receiving an45.29award through this program, eligible hospitals must agree to any45.30and all collection activities the commissioner finds necessary45.31to collect loan payments in those years a payment is due.45.32Subd. 7. [ACCOUNTING TREATMENT.] The commissioner of45.33finance shall record as grants in the state accounting system45.34funds obligated by this section. Loan payments received under45.35this section shall be deposited in the health care access fund.45.36 Subd. 8. [EXPIRATION.] This section expires June 30, 46.119992001. 46.2 Sec. 9. Minnesota Statutes 1998, section 144.99, 46.3 subdivision 1, is amended to read: 46.4 Subdivision 1. [REMEDIES AVAILABLE.] The provisions of 46.5 chapters 103I and 157 and sections 115.71 to 115.77; 144.12, 46.6 subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), 46.7 (14), and (15); 144.1201 to 144.1204; 144.121; 144.1222; 144.35; 46.8 144.381 to 144.385; 144.411 to 144.417; 144.495; 144.71 to 46.9 144.74; 144.9501 to 144.9509; 144.992; 326.37 to 326.45; 326.57 46.10 to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all 46.11 rules, orders, stipulation agreements, settlements, compliance 46.12 agreements, licenses, registrations, certificates, and permits 46.13 adopted or issued by the department or under any other law now 46.14 in force or later enacted for the preservation of public health 46.15 may, in addition to provisions in other statutes, be enforced 46.16 under this section. 46.17 Sec. 10. Minnesota Statutes 1998, section 144.99, is 46.18 amended by adding a subdivision to read: 46.19 Subd. 12. [SECURING RADIOACTIVE MATERIALS.] (a) In the 46.20 event of an emergency that poses a danger to the public health, 46.21 the commissioner shall have the authority to impound radioactive 46.22 materials and the associated shielding in the possession of a 46.23 person who fails to abide by the provisions of the statutes, 46.24 rules, and any other item listed in subdivision 1. If 46.25 impounding the source of these materials is impractical, the 46.26 commissioner shall have the authority to lock or otherwise 46.27 secure a facility that contains the source of such materials, 46.28 but only the portions of the facility as is necessary to protect 46.29 the public health. An action taken under this paragraph is 46.30 effective for up to 72 hours. The commissioner must seek an 46.31 injunction or take other administrative action to secure 46.32 radioactive materials beyond the initial 72-hour period. 46.33 (b) The commissioner may release impounded radioactive 46.34 materials and the associated shielding to the owner of the 46.35 radioactive materials and associated shielding, upon terms and 46.36 conditions that are in accordance with the provisions of 47.1 statutes, rules, and other items listed in subdivision 1. In 47.2 the alternative, the commissioner may bring an action in a court 47.3 of competent jurisdiction for an order directing the disposal of 47.4 impounded radioactive materials and associated shielding or 47.5 directing other disposition as necessary to protect the public 47.6 health and safety and the environment. The costs of 47.7 decontamination, transportation, burial, disposal, or other 47.8 disposition shall be borne by the owner or licensee of the 47.9 radioactive materials and shielding or by any other person who 47.10 has used the radioactive materials and shielding for business 47.11 purposes. 47.12 Sec. 11. Minnesota Statutes 1998, section 145.924, is 47.13 amended to read: 47.14 145.924 [AIDS PREVENTION GRANTS.] 47.15 (a) The commissioner may award grants to boards of health 47.16 as defined in section 145A.02, subdivision 2, state agencies, 47.17 state councils, or nonprofit corporations to provide evaluation 47.18 and counseling services to populations at risk for acquiring 47.19 human immunodeficiency virus infection, including, but not 47.20 limited to, minorities, adolescents, intravenous drug users, and 47.21 homosexual men. 47.22 (b) The commissioner may award grants to agencies 47.23 experienced in providing services to communities of color, for 47.24 the design of innovative outreach and education programs for 47.25 targeted groups within the community who may be at risk of 47.26 acquiring the human immunodeficiency virus infection, including 47.27 intravenous drug users and their partners, adolescents, gay and 47.28 bisexual individuals and women. Grants shall be awarded on a 47.29 request for proposal basis and shall include funds for 47.30 administrative costs. Priority for grants shall be given to 47.31 agencies or organizations that have experience in providing 47.32 service to the particular community which the grantee proposes 47.33 to serve; that have policymakers representative of the targeted 47.34 population; that have experience in dealing with issues relating 47.35 to HIV/AIDS; and that have the capacity to deal effectively with 47.36 persons of differing sexual orientations. For purposes of this 48.1 paragraph, the "communities of color" are: the American-Indian 48.2 community; the Hispanic community; the African-American 48.3 community; and the Asian-Pacific community. 48.4 (c) All state grants under this section for programs 48.5 targeted to adolescents shall include the promotion of 48.6 abstinence from sexual activity outside of marriage. 48.7 Sec. 12. Minnesota Statutes 1998, section 145.9255, 48.8 subdivision 1, is amended to read: 48.9 Subdivision 1. [ESTABLISHMENT.] The commissioner of 48.10 health, in consultation with a representative from Minnesota 48.11 planning, the commissioner of human services, and the 48.12 commissioner of children, families, and learning, shall develop 48.13 and implement the Minnesota education now and babies later (MN 48.14 ENABL) program, targeted to adolescents ages 12 to 14, with the 48.15 goal of reducing the incidence of adolescent pregnancy in the 48.16 state and promoting abstinence until marriage. The program must 48.17 provide a multifaceted, primary prevention, community health 48.18 promotion approach to educating and supporting adolescents in 48.19 the decision to postpone sexual involvement modeled after the 48.20 ENABL program in California. The commissioner of health shall 48.21 consult with the chief of the health education section of the 48.22 California department of health services for general guidance in 48.23 developing and implementing the program. 48.24 Sec. 13. Minnesota Statutes 1998, section 145.9255, 48.25 subdivision 4, is amended to read: 48.26 Subd. 4. [PROGRAM COMPONENTS.] The program must include 48.27 the following four major components: 48.28 (a) A community organization component in which the 48.29 community-based local contractors shall include: 48.30 (1) use of a postponing sexual involvement education 48.31 curriculum targeted to boys and girls ages 12 to 14 in schools 48.32 and/or community settings; 48.33 (2) planning and implementing community organization 48.34 strategies to convey and reinforce the MN ENABL message of 48.35 postponing sexual involvement, including activities promoting 48.36 awareness and involvement of parents and other primary 49.1 caregivers/significant adults, schools, and community; and 49.2 (3) development of local media linkages. 49.3 (b) A statewide, comprehensive media and public relations 49.4 campaign to promote changes in sexual attitudes and behaviors, 49.5 and reinforce the message ofpostponing adolescent sexual49.6involvementpromoting abstinence from sexual activity until 49.7 marriage. 49.8 The commissioner of health, in consultation with the 49.9 commissioner of children, families, and learning, shall contract 49.10 with the attorney general's office to develop and implement the 49.11 media and public relations campaign. In developing the 49.12 campaign, the attorney general's office shall coordinate and 49.13 consult with representatives from ethnic and local communities 49.14 to maximize effectiveness of the social marketing approach to 49.15 health promotion among the culturally diverse population of the 49.16 state. The development and implementation of the campaign is 49.17 subject to input and approval by the commissioner of health. 49.18 The local community-based contractors shall collaborate and 49.19 coordinate efforts with other community organizations and 49.20 interested persons to provide school and community-wide 49.21 promotional activities that support and reinforce the message of 49.22 the MN ENABL curriculum. 49.23 (c) An evaluation component which evaluates the process and 49.24 the impact of the program. 49.25 The "process evaluation" must provide information to the 49.26 state on the breadth and scope of the program. The evaluation 49.27 must identify program areas that might need modification and 49.28 identify local MN ENABL contractor strategies and procedures 49.29 which are particularly effective. Contractors must keep 49.30 complete records on the demographics of clients served, number 49.31 of direct education sessions delivered and other appropriate 49.32 statistics, and must document exactly how the program was 49.33 implemented. The commissioner may select contractor sites for 49.34 more in-depth case studies. 49.35 The "impact evaluation" must provide information to the 49.36 state on the impact of the different components of the MN ENABL 50.1 program and an assessment of the impact of the program on 50.2 adolescents' related sexual knowledge, attitudes, and 50.3 risk-taking behavior. 50.4 The commissioner shall compare the MN ENABL evaluation 50.5 information and data with similar evaluation data from other 50.6 states pursuing a similar adolescent pregnancy prevention 50.7 program modeled after ENABL and use the information to improve 50.8 MN ENABL and build on aspects of the program that have 50.9 demonstrated a delay in adolescent sexual involvement. 50.10 (d) A training component requiring the commissioner of 50.11 health, in consultation with the commissioner of children, 50.12 families, and learning, to provide comprehensive uniform 50.13 training to the local MN ENABL community-based local contractors 50.14 and the direct education program staff. 50.15 The local community-based contractors may use adolescent 50.16 leaders slightly older than the adolescents in the program to 50.17 impart the message to postpone sexual involvement provided: 50.18 (1) the contractor follows a protocol for adult 50.19 mentors/leaders and older adolescent leaders established by the 50.20 commissioner of health; 50.21 (2) the older adolescent leader is accompanied by an adult 50.22 leader; and 50.23 (3) the contractor uses the curriculum as directed and 50.24 required by the commissioner of the department of health to 50.25 implement this part of the program. The commissioner of health 50.26 shall provide technical assistance to community-based local 50.27 contractors. 50.28 Sec. 14. Minnesota Statutes 1998, section 148.5194, 50.29 subdivision 2, is amended to read: 50.30 Subd. 2. [BIENNIAL REGISTRATION FEE.] The fee for initial 50.31 registration and biennial registration, temporary registration, 50.32 or renewal is$160$200. 50.33 Sec. 15. Minnesota Statutes 1998, section 148.5194, 50.34 subdivision 3, is amended to read: 50.35 Subd. 3. [BIENNIAL REGISTRATION FEE FOR DUAL REGISTRATION 50.36 AS A SPEECH-LANGUAGE PATHOLOGIST AND AUDIOLOGIST.] The fee for 51.1 initial registration and biennial registration, temporary 51.2 registration, or renewal is$160$200. 51.3 Sec. 16. Minnesota Statutes 1998, section 148.5194, is 51.4 amended by adding a subdivision to read: 51.5 Subd. 3a. [SURCHARGE FEE.] For a period of four years 51.6 following the effective date of this subdivision, an applicant 51.7 for registration or registration renewal must pay a surcharge 51.8 fee of $25 in addition to any other fees due upon registration 51.9 or registration renewal. 51.10 Sec. 17. Minnesota Statutes 1998, section 148.5194, 51.11 subdivision 4, is amended to read: 51.12 Subd. 4. [PENALTY FEE FOR LATE RENEWALS.] The penalty fee 51.13 for late submission of a renewal application is$15$45. 51.14 Sec. 18. Minnesota Statutes 1998, section 326.40, 51.15 subdivision 2, is amended to read: 51.16 Subd. 2. [MASTER PLUMBER'S LICENSE;BONDAND; INSURANCE 51.17REQUIREMENTS.]The applicant for a master plumber license may51.18give bond to the state in the total penal sum of $2,00051.19conditioned upon the faithful and lawful performance of all work51.20entered upon within the state.Any person contracting to do 51.21 plumbing work must give bond to the state in the amount of 51.22 $25,000. The bond shall be for the benefit of persons injured 51.23 or suffering financial loss by reason of failureof performance51.24 to comply with the requirements of the plumbing code.The term51.25of the bond shall be concurrent with the term of the license.51.26TheA bond given to the state shall be filed with the secretary 51.27 of state and shall be in lieu of all otherlicensebonds to any 51.28 political subdivision required for plumbing work. The bond 51.29 shall be written by a corporate surety licensed to do business 51.30 in the state. 51.31 In addition, each applicant for a master plumber license or 51.32 renewal thereof, may provide evidence of public liability 51.33 insurance, including products liability insurance with limits of 51.34 at least $50,000 per person and $100,000 per occurrence and 51.35 property damage insurance with limits of at least $10,000. The 51.36 insurance shall be written by an insurer licensed to do business 52.1 in the state of Minnesota and each licensed master plumber shall 52.2 maintain on file with the state commissioner of health a 52.3 certificate evidencing the insurance providing that the 52.4 insurance shall not be canceled without the insurer first giving 52.5 15 days written notice to the commissioner. The term of the 52.6 insurance shall be concurrent with the term of the license. The 52.7 certificate shall be in lieu of all other certificates required 52.8 by any political subdivision for licensing purposes. 52.9 Sec. 19. Minnesota Statutes 1998, section 326.40, 52.10 subdivision 4, is amended to read: 52.11 Subd. 4. [ALTERNATIVE COMPLIANCE.] Compliance with the 52.12 local bond requirements of a locale within which work is to be 52.13 performed shall be deemed to satisfy the bond and insurance 52.14 requirements of subdivision 2, provided the local ordinance 52.15 requires at least a $25,000 bond. 52.16 Sec. 20. Minnesota Statutes 1998, section 326.40, 52.17 subdivision 5, is amended to read: 52.18 Subd. 5. [FEE.] The state commissioner of health may 52.19 charge eachapplicant for a master plumber license or for a52.20renewal of a master plumber license and an additional feeperson 52.21 giving bond an annual bond filing fee commensurate with the cost 52.22 of administering the bond and insurance requirements of 52.23 subdivision 2. 52.24 Sec. 21. [REPEALER.] 52.25 (a) Minnesota Statutes 1998, sections 62J.77; 62J.78; 52.26 62J.79; and 145.46, are repealed. 52.27 (b) Laws 1998, chapter 407, article 2, section 104, is 52.28 repealed. 52.29 ARTICLE 3 52.30 LONG-TERM CARE 52.31 Section 1. Minnesota Statutes 1998, section 144A.073, 52.32 subdivision 5, is amended to read: 52.33 Subd. 5. [REPLACEMENT RESTRICTIONS.] (a) Proposals 52.34 submitted or approved under this section involving replacement 52.35 must provide for replacement of the facility on the existing 52.36 site except as allowed in this subdivision. 53.1 (b) Facilities located in a metropolitan statistical area 53.2 other than the Minneapolis-St. Paul seven-county metropolitan 53.3 area may relocate to a site within the same census tract or a 53.4 contiguous census tract. 53.5 (c) Facilities located in the Minneapolis-St. Paul 53.6 seven-county metropolitan area may relocate to a site within the 53.7 same or contiguous health planning area as adopted in March 1982 53.8 by the metropolitan council. 53.9 (d) Facilities located outside a metropolitan statistical 53.10 area may relocate to a site within the same city or township, or 53.11 within a contiguous township. 53.12 (e) A facility relocated to a different site under 53.13 paragraph (b), (c), or (d) must not be relocated to a site more 53.14 than six miles from the existing site. 53.15 (f) The relocation of part of an existing first facility to 53.16 a second location, under paragraphs (d) and (e), may include the 53.17 relocation to the second location of up to four beds from part 53.18 of an existing third facility located in a township contiguous 53.19 to the location of the first facility. The six-mile limit in 53.20 paragraph (e) does not apply to this relocation from the third 53.21 facility. 53.22 (g) For proposals approved on January 13, 1994, under this 53.23 section involving the replacement of 102 licensed and certified 53.24 beds, the relocation of the existing first facility to the 53.25second and third locationsnew location under paragraphs (d) and 53.26 (e) may include the relocation of up to50 percent of the75 53.27 beds of the existingfirstfacilityto each of the locations. 53.28 The six-mile limit in paragraph (e) does not apply to this 53.29 relocationto the third location. Notwithstanding subdivision53.303, construction of this project may be commenced any time prior53.31to January 1, 1996. 53.32 Sec. 2. Minnesota Statutes 1998, section 144A.10, is 53.33 amended by adding a subdivision to read: 53.34 Subd. 1a. [TRAINING AND EDUCATION FOR NURSING FACILITY 53.35 PROVIDERS.] The commissioner of health must establish and 53.36 implement a prescribed process and program for providing 54.1 training and education to providers licensed by the department 54.2 of health, either by itself or in conjunction with the industry 54.3 trade associations, before using any new regulatory guideline, 54.4 regulation, interpretation, program letter or memorandum, or any 54.5 other materials used in surveyor training to survey licensed 54.6 providers. The process should include, but is not limited to, 54.7 the following key components: 54.8 (1) facilitate the implementation of immediate revisions to 54.9 any course curriculum for nursing assistants which reflect any 54.10 new standard of care practice that has been adopted or 54.11 referenced by the health department concerning the issue in 54.12 question; 54.13 (2) conduct training of long-term care providers and health 54.14 department survey inspectors either jointly or during the same 54.15 time frame on the department's new expectations; and 54.16 (3) within available resources the commissioner shall 54.17 cooperate in the development of clinical standards, work with 54.18 vendors of supplies and services regarding hazards, and identify 54.19 research of interest to the long-term care community. 54.20 (Effective date: Section 2 (144A.10, subd. 1a) is 54.21 effective the day following final enactment.) 54.22 Sec. 3. Minnesota Statutes 1998, section 144A.10, is 54.23 amended by adding a subdivision to read: 54.24 Subd. 11. [DATA ON FOLLOW-UP SURVEYS.] (a) If requested, 54.25 and not prohibited by federal law, the commissioner shall make 54.26 available to the nursing home associations and the public 54.27 photocopies of statements of deficiencies and related letters 54.28 from the department pertaining to federal certification 54.29 surveys. The commissioner may charge for the actual cost of 54.30 reproduction of these documents. 54.31 (b) The commissioner shall also make available on a 54.32 quarterly basis aggregate data for all statements of 54.33 deficiencies issued after federal certification follow-up 54.34 surveys related to surveys that were conducted in the quarter 54.35 prior to the immediately preceding quarter. The data shall 54.36 include the number of facilities with deficiencies, the total 55.1 number of deficiencies, the number of facilities that did not 55.2 have any deficiencies, the number of facilities for which a 55.3 resurvey or follow-up survey was not performed, and the average 55.4 number of days between the follow-up or resurvey and the exit 55.5 date of the preceding survey. 55.6 (Effective date: Section 3 (144A.10, subd. 11) is 55.7 effective the day following final enactment.) 55.8 Sec. 4. Minnesota Statutes 1998, section 144A.10, is 55.9 amended by adding a subdivision to read: 55.10 Subd. 12. [NURSE AIDE TRAINING WAIVERS.] Because any 55.11 disruption or delay in the training and registration of nurse 55.12 aides may reduce access to care in certified facilities, the 55.13 commissioner shall grant all possible waivers for the 55.14 continuation of an approved nurse aide training and competency 55.15 evaluation program or nurse aide training program or competency 55.16 evaluation program conducted by or on the site of any certified 55.17 nursing facility or skilled nursing facility that would 55.18 otherwise lose approval for the program or programs. The 55.19 commissioner shall take into consideration the distance to other 55.20 training programs, the frequency of other training programs, and 55.21 the impact that the loss of the onsite training will have on the 55.22 nursing facility's ability to recruit and train nurse aides. 55.23 (Effective date: Section 4 (144A.10, subd. 12) is 55.24 effective the day following final enactment.) 55.25 Sec. 5. Minnesota Statutes 1998, section 144A.10, is 55.26 amended by adding a subdivision to read: 55.27 Subd. 13. [IMMEDIATE JEOPARDY.] When conducting survey 55.28 certification and enforcement activities related to regular, 55.29 expanded, or extended surveys under Code of Federal Regulations, 55.30 title 42, part 488, the commissioner may not issue a finding of 55.31 immediate jeopardy unless the specific event or omission that 55.32 constitutes the violation of the requirements of participation 55.33 poses an imminent risk of life-threatening or serious injury to 55.34 a resident. The commissioner may not issue any findings of 55.35 immediate jeopardy after the conclusion of a regular, expanded, 55.36 or extended survey unless the survey team identified the 56.1 deficient practice or practices that constitute immediate 56.2 jeopardy and the residents at risk prior to the close of the 56.3 exit conference. 56.4 (Effective date: Section 5 (144A.10, subd. 13) is 56.5 effective the day following final enactment.) 56.6 Sec. 6. Minnesota Statutes 1998, section 144A.10, is 56.7 amended by adding a subdivision to read: 56.8 Subd. 14. [INFORMAL DISPUTE RESOLUTION.] The commissioner 56.9 shall respond in writing to a request from a nursing facility 56.10 certified under the federal Medicare and Medicaid programs for 56.11 an informal dispute resolution within 30 days of the exit date 56.12 of the facility's survey. The commissioner's response shall 56.13 identify the commissioner's decision regarding the continuation 56.14 of each deficiency citation challenged by the nursing facility, 56.15 as well as a statement of any changes in findings, level of 56.16 severity or scope, and proposed remedies or sanctions for each 56.17 deficiency citation. 56.18 (Effective date: Section 6 (144A.10, subd. 14) is 56.19 effective the day following final enactment.) 56.20 Sec. 7. [144A.102] [USE OF CIVIL MONEY PENALTIES; WAIVER 56.21 FROM STATE AND FEDERAL RULES AND REGULATIONS.] 56.22 By January 2000, the commissioner of health shall work with 56.23 providers to examine state and federal rules and regulations 56.24 governing the provision of care in licensed nursing facilities 56.25 and apply for federal waivers and identify necessary changes in 56.26 state law to: 56.27 (1) allow the use of civil money penalties imposed upon 56.28 nursing facilities to abate any deficiencies identified in a 56.29 nursing facility's plan of correction; and 56.30 (2) stop the accrual of any fine imposed by the health 56.31 department when a follow-up inspection survey is not conducted 56.32 by the department within the regulatory deadline. 56.33 (Effective date: Section 7 (144A.102) is effective the day 56.34 following final enactment.) 56.35 Sec. 8. Minnesota Statutes 1998, section 144D.01, 56.36 subdivision 4, is amended to read: 57.1 Subd. 4. [HOUSING WITH SERVICES ESTABLISHMENT OR 57.2 ESTABLISHMENT.] "Housing with services establishment" or 57.3 "establishment" means an establishment providing sleeping 57.4 accommodations to one or more adult residents, at least 80 57.5 percent of which are 55 years of age or older, and offering or 57.6 providing, for a fee, one or more regularly scheduled 57.7 health-related services or two or more regularly scheduled 57.8 supportive services, whether offered or provided directly by the 57.9 establishment or by another entity arranged for by the 57.10 establishment. 57.11 Housing with services establishment does not include: 57.12 (1) a nursing home licensed under chapter 144A; 57.13 (2) a hospital, certified boarding care home, or supervised 57.14 living facility licensed under sections 144.50 to 144.56; 57.15 (3) a board and lodging establishment licensed under 57.16 chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, 57.17 9525.0215 to 9525.0355, 9525.0500 to 9525.0660, or 9530.4100 to 57.18 9530.4450, or under chapter 245B; 57.19 (4) a board and lodging establishment which serves as a 57.20 shelter for battered women or other similar purpose; 57.21 (5) a family adult foster care home licensed by the 57.22 department of human services; 57.23 (6) private homes in which the residents are related by 57.24 kinship, law, or affinity with the providers of services; 57.25 (7) residential settings for persons with mental 57.26 retardation or related conditions in which the services are 57.27 licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or 57.28 applicable successor rules or laws; 57.29 (8) a home-sharing arrangement such as when an elderly or 57.30 disabled person or single-parent family makes lodging in a 57.31 private residence available to another person in exchange for 57.32 services or rent, or both; 57.33 (9) a duly organized condominium, cooperative, common 57.34 interest community, or owners' association of the foregoing 57.35 where at least 80 percent of the units that comprise the 57.36 condominium, cooperative, or common interest community are 58.1 occupied by individuals who are the owners, members, or 58.2 shareholders of the units; or 58.3 (10) services for persons with developmental disabilities 58.4 that are provided under a license according to Minnesota Rules, 58.5 parts 9525.2000 to 9525.2140 in effect until January 1, 1998, or 58.6 under chapter 245B. 58.7 Sec. 9. Minnesota Statutes 1998, section 252.28, 58.8 subdivision 1, is amended to read: 58.9 Subdivision 1. [DETERMINATIONS; REDETERMINATIONS.] In 58.10 conjunction with the appropriate county boards, the commissioner 58.11 of human services shall determine, and shall redetermine at 58.12 least every four years, the need, location, size, and program of 58.13 public and privateresidential services andday training and 58.14 habilitation services for persons with mental retardation or 58.15 related conditions. This subdivision does not apply to 58.16 semi-independent living services and residential-based 58.17 habilitation services provided to four or fewer persons at a 58.18 single site funded as home and community-based services. A 58.19 determination of need shall not be required for a change in 58.20 ownership. 58.21 Sec. 10. [252.282] [ICF/MR LOCAL SYSTEM NEEDS PLANNING.] 58.22 Subdivision 1. [HOST COUNTY RESPONSIBILITY.] (a) For 58.23 purposes of this section, "local system needs planning" means 58.24 the determination of need for ICF/MR services by program type, 58.25 location, demographics, and size of licensed services for 58.26 persons with developmental disabilities or related conditions. 58.27 (b) This section does not apply to semi-independent living 58.28 services and residential-based habilitation services funded as 58.29 home and community-based services. 58.30 (c) In collaboration with the commissioner and ICF/MR 58.31 providers, counties shall complete a local system needs planning 58.32 process for each ICF/MR facility. Counties shall evaluate the 58.33 preferences and needs of persons with developmental disabilities 58.34 to determine resource demands through a systematic assessment 58.35 and planning process by May 15, 2000, and by July 1 every two 58.36 years thereafter beginning in 2001. 59.1 (d) A local system needs planning process shall be 59.2 undertaken more frequently when the needs or preferences of 59.3 consumers change significantly to require reformation of the 59.4 resources available to persons with developmental disabilities. 59.5 (e) A local system needs plan shall be amended anytime 59.6 recommendations for modifications to existing ICF/MR services 59.7 are made to the host county, including recommendations for: 59.8 (1) closure; 59.9 (2) relocation of services; 59.10 (3) downsizing; 59.11 (4) rate adjustments exceeding 90 days duration to address 59.12 access; or 59.13 (5) modification of existing services for which a change in 59.14 the framework of service delivery is advocated. 59.15 Subd. 2. [CONSUMER NEEDS AND PREFERENCES.] In conducting 59.16 the local system needs planning process, the host county must 59.17 use information from the individual service plans of persons for 59.18 whom the county is financially responsible and of persons from 59.19 other counties for whom the county has agreed to be the host 59.20 county. The determination of services and supports offered 59.21 within the county shall be based on the preferences and needs of 59.22 consumers. The host county shall also consider the community 59.23 social services plan, waiting lists, and other sources that 59.24 identify unmet needs for services. A review of ICF/MR facility 59.25 licensing and certification surveys, substantiated maltreatment 59.26 reports, and established service standards shall be employed to 59.27 assess the performance of providers and shall be considered in 59.28 the county's recommendations. Consumer satisfaction surveys may 59.29 also be considered in this process. 59.30 Subd. 3. [RECOMMENDATIONS.] (a) Upon completion of the 59.31 local system needs planning assessment, the host county shall 59.32 make recommendations by May 15, 2000, and by July 1 every two 59.33 years thereafter beginning in 2001. If no change is 59.34 recommended, a copy of the assessment along with corresponding 59.35 documentation shall be provided to the commissioner by July 1 59.36 prior to the contract year. 60.1 (b) Except as provided in section 252.292, subdivision 4, 60.2 recommendations regarding closures, relocations, or downsizings 60.3 that include a rate increase and recommendations regarding rate 60.4 adjustments exceeding 90 days shall be submitted to the 60.5 statewide advisory committee for review and determination, along 60.6 with the assessment, plan, and corresponding budget. 60.7 (c) Recommendations for closures, relocations, and 60.8 downsizings that do not include a rate increase and for 60.9 modification of existing services for which a change in the 60.10 framework of service delivery is necessary shall be provided to 60.11 the commissioner by July 1 prior to the contract year or at 60.12 least 90 days prior to the anticipated change, along with the 60.13 assessment and corresponding documentation. 60.14 Subd. 4. [THE STATEWIDE ADVISORY COMMITTEE.] (a) The 60.15 commissioner shall appoint a five-member statewide advisory 60.16 committee. The advisory committee shall include representatives 60.17 of providers and counties and the commissioner or the 60.18 commissioner's designee. 60.19 (b) The criteria for ranking proposals, already developed 60.20 in 1997 by a task force authorized by the legislature, shall be 60.21 adopted and incorporated into the decision-making process. 60.22 Specific guidelines, including time frame for submission of 60.23 requests, shall be established and announced through the State 60.24 Register, and all requests shall be considered in comparison to 60.25 each other and the ranking criteria. The advisory committee 60.26 shall review and recommend requests for facility rate 60.27 adjustments to address closures, downsizing, relocation, or 60.28 access needs within the county and shall forward recommendations 60.29 and documentation to the commissioner. The committee shall 60.30 ensure that: 60.31 (1) applications are in compliance with applicable state 60.32 and federal law and with the state plan; and 60.33 (2) cost projections for the proposed service are within 60.34 fiscal limitations. 60.35 (c) The advisory committee shall review proposals and 60.36 submit recommendations to the commissioner within 60 days 61.1 following the published deadline for submission under 61.2 subdivision 5. 61.3 Subd. 5. [RESPONSIBILITIES OF THE COMMISSIONER.] (a) In 61.4 collaboration with counties, providers, and the statewide 61.5 advisory committee, the commissioner shall ensure that services 61.6 recognize the preferences and needs of persons with 61.7 developmental disabilities and related conditions through a 61.8 recurring systemic review and assessment of ICF/MR facilities 61.9 within the state. 61.10 (b) The commissioner shall publish a notice in the State 61.11 Register twice each calendar year to announce the opportunity 61.12 for counties or providers to submit requests for rate 61.13 adjustments associated with plans for downsizing, relocation, 61.14 and closure of ICF/MR facilities. 61.15 (c) The commissioner shall designate funding parameters to 61.16 counties and to the statewide advisory committee for the overall 61.17 implementation of system needs within the fiscal resources 61.18 allocated by the legislature. 61.19 (d) The commissioner shall contract with ICF/MR providers. 61.20 The second contracts shall cover the period from October 1, 61.21 2001, to December 31, 2002. Subsequent contracts shall be for 61.22 two-year periods beginning January 1, 2003. 61.23 Sec. 11. Minnesota Statutes 1998, section 252.291, is 61.24 amended by adding a subdivision to read: 61.25 Subd. 2a. [EXCEPTION FOR LAKE OWASSO PROJECT.] (a) The 61.26 commissioner shall authorize and grant a license under chapter 61.27 245A to a new intermediate care facility for persons with mental 61.28 retardation effective January 1, 2000, under the following 61.29 circumstances: 61.30 (1) the new facility replaces an existing 64-bed 61.31 intermediate care facility for the mentally retarded located in 61.32 Ramsey county; 61.33 (2) the new facility is located upon a parcel of land 61.34 contiguous to the parcel upon which the existing 64-bed facility 61.35 is located; 61.36 (3) the new facility is comprised of no more than eight 62.1 twin home style buildings and an administration building; 62.2 (4) the total licensed bed capacity of the facility does 62.3 not exceed 64 beds; and 62.4 (5) the existing 64-bed facility is demolished. 62.5 (b) The medical assistance payment rate for the new 62.6 facility shall be the higher of the rate specified in paragraph 62.7 (c) or as otherwise provided by law. 62.8 (c) The new facility shall be considered a newly 62.9 established facility for rate setting purposes, and shall be 62.10 eligible for the investment per bed limit specified in section 62.11 256B.501, subdivision 11, paragraph (c), and the interest 62.12 expense limitation specified in section 256B.501, subdivision 62.13 11, paragraph (d). Notwithstanding section 256B.5011, the newly 62.14 established facility's initial payment rate shall be set 62.15 according to Minnesota Rules, part 9553.0075, and shall not be 62.16 subject to the provisions of section 256B.501, subdivision 5b. 62.17 Sec. 12. Minnesota Statutes 1998, section 256B.0911, 62.18 subdivision 6, is amended to read: 62.19 Subd. 6. [PAYMENT FOR PREADMISSION SCREENING.] (a) The 62.20 total screening payment for each county must be paid monthly by 62.21 certified nursing facilities in the county. The monthly amount 62.22 to be paid by each nursing facility for each fiscal year must be 62.23 determined by dividing the county's annual allocation for 62.24 screenings by 12 to determine the monthly payment and allocating 62.25 the monthly payment to each nursing facility based on the number 62.26 of licensed beds in the nursing facility. 62.27 (b) The commissioner shall include the total annual payment 62.28 for screening for each nursing facility according to section 62.29 256B.431, subdivision 2b, paragraph (g), or 256B.435. 62.30 (c) Payments for screening activities are available to the 62.31 county or counties to cover staff salaries and expenses to 62.32 provide the screening function. The lead agency shall employ, 62.33 or contract with other agencies to employ, within the limits of 62.34 available funding, sufficient personnel to conduct the 62.35 preadmission screening activity while meeting the state's 62.36 long-term care outcomes and objectives as defined in section 63.1 256B.0917, subdivision 1. The local agency shall be accountable 63.2 for meeting local objectives as approved by the commissioner in 63.3 the CSSA biennial plan. 63.4(c)(d) Notwithstanding section 256B.0641, overpayments 63.5 attributable to payment of the screening costs under the medical 63.6 assistance program may not be recovered from a facility. 63.7(d)(e) The commissioner of human services shall amend the 63.8 Minnesota medical assistance plan to include reimbursement for 63.9 the local screening teams. 63.10 Sec. 13. Minnesota Statutes 1998, section 256B.0913, 63.11 subdivision 5, is amended to read: 63.12 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 63.13 Alternative care funding may be used for payment of costs of: 63.14 (1) adult foster care; 63.15 (2) adult day care; 63.16 (3) home health aide; 63.17 (4) homemaker services; 63.18 (5) personal care; 63.19 (6) case management; 63.20 (7) respite care; 63.21 (8) assisted living; 63.22 (9) residential care services; 63.23 (10) care-related supplies and equipment; 63.24 (11) meals delivered to the home; 63.25 (12) transportation; 63.26 (13) skilled nursing; 63.27 (14) chore services; 63.28 (15) companion services; 63.29 (16) nutrition services; 63.30 (17) training for direct informal caregivers;and63.31 (18) telemedicine devices to monitor recipients in their 63.32 own homes as an alternative to hospital care, nursing home care, 63.33 or home visits.; and 63.34 (19) other services including direct cash payments to 63.35 clients, approved by the county agency, subject to the 63.36 provisions of paragraph (m). Total annual payments for other 64.1 services for all clients within a county may not exceed either 64.2 ten percent of that county's annual alternative care program 64.3 base allocation or $5,000, whichever is greater. In no case 64.4 shall this amount exceed the county's total annual alternative 64.5 care program base allocation. 64.6 (b) The county agency must ensure that the funds are used 64.7 only to supplement and not supplant services available through 64.8 other public assistance or services programs. 64.9 (c) Unless specified in statute, the service standards for 64.10 alternative care services shall be the same as the service 64.11 standards defined in the elderly waiver. Except for the county 64.12 agencies' approval of direct cash payments to clients, persons 64.13 or agencies must be employed by or under a contract with the 64.14 county agency or the public health nursing agency of the local 64.15 board of health in order to receive funding under the 64.16 alternative care program. 64.17 (d) The adult foster care rate shall be considered a 64.18 difficulty of care payment and shall not include room and 64.19 board. The adult foster care daily rate shall be negotiated 64.20 between the county agency and the foster care provider. The 64.21 rate established under this section shall not exceed 75 percent 64.22 of the state average monthly nursing home payment for the case 64.23 mix classification to which the individual receiving foster care 64.24 is assigned, and it must allow for other alternative care 64.25 services to be authorized by the case manager. 64.26 (e) Personal care services may be provided by a personal 64.27 care provider organization. A county agency may contract with a 64.28 relative of the client to provide personal care services, but 64.29 must ensure nursing supervision. Covered personal care services 64.30 defined in section 256B.0627, subdivision 4, must meet 64.31 applicable standards in Minnesota Rules, part 9505.0335. 64.32 (f) A county may use alternative care funds to purchase 64.33 medical supplies and equipment without prior approval from the 64.34 commissioner when: (1) there is no other funding source; (2) 64.35 the supplies and equipment are specified in the individual's 64.36 care plan as medically necessary to enable the individual to 65.1 remain in the community according to the criteria in Minnesota 65.2 Rules, part 9505.0210, item A; and (3) the supplies and 65.3 equipment represent an effective and appropriate use of 65.4 alternative care funds. A county may use alternative care funds 65.5 to purchase supplies and equipment from a non-Medicaid certified 65.6 vendor if the cost for the items is less than that of a Medicaid 65.7 vendor. A county is not required to contract with a provider of 65.8 supplies and equipment if the monthly cost of the supplies and 65.9 equipment is less than $250. 65.10 (g) For purposes of this section, residential care services 65.11 are services which are provided to individuals living in 65.12 residential care homes. Residential care homes are currently 65.13 licensed as board and lodging establishments and are registered 65.14 with the department of health as providing special services. 65.15 Residential care services are defined as "supportive services" 65.16 and "health-related services." "Supportive services" means the 65.17 provision of up to 24-hour supervision and oversight. 65.18 Supportive services includes: (1) transportation, when provided 65.19 by the residential care center only; (2) socialization, when 65.20 socialization is part of the plan of care, has specific goals 65.21 and outcomes established, and is not diversional or recreational 65.22 in nature; (3) assisting clients in setting up meetings and 65.23 appointments; (4) assisting clients in setting up medical and 65.24 social services; (5) providing assistance with personal laundry, 65.25 such as carrying the client's laundry to the laundry room. 65.26 Assistance with personal laundry does not include any laundry, 65.27 such as bed linen, that is included in the room and board rate. 65.28 Health-related services are limited to minimal assistance with 65.29 dressing, grooming, and bathing and providing reminders to 65.30 residents to take medications that are self-administered or 65.31 providing storage for medications, if requested. Individuals 65.32 receiving residential care services cannot receive both personal 65.33 care services and residential care services. 65.34 (h) For the purposes of this section, "assisted living" 65.35 refers to supportive services provided by a single vendor to 65.36 clients who reside in the same apartment building of three or 66.1 more units which are not subject to registration under chapter 66.2 144D. Assisted living services are defined as up to 24-hour 66.3 supervision, and oversight, supportive services as defined in 66.4 clause (1), individualized home care aide tasks as defined in 66.5 clause (2), and individualized home management tasks as defined 66.6 in clause (3) provided to residents of a residential center 66.7 living in their units or apartments with a full kitchen and 66.8 bathroom. A full kitchen includes a stove, oven, refrigerator, 66.9 food preparation counter space, and a kitchen utensil storage 66.10 compartment. Assisted living services must be provided by the 66.11 management of the residential center or by providers under 66.12 contract with the management or with the county. 66.13 (1) Supportive services include: 66.14 (i) socialization, when socialization is part of the plan 66.15 of care, has specific goals and outcomes established, and is not 66.16 diversional or recreational in nature; 66.17 (ii) assisting clients in setting up meetings and 66.18 appointments; and 66.19 (iii) providing transportation, when provided by the 66.20 residential center only. 66.21 Individuals receiving assisted living services will not 66.22 receive both assisted living services and homemaking or personal 66.23 care services. Individualized means services are chosen and 66.24 designed specifically for each resident's needs, rather than 66.25 provided or offered to all residents regardless of their 66.26 illnesses, disabilities, or physical conditions. 66.27 (2) Home care aide tasks means: 66.28 (i) preparing modified diets, such as diabetic or low 66.29 sodium diets; 66.30 (ii) reminding residents to take regularly scheduled 66.31 medications or to perform exercises; 66.32 (iii) household chores in the presence of technically 66.33 sophisticated medical equipment or episodes of acute illness or 66.34 infectious disease; 66.35 (iv) household chores when the resident's care requires the 66.36 prevention of exposure to infectious disease or containment of 67.1 infectious disease; and 67.2 (v) assisting with dressing, oral hygiene, hair care, 67.3 grooming, and bathing, if the resident is ambulatory, and if the 67.4 resident has no serious acute illness or infectious disease. 67.5 Oral hygiene means care of teeth, gums, and oral prosthetic 67.6 devices. 67.7 (3) Home management tasks means: 67.8 (i) housekeeping; 67.9 (ii) laundry; 67.10 (iii) preparation of regular snacks and meals; and 67.11 (iv) shopping. 67.12 Assisted living services as defined in this section shall 67.13 not be authorized in boarding and lodging establishments 67.14 licensed according to sections 157.011 and 157.15 to 157.22. 67.15 (i) For establishments registered under chapter 144D, 67.16 assisted living services under this section means the services 67.17 described and licensed under section 144A.4605. 67.18 (j) For the purposes of this section, reimbursement for 67.19 assisted living services and residential care services shall be 67.20 a monthly rate negotiated and authorized by the county agency 67.21 based on an individualized service plan for each resident. The 67.22 rate shall not exceed the nonfederal share of the greater of 67.23 either the statewide or any of the geographic groups' weighted 67.24 average monthly medical assistance nursing facility payment rate 67.25 of the case mix resident class to which the 180-day eligible 67.26 client would be assigned under Minnesota Rules, parts 9549.0050 67.27 to 9549.0059, unless the services are provided by a home care 67.28 provider licensed by the department of health and are provided 67.29 in a building that is registered as a housing with services 67.30 establishment under chapter 144D and that provides 24-hour 67.31 supervision. 67.32 (k) For purposes of this section, companion services are 67.33 defined as nonmedical care, supervision and oversight, provided 67.34 to a functionally impaired adult. Companions may assist the 67.35 individual with such tasks as meal preparation, laundry and 67.36 shopping, but do not perform these activities as discrete 68.1 services. The provision of companion services does not entail 68.2 hands-on medical care. Providers may also perform light 68.3 housekeeping tasks which are incidental to the care and 68.4 supervision of the recipient. This service must be approved by 68.5 the case manager as part of the care plan. Companion services 68.6 must be provided by individuals ornonprofitorganizations who 68.7 are under contract with the local agency to provide the 68.8 service. Any person related to the waiver recipient by blood, 68.9 marriage or adoption cannot be reimbursed under this service. 68.10 Persons providing companion services will be monitored by the 68.11 case manager. 68.12 (l) For purposes of this section, training for direct 68.13 informal caregivers is defined as a classroom or home course of 68.14 instruction which may include: transfer and lifting skills, 68.15 nutrition, personal and physical cares, home safety in a home 68.16 environment, stress reduction and management, behavioral 68.17 management, long-term care decision making, care coordination 68.18 and family dynamics. The training is provided to an informal 68.19 unpaid caregiver of a 180-day eligible client which enables the 68.20 caregiver to deliver care in a home setting with high levels of 68.21 quality. The training must be approved by the case manager as 68.22 part of the individual care plan. Individuals, agencies, and 68.23 educational facilities which provide caregiver training and 68.24 education will be monitored by the case manager. 68.25 (m) A county agency may make payment from their alternative 68.26 care program allocation for other services provided to an 68.27 alternative care program recipient if those services prevent, 68.28 shorten, or delay institutionalization. These services may 68.29 include direct cash payments to the recipient for the purpose of 68.30 purchasing the recipient's services. The following provisions 68.31 apply to payments under this paragraph: 68.32 (1) a cash payment to a client under this provision cannot 68.33 exceed 80 percent of the monthly payment limit for that client 68.34 as specified in subdivision 4, paragraph (a), clause (7); 68.35 (2) a county may not approve any cash payment for a client 68.36 who has been assessed as having a dependency in orientation, 69.1 unless the client has an authorized representative under section 69.2 256.476, subdivision 2, paragraph (g), or for a client who is 69.3 concurrently receiving adult foster care, residential care, or 69.4 assisted living services; 69.5 (3) any service approved under this section must be a 69.6 service which meets the purpose and goals of the program as 69.7 listed in subdivision 1; 69.8 (4) cash payments must also meet the criteria in section 69.9 256.476, subdivision 4, paragraph (b), and recipients of cash 69.10 grants must meet the requirements in section 256.476, 69.11 subdivision 10; and 69.12 (5) the county shall report client outcomes, services, and 69.13 costs under this paragraph in a manner prescribed by the 69.14 commissioner. 69.15 Upon implementation of direct cash payments to clients under 69.16 this section, any person determined eligible for the alternative 69.17 care program who chooses a cash payment approved by the county 69.18 agency shall receive the cash payment under this section and not 69.19 under section 256.476 unless the person was receiving a consumer 69.20 support grant under section 256.476 before implementation of 69.21 direct cash payments under this section. 69.22 Sec. 14. Minnesota Statutes 1998, section 256B.0913, 69.23 subdivision 10, is amended to read: 69.24 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 69.25 appropriation for fiscal years 1992 and beyond shall cover only 69.26 180-day eligible clients. 69.27 (b) Prior to July 1 of each year, the commissioner shall 69.28 allocate to county agencies the state funds available for 69.29 alternative care for persons eligible under subdivision 2. The 69.30 allocation for fiscal year 1992 shall be calculated using a base 69.31 that is adjusted to exclude the medical assistance share of 69.32 alternative care expenditures. The adjusted base is calculated 69.33 by multiplying each county's allocation for fiscal year 1991 by 69.34 the percentage of county alternative care expenditures for 69.35 180-day eligible clients. The percentage is determined based on 69.36 expenditures for services rendered in fiscal year 1989 or 70.1 calendar year 1989, whichever is greater. 70.2 (c) If the county expenditures for 180-day eligible clients 70.3 are 95 percent or more of its adjusted base allocation, the 70.4 allocation for the next fiscal year is 100 percent of the 70.5 adjusted base, plus inflation to the extent that inflation is 70.6 included in the state budget. 70.7 (d) If the county expenditures for 180-day eligible clients 70.8 are less than 95 percent of its adjusted base allocation, the 70.9 allocation for the next fiscal year is the adjusted base 70.10 allocation less the amount of unspent funds below the 95 percent 70.11 level. 70.12 (e) For fiscal year 1992 only, a county may receive an 70.13 increased allocation if annualized service costs for the month 70.14 of May 1991 for 180-day eligible clients are greater than the 70.15 allocation otherwise determined. A county may apply for this 70.16 increase by reporting projected expenditures for May to the 70.17 commissioner by June 1, 1991. The amount of the allocation may 70.18 exceed the amount calculated in paragraph (b). The projected 70.19 expenditures for May must be based on actual 180-day eligible 70.20 client caseload and the individual cost of clients' care plans. 70.21 If a county does not report its expenditures for May, the amount 70.22 in paragraph (c) or (d) shall be used. 70.23 (f) Calculations for paragraphs (c) and (d) are to be made 70.24 as follows: for each county, the determination of expenditures 70.25 shall be based on payments for services rendered from April 1 70.26 through March 31 in the base year, to the extent that claims 70.27 have been submitted by June 1 of that year. Calculations for 70.28 paragraphs (c) and (d) must also include the funds transferred 70.29 to the consumer support grant program for clients who have 70.30 transferred to that program from April 1 through March 31 in the 70.31 base year. 70.32 (g) For the biennium ending June 30, 2001, the allocation 70.33 of state funds to county agencies shall be calculated as 70.34 described in paragraphs (c) and (d). If the annual legislative 70.35 appropriation for the alternative care program is inadequate to 70.36 fund the combined county allocations for fiscal year 2000 or 71.1 2001, the commissioner shall distribute to each county the 71.2 entire annual appropriation as that county's percentage of the 71.3 computed base as calculated in paragraph (f). 71.4 Sec. 15. Minnesota Statutes 1998, section 256B.0913, 71.5 subdivision 12, is amended to read: 71.6 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 71.7 all 180-day eligible clients to help pay for the cost of 71.8 participating in the program. The amount of the premium for the 71.9 alternative care client shall be determined as follows: 71.10 (1) when the alternative care client's income less 71.11 recurring and predictable medical expenses is greater than the 71.12 medical assistance income standard but less than 150 percent of 71.13 the federal poverty guideline, and total assets are less than 71.14$6,000$10,000, the fee is zero; 71.15 (2) when the alternative care client's income less 71.16 recurring and predictable medical expenses is greater than 150 71.17 percent of the federal poverty guideline, and total assets are 71.18 less than$6,000$10,000, the fee is 25 percent of the cost of 71.19 alternative care services or the difference between 150 percent 71.20 of the federal poverty guideline and the client's income less 71.21 recurring and predictable medical expenses, whichever is less; 71.22 and 71.23 (3) when the alternative care client's total assets are 71.24 greater than$6,000$10,000, the fee is 25 percent of the cost 71.25 of alternative care services. 71.26 For married persons, total assets are defined as the total 71.27 marital assets less the estimated community spouse asset 71.28 allowance, under section 256B.059, if applicable. For married 71.29 persons, total income is defined as the client's income less the 71.30 monthly spousal allotment, under section 256B.058. 71.31 All alternative care services except case management shall 71.32 be included in the estimated costs for the purpose of 71.33 determining 25 percent of the costs. 71.34 The monthly premium shall be calculated based on the cost 71.35 of the first full month of alternative care services and shall 71.36 continue unaltered until the next reassessment is completed or 72.1 at the end of 12 months, whichever comes first. Premiums are 72.2 due and payable each month alternative care services are 72.3 received unless the actual cost of the services is less than the 72.4 premium. 72.5 (b) The fee shall be waived by the commissioner when: 72.6 (1) a person who is residing in a nursing facility is 72.7 receiving case management only; 72.8 (2) a person is applying for medical assistance; 72.9 (3) a married couple is requesting an asset assessment 72.10 under the spousal impoverishment provisions; 72.11 (4) a person is a medical assistance recipient, but has 72.12 been approved for alternative care-funded assisted living 72.13 services; 72.14 (5) a person is found eligible for alternative care, but is 72.15 not yet receiving alternative care services; or 72.16 (6) a person's fee under paragraph (a) is less than $25. 72.17 (c) The county agency must collect the premium from the 72.18 client and forward the amounts collected to the commissioner in 72.19 the manner and at the times prescribed by the commissioner. 72.20 Money collected must be deposited in the general fund and is 72.21 appropriated to the commissioner for the alternative care 72.22 program. The client must supply the county with the client's 72.23 social security number at the time of application. If a client 72.24 fails or refuses to pay the premium due, the county shall supply 72.25 the commissioner with the client's social security number and 72.26 other information the commissioner requires to collect the 72.27 premium from the client. The commissioner shall collect unpaid 72.28 premiums using the Revenue Recapture Act in chapter 270A and 72.29 other methods available to the commissioner. The commissioner 72.30 may require counties to inform clients of the collection 72.31 procedures that may be used by the state if a premium is not 72.32 paid. 72.33 (d) The commissioner shall begin to adopt emergency or 72.34 permanent rules governing client premiums within 30 days after 72.35 July 1, 1991, including criteria for determining when services 72.36 to a client must be terminated due to failure to pay a premium. 73.1 Sec. 16. Minnesota Statutes 1998, section 256B.0913, 73.2 subdivision 16, is amended to read: 73.3 Subd. 16. [CONVERSION OF ENROLLMENT.] Upon approval of the 73.4 elderly waiver amendments described in section 256B.0915, 73.5 subdivision 1d, persons currently receiving services shall have 73.6 their eligibility for the elderly waiver program determined 73.7 under section 256B.0915. Persons currently receiving 73.8 alternative care services whose income is under the special 73.9 income standard according to Code of Federal Regulations, title 73.10 42, section 435.236, who are eligible for the elderly waiver 73.11 program shall be transferred to that program and shall receive 73.12 priority access to elderly waiver slots for six months after 73.13 implementation of this subdivision, except that persons whose 73.14 income is above the maintenance needs amount described in 73.15 section 256B.0915, subdivision 1d, paragraph (a), shall have the 73.16 option of remaining in the alternative care program. Persons 73.17 currently enrolled in the alternative care program who are not 73.18 eligible for the elderly waiver program shall continue to be 73.19 eligible for the alternative care programas long as continuous73.20eligibility is maintained. Continued eligibility for the73.21alternative care program shall be reviewed every six months.73.22Persons who apply for the alternative care program after73.23approval of the elderly waiver amendments in section 256B.0915,73.24subdivision 1d, are not eligible for alternative care if they73.25would qualify for the elderly waiver, with or without a73.26spenddown. Persons who apply for the alternative care program 73.27 after approval of the elderly waiver amendments in section 73.28 256B.0915, subdivision 1d, whose income is under the special 73.29 income standard according to Code of Federal Regulations, title 73.30 42, section 435.236, are not eligible for alternative care if 73.31 they would qualify for the elderly waiver, except that persons 73.32 whose income is above the maintenance needs amount described in 73.33 section 256B.0915, subdivision 1d, paragraph (a), shall have the 73.34 option of remaining in the alternative care program. 73.35 Sec. 17. Minnesota Statutes 1998, section 256B.431, 73.36 subdivision 2i, is amended to read: 74.1 Subd. 2i. [OPERATING COSTS AFTER JULY 1, 1988.] (a) 74.2 [OTHER OPERATING COST LIMITS.]For the rate year beginning July74.31, 1988, the commissioner shall increase the other operating74.4cost limits established in Minnesota Rules, part 9549.0055,74.5subpart 2, item E, to 110 percent of the median of the array of74.6allowable historical other operating cost per diems and index74.7these limits as in Minnesota Rules, part 9549.0056, subparts 374.8and 4. The limits must be established in accordance with74.9subdivision 2b, paragraph (d).For rate years beginning on or 74.10 after July 1, 1989, the adjusted other operating cost limits 74.11 must be indexed as in Minnesota Rules, part 9549.0056, subparts 74.12 3 and 4. For the rate period beginning October 1, 1992, and for 74.13 rate years beginning after June 30, 1993, the amount of the 74.14 surcharge under section 256.9657, subdivision 1, shall be 74.15 included in the plant operations and maintenance operating cost 74.16 category. The surcharge shall be an allowable cost for the 74.17 purpose of establishing the payment rate. 74.18 (b) [CARE-RELATED OPERATING COST LIMITS.]For the rate year74.19beginning July 1, 1988, the commissioner shall increase the74.20care-related operating cost limits established in Minnesota74.21Rules, part 9549.0055, subpart 2, items A and B, to 125 percent74.22of the median of the array of the allowable historical case mix74.23operating cost standardized per diems and the allowable74.24historical other care-related operating cost per diems and index74.25those limits as in Minnesota Rules, part 9549.0056, subparts 174.26and 2. The limits must be established in accordance with74.27subdivision 2b, paragraph (d).For rate years beginning on or 74.28 after July 1, 1989, the adjusted care-related limits must be 74.29 indexed as in Minnesota Rules, part 9549.0056, subparts 1 and 2. 74.30 (c) [SALARY ADJUSTMENT PER DIEM.] Effective July 1, 1998, 74.31 to June 30, 2000, the commissioner shall make available the 74.32 salary adjustment per diem calculated in clause (1) or (2) to 74.33 the total operating cost payment rate of each nursing facility 74.34 reimbursed under this section or section 256B.434. The salary 74.35 adjustment per diem for each nursing facility must be determined 74.36 as follows: 75.1 (1) For each nursing facility that reports salaries for 75.2 registered nurses, licensed practical nurses, and aides, 75.3 orderlies and attendants separately, the commissioner shall 75.4 determine the salary adjustment per diem by multiplying the 75.5 total salaries, payroll taxes, and fringe benefits allowed in 75.6 each operating cost category, except management fees and 75.7 administrator and central office salaries and the related 75.8 payroll taxes and fringe benefits, by 3.0 percent and then 75.9 dividing the resulting amount by the nursing facility's actual 75.10 resident days. 75.11 (2) For each nursing facility that does not report salaries 75.12 for registered nurses, licensed practical nurses, aides, 75.13 orderlies, and attendants separately, the salary adjustment per 75.14 diem is the weighted average salary adjustment per diem increase 75.15 determined under clause (1). 75.16 (3) A nursing facility may apply for the salary adjustment 75.17 per diem calculated under clauses (1) and (2). The application 75.18 must be made to the commissioner and contain a plan by which the 75.19 nursing facility will distribute the salary adjustment to 75.20 employees of the nursing facility. In order to apply for a 75.21 salary adjustment, a nursing facility reimbursed under section 75.22 256B.434, must report the information required by clause (1) or 75.23 (2) in the application, in the manner specified by the 75.24 commissioner. For nursing facilities in which the employees are 75.25 represented by an exclusive bargaining representative, an 75.26 agreement negotiated and agreed to by the employer and the 75.27 exclusive bargaining representative, after July 1, 1998, may 75.28 constitute the plan for the salary distribution. The 75.29 commissioner shall review the plan to ensure that the salary 75.30 adjustment per diem is used solely to increase the compensation 75.31 of nursing home facility employees. To be eligible, a facility 75.32 must submit its plan for the salary distribution by December 31, 75.33 1998. If a facility's plan for salary distribution is effective 75.34 for its employees after July 1, 1998, the salary adjustment cost 75.35 per diem shall be effective the same date as its plan. 75.36 (4) Additional costs incurred by nursing facilities as a 76.1 result of this salary adjustment are not allowable costs for 76.2 purposes of the September 30, 1998, cost report. 76.3(d) [NEW BASE YEAR.] The commissioner shall establish new76.4base years for both the reporting year ending September 30,76.51989, and the reporting year ending September 30, 1990. In76.6establishing new base years, the commissioner must take into76.7account:76.8(1) statutory changes made in geographic groups;76.9(2) redefinitions of cost categories; and76.10(3) reclassification, pass-through, or exemption of certain76.11costs such as Public Employee Retirement Act contributions.76.12(e)(d) [NEW BASE YEAR.] The commissioner shall establish a 76.13 new base year for the reporting years ending September 30, 1991, 76.14 and September 30, 1992. In establishing a new base year, the 76.15 commissioner must take into account: 76.16 (1) statutory changes made in geographic groups; 76.17 (2) redefinitions of cost categories; and 76.18 (3) reclassification, pass-through, or exemption of certain 76.19 costs. 76.20 Sec. 18. Minnesota Statutes 1998, section 256B.431, 76.21 subdivision 17, is amended to read: 76.22 Subd. 17. [SPECIAL PROVISIONS FOR MORATORIUM EXCEPTIONS.] 76.23 (a) Notwithstanding Minnesota Rules, part 9549.0060, subpart 3, 76.24 for rate periods beginning on October 1, 1992, and for rate 76.25 years beginning after June 30, 1993, a nursing facility that (1) 76.26 has completed a construction project approved under section 76.27 144A.071, subdivision 4a, clause (m); (2) has completed a 76.28 construction project approved under section 144A.071, 76.29 subdivision 4a, and effective after June 30, 1995; or (3) has 76.30 completed a renovation, replacement, or upgrading project 76.31 approved under the moratorium exception process in section 76.32 144A.073 shall be reimbursed for costs directly identified to 76.33 that project as provided in subdivision 16 and this subdivision. 76.34 (b) Notwithstanding Minnesota Rules, part 9549.0060, 76.35 subparts 5, item A, subitems (1) and (3), and 7, item D, 76.36 allowable interest expense on debt shall include: 77.1 (1) interest expense on debt related to the cost of 77.2 purchasing or replacing depreciable equipment, excluding 77.3 vehicles, not to exceed six percent of the total historical cost 77.4 of the project; and 77.5 (2) interest expense on debt related to financing or 77.6 refinancing costs, including costs related to points, loan 77.7 origination fees, financing charges, legal fees, and title 77.8 searches; and issuance costs including bond discounts, bond 77.9 counsel, underwriter's counsel, corporate counsel, printing, and 77.10 financial forecasts. Allowable debt related to items in this 77.11 clause shall not exceed seven percent of the total historical 77.12 cost of the project. To the extent these costs are financed, 77.13 the straight-line amortization of the costs in this clause is 77.14 not an allowable cost; and 77.15 (3) interest on debt incurred for the establishment of a 77.16 debt reserve fund, net of the interest earned on the debt 77.17 reserve fund. 77.18 (c) Debt incurred for costs under paragraph (b) is not 77.19 subject to Minnesota Rules, part 9549.0060, subpart 5, item A, 77.20 subitem (5) or (6). 77.21 (d) The incremental increase in a nursing facility's rental 77.22 rate, determined under Minnesota Rules, parts 9549.0010 to 77.23 9549.0080, and this section, resulting from the acquisition of 77.24 allowable capital assets, and allowable debt and interest 77.25 expense under this subdivision shall be added to its 77.26 property-related payment rate and shall be effective on the 77.27 first day of the month following the month in which the 77.28 moratorium project was completed. 77.29 (e) Notwithstanding subdivision 3f, paragraph (a), for rate 77.30 periods beginning on October 1, 1992, and for rate years 77.31 beginning after June 30, 1993, the replacement-costs-new per bed 77.32 limit to be used in Minnesota Rules, part 9549.0060, subpart 4, 77.33 item B, for a nursing facility that has completed a renovation, 77.34 replacement, or upgrading project that has been approved under 77.35 the moratorium exception process in section 144A.073, or that 77.36 has completed an addition to or replacement of buildings, 78.1 attached fixtures, or land improvements for which the total 78.2 historical cost exceeds the lesser of $150,000 or ten percent of 78.3 the most recent appraised value, must be $47,500 per licensed 78.4 bed in multiple-bed rooms and $71,250 per licensed bed in a 78.5 single-bed room. These amounts must be adjusted annually as 78.6 specified in subdivision 3f, paragraph (a), beginning January 1, 78.7 1993. 78.8 (f) A nursing facility that completes a project identified 78.9 in this subdivision and, as of April 17, 1992, has not been 78.10 mailed a rate notice with a special appraisal for a completed 78.11 project, or completes a project after April 17, 1992, but before 78.12 September 1, 1992, may elect either to request a special 78.13 reappraisal with the corresponding adjustment to the 78.14 property-related payment rate under the laws in effect on June 78.15 30, 1992, or to submit their capital asset and debt information 78.16 after that date and obtain the property-related payment rate 78.17 adjustment under this section, but not both. 78.18 (g) For purposes of this paragraph, a total replacement 78.19 means the complete replacement of the nursing facility's 78.20 physical plant through the construction of a new physical plant 78.21 or the transfer of the nursing facility's license from one 78.22 physical plant location to another. For total replacement 78.23 projects completed on or after July 1, 1992, the commissioner 78.24 shall compute the incremental change in the nursing facility's 78.25 rental per diem, for rate years beginning on or after July 1, 78.26 1995, by replacing its appraised value, including the historical 78.27 capital asset costs, and the capital debt and interest costs 78.28 with the new nursing facility's allowable capital asset costs 78.29 and the related allowable capital debt and interest costs. If 78.30 the new nursing facility has decreased its licensed capacity, 78.31 the aggregate investment per bed limit in subdivision 3a, 78.32 paragraph (d), shall apply. If the new nursing facility has 78.33 retained a portion of the original physical plant for nursing 78.34 facility usage, then a portion of the appraised value prior to 78.35 the replacement must be retained and included in the calculation 78.36 of the incremental change in the nursing facility's rental per 79.1 diem. For purposes of this part, the original nursing facility 79.2 means the nursing facility prior to the total replacement 79.3 project. The portion of the appraised value to be retained 79.4 shall be calculated according to clauses (1) to (3): 79.5 (1) The numerator of the allocation ratio shall be the 79.6 square footage of the area in the original physical plant which 79.7 is being retained for nursing facility usage. 79.8 (2) The denominator of the allocation ratio shall be the 79.9 total square footage of the original nursing facility physical 79.10 plant. 79.11 (3) Each component of the nursing facility's allowable 79.12 appraised value prior to the total replacement project shall be 79.13 multiplied by the allocation ratio developed by dividing clause 79.14 (1) by clause (2). 79.15 In the case of either type of total replacement as 79.16 authorized under section 144A.071 or 144A.073, the provisions of 79.17 this subdivision shall also apply. For purposes of the 79.18 moratorium exception authorized under section 144A.071, 79.19 subdivision 4a, paragraph (s), if the total replacement involves 79.20 the renovation and use of an existing health care facility 79.21 physical plant, the new allowable capital asset costs and 79.22 related debt and interest costs shall include first the 79.23 allowable capital asset costs and related debt and interest 79.24 costs of the renovation, to which shall be added the allowable 79.25 capital asset costs of the existing physical plant prior to the 79.26 renovation, and if reported by the facility, the related 79.27 allowable capital debt and interest costs. 79.28 (h) Notwithstanding Minnesota Rules, part 9549.0060, 79.29 subpart 11, item C, subitem (2), for a total replacement, as 79.30 defined in paragraph (g), authorized under section 144A.071 or 79.31 144A.073 after July 1, 1999, the replacement costs new per bed 79.32 limit shall be $74,280 per licensed bed in multiple-bed rooms, 79.33 $92,850 per licensed bed in semiprivate rooms with a fixed 79.34 partition separating the resident beds, and $111,420 per 79.35 licensed bed in single rooms. Minnesota Rules, part 9549.0060, 79.36 subpart 11, item C, subitem (2), does not apply. These amounts 80.1 must be adjusted annually as specified in subdivision 3f, 80.2 paragraph (a), beginning January 1, 2000. 80.3 (i) For a total replacement, as defined in paragraph (g), 80.4 authorized under section 144A.073 for a 96-bed nursing home in 80.5 Carlton county, the replacement costs new per bed limit shall be 80.6 $74,280 per licensed bed in multiple-bed rooms, $92,850 per 80.7 licensed bed in semiprivate rooms with a fixed partition 80.8 separating the resident's beds, and $111,420 per licensed bed in 80.9 a single room. Minnesota Rules, part 9549.0060, subpart 11, 80.10 item C, subitem (2), does not apply. The resulting maximum 80.11 allowable replacement costs new multiplied by 1.25 shall 80.12 constitute the project's dollar threshold for purposes of 80.13 application of the limit set forth in section 144A.073, 80.14 subdivision 2. The commissioner of health may waive the 80.15 requirements of section 144A.073, subdivision 3b, paragraph (b), 80.16 clause (2), on the condition that the other requirements of that 80.17 paragraph are met. 80.18 Sec. 19. Minnesota Statutes 1998, section 256B.431, 80.19 subdivision 26, is amended to read: 80.20 Subd. 26. [CHANGES TO NURSING FACILITY REIMBURSEMENT 80.21 BEGINNING JULY 1, 1997.] The nursing facility reimbursement 80.22 changes in paragraphs (a) to (f) shall apply in the sequence 80.23 specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and 80.24 this section, beginning July 1, 1997. 80.25 (a) For rate years beginning on or after July 1, 1997, the 80.26 commissioner shall limit a nursing facility's allowable 80.27 operating per diem for each case mix category for each rate year. 80.28 The commissioner shall group nursing facilities into two groups, 80.29 freestanding and nonfreestanding, within each geographic group, 80.30 using their operating cost per diem for the case mix A 80.31 classification. A nonfreestanding nursing facility is a nursing 80.32 facility whose other operating cost per diem is subject to the 80.33 hospital attached, short length of stay, or the rule 80 limits. 80.34 All other nursing facilities shall be considered freestanding 80.35 nursing facilities. The commissioner shall then array all 80.36 nursing facilities in each grouping by their allowable case mix 81.1 A operating cost per diem. In calculating a nursing facility's 81.2 operating cost per diem for this purpose, the commissioner shall 81.3 exclude the raw food cost per diem related to providing special 81.4 diets that are based on religious beliefs, as determined in 81.5 subdivision 2b, paragraph (h). For those nursing facilities in 81.6 each grouping whose case mix A operating cost per diem: 81.7 (1) is at or below the median of the array, the 81.8 commissioner shall limit the nursing facility's allowable 81.9 operating cost per diem for each case mix category to the lesser 81.10 of the prior reporting year's allowable operating cost per diem 81.11 as specified in Laws 1996, chapter 451, article 3, section 11, 81.12 paragraph (h), plus the inflation factor as established in 81.13 paragraph (d), clause (2), increased by two percentage points, 81.14 or the current reporting year's corresponding allowable 81.15 operating cost per diem; or 81.16 (2) is above the median of the array, the commissioner 81.17 shall limit the nursing facility's allowable operating cost per 81.18 diem for each case mix category to the lesser of the prior 81.19 reporting year's allowable operating cost per diem as specified 81.20 in Laws 1996, chapter 451, article 3, section 11, paragraph (h), 81.21 plus the inflation factor as established in paragraph (d), 81.22 clause (2), increased by one percentage point, or the current 81.23 reporting year's corresponding allowable operating cost per diem. 81.24 For purposes of paragraph (a), if a nursing facility 81.25 reports on its cost report a reduction in cost due to a refund 81.26 or credit for a rate year beginning on or after July 1, 1998, 81.27 the commissioner shall increase that facility's spend-up limit 81.28 for the rate year following the current rate year by the amount 81.29 of the cost reduction divided by its resident days for the 81.30 reporting year preceding the rate year in which the adjustment 81.31 is to be made. 81.32 (b) For rate years beginning on or after July 1, 1997, the 81.33 commissioner shall limit the allowable operating cost per diem 81.34 for high cost nursing facilities. After application of the 81.35 limits in paragraph (a) to each nursing facility's operating 81.36 cost per diem, the commissioner shall group nursing facilities 82.1 into two groups, freestanding or nonfreestanding, within each 82.2 geographic group. A nonfreestanding nursing facility is a 82.3 nursing facility whose other operating cost per diem are subject 82.4 to hospital attached, short length of stay, or rule 80 limits. 82.5 All other nursing facilities shall be considered freestanding 82.6 nursing facilities. The commissioner shall then array all 82.7 nursing facilities within each grouping by their allowable case 82.8 mix A operating cost per diem. In calculating a nursing 82.9 facility's operating cost per diem for this purpose, the 82.10 commissioner shall exclude the raw food cost per diem related to 82.11 providing special diets that are based on religious beliefs, as 82.12 determined in subdivision 2b, paragraph (h). For those nursing 82.13 facilities in each grouping whose case mix A operating cost per 82.14 diem exceeds 1.0 standard deviation above the median, the 82.15 commissioner shall reduce their allowable operating cost per 82.16 diem by three percent. For those nursing facilities in each 82.17 grouping whose case mix A operating cost per diem exceeds 0.5 82.18 standard deviation above the median but is less than or equal to 82.19 1.0 standard deviation above the median, the commissioner shall 82.20 reduce their allowable operating cost per diem by two percent. 82.21 However, in no case shall a nursing facility's operating cost 82.22 per diem be reduced below its grouping's limit established at 82.23 0.5 standard deviations above the median. 82.24 (c) For rate years beginning on or after July 1, 1997, the 82.25 commissioner shall determine a nursing facility's efficiency 82.26 incentive by first computing the allowable difference, which is 82.27 the lesser of $4.50 or the amount by which the facility's other 82.28 operating cost limit exceeds its nonadjusted other operating 82.29 cost per diem for that rate year. The commissioner shall 82.30 compute the efficiency incentive by: 82.31 (1) subtracting the allowable difference from $4.50 and 82.32 dividing the result by $4.50; 82.33 (2) multiplying 0.20 by the ratio resulting from clause 82.34 (1), and then; 82.35 (3) adding 0.50 to the result from clause (2); and 82.36 (4) multiplying the result from clause (3) times the 83.1 allowable difference. 83.2 The nursing facility's efficiency incentive payment shall 83.3 be the lesser of $2.25 or the product obtained in clause (4). 83.4 (d) For rate years beginning on or after July 1, 1997, the 83.5 forecasted price index for a nursing facility's allowable 83.6 operating cost per diem shall be determined under clauses (1) 83.7 and (2) using the change in the Consumer Price Index-All Items 83.8 (United States city average) (CPI-U) as forecasted by Data 83.9 Resources, Inc. The commissioner shall use the indices as 83.10 forecasted in the fourth quarter of the calendar year preceding 83.11 the rate year, subject to subdivision 2l, paragraph (c). 83.12 (1) The CPI-U forecasted index for allowable operating cost 83.13 per diem shall be based on the 21-month period from the midpoint 83.14 of the nursing facility's reporting year to the midpoint of the 83.15 rate year following the reporting year. 83.16 (2) For rate years beginning on or after July 1, 1997, the 83.17 forecasted index for operating cost limits referred to in 83.18 subdivision 21, paragraph (b), shall be based on the CPI-U for 83.19 the 12-month period between the midpoints of the two reporting 83.20 years preceding the rate year. 83.21 (e) After applying these provisions for the respective rate 83.22 years, the commissioner shall index these allowable operating 83.23 cost per diem by the inflation factor provided for in paragraph 83.24 (d), clause (1), and add the nursing facility's efficiency 83.25 incentive as computed in paragraph (c). 83.26 (f) For rate years beginning on or after July 1, 1997, the 83.27 total operating cost payment rates for a nursing facility shall 83.28 be the greater of the total operating cost payment rates 83.29 determined under this section or the total operating cost 83.30 payment rates in effect on June 30, 1997, subject to rate 83.31 adjustments due to field audit or rate appeal resolution. This 83.32 provision shall not apply to subsequent field audit adjustments 83.33 of the nursing facility's operating cost rates for rate years 83.34 beginning on or after July 1, 1997. 83.35 (g) For the rate years beginning on July 1, 1997, July 1, 83.36 1998, and July 1, 1999, a nursing facility licensed for 40 beds 84.1 effective May 1, 1992, with a subsequent increase of 20 84.2 Medicare/Medicaid certified beds, effective January 26, 1993, in 84.3 accordance with an increase in licensure is exempt from 84.4 paragraphs (a) and (b). 84.5 (h) For a nursing facility whose construction project was 84.6 authorized according to section 144A.073, subdivision 5, 84.7 paragraph (g), the operating cost payment rates for thethird84.8 new location shall be determined based on Minnesota Rules, part 84.9 9549.0057. The relocation allowed under section 144A.073, 84.10 subdivision 5, paragraph (g), and the rate determination allowed 84.11 under this paragraph must meet the cost neutrality requirements 84.12 of section 144A.073, subdivision 3c. Paragraphs (a) and (b) 84.13 shall not apply until the second rate year after the settle-up 84.14 cost report is filed. Notwithstanding subdivision 2b, paragraph 84.15 (g), real estate taxes and special assessments payable by 84.16 thethirdnew location, a 501(c)(3) nonprofit corporation, shall 84.17 be included in the payment rates determined under this 84.18 subdivision for all subsequent rate years. 84.19 (i) For the rate year beginning July 1, 1997, the 84.20 commissioner shall compute the payment rate for a nursing 84.21 facility licensed for 94 beds on September 30, 1996, that 84.22 applied in October 1993 for approval of a total replacement 84.23 under the moratorium exception process in section 144A.073, and 84.24 completed the approved replacement in June 1995, with other 84.25 operating cost spend-up limit under paragraph (a), increased by 84.26 $3.98, and after computing the facility's payment rate according 84.27 to this section, the commissioner shall make a one-year positive 84.28 rate adjustment of $3.19 for operating costs related to the 84.29 newly constructed total replacement, without application of 84.30 paragraphs (a) and (b). The facility's per diem, before the 84.31 $3.19 adjustment, shall be used as the prior reporting year's 84.32 allowable operating cost per diem for payment rate calculation 84.33 for the rate year beginning July 1, 1998. A facility described 84.34 in this paragraph is exempt from paragraph (b) for the rate 84.35 years beginning July 1, 1997, and July 1, 1998. 84.36 (j) For the purpose of applying the limit stated in 85.1 paragraph (a), a nursing facility in Kandiyohi county licensed 85.2 for 86 beds that was granted hospital-attached status on 85.3 December 1, 1994, shall have the prior year's allowable 85.4 care-related per diem increased by $3.207 and the prior year's 85.5 other operating cost per diem increased by $4.777 before adding 85.6 the inflation in paragraph (d), clause (2), for the rate year 85.7 beginning on July 1, 1997. 85.8 (k) For the purpose of applying the limit stated in 85.9 paragraph (a), a 117 bed nursing facility located in Pine county 85.10 shall have the prior year's allowable other operating cost per 85.11 diem increased by $1.50 before adding the inflation in paragraph 85.12 (d), clause (2), for the rate year beginning on July 1, 1997. 85.13 (l) For the purpose of applying the limit under paragraph 85.14 (a), a nursing facility in Hibbing licensed for 192 beds shall 85.15 have the prior year's allowable other operating cost per diem 85.16 increased by $2.67 before adding the inflation in paragraph (d), 85.17 clause (2), for the rate year beginning July 1, 1997. 85.18 Sec. 20. Minnesota Statutes 1998, section 256B.431, is 85.19 amended by adding a subdivision to read: 85.20 Subd. 28. [NURSING FACILITY RATE INCREASES BEGINNING JULY 85.21 1, 1999, AND JULY 1, 2000.] (a) For the rate year beginning July 85.22 1, 1999, the commissioner shall make available an operating 85.23 payment rate increase equal to four percent. The commissioner 85.24 shall make available salary adjustments equal to 4.75 percent in 85.25 each category except management fees and administrator and 85.26 central office, which shall be used solely to increase wages or 85.27 pay payroll taxes associated with these wage increases, and 85.28 shall use the remainder of the amount appropriated by the 85.29 legislature to increase per diem payment rates in all operating 85.30 rate categories not subject to the 4.75 percent increase. 85.31 (b) For the rate year beginning July 1, 2000, the 85.32 commissioner shall make available an operating payment rate 85.33 increase equal to three percent. The commissioner shall make 85.34 available salary adjustments equal to 3.5 percent in each 85.35 category except management fees and administrator and central 85.36 office, which shall be used solely to increase wages or pay 86.1 payroll taxes associated with these wage increases, and shall 86.2 use the remainder of the amount appropriated to increase per 86.3 diem payment rates in all operating rate categories not subject 86.4 to the 3.5 percent increase. 86.5 (c) Effective July 1, 1999, to June 30, 2001, the 86.6 commissioner shall make available the salary adjustment per diem 86.7 calculated in clause (1) or (2) to the total operating cost 86.8 payment rate of each nursing facility reimbursed under this 86.9 section or section 256B.434. The salary adjustment per diem for 86.10 each nursing facility must be determined as follows: 86.11 (1) for each nursing facility that reports salaries for 86.12 registered nurses, licensed practical nurses, and aides, 86.13 orderlies, and attendants separately, the commissioner shall 86.14 determine the salary adjustment per diem by multiplying the 86.15 total salaries, payroll taxes, and fringe benefits allowed in 86.16 each operating cost category, except management fees and 86.17 administrator and central office salaries and the related 86.18 payroll taxes and fringe benefits, by 4.75 percent and 3.5 86.19 percent respectively, and then dividing the resulting amount by 86.20 the nursing facility's actual resident days; 86.21 (2) for each nursing facility that does not report salaries 86.22 for registered nurses, licensed practical nurses, aides, 86.23 orderlies, and attendants separately, the salary adjustment per 86.24 diem is the weighted average salary adjustment per diem increase 86.25 determined under clause (1); 86.26 (3) a nursing facility may apply for the salary adjustment 86.27 per diem calculated under clauses (1) and (2). The application 86.28 must be made to the commissioner and contain a plan by which the 86.29 nursing facility will distribute the salary adjustment to 86.30 employees of the nursing facility. In order to apply for a 86.31 salary adjustment, a nursing facility reimbursed under section 86.32 256B.434 must report the information required by clause (1) or 86.33 (2) in the application, in the manner specified by the 86.34 commissioner. For nursing facilities in which the employees are 86.35 represented by an exclusive bargaining representative, an 86.36 agreement negotiated and agreed to by the employer and the 87.1 exclusive bargaining representative may constitute the plan for 87.2 the salary distribution. The commissioner shall review the plan 87.3 to ensure that the salary adjustment per diem is used solely to 87.4 increase the wages of nursing home facility employees and pay 87.5 payroll taxes associated with these increased wages. To be 87.6 eligible, a facility must submit its plan for the salary 87.7 distribution by December 31 each year. A facility may amend its 87.8 plan for the second rate year by submitting a revised plan by 87.9 December 31, 2000. If a facility's plan for salary distribution 87.10 is effective for its employees after July 1 of the year that the 87.11 funds are available, the salary adjustment cost per diem shall 87.12 be effective the same date as its plan; and 87.13 (4) additional costs incurred by nursing facilities as a 87.14 result of this salary adjustment are not allowable costs for 87.15 purposes of the September 30, 1999, or September 30, 2000, cost 87.16 report. 87.17 (d) A copy of the approved distribution plan must be made 87.18 available to all employees. This must be done by giving each 87.19 employee a copy or by posting it in an area of the nursing 87.20 facility to which all employees have access. If an employee 87.21 does not receive the salary adjustment described in their 87.22 facility's approved plan and is unable to resolve the problem 87.23 with the facility's management, the employee may contact the 87.24 employee's union representative. If the employee is not covered 87.25 by a collective bargaining agreement, the employee may contact 87.26 the commissioner at a phone number provided by the commissioner 87.27 and included in the approved plan. 87.28 (e) For the rate year beginning July 1, 1999, the following 87.29 nursing facilities shall be allowed a rate increase equal to 67 87.30 percent of the rate increase that would be allowed if 87.31 subdivision 26, paragraph (a), was not applied: 87.32 (1) a nursing facility in Carver county licensed for 33 87.33 nursing home beds and four boarding care beds; 87.34 (2) a nursing facility in Faribault county licensed for 159 87.35 nursing home beds on September 30, 1998; and 87.36 (3) a nursing facility in Houston county licensed for 68 88.1 nursing home beds on September 30, 1998. 88.2 (f) For the rate year beginning July 1, 1999, the following 88.3 nursing facilities shall be allowed a rate increase equal to 67 88.4 percent of the rate increase that would be allowed if 88.5 subdivision 26, paragraphs (a) and (b), were not applied: 88.6 (1) a nursing facility in Chisago county licensed for 135 88.7 nursing home beds on September 30, 1998; and 88.8 (2) a nursing facility in Murray county licensed for 62 88.9 nursing home beds on September 30, 1998. 88.10 (g) For the rate year beginning July 1, 1999, a nursing 88.11 facility in Hennepin county licensed for 134 beds on September 88.12 30, 1998, shall: 88.13 (1) have the prior year's allowable care-related per diem 88.14 increased by $3.93 and the prior year's other operating cost per 88.15 diem increased by $1.69 before adding the inflation in 88.16 subdivision 26, paragraph (d), clause (2); and 88.17 (2) be allowed a rate increase equal to 67 percent of the 88.18 rate increase that would be allowed if subdivision 26, 88.19 paragraphs (a) and (b), were not applied. 88.20 Sec. 21. Minnesota Statutes 1998, section 256B.434, 88.21 subdivision 3, is amended to read: 88.22 Subd. 3. [DURATION AND TERMINATION OF CONTRACTS.] (a) 88.23 Subject to available resources, the commissioner may begin to 88.24 execute contracts with nursing facilities November 1, 1995. 88.25 (b) All contracts entered into under this section are for a 88.26 term of one year. Either party may terminate a contract at any 88.27 time without cause by providing3090 calendar days advance 88.28 written notice to the other party. The decision to terminate a 88.29 contract is not appealable.If neither party provides written88.30notice of termination the contract shall be renegotiated for88.31additional one-year terms, for up to a total of four consecutive88.32one-year termsNotwithstanding section 16C.05, subdivision 2, 88.33 paragraph (a), clause (5), the contract shall be renegotiated 88.34 for additional one-year terms unless either party provides 88.35 written notice of termination. The provisions of the contract 88.36 shall be renegotiated annually by the parties prior to the 89.1 expiration date of the contract. The parties may voluntarily 89.2 renegotiate the terms of the contract at any time by mutual 89.3 agreement. 89.4 (c) If a nursing facility fails to comply with the terms of 89.5 a contract, the commissioner shall provide reasonable notice 89.6 regarding the breach of contract and a reasonable opportunity 89.7 for the facility to come into compliance. If the facility fails 89.8 to come into compliance or to remain in compliance, the 89.9 commissioner may terminate the contract. If a contract is 89.10 terminated, the contract payment remains in effect for the 89.11 remainder of the rate year in which the contract was terminated, 89.12 but in all other respects the provisions of this section do not 89.13 apply to that facility effective the date the contract is 89.14 terminated. The contract shall contain a provision governing 89.15 the transition back to the cost-based reimbursement system 89.16 established under section 256B.431, subdivision 25, and 89.17 Minnesota Rules, parts 9549.0010 to 9549.0080. A contract 89.18 entered into under this section may be amended by mutual 89.19 agreement of the parties. 89.20 Sec. 22. Minnesota Statutes 1998, section 256B.434, 89.21 subdivision 4, is amended to read: 89.22 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 89.23 nursing facilities which have their payment rates determined 89.24 under this section rather than section 256B.431, subdivision 25, 89.25 the commissioner shall establish a rate under this subdivision. 89.26 The nursing facility must enter into a written contract with the 89.27 commissioner. 89.28 (b) A nursing facility's case mix payment rate for the 89.29 first rate year of a facility's contract under this section is 89.30 the payment rate the facility would have received under section 89.31 256B.431, subdivision 25. 89.32 (c) A nursing facility's case mix payment rates for the 89.33 second and subsequent years of a facility's contract under this 89.34 section are the previous rate year's contract payment rates plus 89.35 an inflation adjustment. The index for the inflation adjustment 89.36 must be based on the change in the Consumer Price Index-All 90.1 Items (United States City average) (CPI-U) forecasted by Data 90.2 Resources, Inc., as forecasted in the fourth quarter of the 90.3 calendar year preceding the rate year. The inflation adjustment 90.4 must be based on the 12-month period from the midpoint of the 90.5 previous rate year to the midpoint of the rate year for which 90.6 the rate is being determined. This paragraph shall not apply 90.7 for the rate years beginning July 1, 1999, and July 1, 2000. 90.8 (d) The commissioner shall develop additional 90.9 incentive-based payments of up to five percent above the 90.10 standard contract rate for achieving outcomes specified in each 90.11 contract. The specified facility-specific outcomes must be 90.12 measurable and approved by the commissioner. The commissioner 90.13 may establish, for each contract, various levels of achievement 90.14 within an outcome. After the outcomes have been specified the 90.15 commissioner shall assign various levels of payment associated 90.16 with achieving the outcome. Any incentive-based payment cancels 90.17 if there is a termination of the contract. In establishing the 90.18 specified outcomes and related criteria the commissioner shall 90.19 consider the following state policy objectives: 90.20 (1) improved cost effectiveness and quality of life as 90.21 measured by improved clinical outcomes; 90.22 (2) successful diversion or discharge to community 90.23 alternatives; 90.24 (3) decreased acute care costs; 90.25 (4) improved consumer satisfaction; 90.26 (5) the achievement of quality; or 90.27 (6) any additional outcomes proposed by a nursing facility 90.28 that the commissioner finds desirable. 90.29 Sec. 23. Minnesota Statutes 1998, section 256B.434, is 90.30 amended by adding a subdivision to read: 90.31 Subd. 4a. [FACILITY RATE INCREASES.] For the rate year 90.32 beginning July 1, 1999, the nursing facilities described in 90.33 clauses (1) to (4) shall receive the rate increases indicated. 90.34 The increases provided under this subdivision shall be included 90.35 in the facility's total payment rates for the purpose of 90.36 determining future rates under this section or any other section: 91.1 (1) a nursing facility in Becker county licensed for 102 91.2 nursing home beds on September 30, 1998, shall receive an 91.3 increase of $1.30 in its case mix class A payment rate; an 91.4 increase of $1.33 in its case mix class B payment rate; an 91.5 increase of $1.36 in its case mix class C payment rate; an 91.6 increase of $1.39 in its case mix class D payment rate; an 91.7 increase of $1.42 in its case mix class E payment rate; an 91.8 increase of $1.42 in its case mix class F payment rate; an 91.9 increase of $1.45 in its case mix class G payment rate; an 91.10 increase of $1.49 in its case mix class H payment rate; an 91.11 increase of $1.51 in its case mix class I payment rate; an 91.12 increase of $1.54 in its case mix class J payment rate; and an 91.13 increase of $1.59 in its case mix class K payment rate; 91.14 (2) a nursing facility in Chisago county licensed for 101 91.15 nursing home beds on September 30, 1998, shall receive an 91.16 increase of $3.67 in each case mix payment rate; 91.17 (3) a nursing facility in Canby, licensed for 75 beds shall 91.18 have its property-related per diem rate increased by $1.21. 91.19 This increase shall be recognized in the facility's contract 91.20 payment rate under this section; and 91.21 (4) a nursing facility in Golden Valley with all its beds 91.22 licensed to provide residential rehabilitative services to young 91.23 adults under Minnesota Rules, parts 9570.2000 to 9570.3400, 91.24 shall have the payment rate computed according to this section 91.25 increased by $14.83. 91.26 Sec. 24. Minnesota Statutes 1998, section 256B.434, 91.27 subdivision 13, is amended to read: 91.28 Subd. 13. [PAYMENT SYSTEM REFORM ADVISORY COMMITTEE.](a)91.29 The commissioner, in consultation with an advisory committee, 91.30 shall study options for reforming the regulatory and 91.31 reimbursement system for nursing facilities to reduce the level 91.32 of regulation, reporting, and procedural requirements, and to 91.33 provide greater flexibility and incentives to stimulate 91.34 competition and innovation. The advisory committee shall 91.35 include, at a minimum, representatives from the long-term care 91.36 provider community, the department of health, and consumers of 92.1 long-term care services.The advisory committee sunsets on June92.230, 1997.Among other things, the commissioner shall consider 92.3 the feasibility and desirability of changing from a 92.4 certification requirement to an accreditation requirement for 92.5 participation in the medical assistance program, options to 92.6 encourage early discharge of short-term residents through the 92.7 provision of intensive therapy, and further modifications needed 92.8 in rate equalization. The commissioner shall also include 92.9 detailed recommendations for a permanent managed care payment 92.10 system to replace the contractual alternative payment 92.11 demonstration project authorized under this section. The 92.12 commissioner shall submit a report with findings and 92.13 recommendations to the legislature by January 15, 1997. 92.14(b) If a permanent managed care payment system has not been92.15enacted into law by July 1, 1997, the commissioner shall develop92.16and implement a transition plan to enable nursing facilities92.17under contract with the commissioner under this section to92.18revert to the cost-based payment system at the expiration of the92.19alternative payment demonstration project. The commissioner92.20shall include in the alternative payment demonstration project92.21contracts entered into under this section a provision to permit92.22an amendment to the contract to be made after July 1, 1997,92.23governing the transition back to the cost-based payment system.92.24The transition plan and contract amendments are not subject to92.25rulemaking requirements.92.26 Sec. 25. Minnesota Statutes 1998, section 256B.435, is 92.27 amended to read: 92.28 256B.435 [NURSING FACILITY REIMBURSEMENT SYSTEM EFFECTIVE 92.29 JULY 1,20002001.] 92.30 Subdivision 1. [IN GENERAL.] Effective July 1,20002001, 92.31 the commissioner shall implement a performance-based contracting 92.32 system to replace the current method of setting operating cost 92.33 payment rates under sections 256B.431 and 256B.434 and Minnesota 92.34 Rules, parts 9549.0010 to 9549.0080. Operating cost payment 92.35 rates for newly established facilities under Minnesota Rules, 92.36 part 9549.0057, shall be established using section 256B.431 and 93.1 Minnesota Rules, parts 9549.0010 to 9549.0070. A nursing 93.2 facility in operation on May 1, 1998, with payment rates not 93.3 established under section 256B.431 or 256B.434 on that date, is 93.4 ineligible for this performance-based contracting system. In 93.5 determining prospective payment rates of nursing facility 93.6 services, the commissioner shall distinguish between operating 93.7 costs and property-related costs. The commissioner of finance 93.8 shall include an annual inflationary adjustment in operating 93.9 costs for nursing facilities using the inflation factor 93.10 specified in subdivision 3 and funding for incentive-based 93.11 payments as a budget change request in each biennial detailed 93.12 expenditure budget submitted to the legislature under section 93.13 16A.11. Property related payment rates, including real estate 93.14 taxes and special assessments, shall be determined under section 93.15 256B.431 or 256B.434 or under a new property-related 93.16 reimbursement system, if one is implemented by the commissioner 93.17 under subdivision 3. The commissioner shall present additional 93.18 recommendations for performance-based contracting for nursing 93.19 facilities to the legislature by February 15, 2000, in the 93.20 following specific areas: 93.21 (1) development of an interim default payment mechanism for 93.22 nursing facilities that do not respond to the state's request 93.23 for proposal but wish to continue participation in the medical 93.24 assistance program, and nursing facilities the state does not 93.25 select in the request for proposal process, and nursing 93.26 facilities whose contract has been canceled; 93.27 (2) development of criteria for facilities to earn 93.28 performance-based incentive payments based on relevant outcomes 93.29 negotiated by nursing facilities and the commissioner and that 93.30 recognize both continuous quality efforts and quality 93.31 improvement; 93.32 (3) development of criteria and a process under which 93.33 nursing facilities can request rate adjustments for low base 93.34 rates, geographic disparities, or other reasons; 93.35 (4) development of a dispute resolution mechanism for 93.36 nursing facilities that are denied a contract, denied incentive 94.1 payments, or denied a rate adjustment; 94.2 (5) development of a property payment system to address the 94.3 capital needs of nursing facilities that will be funded with 94.4 additional appropriations; 94.5 (6) establishment of a transitional plan to move from dual 94.6 assessment instruments to the federally mandated resident 94.7 assessment system, whereby the financial impact for each 94.8 facility would be budget neutral; 94.9 (7) identification of net cost implications for facilities 94.10 and to the department of preparing for and implementing 94.11 performance-based contracting or any proposed alternative 94.12 system; 94.13 (8) identification of facility financial and statistical 94.14 reporting requirements; and 94.15 (9) identification of exemptions from current regulations 94.16 and statutes applicable under performance-based contracting. 94.17 Subd. 1a. [REQUESTS FOR PROPOSALS.] (a) For nursing 94.18 facilities with rates established under section 256B.434 on 94.19 January 1, 2001, the commissioner shall renegotiate contracts 94.20 without requiring a response to a request for proposal, 94.21 notwithstanding the solicitation process described in chapter 94.22 16C. 94.23 (b) Prior to July 1, 2001, the commissioner shall publish 94.24 in the State Register a request for proposals to provide nursing 94.25 facility services according to this section. The commissioner 94.26 will consider proposals from all nursing facilities that have 94.27 payment rates established under section 256B.431. The 94.28 commissioner must respond to all proposals in a timely manner. 94.29 (c) In issuing a request for proposals, the commissioner 94.30 may develop reasonable requirements which, in the judgment of 94.31 the commissioner, are necessary to protect residents or ensure 94.32 that the performance-based contracting system furthers the 94.33 interests of the state of Minnesota. The request for proposals 94.34 may include, but need not be limited to: 94.35 (1) a requirement that a nursing facility make reasonable 94.36 efforts to maximize Medicare payments on behalf of eligible 95.1 residents; 95.2 (2) requirements designed to prevent inappropriate or 95.3 illegal discrimination against residents enrolled in the medical 95.4 assistance program as compared to private paying residents; 95.5 (3) requirements designed to ensure that admissions to a 95.6 nursing facility are appropriate and that reasonable efforts are 95.7 made to place residents in home and community-based settings 95.8 when appropriate; 95.9 (4) a requirement to agree to participate in the 95.10 development of data collection systems and outcome-based 95.11 standards. Among other requirements specified by the 95.12 commissioner, each facility entering into a contract may be 95.13 required to pay an annual fee not to exceed $1,000. The 95.14 commissioner must use revenue generated from the fees to 95.15 contract with a qualified consultant or contractor to develop 95.16 data collection systems and outcome-based contracting standards; 95.17 (5) a requirement that Medicare-certified contractors agree 95.18 to maintain Medicare cost reports and to submit them to the 95.19 commissioner upon request, or at times specified by the 95.20 commissioner; and that contractors that are not 95.21 Medicare-certified agree to maintain a uniform cost report in a 95.22 format established by the commissioner and to submit the report 95.23 to the commissioner upon request, or at times specified by the 95.24 commissioner; 95.25 (6) a requirement that demonstrates willingness and ability 95.26 to develop and maintain data collection and retrieval systems to 95.27 measure outcomes; and 95.28 (7) a requirement to provide all information and assurances 95.29 required by the terms and conditions of the federal waiver or 95.30 federal approval. 95.31 (d) In addition to the information and assurances contained 95.32 in the submitted proposals, the commissioner may consider the 95.33 following criteria in developing the terms of the contract: 95.34 (1) the facility's history of compliance with federal and 95.35 state laws and rules. A facility deemed to be in substantial 95.36 compliance with federal and state laws and rules is eligible to 96.1 respond to a request for proposals. A facility's compliance 96.2 history shall not be the sole determining factor in situations 96.3 where the facility has been sold and the new owners have 96.4 submitted a proposal; 96.5 (2) whether the facility has a record of excessive 96.6 licensure fines or sanctions or fraudulent cost reports; 96.7 (3) the facility's financial history and solvency; and 96.8 (4) other factors identified by the commissioner deemed 96.9 relevant to developing the terms of the contract, including a 96.10 determination that a contract with a particular facility is not 96.11 in the best interests of the residents of the facility or the 96.12 state of Minnesota. 96.13 (e) Notwithstanding the requirements of the solicitation 96.14 process described in chapter 16C, the commissioner may contract 96.15 with nursing facilities established according to section 96.16 144A.073 without issuing a request for proposals. 96.17 (f) Notwithstanding subdivision 1, after July 1, 2001, the 96.18 commissioner may contract with additional nursing facilities, 96.19 according to requests for proposals. 96.20 Subd. 2. [CONTRACT PROVISIONS.] (a) The performance-based 96.21 contract with each nursing facility must include provisions that: 96.22 (1) apply the resident case mix assessment provisions of 96.23 Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or 96.24 another assessment system, with the goal of moving to a single 96.25 assessment system; 96.26 (2) monitor resident outcomes through various methods, such 96.27 as quality indicators based on the minimum data set and other 96.28 utilization and performance measures; 96.29 (3) require the establishment and use of a continuous 96.30 quality improvement process that integrates information from 96.31 quality indicators and regular resident and family satisfaction 96.32 interviews; 96.33 (4) require annual reporting of facility statistical 96.34 information, including resident days by case mix category, 96.35 productive nursing hours, wages and benefits, and raw food costs 96.36 for use by the commissioner in the development of facility 97.1 profiles that include trends in payment and service utilization; 97.2 (5) require from each nursing facility an annual certified 97.3 audited financial statement consisting of a balance sheet, 97.4 income and expense statements, and an opinion from either a 97.5 licensed or certified public accountant, if a certified audit 97.6 was prepared, or unaudited financial statements if no certified 97.7 audit was prepared;and97.8 (6) specify the method for resolving disputes; and 97.9 (7) establish additional requirementsand penaltiesfor 97.10 nursing facilities not meeting the standards set forth in the 97.11 performance-based contract. 97.12 (b) The commissioner may develop additional incentive-based 97.13 payments for achieving specified outcomes specified in each 97.14 contract. The specified facility-specific outcomes must be 97.15 measurable and approved by the commissioner. 97.16 (c) The commissioner may also contract with nursing 97.17 facilities in other ways through requests for proposals, 97.18 including contracts on a risk or nonrisk basis, with nursing 97.19 facilities or consortia of nursing facilities, to provide 97.20 comprehensive long-term care coverage on a premium or capitated 97.21 basis. 97.22 (d) The commissioner may negotiate different contract terms 97.23 for different nursing facilities. 97.24 Subd. 2a. [DURATION AND TERMINATION OF CONTRACTS.] (a) All 97.25 contracts entered into under this section are for a term of one 97.26 year. Either party may terminate this contract at any time 97.27 without cause by providing 90 calendar days' advance written 97.28 notice to the other party. Notwithstanding section 16C.05, 97.29 subdivisions 2, paragraph (a), and 5, if neither party provides 97.30 written notice of termination, the contract shall be 97.31 renegotiated for additional one-year terms or the terms of the 97.32 existing contract will be extended for one year. The provisions 97.33 of the contract shall be renegotiated annually by the parties 97.34 prior to the expiration date of the contract. The parties may 97.35 voluntarily renegotiate the terms of the contract at any time by 97.36 mutual agreement. 98.1 (b) If a nursing facility fails to comply with the terms of 98.2 a contract, the commissioner shall provide reasonable notice 98.3 regarding the breach of contract and a reasonable opportunity 98.4 for the facility to come into compliance. If the facility fails 98.5 to come into compliance or to remain in compliance, the 98.6 commissioner may terminate the contract. If a contract is 98.7 terminated, provisions of section 256B.48, subdivision 1a, shall 98.8 apply. 98.9 Subd. 3. [PAYMENT RATE PROVISIONS.] (a) For rate years 98.10 beginning on or after July 1,20002001, within the limits of 98.11 appropriations specifically for this purpose, the commissioner 98.12 shall determine operating cost payment rates for each licensed 98.13 and certified nursing facility by indexing its operating cost 98.14 payment rates in effect on June 30,20002001, for inflation. 98.15The inflation factor to be used must be based on the change in98.16the Consumer Price Index-All Items, United States city average98.17(CPI-U) as forecasted by Data Resources, Inc. in the fourth98.18quarter preceding the rate year.For rate years beginning on or 98.19 after July 1, 2001, the inflation factor must be based on the 98.20 change in the Employment Cost Index for Private Industry Workers 98.21 - Total Compensation as forecasted by Data Resources, Inc., in 98.22 the fourth quarter preceding the rate year. TheCPI-U98.23 forecasted index for operating cost payment rates shall be based 98.24 on the 12-month period from the midpoint of the nursing 98.25 facility's prior rate year to the midpoint of the rate year for 98.26 which the operating payment rate is being determined. The 98.27 operating cost payment rate to be inflated shall be the total 98.28 payment rate in effect on June 30, 2001, minus the portion 98.29 determined to be the property-related payment rate, minus the 98.30 per diem amount of the preadmission screening cost included in 98.31 the nursing facility's last payment rate established under 98.32 section 256B.431. 98.33 (b)Beginning July 1, 2000, each nursing facility subject98.34to a performance-based contract under this section shall choose98.35one of two methods of payment for property-related costs:98.36(1) the method established in section 256B.434; or99.1(2) the method established in section 256B.431.99.2Once the nursing facility has made the election in this99.3paragraph, that election shall remain in effect for at least99.4four years or until an alternative property payment system is99.5developed.A per diem amount for preadmission screening will be 99.6 added onto the contract payment rates according to the method of 99.7 distribution of county allocation described in section 99.8 256B.0911, subdivision 6, paragraph (a). 99.9 (c) For rate years beginning on or after July 1,20002001, 99.10 the commissioner may implement a new method of payment for 99.11 property-related costs that addresses the capital needs of 99.12 facilities.Notwithstanding paragraph (b),The new property 99.13 payment system or systems, if implemented, shall replace the 99.14 currentmethodmethods of setting property payment rates under 99.15 sections 256B.431 and 256B.434. 99.16 Subd. 4. [CONTRACT PAYMENT RATES; APPEALS.] If an appeal 99.17 is pending concerning the cost-based payment rates that are the 99.18 basis for the calculation of the payment rate under this 99.19 section, the commissioner and the nursing facility may agree on 99.20 an interim contract rate to be used until the appeal is 99.21 resolved. When the appeal is resolved, the contract rate must 99.22 be adjusted retroactively according to the appeal decision. 99.23 Subd. 5. [CONSUMER PROTECTION.] In addition to complying 99.24 with all applicable laws regarding consumer protection, as a 99.25 condition of entering into a contract under this section, a 99.26 nursing facility must agree to: 99.27 (1) establish resident grievance procedures; 99.28 (2) establish expedited grievance procedures to resolve 99.29 complaints made by short-stay residents; and 99.30 (3) make available to residents and families a copy of the 99.31 performance-based contract and outcomes to be achieved. 99.32 Subd. 6. [CONTRACTS ARE VOLUNTARY.] Participation of 99.33 nursing facilities in the medical assistance program is 99.34 voluntary. The terms and procedures governing the 99.35 performance-based contract are determined under this section and 99.36 through negotiations between the commissioner and nursing 100.1 facilities. 100.2 Subd. 7. [FEDERAL REQUIREMENTS.] The commissioner shall 100.3 implement the performance-based contracting system subject to 100.4 any required federal waivers or approval and in a manner that is 100.5 consistent with federal requirements. If a provision of this 100.6 section is inconsistent with a federal requirement, the federal 100.7 requirement supersedes the inconsistent provision. The 100.8 commissioner shall seek federal approval and request waivers as 100.9 necessary to implement this section. 100.10 Subd. 8. [QUALITY MEASURES.] On or after July 1, 1999, the 100.11 commissioner shall implement quality measures, as they are 100.12 developed, for nursing facilities reimbursed under this section, 100.13 section 256B.431, or 256B.434, and shall publicly disclose the 100.14 findings of these measures. Quality measures the commissioner 100.15 may consider include the measures of nursing facility 100.16 performance in clauses (1) to (6): 100.17 (1) quality indicator measures of clinical outcomes; 100.18 (2) findings of the department of health in licensing and 100.19 certification surveys, complaint investigations, and case mix 100.20 reviews; 100.21 (3) measures of the nursing facility's impact on the 100.22 quality of life of residents; 100.23 (4) standardized measures of consumer satisfaction; 100.24 (5) measures of progress on quality improvement; and 100.25 (6) additional measures proposed by nursing facilities that 100.26 the commissioner finds desirable. 100.27 Sec. 26. Minnesota Statutes 1998, section 256B.48, 100.28 subdivision 1, is amended to read: 100.29 Subdivision 1. [PROHIBITED PRACTICES.] A nursing facility 100.30 is not eligible to receive medical assistance payments unless it 100.31 refrains from all of the following: 100.32 (a) Charging private paying residents rates for similar 100.33 services which exceed those which are approved by the state 100.34 agency for medical assistance recipients as determined by the 100.35 prospective desk audit rate, except under the following 100.36 circumstances: the nursing facility may (1) charge private 101.1 paying residents a higher rate for a private room, and (2) 101.2 charge for special services which are not included in the daily 101.3 rate if medical assistance residents are charged separately at 101.4 the same rate for the same services in addition to the daily 101.5 rate paid by the commissioner. Services covered by the payment 101.6 rate must be the same regardless of payment source. Special 101.7 services, if offered, must be available to all residents in all 101.8 areas of the nursing facility and charged separately at the same 101.9 rate. Residents are free to select or decline special 101.10 services. Special services must not include services which must 101.11 be provided by the nursing facility in order to comply with 101.12 licensure or certification standards and that if not provided 101.13 would result in a deficiency or violation by the nursing 101.14 facility. Services beyond those required to comply with 101.15 licensure or certification standards must not be charged 101.16 separately as a special service if they were included in the 101.17 payment rate for the previous reporting year. A nursing 101.18 facility that charges a private paying resident a rate in 101.19 violation of this clause is subject to an action by the state of 101.20 Minnesota or any of its subdivisions or agencies for civil 101.21 damages. A private paying resident or the resident's legal 101.22 representative has a cause of action for civil damages against a 101.23 nursing facility that charges the resident rates in violation of 101.24 this clause. The damages awarded shall include three times the 101.25 payments that result from the violation, together with costs and 101.26 disbursements, including reasonable attorneys' fees or their 101.27 equivalent. A private paying resident or the resident's legal 101.28 representative, the state, subdivision or agency, or a nursing 101.29 facility may request a hearing to determine the allowed rate or 101.30 rates at issue in the cause of action. Within 15 calendar days 101.31 after receiving a request for such a hearing, the commissioner 101.32 shall request assignment of an administrative law judge under 101.33 sections 14.48 to 14.56 to conduct the hearing as soon as 101.34 possible or according to agreement by the parties. The 101.35 administrative law judge shall issue a report within 15 calendar 101.36 days following the close of the hearing. The prohibition set 102.1 forth in this clause shall not apply to facilities licensed as 102.2 boarding care facilities which are not certified as skilled or 102.3 intermediate care facilities level I or II for reimbursement 102.4 through medical assistance. 102.5 (b)Requiring(1) Charging, soliciting, accepting, or 102.6 receiving from an applicant for admission to the facility, or 102.7the guardian or conservatorfrom anyone acting in behalf of the 102.8 applicant, as a condition of admission,to payexpediting the 102.9 admission, or as a requirement for the individual's continued 102.10 stay, any feeor, depositin excess of $100, gift, money, 102.11 donation, or other consideration not otherwise required as 102.12 payment under the state plan. Nothing in this clause would 102.13 prohibit discharge for nonpayment of services in accordance with 102.14 state and federal regulations; 102.15 (2) requiring an individual, or anyone acting in behalf of 102.16 the individual, to loan any money to the nursing facility, or; 102.17 (3) requiring an individual, or anyone acting in behalf of 102.18 the individual, to promise to leave all or part of the 102.19applicant'sindividual's estate to the facility; or 102.20 (4) requiring a third-party guarantee of payment to the 102.21 facility as a condition of admission, expedited admission, or 102.22 continued stay in the facility. 102.23 (c) requiring any resident of the nursing facility to 102.24 utilize a vendor of health care services chosen by the nursing 102.25 facility. 102.26 (d) Providing differential treatment on the basis of status 102.27 with regard to public assistance. 102.28 (e) Discriminating in admissions, services offered, or room 102.29 assignment on the basis of status with regard to public 102.30 assistance or refusal to purchase special services. Admissions 102.31 discrimination shall include, but is not limited to: 102.32 (1) basing admissions decisions upon assurance by the 102.33 applicant to the nursing facility, or the applicant's guardian 102.34 or conservator, that the applicant is neither eligible for nor 102.35 will seek public assistance for payment of nursing facility care 102.36 costs; and 103.1 (2) engaging in preferential selection from waiting lists 103.2 based on an applicant's ability to pay privately or an 103.3 applicant's refusal to pay for a special service. 103.4 The collection and use by a nursing facility of financial 103.5 information of any applicant pursuant to a preadmission 103.6 screening program established by law shall not raise an 103.7 inference that the nursing facility is utilizing that 103.8 information for any purpose prohibited by this paragraph. 103.9 (f) Requiring any vendor of medical care as defined by 103.10 section 256B.02, subdivision 7, who is reimbursed by medical 103.11 assistance under a separate fee schedule, to pay any amount 103.12 based on utilization or service levels or any portion of the 103.13 vendor's fee to the nursing facility except as payment for 103.14 renting or leasing space or equipment or purchasing support 103.15 services from the nursing facility as limited by section 103.16 256B.433. All agreements must be disclosed to the commissioner 103.17 upon request of the commissioner. Nursing facilities and 103.18 vendors of ancillary services that are found to be in violation 103.19 of this provision shall each be subject to an action by the 103.20 state of Minnesota or any of its subdivisions or agencies for 103.21 treble civil damages on the portion of the fee in excess of that 103.22 allowed by this provision and section 256B.433. Damages awarded 103.23 must include three times the excess payments together with costs 103.24 and disbursements including reasonable attorney's fees or their 103.25 equivalent. 103.26 (g) Refusing, for more than 24 hours, to accept a resident 103.27 returning to the same bed or a bed certified for the same level 103.28 of care, in accordance with a physician's order authorizing 103.29 transfer, after receiving inpatient hospital services. 103.30The prohibitions set forth in clause (b) shall not apply to103.31a retirement facility with more than 325 beds including at least103.32150 licensed nursing facility beds and which:103.33(1) is owned and operated by an organization tax-exempt103.34under section 290.05, subdivision 1, clause (i); and103.35(2) accounts for all of the applicant's assets which are103.36required to be assigned to the facility so that only expenses104.1for the cost of care of the applicant may be charged against the104.2account; and104.3(3) agrees in writing at the time of admission to the104.4facility to permit the applicant, or the applicant's guardian,104.5or conservator, to examine the records relating to the104.6applicant's account upon request, and to receive an audited104.7statement of the expenditures charged against the applicant's104.8individual account upon request; and104.9(4) agrees in writing at the time of admission to the104.10facility to permit the applicant to withdraw from the facility104.11at any time and to receive, upon withdrawal, the balance of the104.12applicant's individual account.104.13 For a period not to exceed 180 days, the commissioner may 104.14 continue to make medical assistance payments to a nursing 104.15 facility or boarding care home which is in violation of this 104.16 section if extreme hardship to the residents would result. In 104.17 these cases the commissioner shall issue an order requiring the 104.18 nursing facility to correct the violation. The nursing facility 104.19 shall have 20 days from its receipt of the order to correct the 104.20 violation. If the violation is not corrected within the 20-day 104.21 period the commissioner may reduce the payment rate to the 104.22 nursing facility by up to 20 percent. The amount of the payment 104.23 rate reduction shall be related to the severity of the violation 104.24 and shall remain in effect until the violation is corrected. 104.25 The nursing facility or boarding care home may appeal the 104.26 commissioner's action pursuant to the provisions of chapter 14 104.27 pertaining to contested cases. An appeal shall be considered 104.28 timely if written notice of appeal is received by the 104.29 commissioner within 20 days of notice of the commissioner's 104.30 proposed action. 104.31 In the event that the commissioner determines that a 104.32 nursing facility is not eligible for reimbursement for a 104.33 resident who is eligible for medical assistance, the 104.34 commissioner may authorize the nursing facility to receive 104.35 reimbursement on a temporary basis until the resident can be 104.36 relocated to a participating nursing facility. 105.1 Certified beds in facilities which do not allow medical 105.2 assistance intake on July 1, 1984, or after shall be deemed to 105.3 be decertified for purposes of section 144A.071 only. 105.4 Sec. 27. Minnesota Statutes 1998, section 256B.48, 105.5 subdivision 1a, is amended to read: 105.6 Subd. 1a. [TERMINATION.] If a nursing facility terminates 105.7 its participation in the medical assistance program, whether 105.8 voluntarily or involuntarily, the commissioner may authorize the 105.9 nursing facility to receive continued medical assistance 105.10 reimbursementonly on a temporary basisuntil medical assistance 105.11 residents can be relocated to nursing facilities participating 105.12 in the medical assistance program. 105.13 Sec. 28. Minnesota Statutes 1998, section 256B.48, 105.14 subdivision 1b, is amended to read: 105.15 Subd. 1b. [EXCEPTION.] Notwithstanding any agreement 105.16 between a nursing facility and the department of human services 105.17 or the provisions of this section or section 256B.411, other 105.18 than subdivision 1a, the commissioner may authorize continued 105.19 medical assistance payments to a nursing facility which ceased 105.20 intake of medical assistance recipients prior to July 1, 1983, 105.21 and which charges private paying residents rates that exceed 105.22 those permitted by subdivision 1, paragraph (a), for (i) 105.23 residents who resided in the nursing facility before July 1, 105.24 1983, or (ii) residents for whom the commissioner or any 105.25 predecessors of the commissioner granted a permanent individual 105.26 waiver prior to October 1, 1983. Nursing facilities seeking 105.27 continued medical assistance payments under this subdivision 105.28 shall make the reports required under subdivision 2, except that 105.29 on or after December 31, 1985, the financial statements required 105.30 need not be audited by or contain the opinion of a certified 105.31 public accountant or licensed public accountant, but need only 105.32 be reviewed by a certified public accountant or licensed public 105.33 accountant. In the event that the state is determined by the 105.34 federal government to be no longer eligible for the federal 105.35 share of medical assistance payments made to a nursing facility 105.36 under this subdivision, the commissioner may cease medical 106.1 assistance payments, under this subdivision, to that nursing 106.2 facility.Between October 1, 1992, and July 1, 1993, a facility106.3governed by this subdivision may elect to resume full106.4participation in the medical assistance program by agreeing to106.5comply with all of the requirements of the medical assistance106.6program, including the rate equalization law in subdivision 1,106.7paragraph (a), and all other requirements established in law or106.8rule, and to resume intake of new medical assistance recipients.106.9 Sec. 29. Minnesota Statutes 1998, section 256B.48, 106.10 subdivision 6, is amended to read: 106.11 Subd. 6. [MEDICARE CERTIFICATION.] (a) [DEFINITION.] For 106.12 purposes of this subdivision, "nursing facility" means a nursing 106.13 facility that is certified as a skilled nursing facility or, 106.14 after September 30, 1990, a nursing facility licensed under 106.15 chapter 144A that is certified as a nursing facility. 106.16 (b) [MEDICARE PARTICIPATION REQUIRED.] All nursing 106.17 facilities shall participate in Medicare part A and part B 106.18 unless, after submitting an application, Medicare certification 106.19 is denied by the federal health care financing administration. 106.20 Medicare review shall be conducted at the time of the annual 106.21 medical assistance review. Charges for Medicare-covered 106.22 services provided to residents who are simultaneously eligible 106.23 for medical assistance and Medicare must be billed to Medicare 106.24 part A or part B before billing medical assistance. Medical 106.25 assistance may be billed only for charges not reimbursed by 106.26 Medicare. 106.27 (c)[UNTIL SEPTEMBER 30, 1990.] Until September 30, 1990, a106.28nursing facility satisfies the requirements of paragraph (b)106.29if: (1) at least 50 percent of the facility's beds that are106.30licensed under section 144A and certified as skilled nursing106.31beds under the medical assistance program are Medicare106.32certified; or (2) if a nursing facility's beds are licensed106.33under section 144A, and some are medical assistance certified as106.34skilled nursing beds and others are medical assistance certified106.35as intermediate care facility I beds, at least 50 percent of the106.36facility's total skilled nursing beds and intermediate care107.1facility I beds or 100 percent of its skilled nursing beds,107.2whichever is less, are Medicare certified.107.3(d)[AFTER SEPTEMBER 30, 1990.] After September 30, 1990, a 107.4 nursing facility satisfies the requirements of paragraph (b) if 107.5 at least 50 percent of the facility's beds certified as nursing 107.6 facility beds under the medical assistance program are Medicare 107.7 certified. 107.8(e)(d) [CONFLICT WITH MEDICARE DISTINCT PART 107.9 REQUIREMENTS.] At the request of a facility, the commissioner of 107.10 human services may reduce the 50 percent Medicare participation 107.11 requirement inparagraphsparagraph (c)and (d)to no less than 107.12 20 percent if the commissioner of health determines that, due to 107.13 the facility's physical plant configuration, the facility cannot 107.14 satisfy Medicare distinct part requirements at the 50 percent 107.15 certification level. To receive a reduction in the 107.16 participation requirement, a facility must demonstrate that the 107.17 reduction will not adversely affect access of Medicare-eligible 107.18 residents to Medicare-certified beds. 107.19(f)(e) [INSTITUTIONS FOR MENTAL DISEASE.] The commissioner 107.20 may grant exceptions to the requirements of paragraph (b) for 107.21 nursing facilities that are designated as institutions for 107.22 mental disease. 107.23(g)(f) [NOTICE OF RIGHTS.] The commissioner shall inform 107.24 recipients of their rights under this subdivision and section 107.25 144.651, subdivision 29. 107.26 Sec. 30. Minnesota Statutes 1998, section 256B.50, 107.27 subdivision 1e, is amended to read: 107.28 Subd. 1e. [ATTORNEY'S FEES AND COSTS.] (a) Notwithstanding 107.29 section 15.472, paragraph (a), for an issue appealed under 107.30 subdivision 1, the prevailing party in a contested case 107.31 proceeding or, if appealed, in subsequent judicial review, must 107.32 be awarded reasonable attorney's fees and costs incurred in 107.33 litigating the appeal, if the prevailing party shows that the 107.34 position of the opposing party was not substantially justified. 107.35 The procedures for awarding fees and costs set forth in section 107.36 15.474 must be followed in determining the prevailing party's 108.1 fees and costs except as otherwise provided in this 108.2 subdivision. For purposes of this subdivision, "costs" means 108.3 subpoena fees and mileage, transcript costs, court reporter 108.4 fees, witness fees, postage and delivery costs, photocopying and 108.5 printing costs, amounts charged the commissioner by the office 108.6 of administrative hearings, and direct administrative costs of 108.7 the department; and "substantially justified" means that a 108.8 position had a reasonable basis in law and fact, based on the 108.9 totality of the circumstances prior to and during the contested 108.10 case proceeding and subsequent review. 108.11 (b) When an award is made to the department under this 108.12 subdivision, attorney fees must be calculated at the cost to the 108.13 department. When an award is made to a provider under this 108.14 subdivision, attorney fees must be calculated at the rate 108.15 charged to the provider except that attorney fees awarded must 108.16 be the lesser of the attorney's normal hourly fee or $100 per 108.17 hour. 108.18 (c) In contested case proceedings involving more than one 108.19 issue, the administrative law judge shall determine what portion 108.20 of each party's attorney fees and costs is related to the issue 108.21 or issues on which it prevailed and for which it is entitled to 108.22 an award. In making that determination, the administrative law 108.23 judge shall consider the amount of time spent on each issue, the 108.24 precedential value of the issue, the complexity of the issue, 108.25 and other factors deemed appropriate by the administrative law 108.26 judge. 108.27 (d) When the department prevails on an issue involving more 108.28 than one provider, the administrative law judge shall allocate 108.29 the total amount of any award for attorney fees and costs among 108.30 the providers. In determining the allocation, the 108.31 administrative law judge shall consider each provider's monetary 108.32 interest in the issue and other factors deemed appropriate by 108.33 the administrative law judge. 108.34 (e) Attorney fees and costs awarded to the department for 108.35 proceedings under this subdivision must not be reported or 108.36 treated as allowable costs on the provider's cost report. 109.1 (f) Fees and costs awarded to a provider for proceedings 109.2 under this subdivision must be reimbursed to themby reporting109.3the amount of fees and costs awarded as allowable costs on the109.4provider's cost report for the reporting year in which they were109.5awarded. Fees and costs reported pursuant to this subdivision109.6must be included in the general and administrative cost category109.7but are not subject to categorical or overall cost limitations109.8established in rule or statutewithin 120 days of the final 109.9 decision on the award of attorney fees and costs. 109.10 (g) If the provider fails to pay the awarded attorney fees 109.11 and costs within 120 days of the final decision on the award of 109.12 attorney fees and costs, the department may collect the amount 109.13 due through any method available to it for the collection of 109.14 medical assistance overpayments to providers. Interest charges 109.15 must be assessed on balances outstanding after 120 days of the 109.16 final decision on the award of attorney fees and costs. The 109.17 annual interest rate charged must be the rate charged by the 109.18 commissioner of revenue for late payment of taxes that is in 109.19 effect on the 121st day after the final decision on the award of 109.20 attorney fees and costs. 109.21 (h) Amounts collected by the commissioner pursuant to this 109.22 subdivision must be deemed to be recoveries pursuant to section 109.23 256.01, subdivision 2, clause (15). 109.24 (i) This subdivision applies to all contested case 109.25 proceedings set on for hearing by the commissioner on or after 109.26 April 29, 1988, regardless of the date the appeal was filed. 109.27 Sec. 31. Minnesota Statutes 1998, section 256B.501, is 109.28 amended by adding a subdivision to read: 109.29 Subd. 13. [ICF/MR RATE INCREASES BEGINNING OCTOBER 1, 109.30 1999, AND OCTOBER 1, 2000.] (a) For the rate year beginning 109.31 October 1, 1999, the commissioner shall make available an 109.32 operating payment rate increase equal to four percent. The 109.33 commissioner shall make available salary adjustments equal to 109.34 4.75 percent in each category except management fees and 109.35 administrator and central office, which shall be used solely to 109.36 increase wages or pay payroll taxes associated with these wage 110.1 increases, and shall use the remainder of the amount 110.2 appropriated by the legislature to increase per diem payment 110.3 rates in all operating rate categories not subject to the 4.75 110.4 percent increase. 110.5 (b) For the rate year beginning October 1, 2000, the 110.6 commissioner shall make available an operating payment rate 110.7 increase equal to three percent. The commissioner shall make 110.8 available salary adjustments equal to 3.5 percent in each 110.9 category except management fees and administrator and central 110.10 office, which shall be used solely to increase wages or pay 110.11 payroll taxes associated with these wage increases, and shall 110.12 use the remainder of the amount appropriated by the legislature 110.13 to increase per diem payment rates in all operating rate 110.14 categories not subject to the 3.5 percent increase. 110.15 (c) Effective October 1, 1999, to September 30, 2001, the 110.16 commissioner shall make available the appropriate salary 110.17 adjustment cost per diem calculated in paragraphs (e) to (j) to 110.18 the total operating cost payment rate of each facility subject 110.19 to reimbursement under this section, section 256B.5011, and Laws 110.20 1993, First Special Session chapter 1, article 4, section 11. 110.21 The salary adjustment cost per diem must be determined according 110.22 to paragraphs (d) to (j). 110.23 (d) A state-operated community service, and any facility 110.24 whose payment rates are governed by closure agreements, 110.25 receivership agreements, or Minnesota Rules, part 9553.0075, are 110.26 not eligible for a salary adjustment otherwise granted under 110.27 this subdivision. For purposes of the salary adjustment per 110.28 diem computation and reviews in this subdivision, the term 110.29 "salary adjustment cost" means the facility's allowable program 110.30 operating cost category employee training expenses, and the 110.31 facility's allowable salaries, payroll taxes, and fringe 110.32 benefits. The term does not include these same salary-related 110.33 costs for both administrative or central office employees. 110.34 For the purpose of determining the amount of salary 110.35 adjustment to be granted under this subdivision, the 110.36 commissioner must use the most recent cost report that has been 111.1 subject to desk audit. 111.2 (e) For the rate year beginning October 1, 1999, each 111.3 facility shall receive a salary adjustment cost per diem equal 111.4 to its salary adjustment costs multiplied by 4.75 percent, and 111.5 then divided by the facility's resident days. 111.6 (f) For the rate year beginning October 1, 2000, each 111.7 facility shall receive a salary adjustment cost per diem equal 111.8 to its salary adjustment costs multiplied by 3.5 percent, and 111.9 then divided by the facility's resident days. 111.10 (g) A facility may apply for the salary adjustment per diem 111.11 calculated under this subdivision. The application must be made 111.12 to the commissioner and contain a plan by which the facility 111.13 will distribute the salary adjustment to employees of the 111.14 facility. For facilities in which the employees are represented 111.15 by an exclusive bargaining representative, an agreement 111.16 negotiated and agreed to by the employer and the exclusive 111.17 bargaining representative may constitute the plan for the salary 111.18 distribution. The commissioner shall review the plan to ensure 111.19 that the salary adjustment per diem is used solely to increase 111.20 the wages of facility employees and pay payroll taxes associated 111.21 with these increased wages. To be eligible, a facility must 111.22 submit its plan for the salary distribution by December 31 of 111.23 each year. A facility may amend its plan for the second rate 111.24 year by submitting a revised plan by December 31, 2000. If a 111.25 facility's plan for salary distribution is effective for its 111.26 employees after October 1 of the year that the funds are 111.27 available, the salary adjustment cost per diem shall be 111.28 effective the same date as its plan. 111.29 (h) Additional costs incurred by facilities as a result of 111.30 this salary adjustment are not allowable costs for purposes of 111.31 the December 31, 1999, or December 31, 2000, cost report. 111.32 (i) In order to apply for a salary adjustment, a facility 111.33 reimbursed under section 256B.5011 or Laws 1993, First Special 111.34 Session chapter 1, article 4, section 11, must report the 111.35 information referred to in paragraph (a) in the application, in 111.36 the manner specified by the commissioner. 112.1 (j) A copy of the approved distribution plan must be made 112.2 available to all employees. This must be done by giving each 112.3 employee a copy or by posting it in an area of the facility to 112.4 which all employees have access. If an employee does not 112.5 receive the salary adjustment described in their facility's 112.6 approved plan and is unable to resolve the problem with the 112.7 facility's management, the employee may contact the employee's 112.8 union representative. If the employee is not covered by a 112.9 collective bargaining agreement, the employee may contact the 112.10 commissioner at a telephone number provided by the commissioner 112.11 and included in the approved plan. 112.12 Sec. 32. Minnesota Statutes 1998, section 256B.5011, 112.13 subdivision 1, is amended to read: 112.14 Subdivision 1. [IN GENERAL.] Effective October 1, 2000, 112.15 the commissioner shall implement aperformance-basedcontracting 112.16 system to replace the current method of setting total cost 112.17 payment rates under section 256B.501 and Minnesota Rules, parts 112.18 9553.0010 to 9553.0080. In determining prospective payment 112.19 rates of intermediate care facilities for persons with mental 112.20 retardation or related conditions, the commissioner shall index 112.21 each facility'stotaloperating payment rate by an inflation 112.22 factor as described insubdivision 3section 256B.5012. The 112.23 commissioner of finance shall include annual inflation 112.24 adjustments in operating costs for intermediate care facilities 112.25 for persons with mental retardation and related conditions as a 112.26 budget change request in each biennial detailed expenditure 112.27 budget submitted to the legislature under section 16A.11. 112.28 Sec. 33. Minnesota Statutes 1998, section 256B.5011, 112.29 subdivision 2, is amended to read: 112.30 Subd. 2. [CONTRACT PROVISIONS.] (a) The 112.31performance-basedservice contract with each intermediate care 112.32 facility must include provisions for: 112.33 (1) modifying payments when significant changes occur in 112.34 the needs of the consumers; 112.35 (2)monitoring service quality using performance indicators112.36that measure consumer outcomes;113.1(3)the establishment and use of continuous quality 113.2 improvement processes using the results attained through service 113.3 quality monitoring; 113.4(4) the annual reporting of facility statistical113.5information on all supervisory personnel, direct care personnel,113.6specialized support personnel, hours, wages and benefits,113.7staff-to-consumer ratios, and staffing patterns113.8 (3) appropriate and necessary statistical information 113.9 required by the commissioner; 113.10(5)(4) annual aggregate facility financial informationor113.11an annual certified audited financial statement, including a113.12balance sheet and income and expense statements for each113.13facility, if a certified audit was prepared; and 113.14(6)(5) additional requirementsand penaltiesfor 113.15 intermediate care facilities not meeting the standards set forth 113.16 in theperformance-basedservice contract. 113.17 (b) The commissioner shall recommend to the legislature by 113.18 January 15, 2000, whether the contract should include service 113.19 quality monitoring that may utilize performance indicators that 113.20 measure consumer and program outcomes. Performance measurement 113.21 shall not increase or duplicate regulatory requirements. 113.22 Sec. 34. [256B.5012] [ICF/MR PAYMENT SYSTEM 113.23 IMPLEMENTATION.] 113.24 Subdivision 1. [TOTAL PAYMENT RATE.] The total payment 113.25 rate effective October 1, 2001, for existing ICF/MR facilities 113.26 is the total of the operating payment rate and the property 113.27 payment rate plus inflation factors as defined in this section. 113.28 The initial rate year shall run from October 1, 2001, through 113.29 December 31, 2002. Subsequent rate years shall run from January 113.30 1 through December 31 beginning in the year 2003. 113.31 Subd. 2. [OPERATING PAYMENT RATE.] (a) The operating 113.32 payment rate equals the facility's total payment rate in effect 113.33 on September 30, 2001, minus the property rate. The operating 113.34 payment rate includes the special operating rate and the 113.35 efficiency incentive in effect as of September 30, 2001. Within 113.36 the limits of appropriations specifically for this purpose, the 114.1 operating payment shall be increased for each rate year by the 114.2 annual percentage change in the Employment Cost Index for 114.3 Private Industry Workers - Total Compensation, as forecasted by 114.4 Data Resources, Inc., in the second quarter of the calendar year 114.5 preceding the start of each rate year. In the case of the 114.6 initial rate year beginning October 1, 2001, and continuing 114.7 through December 31, 2002, the percentage change shall be based 114.8 on the percentage change in the Employment Cost Index for 114.9 Private Industry Workers - Total Compensation for the 15-month 114.10 period beginning October 1, 2001, as forecast by Data Resources, 114.11 Inc., in the first quarter of 2001. 114.12 (b) Effective October 1, 2000, the operating payment rate 114.13 shall be adjusted to reflect an occupancy rate equal to 100 114.14 percent of the facility's capacity days as of September 30, 2000. 114.15 Subd. 3. [PROPERTY PAYMENT RATE.] (a) The property payment 114.16 rate effective October 1, 2000, is based on the facility's 114.17 property payment rate in effect on September 30, 2000. 114.18 Effective October 1, 2000, a facility minimum property rate of 114.19 $8.13 shall be applied to all existing ICF/MR facilities. 114.20 Facilities with a property payment rate effective September 30, 114.21 2000, which is below the minimum property rate shall receive an 114.22 increase effective October 1, 2000, equal to the difference 114.23 between the minimum property payment rate and the property 114.24 payment rate in effect as of September 30, 2000. Facilities 114.25 with a property payment rate at or above the minimum property 114.26 payment rate effective September 30, 2000, shall have no change 114.27 in their property payment rate effective October 1, 2000. 114.28 (b) Within the limits of appropriations specifically for 114.29 this purpose, facility property payment rates shall be increased 114.30 annually for inflation, effective January 1, 2002. The increase 114.31 shall be based on each facility's property payment rate in 114.32 effect on September 30, 2000. Property payment rates effective 114.33 September 30, 2000, shall be arrayed from highest to lowest 114.34 before applying the minimum property payment rate in paragraph 114.35 (a). For property payment rates at the 90th percentile or 114.36 above, the annual inflation increase shall be zero. For 115.1 property payment rates below the 90th percentile but equal to or 115.2 above the 75th percentile, the annual inflation increase shall 115.3 be one percent. For property payment rates below the 75th 115.4 percentile, the annual inflation increase shall be two percent. 115.5 Sec. 35. [256B.5013] [PAYMENT RATE ADJUSTMENTS.] 115.6 Subdivision 1. [VARIABLE RATE ADJUSTMENTS.] When there is 115.7 a documented increase in the resource needs of a current ICF/MR 115.8 recipient or recipients, or a person is admitted to a facility 115.9 who requires additional resources, the county of financial 115.10 responsibility may approve an enhanced rate for one or more 115.11 persons in the facility. Resource needs directly attributable 115.12 to an individual that may be considered under the variable rate 115.13 adjustment include increased direct staff hours and other 115.14 specialized services, equipment, and human resources. The 115.15 guidelines in paragraphs (a) to (d) apply for the payment rate 115.16 adjustments under this section. 115.17 (a) All persons must be screened according to section 115.18 256B.092, subdivisions 7 and 8, prior to implementation of the 115.19 new payment system and annually thereafter. Screening data 115.20 shall be analyzed to develop broad profiles of the functional 115.21 characteristics of recipients. Three components shall be used 115.22 to distinguish recipients based on the following broad profiles: 115.23 (1) functional ability to care for and maintain one's own 115.24 basic needs; 115.25 (2) the intensity of any aggressive or destructive 115.26 behavior; and 115.27 (3) any history of obstructive behavior in combination with 115.28 a diagnosis of psychosis or neurosis. 115.29 The profile groups shall be used to link resource needs to 115.30 funding. The resource profile shall determine the level of 115.31 funding that may be authorized by the county. The county of 115.32 financial responsibility may approve a rate adjustment for an 115.33 individual. The commissioner shall recommend to the legislature 115.34 by January 15, 2000, a methodology using the profile groups to 115.35 determine variable rates. The variable rate must be applied to 115.36 expenses related to increased direct staff hours and other 116.1 specialized services, equipment, and human resources. This 116.2 variable rate component plus the facility's current operating 116.3 payment rate equals the individual's total operating payment 116.4 rate. 116.5 (b) A recipient must be screened by the county of financial 116.6 responsibility using the developmental disabilities screening 116.7 document completed immediately prior to approval of a variable 116.8 rate by the county. A comparison of the updated screening and 116.9 the previous screening must demonstrate an increase in resource 116.10 needs. 116.11 (c) Rate adjustments projected to exceed the authorized 116.12 funding level associated with the person's profile must be 116.13 submitted to the commissioner. 116.14 (d) The new rate approved through this process shall not be 116.15 averaged across all persons living at a facility but shall be an 116.16 individual rate. The county of financial responsibility must 116.17 indicate the projected length of time that the additional 116.18 funding may be needed by the individual. The need to continue 116.19 an individual variable rate must be reviewed at the end of the 116.20 anticipated duration of need but at least annually through the 116.21 completion of the developmental disabilities screening document. 116.22 Subd. 2. [OTHER PAYMENT RATE ADJUSTMENTS.] Facility total 116.23 payment rates may be adjusted by the host county, with 116.24 authorization from a statewide advisory committee, if, through 116.25 the local system needs planning process, it is determined that a 116.26 need exists to amend the package of purchased services with a 116.27 resulting increase or decrease in costs. Except as provided in 116.28 section 252.292, subdivision 4, if a provider demonstrates that 116.29 the loss of revenues caused by the downsizing or closure of a 116.30 facility cannot be absorbed by the facility based on current 116.31 operations, the host county or the provider may submit a request 116.32 to the statewide advisory committee for a facility base rate 116.33 adjustment. 116.34 Subd. 3. [RELOCATION.] (a) Property rates for all 116.35 facilities relocated after December 31, 1997, and up to and 116.36 including October 1, 2000, shall have the full annual costs of 117.1 relocation included in their October 1, 2000, property rate. 117.2 The property rate for the relocated home is subject to the costs 117.3 that were allowable under Minnesota Rules, chapter 9553, and the 117.4 investment per bed limitation for newly constructed or newly 117.5 established class B facilities. 117.6 (b) In ensuing years, all relocated homes shall be subject 117.7 to the investment per bed limit for newly constructed or newly 117.8 established class B facilities under section 256B.501, 117.9 subdivision 11. The limits shall be adjusted on January 1 of 117.10 each year by the percentage increase in the construction index 117.11 published by the Bureau of Economic Analysis of the United 117.12 States Department of Commerce in the Survey of Current Business 117.13 Statistics in October of the previous two years. Facilities 117.14 that are relocated within the investment per bed limit may be 117.15 approved by the statewide advisory committee. Costs for 117.16 relocation of a facility that exceed the investment per bed 117.17 limit must be absorbed by the facility. 117.18 (c) The payment rate shall take effect when the new 117.19 facility is licensed and certified by the commissioner of 117.20 health. Rates for facilities that are relocated after December 117.21 31, 1997, through October 1, 2000, shall be adjusted to reflect 117.22 the full inclusion of the relocation costs, subject to the 117.23 investment per bed limit in paragraph (b). The investment per 117.24 bed limit calculated rate for the year in which the facility was 117.25 relocated shall be the investment per bed limit used. 117.26 Subd. 4. [TEMPORARY RATE ADJUSTMENTS TO ADDRESS OCCUPANCY 117.27 AND ACCESS.] If a facility is operating at less than 100 percent 117.28 occupancy on September 30, 2000, or if a recipient is discharged 117.29 from a facility, the commissioner shall adjust the total payment 117.30 rate for up to 90 days for the remaining recipients. This 117.31 mechanism shall not be used to pay for hospital or therapeutic 117.32 leave days beyond the maximums allowed. Facility payment 117.33 adjustments exceeding 90 days to address a demonstrated need for 117.34 access must be submitted to the statewide advisory committee 117.35 with a local system needs assessment, plan, and budget for 117.36 review and recommendation. 118.1 Sec. 36. [256B.5014] [FINANCIAL REPORTING.] 118.2 All facilities shall maintain financial records and shall 118.3 provide annual income and expense reports to the commissioner of 118.4 human services on a form prescribed by the commissioner no later 118.5 than April 30 of each year in order to receive medical 118.6 assistance payments. The reports for the reporting year ending 118.7 December 31 must include: 118.8 (1) salaries and related expenses, including program 118.9 salaries, administrative salaries, other salaries, payroll 118.10 taxes, and fringe benefits; 118.11 (2) general operating expenses, including supplies, 118.12 training, repairs, purchased services and consultants, 118.13 utilities, food, licenses and fees, real estate taxes, 118.14 insurance, and working capital interest; 118.15 (3) property related costs, including depreciation, capital 118.16 debt interest, rent, and leases; and 118.17 (4) total annual resident days. 118.18 Sec. 37. [256B.5015] [PASS-THROUGH OF TRAINING AND 118.19 HABILITATION SERVICES COSTS.] 118.20 Training and habilitation services costs shall be paid as a 118.21 pass-through payment at the lowest rate paid for the comparable 118.22 services at that site under sections 252.40 to 252.46. The 118.23 pass-through payments for training and habilitation services 118.24 shall be paid separately by the commissioner and shall not be 118.25 included in the computation of the total payment rate. 118.26 Sec. 38. Minnesota Statutes 1998, section 256B.69, 118.27 subdivision 6a, is amended to read: 118.28 Subd. 6a. [NURSING HOME SERVICES.] (a) Notwithstanding 118.29 Minnesota Rules, part 9500.1457, subpart 1, item B, up to 90 118.30 days of nursing facility services as defined in section 118.31 256B.0625, subdivision 2, which are provided in a nursing 118.32 facility certified by the Minnesota department of health for 118.33 services provided and eligible for payment under Medicaid, shall 118.34 be covered under the prepaid medical assistance program for 118.35 individuals who are not residing in a nursing facility at the 118.36 time of enrollment in the prepaid medical assistance program. 119.1Liability for coverage of nursing facility services by a119.2participating health plan is limited to 365 days for any person119.3enrolled under the prepaid medical assistance program.119.4 (b) For individuals enrolled in the Minnesota senior health 119.5 options project authorized under subdivision 23, nursing 119.6 facility services shall be covered according to the terms and 119.7 conditions of the federalwaiveragreement governing that 119.8 demonstration project. 119.9 Sec. 39. Minnesota Statutes 1998, section 256B.69, 119.10 subdivision 6b, is amended to read: 119.11 Subd. 6b. [ELDERLYHOME AND COMMUNITY-BASED WAIVER 119.12 SERVICES.]Notwithstanding Minnesota Rules, part 9500.1457,119.13subpart 1, item C, elderly waiver services shall be covered119.14under the prepaid medical assistance program for all individuals119.15who are eligible according to section 256B.0915.(a) For 119.16 individuals enrolled in the Minnesota senior health options 119.17 project authorized under subdivision 23, elderly waiver services 119.18 shall be covered according to the terms and conditions of the 119.19 federalwaiveragreement governing that demonstration project. 119.20 (b) For individuals under age 65 with physical disabilities 119.21 but without a primary diagnosis of mental illness or 119.22 developmental disabilities, except for related conditions, 119.23 enrolled in the Minnesota senior health options project 119.24 authorized under subdivision 23, home and community-based waiver 119.25 services shall be covered according to the terms and conditions 119.26 of the federal agreement governing that demonstration project. 119.27 Sec. 40. Minnesota Statutes 1998, section 256I.04, 119.28 subdivision 3, is amended to read: 119.29 Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP 119.30 RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 119.31 into agreements for new group residential housing beds with 119.32 total rates in excess of the MSA equivalent rate except: (1) 119.33 for group residential housing establishments meeting the 119.34 requirements of subdivision 2a, clause (2) with department 119.35 approval; (2) for group residential housing establishments 119.36 licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 120.1 provided the facility is needed to meet the census reduction 120.2 targets for persons with mental retardation or related 120.3 conditions at regional treatment centers; (3) to ensure 120.4 compliance with the federal Omnibus Budget Reconciliation Act 120.5 alternative disposition plan requirements for inappropriately 120.6 placed persons with mental retardation or related conditions or 120.7 mental illness; (4) up to 80 beds in a single, specialized 120.8 facility located in Hennepin county that will provide housing 120.9 for chronic inebriates who are repetitive users of 120.10 detoxification centers and are refused placement in emergency 120.11 shelters because of their state of intoxication, and planning 120.12 for the specialized facility must have been initiated before 120.13 July 1, 1991, in anticipation of receiving a grant from the 120.14 housing finance agency under section 462A.05, subdivision 20a, 120.15 paragraph (b);or(5) notwithstanding the provisions of 120.16 subdivision 2a, for up to 190 supportive housing units in Anoka, 120.17 Dakota, Hennepin, or Ramsey county for homeless adults with a 120.18 mental illness, a history of substance abuse, or human 120.19 immunodeficiency virus or acquired immunodeficiency syndrome. 120.20 For purposes of this section, "homeless adult" means a person 120.21 who is living on the street or in a shelter or discharged from a 120.22 regional treatment center, community hospital, or residential 120.23 treatment program and has no appropriate housing available and 120.24 lacks the resources and support necessary to access appropriate 120.25 housing. At least 70 percent of the supportive housing units 120.26 must serve homeless adults with mental illness, substance abuse 120.27 problems, or human immunodeficiency virus or acquired 120.28 immunodeficiency syndrome who are about to be or, within the 120.29 previous six months, has been discharged from a regional 120.30 treatment center, or a state-contracted psychiatric bed in a 120.31 community hospital, or a residential mental health or chemical 120.32 dependency treatment program. If a person meets the 120.33 requirements of subdivision 1, paragraph (a), and receives a 120.34 federal or state housing subsidy, the group residential housing 120.35 rate for that person is limited to the supplementary rate under 120.36 section 256I.05, subdivision 1a, and is determined by 121.1 subtracting the amount of the person's countable income that 121.2 exceeds the MSA equivalent rate from the group residential 121.3 housing supplementary rate. A resident in a demonstration 121.4 project site who no longer participates in the demonstration 121.5 program shall retain eligibility for a group residential housing 121.6 payment in an amount determined under section 256I.06, 121.7 subdivision 8, using the MSA equivalent rate. Service funding 121.8 under section 256I.05, subdivision 1a, will end June 30, 1997, 121.9 if federal matching funds are available and the services can be 121.10 provided through a managed care entity. If federal matching 121.11 funds are not available, then service funding will continue 121.12 under section 256I.05, subdivision 1a.; or (6) for group 121.13 residential housing beds in settings meeting the requirements of 121.14 subdivision 2a, paragraph (a), clause (3), which are used 121.15 exclusively for recipients receiving home and community-based 121.16 waiver services under sections 256B.0915, 256B.092, subdivision 121.17 5, 256B.093, and 256B.49, and who resided in a nursing facility 121.18 for the six months immediately prior to the month of entry into 121.19 the group residential housing setting. The group residential 121.20 housing rate for these beds must be set so that the monthly 121.21 group residential housing payment for an individual occupying 121.22 the bed when combined with the nonfederal share of services 121.23 delivered under the waiver for that person does not exceed the 121.24 nonfederal share of the monthly medical assistance payment made 121.25 for the person to the nursing facility in which the person 121.26 resided prior to entry into the group residential housing 121.27 establishment. The rate may not exceed the MSA equivalent rate 121.28 plus $426.37 for any case. 121.29 (b) A county agency may enter into a group residential 121.30 housing agreement for beds with rates in excess of the MSA 121.31 equivalent rate in addition to those currently covered under a 121.32 group residential housing agreement if the additional beds are 121.33 only a replacement of beds with rates in excess of the MSA 121.34 equivalent rate which have been made available due to closure of 121.35 a setting, a change of licensure or certification which removes 121.36 the beds from group residential housing payment, or as a result 122.1 of the downsizing of a group residential housing setting. The 122.2 transfer of available beds from one county to another can only 122.3 occur by the agreement of both counties. 122.4 Sec. 41. Minnesota Statutes 1998, section 256I.05, 122.5 subdivision 1, is amended to read: 122.6 Subdivision 1. [MAXIMUM RATES.] Monthly room and board 122.7 rates negotiated by a county agency for a recipient living in 122.8 group residential housing must not exceed the MSA equivalent 122.9 rate specified under section 256I.03, subdivision 5, with the 122.10 exception that a county agency may negotiate a supplementary 122.11 room and board rate that exceeds the MSA equivalent rateby up122.12to $426.37for recipients of waiver services under title XIX of 122.13 the Social Security Act. This exception is subject to the 122.14 following conditions: 122.15 (1)that the Secretary of Health and Human Services has not122.16approved a state request to include room and board costs which122.17exceed the MSA equivalent rate in an individual's set of waiver122.18services under title XIX of the Social Security Act; or122.19(2) that the Secretary of Health and Human Services has122.20approved the inclusion of room and board costs which exceed the122.21MSA equivalent rate, but in an amount that is insufficient to122.22cover costs which are included in a group residential housing122.23agreement in effect on June 30, 1994; and122.24(3) the amount of the rate that is above the MSA equivalent122.25rate has been approved by the commissioner.the setting is 122.26 licensed by the commissioner of human services under Minnesota 122.27 Rules, parts 9555.5050 to 9555.6265; 122.28 (2) the setting is not the primary residence of the license 122.29 holder and in which the license holder is not the primary 122.30 caregiver; and 122.31 (3) beginning January 1, 2000, the average supplementary 122.32 room and board rate in a county for a calendar year may not 122.33 exceed the average supplementary room and board rate for that 122.34 county in effect on January 1, 2000. If a county has not 122.35 negotiated supplementary room and board rates for any facilities 122.36 located in the county as of January 1, 2000, it may submit a 123.1 supplementary room and board rate request with budget 123.2 information for a facility to the commissioner for approval. 123.3 The county agency may at any time negotiate a higher or lower 123.4 room and board rate than the average supplementary room and 123.5 board ratethat would otherwise be paid under this subdivision. 123.6 Sec. 42. Minnesota Statutes 1998, section 256I.05, 123.7 subdivision 1a, is amended to read: 123.8 Subd. 1a. [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 123.9 the provisions of section 256I.04, subdivision 3, in addition to 123.10 the room and board rate specified in subdivision 1, the county 123.11 agency may negotiate a payment not to exceed $426.37 for other 123.12 services necessary to provide room and board provided by the 123.13 group residence if the residence is licensed by or registered by 123.14 the department of health, or licensed by the department of human 123.15 services to provide services in addition to room and board, and 123.16 if the provider of services is not also concurrently receiving 123.17 funding for services for a recipient under a home and 123.18 community-based waiver under title XIX of the Social Security 123.19 Act; or funding from the medical assistance program under 123.20 section 256B.0627, subdivision 4, for personal care services for 123.21 residents in the setting; or residing in a setting which 123.22 receives funding under Minnesota Rules, parts 9535.2000 to 123.23 9535.3000. If funding is available for other necessary services 123.24 through a home and community-based waiver, or personal care 123.25 services under section 256B.0627, subdivision 4, then the GRH 123.26 rate is limited to the rate set in subdivision 1. Unless 123.27 otherwise provided in law, in no case may the supplementary 123.28 service rate plus the supplementary room and board rate exceed 123.29 $426.37. The registration and licensure requirement does not 123.30 apply to establishments which are exempt from state licensure 123.31 because they are located on Indian reservations and for which 123.32 the tribe has prescribed health and safety requirements. 123.33 Service payments under this section may be prohibited under 123.34 rules to prevent the supplanting of federal funds with state 123.35 funds. The commissioner shall pursue the feasibility of 123.36 obtaining the approval of the Secretary of Health and Human 124.1 Services to provide home and community-based waiver services 124.2 under title XIX of the Social Security Act for residents who are 124.3 not eligible for an existing home and community-based waiver due 124.4 to a primary diagnosis of mental illness or chemical dependency 124.5 and shall apply for a waiver if it is determined to be 124.6 cost-effective. 124.7 (b) The commissioner is authorized to make cost-neutral 124.8 transfers from the GRH fund for beds under this section to other 124.9 funding programs administered by the department after 124.10 consultation with the county or counties in which the affected 124.11 beds are located. The commissioner may also make cost-neutral 124.12 transfers from the GRH fund to county human service agencies for 124.13 beds permanently removed from the GRH census under a plan 124.14 submitted by the county agency and approved by the 124.15 commissioner. The commissioner shall report the amount of any 124.16 transfers under this provision annually to the legislature. 124.17 (c) The provisions of paragraph (b) do not apply to a 124.18 facility that has its reimbursement rate established under 124.19 section 256B.431, subdivision 4, paragraph (c). 124.20 Sec. 43. [ICF/MR REIMBURSEMENT EFFECTIVE OCTOBER 1, 1999.] 124.21 (a) For the rate year beginning October 1, 1999, the 124.22 commissioner of human services shall exempt an intermediate care 124.23 facility for persons with mental retardation from reductions to 124.24 the payment rates under Minnesota Statutes, section 256B.501, 124.25 subdivision 5b, paragraph (d), clause (6), if the facility: 124.26 (1) has had a settle-up payment rate established in the 124.27 reporting year preceding the rate year for the one-time rate 124.28 adjustment; 124.29 (2) is a newly established facility; 124.30 (3) is an A to B conversion that has been converted under 124.31 Minnesota Statutes, section 252.292, since rate year 1990; 124.32 (4) has a payment rate subject to a community conversion 124.33 project under Minnesota Statutes, section 252.292; 124.34 (5) has a payment rate established under Minnesota 124.35 Statutes, section 245A.12 or 245A.13; or 124.36 (6) is a facility created by the relocation of more than 25 125.1 percent of the capacity of a related facility during the 125.2 reporting year. 125.3 (b) Notwithstanding any contrary provision in Minnesota 125.4 Statutes, section 256B.501, for the rate year beginning October 125.5 1, 1999, the commissioner of human services shall, for purposes 125.6 of the spend-up limit, array facilities within each grouping 125.7 established under Minnesota Statutes, section 256B.501, 125.8 subdivision 5b, paragraph (d), clause (4), by each facility's 125.9 cost per resident day. A facility's cost per resident day shall 125.10 be determined by dividing its allowable historical general 125.11 operating cost for the reporting year by the facility's resident 125.12 days for the reporting year. Facilities with a cost per 125.13 resident day at or above the median shall be limited to the 125.14 lesser of: 125.15 (1) the current reporting year's cost per resident day; or 125.16 (2) the prior report year's cost per resident day plus the 125.17 inflation factor established under Minnesota Statutes, section 125.18 256B.501, subdivision 3c, clause (2), increased by three 125.19 percentage points. In no case shall the amount of this 125.20 reduction exceed: (i) three percent for a facility with a 125.21 licensed capacity greater than 16 beds; (ii) two percent for a 125.22 facility with a licensed capacity of nine to 16 beds; and (iii) 125.23 one percent for a facility with a licensed capacity of eight or 125.24 fewer beds. 125.25 (c) The commissioner shall not apply the limits established 125.26 under Minnesota Statutes, section 256B.501, subdivision 5b, 125.27 paragraph (d), clause (8), for the rate year beginning October 125.28 1, 1999. 125.29 (d) Notwithstanding paragraphs (b) and (c), the 125.30 commissioner must utilize facility payment rates based on the 125.31 laws in effect for October 1, 1998, payment rates and use the 125.32 resulting allowable operating cost per diems as the basis for 125.33 the spend-up limits for the rate year beginning October 1, 1999. 125.34 Sec. 44. [DEADLINE EXTENSION.] 125.35 Notwithstanding Minnesota Statutes, section 144A.073, 125.36 subdivision 3, the commissioner of health shall extend approval 126.1 to May 31, 2000, for a total replacement of a 96-bed nursing 126.2 home located in Carlton county previously approved under 126.3 Minnesota Statutes, section 144A.073. 126.4 Sec. 45. [STATE LICENSURE CONFLICTS WITH FEDERAL 126.5 REGULATIONS.] 126.6 Notwithstanding the provisions of Minnesota Rules, part 126.7 4658.0520, an incontinent resident must be checked according to 126.8 a specific time interval written in the resident's care plan. 126.9 The resident's attending physician must authorize in writing any 126.10 interval longer than two hours. 126.11 (Effective date: Section 45 (State Licensure) is effective 126.12 the day following final enactment.) 126.13 Sec. 46. [REPEALER.] 126.14 (a) Minnesota Statutes 1998, sections 144.0723; and 126.15 256B.5011, subdivision 3, are repealed. 126.16 (b) Minnesota Statutes 1998, section 256B.434, subdivision 126.17 17, is repealed effective July 1, 1999. 126.18 (c) Minnesota Statutes 1998, section 256B.501, subdivision 126.19 3g, is repealed effective October 1, 2000. 126.20 (d) Laws 1997, chapter 203, article 4, section 55, is 126.21 repealed. 126.22 (e) Section 45 is repealed effective July 1, 2001. 126.23 Sec. 47. [EFFECTIVE DATE.] 126.24 When preparing the conference committee report for adoption 126.25 by the legislature, the revisor shall combine all effective date 126.26 notations in this article into this effective date section. 126.27 ARTICLE 4 126.28 HEALTH CARE PROGRAMS 126.29 Section 1. Minnesota Statutes 1998, section 16A.76, 126.30 subdivision 2, is amended to read: 126.31 Subd. 2. [RESERVE FINANCING.] The funds in reserve shall 126.32 be equal to the amount of federal financial participation 126.33 received since July 1, 1995, for services and administrative 126.34 activities funded by the health care access fund up to a reserve 126.35 limit of$150,000,000$80,000,000. Investment income attributed 126.36 to the federal contingency reserve balances shall also be 127.1 included in the total reserve amount. 127.2 Sec. 2. Minnesota Statutes 1998, section 60A.15, 127.3 subdivision 1, is amended to read: 127.4 Subdivision 1. [DOMESTIC AND FOREIGN COMPANIES.] (a) On or 127.5 before April 1, June 1, and December 1 of each year, every 127.6 domestic and foreign company, including town and farmers' mutual 127.7 insurance companies, domestic mutual insurance companies, marine 127.8 insurance companies, health maintenance organizations, community 127.9 integrated service networks, and nonprofit health service plan 127.10 corporations, shall pay to the commissioner of revenue 127.11 installments equal to one-third of the insurer's total estimated 127.12 tax for the current year. Except as provided in paragraphs (d), 127.13 (e), (h), and (i), installments must be based on a sum equal to 127.14 two percent of the premiums described in paragraph (b). 127.15 (b) Installments under paragraph (a), (d), or (e) are 127.16 percentages of gross premiums less return premiums on all direct 127.17 business received by the insurer in this state, or by its agents 127.18 for it, in cash or otherwise, during such year. 127.19 (c) Failure of a company to make payments of at least 127.20 one-third of either (1) the total tax paid during the previous 127.21 calendar year or (2) 80 percent of the actual tax for the 127.22 current calendar year shall subject the company to the penalty 127.23 and interest provided in this section, unless the total tax for 127.24 the current tax year is $500 or less. 127.25 (d) For health maintenance organizations, nonprofit health 127.26 service plan corporations, and community integrated service 127.27 networks, the installments must be based on an amount determined 127.28 under paragraph (h) or (i). 127.29 (e) For purposes of computing installments for town and 127.30 farmers' mutual insurance companies and for mutual property 127.31 casualty companies with total assets on December 31, 1989, of 127.32 $1,600,000,000 or less, the following rates apply: 127.33 (1) for all life insurance, two percent; 127.34 (2) for town and farmers' mutual insurance companies and 127.35 for mutual property and casualty companies with total assets of 127.36 $5,000,000 or less, on all other coverages, one percent; and 128.1 (3) for mutual property and casualty companies with total 128.2 assets on December 31, 1989, of $1,600,000,000 or less, on all 128.3 other coverages, 1.26 percent. 128.4 (f) If the aggregate amount of premium tax payments under 128.5 this section and the fire marshal tax payments under section 128.6 299F.21 made during a calendar year is equal to or exceeds 128.7 $120,000, all tax payments in the subsequent calendar year must 128.8 be paid by means of a funds transfer as defined in section 128.9 336.4A-104, paragraph (a). The funds transfer payment date, as 128.10 defined in section 336.4A-401, must be on or before the date the 128.11 payment is due. If the date the payment is due is not a funds 128.12 transfer business day, as defined in section 336.4A-105, 128.13 paragraph (a), clause (4), the payment date must be on or before 128.14 the funds transfer business day next following the date the 128.15 payment is due. 128.16 (g) Premiums under medical assistance, general assistance 128.17 medical care, the MinnesotaCare program, and the Minnesota 128.18 comprehensive health insurance plan and all payments, revenues, 128.19 and reimbursements received from the federal government for 128.20 Medicare-related coverage as defined in section 62A.31, 128.21 subdivision 3, paragraph (e), are not subject to tax under this 128.22 section. 128.23 (h) For calendar years 1997, 1998,and1999, 2000, and 2001 128.24 the installments for health maintenance organizations, community 128.25 integrated service networks, and nonprofit health service plan 128.26 corporations must be based on an amount equal to one percent of 128.27 premiums described under paragraph (b). Health maintenance 128.28 organizations, community integrated service networks, and 128.29 nonprofit health service plan corporations that have met the 128.30 cost containment goals established under section 62J.04 in the 128.31 individual and small employer market for calendar year 1996 are 128.32 exempt from payment of the tax imposed under this section for 128.33 premiums paid after March 30, 1997, and before April 1, 1998. 128.34 Health maintenance organizations, community integrated service 128.35 networks, and nonprofit health service plan corporations that 128.36 have met the cost containment goals established under section 129.1 62J.04 in the individual and small employer market for calendar 129.2 year 1997 are exempt from payment of the tax imposed under this 129.3 section for premiums paid after March 30, 1998, and before April 129.4 1, 1999. Health maintenance organizations, community integrated 129.5 service networks, and nonprofit health service plan corporations 129.6 that have met the cost containment goals established under 129.7 section 62J.04 in the individual and small employer market for 129.8 calendar year 1998 are exempt from payment of the tax imposed 129.9 under this section for premiums paid after March 30, 1999, and 129.10 before January 1,20002002. 129.11 (i) For calendar years after19992001, the commissioner of 129.12 finance shall determine the balance of the health care access 129.13 fund on September 1 of each year beginning September 1,1999129.14 2001. If the commissioner determines that there is no 129.15 structural deficit for the next fiscal year, no tax shall be 129.16 imposed under paragraph (d) for the following calendar year. If 129.17 the commissioner determines that there will be a structural 129.18 deficit in the fund for the following fiscal year, then the 129.19 commissioner, in consultation with the commissioner of revenue, 129.20 shall determine the amount needed to eliminate the structural 129.21 deficit and a tax shall be imposed under paragraph (d) for the 129.22 following calendar year. The commissioner shall determine the 129.23 rate of the tax as either one-quarter of one percent, one-half 129.24 of one percent, three-quarters of one percent, or one percent of 129.25 premiums described in paragraph (b), whichever is the lowest of 129.26 those rates that the commissioner determines will produce 129.27 sufficient revenue to eliminate the projected structural 129.28 deficit. The commissioner of finance shall publish in the State 129.29 Register by October 1 of each year the amount of tax to be 129.30 imposed for the following calendar year.In determining the129.31structural balance of the health care access fund for fiscal129.32years 2000 and 2001, the commissioner shall disregard the129.33transfer amount from the health care access fund to the general129.34fund for expenditures associated with the services provided to129.35pregnant women and children under the age of two enrolled in the129.36MinnesotaCare program.130.1 (j) In approving the premium rates as required in sections 130.2 62L.08, subdivision 8, and 62A.65, subdivision 3, the 130.3 commissioners of health and commerce shall ensure that any 130.4 exemption from the tax as described in paragraphs (h) and (i) is 130.5 reflected in the premium rate. 130.6 Sec. 3. Minnesota Statutes 1998, section 62A.045, is 130.7 amended to read: 130.8 62A.045 [PAYMENTS ON BEHALF OF ENROLLEES IN GOVERNMENT 130.9 HEALTH PROGRAMS.] 130.10 (a) No health plan issued or renewed to provide coverage to 130.11 a Minnesota resident shall contain any provision denying or 130.12 reducing benefits because services are rendered to a person who 130.13 is eligible for or receiving medical benefits pursuant to title 130.14 XIX of the Social Security Act (Medicaid) in this or any other 130.15 state; chapter 256; 256B; or 256D or services pursuant to 130.16 section 252.27; 256L.01 to 256L.10; 260.251, subdivision 1a; or 130.17 393.07, subdivision 1 or 2. No health carrier providing 130.18 benefits under plans covered by this section shall use 130.19 eligibility for medical programs named in this section as an 130.20 underwriting guideline or reason for nonacceptance of the risk. 130.21 (b) If payment for covered expenses has been made under 130.22 state medical programs for health care items or services 130.23 provided to an individual, and a third party has a legal 130.24 liability to make payments, the rights of payment and appeal of 130.25 an adverse coverage decision for the individual, or in the case 130.26 of a child their responsible relative or caretaker, will be 130.27 subrogated to the stateand/or its authorized agentagency. The 130.28 state agency may assert its subrogation rights to payment under 130.29 this section within three years of the date the service was 130.30 rendered. For purposes of this section, "state agency" includes 130.31 prepaid health plans under contract with the department 130.32 according to sections 256B.69, 256D.03, subdivision 4, paragraph 130.33 (d), and 256L.12; children's mental health collaboratives under 130.34 section 245.493; demonstration projects for persons with 130.35 disabilities under section 256B.77; nursing homes under the 130.36 alternative payment demonstration project under section 131.1 256B.434; and county-based purchasing entities under section 131.2 256B.692. 131.3 (c) Notwithstanding any law to the contrary, when a person 131.4 covered by a health plan receives medical benefits according to 131.5 any statute listed in this section, payment for covered services 131.6 or notice of denial for services billed by the provider must be 131.7 issued directly to the provider. If a person was receiving 131.8 medical benefits through the department of human services at the 131.9 time a service was provided, the provider must indicate this 131.10 benefit coverage on any claim forms submitted by the provider to 131.11 the health carrier for those services. If the commissioner of 131.12 human services notifies the health carrier that the commissioner 131.13 has made payments to the provider, payment for benefits or 131.14 notices of denials issued by the health carrier must be issued 131.15 directly to the commissioner. Submission by the department to 131.16 the health carrier of the claim on a department of human 131.17 services claim form is proper notice and shall be considered 131.18 proof of payment of the claim to the provider and supersedes any 131.19 contract requirements of the health carrier relating to the form 131.20 of submission. Liability to the insured for coverage is 131.21 satisfied to the extent that payments for those benefits are 131.22 made by the health carrier to the provider or the commissioner 131.23 as required by this section. 131.24 (d) When a state agency has acquired the rights of an 131.25 individual eligible for medical programs named in this section 131.26 and has health benefits coverage through a health carrier, the 131.27 health carrier shall not impose requirements that are different 131.28 from requirements applicable to an agent or assignee of any 131.29 other individual covered. 131.30 (e) For the purpose of this section, health plan includes 131.31 coverage offered by community integrated service networks, any 131.32 plan governed under the federal Employee Retirement Income 131.33 Security Act of 1974 (ERISA), United States Code, title 29, 131.34 sections 1001 to 1461, and coverage offered under the exclusions 131.35 listed in section 62A.011, subdivision 3, clauses (2), (6), (9), 131.36 (10), and (12). 132.1 Sec. 4. Minnesota Statutes 1998, section 125A.08, is 132.2 amended to read: 132.3 125A.08 [SCHOOL DISTRICT OBLIGATIONS.] 132.4 (a) As defined in this section, to the extent required by 132.5 federal law as of July 1,19992000, every district must ensure 132.6 the following: 132.7 (1) all students with disabilities are provided the special 132.8 instruction and services which are appropriate to their needs. 132.9 Where the individual education plan team has determined 132.10 appropriate goals and objectives based on the student's needs, 132.11 including the extent to which the student can be included in the 132.12 least restrictive environment, and where there are essentially 132.13 equivalent and effective instruction, related services, or 132.14 assistive technology devices available to meet the student's 132.15 needs, cost to the district may be among the factors considered 132.16 by the team in choosing how to provide the appropriate services, 132.17 instruction, or devices that are to be made part of the 132.18 student's individual education plan. The individual education 132.19 plan team shall consider and may authorize services covered by 132.20 medical assistance according to section 256B.0625, subdivision 132.21 26. The student's needs and the special education instruction 132.22 and services to be provided must be agreed upon through the 132.23 development of an individual education plan. The plan must 132.24 address the student's need to develop skills to live and work as 132.25 independently as possible within the community. By grade 9 or 132.26 age 14, the plan must address the student's needs for transition 132.27 from secondary services to post-secondary education and 132.28 training, employment, community participation, recreation, and 132.29 leisure and home living. In developing the plan, districts must 132.30 inform parents of the full range of transitional goals and 132.31 related services that should be considered. The plan must 132.32 include a statement of the needed transition services, including 132.33 a statement of the interagency responsibilities or linkages or 132.34 both before secondary services are concluded; 132.35 (2) children with a disability under age five and their 132.36 families are provided special instruction and services 133.1 appropriate to the child's level of functioning and needs; 133.2 (3) children with a disability and their parents or 133.3 guardians are guaranteed procedural safeguards and the right to 133.4 participate in decisions involving identification, assessment 133.5 including assistive technology assessment, and educational 133.6 placement of children with a disability; 133.7 (4) eligibility and needs of children with a disability are 133.8 determined by an initial assessment or reassessment, which may 133.9 be completed using existing data under United States Code, title 133.10 20, section 33, et seq.; 133.11 (5) to the maximum extent appropriate, children with a 133.12 disability, including those in public or private institutions or 133.13 other care facilities, are educated with children who are not 133.14 disabled, and that special classes, separate schooling, or other 133.15 removal of children with a disability from the regular 133.16 educational environment occurs only when and to the extent that 133.17 the nature or severity of the disability is such that education 133.18 in regular classes with the use of supplementary services cannot 133.19 be achieved satisfactorily; 133.20 (6) in accordance with recognized professional standards, 133.21 testing and evaluation materials, and procedures used for the 133.22 purposes of classification and placement of children with a 133.23 disability are selected and administered so as not to be 133.24 racially or culturally discriminatory; and 133.25 (7) the rights of the child are protected when the parents 133.26 or guardians are not known or not available, or the child is a 133.27 ward of the state. 133.28 (b) For paraprofessionals employed to work in programs for 133.29 students with disabilities, the school board in each district 133.30 shall ensure that: 133.31 (1) before or immediately upon employment, each 133.32 paraprofessional develops sufficient knowledge and skills in 133.33 emergency procedures, building orientation, roles and 133.34 responsibilities, confidentiality, vulnerability, and 133.35 reportability, among other things, to begin meeting the needs of 133.36 the students with whom the paraprofessional works; 134.1 (2) annual training opportunities are available to enable 134.2 the paraprofessional to continue to further develop the 134.3 knowledge and skills that are specific to the students with whom 134.4 the paraprofessional works, including understanding 134.5 disabilities, following lesson plans, and implementing follow-up 134.6 instructional procedures and activities; and 134.7 (3) a districtwide process obligates each paraprofessional 134.8 to work under the ongoing direction of a licensed teacher and, 134.9 where appropriate and possible, the supervision of a school 134.10 nurse. 134.11 (Effective date: Section 4 (125A.08) is effective July 1, 134.12 2000.) 134.13 Sec. 5. Minnesota Statutes 1998, section 125A.21, 134.14 subdivision 1, is amended to read: 134.15 Subdivision 1. [OBLIGATION TO PAY.] Nothing in sections 134.16 125A.03 to 125A.24 and 125A.65 relieves an insurer or similar 134.17 third party from an otherwise valid obligation to pay, or 134.18 changes the validity of an obligation to pay, for services 134.19 rendered to a child with a disability, and the child's family. 134.20 A school district shall pay the nonfederal share of medical 134.21 assistance services provided according to section 256B.0625, 134.22 subdivision 26. Eligible expenditures must not be made from 134.23 federal funds or funds used to match other federal funds. Any 134.24 federal disallowances are the responsibility of the school 134.25 district. A school district may pay or reimburse copayments, 134.26 coinsurance, deductibles, and other enrollee cost-sharing 134.27 amounts, on behalf of the student or family, in connection with 134.28 health and related services provided under an individual 134.29 educational plan. 134.30 (Effective date: Section 5 (125A.21) is effective July 1, 134.31 2000.) 134.32 Sec. 6. Minnesota Statutes 1998, section 125A.74, 134.33 subdivision 1, is amended to read: 134.34 Subdivision 1. [ELIGIBILITY.] A district may enroll as a 134.35 provider in the medical assistance program and receive medical 134.36 assistance payments for covered special education services 135.1 provided to persons eligible for medical assistance under 135.2 chapter 256B. To receive medical assistance payments, the 135.3 district must pay the nonfederal share of medical assistance 135.4 services provided according to section 256B.0625, subdivision 135.5 26, and comply with relevant provisions of state and federal 135.6 statutes and regulations governing the medical assistance 135.7 program. 135.8 (Effective date: Section 6 (125A.74, subd. 1) is effective 135.9 July 1, 2000.) 135.10 Sec. 7. Minnesota Statutes 1998, section 125A.74, 135.11 subdivision 2, is amended to read: 135.12 Subd. 2. [FUNDING.] A district that provides a covered 135.13 service to an eligible person and complies with relevant 135.14 requirements of the medical assistance program is entitled to 135.15 receive payment for theservice provided, including thatportion 135.16 of thepaymentservices that will subsequently be reimbursed by 135.17 the federal government, in the same manner as other medical 135.18 assistance providers.The school district is not required to135.19provide matching funds or pay part of the costs of the service,135.20as long as the rate charged for the service does not exceed135.21medical assistance limits that apply to all medical assistance135.22providers.135.23 (Effective date: Section 7 (125A.74, subd. 2) is effective 135.24 July 1, 2000.) 135.25 Sec. 8. [214.045] [COORDINATION WITH BOARD OF TEACHING.] 135.26 The commissioner of health and the health-related licensing 135.27 boards must coordinate with the board of teaching when modifying 135.28 licensure requirements for regulated persons in order to have 135.29 consistent regulatory requirements for personnel who perform 135.30 services in schools. 135.31 Sec. 9. Minnesota Statutes 1998, section 245.462, 135.32 subdivision 17, is amended to read: 135.33 Subd. 17. [MENTAL HEALTH PRACTITIONER.] "Mental health 135.34 practitioner" means a person providing services to persons with 135.35 mental illness who is qualified in at least one of the following 135.36 ways: 136.1 (1) holds a bachelor's degree in one of the behavioral 136.2 sciences or related fields from an accredited college or 136.3 university and: 136.4 (i) has at least 2,000 hours of supervised experience in 136.5 the delivery of services to persons with mental illness; or 136.6 (ii) is fluent in the non-English language of the ethnic 136.7 group to which at least 50 percent of the practitioner's clients 136.8 belong, completes 40 hours of training in the delivery of 136.9 services to persons with mental illness, and receives clinical 136.10 supervision from a mental health professional at least once a 136.11 week until the requirement of 2,000 hours of supervised 136.12 experience is met; 136.13 (2) has at least 6,000 hours of supervised experience in 136.14 the delivery of services to persons with mental illness; 136.15 (3) is a graduate student in one of the behavioral sciences 136.16 or related fields and is formally assigned by an accredited 136.17 college or university to an agency or facility for clinical 136.18 training; or 136.19 (4) holds a master's or other graduate degree in one of the 136.20 behavioral sciences or related fields from an accredited college 136.21 or university and has less than 4,000 hours post-master's 136.22 experience in the treatment of mental illness. 136.23 Sec. 10. Minnesota Statutes 1998, section 245.4871, 136.24 subdivision 26, is amended to read: 136.25 Subd. 26. [MENTAL HEALTH PRACTITIONER.] "Mental health 136.26 practitioner" means a person providing services to children with 136.27 emotional disturbances. A mental health practitioner must have 136.28 training and experience in working with children. A mental 136.29 health practitioner must be qualified in at least one of the 136.30 following ways: 136.31 (1) holds a bachelor's degree in one of the behavioral 136.32 sciences or related fields from an accredited college or 136.33 university and: 136.34 (i) has at least 2,000 hours of supervised experience in 136.35 the delivery of mental health services to children with 136.36 emotional disturbances; or 137.1 (ii) is fluent in the non-English language of the ethnic 137.2 group to which at least 50 percent of the practitioner's clients 137.3 belong, completes 40 hours of training in the delivery of 137.4 services to children with emotional disturbances, and receives 137.5 clinical supervision from a mental health professional at least 137.6 once a week until the requirement of 2,000 hours of supervised 137.7 experience is met; 137.8 (2) has at least 6,000 hours of supervised experience in 137.9 the delivery of mental health services to children with 137.10 emotional disturbances; 137.11 (3) is a graduate student in one of the behavioral sciences 137.12 or related fields and is formally assigned by an accredited 137.13 college or university to an agency or facility for clinical 137.14 training; or 137.15 (4) holds a master's or other graduate degree in one of the 137.16 behavioral sciences or related fields from an accredited college 137.17 or university and has less than 4,000 hours post-master's 137.18 experience in the treatment of emotional disturbance. 137.19 Sec. 11. [245.99] [ADULT MENTAL ILLNESS CRISIS HOUSING 137.20 ASSISTANCE PROGRAM.] 137.21 Subdivision 1. [CREATION.] The adult mental illness crisis 137.22 housing assistance program is established. 137.23 Subd. 2. [RENTAL ASSISTANCE.] The program shall pay up to 137.24 90 days of housing assistance for persons with a serious and 137.25 persistent mental illness who require inpatient or residential 137.26 care for stabilization. The commissioner of human services may 137.27 extend the length of assistance on a case-by-case basis. 137.28 Subd. 3. [ELIGIBILITY.] Housing assistance under this 137.29 section is available only to persons of low or moderate income 137.30 as determined by the commissioner of human services. 137.31 Subd. 4. [ADMINISTRATION.] The commissioner may contract 137.32 with organizations or government units experienced in housing 137.33 assistance to operate the program under this section. 137.34 Sec. 12. Minnesota Statutes 1998, section 245A.04, 137.35 subdivision 3a, is amended to read: 137.36 Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 138.1 STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 138.2 commissioner shall notify the applicant or license holder and 138.3 the individual who is the subject of the study, in writing or by 138.4 electronic transmission, of the results of the study. When the 138.5 study is completed, a notice that the study was undertaken and 138.6 completed shall be maintained in the personnel files of the 138.7 program. For studies on individuals pertaining to a license to 138.8 provide family day care or group family day care, foster care 138.9 for children in the provider's own home, or foster care or day 138.10 care services for adults in the provider's own home, the 138.11 commissioner is not required to provide a separate notice of the 138.12 background study results to the individual who is the subject of 138.13 the study unless the study results in a disqualification of the 138.14 individual. 138.15 The commissioner shall notify the individual studied if the 138.16 information in the study indicates the individual is 138.17 disqualified from direct contact with persons served by the 138.18 program. The commissioner shall disclose the information 138.19 causing disqualification and instructions on how to request a 138.20 reconsideration of the disqualification to the individual 138.21 studied. An applicant or license holder who is not the subject 138.22 of the study shall be informed that the commissioner has found 138.23 information that disqualifies the subject from direct contact 138.24 with persons served by the program. However, only the 138.25 individual studied must be informed of the information contained 138.26 in the subject's background study unless the only basis for the 138.27 disqualification is failure to cooperate, the Data Practices Act 138.28 provides for release of the information, or the individual 138.29 studied authorizes the release of the information. 138.30 (b) If the commissioner determines that the individual 138.31 studied has a disqualifying characteristic, the commissioner 138.32 shall review the information immediately available and make a 138.33 determination as to the subject's immediate risk of harm to 138.34 persons served by the program where the individual studied will 138.35 have direct contact. The commissioner shall consider all 138.36 relevant information available, including the following factors 139.1 in determining the immediate risk of harm: the recency of the 139.2 disqualifying characteristic; the recency of discharge from 139.3 probation for the crimes; the number of disqualifying 139.4 characteristics; the intrusiveness or violence of the 139.5 disqualifying characteristic; the vulnerability of the victim 139.6 involved in the disqualifying characteristic; and the similarity 139.7 of the victim to the persons served by the program where the 139.8 individual studied will have direct contact. The commissioner 139.9 may determine that the evaluation of the information immediately 139.10 available gives the commissioner reason to believe one of the 139.11 following: 139.12 (1) The individual poses an imminent risk of harm to 139.13 persons served by the program where the individual studied will 139.14 have direct contact. If the commissioner determines that an 139.15 individual studied poses an imminent risk of harm to persons 139.16 served by the program where the individual studied will have 139.17 direct contact, the individual and the license holder must be 139.18 sent a notice of disqualification. The commissioner shall order 139.19 the license holder to immediately remove the individual studied 139.20 from direct contact. The notice to the individual studied must 139.21 include an explanation of the basis of this determination. 139.22 (2) The individual poses a risk of harm requiring 139.23 continuous supervision while providing direct contact services 139.24 during the period in which the subject may request a 139.25 reconsideration. If the commissioner determines that an 139.26 individual studied poses a risk of harm that requires continuous 139.27 supervision, the individual and the license holder must be sent 139.28 a notice of disqualification. The commissioner shall order the 139.29 license holder to immediately remove the individual studied from 139.30 direct contact services or assure that the individual studied is 139.31 within sight or hearing of another staff person when providing 139.32 direct contact services during the period in which the 139.33 individual may request a reconsideration of the 139.34 disqualification. If the individual studied does not submit a 139.35 timely request for reconsideration, or the individual submits a 139.36 timely request for reconsideration, but the disqualification is 140.1 not set aside for that license holder, the license holder will 140.2 be notified of the disqualification and ordered to immediately 140.3 remove the individual from any position allowing direct contact 140.4 with persons receiving services from the license holder. 140.5 (3) The individual does not pose an imminent risk of harm 140.6 or a risk of harm requiring continuous supervision while 140.7 providing direct contact services during the period in which the 140.8 subject may request a reconsideration. If the commissioner 140.9 determines that an individual studied does not pose a risk of 140.10 harm that requires continuous supervision, only the individual 140.11 must be sent a notice of disqualification. The license holder 140.12 must be sent a notice that more time is needed to complete the 140.13 individual's background study. If the individual studied 140.14 submits a timely request for reconsideration, and if the 140.15 disqualification is set aside for that license holder, the 140.16 license holder will receive the same notification received by 140.17 license holders in cases where the individual studied has no 140.18 disqualifying characteristic. If the individual studied does 140.19 not submit a timely request for reconsideration, or the 140.20 individual submits a timely request for reconsideration, but the 140.21 disqualification is not set aside for that license holder, the 140.22 license holder will be notified of the disqualification and 140.23 ordered to immediately remove the individual from any position 140.24 allowing direct contact with persons receiving services from the 140.25 license holder. 140.26 (c) County licensing agencies performing duties under this 140.27 subdivision may develop an alternative system for determining 140.28 the subject's immediate risk of harm to persons served by the 140.29 program, providing the notices under paragraph (b), and 140.30 documenting the action taken by the county licensing agency. 140.31 Each county licensing agency's implementation of the alternative 140.32 system is subject to approval by the commissioner. 140.33 Notwithstanding this alternative system, county licensing 140.34 agencies shall complete the requirements of paragraph (a). 140.35 Sec. 13. Minnesota Statutes 1998, section 245A.08, 140.36 subdivision 5, is amended to read: 141.1 Subd. 5. [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After 141.2 considering the findings of fact, conclusions, and 141.3 recommendations of the administrative law judge, the 141.4 commissioner shall issue a final order. The commissioner shall 141.5 consider, but shall not be bound by, the recommendations of the 141.6 administrative law judge. The appellant must be notified of the 141.7 commissioner's final order as required by chapter 14. The 141.8 notice must also contain information about the appellant's 141.9 rights under chapter 14. The institution of proceedings for 141.10 judicial review of the commissioner's final order shall not stay 141.11 the enforcement of the final order except as provided in section 141.12 14.65. A license holder and each controlling individual of a 141.13 license holder whose license has been revoked because of 141.14 noncompliance with applicable law or rule must not be granted a 141.15 license for five years following the revocation. An applicant 141.16 whose application was denied must not be granted a license for 141.17 two years following a denial, unless the applicant's subsequent 141.18 application contains new information which constitutes a 141.19 substantial change in the conditions that caused the previous 141.20 denial. 141.21 Sec. 14. Minnesota Statutes 1998, section 245B.05, 141.22 subdivision 7, is amended to read: 141.23 Subd. 7. [REPORTING INCIDENTS AND EMERGENCIES.] The 141.24 license holder must report the following incidents to the 141.25 consumer's legal representative, caregiver, and case manager 141.26 within 24 hours of the occurrence, or within 24 hours of receipt 141.27 of the information: 141.28 (1) the death of a consumer; 141.29 (2) any medical emergencies, unexpected serious illnesses, 141.30 or accidents that require physician treatment or 141.31 hospitalization; 141.32 (3) a consumer's unauthorized absence; or 141.33 (4) any fires and incidents involving a law enforcement 141.34 agency. 141.35 Death or serious injury of the consumer must also be 141.36 reported to thecommissionerdepartment of human services 142.1 licensing division and the ombudsman, as required under sections 142.2 245.91 and 245.94, subdivision 2a. 142.3 Sec. 15. Minnesota Statutes 1998, section 245B.07, 142.4 subdivision 5, is amended to read: 142.5 Subd. 5. [STAFF ORIENTATION.] (a) Within 60 days of hiring 142.6 staff who provide direct service, the license holder must 142.7 provide 30 hours of staff orientation. Direct care staff must 142.8 complete 15 of the 30 hours orientation before providing any 142.9 unsupervised direct service to a consumer. If the staff person 142.10 has received orientation training from a license holder licensed 142.11 under this chapter, or provides semi-independent living services 142.12 only, the 15-hour requirement may be reduced to eight hours. 142.13 The total orientation of 30 hours may be reduced to 15 hours if 142.14 the staff person has previously received orientation training 142.15 from a license holder licensed under this chapter. 142.16 (b) The 30 hours of orientation must combine supervised 142.17 on-the-job training with coverage of the following material: 142.18 (1) review of the consumer's service plans and risk 142.19 management plan to achieve an understanding of the consumer as a 142.20 unique individual; 142.21 (2) review and instruction on the license holder's policies 142.22 and procedures, including their location and access; 142.23 (3) emergency procedures; 142.24 (4) explanation of specific job functions, including 142.25 implementing objectives from the consumer's individual service 142.26 plan; 142.27 (5) explanation of responsibilities related to section 142.28 245A.65; sections 626.556 and 626.557, governing maltreatment 142.29 reporting and service planning for children and vulnerable 142.30 adults; and section 245.825, governing use of aversive and 142.31 deprivation procedures; 142.32 (6) medication administration as it applies to the 142.33 individual consumer, from a training curriculum developed by a 142.34 health services professional described in section 245B.05, 142.35 subdivision 5, and when the consumer meets the criteria of 142.36 having overriding health care needs, then medication 143.1 administration taught by a health services professional. Staff 143.2 may administer medications only after they demonstrate the 143.3 ability, as defined in the license holder's medication 143.4 administration policy and procedures. Once a consumer with 143.5 overriding health care needs is admitted, staff will be provided 143.6 with remedial training as deemed necessary by the license holder 143.7 and the health professional to meet the needs of that consumer. 143.8 For purposes of this section, overriding health care needs 143.9 means a health care condition that affects the service options 143.10 available to the consumer because the condition requires: 143.11 (i) specialized or intensive medical or nursing 143.12 supervision; and 143.13 (ii) nonmedical service providers to adapt their services 143.14 to accommodate the health and safety needs of the consumer; 143.15 (7) consumer rights; and 143.16 (8) other topics necessary as determined by the consumer's 143.17 individual service plan or other areas identified by the license 143.18 holder. 143.19 (c) The license holder must document each employee's 143.20 orientation received. 143.21 Sec. 16. Minnesota Statutes 1998, section 245B.07, 143.22 subdivision 8, is amended to read: 143.23 Subd. 8. [POLICIES AND PROCEDURES.] The license holder 143.24 must develop and implement the policies and procedures in 143.25 paragraphs (1) to (3). 143.26 (1) policies and procedures that promote consumer health 143.27 and safety by ensuring: 143.28 (i) consumer safety in emergency situations as identified 143.29 in section 245B.05, subdivision 7; 143.30 (ii) consumer health through sanitary practices; 143.31 (iii) safe transportation, when the license holder is 143.32 responsible for transportation of consumers, with provisions for 143.33 handling emergency situations; 143.34 (iv) a system of recordkeeping for both individuals and the 143.35 organization, for review of incidents and emergencies, and 143.36 corrective action if needed; 144.1 (v) a plan for responding to and reporting all emergencies, 144.2 including deaths, medical emergencies, illnesses, accidents, 144.3 missing consumers, fires, severe weather and natural disasters, 144.4 bomb threats, and other threats; 144.5 (vi) safe medication administration as identified in 144.6 section 245B.05, subdivision 5, incorporating an observed skill 144.7 assessment to ensure that staff demonstrate the ability to 144.8 administer medications consistent with the license holder's 144.9 policy and procedures; 144.10 (vii) psychotropic medication monitoring when the consumer 144.11 is prescribed a psychotropic medication, including the use of 144.12 the psychotropic medication use checklist. If the 144.13 responsibility for implementing the psychotropic medication use 144.14 checklist has not been assigned in the individual service plan 144.15 and the consumer lives in a licensed site, the residential 144.16 license holder shall be designated; and 144.17 (viii) criteria for admission or service initiation 144.18 developed by the license holder; 144.19 (2) policies and procedures that protect consumer rights 144.20 and privacy by ensuring: 144.21 (i) consumer data privacy, in compliance with the Minnesota 144.22 Data Practices Act, chapter 13; and 144.23 (ii) that complaint procedures provide consumers with a 144.24 simple process to bring grievances and consumers receive a 144.25 response to the grievance within a reasonable time period. The 144.26 license holder must provide a copy of the program's grievance 144.27 procedure and time lines for addressing grievances. The 144.28 program's grievance procedure must permit consumers served by 144.29 the program and the authorized representatives to bring a 144.30 grievance to the highest level of authority in the program; and 144.31 (3) policies and procedures that promote continuity and 144.32 quality of consumer supports by ensuring: 144.33 (i) continuity of care and service coordination, including 144.34 provisions for service termination, temporary service 144.35 suspension, and efforts made by the license holder to coordinate 144.36 services with other vendors who also provide support to the 145.1 consumer. The policy must include the following requirements: 145.2 (A) the license holder must notify the consumer or 145.3 consumer's legal representative and the consumer's case manager 145.4 in writing of the intended termination or temporary service 145.5 suspension and the consumer's right to seek a temporary order 145.6 staying the termination or suspension of service according to 145.7 the procedures in section 256.045, subdivision 4a or subdivision 145.8 6, paragraph (c); 145.9 (B) notice of the proposed termination of services, 145.10 including those situations that began with a temporary service 145.11 suspension, must be given at least 60 days before the proposed 145.12 termination is to become effective, unless services are145.13temporarily suspended according to the license holder's written145.14temporary service suspension procedures, in which case notice145.15must be given as soon as possible; 145.16 (C) the license holder must provide information requested 145.17 by the consumer or consumer's legal representative or case 145.18 manager when services are temporarily suspended or upon notice 145.19 of termination; 145.20 (D) use of temporary service suspension procedures are 145.21 restricted to situations in which the consumer's behavior causes 145.22 immediate and serious danger to the health and safety of the 145.23 individual or others; 145.24 (E) prior to giving notice of service termination or 145.25 temporary service suspension, the license holder must document 145.26 actions taken to minimize or eliminate the need for service 145.27 termination or temporary service suspension; and 145.28 (F) during the period of temporary service suspension, the 145.29 license holder will work with the appropriate county agency to 145.30 develop reasonable alternatives to protect the individual and 145.31 others; and 145.32 (ii) quality services measured through a program evaluation 145.33 process including regular evaluations of consumer satisfaction 145.34 and sharing the results of the evaluations with the consumers 145.35 and legal representatives. 145.36 Sec. 17. Minnesota Statutes 1998, section 245B.07, 146.1 subdivision 10, is amended to read: 146.2 Subd. 10. [CONSUMER FUNDS.] (a) The license holder must 146.3 ensure that consumers retain the use and availability of 146.4 personal funds or property unless restrictions are justified in 146.5 the consumer's individual service plan. 146.6 (b) The license holder must ensure separation ofresident146.7 consumer funds from funds of the license holder, theresidential146.8 program, or program staff. 146.9 (c) Whenever the license holder assists a consumer with the 146.10 safekeeping of funds or other property, the license holder 146.11 must have written authorization to do so by the consumer or the 146.12 consumer's legal representative and the case manager. In 146.13 addition, the license holder must: 146.14 (1) document receipt and disbursement of the consumer's 146.15 funds or the property, and include the signature of the146.16consumer, conservator, or payee; 146.17 (2)provide a statement at least quarterly itemizing146.18 annually survey, document, and implement the preferences of the 146.19 consumer, consumer's legal representative, and the case manager 146.20 for frequency of receiving a statement that itemizes receipts 146.21 and disbursements ofresidentconsumer funds or other property; 146.22 and 146.23 (3) return to the consumer upon the consumer's request, 146.24 funds and property in the license holder's possession subject to 146.25 restrictions in the consumer's individual service plan, as soon 146.26 as possible, but no later than three working days after the date 146.27 of the request. 146.28 (d) License holders and program staff must not: 146.29 (1) borrow money from a consumer; 146.30 (2) purchase personal items from a consumer; 146.31 (3) sell merchandise or personal services to a consumer; 146.32 (4) require aresidentconsumer to purchase items for which 146.33 the license holder is eligible for reimbursement; or 146.34 (5) useresidentconsumer funds in a manner that would 146.35 violate section 256B.04, or any rules promulgated under that 146.36 section. 147.1 Sec. 18. Minnesota Statutes 1998, section 252.32, 147.2 subdivision 3a, is amended to read: 147.3 Subd. 3a. [REPORTS AND ALLOCATIONS.] (a) The commissioner 147.4 shall specify requirements for quarterly fiscal and annual 147.5 program reports according to section 256.01, subdivision 2, 147.6 paragraph (17). Program reports shall include data which will 147.7 enable the commissioner to evaluate program effectiveness and to 147.8 audit compliance. The commissioner shall reimburse county costs 147.9 on a quarterly basis. 147.10 (b)Beginning January 1, 1998,The commissioner shall 147.11 allocate state funds made available under this section to county 147.12 social service agencies on a calendar year basis. The 147.13 commissioner shall allocate to each county first in amounts 147.14 equal to each county's guaranteed floor as described in clause 147.15 (1), and second, any remaining funds, after the allocation of147.16funds to the newly participating counties as provided for in147.17clause (3), shall be allocated in proportion to each county's147.18total number of families receiving a grant on July 1 of the most147.19recent calendar yearwill be allocated to county agencies to 147.20 support children in their family homes. 147.21 (1) Each county's guaranteed floor shall be calculated as 147.22 follows: 147.23 (i) 95 percent of the county's allocation received in the 147.24 preceding calendar year. For the calendar year 1998 allocation,147.25the preceding calendar year shall be considered to be double the147.26six-month allocation as provided in clause (2); 147.27 (ii) when the amount of funds available for allocation is 147.28 less than the amount available in the preceding year, each 147.29 county's previous year allocation shall be reduced in proportion 147.30 to the reduction in statewide funding, for the purpose of 147.31 establishing the guaranteed floor. 147.32 (2)For the period July 1, 1997, to December 31, 1997, the147.33commissioner shall allocate to each county an amount equal to147.34the actual, state approved grants issued to the families for the147.35month of January 1997, multiplied by six. This six-month147.36allocation shall be combined with the calendar year 1998148.1allocation and be administered as an 18-month allocation.148.2(3) At the commissioner's discretion, funds may be148.3allocated to any nonparticipating county that requests an148.4allocation under this section. Allocations to newly148.5participating counties are dependent upon the availability of148.6funds, as determined by the actual expenditure amount of the148.7participating counties for the most recently completed calendar148.8year.148.9(4)The commissioner shall regularly review the use of 148.10 family support fund allocations by county. The commissioner may 148.11 reallocate unexpended or unencumbered money at any time to those 148.12 counties that have a demonstrated need for additional funding. 148.13 (c) County allocations under this section will be adjusted 148.14 for transfers that occur according to section 256.476 or when 148.15 the county of financial responsibility changes according to 148.16 chapter 256G for eligible recipients. 148.17 Sec. 19. Minnesota Statutes 1998, section 256.01, 148.18 subdivision 2, is amended to read: 148.19 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 148.20 section 241.021, subdivision 2, the commissioner of human 148.21 services shall: 148.22 (1) Administer and supervise all forms of public assistance 148.23 provided for by state law and other welfare activities or 148.24 services as are vested in the commissioner. Administration and 148.25 supervision of human services activities or services includes, 148.26 but is not limited to, assuring timely and accurate distribution 148.27 of benefits, completeness of service, and quality program 148.28 management. In addition to administering and supervising human 148.29 services activities vested by law in the department, the 148.30 commissioner shall have the authority to: 148.31 (a) require county agency participation in training and 148.32 technical assistance programs to promote compliance with 148.33 statutes, rules, federal laws, regulations, and policies 148.34 governing human services; 148.35 (b) monitor, on an ongoing basis, the performance of county 148.36 agencies in the operation and administration of human services, 149.1 enforce compliance with statutes, rules, federal laws, 149.2 regulations, and policies governing welfare services and promote 149.3 excellence of administration and program operation; 149.4 (c) develop a quality control program or other monitoring 149.5 program to review county performance and accuracy of benefit 149.6 determinations; 149.7 (d) require county agencies to make an adjustment to the 149.8 public assistance benefits issued to any individual consistent 149.9 with federal law and regulation and state law and rule and to 149.10 issue or recover benefits as appropriate; 149.11 (e) delay or deny payment of all or part of the state and 149.12 federal share of benefits and administrative reimbursement 149.13 according to the procedures set forth in section 256.017; 149.14 (f) make contracts with and grants to public and private 149.15 agencies and organizations, both profit and nonprofit, and 149.16 individuals, using appropriated funds; and 149.17 (g) enter into contractual agreements with federally 149.18 recognized Indian tribes with a reservation in Minnesota to the 149.19 extent necessary for the tribe to operate a federally approved 149.20 family assistance program or any other program under the 149.21 supervision of the commissioner. The commissioner shall consult 149.22 with the affected county or counties in the contractual 149.23 agreement negotiations, if the county or counties wish to be 149.24 included, in order to avoid the duplication of county and tribal 149.25 assistance program services. The commissioner may establish 149.26 necessary accounts for the purposes of receiving and disbursing 149.27 funds as necessary for the operation of the programs. 149.28 (2) Inform county agencies, on a timely basis, of changes 149.29 in statute, rule, federal law, regulation, and policy necessary 149.30 to county agency administration of the programs. 149.31 (3) Administer and supervise all child welfare activities; 149.32 promote the enforcement of laws protecting handicapped, 149.33 dependent, neglected and delinquent children, and children born 149.34 to mothers who were not married to the children's fathers at the 149.35 times of the conception nor at the births of the children; 149.36 license and supervise child-caring and child-placing agencies 150.1 and institutions; supervise the care of children in boarding and 150.2 foster homes or in private institutions; and generally perform 150.3 all functions relating to the field of child welfare now vested 150.4 in the state board of control. 150.5 (4) Administer and supervise all noninstitutional service 150.6 to handicapped persons, including those who are visually 150.7 impaired, hearing impaired, or physically impaired or otherwise 150.8 handicapped. The commissioner may provide and contract for the 150.9 care and treatment of qualified indigent children in facilities 150.10 other than those located and available at state hospitals when 150.11 it is not feasible to provide the service in state hospitals. 150.12 (5) Assist and actively cooperate with other departments, 150.13 agencies and institutions, local, state, and federal, by 150.14 performing services in conformity with the purposes of Laws 150.15 1939, chapter 431. 150.16 (6) Act as the agent of and cooperate with the federal 150.17 government in matters of mutual concern relative to and in 150.18 conformity with the provisions of Laws 1939, chapter 431, 150.19 including the administration of any federal funds granted to the 150.20 state to aid in the performance of any functions of the 150.21 commissioner as specified in Laws 1939, chapter 431, and 150.22 including the promulgation of rules making uniformly available 150.23 medical care benefits to all recipients of public assistance, at 150.24 such times as the federal government increases its participation 150.25 in assistance expenditures for medical care to recipients of 150.26 public assistance, the cost thereof to be borne in the same 150.27 proportion as are grants of aid to said recipients. 150.28 (7) Establish and maintain any administrative units 150.29 reasonably necessary for the performance of administrative 150.30 functions common to all divisions of the department. 150.31 (8) Act as designated guardian of both the estate and the 150.32 person of all the wards of the state of Minnesota, whether by 150.33 operation of law or by an order of court, without any further 150.34 act or proceeding whatever, except as to persons committed as 150.35 mentally retarded. For children under the guardianship of the 150.36 commissioner whose interests would be best served by adoptive 151.1 placement, the commissioner may contract with a licensed 151.2 child-placing agency to provide adoption services. A contract 151.3 with a licensed child-placing agency must be designed to 151.4 supplement existing county efforts and may not replace existing 151.5 county programs, unless the replacement is agreed to by the 151.6 county board and the appropriate exclusive bargaining 151.7 representative or the commissioner has evidence that child 151.8 placements of the county continue to be substantially below that 151.9 of other counties. 151.10 (9) Act as coordinating referral and informational center 151.11 on requests for service for newly arrived immigrants coming to 151.12 Minnesota. 151.13 (10) The specific enumeration of powers and duties as 151.14 hereinabove set forth shall in no way be construed to be a 151.15 limitation upon the general transfer of powers herein contained. 151.16 (11) Establish county, regional, or statewide schedules of 151.17 maximum fees and charges which may be paid by county agencies 151.18 for medical, dental, surgical, hospital, nursing and nursing 151.19 home care and medicine and medical supplies under all programs 151.20 of medical care provided by the state and for congregate living 151.21 care under the income maintenance programs. 151.22 (12) Have the authority to conduct and administer 151.23 experimental projects to test methods and procedures of 151.24 administering assistance and services to recipients or potential 151.25 recipients of public welfare. To carry out such experimental 151.26 projects, it is further provided that the commissioner of human 151.27 services is authorized to waive the enforcement of existing 151.28 specific statutory program requirements, rules, and standards in 151.29 one or more counties. The order establishing the waiver shall 151.30 provide alternative methods and procedures of administration, 151.31 shall not be in conflict with the basic purposes, coverage, or 151.32 benefits provided by law, and in no event shall the duration of 151.33 a project exceed four years. It is further provided that no 151.34 order establishing an experimental project as authorized by the 151.35 provisions of this section shall become effective until the 151.36 following conditions have been met: 152.1 (a) The secretary of health, education, and welfare of the 152.2 United States has agreed, for the same project, to waive state 152.3 plan requirements relative to statewide uniformity. 152.4 (b) A comprehensive plan, including estimated project 152.5 costs, shall be approved by the legislative advisory commission 152.6 and filed with the commissioner of administration. 152.7 (13) According to federal requirements, establish 152.8 procedures to be followed by local welfare boards in creating 152.9 citizen advisory committees, including procedures for selection 152.10 of committee members. 152.11 (14) Allocate federal fiscal disallowances or sanctions 152.12 which are based on quality control error rates for the aid to 152.13 families with dependent children, Minnesota family investment 152.14 program-statewide, medical assistance, or food stamp program in 152.15 the following manner: 152.16 (a) One-half of the total amount of the disallowance shall 152.17 be borne by the county boards responsible for administering the 152.18 programs. For the medical assistance, MFIP-S, and AFDC 152.19 programs, disallowances shall be shared by each county board in 152.20 the same proportion as that county's expenditures for the 152.21 sanctioned program are to the total of all counties' 152.22 expenditures for the AFDC, MFIP-S, and medical assistance 152.23 programs. For the food stamp program, sanctions shall be shared 152.24 by each county board, with 50 percent of the sanction being 152.25 distributed to each county in the same proportion as that 152.26 county's administrative costs for food stamps are to the total 152.27 of all food stamp administrative costs for all counties, and 50 152.28 percent of the sanctions being distributed to each county in the 152.29 same proportion as that county's value of food stamp benefits 152.30 issued are to the total of all benefits issued for all 152.31 counties. Each county shall pay its share of the disallowance 152.32 to the state of Minnesota. When a county fails to pay the 152.33 amount due hereunder, the commissioner may deduct the amount 152.34 from reimbursement otherwise due the county, or the attorney 152.35 general, upon the request of the commissioner, may institute 152.36 civil action to recover the amount due. 153.1 (b) Notwithstanding the provisions of paragraph (a), if the 153.2 disallowance results from knowing noncompliance by one or more 153.3 counties with a specific program instruction, and that knowing 153.4 noncompliance is a matter of official county board record, the 153.5 commissioner may require payment or recover from the county or 153.6 counties, in the manner prescribed in paragraph (a), an amount 153.7 equal to the portion of the total disallowance which resulted 153.8 from the noncompliance, and may distribute the balance of the 153.9 disallowance according to paragraph (a). 153.10 (15) Develop and implement special projects that maximize 153.11 reimbursements and result in the recovery of money to the 153.12 state. For the purpose of recovering state money, the 153.13 commissioner may enter into contracts with third parties. Any 153.14 recoveries that result from projects or contracts entered into 153.15 under this paragraph shall be deposited in the state treasury 153.16 and credited to a special account until the balance in the 153.17 account reaches $1,000,000. When the balance in the account 153.18 exceeds $1,000,000, the excess shall be transferred and credited 153.19 to the general fund. All money in the account is appropriated 153.20 to the commissioner for the purposes of this paragraph. 153.21 (16) Have the authority to make direct payments to 153.22 facilities providing shelter to women and their children 153.23 according to section 256D.05, subdivision 3. Upon the written 153.24 request of a shelter facility that has been denied payments 153.25 under section 256D.05, subdivision 3, the commissioner shall 153.26 review all relevant evidence and make a determination within 30 153.27 days of the request for review regarding issuance of direct 153.28 payments to the shelter facility. Failure to act within 30 days 153.29 shall be considered a determination not to issue direct payments. 153.30 (17) Have the authority to establish and enforce the 153.31 following county reporting requirements: 153.32 (a) The commissioner shall establish fiscal and statistical 153.33 reporting requirements necessary to account for the expenditure 153.34 of funds allocated to counties for human services programs. 153.35 When establishing financial and statistical reporting 153.36 requirements, the commissioner shall evaluate all reports, in 154.1 consultation with the counties, to determine if the reports can 154.2 be simplified or the number of reports can be reduced. 154.3 (b) The county board shall submit monthly or quarterly 154.4 reports to the department as required by the commissioner. 154.5 Monthly reports are due no later than 15 working days after the 154.6 end of the month. Quarterly reports are due no later than 30 154.7 calendar days after the end of the quarter, unless the 154.8 commissioner determines that the deadline must be shortened to 154.9 20 calendar days to avoid jeopardizing compliance with federal 154.10 deadlines or risking a loss of federal funding. Only reports 154.11 that are complete, legible, and in the required format shall be 154.12 accepted by the commissioner. 154.13 (c) If the required reports are not received by the 154.14 deadlines established in clause (b), the commissioner may delay 154.15 payments and withhold funds from the county board until the next 154.16 reporting period. When the report is needed to account for the 154.17 use of federal funds and the late report results in a reduction 154.18 in federal funding, the commissioner shall withhold from the 154.19 county boards with late reports an amount equal to the reduction 154.20 in federal funding until full federal funding is received. 154.21 (d) A county board that submits reports that are late, 154.22 illegible, incomplete, or not in the required format for two out 154.23 of three consecutive reporting periods is considered 154.24 noncompliant. When a county board is found to be noncompliant, 154.25 the commissioner shall notify the county board of the reason the 154.26 county board is considered noncompliant and request that the 154.27 county board develop a corrective action plan stating how the 154.28 county board plans to correct the problem. The corrective 154.29 action plan must be submitted to the commissioner within 45 days 154.30 after the date the county board received notice of noncompliance. 154.31 (e) The final deadline for fiscal reports or amendments to 154.32 fiscal reports is one year after the date the report was 154.33 originally due. If the commissioner does not receive a report 154.34 by the final deadline, the county board forfeits the funding 154.35 associated with the report for that reporting period and the 154.36 county board must repay any funds associated with the report 155.1 received for that reporting period. 155.2 (f) The commissioner may not delay payments, withhold 155.3 funds, or require repayment under paragraph (c) or (e) if the 155.4 county demonstrates that the commissioner failed to provide 155.5 appropriate forms, guidelines, and technical assistance to 155.6 enable the county to comply with the requirements. If the 155.7 county board disagrees with an action taken by the commissioner 155.8 under paragraph (c) or (e), the county board may appeal the 155.9 action according to sections 14.57 to 14.69. 155.10 (g) Counties subject to withholding of funds under 155.11 paragraph (c) or forfeiture or repayment of funds under 155.12 paragraph (e) shall not reduce or withhold benefits or services 155.13 to clients to cover costs incurred due to actions taken by the 155.14 commissioner under paragraph (c) or (e). 155.15 (18) Allocate federal fiscal disallowances or sanctions for 155.16 audit exceptions when federal fiscal disallowances or sanctions 155.17 are based on a statewide random sample for the foster care 155.18 program under title IV-E of the Social Security Act, United 155.19 States Code, title 42, in direct proportion to each county's 155.20 title IV-E foster care maintenance claim for that period. 155.21 (19) Be responsible for ensuring the detection, prevention, 155.22 investigation, and resolution of fraudulent activities or 155.23 behavior by applicants, recipients, and other participants in 155.24 the human services programs administered by the department. 155.25 (20) Require county agencies to identify overpayments, 155.26 establish claims, and utilize all available and cost-beneficial 155.27 methodologies to collect and recover these overpayments in the 155.28 human services programs administered by the department. 155.29 (21) Have the authority to administer a drug rebate program 155.30 for drugs purchased pursuant to the senior citizen drug program 155.31 established under section 256.955 after the beneficiary's 155.32 satisfaction of any deductible established in the program. The 155.33 commissioner shall require a rebate agreement from all 155.34 manufacturers of covered drugs as defined in section 256B.0625, 155.35 subdivision 13. For each drug, the amount of the rebate shall 155.36 be equal to the basic rebate as defined for purposes of the 156.1 federal rebate program in United States Code, title 42, section 156.2 1396r-8(c)(1). This basic rebate shall be applied to 156.3 single-source and multiple-source drugs. The manufacturers must 156.4 provide full payment within 30 days of receipt of the state 156.5 invoice for the rebate within the terms and conditions used for 156.6 the federal rebate program established pursuant to section 1927 156.7 of title XIX of the Social Security Act. The manufacturers must 156.8 provide the commissioner with any information necessary to 156.9 verify the rebate determined per drug. The rebate program shall 156.10 utilize the terms and conditions used for the federal rebate 156.11 program established pursuant to section 1927 of title XIX of the 156.12 Social Security Act. 156.13 (22) Incorporate cost reimbursement claims from First Call 156.14 Minnesota into the federal cost reimbursement claiming processes 156.15 of the department according to federal law, rule, and 156.16 regulations. Any reimbursement received is appropriated to the 156.17 commissioner and shall be disbursed to First Call Minnesota 156.18 according to normal department payment schedules. 156.19 Sec. 20. Minnesota Statutes 1998, section 256.015, 156.20 subdivision 1, is amended to read: 156.21 Subdivision 1. [STATE AGENCY HAS LIEN.] When the state 156.22 agency provides, pays for, or becomes liable for medical care or 156.23 furnishes subsistence or other payments to a person, the agency 156.24 shall have a lien for the cost of the care and payments on any 156.25 and all causes of action or recovery rights under any policy, 156.26 plan, or contract providing benefits for health care or injury 156.27 which accrue to the person to whom the care or payments were 156.28 furnished, or to the person's legal representatives, as a result 156.29 of the occurrence that necessitated the medical care, 156.30 subsistence, or other payments. For purposes of this section, 156.31 "state agency" includesauthorized agents of the state agency156.32 prepaid health plans under contract with the commissioner 156.33 according to sections 256B.69, 256D.03, subdivision 4, paragraph 156.34 (d), and 256L.12; children's mental health collaboratives under 156.35 section 245.493; demonstration projects for persons with 156.36 disabilities under section 256B.77; nursing homes under the 157.1 alternative payment demonstration project under section 157.2 256B.434; and county-based purchasing entities under section 157.3 256B.692. 157.4 Sec. 21. Minnesota Statutes 1998, section 256.015, 157.5 subdivision 3, is amended to read: 157.6 Subd. 3. [PROSECUTOR.] The attorney general, or the157.7appropriate county attorney acting at the direction of the157.8attorney general,shall represent thestate agencycommissioner 157.9 to enforce the lien created under this section or, if no action 157.10 has been brought, may initiate and prosecute an independent 157.11 action on behalf of thestate agencycommissioner against a 157.12 person, firm, or corporation that may be liable to the person to 157.13 whom the care or payment was furnished. 157.14 Any prepaid health plan providing services under sections 157.15 256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 157.16 children's mental health collaboratives under section 245.493; 157.17 demonstration projects for persons with disabilities under 157.18 section 256B.77; nursing homes under the alternative payment 157.19 demonstration project under section 256B.434; or the 157.20 county-based purchasing entity providing services under section 157.21 256B.692 may retain legal representation to enforce their lien 157.22 created under this section or, if no action has been brought, 157.23 may initiate and prosecute an independent action on their behalf 157.24 against a person, firm, or corporation that may be liable to the 157.25 person to whom the care or payment was furnished. 157.26 Sec. 22. [256.028] [TAX REBATES.] 157.27 Any federal or state tax rebate received by a recipient of 157.28 a public assistance program shall not be counted as income or as 157.29 an asset for purposes of any of the public assistance programs 157.30 under this chapter or any other chapter, including, but not 157.31 limited to, chapter 256B, 256D, 256E, 256I, 256J, or 256L to the 157.32 extent permitted under federal law. 157.33 Sec. 23. Minnesota Statutes 1998, section 256.955, 157.34 subdivision 3, is amended to read: 157.35 Subd. 3. [PRESCRIPTION DRUG COVERAGE.]Coverage under the157.36program is limited to prescription drugs covered under the158.1medical assistance program as described in section 256B.0625,158.2subdivision 13, subject to a maximum deductible of $300158.3annually, except drugs cleared by the FDA shall be available to158.4qualified senior citizens enrolled in the program without158.5restriction when prescribed for medically accepted indication as158.6defined in the federal rebate program under section 1927 of158.7title XIX of the federal Social Security Act.Coverage under 158.8 the program shall be limited to those prescription drugs that: 158.9 (1) are covered under the medical assistance program as 158.10 described in section 256B.0625, subdivision 13; and 158.11 (2) are provided by manufacturers that have fully executed 158.12 senior drug rebate agreements with the commissioner and comply 158.13 with such agreements. 158.14 Sec. 24. Minnesota Statutes 1998, section 256.955, 158.15 subdivision 4, is amended to read: 158.16 Subd. 4. [APPLICATION PROCEDURES AND COORDINATION WITH 158.17 MEDICAL ASSISTANCE.] Applications and information on the program 158.18 must be made available at county social service agencies, health 158.19 care provider offices, and agencies and organizations serving 158.20 senior citizens. Senior citizens shall submit applications and 158.21 any information specified by the commissioner as being necessary 158.22 to verify eligibility directly to the county social service 158.23 agencies: 158.24 (1) beginning January 1, 1999, the county social service 158.25 agency shall determine medical assistance spenddown eligibility 158.26 of individuals who qualify for the senior citizen drug program 158.27 of individuals; and 158.28 (2) program payments will be used to reduce the spenddown 158.29 obligations of individuals who are determined to be eligible for 158.30 medical assistance with a spenddown as defined in section 158.31 256B.056, subdivision 5. 158.32 Seniors who are eligible for medical assistance with a spenddown 158.33 shall be financially responsible for the deductible amount up to 158.34 the satisfaction of the spenddown. No deductible applies once 158.35 the spenddown has been met. Payments to providers for 158.36 prescription drugs for persons eligible under this subdivision 159.1 shall be reduced by the deductible. 159.2 County social service agencies shall determine an 159.3 applicant's eligibility for the program within 30 days from the 159.4 date the application is received. Eligibility begins the month 159.5 after approval. 159.6 Sec. 25. Minnesota Statutes 1998, section 256.955, 159.7 subdivision 7, is amended to read: 159.8 Subd. 7. [COST SHARING.](a) Enrollees shall pay an annual159.9premium of $120.159.10(b)Program enrollees must satisfy a$300$420 annual 159.11 deductible, based upon expenditures for prescription drugs, to 159.12 be paid as follows: 159.13 (1)$25$35 monthly deductible for persons with a monthly 159.14 spenddown; or 159.15 (2)$150$210 biannual deductible for persons with a 159.16 six-month spenddown. 159.17 (Effective date: Section 25 (256.955, subd. 7) is 159.18 effective the day following final enactment.) 159.19 Sec. 26. Minnesota Statutes 1998, section 256.955, 159.20 subdivision 8, is amended to read: 159.21 Subd. 8. [REPORT.] The commissioner shall annually report 159.22 to the legislature on the senior citizen drug program. The 159.23 report must include demographic information on enrollees, 159.24 per-prescription expenditures, total program expenditures, 159.25 hospital and nursing home costs avoided by enrollees, any 159.26 savings to medical assistance and Medicare resulting from the 159.27 provision of prescription drug coverage under Medicare by health 159.28 maintenance organizations, other public and private options for 159.29 drug assistance to the senior population, any hardships caused 159.30 by the annualpremium anddeductible, and any recommendations 159.31 for changes in the senior drug program. 159.32 Sec. 27. Minnesota Statutes 1998, section 256.955, 159.33 subdivision 9, is amended to read: 159.34 Subd. 9. [PROGRAM LIMITATION.] The commissioner shall 159.35 administer the senior drug program so that the costs total no 159.36 more than funds appropriated plus the drug rebate proceeds. 160.1 Senior drug program rebate revenues are appropriated to the 160.2 commissioner and shall be expended to augment funding of the 160.3 senior drug program. New enrollment shall cease if the 160.4 commissioner determines that, given current enrollment, costs of 160.5 the program will exceed appropriated funds and rebate proceeds. 160.6 This section shall be repealed upon federal approval of the 160.7 waiver to allow the commissioner to provide prescription drug 160.8 coverage for qualified Medicare beneficiaries whose income is 160.9 less than 150 percent of the federal poverty guidelines. 160.10 Sec. 28. Minnesota Statutes 1998, section 256.9685, 160.11 subdivision 1a, is amended to read: 160.12 Subd. 1a. [ADMINISTRATIVE RECONSIDERATION.] 160.13 Notwithstanding sections 256B.04, subdivision 15, and 256D.03, 160.14 subdivision 7, the commissioner shall establish an 160.15 administrative reconsideration process for appeals of inpatient 160.16 hospital services determined to be medically unnecessary. A 160.17 physician or hospital may request a reconsideration of the 160.18 decision that inpatient hospital services are not medically 160.19 necessary by submitting a written request for review to the 160.20 commissioner within 30 days after receiving notice of the 160.21 decision. The reconsideration process shall take place prior to 160.22 the procedures of subdivision 1b and shall be conducted by 160.23 physicians that are independent of the case under 160.24 reconsideration. A majority decision by the physicians is 160.25 necessary to make a determination that the services were not 160.26 medically necessary. 160.27 Sec. 29. Minnesota Statutes 1998, section 256.969, 160.28 subdivision 1, is amended to read: 160.29 Subdivision 1. [HOSPITAL COST INDEX.] (a) The hospital 160.30 cost index shall be the change in the Consumer Price Index-All 160.31 Items (United States city average) (CPI-U) forecasted by Data 160.32 Resources, Inc. The commissioner shall use the indices as 160.33 forecasted in the third quarter of the calendar year prior to 160.34 the rate year. The hospital cost index may be used to adjust 160.35 the base year operating payment rate through the rate year on an 160.36 annually compounded basis. 161.1 (b) For fiscal years beginning on or after July 1, 1993, 161.2 the commissioner of human services shall not provide automatic 161.3 annual inflation adjustments for hospital payment rates under 161.4 medical assistance, nor under general assistance medical care, 161.5 except that the inflation adjustments under paragraph (a) for 161.6 medical assistance, excluding general assistance medical care, 161.7 shall apply through calendar year19992001. The index for 161.8 calendar year 2000 shall be reduced 2.5 percentage points to 161.9 recover overprojections of the index from 1994 to 1996. The 161.10 commissioner of finance shall include as a budget change request 161.11 in each biennial detailed expenditure budget submitted to the 161.12 legislature under section 16A.11 annual adjustments in hospital 161.13 payment rates under medical assistance and general assistance 161.14 medical care, based upon the hospital cost index. 161.15 Sec. 30. Minnesota Statutes 1998, section 256B.04, 161.16 subdivision 16, is amended to read: 161.17 Subd. 16. [PERSONAL CARE SERVICES.] (a) Notwithstanding 161.18 any contrary language in this paragraph, the commissioner of 161.19 human services and the commissioner of health shall jointly 161.20 promulgate rules to be applied to the licensure of personal care 161.21 services provided under the medical assistance program. The 161.22 rules shall consider standards for personal care services that 161.23 are based on the World Institute on Disability's recommendations 161.24 regarding personal care services. These rules shall at a 161.25 minimum consider the standards and requirements adopted by the 161.26 commissioner of health under section 144A.45, which the 161.27 commissioner of human services determines are applicable to the 161.28 provision of personal care services, in addition to other 161.29 standards or modifications which the commissioner of human 161.30 services determines are appropriate. 161.31 The commissioner of human services shall establish an 161.32 advisory group including personal care consumers and providers 161.33 to provide advice regarding which standards or modifications 161.34 should be adopted. The advisory group membership must include 161.35 not less than 15 members, of which at least 60 percent must be 161.36 consumers of personal care services and representatives of 162.1 recipients with various disabilities and diagnoses and ages. At 162.2 least 51 percent of the members of the advisory group must be 162.3 recipients of personal care. 162.4 The commissioner of human services may contract with the 162.5 commissioner of health to enforce the jointly promulgated 162.6 licensure rules for personal care service providers. 162.7 Prior to final promulgation of the joint rule the 162.8 commissioner of human services shall report preliminary findings 162.9 along with any comments of the advisory group and a plan for 162.10 monitoring and enforcement by the department of health to the 162.11 legislature by February 15, 1992. 162.12 Limits on the extent of personal care services that may be 162.13 provided to an individual must be based on the 162.14 cost-effectiveness of the services in relation to the costs of 162.15 inpatient hospital care, nursing home care, and other available 162.16 types of care. The rules must provide, at a minimum: 162.17 (1) that agencies be selected to contract with or employ 162.18 and train staff to provide and supervise the provision of 162.19 personal care services; 162.20 (2) that agencies employ or contract with a qualified 162.21 applicant that a qualified recipient proposes to the agency as 162.22 the recipient's choice of assistant; 162.23 (3) that agencies bill the medical assistance program for a 162.24 personal care service by a personal care assistant and 162.25 supervision bythe registered nursea qualified professional 162.26 supervising the personal care assistant unless the recipient 162.27 selects the fiscal agent option under section 256B.0627, 162.28 subdivision 10; 162.29 (4) that agencies establish a grievance mechanism; and 162.30 (5) that agencies have a quality assurance program. 162.31 (b) The commissioner may waive the requirement for the 162.32 provision of personal care services through an agency in a 162.33 particular county, when there are less than two agencies 162.34 providing services in that county and shall waive the 162.35 requirement for personal care assistants required to join an 162.36 agency for the first time during 1993 when personal care 163.1 services are provided under a relative hardship waiver under 163.2 section 256B.0627, subdivision 4, paragraph (b), clause (7), and 163.3 at least two agencies providing personal care services have 163.4 refused to employ or contract with the independent personal care 163.5 assistant. 163.6 Sec. 31. Minnesota Statutes 1998, section 256B.04, is 163.7 amended by adding a subdivision to read: 163.8 Subd. 19. [PERFORMANCE DATA REPORTING UNIT.] The 163.9 commissioner of human services shall establish a performance 163.10 data reporting unit that serves counties and the state. The 163.11 department shall support this unit and provide technical 163.12 assistance and access to the data warehouse. The performance 163.13 data reporting unit, which will operate within the department's 163.14 central office and consist of both county and department staff, 163.15 shall provide performance data reports to individual counties, 163.16 share expertise from counties and the department perspective, 163.17 and participate in joint planning to link with county databases 163.18 and other county data sources in order to provide information on 163.19 services provided to public clients from state, federal, and 163.20 county funding sources. The performance data reporting unit 163.21 shall provide counties both individual and group summary level 163.22 standard or unique reports on health care eligibility and 163.23 services provided to clients for whom they have financial 163.24 responsibility. 163.25 Sec. 32. Minnesota Statutes 1998, section 256B.042, 163.26 subdivision 1, is amended to read: 163.27 Subdivision 1. [LIEN FOR COST OF CARE.] When the state 163.28 agency provides, pays for, or becomes liable for medical care, 163.29 it shall have a lien for the cost of the care upon any and all 163.30 causes of action or recovery rights under any policy, plan, or 163.31 contract providing benefits for health care or injury, which 163.32 accrue to the person to whom the care was furnished, or to the 163.33 person's legal representatives, as a result of the illness or 163.34 injuries which necessitated the medical care. For purposes of 163.35 this section, "state agency" includes prepaid health plans under 163.36 contract with the commissioner according to sections 256B.69, 164.1 256D.03, subdivision 4, paragraph (d), and 256L.12; children's 164.2 mental health collaboratives under section 245.493; 164.3 demonstration projects for persons with disabilities under 164.4 section 256B.77; nursing facilities under the alternative 164.5 payment demonstration project under section 256B.434; and 164.6 county-based purchasing entities under section 256B.692. 164.7 Sec. 33. Minnesota Statutes 1998, section 256B.042, 164.8 subdivision 2, is amended to read: 164.9 Subd. 2. [LIEN ENFORCEMENT.] (a) The state agency may 164.10 perfect and enforce its lien by following the procedures set 164.11 forth in sections 514.69, 514.70 and 514.71, and its verified 164.12 lien statement shall be filed with the appropriate court 164.13 administrator in the county of financial responsibility. The 164.14 verified lien statement shall contain the following: the name 164.15 and address of the person to whom medical care was furnished, 164.16 the date of injury, the name and address of the vendor or 164.17 vendors furnishing medical care, the dates of the service, the 164.18 amount claimed to be due for the care, and, to the best of the 164.19 state agency's knowledge, the names and addresses of all 164.20 persons, firms, or corporations claimed to be liable for damages 164.21 arising from the injuries. This section shall not affect the 164.22 priority of any attorney's lien. 164.23 (b) The state agency is not subject to any limitations 164.24 period referred to in section 514.69 or 514.71 and has one year 164.25 from the date notice is first received by it under subdivision 164.26 4, paragraph (c), even if the notice is untimely, or one year 164.27 from the date medical bills are first paid by the state agency, 164.28 whichever is later, to file its verified lien statement. The 164.29 state agency may commence an action to enforce the lien within 164.30 one year of (1) the date the notice required by subdivision 4, 164.31 paragraph (c), is received or (2) the date the recipient's cause 164.32 of action is concluded by judgment, award, settlement, or 164.33 otherwise, whichever is later.For purposes of this section,164.34"state agency" includes authorized agents of the state agency.164.35 (c) If the notice required in subdivision 4 is not provided 164.36 by any of the parties to the claim at any stage of the claim, 165.1 the state agency will have one year from the date the state 165.2 agency learns of the lack of notice to commence an action. If 165.3 amounts on the claim or cause of action are paid and the amount 165.4 required to be paid to the state agency under subdivision 5, is 165.5 not paid to the state agency, the state agency may commence an 165.6 action to recover on the lien against any or all of the parties 165.7 or entities which have either paid or received the payments. 165.8 Sec. 34. Minnesota Statutes 1998, section 256B.042, 165.9 subdivision 3, is amended to read: 165.10 Subd. 3. The attorney general, or the appropriate county165.11attorney acting at the direction of the attorney general,shall 165.12 represent thestate agencycommissioner to enforce the lien 165.13 created under this section or, if no action has been brought, 165.14 may initiate and prosecute an independent action on behalf of 165.15 thestate agencycommissioner against a person, firm, or 165.16 corporation that may be liable to the person to whom the care 165.17 was furnished. 165.18 Any prepaid health plan providing services under sections 165.19 256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 165.20 children's mental health collaboratives under section 245.493; 165.21 demonstration projects for persons with disabilities under 165.22 section 256B.77; nursing homes under the alternative payment 165.23 demonstration project under section 256B.434; or the 165.24 county-based purchasing entity providing services under section 165.25 256B.692 may retain legal representation to enforce their lien 165.26 created under this section or, if no action has been brought, 165.27 may initiate and prosecute an independent action on their behalf 165.28 against a person, firm, or corporation that may be liable to the 165.29 person to whom the care or payment was furnished. 165.30 Sec. 35. Minnesota Statutes 1998, section 256B.055, 165.31 subdivision 3a, is amended to read: 165.32 Subd. 3a. [MFIP-S FAMILIES; FAMILIES ELIGIBLE UNDER PRIOR 165.33 AFDC RULES.] (a) Beginning January 1, 1998, or on the date that 165.34 MFIP-S is implemented in counties, medical assistance may be 165.35 paid for a person receiving public assistance under the MFIP-S 165.36 program. 166.1 (b) Beginning January 1, 1998, medical assistance may be 166.2 paid for a person who would have been eligible for public 166.3 assistance under the income and resource standardsand166.4deprivation requirements, or who would have been eligible but 166.5 for excess income or assets, under the state's AFDC plan in 166.6 effect as of July 16, 1996, as required by the Personal 166.7 Responsibility and Work Opportunity Reconciliation Act of 1996 166.8 (PRWORA), Public Law Number 104-193. 166.9 Sec. 36. Minnesota Statutes 1998, section 256B.056, 166.10 subdivision 4, is amended to read: 166.11 Subd. 4. [INCOME.] To be eligible for medical assistance, 166.12 a person eligible under section 256B.055, subdivision 7, not 166.13 receiving supplemental security income program payments, and 166.14 families and children may have an income up to 133-1/3 percent 166.15 of the AFDC income standard in effect under the July 16, 1996, 166.16 AFDC state plan.For rate years beginning on or after July 1,166.171999, the commissioner shall consider increasingEffective July 166.18 1, 2000, the base AFDC standard in effect on July 16, 1996,by166.19an amount equal to the percent change in the Consumer Price166.20Index for all urban consumers for the previous October compared166.21to one year earliershall be increased by two percent. 166.22 Effective January 1, 2000, and each successive January, 166.23 recipients of supplemental security income may have an income up 166.24 to the supplemental security income standard in effect on that 166.25 date. In computing income to determine eligibility of persons 166.26 who are not residents of long-term care facilities, the 166.27 commissioner shall disregard increases in income as required by 166.28 Public Law Numbers 94-566, section 503; 99-272; and 99-509. 166.29 Veterans aid and attendance benefits and Veterans Administration 166.30 unusual medical expense payments are considered income to the 166.31 recipient. 166.32 Sec. 37. Minnesota Statutes 1998, section 256B.057, 166.33 subdivision 3, is amended to read: 166.34 Subd. 3. [QUALIFIED MEDICARE BENEFICIARIES.] A person who 166.35 is entitled to Part A Medicare benefits, whose income is equal 166.36 to or less than85100 percent of the federal poverty 167.1 guidelines, and whose assets are no more than twice the asset 167.2 limit used to determine eligibility for the supplemental 167.3 security income program, is eligible for medical assistance 167.4 reimbursement of Part A and Part B premiums, Part A and Part B 167.5 coinsurance and deductibles, and cost-effective premiums for 167.6 enrollment with a health maintenance organization or a 167.7 competitive medical plan under section 1876 of the Social 167.8 Security Act.The income limit shall be increased to 90 percent167.9of the federal poverty guidelines on January 1, 1990; and to 100167.10percent on January 1, 1991.Reimbursement of the Medicare 167.11 coinsurance and deductibles, when added to the amount paid by 167.12 Medicare, must not exceed the total rate the provider would have 167.13 received for the same service or services if the person were a 167.14 medical assistance recipient with Medicare coverage. Increases 167.15 in benefits under Title II of the Social Security Act shall not 167.16 be counted as income for purposes of this subdivision until the 167.17 first day of the second full month following publication of the 167.18 change in the federal poverty guidelines. 167.19 Sec. 38. Minnesota Statutes 1998, section 256B.057, is 167.20 amended by adding a subdivision to read: 167.21 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 167.22 assistance may be paid for a person who is employed and who: 167.23 (1) meets the definition of disabled under the supplemental 167.24 security income program; 167.25 (2) meets the asset limits in paragraph (b); and 167.26 (3) pays a premium, if required, under paragraph (c). 167.27 Any spousal income or assets shall be disregarded for purposes 167.28 of eligibility and premium determinations. 167.29 (b) For purposes of determining eligibility under this 167.30 subdivision, a person's assets must not exceed $20,000, 167.31 excluding: 167.32 (1) all assets excluded under section 256B.06; 167.33 (2) retirement accounts, including individual accounts, 167.34 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 167.35 (3) medical expense accounts set up through the person's 167.36 employer. 168.1 (c) A person whose earned and unearned income is equal to 168.2 or greater than 200 percent of federal poverty guidelines for 168.3 the applicable family size must pay a premium to be eligible for 168.4 medical assistance. The premium shall be equal to ten percent 168.5 of the person's gross earned and unearned income above 200 168.6 percent of federal poverty guidelines for the applicable family 168.7 size up to the cost of coverage. 168.8 (d) A person's eligibility and premium shall be determined 168.9 by the local county agency. Premiums must be paid to the 168.10 commissioner. All premiums are dedicated to the commissioner. 168.11 (e) Any required premium shall be determined at application 168.12 and redetermined annually at recertification or when a change in 168.13 income occurs. 168.14 (f) The first premium payment is due upon notification from 168.15 the commissioner of the premium amount required. Premiums may 168.16 be paid in installments at the discretion of the commissioner. 168.17 (g) Nonpayment of the premium shall result in denial or 168.18 termination of medical assistance unless the person demonstrates 168.19 good cause for nonpayment. Good cause exists if the 168.20 requirements specified in Minnesota Rules, part 9506.0040, 168.21 subpart 7, items B to D, are met. Nonpayment shall include 168.22 payment with a returned, refused, or dishonored instrument. The 168.23 commissioner may require a guaranteed form of payment as the 168.24 only means to replace a returned, refused, or dishonored 168.25 instrument. 168.26 Sec. 39. Minnesota Statutes 1998, section 256B.0575, is 168.27 amended to read: 168.28 256B.0575 [AVAILABILITY OF INCOME FOR INSTITUTIONALIZED 168.29 PERSONS.] 168.30 When an institutionalized person is determined eligible for 168.31 medical assistance, the income that exceeds the deductions in 168.32 paragraphs (a) and (b) must be applied to the cost of 168.33 institutional care. 168.34 (a) The following amounts must be deducted from the 168.35 institutionalized person's income in the following order: 168.36 (1) the personal needs allowance under section 256B.35 or, 169.1 for a veteran who does not have a spouse or child, or a 169.2 surviving spouse of a veteran having no child, the amount of an 169.3 improved pension received from the veteran's administration not 169.4 exceeding $90 per month; 169.5 (2) the personal allowance for disabled individuals under 169.6 section 256B.36; 169.7 (3) if the institutionalized person has a legally appointed 169.8 guardian or conservator, five percent of the recipient's gross 169.9 monthly income up to $100 as reimbursement for guardianship or 169.10 conservatorship services; 169.11 (4) a monthly income allowance determined under section 169.12 256B.058, subdivision 2, but only to the extent income of the 169.13 institutionalized spouse is made available to the community 169.14 spouse; 169.15 (5) a monthly allowance for children under age 18 which, 169.16 together with the net income of the children, would provide 169.17 income equal to the medical assistance standard for families and 169.18 children according to section 256B.056, subdivision 4, for a 169.19 family size that includes only the minor children. This 169.20 deduction applies only if the children do not live with the 169.21 community spouse and only to the extent that the deduction is 169.22 not included in the personal needs allowance under section 169.23 256B.35, subdivision 1, as child support garnished under a court 169.24 order; 169.25 (6) a monthly family allowance for other family members, 169.26 equal to one-third of the difference between 122 percent of the 169.27 federal poverty guidelines and the monthly income for that 169.28 family member; 169.29 (7) reparations payments made by the Federal Republic of 169.30 Germany and reparations payments made by the Netherlands for 169.31 victims of Nazi persecution between 1940 and 1945;and169.32 (8) all other exclusions from income for institutionalized 169.33 persons as mandated by federal law; and 169.34 (9) amounts for reasonable expenses incurred for necessary 169.35 medical or remedial care for the institutionalized spouse that 169.36 are not medical assistance covered expenses and that are not 170.1 subject to payment by a third party. 170.2 For purposes of clause (6), "other family member" means a 170.3 person who resides with the community spouse and who is a minor 170.4 or dependent child, dependent parent, or dependent sibling of 170.5 either spouse. "Dependent" means a person who could be claimed 170.6 as a dependent for federal income tax purposes under the 170.7 Internal Revenue Code. 170.8 (b) Income shall be allocated to an institutionalized 170.9 person for a period of up to three calendar months, in an amount 170.10 equal to the medical assistance standard for a family size of 170.11 one if: 170.12 (1) a physician certifies that the person is expected to 170.13 reside in the long-term care facility for three calendar months 170.14 or less; 170.15 (2) if the person has expenses of maintaining a residence 170.16 in the community; and 170.17 (3) if one of the following circumstances apply: 170.18 (i) the person was not living together with a spouse or a 170.19 family member as defined in paragraph (a) when the person 170.20 entered a long-term care facility; or 170.21 (ii) the person and the person's spouse become 170.22 institutionalized on the same date, in which case the allocation 170.23 shall be applied to the income of one of the spouses. 170.24 For purposes of this paragraph, a person is determined to be 170.25 residing in a licensed nursing home, regional treatment center, 170.26 or medical institution if the person is expected to remain for a 170.27 period of one full calendar month or more. 170.28 Sec. 40. Minnesota Statutes 1998, section 256B.061, is 170.29 amended to read: 170.30 256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 170.31 (a) If any individual has been determined to be eligible 170.32 for medical assistance, it will be made available for care and 170.33 services included under the plan and furnished in or after the 170.34 third month before the month in which the individual made 170.35 application for such assistance, if such individual was, or upon 170.36 application would have been, eligible for medical assistance at 171.1 the time the care and services were furnished. The commissioner 171.2 may limit, restrict, or suspend the eligibility of an individual 171.3 for up to one year upon that individual's conviction of a 171.4 criminal offense related to application for or receipt of 171.5 medical assistance benefits. 171.6 (b) On the basis of information provided on the completed 171.7 application, an applicant who meets the following criteria shall 171.8 be determined eligible beginning in the month of application: 171.9 (1) whose gross income is less than 90 percent of the 171.10 applicable income standard; 171.11 (2) whose total liquid assets are less than 90 percent of 171.12 the asset limit; 171.13 (3) does not reside in a long-term care facility; and 171.14 (4) meets all other eligibility requirements. 171.15 The applicant must provide all required verifications within 30 171.16 days' notice of the eligibility determination or eligibility 171.17 shall be terminated. 171.18 Sec. 41. Minnesota Statutes 1998, section 256B.0625, is 171.19 amended by adding a subdivision to read: 171.20 Subd. 3b. [TELEMEDICINE.] Medical assistance covers 171.21 telemedicine consultations. Telemedicine consultations must be 171.22 via two-way, interactive video or store and forward technology. 171.23 Store and forward technology includes telemedicine consultations 171.24 that do not occur in real time via synchronous transmissions, 171.25 and that do not require a face-to-face encounter with the 171.26 patient for all or any part of the telemedicine consultation. 171.27 The patient record must include a written opinion from the 171.28 consulting physician providing the telemedicine consultation. A 171.29 communication between two physicians that consists solely of a 171.30 telephone conversation is not a telemedicine consultation. 171.31 Coverage is limited to three telemedicine consultations per 171.32 recipient per calendar week. Telemedicine consultations shall 171.33 be paid at the full allowable rate. 171.34 (Effective date: Section 41 (256B.0625, subd. 3b) is 171.35 effective for services rendered on or after July 1, 1999.) 171.36 Sec. 42. Minnesota Statutes 1998, section 256B.0625, is 172.1 amended by adding a subdivision to read: 172.2 Subd. 3c. [CONSULTATION SERVICES BY PHYSICIANS 172.3 SPECIALIZING IN THE TREATMENT OF CHILD ABUSE AND 172.4 NEGLECT.] Medical assistance covers consultation services by 172.5 physicians specializing in the treatment of child abuse and 172.6 neglect. Alternative media formats may be used when the patient 172.7 is a child being examined for potential abuse or neglect, the 172.8 consulting physician is a specialist in the treatment of child 172.9 abuse and neglect, and the use of two-way, interactive video or 172.10 the occurrence of a second exam would be medically 172.11 contraindicated for the child. 172.12 Sec. 43. Minnesota Statutes 1998, section 256B.0625, 172.13 subdivision 6a, is amended to read: 172.14 Subd. 6a. [HOME HEALTH SERVICES.] Home health services are 172.15 those services specified in Minnesota Rules, part 9505.0290. 172.16 Medical assistance covers home health services at a recipient's 172.17 home residence. Medical assistance does not cover home health 172.18 services for residents of a hospital, nursing facility, or 172.19 intermediate care facility,or a health care facility licensed172.20by the commissioner of health, unless the program is funded172.21under a home and community-based services waiver orunless the 172.22 commissioner of human services has prior authorized skilled 172.23 nurse visits for less than 90 days for a resident at an 172.24 intermediate care facility for persons with mental retardation, 172.25 to prevent an admission to a hospital or nursing facility or 172.26 unless a resident who is otherwise eligible is on leave from the 172.27 facility and the facility either pays for the home health 172.28 services or forgoes the facility per diem for the leave days 172.29 that home health services are used. Home health services must 172.30 be provided by a Medicare certified home health agency. All 172.31 nursing and home health aide services must be provided according 172.32 to section 256B.0627. 172.33 Sec. 44. Minnesota Statutes 1998, section 256B.0625, 172.34 subdivision 8, is amended to read: 172.35 Subd. 8. [PHYSICAL THERAPY.] Medical assistance covers 172.36 physical therapy and related services, including specialized 173.1 maintenance therapy. Services provided by a physical therapy 173.2 assistant shall be reimbursed at the same rate as services 173.3 performed by a physical therapist when the services of the 173.4 physical therapy assistant are provided under the direction of a 173.5 physical therapist who is on the premises. Services provided by 173.6 a physical therapy assistant that are provided under the 173.7 direction of a physical therapist who is not on the premises 173.8 shall be reimbursed at 65 percent of the physical therapist rate. 173.9 Sec. 45. Minnesota Statutes 1998, section 256B.0625, 173.10 subdivision 8a, is amended to read: 173.11 Subd. 8a. [OCCUPATIONAL THERAPY.] Medical assistance 173.12 covers occupational therapy and related services, including 173.13 specialized maintenance therapy. Services provided by an 173.14 occupational therapy assistant shall be reimbursed at the same 173.15 rate as services performed by an occupational therapist when the 173.16 services of the occupational therapy assistant are provided 173.17 under the direction of the occupational therapist who is on the 173.18 premises. Services provided by an occupational therapy 173.19 assistant that are provided under the direction of an 173.20 occupational therapist who is not on the premises shall be 173.21 reimbursed at 65 percent of the occupational therapist rate. 173.22 Sec. 46. Minnesota Statutes 1998, section 256B.0625, is 173.23 amended by adding a subdivision to read: 173.24 Subd. 8b. [SPEECH LANGUAGE PATHOLOGY SERVICES.] Medical 173.25 assistance covers speech language pathology and related 173.26 services, including specialized maintenance therapy. 173.27 Sec. 47. Minnesota Statutes 1998, section 256B.0625, is 173.28 amended by adding a subdivision to read: 173.29 Subd. 8c. [CARE MANAGEMENT; REHABILITATION SERVICES.] (a) 173.30 Effective July 1, 1999, one-time thresholds shall replace annual 173.31 thresholds for provision of rehabilitation services described in 173.32 subdivisions 8, 8a, and 8b. The one-time thresholds will be the 173.33 same in amount and description as the thresholds prescribed by 173.34 the department of human services health care programs provider 173.35 manual for calendar year 1997, except they will not be renewed 173.36 annually, and they will include sensory skills and cognitive 174.1 training skills. 174.2 (b) A care management approach for authorization of 174.3 services beyond the threshold shall be instituted in conjunction 174.4 with the one-time thresholds. The care management approach 174.5 shall require the provider and the department rehabilitation 174.6 reviewer to work together directly through written 174.7 communication, or telephone communication when appropriate, to 174.8 establish a medically necessary care management plan. 174.9 (c) The commissioner shall implement an expedited five-day 174.10 turnaround time to review authorization requests for recipients 174.11 who need emergency rehabilitation services and who have 174.12 exhausted their one-time threshold limit for those services. 174.13 Sec. 48. Minnesota Statutes 1998, section 256B.0625, is 174.14 amended by adding a subdivision to read: 174.15 Subd. 9a. [DENTAL HYGIENIST SERVICES.] Medical assistance 174.16 covers preventive dental services provided by dental hygienists 174.17 if the services are otherwise covered under this chapter as 174.18 dental services, and if the services are within the scope of 174.19 practice of a licensed dental hygienist, as defined in section 174.20 150A.05. 174.21 Sec. 49. Minnesota Statutes 1998, section 256B.0625, 174.22 subdivision 13, is amended to read: 174.23 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 174.24 except for fertility drugs when specifically used to enhance 174.25 fertility, if prescribed by a licensed practitioner and 174.26 dispensed by a licensed pharmacist, by a physician enrolled in 174.27 the medical assistance program as a dispensing physician, or by 174.28 a physician or a nurse practitioner employed by or under 174.29 contract with a community health board as defined in section 174.30 145A.02, subdivision 5, for the purposes of communicable disease 174.31 control. The commissioner, after receiving recommendations from 174.32 professional medical associations and professional pharmacist 174.33 associations, shall designate a formulary committee to advise 174.34 the commissioner on the names of drugs for which payment is 174.35 made, recommend a system for reimbursing providers on a set fee 174.36 or charge basis rather than the present system, and develop 175.1 methods encouraging use of generic drugs when they are less 175.2 expensive and equally effective as trademark drugs. The 175.3 formulary committee shall consist of nine members, four of whom 175.4 shall be physicians who are not employed by the department of 175.5 human services, and a majority of whose practice is for persons 175.6 paying privately or through health insurance, three of whom 175.7 shall be pharmacists who are not employed by the department of 175.8 human services, and a majority of whose practice is for persons 175.9 paying privately or through health insurance, a consumer 175.10 representative, and a nursing home representative. Committee 175.11 members shall serve three-year terms and shall serve without 175.12 compensation. Members may be reappointed once. 175.13 (b) The commissioner shall establish a drug formulary. Its 175.14 establishment and publication shall not be subject to the 175.15 requirements of the Administrative Procedure Act, but the 175.16 formulary committee shall review and comment on the formulary 175.17 contents. The formulary committee shall review and recommend 175.18 drugs which require prior authorization. The formulary 175.19 committee may recommend drugs for prior authorization directly 175.20 to the commissioner, as long as opportunity for public input is 175.21 provided. Prior authorization may be requested by the 175.22 commissioner based on medical and clinical criteria before 175.23 certain drugs are eligible for payment. Before a drug may be 175.24 considered for prior authorization at the request of the 175.25 commissioner: 175.26 (1) the drug formulary committee must develop criteria to 175.27 be used for identifying drugs; the development of these criteria 175.28 is not subject to the requirements of chapter 14, but the 175.29 formulary committee shall provide opportunity for public input 175.30 in developing criteria; 175.31 (2) the drug formulary committee must hold a public forum 175.32 and receive public comment for an additional 15 days; and 175.33 (3) the commissioner must provide information to the 175.34 formulary committee on the impact that placing the drug on prior 175.35 authorization will have on the quality of patient care and 175.36 information regarding whether the drug is subject to clinical 176.1 abuse or misuse. Prior authorization may be required by the 176.2 commissioner before certain formulary drugs are eligible for 176.3 payment. The formulary shall not include: 176.4 (i) drugs or products for which there is no federal 176.5 funding; 176.6 (ii) over-the-counter drugs, except for antacids, 176.7 acetaminophen, family planning products, aspirin, insulin, 176.8 products for the treatment of lice, vitamins for adults with 176.9 documented vitamin deficiencies, vitamins for children under the 176.10 age of seven and pregnant or nursing women, and any other 176.11 over-the-counter drug identified by the commissioner, in 176.12 consultation with the drug formulary committee, as necessary, 176.13 appropriate, and cost-effective for the treatment of certain 176.14 specified chronic diseases, conditions or disorders, and this 176.15 determination shall not be subject to the requirements of 176.16 chapter 14; 176.17 (iii) anorectics, except that medically necessary 176.18 anorectics shall be covered for a recipient previously diagnosed 176.19 as having pickwickian syndrome and currently diagnosed as having 176.20 diabetes and being morbidly obese; 176.21 (iv) drugs for which medical value has not been 176.22 established; and 176.23 (v) drugs from manufacturers who have not signed a rebate 176.24 agreement with the Department of Health and Human Services 176.25 pursuant to section 1927 of title XIX of the Social Security Act 176.26and who have not signed an agreement with the state for drugs176.27purchased pursuant to the senior citizen drug program176.28established under section 256.955. 176.29 The commissioner shall publish conditions for prohibiting 176.30 payment for specific drugs after considering the formulary 176.31 committee's recommendations. 176.32 (c) The basis for determining the amount of payment shall 176.33 be the lower of the actual acquisition costs of the drugs plus a 176.34 fixed dispensing fee; the maximum allowable cost set by the 176.35 federal government or by the commissioner plus the fixed 176.36 dispensing fee; or the usual and customary price charged to the 177.1 public. The pharmacy dispensing fee shall be $3.65. Actual 177.2 acquisition cost includes quantity and other special discounts 177.3 except time and cash discounts. The actual acquisition cost of 177.4 a drug shall be estimated by the commissioner, at average 177.5 wholesale price minus nine percent. The maximum allowable cost 177.6 of a multisource drug may be set by the commissioner and it 177.7 shall be comparable to, but no higher than, the maximum amount 177.8 paid by other third-party payors in this state who have maximum 177.9 allowable cost programs. The commissioner shall set maximum 177.10 allowable costs for multisource drugs that are not on the 177.11 federal upper limit list as described in United States Code, 177.12 title 42, chapter 7, section 1396r-8(e), the Social Security 177.13 Act, and Code of Federal Regulations, title 42, part 447, 177.14 section 447.332. Establishment of the amount of payment for 177.15 drugs shall not be subject to the requirements of the 177.16 Administrative Procedure Act. An additional dispensing fee of 177.17 $.30 may be added to the dispensing fee paid to pharmacists for 177.18 legend drug prescriptions dispensed to residents of long-term 177.19 care facilities when a unit dose blister card system, approved 177.20 by the department, is used. Under this type of dispensing 177.21 system, the pharmacist must dispense a 30-day supply of drug. 177.22 The National Drug Code (NDC) from the drug container used to 177.23 fill the blister card must be identified on the claim to the 177.24 department. The unit dose blister card containing the drug must 177.25 meet the packaging standards set forth in Minnesota Rules, part 177.26 6800.2700, that govern the return of unused drugs to the 177.27 pharmacy for reuse. The pharmacy provider will be required to 177.28 credit the department for the actual acquisition cost of all 177.29 unused drugs that are eligible for reuse. Over-the-counter 177.30 medications must be dispensed in the manufacturer's unopened 177.31 package. The commissioner may permit the drug clozapine to be 177.32 dispensed in a quantity that is less than a 30-day supply. 177.33 Whenever a generically equivalent product is available, payment 177.34 shall be on the basis of the actual acquisition cost of the 177.35 generic drug, unless the prescriber specifically indicates 177.36 "dispense as written - brand necessary" on the prescription as 178.1 required by section 151.21, subdivision 2. 178.2 (d) For purposes of this subdivision, "multisource drugs" 178.3 means covered outpatient drugs, excluding innovator multisource 178.4 drugs for which there are two or more drug products, which: 178.5 (1) are related as therapeutically equivalent under the 178.6 Food and Drug Administration's most recent publication of 178.7 "Approved Drug Products with Therapeutic Equivalence 178.8 Evaluations"; 178.9 (2) are pharmaceutically equivalent and bioequivalent as 178.10 determined by the Food and Drug Administration; and 178.11 (3) are sold or marketed in Minnesota. 178.12 "Innovator multisource drug" means a multisource drug that was 178.13 originally marketed under an original new drug application 178.14 approved by the Food and Drug Administration. 178.15 Sec. 50. Minnesota Statutes 1998, section 256B.0625, 178.16 subdivision 19c, is amended to read: 178.17 Subd. 19c. [PERSONAL CARE.] Medical assistance covers 178.18 personal care services provided by an individual who is 178.19 qualified to provide the services according to subdivision 19a 178.20 and section 256B.0627, where the services are prescribed by a 178.21 physician in accordance with a plan of treatment and are 178.22 supervised bya registered nursethe recipient under the fiscal 178.23 agent option according to section 256B.0627, subdivision 10, or 178.24 a qualified professional. "Qualified professional" means a 178.25 mental health professional as defined in section 245.462, 178.26 subdivision 18, or 245.4871, subdivision 26; or a registered 178.27 nurse as defined in sections 148.171 to 148.285. As part of the 178.28 assessment, the county public health nurse will consult with the 178.29 recipient or responsible party and identify the most appropriate 178.30 person to provide supervision of the personal care assistant. 178.31 The qualified professional shall perform the duties described in 178.32 Minnesota Rules, part 9505.0335, subpart 4. 178.33 Sec. 51. Minnesota Statutes 1998, section 256B.0625, 178.34 subdivision 26, is amended to read: 178.35 Subd. 26. [SPECIAL EDUCATION SERVICES.] (a) Medical 178.36 assistance covers medical services identified in a recipient's 179.1 individualized education plan and covered under the medical 179.2 assistance state plan. Covered services include occupational 179.3 therapy, physical therapy, speech-language therapy, clinical 179.4 psychological services, nursing services, school psychological 179.5 services, school social work services, personal care assistants 179.6 serving as management aides, assistive technology devices, 179.7 transportation services, and other services covered under the 179.8 medical assistance state plan. Mental health services eligible 179.9 for medical assistance reimbursement must be provided through a 179.10 children's mental health collaborative where a collaborative 179.11 exists. The services may be provided by a Minnesota school 179.12 district that is enrolled as a medical assistance provider or 179.13 its subcontractor, and only if the services meet all the 179.14 requirements otherwise applicable if the service had been 179.15 provided by a provider other than a school district, in the 179.16 following areas: medical necessity, physician's orders, 179.17 documentation, personnel qualifications, and prior authorization 179.18 requirements. The nonfederal share of costs for services 179.19 provided under this subdivision is the responsibility of the 179.20 local school district as provided in section 125A.74. Services 179.21 listed in a child's individual education plan are eligible for 179.22 medical assistance reimbursement only if those services meet 179.23 criteria for federal financial participation under the Medicaid 179.24 program. 179.25 (b) Approval of health-related services for inclusion in 179.26 the individual education plan does not require prior 179.27 authorization for purposes of reimbursement under this chapter. 179.28 The commissioner may require physician review and approval of 179.29 the plan not more than once annually or upon any modification of 179.30 the individual education plan that reflects a change in 179.31 health-related services. 179.32 (c) Services of a speech-language pathologist provided 179.33 under this section are covered notwithstanding Minnesota Rules, 179.34 part 9505.0390, subpart 1, item L, if the person: 179.35 (1) holds a masters degree in speech-language pathology; 179.36 (2) is licensed by the Minnesota board of teaching as an 180.1 educational speech-language pathologist; and 180.2 (3) either has a certificate of clinical competence from 180.3 the American Speech and Hearing Association, has completed the 180.4 equivalent educational requirements and work experience 180.5 necessary for the certificate or has completed the academic 180.6 program and is acquiring supervised work experience to qualify 180.7 for the certificate. 180.8 (d) Medical assistance coverage for medically necessary 180.9 services provided under other subdivisions in this section may 180.10 not be denied solely on the basis that the same or similar 180.11 services are covered under this subdivision. 180.12 (e) The commissioner shall develop and implement package 180.13 rates, bundled rates, or per diem rates for special education 180.14 services under which separately covered services are grouped 180.15 together and billed as a unit in order to reduce administrative 180.16 complexity. 180.17 (f) The commissioner shall develop a cost-based payment 180.18 structure for payment of these services. 180.19 (g) Effective July 1, 2000, medical assistance services 180.20 provided under an individual education plan or an individual 180.21 family service plan by local school districts shall not count 180.22 against medical assistance authorization thresholds for that 180.23 child. 180.24 (Effective date: Section 51 (256B.0625, subd. 26) is 180.25 effective July 1, 2000.) 180.26 Sec. 52. Minnesota Statutes 1998, section 256B.0625, 180.27 subdivision 28, is amended to read: 180.28 Subd. 28. [CERTIFIED NURSE PRACTITIONER SERVICES.] Medical 180.29 assistance covers services performed by a certified pediatric 180.30 nurse practitioner, a certified family nurse practitioner, a 180.31 certified adult nurse practitioner, a certified 180.32 obstetric/gynecological nurse practitioner, a certified neonatal 180.33 nurse practitioner, or a certified geriatric nurse practitioner 180.34 in independent practice, if the services are otherwise covered 180.35 under this chapter as a physician service, are provided on an 180.36 inpatient basis and are not part of the cost for inpatient 181.1 services included in the operating payment rate, andif the181.2service isare within the scope of practice of the nurse 181.3 practitioner's license as a registered nurse, as defined in 181.4 section 148.171. 181.5 Sec. 53. Minnesota Statutes 1998, section 256B.0625, 181.6 subdivision 30, is amended to read: 181.7 Subd. 30. [OTHER CLINIC SERVICES.] (a) Medical assistance 181.8 covers rural health clinic services, federally qualified health 181.9 center services, nonprofit community health clinic services, 181.10 public health clinic services, and the services of a clinic 181.11 meeting the criteria established in rule by the commissioner. 181.12 Rural health clinic services and federally qualified health 181.13 center services mean services defined in United States Code, 181.14 title 42, section 1396d(a)(2)(B) and (C). Payment for rural 181.15 health clinic and federally qualified health center services 181.16 shall be made according to applicable federal law and regulation. 181.17 (b) A federally qualified health center that is beginning 181.18 initial operation shall submit an estimate of budgeted costs and 181.19 visits for the initial reporting period in the form and detail 181.20 required by the commissioner. A federally qualified health 181.21 center that is already in operation shall submit an initial 181.22 report using actual costs and visits for the initial reporting 181.23 period. Within 90 days of the end of its reporting period, a 181.24 federally qualified health center shall submit, in the form and 181.25 detail required by the commissioner, a report of its operations, 181.26 including allowable costs actually incurred for the period and 181.27 the actual number of visits for services furnished during the 181.28 period, and other information required by the commissioner. 181.29 Federally qualified health centers that file Medicare cost 181.30 reports shall provide the commissioner with a copy of the most 181.31 recent Medicare cost report filed with the Medicare program 181.32 intermediary for the reporting year which support the costs 181.33 claimed on their cost report to the state. 181.34 (c) In order to continue cost-based payment under the 181.35 medical assistance program according to paragraphs (a) and (b), 181.36 a federally qualified health center or rural health clinic must 182.1 apply for designation as an essential community provider within 182.2 six months of final adoption of rules by the department of 182.3 health according to section 62Q.19, subdivision 7. For those 182.4 federally qualified health centers and rural health clinics that 182.5 have applied for essential community provider status within the 182.6 six-month time prescribed, medical assistance payments will 182.7 continue to be made according to paragraphs (a) and (b) for the 182.8 first three years after application. For federally qualified 182.9 health centers and rural health clinics that either do not apply 182.10 within the time specified above or who have had essential 182.11 community provider status for three years, medical assistance 182.12 payments for health services provided by these entities shall be 182.13 according to the same rates and conditions applicable to the 182.14 same service provided by health care providers that are not 182.15 federally qualified health centers or rural health clinics. 182.16This paragraph takes effect only if the Minnesota health care182.17reform waiver is approved by the federal government, and remains182.18in effect for as long as the Minnesota health care reform waiver182.19remains in effect. When the waiver expires, this paragraph182.20expires, and the commissioner of human services shall publish a182.21notice in the State Register and notify the revisor of statutes.182.22 (d) Effective July 1, 1999, the provisions of paragraph (c) 182.23 requiring a federally qualified health center or a rural health 182.24 clinic to make application for an essential community provider 182.25 designation in order to have cost-based payments made according 182.26 to paragraphs (a) and (b) no longer apply. 182.27 (e) Effective January 1, 2000, payments made according to 182.28 paragraphs (a) and (b) shall be limited to the cost phase-out 182.29 schedule of the Balanced Budget Act of 1997. 182.30 Sec. 54. Minnesota Statutes 1998, section 256B.0625, 182.31 subdivision 32, is amended to read: 182.32 Subd. 32. [NUTRITIONAL PRODUCTS.](a)Medical assistance 182.33 covers nutritional products needed for nutritional 182.34 supplementation because solid food or nutrients thereof cannot 182.35 be properly absorbed by the body or needed for treatment of 182.36 phenylketonuria, hyperlysinemia, maple syrup urine disease, a 183.1 combined allergy to human milk, cow's milk, and soy formula, or 183.2 any other childhood or adult diseases, conditions, or disorders 183.3 identified by the commissioner as requiring a similarly 183.4 necessary nutritional product. Nutritional products needed for 183.5 the treatment of a combined allergy to human milk, cow's milk, 183.6 and soy formula require prior authorization. Separate payment 183.7 shall not be made for nutritional products for residents of 183.8 long-term care facilities. Payment for dietary requirements is 183.9 a component of the per diem rate paid to these facilities. 183.10(b) The commissioner shall designate a nutritional183.11supplementation products advisory committee to advise the183.12commissioner on nutritional supplementation products for which183.13payment is made. The committee shall consist of nine members,183.14one of whom shall be a physician, one of whom shall be a183.15pharmacist, two of whom shall be registered dietitians, one of183.16whom shall be a public health nurse, one of whom shall be a183.17representative of a home health care agency, one of whom shall183.18be a provider of long-term care services, and two of whom shall183.19be consumers of nutritional supplementation products. Committee183.20members shall serve two-year terms and shall serve without183.21compensation.183.22(c) The advisory committee shall review and recommend183.23nutritional supplementation products which require prior183.24authorization. The commissioner shall develop procedures for183.25the operation of the advisory committee so that the advisory183.26committee operates in a manner parallel to the drug formulary183.27committee.183.28 Sec. 55. Minnesota Statutes 1998, section 256B.0625, 183.29 subdivision 35, is amended to read: 183.30 Subd. 35. [FAMILY COMMUNITY SUPPORT SERVICES.] Medical 183.31 assistance covers family community support services as defined 183.32 in section 245.4871, subdivision 17. In addition to the 183.33 provisions of section 245.4871, and to the extent authorized by 183.34 rules promulgated by the state agency, medical assistance covers 183.35 the following services as family community support services: 183.36 (1) services identified in an individual treatment plan 184.1 when provided by a trained behavioral aide under the direction 184.2 of a mental health practitioner or mental health professional; 184.3 (2) mental health crisis intervention and crisis 184.4 stabilization services provided outside of hospital inpatient 184.5 settings; and 184.6 (3) the therapeutic components of preschool and therapeutic 184.7 camp programs. 184.8 Sec. 56. Minnesota Statutes 1998, section 256B.0625, is 184.9 amended by adding a subdivision to read: 184.10 Subd. 41. [MENTAL HEALTH PROFESSIONAL.] Notwithstanding 184.11 Minnesota Rules, part 9505.0175, subpart 28, the definition of a 184.12 mental health professional shall include a person who is 184.13 qualified as specified in section 245.462, subdivision 18, 184.14 clause (5); or 245.4871, subdivision 27, clause (5), for the 184.15 purpose of this section and Minnesota Rules, parts 9505.0170 to 184.16 9505.0475. 184.17 Sec. 57. Minnesota Statutes 1998, section 256B.0625, is 184.18 amended by adding a subdivision to read: 184.19 Subd. 42. [LANGUAGE INTERPRETER SERVICES.] (a) Medical 184.20 assistance covers language interpreter services provided in 184.21 conjunction with another covered health service. 184.22 (b) The commissioner shall establish reimbursement 184.23 standards for interpreter services as follows: 184.24 (1) a per visit maximum rate shall be established; and 184.25 (2) services shall be reimbursed in 15-minute increments. 184.26 Sec. 58. Minnesota Statutes 1998, section 256B.0627, 184.27 subdivision 1, is amended to read: 184.28 Subdivision 1. [DEFINITION.] (a) "Assessment" means a 184.29 review and evaluation of a recipient's need for home care 184.30 services conducted in person. Assessments for private duty 184.31 nursing shall be conducted by a registered private duty nurse. 184.32 Assessments for home health agency services shall be conducted 184.33 by a home health agency nurse. Assessments for personal 184.34 care assistant services shall be conducted by the county public 184.35 health nurse or a certified public health nurse under contract 184.36 with the county.An initial assessment for personal care185.1services is conducted on individuals who are requesting personal185.2care services or for those consumers who have never had a public185.3health nurse assessment. The initialA face-to-face assessment 185.4 must include: aface-to-facehealth status assessment and 185.5 determination ofbaselineneed, evaluation of service outcomes, 185.6 collection ofinitialcase data, identification of appropriate 185.7 services and service plan development or modification, 185.8 coordination ofinitialservices, referrals and follow-up to 185.9 appropriate payers and community resources, completion of 185.10 required reports, obtaining service authorization, and consumer 185.11 education. Areassessment visitface-to-face assessment for 185.12 personal care services is conducted on those recipients who have 185.13 never had a county public health nurse assessment. A 185.14 face-to-face assessment must occur at least annually or when 185.15 there is a significant change inconsumerthe recipient's 185.16 conditionandor when there is a change in the need for personal 185.17 care assistant services.The reassessment visitA service 185.18 update may substitute for the annual face-to-face assessment 185.19 when there is not a significant change in recipient condition or 185.20 a change in the need for personal care assistant service. A 185.21 service update or review for temporary increase includes a 185.22 review of initial baseline data, evaluation of service outcomes, 185.23 redetermination of service need, modification of service plan 185.24 and appropriate referrals, update of initial forms, obtaining 185.25 service authorization, and on going consumer education. 185.26 Assessments for medical assistance home care services for mental 185.27 retardation or related conditions and alternative care services 185.28 for developmentally disabled home and community-based waivered 185.29 recipients may be conducted by the county public health nurse to 185.30 ensure coordination and avoid duplication. Assessments must be 185.31 completed on forms provided by the commissioner within 30 days 185.32 of a request for home care services by a recipient or 185.33 responsible party. 185.34 (b) "Care plan" means a written description of personal 185.35 care assistant services developed by theagency nursequalified 185.36 professional with the recipient or responsible party to be used 186.1 by the personal care assistant with a copy provided to the 186.2 recipient or responsible party. 186.3 (c) "Home care services" means a health service, determined 186.4 by the commissioner as medically necessary, that is ordered by a 186.5 physician and documented in a service plan that is reviewed by 186.6 the physician at least once every6062 days for the provision 186.7 of home health services, or private duty nursing, or at least 186.8 once every 365 days for personal care. Home care services are 186.9 provided to the recipient at the recipient's residence that is a 186.10 place other than a hospital or long-term care facility or as 186.11 specified in section 256B.0625. 186.12 (d) "Medically necessary" has the meaning given in 186.13 Minnesota Rules, parts 9505.0170 to 9505.0475. 186.14 (e) "Personal care assistant" means a person who: (1) is 186.15 at least 18 years old, except for persons 16 to 18 years of age 186.16 who participated in a related school-based job training program 186.17 or have completed a certified home health aide competency 186.18 evaluation; (2) is able to effectively communicate with the 186.19 recipient and personal care provider organization; (3) effective 186.20 July 1, 1996, has completed one of the training requirements as 186.21 specified in Minnesota Rules, part 9505.0335, subpart 3, items A 186.22 to D; (4) has the ability to, and provides covered personal care 186.23 services according to the recipient's care plan, responds 186.24 appropriately to recipient needs, and reports changes in the 186.25 recipient's condition to the supervisingregistered nurse186.26 qualified professional; (5) is not a consumer of personal care 186.27 services; and (6) is subject to criminal background checks and 186.28 procedures specified in section 245A.04.An individual who has186.29been convicted of a crime specified in Minnesota Rules, part186.304668.0020, subpart 14, or a comparable crime in another186.31jurisdiction is disqualified from being a personal care186.32assistant, unless the individual meets the rehabilitation186.33criteria specified in Minnesota Rules, part 4668.0020, subpart186.3415.186.35 (f) "Personal care provider organization" means an 186.36 organization enrolled to provide personal care services under 187.1 the medical assistance program that complies with the 187.2 following: (1) owners who have a five percent interest or more, 187.3 and managerial officials are subject to a background study as 187.4 provided in section 245A.04. This applies to currently enrolled 187.5 personal care provider organizations and those agencies seeking 187.6 enrollment as a personal care provider organization. An 187.7 organization will be barred from enrollment if an owner or 187.8 managerial official of the organization has been convicted of a 187.9 crime specified in section 245A.04, or a comparable crime in 187.10 another jurisdiction, unless the owner or managerial official 187.11 meets the reconsideration criteria specified in section 245A.04; 187.12 (2) the organization must maintain a surety bond and liability 187.13 insurance throughout the duration of enrollment and provides 187.14 proof thereof. The insurer must notify the department of human 187.15 services of the cancellation or lapse of policy; and (3) the 187.16 organization must maintain documentation of services as 187.17 specified in Minnesota Rules, part 9505.2175, subpart 7, as well 187.18 as evidence of compliance with personal care assistant training 187.19 requirements. 187.20 (g) "Responsible party" means an individual residing with a 187.21 recipient of personal care services who is capable of providing 187.22 the supportive care necessary to assist the recipient to live in 187.23 the community, is at least 18 years old, and is not a personal 187.24 care assistant. Responsible parties who are parents of minors 187.25 or guardians of minors or incapacitated persons may delegate the 187.26 responsibility to another adult during a temporary absence of at 187.27 least 24 hours but not more than six months. The person 187.28 delegated as a responsible party must be able to meet the 187.29 definition of responsible party, except that the delegated 187.30 responsible party is required to reside with the recipient only 187.31 while serving as the responsible party. Foster care license 187.32 holders may be designated the responsible party for residents of 187.33 the foster care home if case management is provided as required 187.34 in section 256B.0625, subdivision 19a. For persons who, as of 187.35 April 1, 1992, are sharing personal care services in order to 187.36 obtain the availability of 24-hour coverage, an employee of the 188.1 personal care provider organization may be designated as the 188.2 responsible party if case management is provided as required in 188.3 section 256B.0625, subdivision 19a. 188.4 (h) "Service plan" means a written description of the 188.5 services needed based on the assessment developed by the nurse 188.6 who conducts the assessment together with the recipient or 188.7 responsible party. The service plan shall include a description 188.8 of the covered home care services, frequency and duration of 188.9 services, and expected outcomes and goals. The recipient and 188.10 the provider chosen by the recipient or responsible party must 188.11 be given a copy of the completed service plan within 30 calendar 188.12 days of the request for home care services by the recipient or 188.13 responsible party. 188.14 (i) "Skilled nurse visits" are provided in a recipient's 188.15 residence under a plan of care or service plan that specifies a 188.16 level of care which the nurse is qualified to provide. These 188.17 services are: 188.18 (1) nursing services according to the written plan of care 188.19 or service plan and accepted standards of medical and nursing 188.20 practice in accordance with chapter 148; 188.21 (2) services which due to the recipient's medical condition 188.22 may only be safely and effectively provided by a registered 188.23 nurse or a licensed practical nurse; 188.24 (3) assessments performed only by a registered nurse; and 188.25 (4) teaching and training the recipient, the recipient's 188.26 family, or other caregivers requiring the skills of a registered 188.27 nurse or licensed practical nurse. 188.28 Sec. 59. Minnesota Statutes 1998, section 256B.0627, 188.29 subdivision 2, is amended to read: 188.30 Subd. 2. [SERVICES COVERED.] Home care services covered 188.31 under this section include: 188.32 (1) nursing services under section 256B.0625, subdivision 188.33 6a; 188.34 (2) private duty nursing services under section 256B.0625, 188.35 subdivision 7; 188.36 (3) home health aide services under section 256B.0625, 189.1 subdivision 6a; 189.2 (4) personal care services under section 256B.0625, 189.3 subdivision 19a; 189.4 (5)nursingsupervision of personal care assistant services 189.5 provided by a qualified professional under section 256B.0625, 189.6 subdivision 19a;and189.7 (6) consulting professional of personal care assistant 189.8 services under the fiscal agent option as specified in 189.9 subdivision 10; 189.10 (7) face-to-face assessments by county public health nurses 189.11 for services under section 256B.0625, subdivision 19a; and 189.12 (8) service updates and review of temporary increases for 189.13 personal care assistant services by the county public health 189.14 nurse for services under section 256B.0625, subdivision 19a. 189.15 Sec. 60. Minnesota Statutes 1998, section 256B.0627, 189.16 subdivision 4, is amended to read: 189.17 Subd. 4. [PERSONAL CARE SERVICES.] (a) The personal care 189.18 services that are eligible for payment are the following: 189.19 (1) bowel and bladder care; 189.20 (2) skin care to maintain the health of the skin; 189.21 (3) repetitive maintenance range of motion, muscle 189.22 strengthening exercises, and other tasks specific to maintaining 189.23 a recipient's optimal level of function; 189.24 (4) respiratory assistance; 189.25 (5) transfers and ambulation; 189.26 (6) bathing, grooming, and hairwashing necessary for 189.27 personal hygiene; 189.28 (7) turning and positioning; 189.29 (8) assistance with furnishing medication that is 189.30 self-administered; 189.31 (9) application and maintenance of prosthetics and 189.32 orthotics; 189.33 (10) cleaning medical equipment; 189.34 (11) dressing or undressing; 189.35 (12) assistance with eating and meal preparation and 189.36 necessary grocery shopping; 190.1 (13) accompanying a recipient to obtain medical diagnosis 190.2 or treatment; 190.3 (14) assisting, monitoring, or prompting the recipient to 190.4 complete the services in clauses (1) to (13); 190.5 (15) redirection, monitoring, and observation that are 190.6 medically necessary and an integral part of completing the 190.7 personal care services described in clauses (1) to (14); 190.8 (16) redirection and intervention for behavior, including 190.9 observation and monitoring; 190.10 (17) interventions for seizure disorders, including 190.11 monitoring and observation if the recipient has had a seizure 190.12 that requires intervention within the past three months; 190.13 (18) tracheostomy suctioning using a clean procedure if the 190.14 procedure is properly delegated by a registered nurse. Before 190.15 this procedure can be delegated to a personal care assistant, a 190.16 registered nurse must determine that the tracheostomy suctioning 190.17 can be accomplished utilizing a clean rather than a sterile 190.18 procedure and must ensure that the personal care assistant has 190.19 been taught the proper procedure; and 190.20 (19) incidental household services that are an integral 190.21 part of a personal care service described in clauses (1) to (18). 190.22 For purposes of this subdivision, monitoring and observation 190.23 means watching for outward visible signs that are likely to 190.24 occur and for which there is a covered personal care service or 190.25 an appropriate personal care intervention. For purposes of this 190.26 subdivision, a clean procedure refers to a procedure that 190.27 reduces the numbers of microorganisms or prevents or reduces the 190.28 transmission of microorganisms from one person or place to 190.29 another. A clean procedure may be used beginning 14 days after 190.30 insertion. 190.31 (b) The personal care services that are not eligible for 190.32 payment are the following: 190.33 (1) services not ordered by the physician; 190.34 (2) assessments by personal care provider organizations or 190.35 by independently enrolled registered nurses; 190.36 (3) services that are not in the service plan; 191.1 (4) services provided by the recipient's spouse, legal 191.2 guardian for an adult or child recipient, or parent of a 191.3 recipient under age 18; 191.4 (5) services provided by a foster care provider of a 191.5 recipient who cannot direct the recipient's own care, unless 191.6 monitored by a county or state case manager under section 191.7 256B.0625, subdivision 19a; 191.8 (6) services provided by the residential or program license 191.9 holder in a residence for more than four persons; 191.10 (7) services that are the responsibility of a residential 191.11 or program license holder under the terms of a service agreement 191.12 and administrative rules; 191.13 (8) sterile procedures; 191.14 (9) injections of fluids into veins, muscles, or skin; 191.15 (10) services provided by parents of adult recipients, 191.16 adult children, oradultsiblings of the recipient, unless these 191.17 relatives meet one of the following hardship criteria and the 191.18 commissioner waives this requirement: 191.19 (i) the relative resigns from a part-time or full-time job 191.20 to provide personal care for the recipient; 191.21 (ii) the relative goes from a full-time to a part-time job 191.22 with less compensation to provide personal care for the 191.23 recipient; 191.24 (iii) the relative takes a leave of absence without pay to 191.25 provide personal care for the recipient; 191.26 (iv) the relative incurs substantial expenses by providing 191.27 personal care for the recipient; or 191.28 (v) because of labor conditions, special language needs, or 191.29 intermittent hours of care needed, the relative is needed in 191.30 order to provide an adequate number of qualified personal care 191.31 assistants to meet the medical needs of the recipient; 191.32 (11) homemaker services that are not an integral part of a 191.33 personal care services; 191.34 (12) home maintenance, or chore services; 191.35 (13) services not specified under paragraph (a); and 191.36 (14) services not authorized by the commissioner or the 192.1 commissioner's designee. 192.2 Sec. 61. Minnesota Statutes 1998, section 256B.0627, 192.3 subdivision 5, is amended to read: 192.4 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 192.5 payments for home care services shall be limited according to 192.6 this subdivision. 192.7 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 192.8 recipient may receive the following home care services during a 192.9 calendar year: 192.10 (1)any initial assessmentup to two face-to-face 192.11 assessments to determine a recipient's need for personal care 192.12 assistant services; 192.13 (2)up to two reassessments per yearone service update 192.14 done to determine a recipient's need for personal care services; 192.15 and 192.16 (3) up to five skilled nurse visits. 192.17 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 192.18 services above the limits in paragraph (a) must receive the 192.19 commissioner's prior authorization, except when: 192.20 (1) the home care services were required to treat an 192.21 emergency medical condition that if not immediately treated 192.22 could cause a recipient serious physical or mental disability, 192.23 continuation of severe pain, or death. The provider must 192.24 request retroactive authorization no later than five working 192.25 days after giving the initial service. The provider must be 192.26 able to substantiate the emergency by documentation such as 192.27 reports, notes, and admission or discharge histories; 192.28 (2) the home care services were provided on or after the 192.29 date on which the recipient's eligibility began, but before the 192.30 date on which the recipient was notified that the case was 192.31 opened. Authorization will be considered if the request is 192.32 submitted by the provider within 20 working days of the date the 192.33 recipient was notified that the case was opened; 192.34 (3) a third-party payor for home care services has denied 192.35 or adjusted a payment. Authorization requests must be submitted 192.36 by the provider within 20 working days of the notice of denial 193.1 or adjustment. A copy of the notice must be included with the 193.2 request; 193.3 (4) the commissioner has determined that a county or state 193.4 human services agency has made an error; or 193.5 (5) the professional nurse determines an immediate need for 193.6 up to 40 skilled nursing or home health aide visits per calendar 193.7 year and submits a request for authorization within 20 working 193.8 days of the initial service date, and medical assistance is 193.9 determined to be the appropriate payer. 193.10 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 193.11 authorization will be evaluated according to the same criteria 193.12 applied to prior authorization requests. 193.13 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 193.14 section 256B.0627, subdivision 1, paragraph (a), shall be 193.15 conducted initially, and at least annually thereafter, in person 193.16 with the recipient and result in a completed service plan using 193.17 forms specified by the commissioner. Within 30 days of 193.18 recipient or responsible party request for home care services, 193.19 the assessment, the service plan, and other information 193.20 necessary to determine medical necessity such as diagnostic or 193.21 testing information, social or medical histories, and hospital 193.22 or facility discharge summaries shall be submitted to the 193.23 commissioner. For personal care services: 193.24 (1) The amount and type of service authorized based upon 193.25 the assessment and service plan will follow the recipient if the 193.26 recipient chooses to change providers. 193.27 (2) If the recipient's medical need changes, the 193.28 recipient's provider may assess the need for a change in service 193.29 authorization and request the change from the county public 193.30 health nurse. Within 30 days of the request, the public health 193.31 nurse will determine whether to request the change in services 193.32 based upon the provider assessment, or conduct a home visit to 193.33 assess the need and determine whether the change is appropriate. 193.34 (3) To continue to receive personal care services after the 193.35 first year, the recipient or the responsible party, in 193.36 conjunction with the public health nurse, may complete a service 194.1 update on forms developed by the commissioner according to 194.2 criteria and procedures in subdivision 1.The service update194.3may substitute for the annual reassessment described in194.4subdivision 1.194.5 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 194.6 commissioner's designee, shall review the assessment,the194.7 service update, request for temporary services, service plan, 194.8 and any additional information that is submitted. The 194.9 commissioner shall, within 30 days after receiving a complete 194.10 request, assessment, and service plan, authorize home care 194.11 services as follows: 194.12 (1) [HOME HEALTH SERVICES.] All home health services 194.13 provided by a licensed nurse or a home health aide must be prior 194.14 authorized by the commissioner or the commissioner's designee. 194.15 Prior authorization must be based on medical necessity and 194.16 cost-effectiveness when compared with other care options. When 194.17 home health services are used in combination with personal care 194.18 and private duty nursing, the cost of all home care services 194.19 shall be considered for cost-effectiveness. The commissioner 194.20 shall limit nurse and home health aide visits to no more than 194.21 one visit each per day. 194.22 (2) [PERSONAL CARE SERVICES.] (i) All personal care 194.23 services andregistered nursesupervision by a qualified 194.24 professional must be prior authorized by the commissioner or the 194.25 commissioner's designee except for the assessments established 194.26 in paragraph (a). The amount of personal care services 194.27 authorized must be based on the recipient's home care rating. A 194.28 child may not be found to be dependent in an activity of daily 194.29 living if because of the child's age an adult would either 194.30 perform the activity for the child or assist the child with the 194.31 activity and the amount of assistance needed is similar to the 194.32 assistance appropriate for a typical child of the same age. 194.33 Based on medical necessity, the commissioner may authorize: 194.34 (A) up to two times the average number of direct care hours 194.35 provided in nursing facilities for the recipient's comparable 194.36 case mix level; or 195.1 (B) up to three times the average number of direct care 195.2 hours provided in nursing facilities for recipients who have 195.3 complex medical needs or are dependent in at least seven 195.4 activities of daily living and need physical assistance with 195.5 eating or have a neurological diagnosis; or 195.6 (C) up to 60 percent of the average reimbursement rate, as 195.7 of July 1, 1991, for care provided in a regional treatment 195.8 center for recipients who have Level I behavior, plus any 195.9 inflation adjustment as provided by the legislature for personal 195.10 care service; or 195.11 (D) up to the amount the commissioner would pay, as of July 195.12 1, 1991, plus any inflation adjustment provided for home care 195.13 services, for care provided in a regional treatment center for 195.14 recipients referred to the commissioner by a regional treatment 195.15 center preadmission evaluation team. For purposes of this 195.16 clause, home care services means all services provided in the 195.17 home or community that would be included in the payment to a 195.18 regional treatment center; or 195.19 (E) up to the amount medical assistance would reimburse for 195.20 facility care for recipients referred to the commissioner by a 195.21 preadmission screening team established under section 256B.0911 195.22 or 256B.092; and 195.23 (F) a reasonable amount of time for the provision of 195.24nursingsupervision by a qualified professional of personal care 195.25 services. 195.26 (ii) The number of direct care hours shall be determined 195.27 according to the annual cost report submitted to the department 195.28 by nursing facilities. The average number of direct care hours, 195.29 as established by May 1, 1992, shall be calculated and 195.30 incorporated into the home care limits on July 1, 1992. These 195.31 limits shall be calculated to the nearest quarter hour. 195.32 (iii) The home care rating shall be determined by the 195.33 commissioner or the commissioner's designee based on information 195.34 submitted to the commissioner by the county public health nurse 195.35 on forms specified by the commissioner. The home care rating 195.36 shall be a combination of current assessment tools developed 196.1 under sections 256B.0911 and 256B.501 with an addition for 196.2 seizure activity that will assess the frequency and severity of 196.3 seizure activity and with adjustments, additions, and 196.4 clarifications that are necessary to reflect the needs and 196.5 conditions of recipients who need home care including children 196.6 and adults under 65 years of age. The commissioner shall 196.7 establish these forms and protocols under this section and shall 196.8 use an advisory group, including representatives of recipients, 196.9 providers, and counties, for consultation in establishing and 196.10 revising the forms and protocols. 196.11 (iv) A recipient shall qualify as having complex medical 196.12 needs if the care required is difficult to perform and because 196.13 of recipient's medical condition requires more time than 196.14 community-based standards allow or requires more skill than 196.15 would ordinarily be required and the recipient needs or has one 196.16 or more of the following: 196.17 (A) daily tube feedings; 196.18 (B) daily parenteral therapy; 196.19 (C) wound or decubiti care; 196.20 (D) postural drainage, percussion, nebulizer treatments, 196.21 suctioning, tracheotomy care, oxygen, mechanical ventilation; 196.22 (E) catheterization; 196.23 (F) ostomy care; 196.24 (G) quadriplegia; or 196.25 (H) other comparable medical conditions or treatments the 196.26 commissioner determines would otherwise require institutional 196.27 care. 196.28 (v) A recipient shall qualify as having Level I behavior if 196.29 there is reasonable supporting evidence that the recipient 196.30 exhibits, or that without supervision, observation, or 196.31 redirection would exhibit, one or more of the following 196.32 behaviors that cause, or have the potential to cause: 196.33 (A) injury to the recipient's own body; 196.34 (B) physical injury to other people; or 196.35 (C) destruction of property. 196.36 (vi) Time authorized for personal care relating to Level I 197.1 behavior in subclause (v), items (A) to (C), shall be based on 197.2 the predictability, frequency, and amount of intervention 197.3 required. 197.4 (vii) A recipient shall qualify as having Level II behavior 197.5 if the recipient exhibits on a daily basis one or more of the 197.6 following behaviors that interfere with the completion of 197.7 personal care services under subdivision 4, paragraph (a): 197.8 (A) unusual or repetitive habits; 197.9 (B) withdrawn behavior; or 197.10 (C) offensive behavior. 197.11 (viii) A recipient with a home care rating of Level II 197.12 behavior in subclause (vii), items (A) to (C), shall be rated as 197.13 comparable to a recipient with complex medical needs under 197.14 subclause (iv). If a recipient has both complex medical needs 197.15 and Level II behavior, the home care rating shall be the next 197.16 complex category up to the maximum rating under subclause (i), 197.17 item (B). 197.18 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 197.19 nursing services shall be prior authorized by the commissioner 197.20 or the commissioner's designee. Prior authorization for private 197.21 duty nursing services shall be based on medical necessity and 197.22 cost-effectiveness when compared with alternative care options. 197.23 The commissioner may authorize medically necessary private duty 197.24 nursing services in quarter-hour units when: 197.25 (i) the recipient requires more individual and continuous 197.26 care than can be provided during a nurse visit; or 197.27 (ii) the cares are outside of the scope of services that 197.28 can be provided by a home health aide or personal care assistant. 197.29 The commissioner may authorize: 197.30 (A) up to two times the average amount of direct care hours 197.31 provided in nursing facilities statewide for case mix 197.32 classification "K" as established by the annual cost report 197.33 submitted to the department by nursing facilities in May 1992; 197.34 (B) private duty nursing in combination with other home 197.35 care services up to the total cost allowed under clause (2); 197.36 (C) up to 16 hours per day if the recipient requires more 198.1 nursing than the maximum number of direct care hours as 198.2 established in item (A) and the recipient meets the hospital 198.3 admission criteria established under Minnesota Rules, parts 198.4 9505.0500 to 9505.0540. 198.5 The commissioner may authorize up to 16 hours per day of 198.6 medically necessary private duty nursing services or up to 24 198.7 hours per day of medically necessary private duty nursing 198.8 services until such time as the commissioner is able to make a 198.9 determination of eligibility for recipients who are 198.10 cooperatively applying for home care services under the 198.11 community alternative care program developed under section 198.12 256B.49, or until it is determined by the appropriate regulatory 198.13 agency that a health benefit plan is or is not required to pay 198.14 for appropriate medically necessary health care services. 198.15 Recipients or their representatives must cooperatively assist 198.16 the commissioner in obtaining this determination. Recipients 198.17 who are eligible for the community alternative care program may 198.18 not receive more hours of nursing under this section than would 198.19 otherwise be authorized under section 256B.49. 198.20 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 198.21 ventilator-dependent, the monthly medical assistance 198.22 authorization for home care services shall not exceed what the 198.23 commissioner would pay for care at the highest cost hospital 198.24 designated as a long-term hospital under the Medicare program. 198.25 For purposes of this clause, home care services means all 198.26 services provided in the home that would be included in the 198.27 payment for care at the long-term hospital. 198.28 "Ventilator-dependent" means an individual who receives 198.29 mechanical ventilation for life support at least six hours per 198.30 day and is expected to be or has been dependent for at least 30 198.31 consecutive days. 198.32 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 198.33 or the commissioner's designee shall determine the time period 198.34 for which a prior authorization shall be effective. If the 198.35 recipient continues to require home care services beyond the 198.36 duration of the prior authorization, the home care provider must 199.1 request a new prior authorization. Under no circumstances, 199.2 other than the exceptions in paragraph (b), shall a prior 199.3 authorization be valid prior to the date the commissioner 199.4 receives the request or for more than 12 months. A recipient 199.5 who appeals a reduction in previously authorized home care 199.6 services may continue previously authorized services, other than 199.7 temporary services under paragraph (h), pending an appeal under 199.8 section 256.045. The commissioner must provide a detailed 199.9 explanation of why the authorized services are reduced in amount 199.10 from those requested by the home care provider. 199.11 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 199.12 the commissioner's designee shall determine the medical 199.13 necessity of home care services, the level of caregiver 199.14 according to subdivision 2, and the institutional comparison 199.15 according to this subdivision, the cost-effectiveness of 199.16 services, and the amount, scope, and duration of home care 199.17 services reimbursable by medical assistance, based on the 199.18 assessment, primary payer coverage determination information as 199.19 required, the service plan, the recipient's age, the cost of 199.20 services, the recipient's medical condition, and diagnosis or 199.21 disability. The commissioner may publish additional criteria 199.22 for determining medical necessity according to section 256B.04. 199.23 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 199.24 The agency nurse, the independently enrolled private duty nurse, 199.25 or county public health nurse may request a temporary 199.26 authorization for home care services by telephone. The 199.27 commissioner may approve a temporary level of home care services 199.28 based on the assessment, and service or care plan information, 199.29 and primary payer coverage determination information as required. 199.30 Authorization for a temporary level of home care services 199.31 including nurse supervision is limited to the time specified by 199.32 the commissioner, but shall not exceed 45 days, unless extended 199.33 because the county public health nurse has not completed the 199.34 required assessment and service plan, or the commissioner's 199.35 determination has not been made. The level of services 199.36 authorized under this provision shall have no bearing on a 200.1 future prior authorization. 200.2 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 200.3 Home care services provided in an adult or child foster care 200.4 setting must receive prior authorization by the department 200.5 according to the limits established in paragraph (a). 200.6 The commissioner may not authorize: 200.7 (1) home care services that are the responsibility of the 200.8 foster care provider under the terms of the foster care 200.9 placement agreement and administrative rules. Requests for home 200.10 care services for recipients residing in a foster care setting 200.11 must include the foster care placement agreement and 200.12 determination of difficulty of care; 200.13 (2) personal care services when the foster care license 200.14 holder is also the personal care provider or personal care 200.15 assistant unless the recipient can direct the recipient's own 200.16 care, or case management is provided as required in section 200.17 256B.0625, subdivision 19a; 200.18 (3) personal care services when the responsible party is an 200.19 employee of, or under contract with, or has any direct or 200.20 indirect financial relationship with the personal care provider 200.21 or personal care assistant, unless case management is provided 200.22 as required in section 256B.0625, subdivision 19a; 200.23 (4) home care services when the number of foster care 200.24 residents is greater than four unless the county responsible for 200.25 the recipient's foster placement made the placement prior to 200.26 April 1, 1992, requests that home care services be provided, and 200.27 case management is provided as required in section 256B.0625, 200.28 subdivision 19a; or 200.29 (5) home care services when combined with foster care 200.30 payments, other than room and board payments that exceed the 200.31 total amount that public funds would pay for the recipient's 200.32 care in a medical institution. 200.33 Sec. 62. Minnesota Statutes 1998, section 256B.0627, 200.34 subdivision 8, is amended to read: 200.35 Subd. 8. [SHARED PERSONAL CARE ASSISTANT SERVICES; SHARED200.36CARE.] (a) Medical assistance payments for shared personal care 201.1 assistanceshared careservices shall be limited according to 201.2 this subdivision. 201.3 (b) Recipients of personal care assistant services may 201.4 share staff and the commissioner shall provide a rate system for 201.5 shared personal care assistant services. For two persons 201.6 sharingcareservices, the rate paid to a provider shall not 201.7 exceed 1-1/2 times the rate paid for serving a single 201.8 individual, and for three persons sharingcareservices, the 201.9 rate paid to a provider shall not exceed twice the rate paid for 201.10 serving a single individual. These rates apply only to 201.11 situations in which all recipients were present and received 201.12 sharedcareservices on the date for which the service is 201.13 billed. No more than three persons may receive sharedcare201.14 services from a personal care assistant in a single setting. 201.15 (c) Sharedcareservice is the provision of personal care 201.16 services by a personal care assistant to two or three recipients 201.17 at the same time and in the same setting. For the purposes of 201.18 this subdivision, "setting" means: 201.19 (1) the home or foster care home of one of the individual 201.20 recipients; or 201.21 (2) a child care program in which all recipients served by 201.22 one personal care assistant are participating, which is licensed 201.23 under chapter 245A or operated by a local school district or 201.24 private school. 201.25 The provisions of this subdivision do not apply when a 201.26 personal care assistant is caring for multiple recipients in 201.27 more than one setting. 201.28 (d) The recipient or the recipient's responsible party, in 201.29 conjunction with the county public health nurse, shall determine: 201.30 (1) whether sharedcarepersonal care assistant services is 201.31 an appropriate option based on the individual needs and 201.32 preferences of the recipient; and 201.33 (2) the amount of sharedcareservices allocated as part of 201.34 the overall authorization of personal care services. 201.35 The recipient or the responsible party, in conjunction with 201.36 the supervisingregistered nursequalified professional, shall 202.1approvearrange the setting,and grouping, and arrangementof 202.2 sharedcareservices based on the individual needs and 202.3 preferences of the recipients. Decisions on the selection of 202.4 recipients to sharecareservices must be based on the ages of 202.5 the recipients, compatibility, and coordination of their care 202.6 needs. 202.7 (e) The following items must be considered by the recipient 202.8 or the responsible party and the supervisingnursequalified 202.9 professional, and documented in the recipient'scare planhealth 202.10 service record: 202.11 (1) the additional qualifications needed by the personal 202.12 care assistant to provide care to several recipients in the same 202.13 setting; 202.14 (2) the additional training and supervision needed by the 202.15 personal care assistant to ensure that the needs of the 202.16 recipient are met appropriately and safely. The provider must 202.17 provide on-site supervision by aregistered nursequalified 202.18 professional within the first 14 days of sharedcareservices, 202.19 and monthly thereafter; 202.20 (3) the setting in which the sharedcareservices will be 202.21 provided; 202.22 (4) the ongoing monitoring and evaluation of the 202.23 effectiveness and appropriateness of the service and process 202.24 used to make changes in service or setting; and 202.25 (5) a contingency plan which accounts for absence of the 202.26 recipient in a sharedcareservices setting due to illness or 202.27 other circumstances and staffing contingencies. 202.28 (f) The provider must offer the recipient or the 202.29 responsible party the option of shared orindividualone-on-one 202.30 personal care assistantcareservices. The recipient or the 202.31 responsible party can withdraw from participating in a shared 202.32careservices arrangement at any time. 202.33 (g) In addition to documentation requirements under 202.34 Minnesota Rules, part 9505.2175, a personal care provider must 202.35 meet documentation requirements for shared personal 202.36 care assistant services and must document the following in the 203.1 health service record for each individual recipient sharingcare203.2 services: 203.3 (1)authorizationpermission by the recipient or the 203.4 recipient's responsible party, if any, for the maximum number of 203.5 sharedcareservices hours per week chosen by the recipient; 203.6 (2)authorizationpermission by the recipient or the 203.7 recipient's responsible party, if any, for personal 203.8 care assistant services provided outside the recipient's 203.9 residence; 203.10 (3)authorizationpermission by the recipient or the 203.11 recipient's responsible party, if any, for others to receive 203.12 sharedcareservices in the recipient's residence; 203.13 (4) revocation by the recipient or the recipient's 203.14 responsible party, if any, of the sharedcareservice 203.15 authorization, or the sharedcareservice to be provided to 203.16 others in the recipient's residence, or the sharedcareservice 203.17 to be provided outside the recipient's residence; 203.18 (5) supervision of the sharedcarepersonal care assistant 203.19 services by thesupervisory nursequalified professional, 203.20 including the date, time of day, number of hours spent 203.21 supervising the provision of sharedcareservices, whether the 203.22 supervision was face-to-face or another method of supervision, 203.23 changes in the recipient's condition, sharedcareservices 203.24 scheduling issues and recommendations; 203.25 (6) documentation by thepersonal care assistantqualified 203.26 professional of telephone calls or other discussions with 203.27 thesupervisory nursepersonal care assistant regarding services 203.28 being provided to the recipient; and 203.29 (7) daily documentation of the sharedcareservices 203.30 provided by each identified personal care assistant including: 203.31 (i) the names of each recipient receiving sharedcare203.32 services together; 203.33 (ii) the setting for theday's careshared services, 203.34 including the starting and ending times that the recipient 203.35 received sharedcareservices; and 203.36 (iii) notes by the personal care assistant regarding 204.1 changes in the recipient's condition, problems that may arise 204.2 from the sharing ofcareservices, scheduling issues, care 204.3 issues, and other notes as required by thesupervising nurse204.4 qualified professional. 204.5 (h) Unless otherwise provided in this subdivision, all 204.6 other statutory and regulatory provisions relating to personal 204.7 care services apply to sharedcareservices. 204.8 Nothing in this subdivision shall be construed to reduce 204.9 the total number of hours authorized for an individual recipient. 204.10 Sec. 63. Minnesota Statutes 1998, section 256B.0627, is 204.11 amended by adding a subdivision to read: 204.12 Subd. 9. [FLEXIBLE USE OF PERSONAL CARE ASSISTANT 204.13 HOURS.] (a) The commissioner may allow for the flexible use of 204.14 personal care assistant hours. "Flexible use" means the 204.15 scheduled use of authorized hours of personal care assistant 204.16 services, which vary within the length of the service 204.17 authorization in order to more effectively meet the needs and 204.18 schedule of the recipient. Recipients may use their approved 204.19 hours flexibly within the service authorization period for 204.20 medically necessary covered services specified in the assessment 204.21 required in subdivision 1. The flexible use of authorized hours 204.22 does not increase the total amount of authorized hours available 204.23 to a recipient as determined under subdivision 5. The 204.24 commissioner shall not authorize additional personal care 204.25 assistant services to supplement a service authorization that is 204.26 exhausted before the end date under a flexible service use plan, 204.27 unless the county public health nurse determines a change in 204.28 condition and a need for increased services is established. 204.29 (b) The recipient or responsible party, together with the 204.30 county public health nurse, shall determine whether flexible use 204.31 is an appropriate option based on the needs and preferences of 204.32 the recipient or responsible party, and, if appropriate, must 204.33 ensure that the allocation of hours covers the ongoing needs of 204.34 the recipient over the entire service authorization period. As 204.35 part of the assessment and service planning process, the 204.36 recipient or responsible party must work with the county public 205.1 health nurse to develop a written month-to-month plan of the 205.2 projected use of personal care assistant services that is part 205.3 of the service plan and ensures that the: 205.4 (1) health and safety needs of the recipient will be met; 205.5 (2) total annual authorization will not exceed before the 205.6 end date; and 205.7 (3) how actual use of hours will be monitored. 205.8 (c) If the actual use of personal care assistant service 205.9 varies significantly from the use projected in the plan, the 205.10 written plan must be promptly updated by the recipient or 205.11 responsible party and the county public health nurse. 205.12 (d) The recipient or responsible party, together with the 205.13 provider, must work to monitor and document the use of 205.14 authorized hours and ensure that a recipient is able to manage 205.15 services effectively throughout the authorized period. The 205.16 provider must ensure that the month-to-month plan is 205.17 incorporated into the care plan. Upon request of the recipient 205.18 or responsible party, the provider must furnish regular updates 205.19 to the recipient or responsible party on the amount of personal 205.20 care assistant services used. 205.21 (e) The recipient or responsible party can revoke the 205.22 authorization for flexible use of hours by notifying the 205.23 provider and county public health nurse in writing. 205.24 (f) If the requirements in paragraphs (a) to (e) have not 205.25 substantially been met, the commissioner shall deny, revoke, or 205.26 suspend the authorization to use authorized hours flexibly. The 205.27 recipient or responsible party may appeal the commissioner's 205.28 action according to section 256.045. The denial, revocation, or 205.29 suspension to use the flexible hours option shall not affect the 205.30 recipient's authorized level of personal care assistant services 205.31 as determined under subdivision 5. 205.32 Sec. 64. Minnesota Statutes 1998, section 256B.0627, is 205.33 amended by adding a subdivision to read: 205.34 Subd. 10. [FISCAL AGENT OPTION AVAILABLE FOR PERSONAL CARE 205.35 ASSISTANT SERVICES.] (a) "Fiscal agent option" is an option that 205.36 allows the recipient to: 206.1 (1) use a fiscal agent instead of a personal care provider 206.2 organization; 206.3 (2) supervise the personal care assistant; and 206.4 (3) use a consulting professional. 206.5 The commissioner may allow a recipient of personal care 206.6 assistant services to use a fiscal agent to assist the recipient 206.7 in paying and accounting for medically necessary covered 206.8 personal care assistant services authorized in subdivision 4 and 206.9 within the payment parameters of subdivision 5, unless otherwise 206.10 provided in this subdivision, all other statutory and regulatory 206.11 provisions relating to personal care services apply to a 206.12 recipient using the fiscal agent option. 206.13 (b) The recipient or responsible party shall: 206.14 (1) hire and terminate the personal care assistant and 206.15 consulting professional with the fiscal agent; 206.16 (2) recruit the personal care assistant and consulting 206.17 professional and orient and train the personal care assistant in 206.18 areas that do not require professional delegation as determined 206.19 by the county public health nurse; 206.20 (3) supervise and evaluate the personal care assistant in 206.21 areas that do not require professional delegation as determined 206.22 by the county public health nurse; 206.23 (4) cooperate with a consulting professional and implement 206.24 recommendations pertaining to the health and safety of the 206.25 recipient; 206.26 (5) hire a qualified professional to train and supervise 206.27 the performance of delegated tasks done by the personal care 206.28 assistant; 206.29 (6) monitor services and verify in writing the hours worked 206.30 by the personal care assistant and the consulting professional; 206.31 (7) develop and revise a care plan with assistance from a 206.32 consulting professional; 206.33 (8) verify and document the credentials of the consulting 206.34 professional; and 206.35 (9) enter into a written agreement as specified in 206.36 paragraph (f). 207.1 (c) The duties of the fiscal agent shall be to: 207.2 (1) bill the medical assistance program for personal care 207.3 assistant and consulting professional services; 207.4 (2) request and secure background checks on personal care 207.5 assistants and consulting professionals according to section 207.6 245A.04; 207.7 (3) pay the personal care assistant and consulting 207.8 professional based on actual hours of services provided; 207.9 (4) withhold and pay all applicable federal and state 207.10 taxes; 207.11 (5) verify and document hours worked by the personal care 207.12 assistant and consulting professional; 207.13 (6) make the arrangements and pay unemployment insurance, 207.14 taxes, workers' compensation, liability insurance, and other 207.15 benefits, if any; 207.16 (7) enroll in the medical assistance program as a fiscal 207.17 agent; and 207.18 (8) enter into a written agreement as specified in 207.19 paragraph (f) before services are provided. 207.20 (d) The fiscal agent: 207.21 (1) may not be related to the recipient, consulting 207.22 professional, or the personal care assistant; 207.23 (2) must ensure arm's length transactions with the 207.24 recipient and personal care assistant; and 207.25 (3) shall be considered a joint employer of the personal 207.26 care assistant and consulting professional to the extent 207.27 specified in this section. 207.28 The fiscal agent or owners of the entity that provides 207.29 fiscal agent services under this subdivision must pass a 207.30 criminal background check as required in section 256B.0627, 207.31 subdivision 1, paragraph (e). 207.32 (e) The consulting professional providing assistance to the 207.33 recipient shall meet the qualifications specified in section 207.34 256B.0625, subdivision 19c. The consulting professional shall 207.35 assist the recipient in developing and revising a plan to meet 207.36 the recipient's assessed needs and supervise the performance of 208.1 delegated tasks, as determined by the public health nurse. In 208.2 performing this function, the consulting professional must visit 208.3 the recipient in the recipient's home at least once annually. 208.4 The consulting professional must report to the local county 208.5 public health nurse concerns relating to the health and safety 208.6 of the recipient, and any suspected abuse, neglect, or financial 208.7 exploitation of the recipient to the appropriate authorities. 208.8 (f) The fiscal agent, recipient, or responsible party, 208.9 personal care assistant, and consulting professional shall enter 208.10 into a written agreement before services are started. The 208.11 agreement shall include: 208.12 (1) the duties of the recipient, consulting professional, 208.13 personal care assistant, and fiscal agent based on paragraphs 208.14 (a) to (e); 208.15 (2) the salary and benefits for the personal care assistant 208.16 and those providing professional consultation; 208.17 (3) the administrative fee of the fiscal agent and services 208.18 paid for with that fee, including background check fees; 208.19 (4) procedures to respond to billing or payment complaints; 208.20 and 208.21 (5) procedures for hiring and terminating the personal care 208.22 assistant and those providing professional consultation. 208.23 (g) The rates paid for personal care services and fiscal 208.24 agency services under this subdivision shall be the same rates 208.25 paid for personal care services and qualified professional 208.26 services under subdivision 2 respectively. Except for the 208.27 administrative fee of the fiscal agent specified in paragraph 208.28 (f), the remainder of the rates paid to the fiscal agent must be 208.29 used to pay for the salary and benefits for the personal care 208.30 assistant or those providing professional consultation. 208.31 (h) As part of the assessment defined in subdivision 1, the 208.32 following conditions must be met to use or continue use of a 208.33 fiscal agent: 208.34 (1) the recipient must be able to direct the recipient's 208.35 own care, or the responsible party for the recipient must be 208.36 readily available to direct the care of the personal care 209.1 assistant; 209.2 (2) the recipient or responsible party must be 209.3 knowledgeable of the health care needs of the recipient and be 209.4 able to effectively communicate those needs; 209.5 (3) a face-to-face assessment must be conducted by the 209.6 local county public health nurse at least annually or when there 209.7 is a significant change in the recipient's condition or change 209.8 in the need for personal care assistant services. The county 209.9 public health nurse will determine the services that require 209.10 professional delegation, if any, and the amount and frequency of 209.11 related supervision; 209.12 (4) the recipient cannot select the shared services option 209.13 as specified in subdivision 8; and 209.14 (5) parties must be in compliance with the written 209.15 agreement specified in paragraph (e). 209.16 (i) The commissioner shall deny, revoke, or suspend the 209.17 authorization to use the fiscal agent option if: 209.18 (1) it has been determined by the consulting professional 209.19 or local county public health nurse that the use of this option 209.20 jeopardizes the recipient's health and safety; 209.21 (2) the parties have failed to comply with the written 209.22 agreement specified in paragraph (e); or 209.23 (3) the use of the option has led to abusive or fraudulent 209.24 billing for personal care assistant services. 209.25 The recipient or responsible party may appeal the 209.26 commissioner's action according to section 256.045. The denial, 209.27 revocation, or suspension to use the fiscal agent option shall 209.28 not affect the recipient's authorized level of personal care 209.29 assistant services as determined in subdivision 5. 209.30 (Effective date: Section 64 (256B.0627, subd. 10) is 209.31 effective upon federal approval.) 209.32 Sec. 65. Minnesota Statutes 1998, section 256B.0627, is 209.33 amended by adding a subdivision to read: 209.34 Subd. 11. [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) 209.35 Medical assistance payments for shared private duty nursing 209.36 services by a private duty nurse shall be limited according to 210.1 this subdivision. For the purposes of this section, "private 210.2 duty nursing agency" means an agency licensed under chapter 144A 210.3 to provide private duty nursing services. 210.4 (b) Recipients of private duty nursing services may share 210.5 nursing staff and the commissioner shall provide a rate 210.6 methodology for shared private duty nursing. For two persons 210.7 sharing nursing care, the rate paid to a provider shall not 210.8 exceed 1.5 times the nonwaivered private duty nursing rates paid 210.9 for serving a single individual who is not ventilator dependent, 210.10 by a registered nurse or licensed practical nurse. These rates 210.11 apply only to situations in which both recipients are present 210.12 and receive shared private duty nursing care on the date for 210.13 which the service is billed. No more than two persons may 210.14 receive shared private duty nursing services from a private duty 210.15 nurse in a single setting. 210.16 (c) Shared private duty nursing care is the provision of 210.17 nursing services by a private duty nurse to two recipients at 210.18 the same time and in the same setting. For the purposes of this 210.19 subdivision, "setting" means: 210.20 (1) the home or foster care home of one of the individual 210.21 recipients; or 210.22 (2) a child care program licensed under chapter 245A or 210.23 operated by a local school district or private school; or 210.24 (3) an adult day care service licensed under chapter 245A. 210.25 This subdivision does not apply when a private duty nurse 210.26 is caring for multiple recipients in more than one setting. 210.27 (d) The recipient or the recipient's legal representative, 210.28 and the recipient's physician, in conjunction with the home 210.29 health care agency, shall determine: 210.30 (1) whether shared private duty nursing care is an 210.31 appropriate option based on the individual needs and preferences 210.32 of the recipient; and 210.33 (2) the amount of shared private duty nursing services 210.34 authorized as part of the overall authorization of nursing 210.35 services. 210.36 (e) The recipient or the recipient's legal representative, 211.1 in conjunction with the private duty nursing agency, shall 211.2 approve the setting, grouping, and arrangement of shared private 211.3 duty nursing care based on the individual needs and preferences 211.4 of the recipients. Decisions on the selection of recipients to 211.5 share services must be based on the ages of the recipients, 211.6 compatibility, and coordination of their care needs. 211.7 (f) The following items must be considered by the recipient 211.8 or the recipient's legal representative and the private duty 211.9 nursing agency, and documented in the recipient's health service 211.10 record: 211.11 (1) the additional training needed by the private duty 211.12 nurse to provide care to several recipients in the same setting 211.13 and to ensure that the needs of the recipients are met 211.14 appropriately and safely; 211.15 (2) the setting in which the shared private duty nursing 211.16 care will be provided; 211.17 (3) the ongoing monitoring and evaluation of the 211.18 effectiveness and appropriateness of the service and process 211.19 used to make changes in service or setting; 211.20 (4) a contingency plan which accounts for absence of the 211.21 recipient in a shared private duty nursing setting due to 211.22 illness or other circumstances; 211.23 (5) staffing backup contingencies in the event of employee 211.24 illness or absence; and 211.25 (6) arrangements for additional assistance to respond to 211.26 urgent or emergency care needs of the recipients. 211.27 (g) The provider must offer the recipient or responsible 211.28 party the option of shared or one-on-one private duty nursing 211.29 services. The recipient or responsible party can withdraw from 211.30 participating in a shared service arrangement at any time. 211.31 (h) The private duty nursing agency must document the 211.32 following in the health service record for each individual 211.33 recipient sharing private duty nursing care: 211.34 (1) permission by the recipient or the recipient's legal 211.35 representative for the maximum number of shared nursing care 211.36 hours per week chosen by the recipient; 212.1 (2) permission by the recipient or the recipient's legal 212.2 representative for shared private duty nursing services provided 212.3 outside the recipient's residence; 212.4 (3) permission by the recipient or the recipient's legal 212.5 representative for others to receive shared private duty nursing 212.6 services in the recipient's residence; 212.7 (4) revocation by the recipient or the recipient's legal 212.8 representative of the shared private duty nursing care 212.9 authorization, or the shared care to be provided to others in 212.10 the recipient's residence, or the shared private duty nursing 212.11 services to be provided outside the recipient's residence; and 212.12 (5) daily documentation of the shared private duty nursing 212.13 services provided by each identified private duty nurse, 212.14 including: 212.15 (i) the names of each recipient receiving shared private 212.16 duty nursing services together; 212.17 (ii) the setting for the shared services, including the 212.18 starting and ending times that the recipient received shared 212.19 private duty nursing care; and 212.20 (iii) notes by the private duty nurse regarding changes in 212.21 the recipient's condition, problems that may arise from the 212.22 sharing of private duty nursing services, and scheduling and 212.23 care issues. 212.24 (i) Unless otherwise provided in this subdivision, all 212.25 other statutory and regulatory provisions relating to private 212.26 duty nursing services apply to shared private duty nursing 212.27 services. 212.28 Nothing in this subdivision shall be construed to reduce 212.29 the total number of private duty nursing hours authorized for an 212.30 individual recipient under subdivision 5. 212.31 Sec. 66. Minnesota Statutes 1998, section 256B.0635, 212.32 subdivision 3, is amended to read: 212.33 Subd. 3. [MEDICAL ASSISTANCE FOR MFIP-S PARTICIPANTS WHO 212.34 OPT TO DISCONTINUE MONTHLY CASH ASSISTANCE.]Upon federal212.35approval,Medical assistance is available to persons who 212.36received MFIP-S in at least three of the six months preceding213.1the month in which the person optedopt to discontinue receiving 213.2 MFIP-S cash assistance under section 256J.31, subdivision 12. A 213.3 person who is eligible for medical assistance under this section 213.4 may receive medical assistance without reapplication as long as 213.5 the person meets MFIP-S eligibility requirements, unless the213.6assistance unit does not include a dependent child. Medical 213.7 assistance may be paid pursuant to subdivisions 1 and 2 for 213.8 persons who are no longer eligible for MFIP-S due to increased 213.9 employment or child support. A person may be eligible for 213.10 MinnesotaCare due to increased employment or child support, and 213.11 as such must be informed of the option to transition onto 213.12 MinnesotaCare. 213.13 Sec. 67. Minnesota Statutes 1998, section 256B.064, 213.14 subdivision 1a, is amended to read: 213.15 Subd. 1a. [GROUNDS FORMONETARY RECOVERY ANDSANCTIONS 213.16 AGAINST VENDORS.] The commissioner mayseek monetary recovery213.17andimpose sanctions againstvendorsa vendor of medical care 213.18 for any of the following: fraud, theft, or abuse in connection 213.19 with the provision of medical care to recipients of public 213.20 assistance; a pattern of presentment of false or duplicate 213.21 claims or claims for services not medically necessary; a pattern 213.22 of making false statements of material facts for the purpose of 213.23 obtaining greater compensation than that to which the vendor is 213.24 legally entitled; suspension or termination as a Medicare 213.25 vendor; refusal to grant the state agency access during regular 213.26 business hours to examine all records necessary to disclose the 213.27 extent of services provided to program recipients and 213.28 appropriateness of claims for payment; failure to comply with a 213.29 commissioner's order to repay an overpayment; failure to comply 213.30 with a settlement agreement; failure to comply with the 213.31 disclosure requirements of section 256B.0646; and any reason for 213.32 which a vendor could be excluded from participation in the 213.33 Medicare program under section 1128, 1128A, or 1866(b)(2) of the 213.34 Social Security Act. The determination of services not 213.35 medically necessary may be made by the commissioner in 213.36 consultation with a peer advisory task force appointed by the 214.1 commissioner on the recommendation of appropriate professional 214.2 organizations. The task force expires as provided in section 214.3 15.059, subdivision 5. 214.4 Sec. 68. Minnesota Statutes 1998, section 256B.064, 214.5 subdivision 1b, is amended to read: 214.6 Subd. 1b. [SANCTIONS AVAILABLE.] The commissioner may 214.7 impose the following sanctions for the conduct described in 214.8 subdivision 1a:referral to the appropriate state licensing214.9board,suspension or withholding of payments to a vendor,and 214.10 suspending or terminating participation in the 214.11 program. Regardless of imposition of sanctions, the 214.12 commissioner may make a referral to the appropriate state 214.13 licensing board. 214.14 Sec. 69. Minnesota Statutes 1998, section 256B.064, 214.15 subdivision 1c, is amended to read: 214.16 Subd. 1c. [GROUNDS FOR AND METHODS OF MONETARY RECOVERY.] 214.17 The commissioner may obtain monetary recovery from a vendor who 214.18 has been improperly paid either as a result of conduct described 214.19 in subdivision 1a or as a result of a vendor or department 214.20 error, regardless of whether the error was 214.21 intentional. Patterns need not be proven as a precondition to 214.22 monetary recovery of erroneous or false claims, duplicate 214.23 claims, claims for services not medically necessary, or claims 214.24 based on false statements. The commissioner may obtain monetary 214.25 recovery using methods, including but not limited to the 214.26 following: assessing and recovering money improperly paid and 214.27 debiting from future payments any money improperly 214.28 paid.Patterns need not be proven as a precondition to monetary214.29recovery of erroneous or false claims, duplicate claims, claims214.30for services not medically necessary, or claims based on false214.31statements.The commissioner shall charge interest on money to 214.32 be recovered if the recovery is to be made by installment 214.33 payments or debits, except when the monetary recovery is of an 214.34 overpayment that resulted from a department error. The interest 214.35 charged shall be the rate established by the commissioner of 214.36 revenue under section 270.75. 215.1 Sec. 70. Minnesota Statutes 1998, section 256B.064, is 215.2 amended by adding a subdivision to read: 215.3 Subd. 1e. [SANCTIONS AND MONETARY RECOVERY AGAINST RELATED 215.4 VENDORS.] In a situation where the commissioner is authorized by 215.5 this section to impose sanctions against or make monetary 215.6 recovery from a vendor of medical care, the commissioner may 215.7 also take such action against other vendors that have common 215.8 control or ownership with the vendor. A vendor has common 215.9 control or ownership with another vendor if: 215.10 (1) one or more persons have a direct or indirect ownership 215.11 or control interest in both vendors; 215.12 (2) one vendor has a direct or indirect ownership or 215.13 control interest in the other vendor; 215.14 (3) the vendors have interlocking management or ownership; 215.15 interrelated business interests among family members; or shared 215.16 facilities, equipment, and use of employees; or 215.17 (4) one of the vendors is a new business entity created in 215.18 connection with the termination of the other vendor, and the 215.19 vendors have the same or similar management, ownership, or 215.20 principal employees. 215.21 Sec. 71. Minnesota Statutes 1998, section 256B.064, 215.22 subdivision 2, is amended to read: 215.23 Subd. 2. [IMPOSITION OF MONETARY RECOVERY AND SANCTIONS.] 215.24 (a) The commissioner shall determine any monetary amounts to be 215.25 recovered andthe sanctionsanctions to be imposed upon a vendor 215.26 of medical carefor conduct described by subdivision 1aunder 215.27 this section. Except as provided in paragraph (b), neither a 215.28 monetary recovery nor a sanction will be imposed by the 215.29 commissioner without prior notice and an opportunity for a 215.30 hearing, according to chapter 14, on the commissioner's proposed 215.31 action, provided that the commissioner may suspend or reduce 215.32 payment to a vendor of medical care, except a nursing home or 215.33 convalescent care facility, after notice and prior to the 215.34 hearing if in the commissioner's opinion that action is 215.35 necessary to protect the public welfare and the interests of the 215.36 program. 216.1 (b) Except for a nursing home or convalescent care 216.2 facility, the commissioner may withhold or reduce payments to a 216.3 vendor of medical care without providing advance notice of such 216.4 withholding or reduction ifeitherany of the following occurs: 216.5 (1) the vendor is convicted of a crime involving the 216.6 conduct described in subdivision 1a;or216.7 (2) the commissioner receives reliable evidence of fraud or 216.8 willful misrepresentation by the vendor.; or 216.9 (3) the vendor has requested that prior authorization for 216.10 the vendor's clients be changed to another provider, and: 216.11 (i) the vendor is under investigation for fraud; 216.12 (ii) the vendor has received or is appealing a notice of 216.13 agency action seeking monetary recovery under this section; or 216.14 (iii) the vendor has an established overpayment debt owed 216.15 to the commissioner. 216.16 (c) The commissioner must send notice of the withholding or 216.17 reduction of payments under paragraph (b) within five days of 216.18 taking such action. The notice must: 216.19 (1) state that payments are being withheld according to 216.20 paragraph (b); 216.21 (2) except in the case of a conviction for conduct 216.22 described in subdivision 1a, state that the withholding is for a 216.23 temporary period and cite the circumstances under which 216.24 withholding will be terminated; 216.25 (3) identify the types of claims to which the withholding 216.26 applies; and 216.27 (4) inform the vendor of the right to submit written 216.28 evidence for consideration by the commissioner. 216.29 The withholding or reduction of payments will not continue 216.30 after the commissioner determines there is insufficient evidence 216.31 of fraud or willful misrepresentation by the vendor, or after 216.32 legal proceedings relating to the alleged fraud or willful 216.33 misrepresentation are completed, unless the commissioner has 216.34 sent notice of intention to impose monetary recovery or 216.35 sanctions under paragraph (a). 216.36 (d) Upon receipt of a notice under paragraph (a) that a 217.1 monetary recovery or sanction is to be imposed, a vendor may 217.2 request a contested case, as defined in section 14.02, 217.3 subdivision 3, by filing with the commissioner a written request 217.4 of appeal. The appeal request must be received by the 217.5 commissioner no later than 30 days after the date the 217.6 notification of monetary recovery or sanction was mailed to the 217.7 vendor. The appeal request must specify: 217.8 (1) each disputed item, the reason for the dispute, and an 217.9 estimate of the dollar amount involved for each disputed item; 217.10 (2) the computation that the vendor believes is correct; 217.11 (3) the authority in statute or rule upon which the vendor 217.12 relies for each disputed item; 217.13 (4) the name and address of the person or entity with whom 217.14 contacts may be made regarding the appeal; and 217.15 (5) other information required by the commissioner. 217.16 Sec. 72. [256B.0646] [OWNERSHIP AND CONTROL DISCLOSURE.] 217.17 Subdivision 1. [DEFINITIONS.] The definitions in this 217.18 subdivision apply to this chapter and chapter 256. 217.19 (a) "Indirect ownership interest" means an ownership 217.20 interest in an entity that has an ownership interest in a vendor 217.21 of medical care. Indirect ownership interest also includes an 217.22 ownership interest in an entity that has an indirect ownership 217.23 interest in a vendor of medical care. 217.24 (b) "Managing employee" means a general manager, business 217.25 manager, administrator, director, or other individual who for 217.26 pay or otherwise exercises operational or managerial control 217.27 over, or directly or indirectly conducts the day-to-day 217.28 operation of, a vendor of medical care. 217.29 (c) "Ownership interest" means the possession of equity in 217.30 the capital, stock, or profits of a vendor of medical care. 217.31 (d) "Person" means an individual, corporation, partnership, 217.32 association, or legal entity, however organized. 217.33 (e) "Person with ownership or control interest" means a 217.34 person that: 217.35 (1) has an ownership interest equal to five percent or more 217.36 in a vendor of medical care; 218.1 (2) has an indirect ownership interest equal to five 218.2 percent or more in a vendor of medical care; 218.3 (3) has a combination of direct and indirect ownership 218.4 interests equal to five percent or more in a vendor of medical 218.5 care; 218.6 (4) owns an interest of five percent or more in any 218.7 mortgage, deed of trust, note, or other obligation secured by a 218.8 vendor of medical care, if that interest equals at least five 218.9 percent of the value of the property or assets of a vendor of 218.10 medical care; 218.11 (5) is an officer or director of a vendor of medical care 218.12 that is organized as a corporation; 218.13 (6) is a partner of a vendor of medical care that is 218.14 organized as a partnership; or 218.15 (7) is a managing employee of a vendor of medical care. 218.16 (f) "Provider" means a vendor of medical care who is 218.17 enrolled as a provider in the medical assistance program, 218.18 general assistance program, or MinnesotaCare. 218.19 Subd. 2. [DETERMINATION OF OWNERSHIP OR CONTROL.] (a) A 218.20 prospective or current program provider must disclose the 218.21 information on ownership and control specified in paragraph 218.22 (b). The information must be disclosed on a form provided by 218.23 the commissioner. The disclosure form must be submitted: 218.24 (1) no later than December 31, 1999, if the provider is 218.25 enrolled in the program on the effective date of this section; 218.26 (2) when a vendor applies for enrollment as a program 218.27 provider; 218.28 (3) when an enrolled provider requests a change of address 218.29 or provider name; and 218.30 (4) when required by a schedule established by the 218.31 commissioner for the regular updating of disclosures. The 218.32 schedule must not require updating of disclosures more 218.33 frequently than once a year. 218.34 (b) A disclosure of information on ownership and control 218.35 required by paragraph (a) shall consist of the following 218.36 information about the prospective or current program provider: 219.1 (1) the name and address of each person or entity with an 219.2 ownership or control interest in the provider; 219.3 (2) the name and address of each of the provider's managing 219.4 employees; 219.5 (3) whether any of the persons named due to clause (1) or 219.6 (2) are related to one another as spouses, siblings, parents, 219.7 child, aunt, uncle, niece, nephew, grandchild, or grandparent, 219.8 and, if so, the names of the persons and their relationship; 219.9 (4) the names of any other program providers or vendors in 219.10 which a person named due to clause (1) also has an ownership or 219.11 control interest; and 219.12 (5) for any entity named due to clause (1) that is a 219.13 corporation, the names and addresses of its officers and 219.14 directors. In addition, for each such corporation, the 219.15 following must be attached to the disclosure: a full and 219.16 complete copy of its articles of incorporation and bylaws and 219.17 any amendments and, if a corporation is foreign to this state, a 219.18 copy of its certificate of authority to do business in this 219.19 state. 219.20 (c) Failure to disclose the information on ownership and 219.21 control when required by paragraph (a) shall be grounds for 219.22 denial or termination of provider enrollment. 219.23 Sec. 73. Minnesota Statutes 1998, section 256B.0917, 219.24 subdivision 8, is amended to read: 219.25 Subd. 8. [LIVING-AT-HOME/BLOCK NURSE PROGRAM GRANT.] (a) 219.26 The organization awarded the contract under subdivision 7, shall 219.27 develop and administer a grant program to establish or expand up 219.28 to2730 community-based organizations that will implement 219.29 living-at-home/block nurse programs that are designed to enable 219.30 senior citizens to live as independently as possible in their 219.31 homes and in their communities. At least one-half of the 219.32 programs must be in counties outside the seven-county 219.33 metropolitan area. Nonprofit organizations and units of local 219.34 government are eligible to apply for grants to establish the 219.35 community organizations that will implement living-at-home/block 219.36 nurse programs. In awarding grants, the organization awarded 220.1 the contract under subdivision 7 shall give preference to 220.2 nonprofit organizations and units of local government from 220.3 communities that: 220.4 (1) have high nursing home occupancy rates; 220.5 (2) have a shortage of health care professionals; 220.6 (3) are located in counties adjacent to, or are located in, 220.7 counties with existing living-at-home/block nurse programs; and 220.8 (4) meet other criteria established by LAH/BN, Inc., in 220.9 consultation with the commissioner. 220.10 (b) Grant applicants must also meet the following criteria: 220.11 (1) the local community demonstrates a readiness to 220.12 establish a community model of care, including the formation of 220.13 a board of directors, advisory committee, or similar group, of 220.14 which at least two-thirds is comprised of community citizens 220.15 interested in community-based care for older persons; 220.16 (2) the program has sponsorship by a credible, 220.17 representative organization within the community; 220.18 (3) the program has defined specific geographic boundaries 220.19 and defined its organization, staffing and coordination/delivery 220.20 of services; 220.21 (4) the program demonstrates a team approach to 220.22 coordination and care, ensuring that the older adult 220.23 participants, their families, the formal and informal providers 220.24 are all part of the effort to plan and provide services; and 220.25 (5) the program provides assurances that all community 220.26 resources and funding will be coordinated and that other funding 220.27 sources will be maximized, including a person's own resources. 220.28 (c) Grant applicants must provide a minimum of five percent 220.29 of total estimated development costs from local community 220.30 funding. Grants shall be awarded for four-year periods, and the 220.31 base amount shall not exceed $80,000 per applicant for the grant 220.32 period. The organization under contract may increase the grant 220.33 amount for applicants from communities that have socioeconomic 220.34 characteristics that indicate a higher level of need for 220.35 assistance. Subject to the availability of funding, grants and 220.36 grant renewals awarded or entered into on or after July 1, 1997, 221.1 shall be renewed by LAH/BN, Inc. every four years, unless 221.2 LAH/BN, Inc. determines that the grant recipient has not 221.3 satisfactorily operated the living-at-home/block nurse program 221.4 in compliance with the requirements of paragraphs (b) and (d). 221.5 Grants provided to living-at-home/block nurse programs under 221.6 this paragraph may be used for both program development and the 221.7 delivery of services. 221.8 (d) Each living-at-home/block nurse program shall be 221.9 designed by representatives of the communities being served to 221.10 ensure that the program addresses the specific needs of the 221.11 community residents. The programs must be designed to: 221.12 (1) incorporate the basic community, organizational, and 221.13 service delivery principles of the living-at-home/block nurse 221.14 program model; 221.15 (2) provide senior citizens with registered nurse directed 221.16 assessment, provision and coordination of health and personal 221.17 care services on a sliding fee basis as an alternative to 221.18 expensive nursing home care; 221.19 (3) provide information, support services, homemaking 221.20 services, counseling, and training for the client and family 221.21 caregivers; 221.22 (4) encourage the development and use of respite care, 221.23 caregiver support, and in-home support programs, such as adult 221.24 foster care and in-home adult day care; 221.25 (5) encourage neighborhood residents and local 221.26 organizations to collaborate in meeting the needs of senior 221.27 citizens in their communities; 221.28 (6) recruit, train, and direct the use of volunteers to 221.29 provide informal services and other appropriate support to 221.30 senior citizens and their caregivers; and 221.31 (7) provide coordination and management of formal and 221.32 informal services to senior citizens and their families using 221.33 less expensive alternatives. 221.34 Sec. 74. Minnesota Statutes 1998, section 256B.37, 221.35 subdivision 2, is amended to read: 221.36 Subd. 2. [CIVIL ACTION FOR RECOVERY.] To recover under 222.1 this section, the attorney general, or the appropriate county222.2attorney, acting upon direction from the attorney general,may 222.3 institute or join a civil action to enforce the subrogation 222.4 rights of the commissioner established under this section. 222.5 Any prepaid health plan providing services under sections 222.6 256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 222.7 children's mental health collaboratives under section 245.493; 222.8 demonstration projects for persons with disabilities under 222.9 section 256B.77; nursing homes under the alternative payment 222.10 demonstration project under section 256B.434; or the 222.11 county-based purchasing entity providing services under section 222.12 256B.692 may retain legal representation to enforce the 222.13 subrogation rights created under this section or, if no action 222.14 has been brought, may initiate and prosecute an independent 222.15 action on their behalf against a person, firm, or corporation 222.16 that may be liable to the person to whom the care or payment was 222.17 furnished. 222.18 Sec. 75. Minnesota Statutes 1998, section 256B.501, 222.19 subdivision 8a, is amended to read: 222.20 Subd. 8a. [PAYMENT FOR PERSONS WITH SPECIAL NEEDS FOR 222.21 CRISIS INTERVENTION SERVICES.]State-operated,Community-based 222.22 crisis servicesprovided in accordance with section 252.50,222.23subdivision 7, toauthorized by the commissioner or the 222.24 commissioner's designee for a resident of an intermediate care 222.25 facility for persons with mental retardation (ICF/MR) reimbursed 222.26 under this section shall be paid by medical assistance in 222.27 accordance with the paragraphs (a) to(h)(g). 222.28 (a) "Crisis services" means the specialized services listed 222.29 in clauses (1) to (3) provided to prevent the recipient from 222.30 requiring placement in a more restrictive institutional setting 222.31 such as an inpatient hospital or regional treatment center and 222.32 to maintain the recipient in the present community setting. 222.33 (1) The crisis services provider shall assess the 222.34 recipient's behavior and environment to identify factors 222.35 contributing to the crisis. 222.36 (2) The crisis services provider shall develop a 223.1 recipient-specific intervention plan in coordination with the 223.2 service planning team and provide recommendations for revisions 223.3 to the individual service plan if necessary to prevent or 223.4 minimize the likelihood of future crisis situations. The 223.5 intervention plan shall include a transition plan to aid the 223.6 recipient in returning to the community-based ICF/MR if the 223.7 recipient is receiving residential crisis services. 223.8 (3) The crisis services provider shall consult with and 223.9 provide training and ongoing technical assistance to the 223.10 recipient's service providers to aid in the implementation of 223.11 the intervention plan and revisions to the individual service 223.12 plan. 223.13 (b) "Residential crisis services" means crisis services 223.14 that are provided to a recipient admitted tothe crisis services223.15foster care settingan alternative, state-licensed site approved 223.16 by the commissioner, because the ICF/MR receiving reimbursement 223.17 under this section is not able, as determined by the 223.18 commissioner, to provide the intervention and protection of the 223.19 recipient and others living with the recipient that is necessary 223.20 to prevent the recipient from requiring placement in a more 223.21 restrictive institutional setting. 223.22 (c) Residential crisis services providers mustbe licensed223.23bymaintain a license from the commissionerunder section223.24245A.03 to provide foster care, must exclusively providefor the 223.25 residence when providing crisis services for short-term crisis 223.26 intervention, and must not be located in a private residence. 223.27 (d) Payment ratesare determined annually for each crisis223.28services provider based on cost of care for each provider as223.29defined in section 246.50. Interim payment rates are calculated223.30on a per diem basis by dividing the projected cost of providing223.31care by the projected number of contact days for the fiscal223.32year, as estimated by the commissioner. Final payment rates are223.33calculated by dividing the actual cost of providing care by the223.34actual number of contact days in the applicable fiscal223.35yearshall be established consistent with county negotiated 223.36 crisis intervention services. 224.1 (e)Payment shall be made for each contact day. "Contact224.2day" means any day in which the crisis services provider has224.3face-to-face contact with the recipient or any of the224.4recipient's medical assistance service providers for the purpose224.5of providing crisis services as defined in paragraph (c).224.6(f)Payment for residential crisis services is limited to 224.7 21 days, unless an additional period is authorized by the 224.8 commissioner or part of an approved regional plan.The224.9additional period may not exceed 21 days.224.10(g)(f) Payment for crisis services shall be made only for 224.11 services provided while the ICF/MR receiving reimbursement under 224.12 this section: 224.13 (1) has a shared services agreement with the crisis 224.14 services provider in effectin accordance withunder section 224.15 246.57; and 224.16 (2)has reassigned payment for the provision of the crisis224.17services under this subdivision to the commissioner in224.18accordance with Code of Federal Regulations, title 42, section224.19447.10(e); and224.20(3)has executed a cooperative agreement with the crisis 224.21 services provider to implement the intervention plan and 224.22 revisions to the individual service plan as necessary to prevent 224.23 or minimize the likelihood of future crisis situations, to 224.24 maintain the recipient in the present community setting, and to 224.25 prevent the recipient from requiring a more restrictive 224.26 institutional setting. 224.27(h)(g) Payment to the ICF/MR receiving reimbursement under 224.28 this section shall be made for up to 18 therapeutic leave days 224.29 during which the recipient is receiving residential crisis 224.30 services, if the ICF/MR is otherwise eligible to receive payment 224.31 for a therapeutic leave day under Minnesota Rules, part 224.32 9505.0415. Payment under this paragraph shall be terminated if 224.33 the commissioner determines that the ICF/MR is not meeting the 224.34 terms of thecooperativeshared service agreement under 224.35 paragraph(g)(f) or that the recipient will not return to the 224.36 ICF/MR. 225.1 Sec. 76. Minnesota Statutes 1998, section 256B.69, 225.2 subdivision 3a, is amended to read: 225.3 Subd. 3a. [COUNTY AUTHORITY.] (a) The commissioner, when 225.4 implementing the general assistance medical care, or medical 225.5 assistance prepayment program within a county, must include the 225.6 county board in the process of development, approval, and 225.7 issuance of the request for proposals to provide services to 225.8 eligible individuals within the proposed county. County boards 225.9 must be given reasonable opportunity to make recommendations 225.10 regarding the development, issuance, review of responses, and 225.11 changes needed in the request for proposals. The commissioner 225.12 must provide county boards the opportunity to review each 225.13 proposal based on the identification of community needs under 225.14 chapters 145A and 256E and county advocacy activities. If a 225.15 county board finds that a proposal does not address certain 225.16 community needs, the county board and commissioner shall 225.17 continue efforts for improving the proposal and network prior to 225.18 the approval of the contract. The county board shall make 225.19 recommendations regarding the approval of local networks and 225.20 their operations to ensure adequate availability and access to 225.21 covered services. The provider or health plan must respond 225.22 directly to county advocates and the state prepaid medical 225.23 assistance ombudsperson regarding service delivery and must be 225.24 accountable to the state regarding contracts with medical 225.25 assistance and general assistance medical care funds. The 225.26 county board may recommend a maximum number of participating 225.27 health plans after considering the size of the enrolling 225.28 population; ensuring adequate access and capacity; considering 225.29 the client and county administrative complexity; and considering 225.30 the need to promote the viability of locally developed health 225.31 plans. The county board or a single entity representing a group 225.32 of county boards and the commissioner shall mutually select 225.33 health plans for participation at the time of initial 225.34 implementation of the prepaid medical assistance program in that 225.35 county or group of counties and at the time of contract renewal. 225.36 The commissioner shall also seek input for contract requirements 226.1 from the county or single entity representing a group of county 226.2 boards at each contract renewal and incorporate those 226.3 recommendations into the contract negotiation process. The 226.4 commissioner, in conjunction with the county board, shall 226.5 actively seek to develop a mutually agreeable timetable prior to 226.6 the development of the request for proposal, but counties must 226.7 agree to initial enrollment beginning on or before January 1, 226.8 1999, in either the prepaid medical assistance and general 226.9 assistance medical care programs or county-based purchasing 226.10 under section 256B.692. At least 90 days before enrollment in 226.11 the medical assistance and general assistance medical care 226.12 prepaid programs begins in a county in which the prepaid 226.13 programs have not been established, the commissioner shall 226.14 provide a report to the chairs of senate and house committees 226.15 having jurisdiction over state health care programs which 226.16 verifies that the commissioner complied with the requirements 226.17 for county involvement that are specified in this subdivision. 226.18 (b) The commissioner shall seek a federal waiver to allow a 226.19 fee-for-service plan option to MinnesotaCare enrollees. The 226.20 commissioner shall develop an increase of the premium fees 226.21 required under section 256L.06 up to 20 percent of the premium 226.22 fees for the enrollees who elect the fee-for-service option. 226.23 Prior to implementation, the commissioner shall submit this fee 226.24 schedule to the chair and ranking minority member of the senate 226.25 health care committee, the senate health care and family 226.26 services funding division, the house of representatives health 226.27 and human services committee, and the house of representatives 226.28 health and human services finance division. 226.29 (c) At the option of the county board, the board may 226.30 develop contract requirements related to the achievement of 226.31 local public health goals to meet the health needs of medical 226.32 assistance and general assistance medical care enrollees. These 226.33 requirements must be reasonably related to the performance of 226.34 health plan functions and within the scope of the medical 226.35 assistance and general assistance medical care benefit sets. If 226.36 the county board and the commissioner mutually agree to such 227.1 requirements, the department shall include such requirements in 227.2 all health plan contracts governing the prepaid medical 227.3 assistance and general assistance medical care programs in that 227.4 county at initial implementation of the program in that county 227.5 and at the time of contract renewal. The county board may 227.6 participate in the enforcement of the contract provisions 227.7 related to local public health goals. 227.8 (d) For counties in which prepaid medical assistance and 227.9 general assistance medical care programs have not been 227.10 established, the commissioner shall not implement those programs 227.11 if a county board submits acceptable and timely preliminary and 227.12 final proposals under section 256B.692, until county-based 227.13 purchasing is no longer operational in that county. For 227.14 counties in which prepaid medical assistance and general 227.15 assistance medical care programs are in existence on or after 227.16 September 1, 1997, the commissioner must terminate contracts 227.17 with health plans according to section 256B.692, subdivision 5, 227.18 if the county board submits and the commissioner accepts 227.19 preliminary and final proposals according to that subdivision. 227.20 The commissioner is not required to terminate contracts that 227.21 begin on or after September 1, 1997, according to section 227.22 256B.692 until two years have elapsed from the date of initial 227.23 enrollment. 227.24 (e) In the event that a county board or a single entity 227.25 representing a group of county boards and the commissioner 227.26 cannot reach agreement regarding: (i) the selection of 227.27 participating health plans in that county; (ii) contract 227.28 requirements; or (iii) implementation and enforcement of county 227.29 requirements including provisions regarding local public health 227.30 goals, the commissioner shall resolve all disputes after taking 227.31 into account the recommendations of a three-person mediation 227.32 panel. The panel shall be composed of one designee of the 227.33 president of the association of Minnesota counties, one designee 227.34 of the commissioner of human services, and one designee of the 227.35 commissioner of health. 227.36 (f) If a county which elects to implement county-based 228.1 purchasing ceases to implement county-based purchasing, it is 228.2 prohibited from assuming the responsibility of county-based 228.3 purchasing for a period of five years from the date it 228.4 discontinues purchasing. 228.5 (g) Notwithstanding the requirement in this subdivision 228.6 that a county must agree to initial enrollment on or before 228.7 January 1, 1999, the commissioner shall grant a delayof up to228.8nine monthsin the implementation of the county-based purchasing 228.9 authorized in section 256B.692 until federal waiver authority 228.10 and approval has been granted, if the county or group of 228.11 counties has submitted a preliminary proposal for county-based 228.12 purchasing by September 1, 1997, has not already implemented the 228.13 prepaid medical assistance program before January 1, 1998, and 228.14 has submitted a written request for the delay to the 228.15 commissioner by July 1, 1998. In order for the delay to be 228.16 continued, the county or group of counties must also submit to 228.17 the commissioner the following information by December 1, 1998. 228.18 The information must: 228.19 (1) identify the proposed date of implementation,not later228.20than October 1, 1999as determined under section 256B.692, 228.21 subdivision 5; 228.22 (2) include copies of the county board resolutions which 228.23 demonstrate the continued commitment to the implementation of 228.24 county-based purchasing by the proposed date. County board 228.25 authorization may remain contingent on the submission of a final 228.26 proposal which meets the requirements of section 256B.692, 228.27 subdivision 5, paragraph (b); 228.28 (3) demonstrate actions taken for the establishment of a 228.29 governance structure between the participating counties and 228.30 describe how the fiduciary responsibilities of county-based 228.31 purchasing will be allocated between the counties, if more than 228.32 one county is involved in the proposal; 228.33 (4) describe how the risk of a deficit will be managed in 228.34 the event expenditures are greater than total capitation 228.35 payments. This description must identify how any of the 228.36 following strategies will be used: 229.1 (i) risk contracts with licensed health plans; 229.2 (ii) risk arrangements with providers who are not licensed 229.3 health plans; 229.4 (iii) risk arrangements with other licensed insurance 229.5 entities; and 229.6 (iv) funding from other county resources; 229.7 (5) include, if county-based purchasing will not contract 229.8 with licensed health plans or provider networks, letters of 229.9 interest from local providers in at least the categories of 229.10 hospital, physician, mental health, and pharmacy which express 229.11 interest in contracting for services. These letters must 229.12 recognize any risk transfer identified in clause (4), item (ii); 229.13 and 229.14 (6) describe the options being considered to obtain the 229.15 administrative services required in section 256B.692, 229.16 subdivision 3, clauses (3) and (5). 229.17 (h) For counties which receive a delay under this 229.18 subdivision, the final proposals required under section 229.19 256B.692, subdivision 5, paragraph (b), must be submitted at 229.20 least six months prior to the requested implementation date. 229.21 Authority to implement county-based purchasing remains 229.22 contingent on approval of the final proposal as required under 229.23 section 256B.692. 229.24 (i) If the commissioner is unable to provide 229.25 county-specific, individual-level fee-for-service claims to 229.26 counties by June 4, 1998, the commissioner shall grant a delay 229.27 under paragraph (g) of up to 12 months in the implementation of 229.28 county-based purchasing, and shall require implementation not 229.29 later than January 1, 2000. In order to receive an extension of 229.30 the proposed date of implementation under this paragraph, a 229.31 county or group of counties must submit a written request for 229.32 the extension to the commissioner by August 1, 1998, must submit 229.33 the information required under paragraph (g) by December 1, 229.34 1998, and must submit a final proposal as provided under 229.35 paragraph (h). 229.36 (j) Notwithstanding other requirements of this subdivision, 230.1 the commissioner shall not require the implementation of the 230.2 county-based purchasing authorized in section 256B.692 until six 230.3 months after federal waiver approval has been obtained for 230.4 county-based purchasing if the county or counties have submitted 230.5 the final plan as required in section 256B.692, subdivision 5. 230.6 The commissioner shall allow the county or counties who 230.7 submitted information under section 256B.692, subdivision 5, to 230.8 submit supplemental or additional information which was not 230.9 possible to submit by April 1, 1999. A county or counties shall 230.10 continue to submit the required information and substantive 230.11 detail necessary to obtain a prompt response and waiver 230.12 approval. If amendments to the final plan are necessary due to 230.13 the terms and conditions of the waiver approval, the 230.14 commissioner shall allow the county or group of counties 60 days 230.15 to make the necessary amendment to the final plan and shall not 230.16 require implementation of the county-based purchasing until six 230.17 months after the revised final plan has been submitted. 230.18 Sec. 77. Minnesota Statutes 1998, section 256B.69, is 230.19 amended by adding a subdivision to read: 230.20 Subd. 3b. [PROVISION OF DATA TO COUNTY BOARDS.] The 230.21 commissioner, in consultation with representatives of county 230.22 boards of commissioners, shall identify program information and 230.23 data necessary on an ongoing basis for county boards to: 230.24 (1) make recommendations to the commissioner related to 230.25 state purchasing under the prepaid medical assistance program; 230.26 and 230.27 (2) effectively administer county-based purchasing. 230.28 This information and data must include, but is not limited to, 230.29 county-specific fee-for-service and prepaid health plan claims 230.30 information. This data must not include identifiable 230.31 individual-level claims. 230.32 Sec. 78. Minnesota Statutes 1998, section 256B.69, is 230.33 amended by adding a subdivision to read: 230.34 Subd. 4b. [INDIVIDUAL EDUCATION PLAN AND INDIVIDUALIZED 230.35 FAMILY SERVICE PLAN SERVICES.] The commissioner shall amend the 230.36 federal waiver allowing the state to separate out individual 231.1 education plan and individualized family service plan services 231.2 for children enrolled in the prepaid medical assistance program 231.3 and the MinnesotaCare program. Effective July 1, 1999, or upon 231.4 federal approval, medical assistance coverage of eligible 231.5 individual education plan and individualized family service plan 231.6 services shall not be included in the capitated services for 231.7 children enrolled in health plans through the prepaid medical 231.8 assistance program and the MinnesotaCare program. Upon federal 231.9 approval, local school districts shall bill the commissioner for 231.10 these services, and claims shall be paid on a fee-for-service 231.11 basis. 231.12 Sec. 79. Minnesota Statutes 1998, section 256B.69, 231.13 subdivision 5b, is amended to read: 231.14 Subd. 5b. [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 231.15 prepaid medical assistance and general assistance medical care 231.16 program contract rates set by the commissioner under subdivision 231.17 5 and effective on or after January 1, 1998, capitation rates 231.18 for nonmetropolitan counties shall on a weighted average be no 231.19 less than 88 percent of the capitation rates for metropolitan 231.20 counties, excluding Hennepin county. The commissioner shall 231.21 make a pro rata adjustment in capitation rates paid to counties 231.22 other than nonmetropolitan counties in order to make this 231.23 provision budget neutral. 231.24 (b) For prepaid medical assistance program contract rates 231.25 set by the commissioner under subdivision 5 and effective on or 231.26 after January 1, 2001, capitation rates for nonmetropolitan 231.27 counties shall, on a weighted average, be no less than 89 231.28 percent of the capitation rates for metropolitan counties, 231.29 excluding Hennepin county. 231.30 Sec. 80. Minnesota Statutes 1998, section 256B.69, is 231.31 amended by adding a subdivision to read: 231.32 Subd. 5e. [MEDICAL EDUCATION AND RESEARCH PAYMENTS.] For 231.33 the calendar years 1999, 2000, and 2001, a hospital that 231.34 participates in funding the federal share of the medical 231.35 education and research trust fund payment under Laws 1998, 231.36 chapter 407, article 1, section 3, shall not be held liable for 232.1 any amounts attributable to this payment above the charge limit 232.2 of section 256.969, subdivision 3a. The commissioner of human 232.3 services shall assume liability for any corresponding federal 232.4 share of the payments above the charge limit. 232.5 Sec. 81. Minnesota Statutes 1998, section 256B.692, 232.6 subdivision 2, is amended to read: 232.7 Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.] (a) 232.8 Notwithstanding chapters 62D and 62N, a county that elects to 232.9 purchase medical assistance and general assistance medical care 232.10 in return for a fixed sum without regard to the frequency or 232.11 extent of services furnished to any particular enrollee is not 232.12 required to obtain a certificate of authority under chapter 62D 232.13 or 62N. The county board of commissioners is the governing body 232.14 of a county-based purchasing program. In a multicounty 232.15 arrangement, the governing body is a joint powers board 232.16 established under section 471.59. 232.17 (b) A county that elects to purchase medical assistance and 232.18 general assistance medical care services under this section must 232.19 satisfy the commissioner of health that the requirements for 232.20 assurance of consumer protection, provider protection, and 232.21 fiscal solvency of chapter 62D, applicable to health maintenance 232.22 organizations, or chapter 62N, applicable to community 232.23 integrated service networks, will be met. 232.24 (c) A county must also assure the commissioner of health 232.25 that the requirements of sections 62J.041; 62J.48; 62J.71 to 232.26 62J.73; 62M.01 to 62M.16; all applicable provisions of chapter 232.27 62Q, including sections 62Q.07; 62Q.075; 62Q.105; 62Q.1055; 232.28 62Q.106; 62Q.11; 62Q.12; 62Q.135; 62Q.14; 62Q.145; 62Q.19; 232.29 62Q.23, paragraph (c); 62Q.30; 62Q.43; 62Q.47; 62Q.50; 62Q.52 to 232.30 62Q.56; 62Q.58; 62Q.64; and 72A.201 will be met. 232.31 (d) All enforcement and rulemaking powers available under 232.32 chapters 62D, 62J, 62M, 62N, and 62Q are hereby granted to the 232.33 commissioner of health with respect to counties that purchase 232.34 medical assistance and general assistance medical care services 232.35 under this section. 232.36 (e) The commissioner, in consultation with county 233.1 government, shall develop administrative and financial reporting 233.2 requirements for county-based purchasing programs relating to 233.3 sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 233.4 62N.31, and other sections as necessary, that are specific to 233.5 county administrative, accounting, and reporting systems and 233.6 consistent with other statutory requirements of counties. 233.7 Sec. 82. Minnesota Statutes 1998, section 256B.75, is 233.8 amended to read: 233.9 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 233.10 (a) For outpatient hospital facility fee payments for 233.11 services rendered on or after October 1, 1992, the commissioner 233.12 of human services shall pay the lower of (1) submitted charge, 233.13 or (2) 32 percent above the rate in effect on June 30, 1992, 233.14 except for those services for which there is a federal maximum 233.15 allowable payment. Effective for services rendered on or after 233.16 January 1, 2000, payment rates for nonsurgical outpatient 233.17 hospital facility fees and emergency room facility fees shall be 233.18 increased by eight percent over the rates in effect on December 233.19 31, 1999, except for those services for which there is a federal 233.20 maximum allowable payment. Services for which there is a 233.21 federal maximum allowable payment shall be paid at the lower of 233.22 (1) submitted charge, or (2) the federal maximum allowable 233.23 payment. Total aggregate payment for outpatient hospital 233.24 facility fee services shall not exceed the Medicare upper 233.25 limit. If it is determined that a provision of this section 233.26 conflicts with existing or future requirements of the United 233.27 States government with respect to federal financial 233.28 participation in medical assistance, the federal requirements 233.29 prevail. The commissioner may, in the aggregate, prospectively 233.30 reduce payment rates to avoid reduced federal financial 233.31 participation resulting from rates that are in excess of the 233.32 Medicare upper limitations. 233.33 (b) Notwithstanding paragraph (a), payment for outpatient, 233.34 emergency, and ambulatory surgery hospital facility fee services 233.35 for critical access hospitals designated under section 144.1483, 233.36 clause (11), shall be paid on a cost-based payment system that 234.1 is based on the cost-finding methods and allowable costs of the 234.2 Medicare program. 234.3 (Effective date: Section 82 (256B.75, paragraph (b)) is 234.4 effective for services rendered on or after July 1, 1999.) 234.5 Sec. 83. Minnesota Statutes 1998, section 256B.76, is 234.6 amended to read: 234.7 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 234.8 (a)The physician reimbursement increase provided in234.9section 256B.74, subdivision 2, shall not be implemented.234.10 Effective for services rendered on or after October 1, 1992, the 234.11 commissioner shall make payments for physician services as 234.12 follows: 234.13 (1) payment for level one Health Care Finance 234.14 Administration's common procedural coding system (HCPCS) codes 234.15 titled "office and other outpatient services," "preventive 234.16 medicine new and established patient," "delivery, antepartum, 234.17 and postpartum care," "critical care," Caesarean delivery and 234.18 pharmacologic management provided to psychiatric patients, and 234.19 HCPCS level three codes for enhanced services for prenatal high 234.20 risk, shall be paid at the lower of (i) submitted charges, or 234.21 (ii) 25 percent above the rate in effect on June 30, 1992. If 234.22 the rate on any procedure code within these categories is 234.23 different than the rate that would have been paid under the 234.24 methodology in section 256B.74, subdivision 2, then the larger 234.25 rate shall be paid; 234.26 (2) payments for all other services shall be paid at the 234.27 lower of (i) submitted charges, or (ii) 15.4 percent above the 234.28 rate in effect on June 30, 1992;and234.29 (3) all physician rates shall be converted from the 50th 234.30 percentile of 1982 to the 50th percentile of 1989, less the 234.31 percent in aggregate necessary to equal the above increases 234.32 except that payment rates for home health agency services shall 234.33 be the rates in effect on September 30, 1992.; 234.34 (4) effective for services rendered on or after January 1, 234.35 2000, payment rates for physician and professional services 234.36 shall be increased by 3.5 percent over the rates in effect on 235.1 December 31, 1999, except for home health agency services; and 235.2 (5) the increases in clause (4) shall be implemented 235.3 January 1, 2000, for managed care. 235.4 (b)The dental reimbursement increase provided in section235.5256B.74, subdivision 5, shall not be implemented.Effective for 235.6 services rendered on or after October 1, 1992, the commissioner 235.7 shall make payments for dental services as follows: 235.8 (1) dental services shall be paid at the lower of (i) 235.9 submitted charges, or (ii) 25 percent above the rate in effect 235.10 on June 30, 1992;and235.11 (2) dental rates shall be converted from the 50th 235.12 percentile of 1982 to the 50th percentile of 1989, less the 235.13 percent in aggregate necessary to equal the above increases.; 235.14 (3) effective for services rendered on or after January 1, 235.15 2000, payment rates for dental services shall be increased by 235.16 3.5 percent over the rates in effect on December 31, 1999; 235.17 (4) the commissioner shall increase payments by 20 percent 235.18 over the October 1, 1999, fee-for-service rates, for those 235.19 fee-for-service providers for whom public programs under medical 235.20 assistance, general assistance medical care, and MinnesotaCare 235.21 account for 20 percent or more of their practice; 235.22 (5) the commissioner shall award grants to community 235.23 clinics or other nonprofit community organizations which will 235.24 increase the availability of dental services to public program 235.25 recipients. These grants may be used to fund the costs related 235.26 to coordinating access for recipients, developing and 235.27 implementing patient care criteria, establishing new or 235.28 upgrading existing facilities, acquiring furnishings or 235.29 equipment, recruiting new providers, or other development costs 235.30 that will improve access to dental care in that region. The 235.31 commissioner shall consider the following in awarding the 235.32 grants: (i) potential to successfully increase access to an 235.33 underserved population; (ii) the ability to raise matching 235.34 funds; (iii) the long-term viability of the project to improve 235.35 access beyond the period of initial funding; (iv) the efficiency 235.36 in the use of the funding; and (v) the experience of the 236.1 proposers in providing services to the target population. The 236.2 commissioner shall monitor the grants and may terminate a grant 236.3 if the grantee does not increase dental access for public 236.4 program recipients; 236.5 (6) the commissioner shall fund two initiatives to improve 236.6 dental access that will allow the commissioner to increase rates 236.7 if the percentage of public program recipients with at least one 236.8 dental visit per year increases; 236.9 (7) beginning October 1, 1999, the payment for tooth 236.10 sealants and fluoride treatments shall be the lower of (i) 236.11 submitted charge, or (ii) 80 percent of median 1997 charges; and 236.12 (8) the increases listed in clauses (3), (4), and (7) shall 236.13 be implemented January 1, 2000, for managed care. 236.14 (c) An entity that operates both a Medicare certified 236.15 comprehensive outpatient rehabilitation facility and a facility 236.16 which was certified prior to January 1, 1993, that is licensed 236.17 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 236.18 whom at least 33 percent of the clients receiving rehabilitation 236.19 services in the most recent calendar year are medical assistance 236.20 recipients, shall be reimbursed by the commissioner for 236.21 rehabilitation services at rates that are 38 percent greater 236.22 than the maximum reimbursement rate allowed under paragraph (a), 236.23 clause (2), when those services are (1) provided within the 236.24 comprehensive outpatient rehabilitation facility and (2) 236.25 provided to residents of nursing facilities owned by the entity. 236.26 Sec. 84. [256B.765] [PROVIDER RATE INCREASES.] 236.27 (a) Effective July 1, 2001, within the limits of 236.28 appropriations specifically for this purpose, the commissioner 236.29 shall provide an annual inflation adjustment for the providers 236.30 listed in paragraph (c). The index for the inflation adjustment 236.31 must be based on the change in the Employment Cost Index for 236.32 Private Industry Workers - Total Compensation forecasted by Data 236.33 Resources, Inc., as forecasted in the fourth quarter of the 236.34 calendar year preceding the fiscal year. The commissioner shall 236.35 increase reimbursement or allocation rates by the percentage of 236.36 this adjustment, and county boards shall adjust provider 237.1 contracts as needed. 237.2 (b) The commissioner of finance shall include an annual 237.3 inflationary adjustment in reimbursement rates for the providers 237.4 listed in paragraph (c) using the inflation factor specified in 237.5 paragraph (a) as a budget change request in each biennial 237.6 detailed expenditure budget submitted to the legislature under 237.7 section 16A.11. 237.8 (c) The annual adjustment under paragraph (a) shall be 237.9 provided for home and community-based waiver services for 237.10 persons with mental retardation or related conditions under 237.11 section 256B.501; home and community-based waiver services for 237.12 the elderly under section 256B.0915; waivered services under 237.13 community alternatives for disabled individuals under section 237.14 256B.49; community alternative care waivered services under 237.15 section 256B.49; traumatic brain injury waivered services under 237.16 section 256B.49; nursing services and home health services under 237.17 section 256B.0625, subdivision 6a; personal care services and 237.18 nursing supervision of personal care services under section 237.19 256B.0625, subdivision 19a; private duty nursing services under 237.20 section 256B.0625, subdivision 7; day training and habilitation 237.21 services for adults with mental retardation or related 237.22 conditions under sections 252.40 to 252.46; physical therapy 237.23 services under sections 256B.0625, subdivision 8, and 256D.03, 237.24 subdivision 4; occupational therapy services under sections 237.25 256B.0625, subdivision 8a, and 256D.03, subdivision 4; 237.26 speech-language therapy services under section 256D.03, 237.27 subdivision 4, and Minnesota Rules, part 9505.0390; respiratory 237.28 therapy services under section 256D.03, subdivision 4, and 237.29 Minnesota Rules, part 9505.0295; alternative care services under 237.30 section 256B.0913; adult residential program grants under 237.31 Minnesota Rules, parts 9535.2000 to 9535.3000; adult and family 237.32 community support grants under Minnesota Rules, parts 9535.1700 237.33 to 9535.1760; semi-independent living services under section 237.34 252.275 including SILS funding under county social services 237.35 grants formerly funded under chapter 256I; and community support 237.36 services for deaf and hard-of-hearing adults with mental illness 238.1 who use or wish to use sign language as their primary means of 238.2 communication. 238.3 (d) At least 75 percent of the rate increase provided under 238.4 this section must be used to increase the wages and benefits of 238.5 employees other than administrators and central office 238.6 employees. Providers must submit a plan to the commissioner 238.7 annually describing how the increase is being utilized. 238.8 Sec. 85. Minnesota Statutes 1998, section 256B.77, 238.9 subdivision 7a, is amended to read: 238.10 Subd. 7a. [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible 238.11 for the demonstration project as provided in this subdivision. 238.12 (b) "Eligible individuals" means those persons living in 238.13 the demonstration site who are eligible for medical assistance 238.14 and are disabled based on a disability determination under 238.15 section 256B.055, subdivisions 7 and 12, or who are eligible for 238.16 medical assistance and have been diagnosed as having: 238.17 (1) serious and persistent mental illness as defined in 238.18 section 245.462, subdivision 20; 238.19 (2) severe emotional disturbance as defined in section 238.20245.487245.4871, subdivision 6; or 238.21 (3) mental retardation, or being a mentally retarded person 238.22 as defined in section 252A.02, or a related condition as defined 238.23 in section 252.27, subdivision 1a. 238.24 Other individuals may be included at the option of the county 238.25 authority based on agreement with the commissioner. 238.26 (c)Eligible individuals residing on a federally recognized238.27Indian reservation may be excluded from participation in the238.28demonstration project at the discretion of the tribal government238.29based on agreement with the commissioner, in consultation with238.30the county authority.238.31(d)Eligible individuals include individuals in excluded 238.32 time status, as defined in chapter 256G. Enrollees in excluded 238.33 time at the time of enrollment shall remain in excluded time 238.34 status as long as they live in the demonstration site and shall 238.35 be eligible for 90 days after placement outside the 238.36 demonstration site if they move to excluded time status in a 239.1 county within Minnesota other than their county of financial 239.2 responsibility. 239.3(e)(d) A person who is a sexual psychopathic personality 239.4 as defined in section 253B.02, subdivision 18a, or a sexually 239.5 dangerous person as defined in section 253B.02, subdivision 18b, 239.6 is excluded from enrollment in the demonstration project. 239.7 Sec. 86. Minnesota Statutes 1998, section 256B.77, is 239.8 amended by adding a subdivision to read: 239.9 Subd. 7b. [AMERICAN INDIAN RECIPIENTS.] (a) Beginning on 239.10 or after July 1, 1999, for American Indian recipients of medical 239.11 assistance who are required to enroll with a county 239.12 administrative entity or service delivery organization under 239.13 subdivision 7, medical assistance shall cover health care 239.14 services provided at American Indian health services facilities 239.15 and facilities operated by a tribe or tribal organization under 239.16 funding authorized by United States Code, title 25, sections 239.17 450f to 450n, or title III of the Indian Self-Determination and 239.18 Education Assistance Act, Public Law Number 93-638, if those 239.19 services would otherwise be covered under section 256B.0625. 239.20 Payments for services provided under this subdivision shall be 239.21 made on a fee-for-service basis, and may, at the option of the 239.22 tribe or tribal organization, be made according to rates 239.23 authorized under sections 256.969, subdivision 16, and 239.24 256B.0625, subdivision 34. Implementation of this purchasing 239.25 model is contingent on federal approval. 239.26 (b) The commissioner of human services, in consultation 239.27 with tribal governments, shall develop a plan for tribes to 239.28 assist in the enrollment process for American Indian recipients 239.29 enrolled in the demonstration project for people with 239.30 disabilities under this section. This plan also shall address 239.31 how tribes will be included in ensuring the coordination of care 239.32 for American Indian recipients between Indian health service or 239.33 tribal providers and other providers. 239.34 (c) For purposes of this subdivision, "American Indian" has 239.35 the meaning given to persons to whom services will be provided 239.36 for in Code of Federal Regulations, title 42, section 36.12. 240.1 Sec. 87. Minnesota Statutes 1998, section 256B.77, 240.2 subdivision 8, is amended to read: 240.3 Subd. 8. [RESPONSIBILITIES OF THE COUNTY ADMINISTRATIVE 240.4 ENTITY.] (a) The county administrative entity shall meet the 240.5 requirements of this subdivision, unless the county authority or 240.6 the commissioner, with written approval of the county authority, 240.7 enters into a service delivery contract with a service delivery 240.8 organization for any or all of the requirements contained in 240.9 this subdivision. 240.10 (b) The county administrative entity shall enroll eligible 240.11 individuals regardless of health or disability status. 240.12 (c) The county administrative entity shall provide all 240.13 enrollees timely access to the medical assistance benefit set. 240.14 Alternative services and additional services are available to 240.15 enrollees at the option of the county administrative entity and 240.16 may be provided if specified in the personal support plan. 240.17 County authorities are not required to seek prior authorization 240.18 from the department as required by the laws and rules governing 240.19 medical assistance. 240.20 (d) The county administrative entity shall cover necessary 240.21 services as a result of an emergency without prior 240.22 authorization, even if the services were rendered outside of the 240.23 provider network. 240.24 (e) The county administrative entity shall authorize 240.25 necessary and appropriate services when needed and requested by 240.26 the enrollee or the enrollee's legal representative in response 240.27 to an urgent situation. Enrollees shall have 24-hour access to 240.28 urgent care services coordinated by experienced disability 240.29 providers who have information about enrollees' needs and 240.30 conditions. 240.31 (f) The county administrative entity shall accept the 240.32 capitation payment from the commissioner in return for the 240.33 provision of services for enrollees. 240.34 (g) The county administrative entity shall maintain 240.35 internal grievance and complaint procedures, including an 240.36 expedited informal complaint process in which the county 241.1 administrative entity must respond to verbal complaints within 241.2 ten calendar days, and a formal grievance process, in which the 241.3 county administrative entity must respond to written complaints 241.4 within 30 calendar days. 241.5 (h) The county administrative entity shall provide a 241.6 certificate of coverage, upon enrollment, to each enrollee and 241.7 the enrollee's legal representative, if any, which describes the 241.8 benefits covered by the county administrative entity, any 241.9 limitations on those benefits, and information about providers 241.10 and the service delivery network. This information must also be 241.11 made available to prospective enrollees. This certificate must 241.12 be approved by the commissioner. 241.13 (i) The county administrative entity shall present evidence 241.14 of an expedited process to approve exceptions to benefits, 241.15 provider network restrictions, and other plan limitations under 241.16 appropriate circumstances. 241.17 (j) The county administrative entity shall provide 241.18 enrollees or their legal representatives with written notice of 241.19 their appeal rights under subdivision 16, and of ombudsman and 241.20 advocacy programs under subdivisions 13 and 14, at the following 241.21 times: upon enrollment, upon submission of a written complaint, 241.22 when a service is reduced, denied, or terminated, or when 241.23 renewal of authorization for ongoing service is refused. 241.24 (k) The county administrative entity shall determine 241.25 immediate needs, including services, support, and assessments, 241.26 within 30 calendar daysofafter enrollment, or within a shorter 241.27 time frame if specified in the intergovernmental contract. 241.28 (l) The county administrative entity shall assess the need 241.29 for services of new enrollees within 60 calendar daysofafter 241.30 enrollment, or within a shorter time frame if specified in the 241.31 intergovernmental contract, and periodically reassess the need 241.32 for services for all enrollees. 241.33 (m) The county administrative entity shall ensure the 241.34 development of a personal support plan for each person within 60 241.35 calendar days of enrollment, or within a shorter time frame if 241.36 specified in the intergovernmental contract, unless otherwise 242.1 agreed to by the enrollee and the enrollee's legal 242.2 representative, if any. Until a personal support plan is 242.3 developed and agreed to by the enrollee, enrollees must have 242.4 access to the same amount, type, setting, duration, and 242.5 frequency of covered services that they had at the time of 242.6 enrollment unless other covered services are needed. For an 242.7 enrollee who is not receiving covered services at the time of 242.8 enrollment and for enrollees whose personal support plan is 242.9 being revised, access to the medical assistance benefit set must 242.10 be assured until a personal support plan is developed or 242.11 revised. If an enrollee chooses not to develop a personal 242.12 support plan, the enrollee will be subject to the network and 242.13 prior authorization requirements of the county administrative 242.14 entity or service delivery organization 60 days after 242.15 enrollment. An enrollee can choose to have a personal support 242.16 plan developed at any time. The personal support plan must be 242.17 based on choices, preferences, and assessed needs and strengths 242.18 of the enrollee. The service coordinator shall develop the 242.19 personal support plan, in consultation with the enrollee or the 242.20 enrollee's legal representative and other individuals requested 242.21 by the enrollee. The personal support plan must be updated as 242.22 needed or as requested by the enrollee. Enrollees may choose 242.23 not to have a personal support plan. 242.24 (n) The county administrative entity shall ensure timely 242.25 authorization, arrangement, and continuity of needed and covered 242.26 supports and services. 242.27 (o) The county administrative entity shall offer service 242.28 coordination that fulfills the responsibilities under 242.29 subdivision 12 and is appropriate to the enrollee's needs, 242.30 choices, and preferences, including a choice of service 242.31 coordinator. 242.32 (p) The county administrative entity shall contract with 242.33 schools and other agencies as appropriate to provide otherwise 242.34 covered medically necessary medical assistance services as 242.35 described in an enrollee's individual family support plan, as 242.36 described in sections 125A.26 to 125A.48, or individual 243.1 education plan, as described in chapter 125A. 243.2 (q) The county administrative entity shall develop and 243.3 implement strategies, based on consultation with affected 243.4 groups, to respect diversity and ensure culturally competent 243.5 service delivery in a manner that promotes the physical, social, 243.6 psychological, and spiritual well-being of enrollees and 243.7 preserves the dignity of individuals, families, and their 243.8 communities. 243.9 (r) When an enrollee changes county authorities, county 243.10 administrative entities shall ensure coordination with the 243.11 entity that is assuming responsibility for administering the 243.12 medical assistance benefit set to ensure continuity of supports 243.13 and services for the enrollee. 243.14 (s) The county administrative entity shall comply with 243.15 additional requirements as specified in the intergovernmental 243.16 contract. 243.17 (t) To the extent that alternatives are approved under 243.18 subdivision 17, county administrative entities must provide for 243.19 the health and safety of enrollees and protect the rights to 243.20 privacy and to provide informed consent. 243.21 Sec. 88. Minnesota Statutes 1998, section 256B.77, is 243.22 amended by adding a subdivision to read: 243.23 Subd. 27. [SERVICE COORDINATION TRANSITION.] Demonstration 243.24 sites designated under subdivision 5, with the permission of an 243.25 eligible individual, may implement the provisions of subdivision 243.26 12 beginning 60 calendar days prior to an individual's 243.27 enrollment. This implementation may occur prior to the 243.28 enrollment of eligible individuals, but is restricted to 243.29 eligible individuals. 243.30 Sec. 89. Minnesota Statutes 1998, section 256D.03, 243.31 subdivision 3, is amended to read: 243.32 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 243.33 (a) General assistance medical care may be paid for any person 243.34 who is not eligible for medical assistance under chapter 256B, 243.35 including eligibility for medical assistance based on a 243.36 spenddown of excess income according to section 256B.056, 244.1 subdivision 5, or MinnesotaCare as defined in paragraph (b), 244.2 except as provided in paragraph (c); and: 244.3 (1) who is receiving assistance under section 256D.05, 244.4 except for families with children who are eligible under 244.5 Minnesota family investment program-statewide (MFIP-S), who is 244.6 having a payment made on the person's behalf under sections 244.7 256I.01 to 256I.06, or who resides in group residential housing 244.8 as defined in chapter 256I and can meet a spenddown using the 244.9 cost of remedial services received through group residential 244.10 housing; or 244.11 (2)(i) who is a resident of Minnesota; and whose equity in 244.12 assets is not in excess of $1,000 per assistance unit. Exempt 244.13 assets, the reduction of excess assets, and the waiver of excess 244.14 assets must conform to the medical assistance program in chapter 244.15 256B, with the following exception: the maximum amount of 244.16 undistributed funds in a trust that could be distributed to or 244.17 on behalf of the beneficiary by the trustee, assuming the full 244.18 exercise of the trustee's discretion under the terms of the 244.19 trust, must be applied toward the asset maximum; and 244.20 (ii) who has countable income not in excess of the 244.21 assistance standards established in section 256B.056, 244.22 subdivision 4, or whose excess income is spent down according to 244.23 section 256B.056, subdivision 5, using a six-month budget 244.24 period. The method for calculating earned income disregards and 244.25 deductions for a person who resides with a dependent child under 244.26 age 21 shall follow section 256B.056, subdivision 1a. However, 244.27 if a disregard of $30 and one-third of the remainder has been 244.28 applied to the wage earner's income, the disregard shall not be 244.29 applied again until the wage earner's income has not been 244.30 considered in an eligibility determination for general 244.31 assistance, general assistance medical care, medical assistance, 244.32 or MFIP-S for 12 consecutive months. The earned income and work 244.33 expense deductions for a person who does not reside with a 244.34 dependent child under age 21 shall be the same as the method 244.35 used to determine eligibility for a person under section 244.36 256D.06, subdivision 1, except the disregard of the first $50 of 245.1 earned income is not allowed; 245.2 (3) who would be eligible for medical assistance except 245.3 that the person resides in a facility that is determined by the 245.4 commissioner or the federal Health Care Financing Administration 245.5 to be an institution for mental diseases; or 245.6 (4) who is ineligible for medical assistance under chapter 245.7 256B or general assistance medical care under any other 245.8 provision of this section, and is receiving care and 245.9 rehabilitation services from a nonprofit center established to 245.10 serve victims of torture. These individuals are eligible for 245.11 general assistance medical care only for the period during which 245.12 they are receiving services from the center. During this period 245.13 of eligibility, individuals eligible under this clause shall not 245.14 be required to participate in prepaid general assistance medical 245.15 care. 245.16 (b) Beginning January 1, 2000, applicants or recipients who 245.17 meet all eligibility requirements of MinnesotaCare as defined in 245.18 sections 256L.01 to 256L.16, and are: 245.19 (i) adults with dependent children under 21 whose gross 245.20 family income is equal to or less than 275 percent of the 245.21 federal poverty guidelines; or 245.22 (ii) adults without children with earned income and whose 245.23 family gross income is between 75 percent of the federal poverty 245.24 guidelines and the amount set by section 256L.04, subdivision 7, 245.25 shall be terminated from general assistance medical care upon 245.26 enrollment in MinnesotaCare. 245.27 (c) For services rendered on or after July 1, 1997, 245.28 eligibility is limited to one month prior to application if the 245.29 person is determined eligible in the prior month. A 245.30 redetermination of eligibility must occur every 12 months. 245.31 Beginning January 1, 2000, Minnesota health care program 245.32 applications completed by recipients and applicants who are 245.33 persons described in paragraph (b), may be returned to the 245.34 county agency to be forwarded to the department of human 245.35 services or sent directly to the department of human services 245.36 for enrollment in MinnesotaCare. If all other eligibility 246.1 requirements of this subdivision are met, eligibility for 246.2 general assistance medical care shall be available in any month 246.3 during which a MinnesotaCare eligibility determination and 246.4 enrollment are pending. Upon notification of eligibility for 246.5 MinnesotaCare, notice of termination for eligibility for general 246.6 assistance medical care shall be sent to an applicant or 246.7 recipient. If all other eligibility requirements of this 246.8 subdivision are met, eligibility for general assistance medical 246.9 care shall be available until enrollment in MinnesotaCare 246.10 subject to the provisions of paragraph (e). 246.11 (d) The date of an initial Minnesota health care program 246.12 application necessary to begin a determination of eligibility 246.13 shall be the date the applicant has provided a name, address, 246.14 and social security number, signed and dated, to the county 246.15 agency or the department of human services. If the applicant is 246.16 unable to provide an initial application when health care is 246.17 delivered due to a medical condition or disability, a health 246.18 care provider may act on the person's behalf to complete the 246.19 initial application. The applicant must complete the remainder 246.20 of the application and provide necessary verification before 246.21 eligibility can be determined. The county agency must assist 246.22 the applicant in obtaining verification if necessary. On the 246.23 basis of information provided on the completed application, an 246.24 applicant who meets the following criteria shall be determined 246.25 eligible beginning in the month of application: 246.26 (1) has gross income less than 90 percent of the applicable 246.27 income standard; 246.28 (2) has liquid assets that total within $300 of the asset 246.29 standard; 246.30 (3) does not reside in a long-term care facility; and 246.31 (4) meets all other eligibility requirements. 246.32 The applicant must provide all required verifications within 30 246.33 days' notice of the eligibility determination or eligibility 246.34 shall be terminated. 246.35 (e) County agencies are authorized to use all automated 246.36 databases containing information regarding recipients' or 247.1 applicants' income in order to determine eligibility for general 247.2 assistance medical care or MinnesotaCare. Such use shall be 247.3 considered sufficient in order to determine eligibility and 247.4 premium payments by the county agency. 247.5 (f) General assistance medical care is not available for a 247.6 person in a correctional facility unless the person is detained 247.7 by law for less than one year in a county correctional or 247.8 detention facility as a person accused or convicted of a crime, 247.9 or admitted as an inpatient to a hospital on a criminal hold 247.10 order, and the person is a recipient of general assistance 247.11 medical care at the time the person is detained by law or 247.12 admitted on a criminal hold order and as long as the person 247.13 continues to meet other eligibility requirements of this 247.14 subdivision. 247.15 (g) General assistance medical care is not available for 247.16 applicants or recipients who do not cooperate with the county 247.17 agency to meet the requirements of medical assistance. General 247.18 assistance medical care is limited to payment of emergency 247.19 services only for applicants or recipients as described in 247.20 paragraph (b), whose MinnesotaCare coverage is denied or 247.21 terminated for nonpayment of premiums as required by sections 247.22 256L.06 and 256L.07. 247.23 (h) In determining the amount of assets of an individual, 247.24 there shall be included any asset or interest in an asset, 247.25 including an asset excluded under paragraph (a), that was given 247.26 away, sold, or disposed of for less than fair market value 247.27 within the 60 months preceding application for general 247.28 assistance medical care or during the period of eligibility. 247.29 Any transfer described in this paragraph shall be presumed to 247.30 have been for the purpose of establishing eligibility for 247.31 general assistance medical care, unless the individual furnishes 247.32 convincing evidence to establish that the transaction was 247.33 exclusively for another purpose. For purposes of this 247.34 paragraph, the value of the asset or interest shall be the fair 247.35 market value at the time it was given away, sold, or disposed 247.36 of, less the amount of compensation received. For any 248.1 uncompensated transfer, the number of months of ineligibility, 248.2 including partial months, shall be calculated by dividing the 248.3 uncompensated transfer amount by the average monthly per person 248.4 payment made by the medical assistance program to skilled 248.5 nursing facilities for the previous calendar year. The 248.6 individual shall remain ineligible until this fixed period has 248.7 expired. The period of ineligibility may exceed 30 months, and 248.8 a reapplication for benefits after 30 months from the date of 248.9 the transfer shall not result in eligibility unless and until 248.10 the period of ineligibility has expired. The period of 248.11 ineligibility begins in the month the transfer was reported to 248.12 the county agency, or if the transfer was not reported, the 248.13 month in which the county agency discovered the transfer, 248.14 whichever comes first. For applicants, the period of 248.15 ineligibility begins on the date of the first approved 248.16 application. 248.17 (i) When determining eligibility for any state benefits 248.18 under this subdivision, the income and resources of all 248.19 noncitizens shall be deemed to include their sponsor's income 248.20 and resources as defined in the Personal Responsibility and Work 248.21 Opportunity Reconciliation Act of 1996, title IV, Public Law 248.22 Number 104-193, sections 421 and 422, and subsequently set out 248.23 in federal rules. 248.24 (j)(1) An undocumented noncitizen or a nonimmigrant is 248.25 ineligible for general assistance medical care other than 248.26 emergency services. For purposes of this subdivision, a 248.27 nonimmigrant is an individual in one or more of the classes 248.28 listed in United States Code, title 8, section 1101(a)(15), and 248.29 an undocumented noncitizen is an individual who resides in the 248.30 United States without the approval or acquiescence of the 248.31 Immigration and Naturalization Service. 248.32 (2) This paragraph does not apply to a child under age 18, 248.33 to a Cuban or Haitian entrant as defined in Public Law Number 248.34 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 248.35 aged, blind, or disabled as defined in Code of Federal 248.36 Regulations, title 42, sections 435.520, 435.530, 435.531, 249.1 435.540, and 435.541, or effective October 1, 1998, to an 249.2 individual eligible for general assistance medical care under 249.3 paragraph (a), clause (4), who cooperates with the Immigration 249.4 and Naturalization Service to pursue any applicable immigration 249.5 status, including citizenship, that would qualify the individual 249.6 for medical assistance with federal financial participation. 249.7 (3) For purposes of this paragraph, "emergency services" 249.8 has the meaning given in Code of Federal Regulations, title 42, 249.9 section 440.255(b)(1), except that it also means services 249.10 rendered because of suspected or actual pesticide poisoning. 249.11 (k) Notwithstanding any other provision of law, a 249.12 noncitizen who is ineligible for medical assistance due to the 249.13 deeming of a sponsor's income and resources, is ineligible for 249.14 general assistance medical care. 249.15 Sec. 90. Minnesota Statutes 1998, section 256D.03, 249.16 subdivision 4, is amended to read: 249.17 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 249.18 For a person who is eligible under subdivision 3, paragraph (a), 249.19 clause (3), general assistance medical care covers, except as 249.20 provided in paragraph (c): 249.21 (1) inpatient hospital services; 249.22 (2) outpatient hospital services; 249.23 (3) services provided by Medicare certified rehabilitation 249.24 agencies; 249.25 (4) prescription drugs and other products recommended 249.26 through the process established in section 256B.0625, 249.27 subdivision 13; 249.28 (5) equipment necessary to administer insulin and 249.29 diagnostic supplies and equipment for diabetics to monitor blood 249.30 sugar level; 249.31 (6) eyeglasses and eye examinations provided by a physician 249.32 or optometrist; 249.33 (7) hearing aids; 249.34 (8) prosthetic devices; 249.35 (9) laboratory and X-ray services; 249.36 (10) physician's services; 250.1 (11) medical transportation; 250.2 (12) chiropractic services as covered under the medical 250.3 assistance program; 250.4 (13) podiatric services; 250.5 (14) dental services; 250.6 (15) outpatient services provided by a mental health center 250.7 or clinic that is under contract with the county board and is 250.8 established under section 245.62; 250.9 (16) day treatment services for mental illness provided 250.10 under contract with the county board; 250.11 (17) prescribed medications for persons who have been 250.12 diagnosed as mentally ill as necessary to prevent more 250.13 restrictive institutionalization; 250.14 (18) psychological services, medical supplies and 250.15 equipment, and Medicare premiums, coinsurance and deductible 250.16 payments; 250.17 (19) medical equipment not specifically listed in this 250.18 paragraph when the use of the equipment will prevent the need 250.19 for costlier services that are reimbursable under this 250.20 subdivision; 250.21 (20) services performed by a certified pediatric nurse 250.22 practitioner, a certified family nurse practitioner, a certified 250.23 adult nurse practitioner, a certified obstetric/gynecological 250.24 nurse practitioner, a certified neonatal nurse practitioner, or 250.25 a certified geriatric nurse practitioner in independent 250.26 practice, if the services are otherwise covered under this 250.27 chapter as a physician service, are provided on an inpatient 250.28 basis and are not part of the cost for inpatient services 250.29 included in the operating payment rate, and if the service is 250.30 within the scope of practice of the nurse practitioner's license 250.31 as a registered nurse, as defined in section 148.171;and250.32 (21) services of a certified public health nurse or a 250.33 registered nurse practicing in a public health nursing clinic 250.34 that is a department of, or that operates under the direct 250.35 authority of, a unit of government, if the service is within the 250.36 scope of practice of the public health nurse's license as a 251.1 registered nurse, as defined in section 148.171; 251.2 (22) telemedicine consultations via two-way, interactive 251.3 video or store and forward technology. Store and forward 251.4 technology includes telemedicine consultations that do not occur 251.5 in real time via synchronous transmissions and that do not 251.6 require a face-to-face encounter with the patient for all or any 251.7 part of any such telemedicine consultation. The patient record 251.8 must include a written opinion from the consulting physician 251.9 providing the telemedicine consultation. A communication 251.10 between two physicians that consists solely of a telephone 251.11 conversation is not a telemedicine consultation. Coverage is 251.12 limited to three telemedicine consultations per recipient per 251.13 calendar week. Telemedicine consultations shall be paid at the 251.14 full allowable rate; and 251.15 (23) language interpreter services provided in conjunction 251.16 with another covered health service. Interpreter services 251.17 provided under this subdivision must satisfy the requirements of 251.18 section 256B.0625, subdivision 42. 251.19 (b) Except as provided in paragraph (c), for a recipient 251.20 who is eligible under subdivision 3, paragraph (a), clause (1) 251.21 or (2), general assistance medical care covers the services 251.22 listed in paragraph (a) with the exception of special 251.23 transportation services. 251.24 (c) Gender reassignment surgery and related services are 251.25 not covered services under this subdivision unless the 251.26 individual began receiving gender reassignment services prior to 251.27 July 1, 1995. 251.28 (d) In order to contain costs, the commissioner of human 251.29 services shall select vendors of medical care who can provide 251.30 the most economical care consistent with high medical standards 251.31 and shall where possible contract with organizations on a 251.32 prepaid capitation basis to provide these services. The 251.33 commissioner shall consider proposals by counties and vendors 251.34 for prepaid health plans, competitive bidding programs, block 251.35 grants, or other vendor payment mechanisms designed to provide 251.36 services in an economical manner or to control utilization, with 252.1 safeguards to ensure that necessary services are provided. 252.2 Before implementing prepaid programs in counties with a county 252.3 operated or affiliated public teaching hospital or a hospital or 252.4 clinic operated by the University of Minnesota, the commissioner 252.5 shall consider the risks the prepaid program creates for the 252.6 hospital and allow the county or hospital the opportunity to 252.7 participate in the program in a manner that reflects the risk of 252.8 adverse selection and the nature of the patients served by the 252.9 hospital, provided the terms of participation in the program are 252.10 competitive with the terms of other participants considering the 252.11 nature of the population served. Payment for services provided 252.12 pursuant to this subdivision shall be as provided to medical 252.13 assistance vendors of these services under sections 256B.02, 252.14 subdivision 8, and 256B.0625. For payments made during fiscal 252.15 year 1990 and later years, the commissioner shall consult with 252.16 an independent actuary in establishing prepayment rates, but 252.17 shall retain final control over the rate methodology. 252.18 Notwithstanding the provisions of subdivision 3, an individual 252.19 who becomes ineligible for general assistance medical care 252.20 because of failure to submit income reports or recertification 252.21 forms in a timely manner, shall remain enrolled in the prepaid 252.22 health plan and shall remain eligible for general assistance 252.23 medical care coverage through the last day of the month in which 252.24 the enrollee became ineligible for general assistance medical 252.25 care. 252.26(e) The commissioner of human services may reduce payments252.27provided under sections 256D.01 to 256D.21 and 261.23 in order252.28to remain within the amount appropriated for general assistance252.29medical care, within the following restrictions:252.30(i) For the period July 1, 1985 to December 31, 1985,252.31reductions below the cost per service unit allowable under252.32section 256.966, are permitted only as follows: payments for252.33inpatient and outpatient hospital care provided in response to a252.34primary diagnosis of chemical dependency or mental illness may252.35be reduced no more than 30 percent; payments for all other252.36inpatient hospital care may be reduced no more than 20 percent.253.1Reductions below the payments allowable under general assistance253.2medical care for the remaining general assistance medical care253.3services allowable under this subdivision may be reduced no more253.4than ten percent.253.5(ii) For the period January 1, 1986 to December 31, 1986,253.6reductions below the cost per service unit allowable under253.7section 256.966 are permitted only as follows: payments for253.8inpatient and outpatient hospital care provided in response to a253.9primary diagnosis of chemical dependency or mental illness may253.10be reduced no more than 20 percent; payments for all other253.11inpatient hospital care may be reduced no more than 15 percent.253.12Reductions below the payments allowable under general assistance253.13medical care for the remaining general assistance medical care253.14services allowable under this subdivision may be reduced no more253.15than five percent.253.16(iii) For the period January 1, 1987 to June 30, 1987,253.17reductions below the cost per service unit allowable under253.18section 256.966 are permitted only as follows: payments for253.19inpatient and outpatient hospital care provided in response to a253.20primary diagnosis of chemical dependency or mental illness may253.21be reduced no more than 15 percent; payments for all other253.22inpatient hospital care may be reduced no more than ten253.23percent. Reductions below the payments allowable under medical253.24assistance for the remaining general assistance medical care253.25services allowable under this subdivision may be reduced no more253.26than five percent.253.27(iv) For the period July 1, 1987 to June 30, 1988,253.28reductions below the cost per service unit allowable under253.29section 256.966 are permitted only as follows: payments for253.30inpatient and outpatient hospital care provided in response to a253.31primary diagnosis of chemical dependency or mental illness may253.32be reduced no more than 15 percent; payments for all other253.33inpatient hospital care may be reduced no more than five percent.253.34Reductions below the payments allowable under medical assistance253.35for the remaining general assistance medical care services253.36allowable under this subdivision may be reduced no more than254.1five percent.254.2(v) For the period July 1, 1988 to June 30, 1989,254.3reductions below the cost per service unit allowable under254.4section 256.966 are permitted only as follows: payments for254.5inpatient and outpatient hospital care provided in response to a254.6primary diagnosis of chemical dependency or mental illness may254.7be reduced no more than 15 percent; payments for all other254.8inpatient hospital care may not be reduced. Reductions below254.9the payments allowable under medical assistance for the254.10remaining general assistance medical care services allowable254.11under this subdivision may be reduced no more than five percent.254.12(f)(e) There shall be no copayment required of any 254.13 recipient of benefits for any services provided under this 254.14 subdivision. A hospital receiving a reduced payment as a result 254.15 of this section may apply the unpaid balance toward satisfaction 254.16 of the hospital's bad debts. 254.17(g)(f) Any county may, from its own resources, provide 254.18 medical payments for which state payments are not made. 254.19(h)(g) Chemical dependency services that are reimbursed 254.20 under chapter 254B must not be reimbursed under general 254.21 assistance medical care. 254.22(i)(h) The maximum payment for new vendors enrolled in the 254.23 general assistance medical care program after the base year 254.24 shall be determined from the average usual and customary charge 254.25 of the same vendor type enrolled in the base year. 254.26(j)(i) The conditions of payment for services under this 254.27 subdivision are the same as the conditions specified in rules 254.28 adopted under chapter 256B governing the medical assistance 254.29 program, unless otherwise provided by statute or rule. 254.30 (Effective date: Section 90 (256D.03, subd. 4) is 254.31 effective for services rendered on or after July 1, 1999.) 254.32 Sec. 91. Minnesota Statutes 1998, section 256D.03, 254.33 subdivision 8, is amended to read: 254.34 Subd. 8. [PRIVATE INSURANCE POLICIES.] (a) Private 254.35 accident and health care coverage for medical services is 254.36 primary coverage and must be exhausted before general assistance 255.1 medical care is paid. When a person who is otherwise eligible 255.2 for general assistance medical care has private accident or 255.3 health care coverage, including a prepaid health plan, the 255.4 private health care benefits available to the person must be 255.5 used first and to the fullest extent. General assistance 255.6 medical care payment will not be made when either covered 255.7 charges are paid in full by a third party or the provider has an 255.8 agreement to accept payment for less than charges as payment in 255.9 full. Payment for patients that are simultaneously covered by 255.10 general assistance medical care and a liable third party other 255.11 than Medicare will be determined as the lesser of clauses (1) to 255.12 (3): 255.13 (1) the patient liability according to the provider/insurer 255.14 agreement; 255.15 (2) covered charges minus the third party payment amount; 255.16 or 255.17 (3) the general assistance medical care rate minus the 255.18 third party payment amount. 255.19 A negative difference will not be implemented. 255.20 (b) When a parent or a person with an obligation of support 255.21 has enrolled in a prepaid health care plan under section 255.22 518.171, subdivision 1, the commissioner of human services shall 255.23 limit the recipient of general assistance medical care to the 255.24 benefits payable under that prepaid health care plan to the 255.25 extent that services available under general assistance medical 255.26 care are also available under the prepaid health care plan. 255.27 (c) Upon furnishing general assistance medical care or 255.28 general assistance to any person having private accident or 255.29 health care coverage, or having a cause of action arising out of 255.30 an occurrence that necessitated the payment of assistance, the 255.31 state agency shall be subrogated, to the extent of the cost of 255.32 medical care, subsistence, or other payments furnished, to any 255.33 rights the person may have under the terms of the coverage or 255.34 under the cause of action. For purposes of this subdivision, 255.35 "state agency" includes prepaid health plans under contract with 255.36 the commissioner according to sections 256B.69, 256D.03, 256.1 subdivision 4, paragraph (d), and 256L.12; children's mental 256.2 health collaboratives under section 245.493; demonstration 256.3 projects for persons with disabilities under section 256B.77; 256.4 nursing homes under the alternative payment demonstration 256.5 project under section 256B.434; and county-based purchasing 256.6 entities under section 256B.692. 256.7 This right of subrogation includes all portions of the 256.8 cause of action, notwithstanding any settlement allocation or 256.9 apportionment that purports to dispose of portions of the cause 256.10 of action not subject to subrogation. 256.11 (d) To recover under this section, the attorney generalor256.12the appropriate county attorney, acting upon direction from the256.13attorney general,may institute or join a civil action to 256.14 enforce the subrogation rights the commissioner established 256.15 under this section. 256.16 Any prepaid health plan providing services under sections 256.17 256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 256.18 children's mental health collaboratives under section 245.493; 256.19 demonstration projects for persons with disabilities under 256.20 section 256B.77; nursing homes under the alternative payment 256.21 demonstration project under section 256B.434; or the 256.22 county-based purchasing entity providing services under section 256.23 256B.692 may retain legal representation to enforce the 256.24 subrogation rights created under this section or, if no action 256.25 has been brought, may initiate and prosecute an independent 256.26 action on their behalf against a person, firm, or corporation 256.27 that may be liable to the person to whom the care or payment was 256.28 furnished. 256.29 (e) The state agency must be given notice of monetary 256.30 claims against a person, firm, or corporation that may be liable 256.31 in damages, or otherwise obligated to pay part or all of the 256.32 costs related to an injury when the state agency has paid or 256.33 become liable for the cost of care or payments related to the 256.34 injury. Notice must be given as follows: 256.35 (i) Applicants for general assistance or general assistance 256.36 medical care shall notify the state or county agency of any 257.1 possible claims when they submit the application. Recipients of 257.2 general assistance or general assistance medical care shall 257.3 notify the state or county agency of any possible claims when 257.4 those claims arise. 257.5 (ii) A person providing medical care services to a 257.6 recipient of general assistance medical care shall notify the 257.7 state agency when the person has reason to believe that a third 257.8 party may be liable for payment of the cost of medical care. 257.9 (iii) A person who is party to a claim upon which the state 257.10 agency may be entitled to subrogation under this section shall 257.11 notify the state agency of its potential subrogation claim 257.12 before filing a claim, commencing an action, or negotiating a 257.13 settlement. A person who is a party to a claim includes the 257.14 plaintiff, the defendants, and any other party to the cause of 257.15 action. 257.16 Notice given to the county agency is not sufficient to meet 257.17 the requirements of paragraphs (b) and (c). 257.18 (f) Upon any judgment, award, or settlement of a cause of 257.19 action, or any part of it, upon which the state agency has a 257.20 subrogation right, including compensation for liquidated, 257.21 unliquidated, or other damages, reasonable costs of collection, 257.22 including attorney fees, must be deducted first. The full 257.23 amount of general assistance or general assistance medical care 257.24 paid to or on behalf of the person as a result of the injury 257.25 must be deducted next and paid to the state agency. The rest 257.26 must be paid to the public assistance recipient or other 257.27 plaintiff. The plaintiff, however, must receive at least 257.28 one-third of the net recovery after attorney fees and collection 257.29 costs. 257.30 Sec. 92. Minnesota Statutes 1998, section 256L.03, 257.31 subdivision 5, is amended to read: 257.32 Subd. 5. [COPAYMENTS AND COINSURANCE.] The MinnesotaCare 257.33 benefit plan shall include the following copayments and 257.34 coinsurance requirements for all enrollees except parents and 257.35 relative caretakers of children under the age of 21 in 257.36 households with income at or below 175 percent of the federal 258.1 poverty guidelines and pregnant women and children under the age 258.2 of 21: 258.3 (1) ten percent of the paid charges for inpatient hospital 258.4 services for adult enrollees, subject to an annual inpatient 258.5 out-of-pocket maximum of $1,000 per individual and $3,000 per 258.6 family; 258.7 (2) $3 per prescription for adult enrollees; 258.8 (3) $25 for eyeglasses for adult enrollees; and 258.9 (4) effective July 1, 1998, 50 percent of the 258.10 fee-for-service rate for adult dental care services other than 258.11 preventive care services for persons eligible under section 258.12 256L.04, subdivisions 1 to 7, with income equal to or less than 258.13 175 percent of the federal poverty guidelines. 258.14 Effective July 1, 1997, adult enrollees with family gross 258.15 income that exceeds 175 percent of the federal poverty 258.16 guidelines and who are not pregnant shall be financially 258.17 responsible for the coinsurance amount and amounts which exceed 258.18 the $10,000 inpatient hospital benefit limit. 258.19 When a MinnesotaCare enrollee becomes a member of a prepaid 258.20 health plan, or changes from one prepaid health plan to another 258.21 during a calendar year, any charges submitted towards the 258.22 $10,000 annual inpatient benefit limit, and any out-of-pocket 258.23 expenses incurred by the enrollee for inpatient services, that 258.24 were submitted or incurred prior to enrollment, or prior to the 258.25 change in health plans, shall be disregarded. 258.26 Sec. 93. Minnesota Statutes 1998, section 256L.03, 258.27 subdivision 6, is amended to read: 258.28 Subd. 6. [LIEN.] When the state agency provides, pays for, 258.29 or becomes liable for covered health services, the agency shall 258.30 have a lien for the cost of the covered health services upon any 258.31 and all causes of action accruing to the enrollee, or to the 258.32 enrollee's legal representatives, as a result of the occurrence 258.33 that necessitated the payment for the covered health services. 258.34 All liens under this section shall be subject to the provisions 258.35 of section 256.015. For purposes of this subdivision, "state 258.36 agency" includesauthorized agents of the state agencyprepaid 259.1 health plans under contract with the commissioner according to 259.2 sections 256B.69, 256D.03, subdivision 4, paragraph (d), and 259.3 256L.12; and county-based purchasing entities under section 259.4 256B.692. 259.5 Sec. 94. Minnesota Statutes 1998, section 256L.04, 259.6 subdivision 2, is amended to read: 259.7 Subd. 2. [COOPERATION IN ESTABLISHING THIRD-PARTY 259.8 LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 259.9 eligible for MinnesotaCare, individuals and families must 259.10 cooperate with the state agency to identify potentially liable 259.11 third-party payers and assist the state in obtaining third-party 259.12 payments. "Cooperation" includes, but is not limited to, 259.13 identifying any third party who may be liable for care and 259.14 services provided under MinnesotaCare to the enrollee, providing 259.15 relevant information to assist the state in pursuing a 259.16 potentially liable third party, and completing forms necessary 259.17 to recover third-party payments. 259.18 (b) A parent, guardian, relative caretaker, or child 259.19 enrolled in the MinnesotaCare program must cooperate with the 259.20 department of human services and the local agency in 259.21 establishing the paternity of an enrolled child and in obtaining 259.22 medical care support and payments for the child and any other 259.23 person for whom the person can legally assign rights, in 259.24 accordance with applicable laws and rules governing the medical 259.25 assistance program. A child shall not be ineligible for or 259.26 disenrolled from the MinnesotaCare program solely because the 259.27 child's parent, relative caretaker, or guardian fails to 259.28 cooperate in establishing paternity or obtaining medical support. 259.29 Sec. 95. Minnesota Statutes 1998, section 256L.04, 259.30 subdivision 7, is amended to read: 259.31 Subd. 7. [SINGLE ADULTS AND HOUSEHOLDS WITH NO CHILDREN.] 259.32 The definition of eligible persons includes all individuals and 259.33 households with no children who have gross family incomes that 259.34 are equal to or less than175275 percent of the federal poverty 259.35 guidelines. 259.36 (Effective date: Section 95 (256L.04, subd. 7) is 260.1 effective July 1, 2000.) 260.2 Sec. 96. Minnesota Statutes 1998, section 256L.04, 260.3 subdivision 8, is amended to read: 260.4 Subd. 8. [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL 260.5 ASSISTANCE.] (a) Individuals who receive supplemental security 260.6 income or retirement, survivors, or disability benefits due to a 260.7 disability, or other disability-based pension, who qualify under 260.8 subdivision 7, but who are potentially eligible for medical 260.9 assistance without a spenddown shall be allowed to enroll in 260.10 MinnesotaCare for a period of 60 days, so long as the applicant 260.11 meets all other conditions of eligibility. The commissioner 260.12 shall identify and refer the applications of such individuals to 260.13 their county social service agency. The county and the 260.14 commissioner shall cooperate to ensure that the individuals 260.15 obtain medical assistance coverage for any months for which they 260.16 are eligible. 260.17 (b) The enrollee must cooperate with the county social 260.18 service agency in determining medical assistance eligibility 260.19 within the 60-day enrollment period. Enrollees who do not 260.20 cooperate with medical assistance within the 60-day enrollment 260.21 period shall be disenrolled from the plan within one calendar 260.22 month. Persons disenrolled for nonapplication for medical 260.23 assistance may not reenroll until they have obtained a medical 260.24 assistance eligibility determination. Persons disenrolled for 260.25 noncooperation with medical assistance may not reenroll until 260.26 they have cooperated with the county agency and have obtained a 260.27 medical assistance eligibility determination. 260.28 (c) Beginning January 1, 2000, counties that choose to 260.29 become MinnesotaCare enrollment sites shall consider 260.30 MinnesotaCare applicationsof individuals described in paragraph260.31(a)to also be applications for medical assistanceand shall260.32first determine whether medical assistance eligibility exists. 260.33Adults with children with family income under 175 percent of the260.34federal poverty guidelines for the applicable family size,260.35pregnant women, and children who qualify under subdivision 1260.36 Applicants who are potentially eligible for medical assistance 261.1without a spenddown, except for those described in paragraph 261.2 (a), may choose to enroll in either MinnesotaCare or medical 261.3 assistance. 261.4 (d) The commissioner shall redetermine provider payments 261.5 made under MinnesotaCare to the appropriate medical assistance 261.6 payments for those enrollees who subsequently become eligible 261.7 for medical assistance. 261.8 Sec. 97. Minnesota Statutes 1998, section 256L.04, 261.9 subdivision 11, is amended to read: 261.10 Subd. 11. [MINNESOTACARE OUTREACH.] (a) The commissioner 261.11 shall award grants to public or private organizations to provide 261.12 information on the importance of maintaining insurance coverage 261.13 and on how to obtain coverage through the MinnesotaCare program 261.14 in areas of the state with high uninsured populations. 261.15 (b) In awarding the grants, the commissioner shall consider 261.16 the following: 261.17 (1) geographic areas and populations with high uninsured 261.18 rates; 261.19 (2) the ability to raise matching funds; and 261.20 (3) the ability to contact or serve eligible populations. 261.21 The commissioner shall monitor the grants and may terminate 261.22 a grant if the outreach effort does not increasethe261.23MinnesotaCare programenrollment in medical assistance, general 261.24 assistance medical care, or the MinnesotaCare program. 261.25 Sec. 98. Minnesota Statutes 1998, section 256L.04, 261.26 subdivision 13, is amended to read: 261.27 Subd. 13. [FAMILIES WITHGRANDPARENTS,RELATIVE 261.28 CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] Beginning 261.29 January 1, 1999, in families that include agrandparent,261.30 relative caretaker as defined in the medical assistance program, 261.31 foster parent, or legal guardian, thegrandparent,relative 261.32 caretaker, foster parent, or legal guardian may apply as a 261.33 family or may apply separately for the children. If the 261.34 caretaker applies separately for the children, only the 261.35 children's income is counted and the provisions of subdivision 261.36 1, paragraph (b), do not apply. If thegrandparent,relative 262.1 caretaker, foster parent, or legal guardian applies with the 262.2 children, their income is included in the gross family income 262.3 for determining eligibility and premium amount. 262.4 Sec. 99. Minnesota Statutes 1998, section 256L.05, is 262.5 amended by adding a subdivision to read: 262.6 Subd. 3c. [RETROACTIVE COVERAGE.] Notwithstanding 262.7 subdivision 3, the effective date of coverage shall be the first 262.8 day of the month following termination from medical assistance 262.9 or general assistance medical care for families and individuals 262.10 who are eligible for MinnesotaCare and who submitted a written 262.11 request to the commissioner for MinnesotaCare within 30 days of 262.12 receiving notification of termination from medical assistance or 262.13 general assistance medical care. 262.14 Sec. 100. Minnesota Statutes 1998, section 256L.05, 262.15 subdivision 4, is amended to read: 262.16 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 262.17 human services shall determine an applicant's eligibility for 262.18 MinnesotaCare no more than 30 days from the date that the 262.19 application is received by the department of human services. 262.20 Beginning January 1, 2000, this requirement also applies to 262.21 local county human services agencies that determine eligibility 262.22 for MinnesotaCare. Once annually at application or 262.23 reenrollment, to prevent processing delays, applicants or 262.24 enrollees who, from the information provided on the application, 262.25 appear to meet eligibility requirements shall be enrolled upon 262.26 timely payment of premiums. The enrollee must provide all 262.27 required verifications within 30 days ofenrollmentnotification 262.28 of the eligibility determination or coverage from the program 262.29 shall be terminated. Enrollees who are determined to be 262.30 ineligible when verifications are provided shall be disenrolled 262.31 from the program. 262.32 Sec. 101. Minnesota Statutes 1998, section 256L.06, 262.33 subdivision 3, is amended to read: 262.34 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 262.35 Premiums are dedicated to the commissioner for MinnesotaCare. 262.36 (b) The commissioner shall develop and implement procedures 263.1 to: (1) require enrollees to report changes in income; (2) 263.2 adjust sliding scale premium payments, based upon changes in 263.3 enrollee income; and (3) disenroll enrollees from MinnesotaCare 263.4 for failure to pay required premiums.Beginning July 1, 1998,263.5 Failure to pay includes payment with a dishonored checkand, a 263.6 returned automatic bank withdrawal, or a refused credit card or 263.7 debit card payment. The commissioner may demand a guaranteed 263.8 form of payment, including a cashier's check or a money order, 263.9 as the only means to replace a dishonoredcheck, returned, or 263.10 refused payment. 263.11 (c) Premiums are calculated on a calendar month basis and 263.12 may be paid on a monthly, quarterly, or annual basis, with the 263.13 first payment due upon notice from the commissioner of the 263.14 premium amount required. The commissioner shall inform 263.15 applicants and enrollees of these premium payment options. 263.16 Premium payment is required before enrollment is complete and to 263.17 maintain eligibility in MinnesotaCare. 263.18 (d) Nonpayment of the premium will result in disenrollment 263.19 from the plan within one calendar month after the due date. 263.20 Persons disenrolled for nonpayment or who voluntarily terminate 263.21 coverage from the program may not reenroll until four calendar 263.22 months have elapsed. Persons disenrolled for nonpayment who pay 263.23 all past due premiums as well as current premiums due, within 20 263.24 days of disenrollment, shall be reenrolled for the next month. 263.25 Persons disenrolled for nonpayment or who voluntarily terminate 263.26 coverage from the program may not reenroll for four calendar 263.27 months unless the person demonstrates good cause for 263.28 nonpayment. Good cause does not exist if a person chooses to 263.29 pay other family expenses instead of the premium. The 263.30 commissioner shall define good cause in rule. 263.31 Sec. 102. Minnesota Statutes 1998, section 256L.07, is 263.32 amended to read: 263.33 256L.07 [ELIGIBILITY FORSUBSIDIZED PREMIUMS BASED ON263.34SLIDING SCALEMINNESOTACARE.] 263.35 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Children 263.36 enrolled in the original children's health plan as of September 264.1 30, 1992, children who enrolled in the MinnesotaCare program 264.2 after September 30, 1992, pursuant to Laws 1992, chapter 549, 264.3 article 4, section 17, and children who have family gross 264.4 incomes that are equal to or less than 150 percent of the 264.5 federal poverty guidelines are eligiblefor subsidized premium264.6paymentswithout meeting the requirements of subdivision 2, as 264.7 long as they maintain continuous coverage in the MinnesotaCare 264.8 program or medical assistance. Children who apply for 264.9 MinnesotaCare on or after the implementation date of the 264.10 employer-subsidized health coverage program as described in Laws 264.11 1998, chapter 407, article 5, section 45, who have family gross 264.12 incomes that are equal to or less than 150 percent of the 264.13 federal poverty guidelines, must meet the requirements of 264.14 subdivision 2 to be eligible for MinnesotaCare. 264.15 (b) Families and individuals enrolled in MinnesotaCare 264.16 under section 256L.04, subdivision 1 or 7, whose income 264.17 increases above 275 percent of the federal poverty guidelines, 264.18 are no longer eligible for the program and shall be disenrolled 264.19 by the commissioner.Individuals enrolled in MinnesotaCare264.20under section 256L.04, subdivision 7, whose income increases264.21above 175 percent of the federal poverty guidelines are no264.22longer eligible for the program and shall be disenrolled by the264.23commissioner.For persons disenrolled under this subdivision, 264.24 MinnesotaCare coverage terminates the last day of the calendar 264.25 month following the month in which the commissioner determines 264.26 that the income of a family or individual, determined over a264.27four-month period as required by section 256L.15, subdivision 2,264.28 exceeds program income limits. 264.29 (c) Notwithstanding paragraph (b), individuals and families 264.30 may remain enrolled in MinnesotaCare if ten percent of their 264.31 annual income is less than the annual premium for a policy with 264.32 a $500 deductible available through the Minnesota comprehensive 264.33 health association. Individuals and families who are no longer 264.34 eligible for MinnesotaCare under this subdivision shall be given 264.35 an 18-month notice period from the date that ineligibility is 264.36 determined before disenrollment. 265.1 (Effective date: Section 102 (256L.07, subd. 1) is 265.2 effective July 1, 2000.) 265.3 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 265.4 COVERAGE.] (a) To be eligiblefor subsidized premium payments265.5based on a sliding scale, a family or individual must not have 265.6 access to subsidized health coverage through an employer and 265.7 must not have had access to employer-subsidized coverage through 265.8 a current employer for 18 months prior to application or 265.9 reapplication. A family or individual whose employer-subsidized 265.10 coverage is lost due to an employer terminating health care 265.11 coverage as an employee benefit during the previous 18 months is 265.12 not eligible. 265.13 (b) For purposes of this requirement, subsidized health 265.14 coverage means health coverage for which the employer pays at 265.15 least 50 percent of the cost of coverage for the employee or 265.16 dependent, or a higher percentage as specified by the 265.17 commissioner. Children are eligible for employer-subsidized 265.18 coverage through either parent, including the noncustodial 265.19 parent. The commissioner must treat employer contributions to 265.20 Internal Revenue Code Section 125 plans and any other employer 265.21 benefits intended to pay health care costs as qualified employer 265.22 subsidies toward the cost of health coverage for employees for 265.23 purposes of this subdivision. 265.24 Subd. 3. [OTHER HEALTH COVERAGE.] (a) Families and 265.25 individuals enrolled in the MinnesotaCare program must have no 265.26 health coverage while enrolled or for at least four months prior 265.27 to application and renewal. Children enrolled in the original 265.28 children's health plan and children in families with income 265.29 equal to or less than 150 percent of the federal poverty 265.30 guidelines, who have other health insurance, are eligible if the 265.31other health coverage meets the requirements of Minnesota Rules,265.32part 9506.0020, subpart 3, item B.coverage: 265.33 (1) lacks two or more of the following: 265.34 (i) basic hospital insurance; 265.35 (ii) medical-surgical insurance; 265.36 (iii) prescription drug coverage; 266.1 (iv) dental coverage; or 266.2 (v) vision coverage; 266.3 (2) requires a deductible of $100 or more per person per 266.4 year; or 266.5 (3) lacks coverage because the child has exceeded the 266.6 maximum coverage for a particular diagnosis or the policy 266.7 excludes a particular diagnosis. 266.8 The commissioner may change this eligibility criterion for 266.9 sliding scale premiums in order to remain within the limits of 266.10 available appropriations. The requirement of no health coverage 266.11 does not apply to newborns. The requirement of no other health 266.12 coverage for at least four months prior to application does not 266.13 apply to families with children when a parent has been 266.14 determined to be in need of chemical dependency treatment 266.15 pursuant to an assessment conducted by the county under section 266.16 626.556, subdivision 10, or a case plan under section 257.071 or 266.17 260.191, subdivision 1e. 266.18 (b)For purposes of this section,Medical assistance, 266.19 general assistance medical care, and civilian health and medical 266.20 program of the uniformed service, CHAMPUS, are not considered 266.21 insurance or health coverage for purposes of the four-month 266.22 requirement described in this subdivision. 266.23 (c) For purposes of thissectionsubdivision, Medicare Part 266.24 A or B coverage under title XVIII of the Social Security Act, 266.25 United States Code, title 42, sections 1395c to 1395w-4, is 266.26 considered health coverage. An applicant or enrollee may not 266.27 refuse Medicare coverage to establish eligibility for 266.28 MinnesotaCare. 266.29 (d) Applicants who were recipients of medical assistance or 266.30 general assistance medical care within one month of application 266.31 must meet the provisions of this subdivision and subdivision 2. 266.32 (e) This subdivision does not apply to children who are no 266.33 longer eligible for the subsidized employer health coverage 266.34 program described in chapter 256M due to employment termination. 266.35 (Effective date: Section 102 (256L.07, subd. 3) is 266.36 effective 30 days following federal approval of the state plan 267.1 under title XXI and of the section 1115 waiver request in 267.2 section 118, paragraph (a).) 267.3 Subd. 4. [FAMILIES WITH CHILDREN IN NEED OF CHEMICAL 267.4 DEPENDENCY TREATMENT.] Premiums for families with children when 267.5 a parent has been determined to be in need of chemical 267.6 dependency treatment pursuant to an assessment conducted by the 267.7 county under section 626.556, subdivision 10, or a case plan 267.8 under section 257.071 or 260.191, subdivision 1e, who are 267.9 eligible for MinnesotaCare under section 256L.04, subdivision 1, 267.10 shall be paid by the county of residence of the person in need 267.11 of treatment for one year from the date the family is determined 267.12 to be eligible or if the family is currently enrolled in 267.13 MinnesotaCare from the date the person is determined to be in 267.14 need of chemical dependency treatment. Upon renewal, the family 267.15 is responsible for any premiums owed under section 256L.15. If 267.16 the family is not currently enrolled in MinnesotaCare, the local 267.17 county human services agency shall determine whether the family 267.18 appears to meet the eligibility requirements and shall assist 267.19 the family in applying for the MinnesotaCare program. 267.20 Sec. 103. Minnesota Statutes 1998, section 256L.15, 267.21 subdivision 1, is amended to read: 267.22 Subdivision 1. [PREMIUM DETERMINATION.] Families with 267.23 children and individuals shall pay a premium determined 267.24 according to a sliding fee based onthe cost of coverage asa 267.25 percentage of the family's gross family income. Pregnant women 267.26 and children under age two are exempt from the provisions of 267.27 section 256L.06, subdivision 3, paragraph (b), clause (3), 267.28 requiring disenrollment for failure to pay premiums. For 267.29 pregnant women, this exemption continues until the first day of 267.30 the month following the 60th day postpartum. Women who remain 267.31 enrolled during pregnancy or the postpartum period, despite 267.32 nonpayment of premiums, shall be disenrolled on the first of the 267.33 month following the 60th day postpartum for the penalty period 267.34 that otherwise applies under section 256L.06, unless they begin 267.35 paying premiums. 267.36 Sec. 104. Minnesota Statutes 1998, section 256L.15, 268.1 subdivision 1b, is amended to read: 268.2 Subd. 1b. [PAYMENTS NONREFUNDABLE.] Only MinnesotaCare 268.3 premiumsare not refundablepaid for future months of coverage 268.4 for which a health plan capitation fee has not been paid may be 268.5 refunded. 268.6 Sec. 105. Minnesota Statutes 1998, section 256L.15, 268.7 subdivision 2, is amended to read: 268.8 Subd. 2. [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 268.9 GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 268.10 establish a sliding fee scale to determine the percentage of 268.11 gross individual or family income that households at different 268.12 income levels must pay to obtain coverage through the 268.13 MinnesotaCare program. The sliding fee scale must be based on 268.14 the enrollee's gross individual or family incomeduring the268.15previous four months. The sliding fee scale must contain 268.16 separate tables based on enrollment of one, two, or three or 268.17 more persons. The sliding fee scale begins with a premium of 268.18 1.5 percent of gross individual or family income for individuals 268.19 or families with incomes below the limits for the medical 268.20 assistance program for families and children in effect on 268.21 January 1, 1999, and proceeds through the following evenly 268.22 spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 268.23 percent. These percentages are matched to evenly spaced income 268.24 steps ranging from the medical assistance income limit for 268.25 families and children in effect on January 1, 1999, to 275 268.26 percent of the federal poverty guidelines for the applicable 268.27 family size, up to a family size of five. The sliding fee scale 268.28 for a family of five must be used for families of more than 268.29 five. The sliding fee scale and percentages are not subject to 268.30 the provisions of chapter 14. If a family or individual reports 268.31 increased income after enrollment, premiums shall not be 268.32 adjusted until eligibility renewal. 268.33 (b) Enrolled individuals and families whose gross annual 268.34 income increases above 275 percent of the federal poverty 268.35 guideline shall pay the maximum premium. The maximum premium is 268.36 defined as a base charge for one, two, or three or more 269.1 enrollees so that if all MinnesotaCare cases paid the maximum 269.2 premium, the total revenue would equal the total cost of 269.3 MinnesotaCare medical coverage and administration. In this 269.4 calculation, administrative costs shall be assumed to equal ten 269.5 percent of the total. The costs of medical coverage for 269.6 pregnant women and children under age two and the enrollees in 269.7 these groups shall be excluded from the total. The maximum 269.8 premium for two enrollees shall be twice the maximum premium for 269.9 one, and the maximum premium for three or more enrollees shall 269.10 be three times the maximum premium for one. 269.11 Sec. 106. Minnesota Statutes 1998, section 256L.15, 269.12 subdivision 3, is amended to read: 269.13 Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium 269.14 of $48 is required for all children in families with income at 269.15 or less than 150 percent of federal poverty guidelines. The 269.16 commissioner may reduce the annual premium to $30 for families 269.17 who choose to pay the premium on an annual basis. 269.18 SUBSIDIZED EMPLOYER HEALTH COVERAGE PROGRAM 269.19 Sec. 107. [256M.01] [DEFINITIONS.] 269.20 Subdivision 1. [APPLICABILITY.] For purposes of this 269.21 chapter, the terms defined in this section have the meanings 269.22 given them. 269.23 Subd. 2. [COMMISSIONER.] "Commissioner" means the 269.24 commissioner of human services. 269.25 Subd. 3. [EMPLOYER-SUBSIDIZED HEALTH 269.26 COVERAGE.] "Employer-subsidized health coverage" has the meaning 269.27 provided in section 256L.07, subdivision 2, paragraph (b). 269.28 (Effective date: Section 107 (256M.01) is effective 30 269.29 days following federal approval of the state plan under title 269.30 XXI and of the section 1115 waiver request in section 117, 269.31 paragraph (a).) 269.32 Sec. 108. [256M.03] [ELIGIBILITY FOR EMPLOYER-SUBSIDIZED 269.33 COVERAGE.] 269.34 Subdivision 1. [GENERAL REQUIREMENTS.] (a) A child who is 269.35 under the age of 19 and whose family gross income is equal to or 269.36 less than 275 percent of the federal poverty guidelines for the 270.1 applicable family size and who would otherwise be eligible for 270.2 coverage under the MinnesotaCare program, except for the 270.3 insurance-related barriers to enrollment under section 256L.07, 270.4 subdivisions 2 and 3, is eligible for subsidized payment of the 270.5 employee share of the employer-subsidized dependent health 270.6 coverage available to the child's family in accordance with 270.7 section 256M.05. 270.8 (b) To be eligible under this section, a child must not be 270.9 covered under employer-subsidized dependent health coverage at 270.10 the time of application. 270.11 Subd. 2. [EMPLOYER-SUBSIDIZED HEALTH COVERAGE.] To be 270.12 eligible for the premium payment under this chapter, the 270.13 employer-subsidized coverage offered to employees must meet the 270.14 benchmark coverage selected by the commissioner in accordance 270.15 with section 2103 of title XXI of the Social Security Act, 270.16 unless federal approval is received for the number two qualified 270.17 plan described in section 62E.06 or its actuarial equivalent. 270.18 The commissioner shall select the benchmark option with the 270.19 lowest actuarial value in section 2103(b) of title XXI of the 270.20 Social Security Act. 270.21 Subd. 3. [LOW-COST HEALTH PLAN OPTION.] If an employer 270.22 offers more than one health plan option to employees, 270.23 eligibility for subsidized premium payments shall be limited to 270.24 the lowest cost health plan option offered that serves the 270.25 geographic area in which the eligible child resides. 270.26 Subd. 4. [PROBATIONARY PERIOD.] If an employer has a 270.27 probationary period during which an employee or an employee's 270.28 dependent is not eligible for employer-subsidized health 270.29 coverage, the employee's dependent shall not be considered 270.30 eligible under this section until the employer's probationary 270.31 period is over. 270.32 (Effective date: Section 108 (256M.03) is effective 30 270.33 days following approval of the state plan under title XXI and of 270.34 the section 1115 waiver request described in section 117, 270.35 paragraph (a).) 270.36 Sec. 109. [256M.05] [PAYMENTS.] 271.1 Subdivision 1. [PREMIUMS.] Children who are eligible under 271.2 section 256M.03 shall pay a premium in accordance with the 271.3 MinnesotaCare sliding premium scale as specified in section 271.4 256L.15, except that children in families with income at or 271.5 below 150 percent of the federal poverty guidelines for the 271.6 applicable family size, shall not be required to pay an amount 271.7 in excess of the maximum monthly charge allowable under title 271.8 XXI of the Social Security Act, section 2103(e)(3)(A). The 271.9 commissioner shall inform the employer and the employee of the 271.10 premium owed by each eligible employee and the subsidy amount to 271.11 be paid by the department of human services. The employee shall 271.12 pay the employer the premium owed. The employer may deduct the 271.13 premium from the employee's paycheck. 271.14 Subd. 2. [PAYMENT TO EMPLOYER.] The commissioner shall pay 271.15 the employer the difference between the premiums paid by the 271.16 employee as specified under subdivision 1 and the cost of the 271.17 employee share of the employer-subsidized health coverage. 271.18 Payment of the employee share is limited to the amount of the 271.19 premium attributable to the cost of dependent coverage for the 271.20 eligible children, unless the amount of the premium for 271.21 dependent coverage does not differentiate between adult and 271.22 child dependents. 271.23 Subd. 3. [PAYMENTS TO HEALTH CARE PROVIDERS.] Any 271.24 copayments, deductibles, or coinsurance owed on behalf of an 271.25 eligible child under the employer's health plan shall be paid by 271.26 the commissioner to the health care provider. Payment shall be 271.27 made according to the usual and customary charges established 271.28 under the employer's health plan. The family is responsible for 271.29 notifying the health care provider that they are covered under 271.30 the subsidized employer health coverage program. The provider 271.31 must bill the commissioner for any copayment, deductible, or 271.32 coinsurance owed by the family for covered services provided to 271.33 the eligible child by the health care provider. Upon the 271.34 submission of a bill, the commissioner must promptly pay the 271.35 provider the amount of any copay, deductible, or coinsurance 271.36 owed on behalf of an eligible child plus an administrative fee 272.1 equal to one percent of the total amount paid by the 272.2 commissioner. 272.3 (Effective date: Section 109 (256M.05) is effective 30 272.4 days following federal approval of the state plan under title 272.5 XXI and of the section 1115 waiver request in section 117, 272.6 paragraph (a).) 272.7 Sec. 110. [256M.07] [APPLICATIONS.] 272.8 Subdivision 1. [AVAILABILITY.] Applicants may apply to the 272.9 commissioner or to the licensed insurance broker who provides 272.10 employee benefits to their employer. The licensed insurance 272.11 broker shall accept applications and forward them to the 272.12 commissioner for processing. 272.13 Subd. 2. [PROCESSING.] The commissioner shall determine an 272.14 applicant's initial eligibility. Applicants who from the 272.15 information provided on the application appear to meet the 272.16 eligibility requirements shall be enrolled without income 272.17 verification. 272.18 Subd. 3. [RENEWAL OF ELIGIBILITY.] An enrollee's 272.19 eligibility must be renewed every 12 months. Renewal of 272.20 eligibility may be completed by the licensed insurance broker. 272.21 Renewal applications must include income verification 272.22 information. 272.23 Subd. 4. [OUTREACH.] Any licensed insurance broker who 272.24 refers a family to the MinnesotaCare program in the process of 272.25 determining eligibility under this section shall be paid by the 272.26 commissioner a one-time application fee of $25 per referral if 272.27 any member of the family is determined to be eligible for the 272.28 MinnesotaCare program. 272.29 Subd. 5. [ADMINISTRATION.] The commissioner may contract 272.30 with a private entity to administer the subsidized employer 272.31 health coverage program. 272.32 (Effective date: Section 110 (256M.07) is effective 30 272.33 days following federal approval of the state plan under title 272.34 XXI and of the section 1115 waiver request in section 117, 272.35 paragraph (a).) 272.36 Sec. 111. Minnesota Statutes 1998, section 626.556, 273.1 subdivision 10i, is amended to read: 273.2 Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL 273.3 DETERMINATION OF MALTREATMENT.] (a) An individual or facility 273.4 that the commissioner or a local social service agency 273.5 determines has maltreated a child, or the child's designee, 273.6 regardless of the determination, who contests the investigating 273.7 agency's final determination regarding maltreatment, may request 273.8 the investigating agency to reconsider its final determination 273.9 regarding maltreatment. The request for reconsideration must be 273.10 submitted in writing to the investigating agency within 15 273.11 calendar days after receipt of notice of the final determination 273.12 regarding maltreatment. 273.13 (b) If the investigating agency denies the request or fails 273.14 to act upon the request within 15 calendar days after receiving 273.15 the request for reconsideration, the person or facility entitled 273.16 to a fair hearing under section 256.045 may submit to the 273.17 commissioner of human services a written request for a hearing 273.18 under that section. 273.19 (c) If, as a result of the reconsideration, the 273.20 investigating agency changes the final determination of 273.21 maltreatment, that agency shall notify the parties specified in 273.22 subdivisions 10b, 10d, and 10f. 273.23 (d) If an individual or facility contests the investigating 273.24 agency's final determination regarding maltreatment by 273.25 requesting a fair hearing under section 256.045, the 273.26 commissioner of human services shall assure that the hearing is 273.27 conducted and a decision is reached within 90 days of receipt of 273.28 the request for a hearing. The time for action on the decision 273.29 may be extended for as many days as the hearing is postponed or 273.30 the record is held open for the benefit of either party. 273.31 Sec. 112. Laws 1995, chapter 178, article 2, section 46, 273.32 subdivision 10, is amended to read: 273.33 Subd. 10. [ADDITIONAL WAIVER REQUEST FOR EMPLOYED DISABLED 273.34 PERSONS.] The commissioner shall seek a federal waiver in order 273.35 to implement a work incentive for disabled personseligible for273.36medical assistancewho are not residents of long-term care 274.1 facilities when determining their eligibility for medical 274.2 assistance. The waiver shall request authorization to establish 274.3 a medical assistance earned income disregard for employed 274.4 disabled persons who, but for earned income, are eligible for 274.5 SSDI and whoreceiverequire personal care assistance under the 274.6 Medical Assistance Program. The disregard shall be equivalent 274.7 to the threshold amount applied to persons who qualify under 274.8 section 1619(b) of the Social Security Act, except that when a 274.9 disabled person's earned income reaches the maximum income 274.10 permitted at the threshold under section 1619(b), the person 274.11 shall retain medical assistance eligibility and must contribute 274.12 to the costs of medical care on a sliding fee basis. 274.13 Sec. 113. [CHARITY CARE DATA COLLECTION.] 274.14 The commissioner of health shall determine a definition for 274.15 charity care and bad debt that distinguishes these two terms for 274.16 inpatient and ambulatory care. The commissioner shall use these 274.17 definitions as a basis for collecting data on uncompensated care 274.18 in hospitals, surgical centers, and health care clinics located 274.19 within the seven-county metropolitan area. 274.20 Sec. 114. [MINNESOTACARE APPLICATION SIMPLIFICATION.] 274.21 The commissioner of human services shall develop a one page 274.22 preapplication form for the MinnesotaCare program and may 274.23 develop a pilot project that involves using this form in 274.24 community health clinics, community health offices, and 274.25 disproportionate share hospitals to determine the feasibility of 274.26 using a one page application form for MinnesotaCare. As part of 274.27 this pilot project, the commissioner shall track the number of 274.28 individuals determined to be eligible from the preapplication 274.29 form, the number determined to be eligible upon the completion 274.30 of the full application, and for families with children the cost 274.31 of providing the care to those found eligible. 274.32 Sec. 115. [EXPANSION OF SPECIAL EDUCATION SERVICES.] 274.33 The commissioner of human services shall examine 274.34 opportunities to expand the scope of providers eligible for 274.35 reimbursement for medical assistance services listed in a 274.36 child's individual education plan based on state and federal 275.1 requirements for provider qualifications. The commissioner 275.2 shall complete these activities, in consultation with the 275.3 commissioner of children, families, and learning, by December 275.4 1999 and seek necessary federal approval. 275.5 Sec. 116. [HOME-BASED MENTAL HEALTH SERVICES.] 275.6 By January 1, 2000, the commissioner of human services 275.7 shall amend Minnesota Rules under the expedited process of 275.8 Minnesota Statutes, section 14.389, to effect the following 275.9 changes: 275.10 (1) amend Minnesota Rules, part 9505.0324, subpart 2, to 275.11 permit a county board to contract with any agency qualified 275.12 under Minnesota Rules, part 9505.0324, subparts 4 and 5, as an 275.13 eligible provider of home-based mental health services; 275.14 (2) amend Minnesota Rules, part 9505.0324, subpart 2, to 275.15 permit children's mental health collaboratives approved by the 275.16 children's cabinet under Minnesota Statutes, section 245.493, to 275.17 provide or to contract with any agency qualified under Minnesota 275.18 Rules, part 9505.0324, subparts 4 and 5, as an eligible provider 275.19 of home-based mental health services. 275.20 Sec. 117. [AMENDING MEDICAL ASSISTANCE RULES.] 275.21 By January 1, 2001, the commissioner of human services 275.22 shall amend Minnesota Rules, parts 9505.0323; 9505.0324; 275.23 9505.0326; and 9505.0327, as necessary to implement the changes 275.24 outlined in Minnesota Statutes, section 256B.0625, subdivision 275.25 35. 275.26 Sec. 118. [WAIVER REQUEST.] 275.27 (a) The commissioner of human services shall seek federal 275.28 approval for a waiver under section 1115 of the Social Security 275.29 Act to obtain federal financial participation under title XIX 275.30 for children in the subsidized employer health coverage program 275.31 whose premium obligation under the MinnesotaCare sliding premium 275.32 scale would exceed five percent of gross family income. 275.33 (b) The commissioner of human services shall seek federal 275.34 approval for a waiver under section 1115 of the Social Security 275.35 Act to allow, at the family's option, federal financial 275.36 participation under title XIX for subsidized employer health 276.1 coverage for a Medicaid-eligible child who has a sibling 276.2 eligible for the subsidized employer health coverage program. 276.3 (c) The commissioner of human services shall seek federal 276.4 approval for a waiver under title XXI of the Social Security Act 276.5 for authority to obtain federal financial participation for 276.6 health coverage for the employee's spouse when an employer 276.7 offers family coverage. 276.8 (d) The commissioner of human services shall seek federal 276.9 approval for a modification of the health care reform waiver 276.10 under section 1115 of the Social Security Act to permit the use 276.11 of copayments instead of premium payments for low-income 276.12 enrollees in the MinnesotaCare program. 276.13 Sec. 119. [MEDICARE SUPPLEMENTAL COVERAGE FOR LOW-INCOME 276.14 SENIORS.] 276.15 The commissioner of health, in consultation with the 276.16 commissioners of human services and commerce, shall study the 276.17 extent and type of Medicare supplemental coverage for low-income 276.18 seniors. The commissioner shall also study the qualified 276.19 Medicare beneficiaries eligible under Minnesota Statutes, 276.20 section 256B.057, subdivision 3, in terms of developing a 276.21 comprehensive set of services to supplement Medicare that these 276.22 individuals may need to ensure independence and control of their 276.23 lives. The commissioner shall make recommendations on the 276.24 cost-effectiveness of expanding the benefits offered to 276.25 qualified Medicare beneficiaries including the feasibility of 276.26 the state providing health care coverage options to low-income 276.27 seniors that would provide a comprehensive set of services and 276.28 would build on existing or new Medicare products. The 276.29 commissioner shall also study the fiscal impact of mandating 276.30 coverage for Medicare supplemental products to include long-term 276.31 care services, including home health services, homemaker 276.32 services, and nursing facilities services and the fiscal 276.33 implications of the state paying the premiums for this coverage 276.34 for low-income seniors, including potential savings to the 276.35 medical assistance program. The commissioner shall report to 276.36 the legislature on the findings of the study with any 277.1 recommendations by January 15, 2000. 277.2 Sec. 120. [DENTAL ACCESS STUDY.] 277.3 The commissioner of human services, in consultation with 277.4 the commissioner of health, dental care providers, community 277.5 clinics, client advocacy groups, and counties, shall review the 277.6 dental access problem, evaluate the effects of the dental access 277.7 initiatives adopted by the 1999 legislature, and make 277.8 recommendations on other actions that could improve dental 277.9 access for public program recipients. The commissioner shall 277.10 submit a progress report by January 15, 2000, and a final report 277.11 to the legislature by January 15, 2001. 277.12 Sec. 121. [REPORT ON RATE SETTING AND RISK ADJUSTMENT.] 277.13 The commissioner of human services shall report to the 277.14 legislature, by January 15, 2000, on the current rate setting 277.15 process for state prepaid health care programs, rate setting and 277.16 risk adjustment methods in other states, and the results of the 277.17 application of risk adjustment on a trial basis in Minnesota for 277.18 calendar year 1999. The report must also present an analysis of 277.19 the feasibility of requiring prepaid health plans to report 277.20 vendor costs rather than charges, an analysis of capitation rate 277.21 equalization for MinnesotaCare and the prepaid medical 277.22 assistance program, an analysis of the fiscal impact on state 277.23 and county government if Minnesota Statutes 1998, section 277.24 256B.69, subdivision 5d is repealed, and recommendations for 277.25 providing actuarial and market analyses related to setting 277.26 prepaid health plan rates to the legislature on a timely basis 277.27 that would allow this information to be used in the 277.28 appropriations process. 277.29 Sec. 122. [REPORT ON PREPAID MEDICAL ASSISTANCE PROGRAM.] 277.30 The commissioner of human services shall present 277.31 recommendations to the legislature, by December 15, 1999, on 277.32 methods for implementing county board authority under the 277.33 prepaid medical assistance program. 277.34 Sec. 123. [PHYSICIAN AND PROFESSIONAL SERVICES PAYMENT 277.35 METHODOLOGY CONVERSION.] 277.36 The commissioner of human services shall submit a proposal 278.1 to the legislature by January 15, 2000, detailing the medical 278.2 assistance physician and professional services payment 278.3 methodology conversion to resource based relative value scale. 278.4 Sec. 124. [REPEALER.] 278.5 Minnesota Statutes 1998, sections 256B.74, subdivisions 2 278.6 and 5; and 462A.208, are repealed. 278.7 Sec. 125. [EFFECTIVE DATE.] 278.8 When preparing the conference committee report for adoption 278.9 by the legislature, the revisor shall combine all effective date 278.10 notations in this article into this effective date section. 278.11 ARTICLE 5 278.12 STATE-OPERATED SERVICES; 278.13 CHEMICAL DEPENDENCY; MENTAL HEALTH; LAND CONVEYANCES 278.14 Section 1. Minnesota Statutes 1998, section 16C.10, 278.15 subdivision 5, is amended to read: 278.16 Subd. 5. [SPECIFIC PURCHASES.] The solicitation process 278.17 described in this chapter is not required for acquisition of the 278.18 following: 278.19 (1) merchandise for resale purchased under policies 278.20 determined by the commissioner; 278.21 (2) farm and garden products which, as determined by the 278.22 commissioner, may be purchased at the prevailing market price on 278.23 the date of sale; 278.24 (3) goods and services from the Minnesota correctional 278.25 facilities; 278.26 (4) goods and services from rehabilitation facilities and 278.27 sheltered workshops that are certified by the commissioner of 278.28 economic security; 278.29 (5) goods and services for use by a community-based 278.30residentialfacility operated by the commissioner of human 278.31 services; 278.32 (6) goods purchased at auction or when submitting a sealed 278.33 bid at auction provided that before authorizing such an action, 278.34 the commissioner consult with the requesting agency to determine 278.35 a fair and reasonable value for the goods considering factors 278.36 including, but not limited to, costs associated with submitting 279.1 a bid, travel, transportation, and storage. This fair and 279.2 reasonable value must represent the limit of the state's bid; 279.3 and 279.4 (7) utility services where no competition exists or where 279.5 rates are fixed by law or ordinance. 279.6 Sec. 2. Minnesota Statutes 1998, section 245.462, 279.7 subdivision 4, is amended to read: 279.8 Subd. 4. [CASEMANAGERMANAGEMENT SERVICE PROVIDER.] (a) 279.9 "Casemanagermanagement service provider" meansan individuala 279.10 case manager or case manager associate employed by the county or 279.11 other entity authorized by the county board to provide case 279.12 management services specified in section 245.4711. 279.13 A case manager must have a bachelor's degree in one of the 279.14 behavioral sciences or related fields including, but not limited 279.15 to, social work, psychology, or nursing from an accredited 279.16 college or universityand. A case manager must have at least 279.17 2,000 hours of supervised experience in the delivery of services 279.18 to adults with mental illness, must be skilled in the process of 279.19 identifying and assessing a wide range of client needs, and must 279.20 be knowledgeable about local community resources and how to use 279.21 those resources for the benefit of the client.The case manager279.22shall meet in person with a mental health professional at least279.23once each month to obtain clinical supervision of the case279.24manager's activities. Case managers with a bachelor's degree279.25but without 2,000 hours of supervised experience in the delivery279.26of services to adults with mental illness must complete 40 hours279.27of training approved by the commissioner of human services in279.28case management skills and in the characteristics and needs of279.29adults with serious and persistent mental illness and must279.30receive clinical supervision regarding individual service279.31delivery from a mental health professional at least once each279.32week until the requirement of 2,000 hours of supervised279.33experience is met. Clinical supervision must be documented in279.34the client record.279.35 (b) Supervision for a case manager during the first year of 279.36 service providing case management services shall be one hour per 280.1 week of clinical supervision from a case management supervisor. 280.2 After the first year, the case manager shall receive regular 280.3 ongoing supervision totaling 38 hours per year, of which at 280.4 least one hour per month must be clinical supervision regarding 280.5 individual service delivery with a case management supervisor. 280.6 The remainder may be provided by a case manager with two years 280.7 of experience. Group supervision may not constitute more than 280.8 one-half of the required supervision hours. Clinical 280.9 supervision must be documented in the client record. 280.10 (c) A case manager with a bachelor's degree who is not 280.11 licensed, registered, or certified by a health-related licensing 280.12 board must receive 30 hours of continuing education and training 280.13 in mental illness and mental health services annually. 280.14 (d) A case manager with a bachelor's degree but without 280.15 2,000 hours of supervised experience described in paragraph (a), 280.16 must complete 40 hours of training approved by the commissioner 280.17 covering case management skills and the characteristics and 280.18 needs of adults with serious and persistent mental illness. 280.19 (e) Case managers without a bachelor's degree must meet one 280.20 of the requirements in clauses (1) to (3): 280.21 (1) have three or four years of experience as a case 280.22 manager associate; 280.23 (2) be a registered nurse without a bachelor's degree and 280.24 have a combination of specialized training in psychiatry and 280.25 work experience consisting of community interaction and 280.26 involvement or community discharge planning in a mental health 280.27 setting totaling three years; or 280.28 (3) be a person who qualified as a case manager under the 280.29 1998 department of human services federal waiver provision and 280.30 meet the continuing education and mentoring requirements in this 280.31 section. 280.32 (f) A case manager associate must work under the direction 280.33 of a case manager or case management supervisor and must be 21 280.34 years of age. A case manager associate must also have a high 280.35 school diploma and meet one of the following criteria: 280.36 (1) have an associate of arts degree in one of the 281.1 behavioral sciences or human services; 281.2 (2) be a registered nurse without a bachelor's degree; 281.3 (3) within the previous ten years, have three years of life 281.4 experience with serious and persistent mental illness as defined 281.5 in section 245.462, subdivision 20, or as a child had severe 281.6 emotional disturbance, as defined in section 245.4871, 281.7 subdivision 6, or three years of life experience as a primary 281.8 caregiver to an adult with serious and persistent mental illness 281.9 within the previous ten years; 281.10 (4) have 6,000 hours work experience as a nondegreed state 281.11 hospital technician; or 281.12 (5) be a mental health practitioner as defined in section 281.13 245.462, subdivision 17, clause (2). 281.14 Individuals meeting one of the criteria in clauses (1) to 281.15 (4) may qualify as a case manager after four years of supervised 281.16 work experience as a case manager associate. Individuals 281.17 meeting the criteria in clause (5) may qualify as a case manager 281.18 after three years of supervised experience as a case manager 281.19 associate. 281.20 Case management associates must have 40 hours preservice 281.21 training under paragraph (d) and receive at least 40 hours of 281.22 continuing education in mental illness and mental health 281.23 services annually. Case manager associates shall receive at 281.24 least five hours of mentoring per week from a case management 281.25 mentor. A "case management mentor" means a qualified, 281.26 practicing case manager or case management supervisor who 281.27 teaches or advises and provides intensive training and clinical 281.28 supervision to one or more case manager associates. Mentoring 281.29 may occur while providing direct services to consumers in the 281.30 office or in the field and may be provided to individuals or 281.31 groups of case manager associates. At least two mentoring hours 281.32 per week must be individual and face-to-face. 281.33 (g) A case management supervisor must meet the criteria for 281.34 mental health professionals, as specified in section 245.462, 281.35 subdivision 18. 281.36Until June 30, 1999,(h) An immigrant who does not have the 282.1 qualifications specified in this subdivision may provide case 282.2 management services to adult immigrants with serious and 282.3 persistent mental illness who are members of the same ethnic 282.4 group as the case manager if the person: (1) is currently 282.5 enrolled in and is actively pursuing credits toward the 282.6 completion of a bachelor's degree in one of the behavioral 282.7 sciences or a related field including, but not limited to, 282.8 social work, psychology, or nursing from an accredited college 282.9 or university; (2) completes 40 hours of training as specified 282.10 in this subdivision; and (3) receives clinical supervision at 282.11 least once a week until the requirements of this subdivision are 282.12 met. 282.13(b) The commissioner may approve waivers submitted by282.14counties to allow case managers without a bachelor's degree but282.15with 6,000 hours of supervised experience in the delivery of282.16services to adults with mental illness if the person:282.17(1) meets the qualifications for a mental health282.18practitioner in subdivision 26;282.19(2) has completed 40 hours of training approved by the282.20commissioner in case management skills and in the282.21characteristics and needs of adults with serious and persistent282.22mental illness; and282.23(3) demonstrates that the 6,000 hours of supervised282.24experience are in identifying functional needs of persons with282.25mental illness, coordinating assessment information and making282.26referrals to appropriate service providers, coordinating a282.27variety of services to support and treat persons with mental282.28illness, and monitoring to ensure appropriate provision of282.29services. The county board is responsible to verify that all282.30qualifications, including content of supervised experience, have282.31been met.282.32 Sec. 3. Minnesota Statutes 1998, section 245.462, 282.33 subdivision 17, is amended to read: 282.34 Subd. 17. [MENTAL HEALTH PRACTITIONER.] "Mental health 282.35 practitioner" means a person providing services to persons with 282.36 mental illness who is qualified in at least one of the following 283.1 ways: 283.2 (1) holds a bachelor's degree in one of the behavioral 283.3 sciences or related fields from an accredited college or 283.4 university and: 283.5 (i) has at least 2,000 hours of supervised experience in 283.6 the delivery of services to persons with mental illness; or 283.7 (ii) is fluent in the non-English language of the ethnic 283.8 group to which at least 50 percent of the practitioner's clients 283.9 belong, completes 40 hours of training in the delivery of 283.10 services to persons with mental illness, and receives clinical 283.11 supervision from a mental health professional at least once a 283.12 week until the requirement of 2,000 hours of supervised 283.13 experience is met; 283.14 (2) has at least 6,000 hours of supervised experience in 283.15 the delivery of services to persons with mental illness; 283.16 (3) is a graduate student in one of the behavioral sciences 283.17 or related fields and is formally assigned by an accredited 283.18 college or university to an agency or facility for clinical 283.19 training; or 283.20 (4) holds a master's or other graduate degree in one of the 283.21 behavioral sciences or related fields from an accredited college 283.22 or university and has less than 4,000 hours post-master's 283.23 experience in the treatment of mental illness. 283.24 Sec. 4. Minnesota Statutes 1998, section 245.4711, 283.25 subdivision 1, is amended to read: 283.26 Subdivision 1. [AVAILABILITY OF CASE MANAGEMENT SERVICES.] 283.27 (a) By January 1, 1989, the county board shall provide case 283.28 management services for all adults with serious and persistent 283.29 mental illness who are residents of the county and who request 283.30 or consent to the services and to each adult for whom the court 283.31 appoints a case manager. Staffing ratios must be sufficient to 283.32 serve the needs of the clients. The case manager must meet the 283.33 requirements in section 245.462, subdivision 4. 283.34 (b) Case management services provided to adults with 283.35 serious and persistent mental illness eligible for medical 283.36 assistance must be billed to the medical assistance program 284.1 under sections 256B.02, subdivision 8, and 256B.0625. 284.2 (c) Case management services are eligible for reimbursement 284.3 under the medical assistance program. Costs associated with 284.4 mentoring, supervision, and continuing education may be included 284.5 in the reimbursement rate methodology used for case management 284.6 services under the medical assistance program. 284.7 Sec. 5. Minnesota Statutes 1998, section 245.4712, 284.8 subdivision 2, is amended to read: 284.9 Subd. 2. [DAY TREATMENT SERVICES PROVIDED.] (a) Day 284.10 treatment services must be developed as a part of the community 284.11 support services available to adults with serious and persistent 284.12 mental illness residing in the county. Adults may be required 284.13 to pay a fee according to section 245.481. Day treatment 284.14 services must be designed to: 284.15 (1) provide a structured environment for treatment; 284.16 (2) provide support for residing in the community; 284.17 (3) prevent placement in settings that are more intensive, 284.18 costly, or restrictive than necessary and appropriate to meet 284.19 client need; 284.20 (4) coordinate with or be offered in conjunction with a 284.21 local education agency's special education program; and 284.22 (5) operate on a continuous basis throughout the year. 284.23 (b) For purposes of complying with medical assistance 284.24 requirements, an adult day treatment program may choose among 284.25 the methods of clinical supervision specified in: 284.26 (1) Minnesota Rules, part 9505.0323, subpart 1, item F; 284.27 (2) Minnesota Rules, part 9505.0324, subpart 6, item F; or 284.28 (3) Minnesota Rules, part 9520.0800, subparts 2 to 6. 284.29 A day treatment program may demonstrate compliance with 284.30 these clinical supervision requirements by obtaining 284.31 certification from the commissioner under Minnesota Rules, parts 284.32 9520.0750 to 9520.0870, or by documenting in its own records 284.33 that it complies with one of the above methods. 284.34 (c) County boards may request a waiver from including day 284.35 treatment services if they can document that: 284.36 (1) an alternative plan of care exists through the county's 285.1 community support services for clients who would otherwise need 285.2 day treatment services; 285.3 (2) day treatment, if included, would be duplicative of 285.4 other components of the community support services; and 285.5 (3) county demographics and geography make the provision of 285.6 day treatment services cost ineffective and infeasible. 285.7 Sec. 6. Minnesota Statutes 1998, section 245.4871, 285.8 subdivision 4, is amended to read: 285.9 Subd. 4. [CASEMANAGERMANAGEMENT SERVICE PROVIDER.] (a) 285.10 "Casemanagermanagement service provider" meansan individuala 285.11 case manager or case manager associate employed by the county or 285.12 other entity authorized by the county board to provide case 285.13 management services specified in subdivision 3 for the child 285.14 with severe emotional disturbance and the child's family. A 285.15 case manager must have experience and training in working with 285.16 children. 285.17 (b) A case manager must: 285.18 (1) have at least a bachelor's degree in one of the 285.19 behavioral sciences or a related field including, but not 285.20 limited to, social work, psychology, or nursing from an 285.21 accredited college or university; 285.22 (2) have at least 2,000 hours of supervised experience in 285.23 the delivery of mental health services to children; 285.24 (3) have experience and training in identifying and 285.25 assessing a wide range of children's needs; and 285.26 (4) be knowledgeable about local community resources and 285.27 how to use those resources for the benefit of children and their 285.28 families. 285.29 (c) The case manager may be a member of any professional 285.30 discipline that is part of the local system of care for children 285.31 established by the county board. 285.32 (d) The case managermust meet in person with a mental285.33health professional at least once each month to obtain clinical285.34supervisionshall receive regular ongoing supervision totaling 285.35 38 hours per year, of which at least one hour per month must be 285.36 clinical supervision regarding individual service delivery with 286.1 a case management supervisor. The remainder may be provided by 286.2 a case manager with two years of experience. Group supervision 286.3 may not constitute more than one-half of the required 286.4 supervision hours. 286.5 (e) Case managers with a bachelor's degree but without 286.6 2,000 hours of supervised experience in the delivery of mental 286.7 health services to children with emotional disturbance must: 286.8 (1) begin 40 hours of training approved by the commissioner 286.9 of human services in case management skills and in the 286.10 characteristics and needs of children with severe emotional 286.11 disturbance before beginning to provide case management 286.12 services; and 286.13 (2) receive clinical supervision regarding individual 286.14 service delivery from a mental health professional at leastonce286.15 one hour each week until the requirement of 2,000 hours of 286.16 experience is met. 286.17 (f) Clinical supervision must be documented in the child's 286.18 record. When the case manager is not a mental health 286.19 professional, the county board must provide or contract for 286.20 needed clinical supervision. 286.21 (g) The county board must ensure that the case manager has 286.22 the freedom to access and coordinate the services within the 286.23 local system of care that are needed by the child. 286.24 (h) Case managers who have a bachelor's degree but are not 286.25 licensed, registered, or certified by a health-related licensing 286.26 board must receive 30 hours of continuing education and training 286.27 in severe emotional disturbance and mental health services 286.28 annually. 286.29 (i) Case managers without a bachelor's degree must meet one 286.30 of the requirements in clauses (1) to (3): 286.31 (1) have three or four years of experience as a case 286.32 manager associate; 286.33 (2) be a registered nurse without a bachelor's degree who 286.34 has a combination of specialized training in psychiatry and work 286.35 experience consisting of community interaction and involvement 286.36 or community discharge planning in a mental health setting 287.1 totaling three years; or 287.2 (3) be a person who qualified as a case manager under the 287.3 1998 department of human services federal waiver provision and 287.4 meets the continuing education and mentoring requirements in 287.5 this section. 287.6 (j) A case manager associate (CMA) must work under the 287.7 direction of a case manager or case management supervisor and 287.8 must be 21 years of age. A case manager associate must also 287.9 have a high school diploma and meet one of the following 287.10 criteria: 287.11 (1) have an associate of arts degree in one of the 287.12 behavioral sciences or human services; 287.13 (2) be a registered nurse without a bachelor's degree; 287.14 (3) have three years of life experience as a primary 287.15 caregiver to a child with serious emotional disturbance as 287.16 defined in section 245.4871, subdivision 6, within the last ten 287.17 years; 287.18 (4) have 6,000 hours work experience as a nondegreed state 287.19 hospital technician; or 287.20 (5) be a mental health practitioner as defined in section 287.21 245.462, subdivision 17, clause (2). 287.22 Individuals meeting one of the criteria in clauses (1) to 287.23 (4) may qualify as a case manager after four years of supervised 287.24 work experience as a case manager associate. Individuals 287.25 meeting the criteria in clause (5) may qualify as a case manager 287.26 after three years of supervised experience as a case manager 287.27 associate. 287.28 Case manager associates must have 40 hours of preservice 287.29 training under paragraph (e), clause (1), and receive at least 287.30 40 hours of continuing education in severe emotional disturbance 287.31 and mental health service annually. Case manager associates 287.32 shall receive at least five hours of mentoring per week from a 287.33 case management mentor. A "case management mentor" means a 287.34 qualified, practicing case manager or case management supervisor 287.35 who teaches or advises and provides intensive training and 287.36 clinical supervision to one or more case manager associates. 288.1 Mentoring may occur while providing direct services to consumers 288.2 in the office or in the field and may be provided to individuals 288.3 or groups of case manager associates. At least two mentoring 288.4 hours per week must be individual and face-to-face. 288.5 (k) A case management supervisor must meet the criteria for 288.6 a mental health professional as specified in section 245.4871, 288.7 subdivision 27. 288.8Until June 30, 1999,(l) An immigrant who does not have the 288.9 qualifications specified in this subdivision may provide case 288.10 management services to child immigrants with severe emotional 288.11 disturbance of the same ethnic group as the immigrant if the 288.12 person: 288.13 (1) is currently enrolled in and is actively pursuing 288.14 credits toward the completion of a bachelor's degree in one of 288.15 the behavioral sciences or related fields at an accredited 288.16 college or university; 288.17 (2) completes 40 hours of training as specified in this 288.18 subdivision; and 288.19 (3) receives clinical supervision at least once a week 288.20 until the requirements of obtaining a bachelor's degree and 288.21 2,000 hours of supervised experience are met. 288.22(i) The commissioner may approve waivers submitted by288.23counties to allow case managers without a bachelor's degree but288.24with 6,000 hours of supervised experience in the delivery of288.25services to children with severe emotional disturbance if the288.26person:288.27(1) meets the qualifications for a mental health288.28practitioner in subdivision 26;288.29(2) has completed 40 hours of training approved by the288.30commissioner in case management skills and in the288.31characteristics and needs of children with severe emotional288.32disturbance; and288.33(3) demonstrates that the 6,000 hours of supervised288.34experience are in identifying functional needs of children with288.35severe emotional disturbance, coordinating assessment288.36information and making referrals to appropriate service289.1providers, coordinating a variety of services to support and289.2treat children with severe emotional disturbance, and monitoring289.3to ensure appropriate provision of services. The county board289.4is responsible to verify that all qualifications, including289.5content of supervised experience, have been met.289.6 Sec. 7. Minnesota Statutes 1998, section 245.4871, 289.7 subdivision 26, is amended to read: 289.8 Subd. 26. [MENTAL HEALTH PRACTITIONER.] "Mental health 289.9 practitioner" means a person providing services to children with 289.10 emotional disturbances. A mental health practitioner must have 289.11 training and experience in working with children. A mental 289.12 health practitioner must be qualified in at least one of the 289.13 following ways: 289.14 (1) holds a bachelor's degree in one of the behavioral 289.15 sciences or related fields from an accredited college or 289.16 university and: 289.17 (i) has at least 2,000 hours of supervised experience in 289.18 the delivery of mental health services to children with 289.19 emotional disturbances; or 289.20 (ii) is fluent in the non-English language of the ethnic 289.21 group to which at least 50 percent of the practitioner's clients 289.22 belong, completes 40 hours of training in the delivery of 289.23 services to children with emotional disturbances, and receives 289.24 clinical supervision from a mental health professional at least 289.25 once a week until the requirement of 2,000 hours of supervised 289.26 experience is met; 289.27 (2) has at least 6,000 hours of supervised experience in 289.28 the delivery of mental health services to children with 289.29 emotional disturbances; 289.30 (3) is a graduate student in one of the behavioral sciences 289.31 or related fields and is formally assigned by an accredited 289.32 college or university to an agency or facility for clinical 289.33 training; or 289.34 (4) holds a master's or other graduate degree in one of the 289.35 behavioral sciences or related fields from an accredited college 289.36 or university and has less than 4,000 hours post-master's 290.1 experience in the treatment of emotional disturbance. 290.2 Sec. 8. Minnesota Statutes 1998, section 245.4881, 290.3 subdivision 1, is amended to read: 290.4 Subdivision 1. [AVAILABILITY OF CASE MANAGEMENT SERVICES.] 290.5 (a) By April 1, 1992, the county board shall provide case 290.6 management services for each child with severe emotional 290.7 disturbance who is a resident of the county and the child's 290.8 family who request or consent to the services. Staffing ratios 290.9 must be sufficient to serve the needs of the clients. The case 290.10 manager must meet the requirements in section 245.4871, 290.11 subdivision 4. 290.12 (b) Except as permitted by law and the commissioner under 290.13 demonstration projects, case management services provided to 290.14 children with severe emotional disturbance eligible for medical 290.15 assistance must be billed to the medical assistance program 290.16 under sections 256B.02, subdivision 8, and 256B.0625. 290.17 (c) Case management services are eligible for reimbursement 290.18 under the medical assistance program. Costs of mentoring, 290.19 supervision, and continuing education may be included in the 290.20 reimbursement rate methodology used for case management services 290.21 under the the medical assistance program. 290.22 Sec. 9. [246.0136] [TRANSITION OF REGIONAL TREATMENT 290.23 CENTERS AND OTHER STATE-OPERATED SERVICES.] 290.24 Beginning with the 2000-2001 biennium the commissioner of 290.25 human services is directed to establish enterprise activities 290.26 within state-operated services. Enterprise activities are 290.27 defined as the range of services needed by people with 290.28 disabilities, which are delivered by state employees, and are 290.29 fully funded by public or private third-party health insurance 290.30 or other revenue sources that are available to the client that 290.31 provide reimbursement for the care provided. State-operated 290.32 services shall specialize in caring for vulnerable people for 290.33 whom no other providers are available or for whom state-operated 290.34 services may be the provider selected by the payer. The 290.35 commissioner shall determine prior to the biennial budget 290.36 request the programs or services within state-operated services 291.1 that may be transitioned to enterprise activities. Prior to the 291.2 implementation of the enterprise activity, the commissioner 291.3 shall demonstrate that there is public or private third-party 291.4 health insurance or other revenue available to the individuals 291.5 served, that the revenues collected fully fund the services, and 291.6 that there are sufficient funds for cash flow purposes. In 291.7 subsequent biennia the base state appropriation for 291.8 state-operated services will be reduced proportionate to the 291.9 size of the enterprise activity. Implementation of enterprise 291.10 activities shall not limit access to services by vulnerable 291.11 populations served by state-operated services. 291.12 Implementation will include consultation with stakeholders 291.13 including county boards, county social service agencies, 291.14 consumers, families, advocates, local mental health advisory 291.15 councils, local private and public providers, representatives of 291.16 state public employee bargaining units, and other affected state 291.17 and local agencies. All enterprise activities must conform with 291.18 collective bargaining agreements negotiated on behalf of 291.19 employees by their exclusive representatives. Implementation 291.20 shall include consideration of: 291.21 (1) creating public or private partnerships to facilitate 291.22 client access to needed services; 291.23 (2) administrative simplification and efficiencies 291.24 throughout the state-operated services system; 291.25 (3) creating a public group practice for state-operated 291.26 medical staff to increase flexibility in meeting client needs 291.27 and maximize third-party reimbursement; 291.28 (4) converting or disposing of buildings not utilized and 291.29 surplus land; and 291.30 (5) exploring the efficiencies and benefits of establishing 291.31 state-operated services as an independent state agency. 291.32 The commissioner of human services shall submit a report to 291.33 the legislature each January throughout a six-year 291.34 implementation period. 291.35 Sec. 10. Minnesota Statutes 1998, section 246.18, 291.36 subdivision 6, is amended to read: 292.1 Subd. 6. [COLLECTIONS DEDICATED.]Except for292.2state-operated programs and services funded through a direct292.3appropriation from the legislature, money received within the292.4regional treatment center system for the following292.5state-operated services is dedicated to the commissioner for the292.6provision of those services:292.7(1) community-based residential and day training and292.8habilitation services for mentally retarded persons;292.9(2) community health clinic services;292.10(3) accredited hospital outpatient department services;292.11(4) certified rehabilitation agency and rehabilitation292.12hospital services; or292.13(5) community-based transitional support services for292.14adults with serious and persistent mental illness.Except for 292.15 state-operated programs funded through a direct appropriation 292.16 from the legislature, any state-operated program or service 292.17 established and operated as an enterprise activity, shall retain 292.18 the revenues earned in an interest-bearing account. 292.19 When the commissioner determines the intent to transition 292.20 from a direct appropriation to enterprise activity, all 292.21 collections for the targeted state-operated service shall be 292.22 retained and deposited into an interest-bearing account. At the 292.23 end of the fiscal year, prior to establishing the enterprise 292.24 activity, collections up to the amount of the appropriation for 292.25 the targeted service shall be deposited to the general fund. 292.26 All funds in excess of the amount of the appropriation will be 292.27 retained and used by the enterprise activity for cash flow 292.28 purposes. 292.29 These funds must be deposited in the state treasury in a 292.30 revolving account and funds in the revolving account are 292.31 appropriated to the commissioner to operate the services 292.32 authorized, and any unexpended balances do not cancel but are 292.33 available until spent. 292.34 Sec. 11. Minnesota Statutes 1998, section 252.46, 292.35 subdivision 6, is amended to read: 292.36 Subd. 6. [VARIANCES.] (a) A variance from the minimum or 293.1 maximum payment rates in subdivisions 2 and 3 may be granted by 293.2 the commissioner when the vendor requests and the county board 293.3 submits to the commissioner a written variance request on forms 293.4 supplied by the commissioner with the recommended payment rates. 293.5 (b) A variance to the rate maximum may be utilized for 293.6 costs associated with compliance with state administrative 293.7 rules, compliance with court orders, capital costs required for 293.8 continued licensure, increased insurance costs, start-up and 293.9 conversion costs for supported employment, direct service staff 293.10 salaries and benefits, transportation, and other program related 293.11 costs whenanyone of thecriteriacriterion in clauses (1) to 293.12 (4) is also met: 293.13(1) change is necessary to comply with licensing citations;293.14(2) a licensed vendor currently serving fewer than 70293.15persons with payment rates of 80 percent or less of the293.16statewide average rates and with clients meeting the behavioral293.17or medical criteria under clause (3) approved by the293.18commissioner as a significant program change under section293.19252.28;293.20(3)(1) A determination of need under section 252.28 is 293.21 approved for a significant program changeis approved by the293.22commissioner under section 252.28that is necessary for a vendor 293.23 to provide authorized services toa new client or clients with293.24very severe self-injurious or assaultive behavior, or medical293.25conditions requiring delivery of physician-prescribed medical293.26interventions requiring one-to-one staffing for at least 15293.27minutes each time they are performed, or to a new client or293.28clients directly discharged to the vendor's program from a293.29regional treatment center; or293.30(4) there is a need to maintain required staffing levels in293.31order to provide authorized services approved by the293.32commissioner under section 252.28, that is necessitated by a293.33significant and permanent decrease in licensed capacity or293.34clientele.293.35The county shall review the adequacy of services provided293.36by vendors whose payment rates are 80 percent or more of the294.1statewide average rates and 50 percent or more of the vendor's294.2clients meet the behavioral or medical criteria in clause (3).294.3A variance under this paragraph may be approved only if the294.4costs to the medical assistance program do not exceed the294.5medical assistance costs for all clients served by the294.6alternatives and all clients remaining in the existing services.294.7 one or more clients who meet one or more of the following 294.8 criteria: 294.9 (a) the client is a new client and: 294.10 (i) exhibits severe behavior as indicated on the screening 294.11 document; 294.12 (ii) periodically requires one-to-one staff time for at 294.13 least 15 minutes at a time to deliver physician prescribed 294.14 medical interventions; or 294.15 (iii) has been discharged directly to the vendor's program 294.16 from a regional treatment center or the Minnesota extended 294.17 treatment option. 294.18 (b) the client is an existing client who has developed one 294.19 of the following changed circumstances which increases costs 294.20 that are not covered by the vendor's current rate, and for whom 294.21 a significant program change is necessary to ensure the 294.22 continued provision of authorized services to that client: 294.23 (i) severe behavior as indicated on the screening document; 294.24 (ii) a medical condition periodically requiring one-to-one 294.25 staff time for at least 15 minutes at a time to deliver 294.26 physician prescribed medical interventions; or 294.27 (iii) a permanent decrease in skill functioning, as 294.28 verified by medical reports or assessments; 294.29 (2) A licensing determination requires a program change 294.30 that the vendor cannot comply with due to funding restraints; 294.31 (3) A determination of need under section 252.28 is 294.32 approved for a significant and permanent decrease in licensed 294.33 capacity and the vendor demonstrates the need to retain certain 294.34 staffing levels to serve the remaining clients; or 294.35 (4) In cases where conditions in clauses (1) to (3) do not 294.36 apply, but a determination of need under section 252.28 is 295.1 approved for an unusual circumstance which exists that 295.2 significantly impacts the type or amount of services delivered, 295.3 as evidenced by documentation presented by the vendor and with 295.4 the concurrence of the commissioner. 295.5(b)(c) A variance to the rate minimum may be granted when: 295.6 (1) the county board contracts for increased services from 295.7 a vendor and for some or all individuals receiving services from 295.8 the vendor lower per unit fixed costs result; or 295.9 (2) when the actual costs of delivering authorized service 295.10 over a 12-month contract period have decreased. 295.11(c)(d) The written variance request under this subdivision 295.12 must include documentation that all the following criteria have 295.13 been met: 295.14 (1) The commissioner and the county board have both 295.15 conducted a review and have identified a need for a change in 295.16 the payment rates and recommended an effective date for the 295.17 change in the rate. 295.18 (2) The vendor documents efforts to reallocate current 295.19 staff and any additional staffing needs cannot be met by using 295.20 temporary special needs rate exceptions under Minnesota Rules, 295.21 parts 9510.1020 to 9510.1140. 295.22 (3) The vendor documents that financial resources have been 295.23 reallocated before applying for a variance. No variance may be 295.24 granted for equipment, supplies, or other capital expenditures 295.25 when depreciation expense for repair and replacement of such 295.26 items is part of the current rate. 295.27 (4) For variances related to loss of clientele, the vendor 295.28 documents the other program and administrative expenses, if any, 295.29 that have been reduced. 295.30 (5) The county board submits verification of the conditions 295.31 for which the variance is requested, a description of the nature 295.32 and cost of the proposed changes, and how the county will 295.33 monitor the use of money by the vendor to make necessary changes 295.34 in services. 295.35 (6) The county board's recommended payment rates do not 295.36 exceed 95 percent of the greater of 125 percent of the current 296.1 statewide median or 125 percent of the regional average payment 296.2 rates, whichever is higher, for each of the regional commission 296.3 districts under sections 462.381 to 462.396 in which the vendor 296.4 is located except for the following: when a variance is 296.5 recommended to allow authorized service delivery to new clients 296.6 with severeself-injurious or assaultivebehaviors or with 296.7 medical conditions requiring delivery of physician prescribed 296.8 medical interventions, or to persons being directly discharged 296.9 from a regional treatment center or Minnesota extended treatment 296.10 options to the vendor's program, those persons must be assigned 296.11 a payment rate of 200 percent of the current statewide average 296.12 rates. All other clients receiving services from the vendor 296.13 must be assigned a payment rate equal to the vendor's current 296.14 rate unless the vendor's current rate exceeds 95 percent of 125 296.15 percent of the statewide median or 125 percent of the regional 296.16 average payment rates, whichever is higher. When the vendor's 296.17 rates exceed 95 percent of 125 percent of the statewide median 296.18 or 125 percent of the regional average rates, the maximum rates 296.19 assigned to all other clients must be equal to the greater of 95 296.20 percent of 125 percent of the statewide median or 125 percent of 296.21 the regional average rates. The maximum payment rate that may 296.22 be recommended for the vendor under these conditions is 296.23 determined by multiplying the number of clients at each limit by 296.24 the rate corresponding to that limit and then dividing the sum 296.25 by the total number of clients. 296.26(d)(e) The commissioner shall have 60 calendar days from 296.27 the date of the receipt of the complete request to accept or 296.28 reject it, or the request shall be deemed to have been granted. 296.29 If the commissioner rejects the request, the commissioner shall 296.30 state in writing the specific objections to the request and the 296.31 reasons for its rejection. 296.32 Sec. 12. Minnesota Statutes 1998, section 253B.045, is 296.33 amended by adding a subdivision to read: 296.34 Subd. 5. [HEALTH PLAN COMPANY; DEFINITION.] For purposes 296.35 of this section, "health plan company" has the meaning given it 296.36 in section 62Q.01, subdivision 4, and also includes a 297.1 demonstration provider as defined in section 256B.69, 297.2 subdivision 2, paragraph (b), a county or group of counties 297.3 participating in county-based purchasing according to section 297.4 256B.692, and a children's mental health collaborative under 297.5 contract to provide medical assistance for individuals enrolled 297.6 in the prepaid medical assistance and MinnesotaCare programs 297.7 according to sections 245.493 to 245.496. 297.8 Sec. 13. Minnesota Statutes 1998, section 253B.045, is 297.9 amended by adding a subdivision to read: 297.10 Subd. 6. [COVERAGE.] A health plan company must provide 297.11 coverage, according to the terms of the policy, contract, or 297.12 certificate of coverage, for all medically necessary covered 297.13 services as determined by section 62Q.53 provided to an enrollee 297.14 that are ordered by the court under this chapter. 297.15 Sec. 14. Minnesota Statutes 1998, section 253B.07, 297.16 subdivision 1, is amended to read: 297.17 Subdivision 1. [PREPETITION SCREENING.] (a) Prior to 297.18 filing a petition for commitment of or early intervention for a 297.19 proposed patient, an interested person shall apply to the 297.20 designated agency in the county of the proposed patient's 297.21 residence or presence for conduct of a preliminary 297.22 investigation, except when the proposed patient has been 297.23 acquitted of a crime under section 611.026 and the county 297.24 attorney is required to file a petition for commitment. The 297.25 designated agency shall appoint a screening team to conduct an 297.26 investigation which shall include: 297.27 (i) a personal interview with the proposed patient and 297.28 other individuals who appear to have knowledge of the condition 297.29 of the proposed patient. If the proposed patient is not 297.30 interviewed, reasons must be documented; 297.31 (ii) identification and investigation of specific alleged 297.32 conduct which is the basis for application; 297.33 (iii) identification, exploration, and listing of the 297.34 reasons for rejecting or recommending alternatives to 297.35 involuntary placement;and297.36 (iv) in the case of a commitment based on mental illness, 298.1 the following information, if it is known or available: 298.2 information that may be relevant to the administration of 298.3 neuroleptic medications, if necessary, including the existence 298.4 of a declaration under section 253B.03, subdivision 6d, or a 298.5 health care directive under chapter 145C or a guardian, 298.6 conservator, proxy, or agent with authority to make health care 298.7 decisions for the proposed patient; information regarding the 298.8 capacity of the proposed patient to make decisions regarding 298.9 administration of neuroleptic medication; and whether the 298.10 proposed patient is likely to consent or refuse consent to 298.11 administration of the medication.; and 298.12 (v) seeking input from the proposed patient's health plan 298.13 company to provide the court with information about services the 298.14 enrollee needs and the "least restrictive alternatives." 298.15 (b) In conducting the investigation required by this 298.16 subdivision, the screening team shall have access to all 298.17 relevant medical records of proposed patients currently in 298.18 treatment facilities. Data collected pursuant to this clause 298.19 shall be considered private data on individuals. The 298.20 prepetition screening report is not admissible in any court 298.21 proceedings unrelated to the commitment proceedings. 298.22 (c) When the prepetition screening team recommends 298.23 commitment, a written report shall be sent to the county 298.24 attorney for the county in which the petition is to be filed. 298.25 (d) The prepetition screening team shall refuse to support 298.26 a petition if the investigation does not disclose evidence 298.27 sufficient to support commitment. Notice of the prepetition 298.28 screening team's decision shall be provided to the prospective 298.29 petitioner. 298.30 (e) If the interested person wishes to proceed with a 298.31 petition contrary to the recommendation of the prepetition 298.32 screening team, application may be made directly to the county 298.33 attorney, who may determine whether or not to proceed with the 298.34 petition. Notice of the county attorney's determination shall 298.35 be provided to the interested party. 298.36 (f) If the proposed patient has been acquitted of a crime 299.1 under section 611.026, the county attorney shall apply to the 299.2 designated county agency in the county in which the acquittal 299.3 took place for a preliminary investigation unless substantially 299.4 the same information relevant to the proposed patient's current 299.5 mental condition, as could be obtained by a preliminary 299.6 investigation, is part of the court record in the criminal 299.7 proceeding or is contained in the report of a mental examination 299.8 conducted in connection with the criminal proceeding. If a 299.9 court petitions for commitment pursuant to the rules of criminal 299.10 or juvenile procedure or a county attorney petitions pursuant to 299.11 acquittal of a criminal charge under section 611.026, the 299.12 prepetition investigation, if required by this section, shall be 299.13 completed within seven days after the filing of the petition. 299.14 Sec. 15. Minnesota Statutes 1998, section 253B.185, is 299.15 amended by adding a subdivision to read: 299.16 Subd. 5. [AFTERCARE AND CASE MANAGEMENT.] The state, in 299.17 collaboration with the designated agency, is responsible for 299.18 arranging and funding the aftercare and case management services 299.19 for persons under commitment as sexual psychopathic 299.20 personalities and sexually dangerous persons discharged after 299.21 July 1, 1999. 299.22 Sec. 16. Minnesota Statutes 1998, section 254B.01, is 299.23 amended by adding a subdivision to read: 299.24 Subd. 7. [ROOM AND BOARD RATE.] "Room and board rate" 299.25 means a rate set for shelter, fuel, food, utilities, household 299.26 supplies, and other costs necessary to provide room and board 299.27 for a person in need of chemical dependency services. 299.28 Sec. 17. Minnesota Statutes 1998, section 254B.03, 299.29 subdivision 2, is amended to read: 299.30 Subd. 2. [CHEMICAL DEPENDENCYSERVICESFUND PAYMENT.] (a) 299.31 Payment from the chemical dependency fund is limited to payments 299.32 for services other than detoxification that, if located outside 299.33 of federally recognized tribal lands, would be required to be 299.34 licensed by the commissioner as a chemical dependency treatment 299.35 or rehabilitation program under sections 245A.01 to 245A.16, and 299.36 services other than detoxification provided in another state 300.1 that would be required to be licensed as a chemical dependency 300.2 program if the program were in the state. Out of state vendors 300.3 must also provide the commissioner with assurances that the 300.4 program complies substantially with state licensing requirements 300.5 and possesses all licenses and certifications required by the 300.6 host state to provide chemical dependency treatment.Hospitals300.7may apply for and receive licenses to be eligible vendors,300.8notwithstanding the provisions of section 245A.03.Except for 300.9 chemical dependency transitional rehabilitation programs, 300.10 vendors receiving payments from the chemical dependency fund 300.11 must not require copayment from a recipient of benefits for 300.12 services provided under this subdivision. Payment from the 300.13 chemical dependency fund shall be made for necessary room and 300.14 board costs provided by vendors certified according to section 300.15 254B.05, or in a community hospital licensed by the commissioner 300.16 of the department of health according to sections 144.50 to 300.17 144.56 to a client who is: 300.18 (1) determined to meet the criteria for placement in a 300.19 residential chemical dependency treatment program according to 300.20 rules adopted under section 254A.03, subdivision 3; and 300.21 (2) concurrently receiving a chemical dependency treatment 300.22 service in a program licensed by the commissioner and reimbursed 300.23 by the chemical dependency fund. 300.24 (b) A county may, from its own resources, provide chemical 300.25 dependency services for which state payments are not made. A 300.26 county may elect to use the same invoice procedures and obtain 300.27 the same state payment services as are used for chemical 300.28 dependency services for which state payments are made under this 300.29 section if county payments are made to the state in advance of 300.30 state payments to vendors. When a county uses the state system 300.31 for payment, the commissioner shall make monthly billings to the 300.32 county using the most recent available information to determine 300.33 the anticipated services for which payments will be made in the 300.34 coming month. Adjustment of any overestimate or underestimate 300.35 based on actual expenditures shall be made by the state agency 300.36 by adjusting the estimate for any succeeding month. 301.1 (c) The commissioner shall coordinate chemical dependency 301.2 services and determine whether there is a need for any proposed 301.3 expansion of chemical dependency treatment services. The 301.4 commissioner shall deny vendor certification to any provider 301.5 that has not received prior approval from the commissioner for 301.6 the creation of new programs or the expansion of existing 301.7 program capacity. The commissioner shall consider the 301.8 provider's capacity to obtain clients from outside the state 301.9 based on plans, agreements, and previous utilization history, 301.10 when determining the need for new treatment services. 301.11 Sec. 18. Minnesota Statutes 1998, section 254B.05, 301.12 subdivision 1, is amended to read: 301.13 Subdivision 1. [LICENSURE REQUIRED.] Programs licensed by 301.14 the commissioner are eligible vendors. Hospitals may apply for 301.15 and receive licenses to be eligible vendors, notwithstanding the 301.16 provisions of section 245A.03. American Indian programs located 301.17 on federally recognized tribal lands that provide chemical 301.18 dependency primary treatment, extended care, transitional 301.19 residence, or outpatient treatment services, and are licensed by 301.20 tribal government are eligible vendors. Detoxification programs 301.21 are not eligible vendors. Programs that are not licensed as a 301.22 chemical dependency residential or nonresidential treatment 301.23 program by the commissioner or by tribal government are not 301.24 eligible vendors. To be eligible for payment under the 301.25 Consolidated Chemical Dependency Treatment Fund, a vendor of a 301.26 chemical dependency service must participate in the Drug and 301.27 Alcohol Abuse Normative Evaluation System and the treatment 301.28 accountability plan. 301.29 Effective January 1, 2000, vendors of room and board are 301.30 eligible for chemical dependency fund payment if the vendor: 301.31 (1) is certified by the county or tribal governing body as 301.32 having rules prohibiting residents bringing chemicals into the 301.33 facility or using chemicals while residing in the facility and 301.34 provide consequences for infractions of those rules; 301.35 (2) has a current contract with a county or tribal 301.36 governing body; 302.1 (3) is determined to meet applicable health and safety 302.2 requirements; 302.3 (4) is not a jail or prison; and 302.4 (5) is not concurrently receiving funds under chapter 256I 302.5 for the recipient. 302.6 Sec. 19. Minnesota Statutes 1998, section 256B.0625, 302.7 subdivision 20, is amended to read: 302.8 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 302.9 extent authorized by rule of the state agency, medical 302.10 assistance covers case management services to persons with 302.11 serious and persistent mental illness and children with severe 302.12 emotional disturbance. Services provided under this section 302.13 must meet the relevant standards in sections 245.461 to 302.14 245.4888, the Comprehensive Adult and Children's Mental Health 302.15 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 302.16 9505.0322, excluding subpart 10. 302.17 (b) Entities meeting program standards set out in rules 302.18 governing family community support services as defined in 302.19 section 245.4871, subdivision 17, are eligible for medical 302.20 assistance reimbursement for case management services for 302.21 children with severe emotional disturbance when these services 302.22 meet the program standards in Minnesota Rules, parts 9520.0900 302.23 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 302.24 (c) Medical assistance and MinnesotaCare payment for mental 302.25 health case management shall be made on a monthly basis. In 302.26 order to receive payment for an eligible child, the provider 302.27 must document at least a face-to-face contact with the child, 302.28 the child's parents, or the child's legal representative. To 302.29 receive payment for an eligible adult, the provider must 302.30 document: 302.31 (1) at least a face-to-face contact with the adult or the 302.32 adult's legal representative; or 302.33 (2) at least a telephone contact with the adult or the 302.34 adult's legal representative and document a face-to-face contact 302.35 with the adult or the adult's legal representative within the 302.36 preceding two months. 303.1 (d) Payment for mental health case management provided by 303.2 county or state staff shall be based on the monthly rate 303.3 methodology under section 256B.094, subdivision 6, paragraph 303.4 (b), with separate rates calculated for child welfare and mental 303.5 health, and within mental health, separate rates for children 303.6 and adults. 303.7 (e) Payment for mental health case management provided by 303.8 county-contracted vendors shall be based on a monthly rate 303.9 negotiated by the host county. The negotiated rate must not 303.10 exceed the rate charged by the vendor for the same service to 303.11 other payers. If the service is provided by a team of 303.12 contracted vendors, the county may negotiate a team rate with a 303.13 vendor who is a member of the team. The team shall determine 303.14 how to distribute the rate among its members. No reimbursement 303.15 received by contracted vendors shall be returned to the county, 303.16 except to reimburse the county for advance funding provided by 303.17 the county to the vendor. 303.18 (f) If the service is provided by a team which includes 303.19 contracted vendors and county or state staff, the costs for 303.20 county or state staff participation in the team shall be 303.21 included in the rate for county-provided services. In this 303.22 case, the contracted vendor and the county may each receive 303.23 separate payment for services provided by each entity in the 303.24 same month. In order to prevent duplication of services, the 303.25 county must document, in the recipient's file, the need for team 303.26 case management and a description of the roles of the team 303.27 members. 303.28 (g) The commissioner shall calculate the nonfederal share 303.29 of actual medical assistance and general assistance medical care 303.30 payments for each county, based on the higher of calendar year 303.31 1995 or 1996, by service date, project that amount forward to 303.32 1999, and transfer one-half of the result from medical 303.33 assistance and general assistance medical care to each county's 303.34 mental health grants under sections 245.4886 and 256E.12 for 303.35 calendar year 1999. The annualized minimum amount added to each 303.36 county's mental health grant shall be $3,000 per year for 304.1 children and $5,000 per year for adults. The commissioner may 304.2 reduce the statewide growth factor in order to fund these 304.3 minimums. The annualized total amount transferred shall become 304.4 part of the base for future mental health grants for each county. 304.5 (h) Any net increase in revenue to the county as a result 304.6 of the change in this section must be used to provide expanded 304.7 mental health services as defined in sections 245.461 to 304.8 245.4888, the Comprehensive Adult and Children's Mental Health 304.9 Acts, excluding inpatient and residential treatment. For 304.10 adults, increased revenue may also be used for services and 304.11 consumer supports which are part of adult mental health projects 304.12 approved under Laws 1997, chapter 203, article 7, section 25. 304.13 For children, increased revenue may also be used for respite 304.14 care and nonresidential individualized rehabilitation services 304.15 as defined in section 245.492, subdivisions 17 and 23. 304.16 "Increased revenue" has the meaning given in Minnesota Rules, 304.17 part 9520.0903, subpart 3. 304.18 (i) Notwithstanding section 256B.19, subdivision 1, the 304.19 nonfederal share of costs for mental health case management 304.20 shall be provided by the recipient's county of responsibility, 304.21 as defined in sections 256G.01 to 256G.12, from sources other 304.22 than federal funds or funds used to match other federal funds. 304.23 (j) The commissioner may suspend, reduce, or terminate the 304.24 reimbursement to a provider that does not meet the reporting or 304.25 other requirements of this section. The county of 304.26 responsibility, as defined in sections 256G.01 to 256G.12, is 304.27 responsible for any federal disallowances. The county may share 304.28 this responsibility with its contracted vendors. 304.29 (k) The commissioner shall set aside a portion of the 304.30 federal funds earned under this section to repay the special 304.31 revenue maximization account under section 256.01, subdivision 304.32 2, clause (15). The repayment is limited to: 304.33 (1) the costs of developing and implementing this section; 304.34 and 304.35 (2) programming the information systems. 304.36 (l) Notwithstanding section 256.025, subdivision 2, 305.1 payments to counties for case management expenditures under this 305.2 section shall only be made from federal earnings from services 305.3 provided under this section. Payments to contracted vendors 305.4 shall include both the federal earnings and the county share. 305.5 (m) Notwithstanding section 256B.041, county payments for 305.6 the cost of mental health case management services provided by 305.7 county or state staff shall not be made to the state treasurer. 305.8 For the purposes of mental health case management services 305.9 provided by county or state staff under this section, the 305.10 centralized disbursement of payments to counties under section 305.11 256B.041 consists only of federal earnings from services 305.12 provided under this section. 305.13 (n) Case management services under this subdivision do not 305.14 include therapy, treatment, legal, or outreach services. 305.15 (o) If the recipient is a resident of a nursing facility, 305.16 intermediate care facility, or hospital, and the recipient's 305.17 institutional care is paid by medical assistance, payment for 305.18 case management services under this subdivision is limited to 305.19 the last 30 days of the recipient's residency in that facility 305.20 and may not exceed more than two months in a calendar year. 305.21 (p) Payment for case management services under this 305.22 subdivision shall not duplicate payments made under other 305.23 program authorities for the same purpose. 305.24 (q) By July 1, 2000, the commissioner shall evaluate the 305.25 effectiveness of the changes required by this section, including 305.26 changes in number of persons receiving mental health case 305.27 management, changes in hours of service per person, and changes 305.28 in caseload size. 305.29 (r) For each calendar year beginning with the calendar year 305.30 2001, the annualized amount of state funds for each county 305.31 determined under paragraph (g) shall be adjusted by the county's 305.32 percentage change in the average number of clients per month who 305.33 received case management under this section during the fiscal 305.34 year that ended six months prior to the calendar year in 305.35 question, in comparison to the prior fiscal year. 305.36 (s) For counties receiving the minimum allocation of $3,000 306.1 or $5,000 described in paragraph (g), the adjustment in 306.2 paragraph (r) shall be determined so that the county receives 306.3 the higher of the following amounts: 306.4 (1) a continuation of the minimum allocation in paragraph 306.5 (g); or 306.6 (2) an amount based on that county's average number of 306.7 clients per month who received case management under this 306.8 section during the fiscal year that ended six months prior to 306.9 the calendar year in question, in comparison to the prior fiscal 306.10 year, times the average statewide grant per person per month for 306.11 counties not receiving the minimum allocation. 306.12 (t) The adjustments in paragraphs (r) and (s) shall be 306.13 calculated separately for children and adults. 306.14 Sec. 20. Laws 1995, chapter 207, article 8, section 41, as 306.15 amended by Laws 1997, chapter 203, article 7, section 25, is 306.16 amended to read: 306.17 Sec. 41. [PILOT PROJECTSINITIATIVES TOTESTPROVIDE 306.18 ALTERNATIVES TO DELIVERY OF ADULT MENTAL HEALTH SERVICES.] 306.19 Subdivision 1. [AUTHORIZATION FORPILOT PROJECTSADULT 306.20 MENTAL HEALTH INITIATIVES.] The commissioner of human services 306.21 may approvepilot projectsadult mental health initiatives to 306.22testprovide alternatives to orthe enhancedenhance 306.23 coordination of the delivery of mental health services required 306.24 under the Minnesota comprehensive adult mental health act, 306.25 Minnesota Statutes, sections 245.461 to 245.486. 306.26 Subd. 2. [PROGRAM DESIGN AND IMPLEMENTATION.] (a) The 306.27pilot projectsadult mental health initiatives shall be 306.28 established to design, plan, and improve the mental health 306.29 service delivery system for adults with serious and persistent 306.30 mental illness that would: 306.31 (1) provide an expanded array of services from which 306.32 clients can choose services appropriate to their needs; 306.33 (2) be based on purchasing strategies that improve access 306.34 and coordinate services without cost shifting; 306.35 (3) incorporate existing state facilities and resources 306.36 into the community mental health infrastructure through creative 307.1 partnerships with local vendors; and 307.2 (4) utilize existing categorical funding streams and 307.3 reimbursement sources in combined and creative ways, except 307.4 appropriations to regional treatment centers and all funds that 307.5 are attributable to the operation of state-operated services are 307.6 excluded unless appropriated specifically by the legislature for 307.7 a purpose consistent with this section. 307.8 (b) Allprojectsinitiatives funded by January 1, 1997, 307.9 must complete the planning phase and be operational by June 30, 307.10 1997; all projects funded by January 1, 1998, must be 307.11 operational by June 30, 1998. 307.12 Subd. 3. [PROGRAM EVALUATION.] Evaluation of eachproject307.13 initiative will be based on outcome evaluation criteria 307.14 negotiated with each project prior to implementation. 307.15 Subd. 4. [NOTICE OF PROJECT DISCONTINUATION.] Eachproject307.16 initiative may be discontinued for any reason by theproject's307.17 initiative's managing entity or the commissioner of human 307.18 services, after 90 days' written notice to the other party. 307.19 Subd. 5. [PLANNING FORPILOT PROJECTSADULT MENTAL HEALTH 307.20 INITIATIVES.] Each local plan fora pilot projectan initiative 307.21 must be developed under the direction of the county board, or 307.22 multiple county boards acting jointly, as the local mental 307.23 health authority. The planning process for each 307.24pilotinitiative shall include, but not be limited to, mental 307.25 health consumers, families, advocates, local mental health 307.26 advisory councils, local and state providers, representatives of 307.27 state and local public employee bargaining units, and the 307.28 department of human services. As part of the planning process, 307.29 the county board or boards shall designate a managing entity 307.30 responsible for receipt of funds and management of thepilot307.31projectinitiative. 307.32 Subd. 6. [DUTIES OF COMMISSIONER.] (a) For purposes of the 307.33pilot projectsadult mental health initiatives, the commissioner 307.34 shall facilitate integration of funds or other resources as 307.35 needed and requested by eachprojectinitiative. These 307.36 resources may include: 308.1 (1) residential services funds administered under Minnesota 308.2 Rules, parts 9535.2000 to 9535.3000, in an amount to be 308.3 determined by mutual agreement between theproject's308.4 initiative's managing entity and the commissioner of human 308.5 services after an examination of the county's historical 308.6 utilization of facilities located both within and outside of the 308.7 county and licensed under Minnesota Rules, parts 9520.0500 to 308.8 9520.0690; 308.9 (2) community support services funds administered under 308.10 Minnesota Rules, parts 9535.1700 to 9535.1760; 308.11 (3) other mental health special project funds; 308.12 (4) medical assistance, general assistance medical care, 308.13 MinnesotaCare and group residential housing if requested by the 308.14project'sinitiative's managing entity, and if the commissioner 308.15 determines this would be consistent with the state's overall 308.16 health care reform efforts; and 308.17 (5) regional treatment center nonfiscal resources to the 308.18 extent agreed to by theproject'sinitiative's managing entity 308.19 and the regional treatment center. 308.20 (b) The commissioner shall consider the following criteria 308.21 in awarding start-up and implementation grants for thepilot308.22projectsadult mental health initiatives: 308.23 (1) the ability of the proposedprojectsinitiatives to 308.24 accomplish the objectives described in subdivision 2; 308.25 (2) the size of the target population to be served; and 308.26 (3) geographical distribution. 308.27 (c)The commissioner shall review overall status of the308.28projects at least every two years and recommend any legislative308.29changes needed by January 15 of each odd-numbered year.308.30(d)The commissioner may waive administrative rule 308.31 requirements which are incompatible with the implementation of 308.32 thepilot projectadult mental health initiatives. 308.33(e)(d) The commissioner may exempt the participating 308.34 counties from fiscal sanctions for noncompliance with 308.35 requirements in laws and rules which are incompatible with the 308.36 implementation of thepilot projectadult mental health 309.1 initiative. 309.2(f)(e) The commissioner may award grants to an entity 309.3 designated by a county board or group of county boards to pay 309.4 for start-up and implementation costs of thepilot projectadult 309.5 mental health initiative. 309.6 Subd. 7. [DUTIES OF COUNTY BOARD.] The county board, or 309.7 other entity which is approved to administera pilot projectan 309.8 adult mental health initiative, shall: 309.9 (1) administer the project in a manner which is consistent 309.10 with the objectives described in subdivision 2 and the planning 309.11 process described in subdivision 5; 309.12 (2) assure that no one is denied services for which they 309.13 would otherwise be eligible; and 309.14 (3) provide the commissioner of human services with timely 309.15 and pertinent information through the following methods: 309.16 (i) submission of community social services act plans and 309.17 plan amendments; 309.18 (ii) submission of social services expenditure and grant 309.19 reconciliation reports, based on a coding format to be 309.20 determined by mutual agreement between theproject's309.21 initiative's managing entity and the commissioner; and 309.22 (iii) submission of data and participation in an evaluation 309.23 of thepilot projectsadult mental health initiatives, to be 309.24 designed cooperatively by the commissioner and theprojects309.25 initiatives. 309.26 Sec. 21. Laws 1997, chapter 203, article 9, section 19, is 309.27 amended to read: 309.28 Sec. 19. [TRANSITION FOR THE COMPULSIVE GAMBLING TREATMENT 309.29 PROGRAM.] 309.30 The commissioner of human services shall conduct a 309.31 transition of treatment programs for compulsive gambling from 309.32 the treatment center model to a model in which reimbursement for 309.33 treatment of an individual compulsive gambler from an approved 309.34 provider is on a fee-for-service basis on the following schedule: 309.35 (1) one-third of compulsive gamblers treated through the 309.36 program must receive services paid for from the individual 310.1 treatment reimbursement model beginning October 1, 1997; 310.2 (2) two-thirds of compulsive gamblers treated through the 310.3 program must receive services paid for from the individual 310.4 treatment reimbursement model beginning July 1, 1998; and 310.5 (3) 100 percent of compulsive gamblers treated through the 310.6 program must receive treatment paid for from the individual 310.7 treatment reimbursement model beginning July 1,19992000. 310.8 Sec. 22. Laws 1998, chapter 407, article 7, section 2, 310.9 subdivision 3, is amended to read: 310.10 Subd. 3. [LAND DESCRIPTION.] That part of the Northeast 310.11 Quarter (NE l/4) of Section3029, Township 45 North, Range 30 310.12 West, Crow Wing county, Minnesota, described as follows: 310.13 Commencing at the southeast corner of said Northeast 310.14 quarter; thence North 00 degrees 46 minutes 05 seconds 310.15 West, bearing based on the Crow Wing county Coordinate 310.16 Database NAD 83/94, 1520.06 feet along the east line of 310.17 said Northeast quarter to the point of beginning; thence 310.18 continue North 00 degrees 46 minutes 05 seconds West 634.14 310.19 feet along said east line of the Northeast quarter; thence 310.20 South 89 degrees 13 minutes 20 seconds West 550.00 feet; 310.21 thence South 18 degrees 57 minutes 23 seconds East 115.59 310.22 feet; thence South 42 degrees 44 minutes 39 seconds East 310.23 692.37 feet; thence South 62 degrees 46 minutes 19 seconds 310.24 East 20.24 feet; thence North 89 degrees 13 minutes 55 310.25 seconds East 33.00 feet to the point of beginning. 310.26 Containing 4.69 acres, more or less. Subject to the 310.27 right-of-way of the Township road along the east side 310.28 thereof, subject to other easements, reservations, and 310.29 restrictions of record, if any. 310.30 Sec. 23. [ESTABLISHMENT AND PURPOSE OF THE SUPPORTIVE 310.31 HOUSING AND MANAGED CARE PILOT PROJECT.] 310.32 Subdivision 1. [ESTABLISHMENT AND PURPOSE.] If funding is 310.33 available, the commissioner of human services may establish a 310.34 supportive housing and managed care pilot project to determine 310.35 whether integrating the delivery of housing, supportive 310.36 services, and health care into a single, flexible program will 311.1 reduce public expenditures on homeless individuals, increase 311.2 their employment rates, and provide a new alternative to 311.3 providing services to a hard-to-serve population. 311.4 The commissioner of human services may create a block grant 311.5 program for counties for the purpose of providing rent subsidies 311.6 and supportive services to eligible individuals. Minimum 311.7 project and application requirements may be developed by the 311.8 commissioner in cooperation with counties and their nonprofit 311.9 partners with the goal to provide the maximum flexibility in 311.10 program design. If any funds are available, the funds must be 311.11 coordinated with health care services for eligible individuals. 311.12 Subd. 2. [COUNTY ELIGIBILITY.] If the commissioner 311.13 establishes the pilot project under subdivision 1, a county may 311.14 request funding for the purposes of the pilot project if the 311.15 county: 311.16 (1) agrees to develop, in cooperation with nonprofit 311.17 partners, a supportive housing and managed care pilot project 311.18 that integrates the delivery of housing, support services, and 311.19 health care for eligible individuals or agrees to contract with 311.20 an existing integrated program; and 311.21 (2) develops a method for evaluating the quality of the 311.22 integrated services provided and the amount of any resulting 311.23 cost savings to the county and state. 311.24 Subd. 3. [PARTICIPANT ELIGIBILITY.] In order to be 311.25 eligible for the pilot project, a county must determine that an 311.26 individual: 311.27 (1) meets the eligibility requirements of the group 311.28 residential housing program under Minnesota Statutes, section 311.29 256I.04, subdivision 1; 311.30 (2) is a homeless person or a person at risk of 311.31 homelessness. For purposes of this pilot project, "homeless 311.32 person" means a person who is living, or at imminent risk of 311.33 living, on the street, in a shelter, or is evicted from a 311.34 dwelling or discharged from a regional human services center, 311.35 community hospital, or residential treatment program, and has no 311.36 appropriate housing available and lacks the resources necessary 312.1 to access permanent housing as determined by the county 312.2 requesting funding under the pilot project; and 312.3 (3) is a person with mental illness, a history of substance 312.4 abuse, or a person with HIV. 312.5 Subd. 4. [FUNDING.] If the commissioner establishes the 312.6 pilot project under subdivision 1, a county may request funding 312.7 from the commissioner for a specified number of eligible 312.8 participants for the pilot project. The commissioner shall 312.9 review the request for compliance with subdivisions 1 to 3 and 312.10 may approve or disapprove the request. The commissioner shall 312.11 transfer funding to be allocated to participating counties as a 312.12 block grant and paid on a monthly basis. 312.13 Subd. 5. [REPORT.] If the commissioner establishes the 312.14 pilot project under subdivision 1, participating counties and 312.15 the commissioner of human services shall collaborate to prepare 312.16 and issue an annual report beginning December 1, 2001, to the 312.17 appropriate committee chairs in the senate and house on the use 312.18 of state resources, including other funds leveraged for this 312.19 initiative, the status of individuals being served in the pilot 312.20 project, and the cost-effectiveness of the pilot project. The 312.21 commissioner shall provide data that may be needed to evaluate 312.22 the pilot project to counties that request the data. 312.23 Subd. 6. [SUNSET.] The pilot project shall sunset June 30, 312.24 2005. 312.25 Sec. 24. [CONVEYANCE OF STATE LANDS TO COUNTY OF ISANTI.] 312.26 (a) Notwithstanding Minnesota Statutes, sections 94.09 to 312.27 94.16, the commissioner of human services, through the 312.28 commissioner of administration, may transfer to the county of 312.29 Isanti the lands described in paragraph (c), for no 312.30 consideration. The commissioner of human services and the 312.31 county may attach to the transfer conditions that they agree are 312.32 appropriate, including conditions that relate to water and sewer 312.33 service. The deed to convey the property must contain a clause 312.34 that the property shall revert to the state if the property 312.35 ceases to be used for a public purpose. 312.36 (b) The conveyance must be in a form approved by the 313.1 attorney general. 313.2 (c) The land that may be transferred consists of 21.9 313.3 acres, more or less, and is described as follows: 313.4 That part of the Southwest Quarter of the Southeast Quarter 313.5 and that part of Government Lot 4, both in Section 32, 313.6 Township 36, Range 23, Isanti County, Minnesota, described 313.7 jointly as follows: Commencing at the southwest corner of 313.8 the Southwest Quarter of the Southeast Quarter of Section 313.9 32; thence North 89 degrees 45 minutes 12 seconds East, 313.10 assumed bearing, along the south line of said SW 1/4 of SE 313.11 1/4, a distance of 609.48 feet; thence North 1 degree 30 313.12 minutes 30 seconds West, a distance of 149.17 feet to the 313.13 point of beginning of the parcel to be herein described; 313.14 thence continuing North 1 degrees 30 minutes 30 seconds 313.15 West, a distance of 1113.59 feet; thence South 89 degrees 313.16 59 minutes 36 seconds West, a distance of 496.41 feet; 313.17 thence southwesterly along a tangential curve concave to 313.18 the southeast, radius 318.10 feet, central angle 90 degrees 313.19 16 minutes 37 seconds, for an arc length of 501.21 feet; 313.20 thence South 0 degrees 17 minutes 01 seconds East, tangent 313.21 to said curve, for a distance of 86.59 feet; thence 313.22 southerly along a tangential curve concave to the west, 313.23 radius 398.10 feet, central angle 29 degrees 47 minutes 02 313.24 seconds, for an arc length of 206.94 feet; thence south 29 313.25 degrees 30 minutes 01 seconds West, tangent to said curve, 313.26 for a distance of 34.23 feet; thence southerly along a 313.27 tangential curve concave to the east, radius 318.10 feet, 313.28 central angle 29 degrees 49 minutes 32 seconds, for an arc 313.29 length of 165.59 feet; thence South 0 degrees 19 minutes 31 313.30 seconds East, tangent to said curve for a distance of 313.31 320.65 feet to the point of intersection with a line that 313.32 bears West (North 90 degrees 00 minutes West) from the 313.33 point of beginning; thence East (North 90 degrees 00 313.34 minutes East), a distance of 951.22 feet to the point of 313.35 beginning. 313.36 Subject to the existing city of Cambridge water main 314.1 easement. 314.2 (d) The county of Isanti may use the land for economic 314.3 development. Economic development is a public purpose within 314.4 the meaning of the term as used in Laws 1990, chapter 610, 314.5 article 1, section 12, subdivision 5, and sales or conveyances 314.6 to private parties shall be considered economic development. 314.7 Property conveyed by the state under this section shall not 314.8 revert to the state if it is conveyed or otherwise encumbered by 314.9 the county as part of the county economic development activity. 314.10 Sec. 25. [CONVEYANCE OF STATE LAND TO CITY OF CAMBRIDGE.] 314.11 (a) Notwithstanding Minnesota Statutes, sections 94.09 to 314.12 94.16, the commissioner of human services, through the 314.13 commissioner of administration, may transfer to the city of 314.14 Cambridge the lands described in paragraph (c), for no 314.15 consideration. The commissioner of human services and the city 314.16 may attach to the transfer conditions that they agree are 314.17 appropriate, including conditions that relate to water and sewer 314.18 service. The deed to convey the property must contain a clause 314.19 that the property shall revert to the state if the property 314.20 ceases to be used for a public purpose. 314.21 (b) The conveyance must be in a form approved by the 314.22 attorney general. 314.23 (c) Subject to the right-of-way for state trunk highway No. 314.24 293 and south Dellwood street and subject to other easements, 314.25 reservations, road or street right-of-ways, and restrictions of 314.26 record, if any, the land to be conveyed may include all or part 314.27 of any of the parcels described as follows: 314.28 (1) that part of the Northeast Quarter of the Northeast 314.29 Quarter of Section 5, Township 35, Range 23, Isanti County, 314.30 Minnesota, lying north of a line drawn parallel with and 50 314.31 feet north of the center line of State Highway No. 293, as 314.32 laid out and constructed and lying westerly of the 314.33 following described line: 314.34 Commencing at a point where the West line of the 314.35 right-of-way of the Great Northern Railway Company 314.36 (presently the Burlington Northern and Santa Fe Railway) 315.1 intersects the North line of said Section 5, said point now 315.2 being the intersection of the North line of said Section 5 315.3 with the center line of State Trunk Highway No. 65 as now 315.4 laid out and constructed (presently known as South Main 315.5 Street); thence on a bearing of West and along the North 315.6 line of said Section 5 a distance of 539.5 feet to the 315.7 point of beginning of the line to be herein described; 315.8 thence on a bearing of South, a distance of 451.75 feet to 315.9 the point of intersection with a line drawn parallel with 315.10 and distant 50 feet north of the center line of State 315.11 Highway No. 293, as laid out and constructed and there 315.12 terminating. Containing 1/4 acre, more or less. 315.13 (2) that part of the Northwest Quarter of the Southeast 315.14 Quarter and that part of Governments Lots 3 and 4, all in 315.15 Section 32, Township 36, Range 23, Isanti County, 315.16 Minnesota, described jointly as follows: 315.17 Commencing at the East quarter corner of Section 32, 315.18 Township 36, Range 23, Isanti County, Minnesota; thence 315.19 South 89 degrees 44 minutes 35 seconds West, assumed 315.20 bearing, along the east-west quarter line of said Section 315.21 32, a distance of 2251.43 feet; thence South 1 degree 48 315.22 minutes 40 seconds East, a distance of 344.47 feet to the 315.23 south line of Lot 30 of Auditor's Subdivision No. 9; thence 315.24 South 89 degrees 35 minutes 5 seconds West, along said 315.25 south line and the westerly projection thereof, a distance 315.26 of 740.00 feet to the point of beginning of the parcel to 315.27 be herein described; thence North 89 degrees 35 minutes, 05 315.28 seconds East, retracing the last described course, a 315.29 distance of 534.66 feet to the northwest corner of the 315.30 recorded plat of RIVERWOOD VILLAGE; thence South 2 degrees 315.31 40 minutes 50 seconds East, a distance of 338.38 feet, 315.32 along the westerly line of said RIVERWOOD VILLAGE to the 315.33 southwest corner of said RIVERWOOD VILLAGE; thence North 89 315.34 degrees 44 minutes 50 seconds East, along the south line of 315.35 said RIVERWOOD VILLAGE, a distance of 1074.56 feet; thence 315.36 South 3 degrees 35 minutes 15 seconds East, a distance of 316.1 258.66 feet; thence southwesterly along a tangential curve 316.2 concave to the northwest, radius 318.10 feet, central angle 316.3 93 degrees 34 minutes 51 seconds for an arc length of 316.4 519.56 feet; thence South 89 degrees 59 minutes 37 seconds 316.5 West tangent to said curve for a distance of 825.86 feet; 316.6 thence southwesterly along a tangential curve concave to 316.7 the southeast, radius 398.10 feet, central angle 70 degrees 316.8 55 minutes 13 seconds, for an arc length of 492.76 feet; 316.9 thence South 89 degrees 51 minutes 30 seconds West, not 316.10 tangent to the last described curve for a distance of 316.11 523.31 feet; thence South 1 degree 57 minutes 33 seconds 316.12 West, a distance of 29.59 feet; thence South 89 degrees 57 316.13 minutes 55 seconds West, a distance of 1020 feet, more or 316.14 less, to the easterly shoreline of the Rum River; thence 316.15 northerly along said easterly shoreline to the point of 316.16 intersection with a line that bears North 45 degrees 24 316.17 minutes 55 seconds West from the point of beginning; thence 316.18 South 45 degrees 24 minutes 55 seconds East, along said 316.19 line, a distance of 180 feet, more or less, to the point of 316.20 beginning. Containing 48 acres, more or less. 316.21 (3) that part of the Northwest Quarter of the Northeast 316.22 Quarter and that part of the Northeast Quarter of the 316.23 Northwest Quarter, both in Section 5, Township 35, Range 316.24 23, Isanti County, Minnesota, described jointly as follows: 316.25 Beginning at the northwest corner of the NW 1/4 of NE 1/4 316.26 of Section 5; thence North 89 degrees 45 minutes 12 seconds 316.27 East, assumed bearing, along the north line of said NW 1/4 316.28 of NE 1/4, a distance of 1321.82 feet to the northeast 316.29 corner of said NW 1/4 of NE 1/4 thence South 4 degrees 04 316.30 minutes 02 seconds West, along the east line of said NW 1/4 316.31 of NE 1/4, a distance of 452.83 feet; thence South 89 316.32 degrees 45 minutes 02 seconds West, a distance of 1393.6 316.33 feet; thence northwesterly, along a nontangential curve 316.34 concave to the northeast, radius 318.17 feet, central angle 316.35 75 degrees 28 minutes 03 seconds, for an arc length of 316.36 419.08 feet (the chord of said curve bears North 38 degrees 317.1 03 minutes 32 seconds West and has a length of 389.44 317.2 feet); thence North 0 degrees 19 minutes 31 seconds West, 317.3 tangent to said curve, for a distance of 142.65 feet to the 317.4 north line of the NE 1/4 of NW 1/4 of said Section 5; 317.5 thence North 89 degrees 32 minutes 15 seconds East, along 317.6 said north line, a distance of 344.81 feet to the point of 317.7 beginning. Containing 16 acres, more or less. 317.8 (4) that part of the Southwest Quarter of the Southeast 317.9 Quarter, that part of the Northwest Quarter of the 317.10 Southeast Quarter and that part of Government Lot 4, all in 317.11 Section 32, Township 36, Range 23, Isanti County, 317.12 Minnesota, described jointly as follows: 317.13 Beginning at the southwest corner of the SW 1/4 of SE 1/4 317.14 of Section 32; thence North 89 degrees 45 minutes 12 317.15 seconds East, assumed bearing, along the south line of said 317.16 SW 1/4 of SE 1/4, a distance of 1321.82 feet to the 317.17 southeast corner of said SW 1/4 of SE 1/4 thence North 2 317.18 degrees 40 minutes 49 seconds West, along the east line of 317.19 said SW 1/4 of SE 1/4 and along the east line of the NW 1/4 317.20 of SE 1/4, a distance of 1465.32 feet; thence southwesterly 317.21 along a nontangential curve concave to the northwest, 317.22 radius 398.10 feet, central angle 60 degrees 52 minutes 54 317.23 seconds, for an arc length of 423.02 feet (said curve has a 317.24 chord that bears South 59 degrees 33 minutes 09 seconds 317.25 West and a chord length of 403.40 feet); thence South 89 317.26 degrees 59 minutes 37 seconds West, tangent to said curve, 317.27 for a distance of 825.68 feet; thence southwesterly along a 317.28 tangential curve concave to the southeast, radius 318.10 317.29 feet, central angle 90 degrees 16 minutes 37 seconds, for 317.30 an arc length of 501.21 feet; thence South 0 degrees 17 317.31 minutes 01 seconds East, tangent to said curve, for a 317.32 distance of 86.59 feet; thence southerly along a tangential 317.33 curve concave to the West, radius 398.10 feet, central 317.34 angle 29 degrees 47 minutes 02 seconds, for an arc length 317.35 of 206.94 feet; thence South 29 degrees 30 minutes 01 317.36 seconds West tangent to said curve, for a distance of 34.23 318.1 feet; thence southerly along a tangential curve concave to 318.2 the east, radius 318.20 feet, central angle 29 degrees 49 318.3 minutes 32 seconds for an arc length of 165.59 feet; thence 318.4 South 0 degrees 19 minutes 31 seconds East, tangent to said 318.5 curve, for a distance of 475.17 feet to the south line of 318.6 Government Lot 4, Section 32; thence North 89 degrees 32 318.7 minutes 15 seconds East, along said south line, a distance 318.8 of 344.81 feet to the point of beginning. Containing 44.9 318.9 acres, more or less. 318.10 EXCEPTING THEREFROM that parcel described on Quit Claim 318.11 Deed from the State of Minnesota to Wilfred R. and June E. 318.12 Norman, filed in Book 92 of Deeds, page 647, in the office 318.13 of the County Recorder, Isanti County, Minnesota. 318.14 ALSO EXCEPTING THEREFROM that parcel described on Quit 318.15 Claim Deed from the State of Minnesota to Frank C. Brody 318.16 and Lorraine D.S. Brody, filed in Book 102 of Deeds, page 318.17 232, in the office of the County Recorder, Isanti County, 318.18 Minnesota. 318.19 (d) The city of Cambridge may use the land for economic 318.20 development. Economic development is a public purpose within 318.21 the meaning of the term as used in Laws 1990, chapter 610, 318.22 article 1, section 12, subdivision 5, and sales or conveyances 318.23 to private parties shall be considered economic development. 318.24 Property conveyed by the state under this section shall not 318.25 revert to the state if it is conveyed or otherwise encumbered by 318.26 the city as a part of the city economic development activity. 318.27 Sec. 26. [CONVEYANCE OF CITY LAND TO STATE OF MINNESOTA.] 318.28 (a) The commissioner of administration may accept all, or 318.29 any part of, the land described in paragraph (d) from the city 318.30 of Cambridge, after the city council passes a resolution which 318.31 declares the property is surplus to its needs. 318.32 (b) The conveyance shall be in a form approved by the 318.33 attorney general. 318.34 (c) The conveyance may be subject to a scenic easement, as 318.35 defined in Minnesota Statutes, section 103F.311, subdivision 6. 318.36 The easement shall be under the custodial control of the 319.1 commissioner of natural resources and only required on the 319.2 portion of conveyed land that is designated for inclusion in the 319.3 wild and scenic river system under Minnesota Statutes, section 319.4 103F.325. The scenic easement shall allow for continued use of 319.5 any existing structures located within the easement and for 319.6 development of walking paths or trails within the easement. 319.7 (d) Subject to the right-of-way for state trunk highway No. 319.8 293, and subject to other easements, reservations, street 319.9 right-of-ways, and restrictions of record, if any, the land to 319.10 be conveyed may include all, or part of, the parcel described as 319.11 follows: 319.12 That part of Government Lot 4 and that part of the 319.13 Northeast Quarter of the Northwest Quarter, all in Section 319.14 5, Township 35, Range 23, Isanti County, Minnesota, 319.15 described jointly as follows: Commencing at the Northeast 319.16 corner of the Northwest Quarter of Section 5, thence South 319.17 89 degrees 47 minutes 10 seconds West, assumed bearing 319.18 along the north line of the Northwest Quarter of Section 5, 319.19 a distance of 656.00 feet to the point of beginning of the 319.20 parcel to be herein described, thence South 00 degrees 03 319.21 minutes 35 seconds East, a distance of 350.00 feet, thence 319.22 South 89 degrees 47 minutes 10 seconds West, parallel with 319.23 the north line of said Northwest Quarter of Section 5 to 319.24 the easterly shoreline of the Rum River, thence 319.25 northeasterly along said easterly shoreline to the north 319.26 line of the Northwest Quarter of Section 5, thence North 89 319.27 degrees 47 minutes 10 seconds East, along said north line 319.28 to the point of beginning. 319.29 ARTICLE 6 319.30 ASSISTANCE PROGRAMS 319.31 Section 1. Minnesota Statutes 1998, section 256D.051, 319.32 subdivision 2a, is amended to read: 319.33 Subd. 2a. [DUTIES OF COMMISSIONER.] In addition to any 319.34 other duties imposed by law, the commissioner shall: 319.35 (1) based on this section and section 256D.052 and Code of 319.36 Federal Regulations, title 7, section 273.7, supervise the 320.1 administration of food stamp employment and training services to 320.2 county agencies; 320.3 (2) disburse money appropriated for food stamp employment 320.4 and training services to county agencies based upon the county's 320.5 costs as specified in section256D.06256D.051, subdivision 6c; 320.6 (3) accept and supervise the disbursement of any funds that 320.7 may be provided by the federal government or from other sources 320.8 for use in this state for food stamp employment and training 320.9 services; 320.10 (4) cooperate with other agencies including any agency of 320.11 the United States or of another state in all matters concerning 320.12 the powers and duties of the commissioner under this section and 320.13 section 256D.052; and 320.14 (5) in cooperation with the commissioner of economic 320.15 security, ensure that each component of an employment and 320.16 training program carried out under this section is delivered 320.17 through a statewide workforce development system, unless the 320.18 component is not available locally through such a system. 320.19 Sec. 2. Minnesota Statutes 1998, section 256D.051, is 320.20 amended by adding a subdivision to read: 320.21 Subd. 6c. [PROGRAM FUNDING.] Within the limits of 320.22 available resources, the commissioner shall reimburse the actual 320.23 costs of county agencies and their employment and training 320.24 service providers for the provision of food stamp employment and 320.25 training services, including participant support services, 320.26 direct program services, and program administrative activities. 320.27 No more than 15 percent of program funds may be used for 320.28 administrative activities. The county agency may expend county 320.29 funds in excess of the limits of this subdivision without state 320.30 reimbursement. 320.31 Program funds shall be allocated based on the county's 320.32 average number of food stamp cases as compared to the statewide 320.33 total number of such cases. The average number of cases shall 320.34 be based on counts of cases as of March 31, June 30, September 320.35 30, and December 31 of the previous calendar year. The 320.36 commissioner may reallocate unexpended money appropriated under 321.1 this section to those county agencies that demonstrate a need 321.2 for additional funds. 321.3 Sec. 3. Minnesota Statutes 1998, section 256D.053, 321.4 subdivision 1, is amended to read: 321.5 Subdivision 1. [PROGRAM ESTABLISHED.]For the period of321.6July 1, 1998, to June 30, 1999,The Minnesota food assistance 321.7 program is established to provide food assistance to legal 321.8 noncitizens residing in this state who are ineligible to 321.9 participate in the federal Food Stamp Program solely due to the 321.10 provisions of section 402 or 403 of Public Law Number 104-193, 321.11 as authorized by Title VII of the 1997 Emergency Supplemental 321.12 Appropriations Act, Public Law Number 105-18, and as amended by 321.13 Public Law Number 105-185. 321.14 Sec. 4. Minnesota Statutes 1998, section 256D.06, 321.15 subdivision 5, is amended to read: 321.16 Subd. 5. Any applicant, otherwise eligible for general 321.17 assistance and possibly eligible for maintenance benefits from 321.18 any other source shall (a) make application for those benefits 321.19 within 30 days of the general assistance application; and (b) 321.20 execute an interim assistance authorization agreement on a form 321.21 as directed by the commissioner. The commissioner shall review 321.22 a denial of an application for other maintenance benefits and 321.23 may require a recipient of general assistance to file an appeal 321.24 of the denial if appropriate. If found eligible for benefits 321.25 from other sources, and a payment received from another source 321.26 relates to the period during which general assistance was also 321.27 being received, the recipient shall be required to reimburse the 321.28 county agency for the interim assistance paid. Reimbursement 321.29 shall not exceed the amount of general assistance paid during 321.30 the time period to which the other maintenance benefits apply 321.31 and shall not exceed the state standard applicable to that time 321.32 period. The commissioner shall adopt rules authorizing county 321.33 agencies or other client representatives to retain from the 321.34 amount recovered under an interim assistance agreement 25 321.35 percent plus actual reasonable fees, costs, and disbursements of 321.36 appeals and litigation, of providing special assistance to the 322.1 recipient in processing the recipient's claim for maintenance 322.2 benefits from another source. The money retained under this 322.3 section shall be from the state share of the recovery. The 322.4 commissioner or the county agency may contract with qualified 322.5 persons to provide the special assistance. The rules adopted by 322.6 the commissioner shall include the methods by which county 322.7 agencies shall identify, refer, and assist recipients who may be 322.8 eligible for benefits under federal programs for the disabled. 322.9 This subdivision does not require repayment of per diem payments 322.10 made to shelters for battered women pursuant to section 256D.05, 322.11 subdivision 3. 322.12 Sec. 5. Minnesota Statutes 1998, section 256J.08, 322.13 subdivision 11, is amended to read: 322.14 Subd. 11. [CAREGIVER.] "Caregiver" means a minor child's 322.15 natural or adoptive parent or parents and stepparent who live in 322.16 the home with the minor child. For purposes of determining 322.17 eligibility for this program, caregiver also means any of the 322.18 following individuals, if adults, who live with and provide care 322.19 and support to a minor child when the minor child's natural or 322.20 adoptive parent or parents or stepparents do not reside in the 322.21 same home: legal custodian or guardian, grandfather, 322.22 grandmother, brother, sister, half-brother, half-sister, 322.23 stepbrother, stepsister, uncle, aunt, first cousin or first 322.24 cousin once removed, nephew, niece, person of preceding 322.25 generation as denoted by prefixes of "great," "great-great," or 322.26 "great-great-great," or a spouse of any person named in the 322.27 above groups even after the marriage ends by death or divorce. 322.28 Sec. 6. Minnesota Statutes 1998, section 256J.08, 322.29 subdivision 24, is amended to read: 322.30 Subd. 24. [DISREGARD.] "Disregard" means earned income 322.31 that is not counted when determining initial eligibility or 322.32 ongoing eligibility and calculating the amount of the assistance 322.33 payment for participants. The commissioner shall determine the 322.34 amount of the disregard according to section 256J.24, 322.35 subdivision 10. 322.36 Sec. 7. Minnesota Statutes 1998, section 256J.08, is 323.1 amended by adding a subdivision to read: 323.2 Subd. 28a. [ENCUMBRANCE.] "Encumbrance" means a legal 323.3 claim against real or personal property that is payable upon the 323.4 sale of that property. 323.5 Sec. 8. Minnesota Statutes 1998, section 256J.08, is 323.6 amended by adding a subdivision to read: 323.7 Subd. 55a. [MFIP STANDARD OF NEED.] "MFIP standard of need" 323.8 means the appropriate standard used to determine MFIP benefit 323.9 payments for the MFIP unit and applies to: 323.10 (1) the transitional standard, sections 256J.08, 323.11 subdivision 85, and 256J.24, subdivision 5; 323.12 (2) the shared household standard, section 256J.24, 323.13 subdivision 9; and 323.14 (3) the interstate transition standard, section 256J.43. 323.15 Sec. 9. Minnesota Statutes 1998, section 256J.08, 323.16 subdivision 65, is amended to read: 323.17 Subd. 65. [PARTICIPANT.] "Participant" means a person who 323.18 is currently receiving cash assistanceandor the food portion 323.19 available throughMFIP-SMFIP as funded by TANF and the food 323.20 stamp program. A person who fails to withdraw or access 323.21 electronically any portion of the person's cash and food 323.22 assistance payment by the end of the payment month, who makes a 323.23 written request for closure before the first of a payment month 323.24 and repays cash and food assistance electronically issued for 323.25 that payment month within that payment month, or who returns any 323.26 uncashed assistance check and food coupons and withdraws from 323.27 the program is not a participant. A person who withdraws a cash 323.28 or food assistance payment by electronic transfer or receives 323.29 and cashesa cashan MFIP assistance check or food coupons and 323.30 is subsequently determined to be ineligible for assistance for 323.31 that period of time is a participant, regardless whether that 323.32 assistance is repaid. The term "participant" includes the 323.33 caregiver relative and the minor child whose needs are included 323.34 in the assistance payment. A person in an assistance unit who 323.35 does not receive a cash and food assistance payment because the 323.36 person has been suspended fromMFIP-S or because the person's324.1need falls below the $10 minimum payment levelMFIP is a 324.2 participant. 324.3 Sec. 10. Minnesota Statutes 1998, section 256J.08, 324.4 subdivision 82, is amended to read: 324.5 Subd. 82. [SANCTION.] "Sanction" means the reduction of a 324.6 family's assistance payment by a specified percentage of 324.7 theapplicable transitionalMFIP standard of need because: a 324.8 nonexempt participant fails to comply with the requirements of 324.9 sections 256J.52 to 256J.55; a parental caregiver fails without 324.10 good cause to cooperate with the child support enforcement 324.11 requirements; or a participant fails to comply with the 324.12 insurance, tort liability, or other requirements of this chapter. 324.13 Sec. 11. Minnesota Statutes 1998, section 256J.08, 324.14 subdivision 83, is amended to read: 324.15 Subd. 83. [SIGNIFICANT CHANGE.] "Significant change" means 324.16 a decline in gross income of36 percentthe amount of the 324.17 disregard as defined in subdivision 24 or more from the income 324.18 used to determine the grant for the current month. 324.19 Sec. 12. Minnesota Statutes 1998, section 256J.08, 324.20 subdivision 86a, is amended to read: 324.21 Subd. 86a. [UNRELATED MEMBER.] "Unrelated member" means an 324.22 individual in the household who does not meet the definition of 324.23 an eligible caregiver, but does not include an individual who324.24provides child care to a child in the assistance unit. 324.25 Sec. 13. Minnesota Statutes 1998, section 256J.11, 324.26 subdivision 2, is amended to read: 324.27 Subd. 2. [NONCITIZENS; FOOD PORTION.](a) For the period324.28September 1, 1997, to October 31, 1997, noncitizens who do not324.29meet one of the exemptions in section 412 of the Personal324.30Responsibility and Work Opportunity Reconciliation Act of 1996,324.31but were residing in this state as of July 1, 1997, are eligible324.32for the 6/10 of the average value of food stamps for the same324.33family size and composition until MFIP-S is operative in the324.34noncitizen's county of financial responsibility and thereafter,324.35the 6/10 of the food portion of MFIP-S. However, federal food324.36stamp dollars cannot be used to fund the food portion of MFIP-S325.1benefits for an individual under this subdivision.325.2(b) For the period November 1, 1997, to June 30, 1999,325.3noncitizens who do not meet one of the exemptions in section 412325.4of the Personal Responsibility and Work Opportunity325.5Reconciliation Act of 1996, and are receiving cash assistance325.6under the AFDC, family general assistance, MFIP or MFIP-S325.7programs are eligible for the average value of food stamps for325.8the same family size and composition until MFIP-S is operative325.9in the noncitizen's county of financial responsibility and325.10thereafter, the food portion of MFIP-S. However, federal food325.11stamp dollars cannot be used to fund the food portion of MFIP-S325.12benefits for an individual under this subdivisionState dollars 325.13 shall fund the food portion of a noncitizen's MFIP benefits when 325.14 federal food stamp dollars cannot be used to fund those 325.15 benefits. The assistance provided under this subdivision, which 325.16 is designated as a supplement to replace lost benefits under the 325.17 federal food stamp program, must be disregarded as income in all 325.18 programs that do not count food stamps as income where the 325.19 commissioner has the authority to make the income disregard 325.20 determination for the program. 325.21(c) The commissioner shall submit a state plan to the325.22secretary of agriculture to allow the commissioner to purchase325.23federal Food Stamp Program benefits in an amount equal to the325.24MFIP-S food portion for each legal noncitizen receiving MFIP-S325.25assistance who is ineligible to participate in the federal Food325.26Stamp Program solely due to the provisions of section 402 or 403325.27of Public Law Number 104-193, as authorized by Title VII of the325.281997 Emergency Supplemental Appropriations Act, Public Law325.29Number 105-18. The commissioner shall enter into a contract as325.30necessary with the secretary to use the existing federal Food325.31Stamp Program benefits delivery system for the purposes of325.32administering the food portion of MFIP-S under this subdivision.325.33 Sec. 14. Minnesota Statutes 1998, section 256J.11, 325.34 subdivision 3, is amended to read: 325.35 Subd. 3. [BENEFITS FUNDED WITH STATE MONEY.] Legal adult 325.36 noncitizens who have resided in the country for four years or 326.1 more as a lawful permanent resident, whose benefits are funded 326.2 entirely with state money, and who are under 70 years of age, 326.3 must, as a condition of eligibility: 326.4 (1) be enrolled in a literacy class, English as a second 326.5 language class, or a citizen class; 326.6 (2) be applying for admission to a literacy class, English 326.7 as a second language class, and is on a waiting list; 326.8 (3) be in the process of applying for a waiver from the 326.9 Immigration and Naturalization Service of the English language 326.10 or civics requirements of the citizenship test; 326.11 (4) have submitted an application for citizenship to the 326.12 Immigration and Naturalization Service and is waiting for a 326.13 testing date or a subsequent swearing in ceremony; or 326.14 (5) have been denied citizenship due to a failure to pass 326.15 the test after two attempts or because of an inability to 326.16 understand the rights and responsibilities of becoming a United 326.17 States citizen, as documented by the Immigration and 326.18 Naturalization Service or the county. 326.19 If the county social service agency determines that a legal 326.20 noncitizen subject to the requirements of this subdivision will 326.21 require more than one year of English language training, then 326.22 the requirements of clause (1) or (2) shall be imposed after the 326.23 legal noncitizen has resided in the country for three years. 326.24 Individuals who reside in a facility licensed under chapter 326.25 144A, 144D, 245A, or 256I are exempt from the requirements of 326.26 this subdivision. 326.27 Sec. 15. Minnesota Statutes 1998, section 256J.12, 326.28 subdivision 1a, is amended to read: 326.29 Subd. 1a. [30-DAY RESIDENCY REQUIREMENT.] An assistance 326.30 unit is considered to have established residency in this state 326.31 only when a child or caregiver has resided in this state for at 326.32 least 30 consecutive days with the intention of making the 326.33 person's home here and not for any temporary purpose. The birth 326.34 of a child in Minnesota to a member of the assistance unit does 326.35 not automatically establish the residency in this state under 326.36 this subdivision of the other members of the assistance unit. 327.1 Time spent in a shelter for battered women shall count toward 327.2 satisfying the 30-day residency requirement. 327.3 Sec. 16. Minnesota Statutes 1998, section 256J.12, 327.4 subdivision 2, is amended to read: 327.5 Subd. 2. [EXCEPTIONS.] (a) A county shall waive the 30-day 327.6 residency requirement where unusual hardship would result from 327.7 denial of assistance. 327.8 (b) For purposes of this section, unusual hardship means an 327.9 assistance unit: 327.10 (1) is without alternative shelter; or 327.11 (2) is without available resources for food. 327.12 (c) For purposes of this subdivision, the following 327.13 definitions apply (1) "metropolitan statistical area" is as 327.14 defined by the U.S. Census Bureau; (2) "alternative shelter" 327.15 includes any shelter that is located within the metropolitan 327.16 statistical area containing the county and for which the family 327.17 is eligible, provided the assistance unit does not have to 327.18 travel more than 20 miles to reach the shelter and has access to 327.19 transportation to the shelter. Clause (2) does not apply to 327.20 counties in the Minneapolis-St. Paul metropolitan statistical 327.21 area. 327.22 (d) Applicants are considered to meet the residency 327.23 requirement under subdivision 1a if they once resided in 327.24 Minnesota and: 327.25 (1) joined the United States armed services, returned to 327.26 Minnesota within 30 days of leaving the armed services, and 327.27 intend to remain in Minnesota; or 327.28 (2) left to attend school in another state, paid 327.29 nonresident tuition or Minnesota tuition rates under a 327.30 reciprocity agreement, and returned to Minnesota within 30 days 327.31 of graduation with the intent to remain in Minnesota. 327.32 (e) The 30-day residence requirement is met when: 327.33 (1) a minor child or a minor caregiver moves from another 327.34 state to the residence of a relative caregiver; and 327.35(2) the minor caregiver applies for and receives family327.36cash assistance;328.1(3) the relative caregiver chooses not to be part of the328.2MFIP-S assistance unit; and328.3(4) the relative caregiver has resided in Minnesota for at328.4least 30 days prior to the date the assistance unit applies for328.5cash assistance.328.6(f) Ineligible mandatory unit members who have resided in328.7Minnesota for 12 months immediately before the unit's date of328.8application establish the other assistance unit members'328.9eligibility for the MFIP-S transitional standard.328.10 (2) the relative caregiver has resided in Minnesota for at 328.11 least 30 consecutive days and: 328.12 (i) the minor caregiver applies for and receives MFIP; or 328.13 (ii) the relative caregiver applies for assistance for the 328.14 minor child but does not choose to be a member of the MFIP 328.15 assistance unit. 328.16 Sec. 17. Minnesota Statutes 1998, section 256J.14, is 328.17 amended to read: 328.18 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 328.19 (a) The definitions in this paragraph only apply to this 328.20 subdivision. 328.21 (1) "Household of a parent, legal guardian, or other adult 328.22 relative" means the place of residence of: 328.23 (i) a natural or adoptive parent; 328.24 (ii) a legal guardian according to appointment or 328.25 acceptance under section 260.242, 525.615, or 525.6165, and 328.26 related laws; 328.27 (iii) a caregiver as defined in section 256J.08, 328.28 subdivision 11; or 328.29 (iv) an appropriate adult relative designated by a county 328.30 agency. 328.31 (2) "Adult-supervised supportive living arrangement" means 328.32 a private family setting which assumes responsibility for the 328.33 care and control of the minor parent and minor child, or other 328.34 living arrangement, not including a public institution, licensed 328.35 by the commissioner of human services which ensures that the 328.36 minor parent receives adult supervision and supportive services, 329.1 such as counseling, guidance, independent living skills 329.2 training, or supervision. 329.3 (b) A minor parent and the minor child who is in the care 329.4 of the minor parent must reside in the household of a parent, 329.5 legal guardian, other adult relative, or in an adult-supervised 329.6 supportive living arrangement in order to receiveMFIP-SMFIP 329.7 unless: 329.8 (1) the minor parent has no living parent, other adult 329.9 relative, or legal guardian whose whereabouts is known; 329.10 (2) no living parent, other adult relative, or legal 329.11 guardian of the minor parent allows the minor parent to live in 329.12 the parent's, other adult relative's, or legal guardian's home; 329.13 (3) the minor parent lived apart from the minor parent's 329.14 own parent or legal guardian for a period of at least one year 329.15 before either the birth of the minor child or the minor parent's 329.16 application forMFIP-SMFIP; 329.17 (4) the physical or emotional health or safety of the minor 329.18 parent or minor child would be jeopardized if the minor parent 329.19 and the minor child resided in the same residence with the minor 329.20 parent's parent, other adult relative, or legal guardian; or 329.21 (5) an adult supervised supportive living arrangement is 329.22 not available for the minor parent and child in the county in 329.23 which the minor parent and child currently reside. If an adult 329.24 supervised supportive living arrangement becomes available 329.25 within the county, the minor parent and child must reside in 329.26 that arrangement. 329.27 (c) Minor applicants must be informed orally and in writing 329.28 about the eligibility requirements and their rights and 329.29 obligations under theMFIP-SMFIP program. The county must 329.30 advise the minor of the possible exemptions and specifically ask 329.31 whether one or more of these exemptions is applicable. If the 329.32 minor alleges one or more of these exemptions, then the county 329.33 must assist the minor in obtaining the necessary verifications 329.34 to determine whether or not these exemptions apply. 329.35 (d) If the county worker has reason to suspect that the 329.36 physical or emotional health or safety of the minor parent or 330.1 minor child would be jeopardized if they resided with the minor 330.2 parent's parent, other adult relative, or legal guardian, then 330.3 the county worker must make a referral to child protective 330.4 services to determine if paragraph (b), clause (4), applies. A 330.5 new determination by the county worker is not necessary if one 330.6 has been made within the last six months, unless there has been 330.7 a significant change in circumstances which justifies a new 330.8 referral and determination. 330.9 (e) If a minor parent is not living with a parent, legal 330.10 guardian, or other adult relative due to paragraph (b), clause 330.11 (1), (2), or (4), the minor parent must reside, when possible, 330.12 in a living arrangement that meets the standards of paragraph 330.13 (a), clause (2). 330.14 (f)When a minor parent and minor child live with a parent,330.15other adult relative, legal guardian, or in an adult-supervised330.16supportiveRegardless of living arrangement,MFIP-SMFIP must be 330.17 paid, when possible, in the form of a protective payment on 330.18 behalf of the minor parent and minor child according to section 330.19 256J.39, subdivisions 2 to 4. 330.20 Sec. 18. Minnesota Statutes 1998, section 256J.20, 330.21 subdivision 3, is amended to read: 330.22 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 330.23MFIP-SMFIP, the equity value of all nonexcluded real and 330.24 personal property of the assistance unit must not exceed $2,000 330.25 for applicants and $5,000 for ongoing participants. The value 330.26 of assets in clauses (1) to (20) must be excluded when 330.27 determining the equity value of real and personal property: 330.28 (1) a licensed vehicle up to a loan value of less than or 330.29 equal to $7,500. The county agency shall apply any excess loan 330.30 value as if it were equity value to the asset limit described in 330.31 this section. If the assistance unit owns more than one 330.32 licensed vehicle, the county agency shall determine the vehicle 330.33 with the highest loan value and count only the loan value over 330.34 $7,500, excluding: (i) the value of one vehicle per physically 330.35 disabled person when the vehicle is needed to transport the 330.36 disabled unit member; this exclusion does not apply to mentally 331.1 disabled people; (ii) the value of special equipment for a 331.2 handicapped member of the assistance unit; and (iii) any vehicle 331.3 used for long-distance travel, other than daily commuting, for 331.4 the employment of a unit member. 331.5 The county agency shall count the loan value of all other 331.6 vehicles and apply this amount as if it were equity value to the 331.7 asset limit described in this section.The value of special331.8equipment for a handicapped member of the assistance unit is331.9excluded.To establish the loan value of vehicles, a county 331.10 agency must use the N.A.D.A. Official Used Car Guide, Midwest 331.11 Edition, for newer model cars. When a vehicle is not listed in 331.12 the guidebook, or when the applicant or participant disputes the 331.13 loan value listed in the guidebook as unreasonable given the 331.14 condition of the particular vehicle, the county agency may 331.15 require the applicant or participant document the loan value by 331.16 securing a written statement from a motor vehicle dealer 331.17 licensed under section 168.27, stating the amount that the 331.18 dealer would pay to purchase the vehicle. The county agency 331.19 shall reimburse the applicant or participant for the cost of a 331.20 written statement that documents a lower loan value; 331.21 (2) the value of life insurance policies for members of the 331.22 assistance unit; 331.23 (3) one burial plot per member of an assistance unit; 331.24 (4) the value of personal property needed to produce earned 331.25 income, including tools, implements, farm animals, inventory, 331.26 business loans, business checking and savings accounts used at 331.27 least annually and used exclusively for the operation of a 331.28 self-employment business, and any motor vehicles if at least 50 331.29 percent of the vehicle's use is to produce income and if the 331.30 vehicles are essential for the self-employment business; 331.31 (5) the value of personal property not otherwise specified 331.32 which is commonly used by household members in day-to-day living 331.33 such as clothing, necessary household furniture, equipment, and 331.34 other basic maintenance items essential for daily living; 331.35 (6) the value of real and personal property owned by a 331.36 recipient of Supplemental Security Income or Minnesota 332.1 supplemental aid; 332.2 (7) the value of corrective payments, but only for the 332.3 month in which the payment is received and for the following 332.4 month; 332.5 (8) a mobile home or other vehicle used by an applicant or 332.6 participant as the applicant's or participant's home; 332.7 (9) money in a separate escrow account that is needed to 332.8 pay real estate taxes or insurance and that is used for this 332.9 purpose; 332.10 (10) money held in escrow to cover employee FICA, employee 332.11 tax withholding, sales tax withholding, employee worker 332.12 compensation, business insurance, property rental, property 332.13 taxes, and other costs that are paid at least annually, but less 332.14 often than monthly; 332.15 (11) monthly assistance, emergency assistance, and 332.16 diversionary payments for the current month's needs; 332.17 (12) the value of school loans, grants, or scholarships for 332.18 the period they are intended to cover; 332.19 (13) payments listed in section 256J.21, subdivision 2, 332.20 clause (9), which are held in escrow for a period not to exceed 332.21 three months to replace or repair personal or real property; 332.22 (14) income received in a budget month through the end of 332.23 the payment month; 332.24 (15) savings from earned income of a minor child or a minor 332.25 parent that are set aside in a separate account designated 332.26 specifically for future education or employment costs; 332.27 (16) the federal earned income credit, Minnesota working 332.28 family credit, state and federal income tax refunds, state 332.29 homeowners and renters credits under chapter 290A, property tax 332.30 rebatesunder Laws 1997, chapter 231, article 1, section 16,and 332.31 other federal or state tax rebates in the month received and the 332.32 following month; 332.33 (17) payments excluded under federal law as long as those 332.34 payments are held in a separate account from any nonexcluded 332.35 funds; 332.36 (18) money received by a participant of the corps to career 333.1 program under section 84.0887, subdivision 2, paragraph (b), as 333.2 a postservice benefit under the federal Americorps Act; 333.3 (19) the assets of children ineligible to receiveMFIP-S333.4 MFIP benefits because foster care or adoption assistance 333.5 payments are made on their behalf; and 333.6 (20) the assets of persons whose income is excluded under 333.7 section 256J.21, subdivision 2, clause (43). 333.8 Sec. 19. Minnesota Statutes 1998, section 256J.21, 333.9 subdivision 2, is amended to read: 333.10 Subd. 2. [INCOME EXCLUSIONS.] (a) The following must be 333.11 excluded in determining a family's available income: 333.12 (1) payments for basic care, difficulty of care, and 333.13 clothing allowances received for providing family foster care to 333.14 children or adults under Minnesota Rules, parts 9545.0010 to 333.15 9545.0260 and 9555.5050 to 9555.6265, and payments received and 333.16 used for care and maintenance of a third-party beneficiary who 333.17 is not a household member; 333.18 (2) reimbursements for employment training received through 333.19 the Job Training Partnership Act, United States Code, title 29, 333.20 chapter 19, sections 1501 to 1792b; 333.21 (3) reimbursement for out-of-pocket expenses incurred while 333.22 performing volunteer services, jury duty,oremployment, or 333.23 informal carpooling arrangements directly related to employment; 333.24 (4) all educational assistance, except the county agency 333.25 must count graduate student teaching assistantships, 333.26 fellowships, and other similar paid work as earned income and, 333.27 after allowing deductions for any unmet and necessary 333.28 educational expenses, shall count scholarships or grants awarded 333.29 to graduate students that do not require teaching or research as 333.30 unearned income; 333.31 (5) loans, regardless of purpose, from public or private 333.32 lending institutions, governmental lending institutions, or 333.33 governmental agencies; 333.34 (6) loans from private individuals, regardless of purpose, 333.35 provided an applicant or participant documents that the lender 333.36 expects repayment; 334.1 (7)(i) state income tax refunds; and 334.2 (ii) federal income tax refunds; 334.3 (8)(i) federal earned income credits; 334.4 (ii) Minnesota working family credits; 334.5 (iii) state homeowners and renters credits under chapter 334.6 290A; and 334.7 (iv)property tax rebates under Laws 1997, chapter 231,334.8article 1, section 16; and334.9(v) otherfederal or state tax rebates; 334.10 (9) funds received for reimbursement, replacement, or 334.11 rebate of personal or real property when these payments are made 334.12 by public agencies, awarded by a court, solicited through public 334.13 appeal, or made as a grant by a federal agency, state or local 334.14 government, or disaster assistance organizations, subsequent to 334.15 a presidential declaration of disaster; 334.16 (10) the portion of an insurance settlement that is used to 334.17 pay medical, funeral, and burial expenses, or to repair or 334.18 replace insured property; 334.19 (11) reimbursements for medical expenses that cannot be 334.20 paid by medical assistance; 334.21 (12) payments by a vocational rehabilitation program 334.22 administered by the state under chapter 268A, except those 334.23 payments that are for current living expenses; 334.24 (13) in-kind income, including any payments directly made 334.25 by a third party to a provider of goods and services; 334.26 (14) assistance payments to correct underpayments, but only 334.27 for the month in which the payment is received; 334.28 (15) emergency assistance payments; 334.29 (16) funeral and cemetery payments as provided by section 334.30 256.935; 334.31 (17) nonrecurring cash gifts of $30 or less, not exceeding 334.32 $30 per participant in a calendar month; 334.33 (18) any form of energy assistance payment made through 334.34 Public Law Number 97-35, Low-Income Home Energy Assistance Act 334.35 of 1981, payments made directly to energy providers by other 334.36 public and private agencies, and any form of credit or rebate 335.1 payment issued by energy providers; 335.2 (19) Supplemental Security Income, including retroactive 335.3 payments; 335.4 (20) Minnesota supplemental aid, including retroactive 335.5 payments; 335.6 (21) proceeds from the sale of real or personal property; 335.7 (22) adoption assistance payments under section 259.67; 335.8 (23) state-funded family subsidy program payments made 335.9 under section 252.32 to help families care for children with 335.10 mental retardation or related conditions; 335.11 (24) interest payments and dividends from property that is 335.12 not excluded from and that does not exceed the asset limit; 335.13 (25) rent rebates; 335.14 (26) income earned by a minor caregiveror, minor child 335.15 through age 6, or a minor child who is at least a half-time 335.16 student in an approved elementary or secondary education 335.17 program; 335.18 (27) income earned by a caregiver under age 20 who is at 335.19 least a half-time student in an approved elementary or secondary 335.20 education program; 335.21 (28)MFIP-SMFIP child care payments under section 119B.05; 335.22 (29) all other payments made throughMFIP-SMFIP to support 335.23 a caregiver's pursuit of greater self-support; 335.24 (30) income a participant receives related to shared living 335.25 expenses; 335.26 (31) reverse mortgages; 335.27 (32) benefits provided by the Child Nutrition Act of 1966, 335.28 United States Code, title 42, chapter 13A, sections 1771 to 335.29 1790; 335.30 (33) benefits provided by the women, infants, and children 335.31 (WIC) nutrition program, United States Code, title 42, chapter 335.32 13A, section 1786; 335.33 (34) benefits from the National School Lunch Act, United 335.34 States Code, title 42, chapter 13, sections 1751 to 1769e; 335.35 (35) relocation assistance for displaced persons under the 335.36 Uniform Relocation Assistance and Real Property Acquisition 336.1 Policies Act of 1970, United States Code, title 42, chapter 61, 336.2 subchapter II, section 4636, or the National Housing Act, United 336.3 States Code, title 12, chapter 13, sections 1701 to 1750jj; 336.4 (36) benefits from the Trade Act of 1974, United States 336.5 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 336.6 (37) war reparations payments to Japanese Americans and 336.7 Aleuts under United States Code, title 50, sections 1989 to 336.8 1989d; 336.9 (38) payments to veterans or their dependents as a result 336.10 of legal settlements regarding Agent Orange or other chemical 336.11 exposure under Public Law Number 101-239, section 10405, 336.12 paragraph (a)(2)(E); 336.13 (39) income that is otherwise specifically excluded from 336.14the MFIP-S programMFIP consideration in federal law, state law, 336.15 or federal regulation; 336.16 (40) security and utility deposit refunds; 336.17 (41) American Indian tribal land settlements excluded under 336.18 Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 336.19 Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 336.20 reservations and payments to members of the White Earth Band, 336.21 under United States Code, title 25, chapter 9, section 331, and 336.22 chapter 16, section 1407; 336.23 (42) all income of the minor parent'sparentparents and 336.24stepparentstepparents when determining the grant for the minor 336.25 parent in households that include a minor parent living witha336.26parentparents orstepparentstepparents onMFIP-SMFIP with 336.27 other children; and 336.28 (43) income of the minor parent'sparentparents and 336.29stepparentstepparents equal to 200 percent of the federal 336.30 poverty guideline for a family size not including the minor 336.31 parent and the minor parent's child in households that include a 336.32 minor parent living witha parentparents orstepparent336.33 stepparents not onMFIP-SMFIP when determining the grant for 336.34 the minor parent. The remainder of income is deemed as 336.35 specified in section 256J.37, subdivision 1b; 336.36 (44) payments made to children eligible for relative 337.1 custody assistance under section 257.85; 337.2 (45) vendor payments for goods and services made on behalf 337.3 of a client unless the client has the option of receiving the 337.4 payment in cash; and 337.5 (46) the principal portion of a contract for deed payment. 337.6 Sec. 20. Minnesota Statutes 1998, section 256J.21, 337.7 subdivision 3, is amended to read: 337.8 Subd. 3. [INITIAL INCOME TEST.] The county agency shall 337.9 determine initial eligibility by considering all earned and 337.10 unearned income that is not excluded under subdivision 2. To be 337.11 eligible forMFIP-SMFIP, the assistance unit's countable income 337.12 minus the disregards in paragraphs (a) and (b) must be below the 337.13 transitional standard of assistance according to section 256J.24 337.14 for that size assistance unit. 337.15 (a) The initial eligibility determination must disregard 337.16 the following items: 337.17 (1) the employment disregard is 18 percent of the gross 337.18 earned income whether or not the member is working full time or 337.19 part time; 337.20 (2) dependent care costs must be deducted from gross earned 337.21 income for the actual amount paid for dependent care up to a 337.22 maximum of $200 per month for each child less than two years of 337.23 age, and $175 per month for each child two years of age and 337.24 older under this chapter and chapter 119B; 337.25 (3) all payments made according to a court order for 337.26 spousal support or the support of children not living in the 337.27 assistance unit's household shall be disregarded from the income 337.28 of the person with the legal obligation to pay support, provided 337.29 that, if there has been a change in the financial circumstances 337.30 of the person with the legal obligation to pay support since the 337.31 support order was entered, the person with the legal obligation 337.32 to pay support has petitioned for a modification of the support 337.33 order; and 337.34 (4) an allocation for the unmet need of an ineligible 337.35 spouse or an ineligible child under the age of 21 for whom the 337.36 caregiver is financially responsible and who lives with the 338.1 caregiver according to section 256J.36. 338.2 (b) Notwithstanding paragraph (a), when determining initial 338.3 eligibility for applicant units when at least one member has 338.4 receivedAFDC, family general assistance, MFIP, MFIP-R,work 338.5 first,orMFIP-SMFIP in this state within four months of the 338.6 most recent application forMFIP-SMFIP, apply theemployment338.7 disregard as defined in section 256J.08, subdivision 24, for all 338.8 unit membersis 36 percent of the gross earned income. 338.9 After initial eligibility is established, the assistance 338.10 payment calculation is based on the monthly income test. 338.11 Sec. 21. Minnesota Statutes 1998, section 256J.21, 338.12 subdivision 4, is amended to read: 338.13 Subd. 4. [MONTHLY INCOME TEST AND DETERMINATION OF 338.14 ASSISTANCE PAYMENT.] The county agency shall determine ongoing 338.15 eligibility and the assistance payment amount according to the 338.16 monthly income test. To be eligible forMFIP-SMFIP, the result 338.17 of the computations in paragraphs (a) to (e) must be at least $1. 338.18 (a) Applya 36 percentan income disregard as defined in 338.19 section 256J.08, subdivision 24, to gross earnings and subtract 338.20 this amount from the family wage level. If the difference is 338.21 equal to or greater than thetransitionalMFIP standard of need, 338.22 the assistance payment is equal to thetransitionalMFIP 338.23 standard of need. If the difference is less than 338.24 thetransitionalMFIP standard of need, the assistance payment 338.25 is equal to the difference. The employment disregard in this 338.26 paragraph must be deducted every month there is earned income. 338.27 (b) All payments made according to a court order for 338.28 spousal support or the support of children not living in the 338.29 assistance unit's household must be disregarded from the income 338.30 of the person with the legal obligation to pay support, provided 338.31 that, if there has been a change in the financial circumstances 338.32 of the person with the legal obligation to pay support since the 338.33 support order was entered, the person with the legal obligation 338.34 to pay support has petitioned for a modification of the court 338.35 order. 338.36 (c) An allocation for the unmet need of an ineligible 339.1 spouse or an ineligible child under the age of 21 for whom the 339.2 caregiver is financially responsible and who lives with the 339.3 caregiver must be made according to section 256J.36. 339.4 (d) Subtract unearned income dollar for dollar from 339.5 thetransitionalMFIP standard of need to determine the 339.6 assistance payment amount. 339.7 (e) When income is both earned and unearned, the amount of 339.8 the assistance payment must be determined by first treating 339.9 gross earned income as specified in paragraph (a). After 339.10 determining the amount of the assistance payment under paragraph 339.11 (a), unearned income must be subtracted from that amount dollar 339.12 for dollar to determine the assistance payment amount. 339.13 (f) When the monthly income is greater than the 339.14transitional or family wage levelMFIP standard of need after 339.15applicabledeductions and the income will only exceed the 339.16 standard for one month, the county agency must suspend the 339.17 assistance payment for the payment month. 339.18 Sec. 22. Minnesota Statutes 1998, section 256J.24, 339.19 subdivision 2, is amended to read: 339.20 Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 339.21 for minor caregivers and their children who must be in a 339.22 separate assistance unit from the other persons in the 339.23 household, when the following individuals live together, they 339.24 must be included in the assistance unit: 339.25 (1) a minor child, including a pregnant minor; 339.26 (2) the minor child's minor siblings, minor half-siblings, 339.27 and minor step-siblings; 339.28 (3) the minor child's natural parents, adoptive parents, 339.29 and stepparents; and 339.30 (4) the spouse of a pregnant woman. 339.31 Sec. 23. Minnesota Statutes 1998, section 256J.24, 339.32 subdivision 3, is amended to read: 339.33 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 339.34 ASSISTANCE UNIT.] (a) The following individuals who are part of 339.35 the assistance unit determined under subdivision 2 are 339.36 ineligible to receiveMFIP-SMFIP: 340.1 (1) individuals receiving Supplemental Security Income or 340.2 Minnesota supplemental aid; 340.3 (2)individuals living at home while performing340.4court-imposed, unpaid community service work due to a criminal340.5conviction;340.6(3)individuals disqualified from the food stamp program or 340.7MFIP-SMFIP, until the disqualification ends; 340.8(4)(3) children on whose behalf federal, state or local 340.9 foster care payments are made, except as provided in sections 340.10 256J.13, subdivision 2, and 256J.74, subdivision 2; and 340.11(5)(4) children receiving ongoing monthly adoption 340.12 assistance payments under section 259.67. 340.13 (b) The exclusion of a person under this subdivision does 340.14 not alter the mandatory assistance unit composition. 340.15 Sec. 24. Minnesota Statutes 1998, section 256J.24, 340.16 subdivision 7, is amended to read: 340.17 Subd. 7. [FAMILY WAGE LEVEL STANDARD.] The family wage 340.18 level standard is 110 percent of the transitional standard under 340.19 subdivision 5 and is the standard used when there is earned 340.20 income in the assistance unit. As specified in section 256J.21, 340.21 earned income is subtracted from the family wage level to 340.22 determine the amount of the assistance payment. Not including 340.23 the family wage level standard, assistance payments may not 340.24 exceed theshared household standard or the transitionalMFIP 340.25 standard of need for the assistance unit, whichever is less. 340.26 Sec. 25. Minnesota Statutes 1998, section 256J.24, 340.27 subdivision 8, is amended to read: 340.28 Subd. 8. [ASSISTANCE PAID TO ELIGIBLE ASSISTANCE UNITS.] 340.29 Except for assistance units with nonparental caregivers, 340.30 payments for shelter up to the amount of the cash portion 340.31 ofMFIP-SMFIP benefits for which the assistance unit is 340.32 eligible shall be vendor paid for as many months as the 340.33 assistance unit is eligible or six months, whichever comes 340.34 first. The residual amount of the grant after vendor payment, 340.35 if any, must be paid to theMFIP-SMFIP caregiver. 340.36 Sec. 26. Minnesota Statutes 1998, section 256J.24, 341.1 subdivision 9, is amended to read: 341.2 Subd. 9. [SHARED HOUSEHOLD STANDARD;MFIP-SMFIP.] (a) 341.3 Except as prohibited in paragraph (b), the county agency must 341.4 use the shared household standard when the household includes 341.5 one or more unrelated members, as that term is defined in 341.6 section 256J.08, subdivision 86a. The county agency must use 341.7 the shared household standard, unless a member of the assistance 341.8 unit is a victim of domestic violence and has an approved safety 341.9 plan, regardless of the number of unrelated members in the 341.10 household. 341.11 (b) The county agency must not use the shared household 341.12 standard when all unrelated members are one of the following: 341.13 (1) a recipient of public assistance benefits, including 341.14 food stamps, Supplemental Security Income, adoption assistance, 341.15 relative custody assistance, or foster care payments; 341.16 (2) a roomer or boarder, or a person to whom the assistance 341.17 unit is paying room or board; 341.18 (3) a minor child under the age of 18; 341.19 (4) a minor caregiver living with the minor caregiver's 341.20 parents or in an approved supervised living arrangement;or341.21 (5) a caregiver who is not the parent of the minor child in 341.22 the assistance unit; or 341.23 (6) an individual who provides child care to a child in the 341.24 MFIP assistance unit. 341.25 (c) The shared household standard must be discontinued if 341.26 it is not approved by the United States Department of 341.27 Agriculture under theMFIP-SMFIP waiver. 341.28 Sec. 27. Minnesota Statutes 1998, section 256J.24, is 341.29 amended by adding a subdivision to read: 341.30 Subd. 10. [MFIP EXIT LEVEL.] In state fiscal years 2000 341.31 and 2001, the commissioner shall adjust the MFIP earned income 341.32 disregard to ensure that participants do not lose eligibility 341.33 for MFIP until their income reaches at least 120 percent of the 341.34 federal poverty guidelines in effect in October of each fiscal 341.35 year. Adjustments to the disregard shall be based on a 341.36 household size of three and shall be implemented at the same 342.1 time as the October food stamp cost-of-living adjustment is 342.2 reflected in the food portion of MFIP transitional standard as 342.3 required under subdivision 5a. 342.4 Sec. 28. Minnesota Statutes 1998, section 256J.26, 342.5 subdivision 1, is amended to read: 342.6 Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a) 342.7 Applicants or participants who have been convicted of a drug 342.8 offense committed after July 1, 1997, may, if otherwise 342.9 eligible, receiveAFDC or MFIP-SMFIP benefits subject to the 342.10 following conditions: 342.11 (1) Benefits for the entire assistance unit must be paid in 342.12 vendor form for shelter and utilities during any time the 342.13 applicant is part of the assistance unit. 342.14 (2) The convicted applicant or participant shall be subject 342.15 to random drug testing as a condition of continued eligibility 342.16 and following any positive test for an illegal controlled 342.17 substance is subject to the following sanctions: 342.18 (i) for failing a drug test the first time, the 342.19 participant's grant shall be reduced by ten percent of the 342.20MFIP-S transitionalMFIP standard of need,the shared household342.21standard, or the interstate transitional standard, whichever is342.22applicableprior to making vendor payments for shelter and 342.23 utility costs; or 342.24 (ii) for failing a drug test two or more times, the 342.25 residual amount of the participant's grant after making vendor 342.26 payments for shelter and utility costs, if any, must be reduced 342.27 by an amount equal to 30 percent of theMFIP-S transitional342.28standard, the shared household standard, or the interstate342.29transitional standard, whichever is applicableMFIP standard of 342.30 need. 342.31 (3) A participant who fails an initial drug test and is 342.32 under a sanction due to other MFIP program requirements is 342.33 subject to the sanction in clause (2)(ii). 342.34 (b) Applicants requesting only food stamps or participants 342.35 receiving only food stamps, who have been convicted of a drug 342.36 offense that occurred after July 1, 1997, may, if otherwise 343.1 eligible, receive food stamps if the convicted applicant or 343.2 participant is subject to random drug testing as a condition of 343.3 continued eligibility. Following a positive test for an illegal 343.4 controlled substance, the applicant is subject to the following 343.5 sanctions: 343.6 (1) for failing a drug test the first time, food stamps 343.7 shall be reduced by ten percent of the applicable food stamp 343.8 allotment; and 343.9 (2) for failing a drug test two or more times, food stamps 343.10 shall be reduced by an amount equal to 30 percent of the 343.11 applicable food stamp allotment. 343.12 (c) For the purposes of this subdivision, "drug offense" 343.13 meansa convictionan offense that occurred after July 1, 1997, 343.14 of sections 152.021 to 152.025, 152.0261, or 152.096. Drug 343.15 offense also means a conviction in another jurisdiction of the 343.16 possession, use, or distribution of a controlled substance, or 343.17 conspiracy to commit any of these offenses, if the offense 343.18 occurred after July 1, 1997, and the conviction is a felony 343.19 offense in that jurisdiction, or in the case of New Jersey, a 343.20 high misdemeanor. 343.21 Sec. 29. Minnesota Statutes 1998, section 256J.30, 343.22 subdivision 2, is amended to read: 343.23 Subd. 2. [REQUIREMENT TO APPLY FOR OTHER BENEFITS.] An 343.24 applicant or participant must apply for, accept if eligible, and 343.25 follow through with appealing any denials of eligibility for 343.26 benefits from other programs for which the applicant or 343.27 participant is potentially eligible and which would, if 343.28 received, offset assistance payments. An applicant's or 343.29 participant's failure to complete application for these benefits 343.30 without good cause results in denial or termination of 343.31 assistance. Good cause for failure to apply for these benefits 343.32 is allowed when circumstances beyond the control of the 343.33 applicant or participant prevent the applicant or participant 343.34 from making an application. 343.35 Sec. 30. Minnesota Statutes 1998, section 256J.30, 343.36 subdivision 7, is amended to read: 344.1 Subd. 7. [DUE DATE OFMFIP-SMFIP HOUSEHOLD REPORT FORM.] 344.2 AnMFIP-SMFIP household report form must be received by the 344.3 county agency by the eighth calendar day of the month following 344.4 the reporting period covered by the form. When the eighth 344.5 calendar day of the month falls on a weekend or holiday, 344.6 theMFIP-SMFIP household report form must be received by the 344.7 county agency the first working day that follows the eighth 344.8 calendar day.The county agency must send a notice of344.9termination because of a late or incomplete MFIP-S household344.10report form.344.11 Sec. 31. Minnesota Statutes 1998, section 256J.30, 344.12 subdivision 8, is amended to read: 344.13 Subd. 8. [LATEMFIP-SMFIP HOUSEHOLD REPORT FORMS.] 344.14 Paragraphs (a) to (d) apply to the reporting requirements in 344.15 subdivision 7. 344.16 (a) Whena caregiver submitsthe county agency receives an 344.17 incompleteMFIP-SMFIP household report formbefore the last344.18working day of the month on which a ten-day notice of344.19termination can be issued, the county agency must immediately 344.20 return the incomplete formon or before the ten-day notice344.21deadline or any previously sent ten-day notice of termination is344.22invalidand clearly state what the caregiver must do for the 344.23 form to be complete. 344.24 (b)When a complete MFIP-S household report form is not344.25received by a county agency before the last ten days of the344.26month in which the form is due, the county agency must sendThe 344.27 automated eligibility system must send a notice of proposed 344.28 termination of assistance to the assistance unit if a complete 344.29 MFIP household report form is not received by a county agency. 344.30 The automated notice must be mailed to the caregiver by 344.31 approximately the 16th of the month. When a caregiver submits 344.32 an incomplete form on or after the date a notice of proposed 344.33 termination has been sent, the termination is valid unless the 344.34 caregiver submits a complete form before the end of the month. 344.35 (c) An assistance unit required to submit anMFIP-SMFIP 344.36 household report form is considered to have continued its 345.1 application for assistance if a completeMFIP-SMFIP household 345.2 report form is received within a calendar month after the month 345.3 in whichassistance was receivedthe form was due and assistance 345.4 shall be paid for the period beginning with the first day ofthe345.5month in which the report was duethat calendar month. 345.6 (d) A county agency must allow good cause exemptions from 345.7 the reporting requirements under subdivisions 5 and 6 when any 345.8 of the following factors cause a caregiver to fail to provide 345.9 the county agency with a completedMFIP-SMFIP household report 345.10 form before the end of the month in which the form is due: 345.11 (1) an employer delays completion of employment 345.12 verification; 345.13 (2) a county agency does not help a caregiver complete the 345.14MFIP-SMFIP household report form when the caregiver asks for 345.15 help; 345.16 (3) a caregiver does not receive anMFIP-SMFIP household 345.17 report form due to mistake on the part of the department or the 345.18 county agency or due to a reported change in address; 345.19 (4) a caregiver is ill, or physically or mentally 345.20 incapacitated; or 345.21 (5) some other circumstance occurs that a caregiver could 345.22 not avoid with reasonable care which prevents the caregiver from 345.23 providing a completedMFIP-SMFIP household report form before 345.24 the end of the month in which the form is due. 345.25 Sec. 32. Minnesota Statutes 1998, section 256J.30, 345.26 subdivision 9, is amended to read: 345.27 Subd. 9. [CHANGES THAT MUST BE REPORTED.] A caregiver must 345.28 report the changes or anticipated changes specified in clauses 345.29 (1) to (16) within ten days of the date they occur,within ten345.30days of the date the caregiver learns that the change will345.31occur,at the time of the periodic recertification of 345.32 eligibility under section 256J.32, subdivision 6, or within 345.33 eight calendar days of a reporting period as in subdivision 5 or 345.34 6, whichever occurs first. A caregiver must report other 345.35 changes at the time of the periodic recertification of 345.36 eligibility under section 256J.32, subdivision 6, or at the end 346.1 of a reporting period under subdivision 5 or 6, as applicable. 346.2 A caregiver must make these reports in writing to the county 346.3 agency. When a county agency could have reduced or terminated 346.4 assistance for one or more payment months if a delay in 346.5 reporting a change specified under clauses (1) to (16) had not 346.6 occurred, the county agency must determine whether a timely 346.7 notice under section 256J.31, subdivision 4, could have been 346.8 issued on the day that the change occurred. When a timely 346.9 notice could have been issued, each month's overpayment 346.10 subsequent to that notice must be considered a client error 346.11 overpayment under section 256J.38. Calculation of overpayments 346.12 for late reporting under clause (17) is specified in section 346.13 256J.09, subdivision 9. Changes in circumstances which must be 346.14 reported within ten days must also be reported on theMFIP-S346.15 MFIP household report form for the reporting period in which 346.16 those changes occurred. Within ten days, a caregiver must 346.17 report: 346.18 (1) a change in initial employment; 346.19 (2) a change in initial receipt of unearned income; 346.20 (3) a recurring change in unearned income; 346.21 (4) a nonrecurring change of unearned income that exceeds 346.22 $30; 346.23 (5) the receipt of a lump sum; 346.24 (6) an increase in assets that may cause the assistance 346.25 unit to exceed asset limits; 346.26 (7) a change in the physical or mental status of an 346.27 incapacitated member of the assistance unit if the physical or 346.28 mental status is the basis of exemption from anMFIP-S work and346.29trainingMFIP employment services program; 346.30 (8) a change in employment status; 346.31 (9)a change in household composition, including births,346.32returns to and departures from the home of assistance unit346.33members and financially responsible persons, or a change in the346.34custody of a minor childinformation affecting an exception 346.35 under section 256J.24, subdivision 9; 346.36 (10) a change in health insurance coverage; 347.1 (11) the marriage or divorce of an assistance unit member; 347.2 (12) the death of a parent, minor child, or financially 347.3 responsible person; 347.4 (13) a change in address or living quarters of the 347.5 assistance unit; 347.6 (14) the sale, purchase, or other transfer of property; 347.7 (15) a change in school attendance of a custodial parent or 347.8 an employed child;and347.9 (16) filing a lawsuit, a workers' compensation claim, or a 347.10 monetary claim against a third party; and 347.11 (17) a change in household composition, including births, 347.12 returns to and departures from the home of assistance unit 347.13 members and financially responsible persons, or a change in the 347.14 custody of a minor child. 347.15 Sec. 33. Minnesota Statutes 1998, section 256J.31, 347.16 subdivision 5, is amended to read: 347.17 Subd. 5. [MAILING OF NOTICE.] The notice of adverse action 347.18 shall be issued according to paragraphs (a) to(c)(d). 347.19 (a) Acounty agency shall mail anotice of adverse action 347.20 must be mailed at least ten days before the effective date of 347.21 the adverse action, except as provided in paragraphs (b)and (c)347.22 to (d). 347.23 (b)A county agency must mail a notice of adverse action at347.24least five days before the effective date of the adverse action347.25when the county agency has factual information that requires an347.26action to reduce, suspend, or terminate assistance based on347.27probable fraud.347.28(c) A county agency shall mailA notice of adverse action 347.29before or on the effective date of the adverse actionmust be 347.30 mailed no later than four working days before the end of the 347.31 month when the county agency: 347.32 (1)receives the caregiver's signed monthly MFIP-S347.33household report form that includes information that requires347.34payment reduction, suspension, or termination;347.35(2)is informed of the death ofa participantthe only 347.36 caregiver orthepayee in an assistance unit; 348.1(3)(2) receives a signed statement from the caregiver that 348.2 assistance is no longer wanted; 348.3(4) receives a signed statement from the caregiver that348.4provides information that requires the termination or reduction348.5of assistance(3) has factual information to reduce, suspend, or 348.6 terminate assistance based on the failure to timely report 348.7 changes; 348.8(5) verifies that a member of the assistance unit is absent348.9from the home and does not meet temporary absence provisions in348.10section 256J.13;348.11(6)(4) verifies that a member of the assistance unit has 348.12 entered a regional treatment center or a licensed residential 348.13 facility for medical or psychological treatment or 348.14 rehabilitation; 348.15(7)(5) verifies that a member of an assistance unit has 348.16 been removed from the home as a result of a judicial 348.17 determination or placed in foster care, and the provisions of 348.18 section 256J.13, subdivision 2, paragraph (c), clause (2), do 348.19 not apply; 348.20(8) verifies that a member of an assistance unit has been348.21approved to receive assistance by another state;or 348.22(9)(6) cannot locate a caregiver. 348.23 (c) A notice of adverse action must be mailed for a payment 348.24 month when the caregiver makes a written request for closure 348.25 before the first of that payment month. 348.26 (d) A notice of adverse action must be mailed before the 348.27 effective date of the adverse action when the county agency 348.28 receives the caregiver's signed and completed MFIP household 348.29 report form or recertification form that includes information 348.30 that requires payment reduction, suspension, or termination. 348.31 Sec. 34. Minnesota Statutes 1998, section 256J.31, 348.32 subdivision 12, is amended to read: 348.33 Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 348.34 participant who is not in vendor payment status may discontinue 348.35 receipt of the cash assistance portion ofMFIP-SMFIP assistance 348.36 grant and retain eligibility for child care assistance under 349.1 section 119B.05 and for medical assistance under sections 349.2 256B.055, subdivision 3a, and 256B.0635. For the months a 349.3 participant chooses to discontinue the receipt of the cash 349.4 portion of the MFIP grant, the assistance unit accrues months of 349.5 eligibility to be applied toward eligibility for child care 349.6 under section 119B.05 and for medical assistance under sections 349.7 256B.055, subdivision 3a, and 256B.0635. 349.8 Sec. 35. Minnesota Statutes 1998, section 256J.32, 349.9 subdivision 4, is amended to read: 349.10 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 349.11 verify the following at application: 349.12 (1) identity of adults; 349.13 (2) presence of the minor child in the home, if 349.14 questionable; 349.15 (3) relationship of a minor child to caregivers in the 349.16 assistance unit; 349.17 (4) age, if necessary to determineMFIP-SMFIP eligibility; 349.18 (5) immigration status; 349.19 (6) social security number according to the requirements of 349.20 section 256J.30, subdivision 12; 349.21 (7) income; 349.22 (8) self-employment expenses used as a deduction; 349.23 (9) source and purpose of deposits and withdrawals from 349.24 business accounts; 349.25 (10) spousal support and child support payments made to 349.26 persons outside the household; 349.27 (11) real property; 349.28 (12) vehicles; 349.29 (13) checking and savings accounts; 349.30 (14) savings certificates, savings bonds, stocks, and 349.31 individual retirement accounts; 349.32 (15) pregnancy, if related to eligibility; 349.33 (16) inconsistent information, if related to eligibility; 349.34 (17) medical insurance; 349.35 (18)anticipated graduation date of an 18-year-old;349.36(19)burial accounts; 350.1(20)(19) school attendance, if related to eligibility; 350.2(21)(20) residence; 350.3(22)(21) a claim of domestic violence if used as a basis 350.4 for a deferral or exemption from the 60-month time limit in 350.5 section 256J.42 or employment and training services requirements 350.6 in section 256J.56;and350.7(23)(22) disability if used as an exemption from 350.8 employment and training services requirements under section 350.9 256J.56; and 350.10 (23) information needed to establish an exception under 350.11 section 256J.24, subdivision 9. 350.12 Sec. 36. Minnesota Statutes 1998, section 256J.32, 350.13 subdivision 6, is amended to read: 350.14 Subd. 6. [RECERTIFICATION.] The county agency shall 350.15 recertify eligibility in an annual face-to-face interview with 350.16 the participant and verify the following: 350.17 (1) presence of the minor child in the home, if 350.18 questionable; 350.19 (2) income, unless excluded, including self-employment 350.20 expenses used as a deduction or deposits or withdrawals from 350.21 business accounts; 350.22 (3) assets when the value is within $200 of the asset 350.23 limit;and350.24 (4) information to establish an exception under section 350.25 256J.24, subdivision 9, if questionable; and 350.26 (5) inconsistent information, if related to eligibility. 350.27 Sec. 37. Minnesota Statutes 1998, section 256J.33, is 350.28 amended to read: 350.29 256J.33 [PROSPECTIVE AND RETROSPECTIVE DETERMINATION OF 350.30MFIP-SMFIP ELIGIBILITY.] 350.31 Subdivision 1. [DETERMINATION OF ELIGIBILITY.] A county 350.32 agency must determineMFIP-SMFIP eligibility prospectively for 350.33 a payment month based on retrospectively assessing income and 350.34 the county agency's best estimate of the circumstances that will 350.35 exist in the payment month. 350.36 Except as described in section 256J.34, subdivision 1, when 351.1 prospective eligibility exists, a county agency must calculate 351.2 the amount of the assistance payment using retrospective 351.3 budgeting. To determineMFIP-SMFIP eligibility and the 351.4 assistance payment amount, a county agency must apply countable 351.5 income, described in section 256J.37, subdivisions 3 to 10, 351.6 received by members of an assistance unit or by other persons 351.7 whose income is counted for the assistance unit, described under 351.8 sections 256J.21 and 256J.37, subdivisions 1 to 2. 351.9 This income must be applied to thetransitionalMFIP 351.10 standard, shared household standard,of need or family 351.11 wagestandardlevel subject to this section and sections 256J.34 351.12 to 256J.36. Income received in a calendar month and not 351.13 otherwise excluded under section 256J.21, subdivision 2, must be 351.14 applied to the needs of an assistance unit. 351.15 Subd. 2. [PROSPECTIVE ELIGIBILITY.] A county agency must 351.16 determine whether the eligibility requirements that pertain to 351.17 an assistance unit, including those in sections 256J.11 to 351.18 256J.15 and 256J.20, will be met prospectively for the payment 351.19 month. Except for the provisions in section 256J.34, 351.20 subdivision 1, the income test will be applied retrospectively. 351.21 Subd. 3. [RETROSPECTIVE ELIGIBILITY.] After the first two 351.22 months ofMFIP-SMFIP eligibility, a county agency must continue 351.23 to determine whether an assistance unit is prospectively 351.24 eligible for the payment month by looking at all factors other 351.25 than income and then determine whether the assistance unit is 351.26 retrospectively income eligible by applying the monthly income 351.27 test to the income from the budget month. When the monthly 351.28 income test is not satisfied, the assistance payment must be 351.29 suspended when ineligibility exists for one month or ended when 351.30 ineligibility exists for more than one month. 351.31 Subd. 4. [MONTHLY INCOME TEST.] A county agency must apply 351.32 the monthly income test retrospectively for each month ofMFIP-S351.33 MFIP eligibility. An assistance unit is not eligible when the 351.34 countable income equals or exceeds thetransitionalMFIP 351.35 standard, the shared household standard,of need or the family 351.36 wage level for the assistance unit. The income applied against 352.1 the monthly income test must include: 352.2 (1) gross earned income from employment, prior to mandatory 352.3 payroll deductions, voluntary payroll deductions, wage 352.4 authorizations, and after the disregards in section 256J.21, 352.5 subdivision 4, and the allocations in section 256J.36, unless 352.6 the employment income is specifically excluded under section 352.7 256J.21, subdivision 2; 352.8 (2) gross earned income from self-employment less 352.9 deductions for self-employment expenses in section 256J.37, 352.10 subdivision 5, but prior to any reductions for personal or 352.11 business state and federal income taxes, personal FICA, personal 352.12 health and life insurance, and after the disregards in section 352.13 256J.21, subdivision 4, and the allocations in section 256J.36; 352.14 (3) unearned income after deductions for allowable expenses 352.15 in section 256J.37, subdivision 9, and allocations in section 352.16 256J.36, unless the income has been specifically excluded in 352.17 section 256J.21, subdivision 2; 352.18 (4) gross earned income from employment as determined under 352.19 clause (1) which is received by a member of an assistance unit 352.20 who is a minor child or minor caregiver and less than a 352.21 half-time student; 352.22 (5) child support and spousal support received or 352.23 anticipated to be received by an assistance unit; 352.24 (6) the income of a parent when that parent is not included 352.25 in the assistance unit; 352.26 (7) the income of an eligible relative and spouse who seek 352.27 to be included in the assistance unit; and 352.28 (8) the unearned income of a minor child included in the 352.29 assistance unit. 352.30 Subd. 5. [WHEN TO TERMINATE ASSISTANCE.] When an 352.31 assistance unit is ineligible forMFIP-SMFIP assistance for two 352.32 consecutive months, the county agency must terminateMFIP-SMFIP 352.33 assistance. 352.34 Sec. 38. Minnesota Statutes 1998, section 256J.34, 352.35 subdivision 1, is amended to read: 352.36 Subdivision 1. [PROSPECTIVE BUDGETING.] A county agency 353.1 must use prospective budgeting to calculate the assistance 353.2 payment amount for the first two months for an applicant who has 353.3 not received assistance in this state for at least one payment 353.4 month preceding the first month of payment under a current 353.5 application. Notwithstanding subdivision 3, paragraph (a), 353.6 clause (2), a county agency must use prospective budgeting for 353.7 the first two months for a person who applies to be added to an 353.8 assistance unit. Prospective budgeting is not subject to 353.9 overpayments or underpayments unless fraud is determined under 353.10 section 256.98. 353.11 (a) The county agency must apply the income received or 353.12 anticipated in the first month ofMFIP-SMFIP eligibility 353.13 against the need of the first month. The county agency must 353.14 apply the income received or anticipated in the second month 353.15 against the need of the second month. 353.16 (b) When the assistance payment for any part of the first 353.17 two months is based on anticipated income, the county agency 353.18 must base the initial assistance payment amount on the 353.19 information available at the time the initial assistance payment 353.20 is made. 353.21 (c) The county agency must determine the assistance payment 353.22 amount for the first two months ofMFIP-SMFIP eligibility by 353.23 budgeting both recurring and nonrecurring income for those two 353.24 months. 353.25 (d) The county agency must budget the child support income 353.26 received or anticipated to be received by an assistance unit to 353.27 determine the assistance payment amount from the month of 353.28 application through the date in whichMFIP-SMFIP eligibility is 353.29 determined and assistance is authorized. Child support income 353.30 which has been budgeted to determine the assistance payment in 353.31 the initial two months is considered nonrecurring income. An 353.32 assistance unit must forward any payment of child support to the 353.33 child support enforcement unit of the county agency following 353.34 the date in which assistance is authorized. 353.35 Sec. 39. Minnesota Statutes 1998, section 256J.34, 353.36 subdivision 3, is amended to read: 354.1 Subd. 3. [ADDITIONAL USES OF RETROSPECTIVE BUDGETING.] 354.2 Notwithstanding subdivision 1, the county agency must use 354.3 retrospective budgeting to calculate the monthly assistance 354.4 payment amount for the first two months under paragraphs (a) and 354.5 (b). 354.6 (a) The county agency must use retrospective budgeting to 354.7 determine the amount of the assistance payment in the first two 354.8 months ofMFIP-SMFIP eligibility: 354.9 (1) when an assistance unit applies for assistance for the 354.10 same month for which assistance has been interrupted, the 354.11 interruption in eligibility is less than one payment month, the 354.12 assistance payment for the preceding month was issued in this 354.13 state, and the assistance payment for the immediately preceding 354.14 month was determined retrospectively; or 354.15 (2) when a person applies in order to be added to an 354.16 assistance unit, that assistance unit has received assistance in 354.17 this state for at least the two preceding months, and that 354.18 person has been living with and has been financially responsible 354.19 for one or more members of that assistance unit for at least the 354.20 two preceding months. 354.21 (b) Except as provided in clauses (1) to (4), the county 354.22 agency must use retrospective budgeting and apply income 354.23 received in the budget month by an assistance unit and by a 354.24 financially responsible household member who is not included in 354.25 the assistance unit against theappropriate transitional or354.26family wage levelMFIP standard of need or family wage level to 354.27 determine the assistance payment to be issued for the payment 354.28 month. 354.29 (1) When a source of income ends prior to the third payment 354.30 month, that income is not considered in calculating the 354.31 assistance payment for that month. When a source of income ends 354.32 prior to the fourth payment month, that income is not considered 354.33 when determining the assistance payment for that month. 354.34 (2) When a member of an assistance unit or a financially 354.35 responsible household member leaves the household of the 354.36 assistance unit, the income of that departed household member is 355.1 not budgeted retrospectively for any full payment month in which 355.2 that household member does not live with that household and is 355.3 not included in the assistance unit. 355.4 (3) When an individual is removed from an assistance unit 355.5 because the individual is no longer a minor child, the income of 355.6 that individual is not budgeted retrospectively for payment 355.7 months in which that individual is not a member of the 355.8 assistance unit, except that income of an ineligible child in 355.9 the household must continue to be budgeted retrospectively 355.10 against the child's needs when the parent or parents of that 355.11 child request allocation of their income against any unmet needs 355.12 of that ineligible child. 355.13 (4) When a person ceases to have financial responsibility 355.14 for one or more members of an assistance unit, the income of 355.15 that person is not budgeted retrospectively for the payment 355.16 months which follow the month in which financial responsibility 355.17 ends. 355.18 Sec. 40. Minnesota Statutes 1998, section 256J.34, 355.19 subdivision 4, is amended to read: 355.20 Subd. 4. [SIGNIFICANT CHANGE IN GROSS INCOME.] The county 355.21 agency must recalculate the assistance payment when an 355.22 assistance unit experiences a significant change, as defined in 355.23 section 256J.08, resulting in a reduction in the gross income 355.24 received in the payment month from the gross income received in 355.25 the budget month. The county agency must issue a supplemental 355.26 assistance payment based on the county agency's best estimate of 355.27 the assistance unit's income and circumstances for the payment 355.28 month.Budget adjustmentsSupplemental assistance payments that 355.29 result from significant changes are limited to two in a 12-month 355.30 period regardless of the reason for the change.Budget355.31adjustmentsNotwithstanding any other statute or rule of law, 355.32 supplementary assistance payments shall not be made when the 355.33 significant change in income is the result of receipt of a lump 355.34 sum, receipt of an extra paycheck, business fluctuation in 355.35 self-employment income, or an assistance unit member's 355.36 participation in a strike or other labor action. Supplementary 356.1 assistance payments due to a significant change in the amount of 356.2 direct support received must not be made after the date the 356.3 assistance unit is required to forward support to the child 356.4 support enforcement unit under subdivision 1, paragraph (d). 356.5 Sec. 41. Minnesota Statutes 1998, section 256J.35, is 356.6 amended to read: 356.7 256J.35 [AMOUNT OF ASSISTANCE PAYMENT.] 356.8 Except as provided in paragraphs (a) to(d)(c), the amount 356.9 of an assistance payment is equal to the difference between the 356.10transitionalMFIP standard, shared household standard,of need 356.11 or the Minnesota family wage level in section 256J.24, whichever356.12is less,and countable income. 356.13 (a) WhenMFIP-SMFIP eligibility exists for the month of 356.14 application, the amount of the assistance payment for the month 356.15 of application must be prorated from the date of application or 356.16 the date all other eligibility factors are met for that 356.17 applicant, whichever is later. This provision applies when an 356.18 applicant loses at least one day ofMFIP-SMFIP eligibility. 356.19 (b)MFIP-SMFIP overpayments to an assistance unit must be 356.20 recouped according to section 256J.38, subdivision 4. 356.21 (c) An initial assistance payment must not be made to an 356.22 applicant who is not eligible on the date payment is made. 356.23(d) An individual whose needs have been otherwise provided356.24for in another state, in whole or in part by county, state, or356.25federal dollars during a month, is ineligible to receive MFIP-S356.26for the month.356.27 Sec. 42. Minnesota Statutes 1998, section 256J.36, is 356.28 amended to read: 356.29 256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD 356.30 MEMBERS.] 356.31 Except as prohibited in paragraphs (a) and (b), an 356.32 allocation of income is allowed from the caregiver's income to 356.33 meet the unmet need of an ineligible spouse or an ineligible 356.34 child under the age of 21 for whom the caregiver is financially 356.35 responsible who also lives with the caregiver. That allocation 356.36 is allowed in an amount up to the difference between theMFIP-S357.1transitionalMFIP standard of need for the assistance unit when 357.2 that ineligible person is included in the assistance unit and 357.3 theMFIP-S family allowanceMFIP standard of need for the 357.4 assistance unit when the ineligible person is not included in 357.5 the assistance unit. These allocations must be deducted from 357.6 the caregiver's counted earnings and from unearned income 357.7 subject to paragraphs (a) and (b). 357.8 (a) Income of a minor child in the assistance unit must not 357.9 be allocated to meet the need of an ineligible person, including 357.10 the child's parent, even when that parent is the payee of the 357.11 child's income. 357.12 (b) Income of a caregiver must not be allocated to meet the 357.13 needs of a disqualified person. 357.14 Sec. 43. Minnesota Statutes 1998, section 256J.37, 357.15 subdivision 1, is amended to read: 357.16 Subdivision 1. [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD 357.17 MEMBERS.] Unless otherwise provided under subdivision 1a or 1b, 357.18 the income of ineligible household members must be deemed after 357.19 allowing the following disregards: 357.20 (1) the first 18 percent of the ineligible family member's 357.21 gross earned income; 357.22 (2) amounts the ineligible person actually paid to 357.23 individuals not living in the same household but whom the 357.24 ineligible person claims or could claim as dependents for 357.25 determining federal personal income tax liability; 357.26 (3) all payments made by the ineligible person according to 357.27 a court order for spousal support or the support of children not 357.28 living in the assistance unit's household, provided that, if 357.29 there has been a change in the financial circumstances of the 357.30 ineligible person since the support order was entered, the 357.31 ineligible person has petitioned for a modification of the 357.32 support order; and 357.33 (4) an amount for the needs of the ineligible person and 357.34 other persons who live in the household but are not included in 357.35 the assistance unit and are or could be claimed by an ineligible 357.36 person as dependents for determining federal personal income tax 358.1 liability. This amount is equal to the difference between the 358.2MFIP-S transitionalMFIP standard of need when the ineligible 358.3 person is included in the assistance unit and theMFIP-S358.4transitionalMFIP standard of need when the ineligible person is 358.5 not included in the assistance unit. 358.6 Sec. 44. Minnesota Statutes 1998, section 256J.37, 358.7 subdivision 1a, is amended to read: 358.8 Subd. 1a. [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The 358.9 income of disqualified members must be deemed after allowing the 358.10 following disregards: 358.11 (1) the first 18 percent of the disqualified member's gross 358.12 earned income; 358.13 (2) amounts the disqualified member actually paid to 358.14 individuals not living in the same household but whom the 358.15 disqualified member claims or could claim as dependents for 358.16 determining federal personal income tax liability; 358.17 (3) all payments made by the disqualified member according 358.18 to a court order for spousal support or the support of children 358.19 not living in the assistance unit's household, provided that, if 358.20 there has been a change in the financial circumstances of the 358.21 disqualified member's legal obligation to pay support since the 358.22 support order was entered, the disqualified member has 358.23 petitioned for a modification of the support order; and 358.24 (4) an amount for the needs of other persons who live in 358.25 the household but are not included in the assistance unit and 358.26 are or could be claimed by the disqualified member as dependents 358.27 for determining federal personal income tax liability. This 358.28 amount is equal to the difference between theMFIP-S358.29transitionalMFIP standard of need when the ineligible person is 358.30 included in the assistance unit and theMFIP-S transitionalMFIP 358.31 standard of need when the ineligible person is not included in 358.32 the assistance unit. An amount shall not be allowed for the 358.33 needs of a disqualified member. 358.34 Sec. 45. Minnesota Statutes 1998, section 256J.37, 358.35 subdivision 2, is amended to read: 358.36 Subd. 2. [DEEMED INCOME AND ASSETS OF SPONSOR OF 359.1 NONCITIZENS.]If a noncitizen applies for or receives MFIP-S,359.2the county must deem the income and assets of the noncitizen's359.3sponsor and the sponsor's spouse who have signed an affidavit of359.4support for the noncitizen as specified in Public Law Number359.5104-193, title IV, sections 421 and 422, the Personal359.6Responsibility and Work Opportunity Reconciliation Act of 1996.359.7The income of a sponsor and the sponsor's spouse is considered359.8unearned income of the noncitizen. The assets of a sponsor and359.9the sponsor's spouse are considered available assets of the359.10noncitizen.(a) If a noncitizen applies for or receives MFIP, 359.11 the county must deem the income and assets of the noncitizen's 359.12 sponsor and the sponsor's spouse as provided in this paragraph 359.13 and paragraph (b) or (c), whichever is applicable. The deemed 359.14 income of a sponsor and the sponsor's spouse is considered 359.15 unearned income of the noncitizen. The deemed assets of a 359.16 sponsor and the sponsor's spouse are considered available assets 359.17 of the noncitizen. 359.18 (b) The income and assets of a sponsor who signed an 359.19 affidavit of support under title IV, sections 421, 422, and 423, 359.20 of Public Law Number 104-193, the Personal Responsibility and 359.21 Work Opportunity Reconciliation Act of 1996, and the income and 359.22 assets of the sponsor's spouse, must be deemed to the noncitizen 359.23 to the extent required by those sections of Public Law Number 359.24 104-193. 359.25 (c) The income and assets of a sponsor and the sponsor's 359.26 spouse to whom the provisions of paragraph (b) do not apply must 359.27 be deemed to the noncitizen to the full extent allowed under 359.28 title V, section 5505, of Public Law Number 105-33, the Balanced 359.29 Budget Act of 1997. 359.30 Sec. 46. Minnesota Statutes 1998, section 256J.37, 359.31 subdivision 9, is amended to read: 359.32 Subd. 9. [UNEARNED INCOME.](a)The county agency must 359.33 apply unearned income to thetransitionalapplicable MFIP 359.34 standard. When determining the amount of unearned income, the 359.35 county agency must deduct the costs necessary to secure payments 359.36 of unearned income. These costs include legal fees, medical 360.1 fees, and mandatory deductions such as federal and state income 360.2 taxes. 360.3(b) Effective July 1, 1999, the county agency shall count360.4$100 of the value of public and assisted rental subsidies360.5provided through the Department of Housing and Urban Development360.6(HUD) as unearned income. The full amount of the subsidy must360.7be counted as unearned income when the subsidy is less than $100.360.8 Sec. 47. Minnesota Statutes 1998, section 256J.37, 360.9 subdivision 10, is amended to read: 360.10 Subd. 10. [TREATMENT OF LUMP SUMS.] (a) The county agency 360.11 must treat lump-sum payments as earned or unearned income. If 360.12 the lump-sum payment is included in the category of income 360.13 identified in subdivision 9, it must be treated as unearned 360.14 income. A lump sum is counted as income in the month received 360.15 and budgeted either prospectively or retrospectively depending 360.16 on the budget cycle at the time of receipt. When an individual 360.17 receives a lump-sum payment, that lump sum must be combined with 360.18 all other earned and unearned income received in the same budget 360.19 month, and it must be applied according to paragraphs (a) to 360.20 (c). A lump sum may not be carried over into subsequent months. 360.21 Any funds that remain in the third month after the month of 360.22 receipt are counted in the asset limit. 360.23 (b) For a lump sum received by an applicant during the 360.24 first two months, prospective budgeting is used to determine the 360.25 payment and the lump sum must be combined with other earned or 360.26 unearned income received and budgeted in that prospective month. 360.27 (c) For a lump sum received by a participant after the 360.28 first two months ofMFIP-SMFIP eligibility, the lump sum must 360.29 be combined with other income received in that budget month, and 360.30 the combined amount must be applied retrospectively against the 360.31 applicable payment month. 360.32 (d) When a lump sum, combined with other income under 360.33 paragraphs (b) and (c), is less than thetransitionalMFIP 360.34 standard of need for theapplicableappropriate payment month, 360.35 the assistance payment must be reduced according to the amount 360.36 of the countable income. When the countable income is greater 361.1 than thetransitionalMFIP standardor the family wage361.2standardor family wage level, the assistance payment must be 361.3 suspended for the payment month. 361.4 Sec. 48. Minnesota Statutes 1998, section 256J.38, 361.5 subdivision 4, is amended to read: 361.6 Subd. 4. [RECOUPING OVERPAYMENTS FROM PARTICIPANTS.] A 361.7 participant may voluntarily repay, in part or in full, an 361.8 overpayment even if assistance is reduced under this 361.9 subdivision, until the total amount of the overpayment is 361.10 repaid. When an overpayment occurs due to fraud, the county 361.11 agency must recover ten percent of thetransitionalapplicable 361.12 standard or the amount of the monthly assistance payment, 361.13 whichever is less. When a nonfraud overpayment occurs, the 361.14 county agency must recover three percent of thetransitional361.15 MFIP standard of need or the amount of the monthly assistance 361.16 payment, whichever is less. 361.17 Sec. 49. Minnesota Statutes 1998, section 256J.42, 361.18 subdivision 1, is amended to read: 361.19 Subdivision 1. [TIME LIMIT.] (a) Except for the exemptions 361.20 in this sectionand in section 256J.11, subdivision 2, an 361.21 assistance unit in which any adult caregiver has received 60 361.22 months of cash assistance funded in whole or in part by the TANF 361.23 block grant in this or any other state or United States 361.24 territory,MFIP-Sor from a tribal TANF program, MFIP, AFDC, or 361.25 family general assistance, funded in whole or in part by state 361.26 appropriations, is ineligible to receiveMFIP-SMFIP. Any cash 361.27 assistance funded with TANF dollars in this or any other state 361.28 or United States territory, or from a tribal TANF program, or 361.29MFIP-SMFIP assistance funded in whole or in part by state 361.30 appropriations, that was received by the unit on or after the 361.31 date TANF was implemented, including any assistance received in 361.32 states or United States territories of prior residence, counts 361.33 toward the 60-month limitation. The 60-month limit applies to a 361.34 minor who is the head of a household or who is married to the 361.35 head of a household except under subdivision 5. The 60-month 361.36 time period does not need to be consecutive months for this 362.1 provision to apply. 362.2 (b) The months before July 1998 in which individuals 362.3receivereceived assistance as part of the field trials as an 362.4 MFIP, MFIP-R, or MFIP or MFIP-R comparison group familyunder362.5sections 256.031 to 256.0361 or sections 256.047 to 256.048are 362.6 not included in the 60-month time limit. 362.7 Sec. 50. Minnesota Statutes 1998, section 256J.42, 362.8 subdivision 5, is amended to read: 362.9 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 362.10 assistance received by an assistance unit does not count toward 362.11 the 60-month limit on assistance during a month in which the 362.12 caregiver is in the category in section 256J.56, paragraph (a), 362.13 clause (1).The exemption applies for the period of time the362.14caregiver belongs to one of the categories specified in this362.15subdivision.362.16 (b) From July 1, 1997, until the dateMFIP-SMFIP is 362.17 operative in the caregiver's county of financial responsibility, 362.18 any cash assistance received by a caregiver who is complying 362.19 with sections 256.73, subdivision 5a, and 256.736, if 362.20 applicable, does not count toward the 60-month limit on 362.21 assistance. Thereafter, any cash assistance received by a minor 362.22 caregiver who is complying with the requirements of sections 362.23 256J.14 and 256J.54, if applicable, does not count towards the 362.24 60-month limit on assistance. 362.25 (c) Any diversionary assistance or emergency assistance 362.26 received does not count toward the 60-month limit. 362.27 (d) Any cash assistance received by an 18- or 19-year-old 362.28 caregiver who is complying with the requirements of section 362.29 256J.54 does not count toward the 60-month limit. 362.30 Sec. 51. Minnesota Statutes 1998, section 256J.42, is 362.31 amended by adding a subdivision to read: 362.32 Subd. 6. [FAMILIES WITH INCAPACITATED MEMBERS.] Any cash 362.33 assistance received by a caregiver does not count toward the 362.34 60-month limit on assistance during a month in which a caregiver 362.35 qualifies for an exemption from MFIP-S work requirements because 362.36 the caregiver: 363.1 (1) is suffering from a professionally certified permanent 363.2 injury or incapacity which is expected to continue for more than 363.3 30 days and which prevents the person from obtaining or 363.4 retaining employment; or 363.5 (2) is required to care for another member in the household 363.6 who has a professionally certified illness or incapacity that is 363.7 expected to last for more than 30 days and the caregiver's 363.8 presence replaces other specialized care arrangements. 363.9 Sec. 52. Minnesota Statutes 1998, section 256J.43, is 363.10 amended to read: 363.11 256J.43 [INTERSTATEPAYMENTTRANSITIONAL STANDARDS.] 363.12 Subdivision 1. [PAYMENT.] (a) Effective July 1, 1997, the 363.13 amount of assistance paid to an eligible unit in which all 363.14 members have resided in this state for fewer than 12 consecutive 363.15 calendar months immediately preceding the date of application 363.16 shall be the lesser of either the interstate transitional 363.17 standard that would have been received by the assistance unit 363.18 from the state of immediate prior residence, or the amount 363.19 calculated in accordance withAFDC or MFIP-SMFIP standards. 363.20 The lesser payment must continue until the assistance unit meets 363.21 the 12-month requirement. An assistance unit that has not 363.22 resided in Minnesota for 12 months from the date of application 363.23 is not exempt from the interstatepaymenttransitional standards 363.24 provisions solely because a child is born in Minnesota to a 363.25 member of the assistance unit. Payment must be calculated by 363.26 applying thisstate'sMFIP's budgeting policies, and the unit's 363.27 net income must be deducted from the payment standard in the 363.28 other state or the MFIP transitional or shared household 363.29 standard in this state, whichever is lower. Payment shall be 363.30 made in vendor form for shelter and utilities, up to the limit 363.31 of the grant amount, and residual amounts, if any, shall be paid 363.32 directly to the assistance unit. 363.33 (b) During the first 12 months an assistance unit resides 363.34 in this state, the number of months that a unit is eligible to 363.35 receiveAFDC or MFIP-SMFIP benefits is limited to the number of 363.36 months the assistance unit would have been eligible to receive 364.1 similar benefits in the state of immediate prior residence. 364.2 (c) This policy applies whether or not the assistance unit 364.3 received similar benefits while residing in the state of 364.4 previous residence. 364.5 (d) When an assistance unit moves to this state from 364.6 another state where the assistance unit has exhausted that 364.7 state's time limit for receiving benefits under that state's 364.8 TANF program, the unit will not be eligible to receive anyAFDC364.9or MFIP-SMFIP benefits in this state for 12 months from the 364.10 date the assistance unit moves here. 364.11 (e) For the purposes of this section, "state of immediate 364.12 prior residence" means: 364.13 (1) the state in which the applicant declares the applicant 364.14 spent the most time in the 30 days prior to moving to this 364.15 state; or 364.16 (2) the state in which an applicant who is a migrant worker 364.17 maintains a home. 364.18 (f) The commissioner shall annually verify and update all 364.19 other states' payment standards as they are to be in effect in 364.20 July of each year. 364.21 (g) Applicants must provide verification of their state of 364.22 immediate prior residence, in the form of tax statements, a 364.23 driver's license, automobile registration, rent receipts, or 364.24 other forms of verification approved by the commissioner. 364.25 (h) Migrant workers, as defined in section 256J.08, and 364.26 their immediate families are exempt from this section, provided 364.27 the migrant worker provides verification that the migrant family 364.28 worked in this state within the last 12 months and earned at 364.29 least $1,000 in gross wages during the time the migrant worker 364.30 worked in this state. 364.31 Subd. 2. [TEMPORARY ABSENCE FROM MINNESOTA.] (a) For an 364.32 assistance unit that has met the requirements of section 364.33 256J.12, the number of months that the assistance unit receives 364.34 benefits under the interstatepaymenttransitional standards in 364.35 this section is not affected by an absence from Minnesota for 364.36 fewer than 30 consecutive days. 365.1 (b) For an assistance unit that has met the requirements of 365.2 section 256J.12, the number of months that the assistance unit 365.3 receives benefits under the interstatepaymenttransitional 365.4 standards in this section is not affected by an absence from 365.5 Minnesota for more than 30 consecutive days but fewer than 90 365.6 consecutive days, provided the assistance unit continues to 365.7 maintain a residence in Minnesota during the period of absence. 365.8 Subd. 3. [EXCEPTIONS TO THE INTERSTATE PAYMENT POLICY.] 365.9 Applicants who lived in another state in the 12 months prior to 365.10 applying for assistance are exempt from the interstate payment 365.11 policy for the months that a member of the unit: 365.12 (1) served in the United States armed services, provided 365.13 the person returned to Minnesota within 30 days of leaving the 365.14 armed forces, and intends to remain in Minnesota; 365.15 (2) attended school in another state, paid nonresident 365.16 tuition or Minnesota tuition rates under a reciprocity 365.17 agreement, provided the person left Minnesota specifically to 365.18 attend school and returned to Minnesota within 30 days of 365.19 graduation with the intent to remain in Minnesota; or 365.20 (3) meets the following criteria: 365.21 (i) a minor child or a minor caregiver moves from another 365.22 state to the residence of a relative caregiver; 365.23 (ii) the minor caregiver applies for and receives family 365.24 cash assistance; 365.25 (iii) the relative caregiver chooses not to be part of the 365.26MFIP-SMFIP assistance unit; and 365.27 (iv) the relative caregiver has resided in Minnesota for at 365.28 least 12 months from the date the assistance unit applies for 365.29 cash assistance. 365.30 Subd. 4. [INELIGIBLE MANDATORY UNIT MEMBERS.] Ineligible 365.31 mandatory unit members who have resided in Minnesota for 12 365.32 months immediately before the unit's date of application 365.33 establish the other assistance unit members' eligibility for the 365.34MFIP-SMFIP transitional standard, shared household or family 365.35 wage level, whichever is applicable. 365.36 Sec. 53. Minnesota Statutes 1998, section 256J.45, 366.1 subdivision 1, is amended to read: 366.2 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 366.3 county agency must provide eachMFIP-SMFIP caregiver who is not 366.4 exempt under section 256J.56, paragraph (a), clause (6) or (8), 366.5 with a face-to-face orientation.The caregiver must attend the366.6orientation.The county agency must informthe caregiver366.7 caregivers who are not exempt under section 256J.56, paragraph 366.8 (a), clause (6) or (8), that failure to attend the orientation 366.9 is considered an occurrence of noncompliance with program 366.10 requirements, and will result in the imposition of a sanction 366.11 under section 256J.46. If the client complies with the 366.12 orientation requirement prior to the first day of the month in 366.13 which the grant reduction is proposed to occur, the orientation 366.14 sanction shall be lifted. 366.15 Sec. 54. Minnesota Statutes 1998, section 256J.46, 366.16 subdivision 1, is amended to read: 366.17 Subdivision 1. [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 366.18 WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without 366.19 good cause to comply with the requirements of this chapter, and 366.20 who is not subject to a sanction under subdivision 2, shall be 366.21 subject to a sanction as provided in this subdivision. 366.22 A sanction under this subdivision becomes effective the 366.23 month following the month in which a required notice is given. 366.24 A sanction must not be imposed when a participant comes into 366.25 compliance with the requirements for orientation under section 366.26 256J.45 or third-party liability for medical services under 366.27 section 256J.30, subdivision 10, prior to the effective date of 366.28 the sanction. A sanction must not be imposed when a participant 366.29 comes into compliance with the requirements for employment and 366.30 training services under sections 256J.49 to 256J.72 ten days 366.31 prior to the effective date of the sanction. For purposes of 366.32 this subdivision, each month that a participant fails to comply 366.33 with a requirement of this chapter shall be considered a 366.34 separate occurrence of noncompliance. A participant who has had 366.35 one or more sanctions imposed must remain in compliance with the 366.36 provisions of this chapter for six months in order for a 367.1 subsequent occurrence of noncompliance to be considered a first 367.2 occurrence. 367.3 (b) Sanctions for noncompliance shall be imposed as follows: 367.4 (1) For the first occurrence of noncompliance by a 367.5 participant in a single-parent household or by one participant 367.6 in a two-parent household, the assistance unit's grant shall be 367.7 reduced by ten percent of theMFIP-S transitionalMFIP standard,367.8the shared household standard, or the interstate transitional367.9standardof need for an assistance unit of the same size,367.10whichever is applicable,with the residual grant paid to the 367.11 participant. The reduction in the grant amount must be in 367.12 effect for a minimum of one month and shall be removed in the 367.13 month following the month that the participant returns to 367.14 compliance. 367.15 (2) For a second or subsequent occurrence of noncompliance, 367.16 or when both participants in a two-parent household are out of 367.17 compliance at the same time, the assistance unit's shelter costs 367.18 shall be vendor paid up to the amount of the cash portion of the 367.19MFIP-SMFIP grant for which the participant's assistance unit is 367.20 eligible. At county option, the assistance unit's utilities may 367.21 also be vendor paid up to the amount of the cash portion of the 367.22MFIP-SMFIP grant remaining after vendor payment of the 367.23 assistance unit's shelter costs. The residual amount of the 367.24 grant after vendor payment, if any, must be reduced by an amount 367.25 equal to 30 percent of theMFIP-S transitionalMFIP standard,367.26the shared household standard, or the interstate transitional367.27standardof need for an assistance unit of the same size,367.28whichever is applicable,before the residual grant is paid to 367.29 the assistance unit. The reduction in the grant amount must be 367.30 in effect for a minimum of one month and shall be removed in the 367.31 month following the month that a participant in a one-parent 367.32 household returns to compliance. In a two-parent household, the 367.33 grant reduction must be in effect for a minimum of one month and 367.34 shall be removed in the month following the month both 367.35 participants return to compliance. The vendor payment of 367.36 shelter costs and, if applicable, utilities shall be removed six 368.1 months after the month in which the participant or participants 368.2 return to compliance. 368.3 (c) No later than during the second month that a sanction 368.4 under paragraph (b), clause (2), is in effect due to 368.5 noncompliance with employment services, the participant's case 368.6 file must be reviewed to determine if: 368.7 (i) the continued noncompliance can be explained and 368.8 mitigated by providing a needed preemployment activity, as 368.9 defined in section 256J.49, subdivision 13, clause (16); 368.10 (ii) the participant qualifies for a good cause exception 368.11 under section 256J.57; or 368.12 (iii) the participant qualifies for an exemption under 368.13 section 256J.56. 368.14 If the lack of an identified activity can explain the 368.15 noncompliance, the county must work with the participant to 368.16 provide the identified activity, and the county must restore the 368.17 participant's grant amount to the full amount for which the 368.18 assistance unit is eligible. The grant must be restored 368.19 retroactively to the first day of the month in which the 368.20 participant was found to lack preemployment activities or to 368.21 qualify for an exemption or good cause exception. 368.22 If the participant is found to qualify for a good cause 368.23 exception or an exemption, the county must restore the 368.24 participant's grant to the full amount for which the assistance 368.25 unit is eligible. 368.26 Sec. 55. Minnesota Statutes 1998, section 256J.46, 368.27 subdivision 2, is amended to read: 368.28 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 368.29 REQUIREMENTS.] The grant of anMFIP-SMFIP caregiver who refuses 368.30 to cooperate, as determined by the child support enforcement 368.31 agency, with support requirements under section 256.741, shall 368.32 be subject to sanction as specified in this subdivision. The 368.33 assistance unit's grant must be reduced by 25 percent of the 368.34 applicabletransitionalMFIP standard of need. The residual 368.35 amount of the grant, if any, must be paid to the caregiver. A 368.36 sanction under this subdivision becomes effective the first 369.1 month following the month in which a required notice is given. 369.2 A sanction must not be imposed when a caregiver comes into 369.3 compliance with the requirements under section 256.741 prior to 369.4 the effective date of the sanction. The sanction shall be 369.5 removed in the month following the month that the caregiver 369.6 cooperates with the support requirements. Each month that 369.7 anMFIP-SMFIP caregiver fails to comply with the requirements 369.8 of section 256.741 must be considered a separate occurrence of 369.9 noncompliance. AnMFIP-SMFIP caregiver who has had one or more 369.10 sanctions imposed must remain in compliance with the 369.11 requirements of section 256.741 for six months in order for a 369.12 subsequent sanction to be considered a first occurrence. 369.13 Sec. 56. Minnesota Statutes 1998, section 256J.46, 369.14 subdivision 2a, is amended to read: 369.15 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the 369.16 provisions of subdivisions 1 and 2, for a participant subject to 369.17 a sanction for refusal to comply with child support requirements 369.18 under subdivision 2 and subject to a concurrent sanction for 369.19 refusal to cooperate with other program requirements under 369.20 subdivision 1, sanctions shall be imposed in the manner 369.21 prescribed in this subdivision. 369.22 A participant who has had one or more sanctions imposed 369.23 under this subdivision must remain in compliance with the 369.24 provisions of this chapter for six months in order for a 369.25 subsequent occurrence of noncompliance to be considered a first 369.26 occurrence. Any vendor payment of shelter costs or utilities 369.27 under this subdivision must remain in effect for six months 369.28 after the month in which the participant is no longer subject to 369.29 sanction under subdivision 1. 369.30 (b) If the participant was subject to sanction for: 369.31 (i) noncompliance under subdivision 1 before being subject 369.32 to sanction for noncooperation under subdivision 2; or 369.33 (ii) noncooperation under subdivision 2 before being 369.34 subject to sanction for noncompliance under subdivision 1; 369.35 the participant shall be sanctioned as provided in subdivision 369.36 1, paragraph (b), clause (2), and the requirement that the 370.1 county conduct a review as specified in subdivision 1, paragraph 370.2 (c), remains in effect. 370.3 (c) A participant who first becomes subject to sanction 370.4 under both subdivisions 1 and 2 in the same month is subject to 370.5 sanction as follows: 370.6 (i) in the first month of noncompliance and noncooperation, 370.7 the participant's grant must be reduced by 25 percent of the 370.8 applicabletransitionalMFIP standard of need, with any residual 370.9 amount paid to the participant; 370.10 (ii) in the second and subsequent months of noncompliance 370.11 and noncooperation, the participant shall be sanctioned as 370.12 provided in subdivision 1, paragraph (b), clause (2). 370.13 The requirement that the county conduct a review as 370.14 specified in subdivision 1, paragraph (c), remains in effect. 370.15 (d) A participant remains subject to sanction under 370.16 subdivision 2 if the participant: 370.17 (i) returns to compliance and is no longer subject to 370.18 sanction under subdivision 1; or 370.19 (ii) has the sanction under subdivision 1, paragraph (b), 370.20 removed upon completion of the review under subdivision 1, 370.21 paragraph (c). 370.22 A participant remains subject to sanction under subdivision 370.23 1, paragraph (b), if the participant cooperates and is no longer 370.24 subject to sanction under subdivision 2. 370.25 Sec. 57. Minnesota Statutes 1998, section 256J.47, 370.26 subdivision 4, is amended to read: 370.27 Subd. 4. [INELIGIBILITY FORMFIP-SMFIP; EMERGENCY 370.28 ASSISTANCE; AND EMERGENCY GENERAL ASSISTANCE.] Upon receipt of 370.29 diversionary assistance, the family is ineligible forMFIP-S370.30 MFIP, emergency assistance, and emergency general assistance for 370.31 a period of time. To determine the period of ineligibility, the 370.32 county shall use the following formula: regardless of household 370.33 changes, the county agency must calculate the number of days of 370.34 ineligibility by dividing the diversionary assistance issued by 370.35 thetransitionalMFIP standard of need a family of the same size 370.36 and composition would have received underMFIP-S, or if371.1applicable the interstate transitional standard,MFIP multiplied 371.2 by 30, truncating the result. The ineligibility period begins 371.3 the date the diversionary assistance is issued. 371.4 Sec. 58. Minnesota Statutes 1998, section 256J.48, 371.5 subdivision 2, is amended to read: 371.6 Subd. 2. [ELIGIBILITY.] Notwithstanding other eligibility 371.7 provisions of this chapter, any family without resources 371.8 immediately available to meet emergency needs identified in 371.9 subdivision 3 shall be eligible for an emergency grant under the 371.10 following conditions: 371.11 (1) a family member has resided in this state for at least 371.12 30 days; 371.13 (2) the family is without resources immediately available 371.14 to meet emergency needs; 371.15 (3) assistance is necessary to avoid destitution or provide 371.16 emergency shelter arrangements; 371.17 (4) the family's destitution or need for shelter or 371.18 utilities did not arise because the assistance unit is under 371.19 sanction, the caregiver is disqualified, or the child or 371.20 relative caregiver refused without good cause under section 371.21 256J.57 to accept employment or training for employment in this 371.22 state or another state; and 371.23 (5) at least one child or pregnant woman in the emergency 371.24 assistance unit meetsMFIP-SMFIP citizenship requirements in 371.25 section 256J.11. 371.26 Sec. 59. Minnesota Statutes 1998, section 256J.48, 371.27 subdivision 3, is amended to read: 371.28 Subd. 3. [EMERGENCY NEEDS.] Emergency needs are limited to 371.29 the following: 371.30 (a) [RENT.] A county agency may deny assistance to prevent 371.31 eviction from rented or leased shelter of an otherwise eligible 371.32 applicant when the county agency determines that an applicant's 371.33 anticipated income will not cover continued payment for shelter, 371.34 subject to conditions in clauses (1) to (3): 371.35 (1) a county agency must not deny assistance when an 371.36 applicant can document that the applicant is unable to locate 372.1 habitable shelter, unless the county agency can document that 372.2 one or more habitable shelters are available in the community 372.3 that will result in at least a 20 percent reduction in monthly 372.4 expense for shelter and that this shelter will be cost-effective 372.5 for the applicant; 372.6 (2) when no alternative shelter can be identified by either 372.7 the applicant or the county agency, the county agency shall not 372.8 deny assistance because anticipated income will not cover rental 372.9 obligation; and 372.10 (3) when cost-effective alternative shelter is identified, 372.11 the county agency shall issue assistance for moving expenses as 372.12 provided in paragraph (e). 372.13 (b) [DEFINITIONS.] For purposes of paragraph (a), the 372.14 following definitions apply (1) "metropolitan statistical area" 372.15 is as defined by the United States Census Bureau; (2) 372.16 "alternative shelter" includes any shelter that is located 372.17 within the metropolitan statistical area containing the county 372.18 and for which the applicant is eligible, provided the applicant 372.19 does not have to travel more than 20 miles to reach the shelter 372.20 and has access to transportation to the shelter. Clause (2) 372.21 does not apply to counties in the Minneapolis-St. Paul 372.22 metropolitan statistical area. 372.23 (c) [MORTGAGE AND CONTRACT FOR DEED ARREARAGES.] A county 372.24 agency shall issue assistance for mortgage or contract for deed 372.25 arrearages on behalf of an otherwise eligible applicant 372.26 according to clauses (1) to (4): 372.27 (1) assistance for arrearages must be issued only when a 372.28 home is owned, occupied, and maintained by the applicant; 372.29 (2) assistance for arrearages must be issued only when no 372.30 subsequent foreclosure action is expected within the 12 months 372.31 following the issuance; 372.32 (3) assistance for arrearages must be issued only when an 372.33 applicant has been refused refinancing through a bank or other 372.34 lending institution and the amount payable, when combined with 372.35 any payments made by the applicant, will be accepted by the 372.36 creditor as full payment of the arrearage; 373.1 (4) costs paid by a family which are counted toward the 373.2 payment requirements in this clause are: principal and interest 373.3 payments on mortgages or contracts for deed, balloon payments, 373.4 homeowner's insurance payments, manufactured home lot rental 373.5 payments, and tax or special assessment payments related to the 373.6 homestead. Costs which are not counted include closing costs 373.7 related to the sale or purchase of real property. 373.8 To be eligible for assistance for costs specified in clause 373.9 (4) which are outstanding at the time of foreclosure, an 373.10 applicant must have paid at least 40 percent of the family's 373.11 gross income toward these costs in the month of application and 373.12 the 11-month period immediately preceding the month of 373.13 application. 373.14 When an applicant is eligible under clause (4), a county 373.15 agency shall issue assistance up to a maximum of four times the 373.16MFIP-S transitionalMFIP standard of need for a comparable 373.17 assistance unit. 373.18 (d) [DAMAGE OR UTILITY DEPOSITS.] A county agency shall 373.19 issue assistance for damage or utility deposits when necessary 373.20 to alleviate the emergency. The county may require that 373.21 assistance paid in the form of a damage deposit, less any amount 373.22 retained by the landlord to remedy a tenant's default in payment 373.23 of rent or other funds due to the landlord under a rental 373.24 agreement, or to restore the premises to the condition at the 373.25 commencement of the tenancy, ordinary wear and tear excepted, be 373.26 returned to the county when the individual vacates the premises 373.27 or be paid to the recipient's new landlord as a vendor payment. 373.28 The county may require that assistance paid in the form of a 373.29 utility deposit less any amount retained to satisfy outstanding 373.30 utility costs be returned to the county when the person vacates 373.31 the premises, or be paid for the person's new housing unit as a 373.32 vendor payment. The vendor payment of returned funds shall not 373.33 be considered a new use of emergency assistance. 373.34 (e) [MOVING EXPENSES.] A county agency shall issue 373.35 assistance for expenses incurred when a family must move to a 373.36 different shelter according to clauses (1) to (4): 374.1 (1) moving expenses include the cost to transport personal 374.2 property belonging to a family, the cost for utility connection, 374.3 and the cost for securing different shelter; 374.4 (2) moving expenses must be paid only when the county 374.5 agency determines that a move is cost-effective; 374.6 (3) moving expenses must be paid at the request of an 374.7 applicant, but only when destitution or threatened destitution 374.8 exists; and 374.9 (4) moving expenses must be paid when a county agency 374.10 denies assistance to prevent an eviction because the county 374.11 agency has determined that an applicant's anticipated income 374.12 will not cover continued shelter obligation in paragraph (a). 374.13 (f) [HOME REPAIRS.] A county agency shall pay for repairs 374.14 to the roof, foundation, wiring, heating system, chimney, and 374.15 water and sewer system of a home that is owned and lived in by 374.16 an applicant. 374.17 The applicant shall document, and the county agency shall 374.18 verify the need for and method of repair. 374.19 The payment must be cost-effective in relation to the 374.20 overall condition of the home and in relation to the cost and 374.21 availability of alternative housing. 374.22 (g) [UTILITY COSTS.] Assistance for utility costs must be 374.23 made when an otherwise eligible family has had a termination or 374.24 is threatened with a termination of municipal water and sewer 374.25 service, electric, gas or heating fuel service, refuse removal 374.26 service, or lacks wood when that is the heating source, subject 374.27 to the conditions in clauses (1) and (2): 374.28 (1) a county agency must not issue assistance unless the 374.29 county agency receives confirmation from the utility provider 374.30 that assistance combined with payment by the applicant will 374.31 continue or restore the utility; and 374.32 (2) a county agency shall not issue assistance for utility 374.33 costs unless a family paid at least eight percent of the 374.34 family's gross income toward utility costs due during the 374.35 preceding 12 months. 374.36 Clauses (1) and (2) must not be construed to prevent the 375.1 issuance of assistance when a county agency must take immediate 375.2 and temporary action necessary to protect the life or health of 375.3 a child. 375.4 (h) [SPECIAL DIETS.] Effective January 1, 1998, a county 375.5 shall pay for special diets or dietary items forMFIP-SMFIP 375.6 participants. Persons receiving emergency assistance funds for 375.7 special diets or dietary items are also eligible to receive 375.8 emergency assistance for shelter and utility emergencies, if 375.9 otherwise eligible. The need for special diets or dietary items 375.10 must be prescribed by a licensed physician. Costs for special 375.11 diets shall be determined as percentages of the allotment for a 375.12 one-person household under the Thrifty Food Plan as defined by 375.13 the United States Department of Agriculture. The types of diets 375.14 and the percentages of the Thrifty Food Plan that are covered 375.15 are as follows: 375.16 (1) high protein diet, at least 80 grams daily, 25 percent 375.17 of Thrifty Food Plan; 375.18 (2) controlled protein diet, 40 to 60 grams and requires 375.19 special products, 100 percent of Thrifty Food Plan; 375.20 (3) controlled protein diet, less than 40 grams and 375.21 requires special products, 125 percent of Thrifty Food Plan; 375.22 (4) low cholesterol diet, 25 percent of Thrifty Food Plan; 375.23 (5) high residue diet, 20 percent of Thrifty Food Plan; 375.24 (6) pregnancy and lactation diet, 35 percent of Thrifty 375.25 Food Plan; 375.26 (7) gluten-free diet, 25 percent of Thrifty Food Plan; 375.27 (8) lactose-free diet, 25 percent of Thrifty Food Plan; 375.28 (9) antidumping diet, 15 percent of Thrifty Food Plan; 375.29 (10) hypoglycemic diet, 15 percent of Thrifty Food Plan; or 375.30 (11) ketogenic diet, 25 percent of Thrifty Food Plan. 375.31 Sec. 60. Minnesota Statutes 1998, section 256J.50, 375.32 subdivision 1, is amended to read: 375.33 Subdivision 1. [EMPLOYMENT AND TRAINING SERVICES COMPONENT 375.34 OFMFIP-SMFIP.] (a) By January 1, 1998, each county must 375.35 develop and implement an employment and training services 375.36 component ofMFIP-SMFIP which is designed to put participants 376.1 on the most direct path to unsubsidized employment. 376.2 Participation in these services is mandatory for allMFIP-SMFIP 376.3 caregivers, unless the caregiver is exempt under section 256J.56. 376.4 (b)A county may provide employment and training services376.5to MFIP-S caregivers who are exempt from the employment and376.6training services component but volunteer for the services.A 376.7 county must provide employment and training services under 376.8 sections 256J.515 to 256J.74 within 30 days after the 376.9 caregiver's participation becomes mandatory under subdivision 5. 376.10 Sec. 61. Minnesota Statutes 1998, section 256J.515, is 376.11 amended to read: 376.12 256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.] 376.13 During the first meeting with participants, job counselors 376.14 must ensure that an overview of employment and training services 376.15 is provided that: 376.16 (1) stresses the necessity and opportunity of immediate 376.17 employment; 376.18 (2) outlines the job search resources offered; 376.19 (3) outlines education or training opportunities available; 376.20 (4) describes the range of work activities, including 376.21 activities under section 256J.49, subdivision 13, clause (18), 376.22 that are allowable underMFIP-SMFIP to meet the individual 376.23 needs of participants; 376.24 (5) explains the requirements to comply with an employment 376.25 plan; 376.26 (6) explains the consequences for failing to comply; and 376.27 (7) explains the services that are available to support job 376.28 search and work and education. 376.29 Failure to attend the overview of employment and training 376.30 services without good cause results in the imposition of a 376.31 sanction under section 256J.46. 376.32 Sec. 62. Minnesota Statutes 1998, section 256J.52, 376.33 subdivision 1, is amended to read: 376.34 Subdivision 1. [APPLICATION LIMITED TO CERTAIN 376.35 PARTICIPANTS.] This section applies to participants receiving 376.36MFIP-SMFIP assistance who are not exempt under section 256J.56, 377.1 and to caregivers who volunteer for employment and training 377.2 servicesunder section 256J.50. 377.3 Sec. 63. Minnesota Statutes 1998, section 256J.52, 377.4 subdivision 4, is amended to read: 377.5 Subd. 4. [SECONDARY ASSESSMENT.] (a) The job counselor 377.6 must conduct a secondary assessment for those participants who: 377.7 (1) in the judgment of the job counselor, have barriers to 377.8 obtaining employment that will not be overcome with a job search 377.9 support plan under subdivision 3; 377.10 (2) have completed eight weeks of job search under 377.11 subdivision 3 without obtaining suitable employment; 377.12 (3) have not received a secondary assessment, are working 377.13 at least 20 hours per week, and the participant, job counselor, 377.14 or county agency requests a secondary assessment; or 377.15 (4) have an existing job search plan or employment plan 377.16 developed for another program or are already involved in 377.17 training or education activities under section 256J.55, 377.18 subdivision 5. 377.19 (b) In the secondary assessment the job counselor must 377.20 evaluate the participant's skills and prior work experience, 377.21 family circumstances, interests and abilities, need for 377.22 preemployment activities, supportive or educational services, 377.23 and the extent of any barriers to employment. Failure to 377.24 complete a secondary assessment shall result in the imposition 377.25 of a sanction as specified in sections 256J.46 and 256J.57. The 377.26 job counselor must use the information gathered through the 377.27 secondary assessment to develop an employment plan under 377.28 subdivision 5. 377.29 (c) In the secondary assessment the job counselor may 377.30 require the participant to complete a professional medical 377.31 substance abuse or psychological assessment as a component of 377.32 the secondary assessment when the job counselor has a reasonable 377.33 belief, based on objective evidence, that a participant's 377.34 ability to obtain and retain suitable employment is impaired by 377.35 a medical condition. The job counselor must ensure that 377.36 appropriate services are available to participants to 378.1 accommodate any disabilities identified by an assessment. Data 378.2 gathered as part of a professional assessment shall be 378.3 classified and disclosed in accordance with the data practices 378.4 provisions specified in section 13.46. 378.5 (d) The provider shall make available to participants 378.6 information regarding additional vendors or resources which 378.7 provide employment and training services that may be available 378.8 to the participant under a plan developed under this section. 378.9 The information must include a brief summary of services 378.10 provided and related performance indicators. Performance 378.11 indicators must include, but are not limited to, the average 378.12 time to complete program offerings, placement rates, entry and 378.13 average wages, and retention rates. To be included in the 378.14 information given to participants, a vendor or resource must 378.15 provide counties with relevant information in the format 378.16 required by the county. 378.17 Sec. 64. Minnesota Statutes 1998, section 256J.52, is 378.18 amended by adding a subdivision to read: 378.19 Subd. 5a. [BASIC EDUCATION ACTIVITIES IN 378.20 PLAN.] Participants with low skills in reading or mathematics 378.21 who are proficient only at or below an eighth-grade level must 378.22 be allowed to include basic education activities or an English 378.23 as a second language program in a job search support plan or an 378.24 employment plan, whichever is applicable. 378.25 Sec. 65. Minnesota Statutes 1998, section 256J.52, 378.26 subdivision 8, is amended to read: 378.27 Subd. 8. [ADMINISTRATIVE SUPPORT FOR POSTEMPLOYMENT 378.28 EDUCATION AND TRAINING.] After a caregiver receivingMFIP-SMFIP 378.29 has been employed for six consecutive months, during which time 378.30 the caregiver works on average more than 20 hours per week, or 378.31 if the job counselor determines that the caregiver is not likely 378.32 to exit MFIP within 12 months because the caregiver's current 378.33 employment offers limited opportunities for advancement, the 378.34 caregiver's job counselor shall inform the caregiver that the 378.35 caregiver may request a secondary assessment described in 378.36 subdivision 4 and shallprovide information about: 379.1 (1) explore, investigate, and examine potential training 379.2 options, which may be through the caregiver's current employer, 379.3 the Minnesota job skills partnership, other employers, technical 379.4 colleges or other educational institutions, nonprofit 379.5 organizations, county services, state agencies, or any other 379.6 resource available that will enhance the caregiver's skills and 379.7 improve the potential for increase earnings; 379.8 (2) present part-time education and training options 379.9 available to the caregiver that are consistent with the 379.10 caregiver's interests and career path;and379.11(2)(3) provide information about child care and 379.12 transportation resources available to support postemployment 379.13 education and training; and 379.14 (4) ensure that the caregiver is apprised of the training 379.15 options and is allowed to pursue ongoing training needed to 379.16 achieve self-sufficiency. 379.17 Sec. 66. [256J.535] [SUPPORTING PARENTS MAKING 379.18 SATISFACTORY PROGRESS IN EDUCATION AND TRAINING.] 379.19 For each semester or quarter, whichever is applicable, that 379.20 a participant is enrolled in a post-secondary education or 379.21 training program and is maintaining a 2.5 grade point average, 379.22 on a 4.0 scale, the number of months the participant maintained 379.23 a 2.5 grade point average shall be added prospectively to the 379.24 total number of months the participant has remaining on 379.25 assistance. The participant must provide verification of the 379.26 2.5 grade point average to the county agency after each 379.27 applicable semester or quarter. A participant may take 379.28 advantage of this section for no more than a total of 36 months. 379.29 Sec. 67. Minnesota Statutes 1998, section 256J.55, 379.30 subdivision 4, is amended to read: 379.31 Subd. 4. [CHOICE OF PROVIDER.]A participantMFIP 379.32 caregivers must be able to choose from at least two employment 379.33 and training service providers, unless the county has 379.34 demonstrated to the commissioner that the provision of multiple 379.35 employment and training service providers would result in 379.36 financial hardship for the county, or the county is utilizing a 380.1 workforce center as specified in section 256J.50, subdivision 380.2 8. Both parents in a two-parent family must choose the same 380.3 employment and training service provider unless a special need, 380.4 such as bilingual services, is identified but not available 380.5 through one service provider. 380.6 Sec. 68. Minnesota Statutes 1998, section 256J.56, is 380.7 amended to read: 380.8 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 380.9 EXEMPTIONS.] 380.10 (a) AnMFIP-SMFIP caregiver is exempt from the 380.11 requirements of sections 256J.52 to 256J.55 if the caregiver 380.12 belongs to any of the following groups: 380.13 (1) individuals who are age 60 or older; 380.14 (2) individuals who are suffering from a professionally 380.15 certified permanent or temporary illness, injury, or incapacity 380.16 which is expected to continue for more than 30 days and which 380.17 prevents the person from obtaining or retaining employment. 380.18 Persons in this category with a temporary illness, injury, or 380.19 incapacity must be reevaluated at least quarterly; 380.20 (3) caregivers whose presence in the home is required 380.21 because of the professionally certified illness or incapacity of 380.22 another member in the assistance unit, a relative in the 380.23 household, or a foster child in the household; 380.24 (4) women who are pregnant, if the pregnancy has resulted 380.25 in a professionally certified incapacity that prevents the woman 380.26 from obtaining or retaining employment; 380.27 (5) caregivers of a child under the age of one year who 380.28 personally provide full-time care for the child. This exemption 380.29 may be used for only 12 months in a lifetime. In two-parent 380.30 households, only one parent or other relative may qualify for 380.31 this exemption; 380.32 (6) individuals who are single parents, or one parent in a 380.33 two-parent family, employed at least 35 hours per week; 380.34 (7) individuals experiencing a personal or family crisis 380.35 that makes them incapable of participating in the program, as 380.36 determined by the county agency. If the participant does not 381.1 agree with the county agency's determination, the participant 381.2 may seek professional certification, as defined in section 381.3 256J.08, that the participant is incapable of participating in 381.4 the program. 381.5 Persons in this exemption category must be reevaluated 381.6 every 60 days; or 381.7 (8) second parents in two-parent families employed for 20 381.8 or more hours per week, provided the first parent is employed at 381.9 least 35 hours per week. 381.10 A caregiver who is exempt under clause (5) must enroll in 381.11 and attend an early childhood and family education class, a 381.12 parenting class, or some similar activity, if available, during 381.13 the period of time the caregiver is exempt under this section. 381.14 Notwithstanding section 256J.46, failure to attend the required 381.15 activity shall not result in the imposition of a sanction. 381.16 (b) The county agency must provide employment and training 381.17 services toMFIP-SMFIP caregivers who are exempt under this 381.18 section, but who volunteer to participate. Exempt volunteers 381.19 may request approval for any work activity under section 381.20 256J.49, subdivision 13. The hourly participation requirements 381.21 for nonexempt caregivers under section 256J.50, subdivision 5, 381.22 do not apply to exempt caregivers who volunteer to participate. 381.23 Sec. 69. Minnesota Statutes 1998, section 256J.57, 381.24 subdivision 1, is amended to read: 381.25 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 381.26 county agency shall not impose the sanction under section 381.27 256J.46 if it determines that the participant has good cause for 381.28 failing to comply with the requirements of sections 256J.52 to 381.29 256J.55. Good cause exists when: 381.30 (1) appropriate child care is not available; 381.31 (2) the job does not meet the definition of suitable 381.32 employment; 381.33 (3) the participant is ill or injured; 381.34 (4) a member of the assistance unit, a relative in the 381.35 household, or a foster child in the household is ill and needs 381.36 care by the participant that prevents the participant from 382.1 complying with the job search support plan or employment plan; 382.2 (5) the parental caregiver is unable to secure necessary 382.3 transportation; 382.4 (6) the parental caregiver is in an emergency situation 382.5 that prevents compliance with the job search support plan or 382.6 employment plan; 382.7 (7) the schedule of compliance with the job search support 382.8 plan or employment plan conflicts with judicial proceedings; 382.9 (8) a mandatory MFIP meeting is scheduled during a time 382.10 that conflicts with a judicial proceeding or a meeting related 382.11 to a juvenile court matter, or a participant's work schedule; 382.12 (9) the parental caregiver is already participating in 382.13 acceptable work activities; 382.14(9)(10) the employment plan requires an educational 382.15 program for a caregiver under age 20, but the educational 382.16 program is not available; 382.17(10)(11) activities identified in the job search support 382.18 plan or employment plan are not available; 382.19(11)(12) the parental caregiver is willing to accept 382.20 suitable employment, but suitable employment is not available; 382.21 or 382.22(12)(13) the parental caregiver documents other verifiable 382.23 impediments to compliance with the job search support plan or 382.24 employment plan beyond the parental caregiver's control. 382.25 The job counselor shall work with the participant to 382.26 reschedule mandatory meetings for individuals who fall under 382.27 clauses (1), (3), (4), (5), (6), (7), and (8). 382.28 Sec. 70. [256J.58] [SUPPORTING WORKING FAMILIES.] 382.29 Subdivision 1. [WORK REQUIRED.] To reward and support 382.30 caregivers who are earning income and working the number of 382.31 hours required under section 256J.50, subdivision 5, months in 382.32 which the caregiver has reported weekly hours of employment 382.33 equal to or greater than the work requirement will not count 382.34 toward the 60-month lifetime limit on assistance. 382.35 Subd. 2. [MONTHS COUNTED.] Count each month of MFIP cash 382.36 benefits received in this state for purposes of the 60-month 383.1 lifetime limit, except as follows: 383.2 (1) do not count a month in which a single-parent caregiver 383.3 who does not have a child under six years of age has earnings 383.4 that average 30 hours or more per week; 383.5 (2) do not count a month in which the caregivers in a 383.6 two-parent family have earnings that average 55 hours or more 383.7 per week; and 383.8 (3) do not count a month in which a single-parent caregiver 383.9 who has a child under six years of age has earnings that average 383.10 20 hours or more per week. 383.11 Sec. 71. Minnesota Statutes 1998, section 256J.62, 383.12 subdivision 1, is amended to read: 383.13 Subdivision 1. [ALLOCATION.] Money appropriated forMFIP-S383.14 MFIP employment and training services must be allocated to 383.15 counties and eligible tribal providers as specified in this 383.16 section. 383.17 Sec. 72. Minnesota Statutes 1998, section 256J.62, is 383.18 amended by adding a subdivision to read: 383.19 Subd. 2a. [CASELOAD-BASED FUNDS ALLOCATION.] Effective for 383.20 state fiscal year 2000, and for all subsequent years, money 383.21 shall be allocated to counties and eligible tribal providers 383.22 based on their average number of MFIP cases as a proportion of 383.23 the statewide total number of MFIP cases: 383.24 (1) the average number of cases must be based upon counts 383.25 of MFIP or tribal TANF cases as of March 31, June 30, September 383.26 30, and December 31 of the previous calendar year, less the 383.27 number of child only cases and cases where all the caregivers 383.28 are age 60 or over. Two-parent cases, with the exception of 383.29 those with a caregiver age 60 or over, will be multiplied by a 383.30 factor of two; 383.31 (2) the MFIP or tribal TANF case count for each eligible 383.32 tribal provider shall be based upon the number of MFIP or tribal 383.33 TANF cases who are enrolled in, or are eligible for enrollment 383.34 in their reservation; and the case must be an active MFIP case; 383.35 and the case members must reside within the tribal program's 383.36 service delivery area; 384.1 (3) MFIP or tribal TANF cases counted for determining 384.2 allocations to tribal providers shall be removed from the case 384.3 counts of the respective counties where they reside to prevent 384.4 duplicate counts; 384.5 (4) prior to allocating funds to counties and tribal 384.6 providers, $1,000,000 shall be set aside to allow the 384.7 commissioner to use these set-aside funds to provide funding to 384.8 county or tribal providers who experience an unforeseen influx 384.9 of participants or other emergent situations beyond their 384.10 control; and 384.11 (5) the commissioner shall use a portion of the funds in 384.12 clause (4) to offset a reduction in funds allocated to any 384.13 county between state fiscal year 1999 and state fiscal year 2000 384.14 that results from the adjustment in clause (3). The funding 384.15 provided under this clause must reduce by half the reduction for 384.16 state fiscal year 2000 that any county would otherwise 384.17 experience in the absence of this clause. 384.18 Any funds specified in this clause that remain unspent by March 384.19 31 of each year shall be reallocated out to county and tribal 384.20 providers using the funding formula detailed in clauses (1) to 384.21 (5). 384.22 Sec. 73. Minnesota Statutes 1998, section 256J.62, 384.23 subdivision 6, is amended to read: 384.24 Subd. 6. [BILINGUAL EMPLOYMENT AND TRAINING SERVICES TO 384.25 REFUGEES.] Funds appropriated to cover the costs of bilingual 384.26 employment and training services to refugees shall be allocated 384.27 to county agencies as follows: 384.28 (1) for state fiscal year 1998, the allocation shall be 384.29 based on the county's proportion of the total statewide number 384.30 of AFDC refugee cases in the previous fiscal year. Counties 384.31 with less than one percent of the statewide number of AFDC, 384.32 MFIP-R, or MFIP refugee cases shall not receive an allocation of 384.33 bilingual employment and training services funds; and 384.34 (2) for each subsequent fiscal year, the allocation shall 384.35 be based on the county's proportion of the total statewide 384.36 number ofMFIP-SMFIP refugee cases in the previous fiscal year. 385.1 Counties with less than one percent of the statewide number of 385.2MFIP-SMFIP refugee cases shall not receive an allocation of 385.3 bilingual employment and training services funds. 385.4 Sec. 74. Minnesota Statutes 1998, section 256J.62, 385.5 subdivision 7, is amended to read: 385.6 Subd. 7. [WORK LITERACY LANGUAGE PROGRAMS.] Funds 385.7 appropriated to cover the costs of work literacy language 385.8 programs to non-English-speaking recipients shall be allocated 385.9 to county agencies as follows: 385.10 (1) for state fiscal year 1998, the allocation shall be 385.11 based on the county's proportion of the total statewide number 385.12 of AFDC or MFIP cases in the previous fiscal year where the lack 385.13 of English is a barrier to employment. Counties with less than 385.14 two percent of the statewide number of AFDC or MFIP cases where 385.15 the lack of English is a barrier to employment shall not receive 385.16 an allocation of the work literacy language program funds; and 385.17 (2) for each subsequent fiscal year, the allocation shall 385.18 be based on the county's proportion of the total statewide 385.19 number ofMFIP-SMFIP cases in the previous fiscal year where 385.20 the lack of English is a barrier to employment. Counties with 385.21 less than two percent of the statewide number ofMFIP-SMFIP 385.22 cases where the lack of English is a barrier to employment shall 385.23 not receive an allocation of the work literacy language program 385.24 funds. 385.25 Sec. 75. Minnesota Statutes 1998, section 256J.62, 385.26 subdivision 8, is amended to read: 385.27 Subd. 8. [REALLOCATION.] The commissioner of human 385.28 services shall review county agency expenditures ofMFIP-SMFIP 385.29 employment and training services funds at the end of the third 385.30 quarter of the first year of the biennium and each quarter after 385.31 that and may reallocate unencumbered or unexpended money 385.32 appropriated under this section to those county agencies that 385.33 can demonstrate a need for additional money. 385.34 Sec. 76. Minnesota Statutes 1998, section 256J.62, 385.35 subdivision 9, is amended to read: 385.36 Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] At the 386.1 request of the caregiver, the county may continue to provide 386.2 case management, counseling or other support services to a 386.3 participant following the participant's achievement of the 386.4 employment goal, for up to six months following termination of 386.5 the participant's eligibility forMFIP-SMFIP. 386.6 A county may expend funds for a specific employment and 386.7 training service for the duration of that service to a 386.8 participant if the funds are obligated or expended prior to the 386.9 participant losingMFIP-SMFIP eligibility. 386.10 Sec. 77. Minnesota Statutes 1998, section 256J.67, 386.11 subdivision 4, is amended to read: 386.12 Subd. 4. [EMPLOYMENT PLAN.] (a) The caretaker's employment 386.13 plan must include the length of time needed in the work 386.14 experience program, the need to continue job-seeking activities 386.15 while participating in work experience, and the caregiver's 386.16 employment goals. 386.17 (b) After each six months of a caregiver's participation in 386.18 a work experience job placement, and at the conclusion of each 386.19 work experience assignment under this section, the county agency 386.20 shall reassess and revise, as appropriate, the caregiver's 386.21 employment plan. 386.22 (c) A caregiver may claim good cause under section 256J.57, 386.23 subdivision 1, for failure to cooperate with a work experience 386.24 job placement. 386.25 (d) The county agency shall limit the maximum number of 386.26 hours any participant may work under this section to the amount 386.27 of thetransitionalMFIP standard of need divided by the federal 386.28 or applicable state minimum wage, whichever is higher. After a 386.29 participant has been assigned to a position for nine months, the 386.30 participant may not continue in that assignment unless the 386.31 maximum number of hours a participant works is no greater than 386.32 the amount of thetransitionalMFIP standard of need divided by 386.33 the rate of pay for individuals employed in the same or similar 386.34 occupations by the same employer at the same site. This limit 386.35 does not apply if it would prevent a participant from counting 386.36 toward the federal work participation rate. 387.1 Sec. 78. Minnesota Statutes 1998, section 256J.74, 387.2 subdivision 2, is amended to read: 387.3 Subd. 2. [CONCURRENT ELIGIBILITY, LIMITATIONS.] (a) An 387.4 individual whose needs have been otherwise provided for in 387.5 another state, in whole or in part by county, state, or federal 387.6 dollars during a month, is ineligible to receive MFIP for the 387.7 month. 387.8 (b) A county agency must not count an applicant or 387.9 participant as a member of more than one assistance unit in this 387.10 state in a given payment month, except as provided in clauses 387.11 (1) and (2). 387.12 (1) A participant who is a member of an assistance unitin387.13this stateis eligible to be included in a second assistance 387.14 unit thefirst fullmonth after the month the participant joins 387.15 the second unit. 387.16 (2) An applicant whose needs are met through federal, 387.17 state, or local foster carethat is reimbursed under title IV-E387.18of the Social Security Actpayments for the first part of an 387.19 application month is eligible to receive assistance for the 387.20 remaining part of the month in which the applicant returns 387.21 home.Title IV-EFoster care paymentsand adoption assistance387.22paymentsmust be considered prorated payments rather than a 387.23 duplication ofMFIP-SMFIP need. 387.24 Sec. 79. [256J.751] [COUNTY PERFORMANCE MANAGEMENT.] 387.25 (a) The commissioner shall report quarterly to all counties 387.26 each county's performance on the following measures: 387.27 (1) percent of MFIP caseload working in paid employment; 387.28 (2) percent of MFIP caseload receiving only the food 387.29 portion of assistance; 387.30 (3) number of MFIP cases that have left assistance; 387.31 (4) federal participation requirements as specified in 387.32 title 1 of Public Law Number 104-193; and 387.33 (5) median placement wage rate. 387.34 (b) By January 1, 2000, the commissioner shall, in 387.35 consultation with counties, develop measures for county 387.36 performance in addition to those in paragraph (a). In 388.1 developing these measures, the commissioner must consider: 388.2 (1) a measure for MFIP cases that leave assistance due to 388.3 employment; 388.4 (2) job retention after participants leave MFIP; and 388.5 (3) participant's earnings at a follow-up point after the 388.6 participant has left MFIP. 388.7 (c) If sanctions occur for failure to meet the performance 388.8 standards specified in title 1 of Public Law Number 104-193 of 388.9 the Personal Responsibility and Work Opportunity Act of 1996, 388.10 the state shall pay 88 percent of the sanction. The remaining 388.11 12 percent of the sanction will be paid by the counties. The 388.12 county portion of the sanction will be distributed across all 388.13 counties in proportion to each county's percentage of the MFIP 388.14 average monthly caseload during the period for which the 388.15 sanction was applied. 388.16 (d) If a county fails to meet the performance standards 388.17 specified in title 1 of Public Law Number 104-193 of the 388.18 Personal Responsibility and Work Opportunity Act of 1996 for any 388.19 year, the commissioner shall work with counties to organize a 388.20 joint state-county technical assistance team to work with the 388.21 county. The commissioner shall coordinate any technical 388.22 assistance with other departments and agencies including the 388.23 departments of economic security and children, families, and 388.24 learning as necessary to achieve the purpose of this paragraph. 388.25 Sec. 80. Minnesota Statutes 1998, section 256J.76, 388.26 subdivision 1, is amended to read: 388.27 Subdivision 1. [ADMINISTRATIVE FUNCTIONS.] Beginning July 388.28 1, 1997, counties will receive federal funds from the TANF block 388.29 grant for use in supporting eligibility, fraud control, and 388.30 other related administrative functions. The federal funds 388.31 available for distribution, as determined by the commissioner, 388.32 must be an amount equal to federal administrative aid 388.33 distributed for fiscal year 1996 under titles IV-A and IV-F of 388.34 the Social Security Act in effect prior to October 1, 1996. 388.35 This amount must include the amount paid for local 388.36 collaboratives under sections 245.4932 and 256F.13, but must not 389.1 include administrative aid associated with child care under 389.2 section 119B.05, with emergency assistance intensive family 389.3 preservation services under section 256.8711, with 389.4 administrative activities as part of the employment and training 389.5 services under section 256.736, or with fraud prevention 389.6 investigation activities under section 256.983. Before July 15, 389.7 1999, a county may ask for a review of the commissioner's 389.8 determination when the county believes fiscal year 1996 389.9 information was inaccurate or incomplete. By August 15, 1999, 389.10 the commissioner must adjust that county's base when the 389.11 commissioner has determined that inaccurate or incomplete 389.12 information was used to develop that base. The commissioner 389.13 shall adjust the county's 1999 allocation amount to reflect the 389.14 base change. 389.15 Sec. 81. Minnesota Statutes 1998, section 256J.76, 389.16 subdivision 2, is amended to read: 389.17 Subd. 2. [ALLOCATION OF COUNTY FUNDS.] (a) The 389.18 commissioner shall determine and allocate the funds available to 389.19 each county, on a calendar year basis, proportional to the 389.20 amount paid to each county for fiscal year 1996, excluding the 389.21 amount paid for local collaboratives under sections 245.4932 and 389.22 256F.13. For the period beginning July 1, 1997, and ending 389.23 December 31, 1998, each county shall receive 150 percent of its 389.24 base year allocation. 389.25 (b) Beginning January 1, 2000, the commissioner shall 389.26 allocate funds made available under this section on a calendar 389.27 year basis to each county first, in amounts equal to each 389.28 county's guaranteed floor as described in clause (1), second, to 389.29 provide an allocation of up to $2,000 to each county as provided 389.30 for in clause (2), and third, any remaining funds shall be 389.31 allocated in proportion to the sum of each county's average 389.32 monthly MFIP cases plus ten percent of each county's average 389.33 monthly MFIP recipients with budgeted earnings as determined by 389.34 the most recent calendar year data available. 389.35 (1) Each county's guaranteed floor shall be calculated as 389.36 follows: 390.1 (i) 90 percent of that county's allocation in the preceding 390.2 calendar year; or 390.3 (ii) when the amount of funds available is less than the 390.4 guaranteed floor, each county's allocation shall be equal to the 390.5 previous calendar year allocation reduced by the same percentage 390.6 that the statewide allocation was reduced. 390.7 (2) Each county shall be allocated up to $2,000. If, after 390.8 application of the guaranteed floor, funds are insufficient to 390.9 provide $2,000 per county, each county's allocation under this 390.10 clause shall be an equal share of remaining funds available. 390.11 Sec. 82. Minnesota Statutes 1998, section 256J.76, 390.12 subdivision 4, is amended to read: 390.13 Subd. 4. [REPORTING REQUIREMENT AND REIMBURSEMENT.] The 390.14 commissioner shall specify requirements for reporting according 390.15 to section 256.01, subdivision 2, paragraph (17). Each county 390.16 shall be reimbursed at a rate of 50 percent of eligible 390.17 expenditures up to the limit of its allocation. The 390.18 commissioner shall regularly review each county's eligible 390.19 expenditures compared to its allocation. The commissioner may 390.20 reallocate funds at any time, from counties which have not or 390.21 will not have expended their allocations, to counties that have 390.22 eligible expenditures in excess of their allocation. 390.23 Sec. 83. [STUDY OF EXTENSIONS TO 60-MONTH LIMIT.] 390.24 By January 15, 2000, the commissioner of human services 390.25 shall submit to the legislature recommendations regarding how to 390.26 implement any extension of assistance to MFIP families that 390.27 includes an adult caregiver who has received 60 months of cash 390.28 assistance funded in whole or in part by the TANF block grant. 390.29 Sec. 84. [UNIVERSITY OF MINNESOTA MFIP PILOT PROJECT.] 390.30 Notwithstanding Minnesota Statutes, section 256J.53, 390.31 subdivision 1, job counselors may approve employment plans that 390.32 include the University of Minnesota student parent MFIP 390.33 program. Plans must support participation in the program and 390.34 require participants to accept the job guaranteed by the 390.35 University of Minnesota, or a comparably paid job, at the end of 390.36 the second year of education. 391.1 Sec. 85. [REVIEW OF MINNESOTA SUPPLEMENTAL AID SPECIAL 391.2 DIET ALLOWANCE; REPORT.] 391.3 The commissioner of human services shall review the 391.4 Minnesota supplemental aid special diet allowance under 391.5 Minnesota Statutes, section 256D.44, subdivision 5, and provide 391.6 a report to the appropriate senate and house committee chairs by 391.7 December 1, 1999, which contains updated special diet allowance 391.8 rates. 391.9 Sec. 86. [MFIP WORKERS' COMPENSATION CLAIMS.] 391.10 The commissioner of human services, with the assistance of 391.11 the commissioner of labor and industry, shall provide the 391.12 members of the senate and house policy committees having 391.13 jurisdiction over issues related to the departments of human 391.14 services and labor and industry with the number of MFIP 391.15 participants who filed workers' compensation claims in fiscal 391.16 year 1999. The information is due by February 1, 2000. 391.17 Sec. 87. [REPEALER.] 391.18 Minnesota Statutes 1998, sections 256D.051, subdivisions 6 391.19 and 19; 256D.053, subdivision 4; 256J.03; 256J.30, subdivision 391.20 6; 256J.53, subdivision 4; and 256J.62, subdivisions 2, 3, and 391.21 5; and Laws 1997, chapter 85, article 1, section 63, are 391.22 repealed. 391.23 ARTICLE 7 391.24 CHILD SUPPORT 391.25 Section 1. Minnesota Statutes 1998, section 256.87, 391.26 subdivision 1a, is amended to read: 391.27 Subd. 1a. [CONTINUING SUPPORT CONTRIBUTIONS.] In addition 391.28 to granting the county or state agency a money judgment, the 391.29 court may, upon a motion or order to show cause, order 391.30 continuing support contributions by a parent found able to 391.31 reimburse the county or state agency. The order shall be 391.32 effective for the period of time during which the recipient 391.33 receives public assistance from any county or state agency and 391.34 thereafter. The order shall require support according to 391.35 chapter 518 and include the names and social security numbers of 391.36 the father, mother, and the child or children. An order for 392.1 continuing contributions is reinstated without further hearing 392.2 upon notice to the parent by any county or state agency that 392.3 public assistance, as defined in section 256.741, is again being 392.4 provided for the child of the parent. The notice shall be in 392.5 writing and shall indicate that the parent may request a hearing 392.6 for modification of the amount of support or maintenance. 392.7 Sec. 2. Minnesota Statutes 1998, section 257.66, 392.8 subdivision 3, is amended to read: 392.9 Subd. 3. [JUDGMENT; ORDER.] The judgment or order shall 392.10 contain provisions concerning the duty of support, the custody 392.11 of the child, the name of the child, the social security number 392.12 of the mother, father, and child, if known at the time of 392.13 adjudication, visitation privileges with the child, the 392.14 furnishing of bond or other security for the payment of the 392.15 judgment, or any other matter in the best interest of the 392.16 child. Custody and visitation and all subsequent motions 392.17 related to them shall proceed and be determined under section 392.18 257.541. The remaining matters and all subsequent motions 392.19 related to them shall proceed and be determined in accordance 392.20 with chapter 518. The judgment or order may direct the 392.21 appropriate party to pay all or a proportion of the reasonable 392.22 expenses of the mother's pregnancy and confinement, including 392.23 the mother's lost wages due to medical necessity, after 392.24 consideration of the relevant facts, including the relative 392.25 financial means of the parents; the earning ability of each 392.26 parent; and any health insurance policies held by either parent, 392.27 or by a spouse or parent of the parent, which would provide 392.28 benefits for the expenses incurred by the mother during her 392.29 pregnancy and confinement. Pregnancy and confinement expenses 392.30 and genetic testing costs, submitted by the public authority, 392.31 are admissible as evidence without third-party foundation 392.32 testimony and constitute prima facie evidence of the amounts 392.33 incurred for those services or for the genetic testing. 392.34 Remedies available for the collection and enforcement of child 392.35 support apply to confinement costs and are considered additional 392.36 child support. 393.1 Sec. 3. Minnesota Statutes 1998, section 257.75, 393.2 subdivision 2, is amended to read: 393.3 Subd. 2. [REVOCATION OF RECOGNITION.] A recognition may be 393.4 revoked in a writing signed by the mother or father before a 393.5 notary public and filed with the state registrar of vital 393.6 statistics within the earlier of3060 days after the 393.7 recognition is executed or the date of an administrative or 393.8 judicial hearing relating to the child in which the revoking 393.9 party is a party to the related action. A joinder in a 393.10 recognition may be revoked in a writing signed by the man who 393.11 executed the joinder and filed with the state registrar of vital 393.12 statistics within3060 days after the joinder is executed. 393.13 Upon receipt of a revocation of the recognition of parentage or 393.14 joinder in a recognition, the state registrar of vital 393.15 statistics shall forward a copy of the revocation to the 393.16 nonrevoking parent, or, in the case of a joinder in a 393.17 recognition, to the mother and father who executed the 393.18 recognition. 393.19 Sec. 4. Minnesota Statutes 1998, section 518.10, is 393.20 amended to read: 393.21 518.10 [REQUISITES OF PETITION.] 393.22 The petition for dissolution of marriage or legal 393.23 separation shall state and allege: 393.24 (a) the name, address, and, in circumstances in which child 393.25 support or spousal maintenance will be addressed, social 393.26 security number of the petitioner and any prior or other name 393.27 used by the petitioner; 393.28 (b) the name and, if known, the address and, in 393.29 circumstances in which child support or spousal maintenance will 393.30 be addressed, social security number of the respondent and any 393.31 prior or other name used by the respondent and known to the 393.32 petitioner; 393.33 (c) the place and date of the marriage of the parties; 393.34 (d) in the case of a petition for dissolution, that either 393.35 the petitioner or the respondent or both: 393.36 (1) has resided in this state for not less than 180 days 394.1 immediately preceding the commencement of the proceeding, or 394.2 (2) has been a member of the armed services and has been 394.3 stationed in this state for not less than 180 days immediately 394.4 preceding the commencement of the proceeding, or 394.5 (3) has been a domiciliary of this state for not less than 394.6 180 days immediately preceding the commencement of the 394.7 proceeding; 394.8 (e) the name at the time of the petition and any prior or 394.9 other name, social security number, age, and date of birth of 394.10 each living minor or dependent child of the parties born before 394.11 the marriage or born or adopted during the marriage and a 394.12 reference to, and the expected date of birth of, a child of the 394.13 parties conceived during the marriage but not born; 394.14 (f) whether or not a separate proceeding for dissolution, 394.15 legal separation, or custody is pending in a court in this state 394.16 or elsewhere; 394.17 (g) in the case of a petition for dissolution, that there 394.18 has been an irretrievable breakdown of the marriage 394.19 relationship; 394.20 (h) in the case of a petition for legal separation, that 394.21 there is a need for a decree of legal separation; 394.22 (i) any temporary or permanent maintenance, child support, 394.23 child custody, disposition of property, attorneys' fees, costs 394.24 and disbursements applied for without setting forth the amounts; 394.25 and 394.26 (j) whether an order for protection under chapter 518B or a 394.27 similar law of another state that governs the parties or a party 394.28 and a minor child of the parties is in effect and, if so, the 394.29 district court or similar jurisdiction in which it was entered. 394.30 The petition shall be verified by the petitioner or 394.31 petitioners, and its allegations established by competent 394.32 evidence. 394.33 Sec. 5. Minnesota Statutes 1998, section 518.551, is 394.34 amended by adding a subdivision to read: 394.35 Subd. 15. [LICENSE SUSPENSION.] (a) Upon motion of an 394.36 obligee or the public authority, which has been properly served 395.1 on the obligor by first class mail at the last known address or 395.2 in person, and if at a hearing, the court finds that (1) the 395.3 obligor is in arrears in court-ordered child support or 395.4 maintenance payments, or both, in an amount equal to or greater 395.5 than three times the obligor's total monthly support and 395.6 maintenance payments and is not in compliance with a written 395.7 payment agreement regarding both current support and arrearages, 395.8 or (2) has failed, after receiving notice, to comply with a 395.9 subpoena relating to a paternity or child support proceeding, 395.10 the court may direct the commissioner of natural resources to 395.11 suspend or bar receipt of the obligor's recreational license or 395.12 licenses. 395.13 (b) For purposes of this subdivision, a recreational 395.14 license includes all licenses, permits, and stamps issued 395.15 centrally by the commissioner of natural resources under 395.16 sections 97B.301, 97B.401, 97B.501, 97B.515, 97B.601, 97B.715, 395.17 97B.721, 97B.801, 97C.301, and 97C.305. 395.18 (c) An obligor whose recreational license or licenses have 395.19 been suspended or barred may provide proof to the court that the 395.20 obligor is in compliance with all written payment agreements 395.21 regarding both current support and arrearages. Within 15 days 395.22 of receipt of that proof, the court shall notify the 395.23 commissioner of natural resources that the obligor's 395.24 recreational license or licenses should no longer be suspended 395.25 nor should receipt be barred. 395.26 Sec. 6. Minnesota Statutes 1998, section 518.5853, is 395.27 amended by adding a subdivision to read: 395.28 Subd. 11. [COLLECTIONS UNIT RECOUPMENT ACCOUNT.] The 395.29 commissioner of human services may establish a revolving account 395.30 to cover funds issued in error due to insufficient funds or 395.31 other reasons. Appropriations for this purpose and all 395.32 recoupments against payments from the account shall be deposited 395.33 in the collections unit's recoupment account and are 395.34 appropriated to the commissioner. Any unexpended balance in the 395.35 account does not cancel, but is available until expended. 395.36 Sec. 7. [CHILD SUPPORT ARREARAGE FORGIVENESS REPORT.] 396.1 The commissioner of human services shall examine the 396.2 feasibility of forgiving child support arrears in a fair and 396.3 consistent manner and shall develop child support arrearage 396.4 forgiveness policies to be used throughout the state. Also, the 396.5 commissioner shall explore the possibility of forwarding a 396.6 portion of, or the entire amount of, the current child support 396.7 payment to the custodial parent in order to bridge the child 396.8 support with the family. The information must be in a report to 396.9 the chairs of the appropriate senate and house committees and 396.10 their members by December 1, 1999. 396.11 ARTICLE 8 396.12 CHILD PROTECTION AND 396.13 RELATED MAXIMIZATION OF FEDERAL FUNDS 396.14 Section 1. Minnesota Statutes 1998, section 144.1761, 396.15 subdivision 1, is amended to read: 396.16 Subdivision 1. [REQUEST.] (a) Whenever an adopted person 396.17 requests the state registrar to disclose the information on the 396.18 adopted person's original birth certificate, the state registrar 396.19 shall act in accordance with the provisions of section 259.89. 396.20 (b) The state registrar shall provide a copy of an adopted 396.21 person's original birth certificate to an authorized 396.22 representative of a federally recognized American Indian tribe 396.23 for the sole purpose of determining the adopted person's 396.24 eligibility for enrollment or membership. Information contained 396.25 on the birth certificate may not be used to provide the adopted 396.26 person information about the person's birth parents except as 396.27 provided in this section or section 259.83. 396.28 Sec. 2. Minnesota Statutes 1998, section 245A.30, is 396.29 amended to read: 396.30 245A.30 [LICENSING PROHIBITION FOR CERTAIN JUVENILE 396.31 FACILITIES.] 396.32 The commissioner may not: 396.33 (1) issue any license under Minnesota Rules, parts 396.34 9545.0905 to 9545.1125, for the residential placement of 396.35 juveniles at a facility if the facility accepts juveniles who 396.36 reside outside of Minnesota without an agreement with the entity 397.1 placing the juvenile at the facility that obligates the entity 397.2 to pay the educational and medical expenses of the juvenile; or 397.3 (2) renew a license under Minnesota Rules, parts 9545.0905 397.4 to 9545.1125, for the residential placement of juveniles if the 397.5 facility accepts juveniles who reside outside of Minnesota 397.6 without an agreement with the entity placing the juvenile at the 397.7 facility that obligates the entity to pay the educational and 397.8 medical expenses of the juvenile. 397.9 (Effective Date: Section 2 (245A.30) is effective July 1, 397.10 2000.) 397.11 Sec. 3. [254A.175] [CHEMICAL DEPENDENCY TREATMENT MODELS 397.12 FOR FAMILIES WITH POTENTIAL CHILD PROTECTION PROBLEMS.] 397.13 The commissioner shall explore and experiment with 397.14 different chemical dependency service models for parents with 397.15 children who are found to be in need of chemical dependency 397.16 treatment pursuant to an assessment under section 626.556, 397.17 subdivision 10, or a case plan under section 257.071 or 260.191, 397.18 subdivision 1e. The commissioner shall tailor services to 397.19 better serve this high-risk population, which may include 397.20 long-term treatment that allows the children to stay with the 397.21 parent at the treatment facility. 397.22 Sec. 4. Minnesota Statutes 1998, section 254B.04, 397.23 subdivision 1, is amended to read: 397.24 Subdivision 1. [ELIGIBILITY.] (a) Persons eligible for 397.25 benefits under Code of Federal Regulations, title 25, part 20, 397.26 persons eligible for medical assistance benefits under sections 397.27 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, 397.28 or who meet the income standards of section 256B.056, 397.29 subdivision 4, and persons eligible for general assistance 397.30 medical care under section 256D.03, subdivision 3, are entitled 397.31 to chemical dependency fund services. State money appropriated 397.32 for this paragraph must be placed in a separate account 397.33 established for this purpose. 397.34 Persons with dependent children who are determined to be in 397.35 need of chemical dependency treatment pursuant to an assessment 397.36 under section 626.556, subdivision 10, or a case plan under 398.1 section 257.071 or 260.191, subdivision 1e, shall be assisted by 398.2 the local agency to access needed treatment services. Treatment 398.3 services must be appropriate for the individual or family, which 398.4 may include long-term care treatment or treatment in a facility 398.5 that allows the dependent children to stay in the treatment 398.6 facility. The county shall pay for out-of-home placement costs, 398.7 if applicable. 398.8 (b) A person not entitled to services under paragraph (a), 398.9 but with family income that is less than 60 percent of the state 398.10 median income for a family of like size and composition, shall 398.11 be eligible to receive chemical dependency fund services within 398.12 the limit of funds available after persons entitled to services 398.13 under paragraph (a) have been served. If notified by the state 398.14 agency of limited funds, a county must give preferential 398.15 treatment to persons with dependent children who are in need of 398.16 chemical dependency treatment pursuant to an assessment under 398.17 section 626.556, subdivision 10, or a case plan under section 398.18 257.071 or 260.191, subdivision 1e. A county may spend money 398.19 from its own sources to serve persons under this paragraph. 398.20 State money appropriated for this paragraph must be placed in a 398.21 separate account established for this purpose. 398.22 (c) Persons whose income is between 60 percent and 115 398.23 percent of the state median income shall be eligible for 398.24 chemical dependency services on a sliding fee basis, within the 398.25 limit of funds available, after persons entitled to services 398.26 under paragraph (a) and persons eligible for services under 398.27 paragraph (b) have been served. Persons eligible under this 398.28 paragraph must contribute to the cost of services according to 398.29 the sliding fee scale established under subdivision 3. A county 398.30 may spend money from its own sources to provide services to 398.31 persons under this paragraph. State money appropriated for this 398.32 paragraph must be placed in a separate account established for 398.33 this purpose. 398.34 Sec. 5. Minnesota Statutes 1998, section 256.01, 398.35 subdivision 2, is amended to read: 398.36 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 399.1 section 241.021, subdivision 2, the commissioner of human 399.2 services shall: 399.3 (1) Administer and supervise all forms of public assistance 399.4 provided for by state law and other welfare activities or 399.5 services as are vested in the commissioner. Administration and 399.6 supervision of human services activities or services includes, 399.7 but is not limited to, assuring timely and accurate distribution 399.8 of benefits, completeness of service, and quality program 399.9 management. In addition to administering and supervising human 399.10 services activities vested by law in the department, the 399.11 commissioner shall have the authority to: 399.12 (a) require county agency participation in training and 399.13 technical assistance programs to promote compliance with 399.14 statutes, rules, federal laws, regulations, and policies 399.15 governing human services; 399.16 (b) monitor, on an ongoing basis, the performance of county 399.17 agencies in the operation and administration of human services, 399.18 enforce compliance with statutes, rules, federal laws, 399.19 regulations, and policies governing welfare services and promote 399.20 excellence of administration and program operation; 399.21 (c) develop a quality control program or other monitoring 399.22 program to review county performance and accuracy of benefit 399.23 determinations; 399.24 (d) require county agencies to make an adjustment to the 399.25 public assistance benefits issued to any individual consistent 399.26 with federal law and regulation and state law and rule and to 399.27 issue or recover benefits as appropriate; 399.28 (e) delay or deny payment of all or part of the state and 399.29 federal share of benefits and administrative reimbursement 399.30 according to the procedures set forth in section 256.017; 399.31 (f) make contracts with and grants to public and private 399.32 agencies and organizations, both profit and nonprofit, and 399.33 individuals, using appropriated funds; and 399.34 (g) enter into contractual agreements with federally 399.35 recognized Indian tribes with a reservation in Minnesota to the 399.36 extent necessary for the tribe to operate a federally approved 400.1 family assistance program or any other program under the 400.2 supervision of the commissioner. The commissioner shall consult 400.3 with the affected county or counties in the contractual 400.4 agreement negotiations, if the county or counties wish to be 400.5 included, in order to avoid the duplication of county and tribal 400.6 assistance program services. The commissioner may establish 400.7 necessary accounts for the purposes of receiving and disbursing 400.8 funds as necessary for the operation of the programs. 400.9 (2) Inform county agencies, on a timely basis, of changes 400.10 in statute, rule, federal law, regulation, and policy necessary 400.11 to county agency administration of the programs. 400.12 (3) Administer and supervise all child welfare activities; 400.13 promote the enforcement of laws protecting handicapped, 400.14 dependent, neglected and delinquent children, and children born 400.15 to mothers who were not married to the children's fathers at the 400.16 times of the conception nor at the births of the children; 400.17 license and supervise child-caring and child-placing agencies 400.18 and institutions; supervise the care of children in boarding and 400.19 foster homes or in private institutions; and generally perform 400.20 all functions relating to the field of child welfare now vested 400.21 in the state board of control. 400.22 (4) Administer and supervise all noninstitutional service 400.23 to handicapped persons, including those who are visually 400.24 impaired, hearing impaired, or physically impaired or otherwise 400.25 handicapped. The commissioner may provide and contract for the 400.26 care and treatment of qualified indigent children in facilities 400.27 other than those located and available at state hospitals when 400.28 it is not feasible to provide the service in state hospitals. 400.29 (5) Assist and actively cooperate with other departments, 400.30 agencies and institutions, local, state, and federal, by 400.31 performing services in conformity with the purposes of Laws 400.32 1939, chapter 431. 400.33 (6) Act as the agent of and cooperate with the federal 400.34 government in matters of mutual concern relative to and in 400.35 conformity with the provisions of Laws 1939, chapter 431, 400.36 including the administration of any federal funds granted to the 401.1 state to aid in the performance of any functions of the 401.2 commissioner as specified in Laws 1939, chapter 431, and 401.3 including the promulgation of rules making uniformly available 401.4 medical care benefits to all recipients of public assistance, at 401.5 such times as the federal government increases its participation 401.6 in assistance expenditures for medical care to recipients of 401.7 public assistance, the cost thereof to be borne in the same 401.8 proportion as are grants of aid to said recipients. 401.9 (7) Establish and maintain any administrative units 401.10 reasonably necessary for the performance of administrative 401.11 functions common to all divisions of the department. 401.12 (8) Act as designated guardian of both the estate and the 401.13 person of all the wards of the state of Minnesota, whether by 401.14 operation of law or by an order of court, without any further 401.15 act or proceeding whatever, except as to persons committed as 401.16 mentally retarded. For children under the guardianship of the 401.17 commissioner whose interests would be best served by adoptive 401.18 placement, the commissioner may contract with a licensed 401.19 child-placing agency to provide adoption services. A contract 401.20 with a licensed child-placing agency must be designed to 401.21 supplement existing county efforts and may not replace existing 401.22 county programs, unless the replacement is agreed to by the 401.23 county board and the appropriate exclusive bargaining 401.24 representative or the commissioner has evidence that child 401.25 placements of the county continue to be substantially below that 401.26 of other counties. Funds encumbered and obligated under an 401.27 agreement for a specific child shall remain available until the 401.28 terms of the agreement are fulfilled or the agreement is 401.29 terminated. 401.30 (9) Act as coordinating referral and informational center 401.31 on requests for service for newly arrived immigrants coming to 401.32 Minnesota. 401.33 (10) The specific enumeration of powers and duties as 401.34 hereinabove set forth shall in no way be construed to be a 401.35 limitation upon the general transfer of powers herein contained. 401.36 (11) Establish county, regional, or statewide schedules of 402.1 maximum fees and charges which may be paid by county agencies 402.2 for medical, dental, surgical, hospital, nursing and nursing 402.3 home care and medicine and medical supplies under all programs 402.4 of medical care provided by the state and for congregate living 402.5 care under the income maintenance programs. 402.6 (12) Have the authority to conduct and administer 402.7 experimental projects to test methods and procedures of 402.8 administering assistance and services to recipients or potential 402.9 recipients of public welfare. To carry out such experimental 402.10 projects, it is further provided that the commissioner of human 402.11 services is authorized to waive the enforcement of existing 402.12 specific statutory program requirements, rules, and standards in 402.13 one or more counties. The order establishing the waiver shall 402.14 provide alternative methods and procedures of administration, 402.15 shall not be in conflict with the basic purposes, coverage, or 402.16 benefits provided by law, and in no event shall the duration of 402.17 a project exceed four years. It is further provided that no 402.18 order establishing an experimental project as authorized by the 402.19 provisions of this section shall become effective until the 402.20 following conditions have been met: 402.21 (a) The secretary of health, education, and welfare of the 402.22 United States has agreed, for the same project, to waive state 402.23 plan requirements relative to statewide uniformity. 402.24 (b) A comprehensive plan, including estimated project 402.25 costs, shall be approved by the legislative advisory commission 402.26 and filed with the commissioner of administration. 402.27 (13) According to federal requirements, establish 402.28 procedures to be followed by local welfare boards in creating 402.29 citizen advisory committees, including procedures for selection 402.30 of committee members. 402.31 (14) Allocate federal fiscal disallowances or sanctions 402.32 which are based on quality control error rates for the aid to 402.33 families with dependent children, Minnesota family investment 402.34 program-statewide, medical assistance, or food stamp program in 402.35 the following manner: 402.36 (a) One-half of the total amount of the disallowance shall 403.1 be borne by the county boards responsible for administering the 403.2 programs. For the medical assistance, MFIP-S, and AFDC 403.3 programs, disallowances shall be shared by each county board in 403.4 the same proportion as that county's expenditures for the 403.5 sanctioned program are to the total of all counties' 403.6 expenditures for the AFDC, MFIP-S, and medical assistance 403.7 programs. For the food stamp program, sanctions shall be shared 403.8 by each county board, with 50 percent of the sanction being 403.9 distributed to each county in the same proportion as that 403.10 county's administrative costs for food stamps are to the total 403.11 of all food stamp administrative costs for all counties, and 50 403.12 percent of the sanctions being distributed to each county in the 403.13 same proportion as that county's value of food stamp benefits 403.14 issued are to the total of all benefits issued for all 403.15 counties. Each county shall pay its share of the disallowance 403.16 to the state of Minnesota. When a county fails to pay the 403.17 amount due hereunder, the commissioner may deduct the amount 403.18 from reimbursement otherwise due the county, or the attorney 403.19 general, upon the request of the commissioner, may institute 403.20 civil action to recover the amount due. 403.21 (b) Notwithstanding the provisions of paragraph (a), if the 403.22 disallowance results from knowing noncompliance by one or more 403.23 counties with a specific program instruction, and that knowing 403.24 noncompliance is a matter of official county board record, the 403.25 commissioner may require payment or recover from the county or 403.26 counties, in the manner prescribed in paragraph (a), an amount 403.27 equal to the portion of the total disallowance which resulted 403.28 from the noncompliance, and may distribute the balance of the 403.29 disallowance according to paragraph (a). 403.30 (15) Develop and implement special projects that maximize 403.31 reimbursements and result in the recovery of money to the 403.32 state. For the purpose of recovering state money, the 403.33 commissioner may enter into contracts with third parties. Any 403.34 recoveries that result from projects or contracts entered into 403.35 under this paragraph shall be deposited in the state treasury 403.36 and credited to a special account until the balance in the 404.1 account reaches $1,000,000. When the balance in the account 404.2 exceeds $1,000,000, the excess shall be transferred and credited 404.3 to the general fund. All money in the account is appropriated 404.4 to the commissioner for the purposes of this paragraph. 404.5 (16) Have the authority to make direct payments to 404.6 facilities providing shelter to women and their children 404.7 according to section 256D.05, subdivision 3. Upon the written 404.8 request of a shelter facility that has been denied payments 404.9 under section 256D.05, subdivision 3, the commissioner shall 404.10 review all relevant evidence and make a determination within 30 404.11 days of the request for review regarding issuance of direct 404.12 payments to the shelter facility. Failure to act within 30 days 404.13 shall be considered a determination not to issue direct payments. 404.14 (17) Have the authority to establish and enforce the 404.15 following county reporting requirements: 404.16 (a) The commissioner shall establish fiscal and statistical 404.17 reporting requirements necessary to account for the expenditure 404.18 of funds allocated to counties for human services programs. 404.19 When establishing financial and statistical reporting 404.20 requirements, the commissioner shall evaluate all reports, in 404.21 consultation with the counties, to determine if the reports can 404.22 be simplified or the number of reports can be reduced. 404.23 (b) The county board shall submit monthly or quarterly 404.24 reports to the department as required by the commissioner. 404.25 Monthly reports are due no later than 15 working days after the 404.26 end of the month. Quarterly reports are due no later than 30 404.27 calendar days after the end of the quarter, unless the 404.28 commissioner determines that the deadline must be shortened to 404.29 20 calendar days to avoid jeopardizing compliance with federal 404.30 deadlines or risking a loss of federal funding. Only reports 404.31 that are complete, legible, and in the required format shall be 404.32 accepted by the commissioner. 404.33 (c) If the required reports are not received by the 404.34 deadlines established in clause (b), the commissioner may delay 404.35 payments and withhold funds from the county board until the next 404.36 reporting period. When the report is needed to account for the 405.1 use of federal funds and the late report results in a reduction 405.2 in federal funding, the commissioner shall withhold from the 405.3 county boards with late reports an amount equal to the reduction 405.4 in federal funding until full federal funding is received. 405.5 (d) A county board that submits reports that are late, 405.6 illegible, incomplete, or not in the required format for two out 405.7 of three consecutive reporting periods is considered 405.8 noncompliant. When a county board is found to be noncompliant, 405.9 the commissioner shall notify the county board of the reason the 405.10 county board is considered noncompliant and request that the 405.11 county board develop a corrective action plan stating how the 405.12 county board plans to correct the problem. The corrective 405.13 action plan must be submitted to the commissioner within 45 days 405.14 after the date the county board received notice of noncompliance. 405.15 (e) The final deadline for fiscal reports or amendments to 405.16 fiscal reports is one year after the date the report was 405.17 originally due. If the commissioner does not receive a report 405.18 by the final deadline, the county board forfeits the funding 405.19 associated with the report for that reporting period and the 405.20 county board must repay any funds associated with the report 405.21 received for that reporting period. 405.22 (f) The commissioner may not delay payments, withhold 405.23 funds, or require repayment under paragraph (c) or (e) if the 405.24 county demonstrates that the commissioner failed to provide 405.25 appropriate forms, guidelines, and technical assistance to 405.26 enable the county to comply with the requirements. If the 405.27 county board disagrees with an action taken by the commissioner 405.28 under paragraph (c) or (e), the county board may appeal the 405.29 action according to sections 14.57 to 14.69. 405.30 (g) Counties subject to withholding of funds under 405.31 paragraph (c) or forfeiture or repayment of funds under 405.32 paragraph (e) shall not reduce or withhold benefits or services 405.33 to clients to cover costs incurred due to actions taken by the 405.34 commissioner under paragraph (c) or (e). 405.35 (18) Allocate federal fiscal disallowances or sanctions for 405.36 audit exceptions when federal fiscal disallowances or sanctions 406.1 are based on a statewide random sample for the foster care 406.2 program under title IV-E of the Social Security Act, United 406.3 States Code, title 42, in direct proportion to each county's 406.4 title IV-E foster care maintenance claim for that period. 406.5 (19) Be responsible for ensuring the detection, prevention, 406.6 investigation, and resolution of fraudulent activities or 406.7 behavior by applicants, recipients, and other participants in 406.8 the human services programs administered by the department. 406.9 (20) Require county agencies to identify overpayments, 406.10 establish claims, and utilize all available and cost-beneficial 406.11 methodologies to collect and recover these overpayments in the 406.12 human services programs administered by the department. 406.13 (21) Have the authority to administer a drug rebate program 406.14 for drugs purchased pursuant to the senior citizen drug program 406.15 established under section 256.955 after the beneficiary's 406.16 satisfaction of any deductible established in the program. The 406.17 commissioner shall require a rebate agreement from all 406.18 manufacturers of covered drugs as defined in section 256B.0625, 406.19 subdivision 13. For each drug, the amount of the rebate shall 406.20 be equal to the basic rebate as defined for purposes of the 406.21 federal rebate program in United States Code, title 42, section 406.22 1396r-8(c)(1). This basic rebate shall be applied to 406.23 single-source and multiple-source drugs. The manufacturers must 406.24 provide full payment within 30 days of receipt of the state 406.25 invoice for the rebate within the terms and conditions used for 406.26 the federal rebate program established pursuant to section 1927 406.27 of title XIX of the Social Security Act. The manufacturers must 406.28 provide the commissioner with any information necessary to 406.29 verify the rebate determined per drug. The rebate program shall 406.30 utilize the terms and conditions used for the federal rebate 406.31 program established pursuant to section 1927 of title XIX of the 406.32 Social Security Act. 406.33 Sec. 6. Minnesota Statutes 1998, section 256B.0625, is 406.34 amended by adding a subdivision to read: 406.35 Subd. 41. [RESIDENTIAL SERVICES FOR CHILDREN WITH SEVERE 406.36 EMOTIONAL DISTURBANCE.] Medical assistance covers rehabilitative 407.1 services in accordance with section 256B.0945 that are provided 407.2 by a county through a residential facility, for children who 407.3 have been diagnosed with severe emotional disturbance and have 407.4 been determined to require the level of care provided in a 407.5 residential facility. 407.6 (Effective Date: Section 6 (256B.0625, adding subdivision 407.7 41) is effective July 1, 2000.) 407.8 Sec. 7. Minnesota Statutes 1998, section 256B.094, 407.9 subdivision 3, is amended to read: 407.10 Subd. 3. [COORDINATION AND PROVISION OF SERVICES.] (a) In 407.11 a county or reservation where a prepaid medical assistance 407.12 provider has contracted under section 256B.031 or 256B.69 to 407.13 provide mental health services, the case management provider 407.14 shall coordinate with the prepaid provider to ensure that all 407.15 necessary mental health services required under the contract are 407.16 provided to recipients of case management services. 407.17 (b) When the case management provider determines that a 407.18 prepaid provider is not providing mental health services as 407.19 required under the contract, the case management provider shall 407.20 assist the recipient to appeal the prepaid provider's denial 407.21 pursuant to section 256.045, and may make other arrangements for 407.22 provision of the covered services. 407.23 (c) The case management provider may bill the provider of 407.24 prepaid health care services for any mental health services 407.25 provided to a recipient of case management services which the 407.26 county or tribal social services arranges for or provides and 407.27 which are included in the prepaid provider's contract, and which 407.28 were determined to be medically necessary as a result of an 407.29 appeal pursuant to section 256.045. The prepaid provider must 407.30 reimburse the mental health provider, at the prepaid provider's 407.31 standard rate for that service, for any services delivered under 407.32 this subdivision. 407.33 (d) If the county or tribal social services has not 407.34 obtained prior authorization for this service, or an appeal 407.35 results in a determination that the services were not medically 407.36 necessary, the county or tribal social services may not seek 408.1 reimbursement from the prepaid provider. 408.2 Sec. 8. Minnesota Statutes 1998, section 256B.094, 408.3 subdivision 5, is amended to read: 408.4 Subd. 5. [CASE MANAGER.] To provide case management 408.5 services, a case manager must be employed or contracted by and 408.6 authorized by the case management provider to provide case 408.7 management services and meet all requirements under section 408.8 256F.10. 408.9 Sec. 9. Minnesota Statutes 1998, section 256B.094, 408.10 subdivision 6, is amended to read: 408.11 Subd. 6. [MEDICAL ASSISTANCE REIMBURSEMENT OF CASE 408.12 MANAGEMENT SERVICES.] (a) Medical assistance reimbursement for 408.13 services under this section shall be made on a monthly basis. 408.14 Payment is based on face-to-face or telephone contacts between 408.15 the case manager and the client, client's family, primary 408.16 caregiver, legal representative, or other relevant person 408.17 identified as necessary to the development or implementation of 408.18 the goals of the individual service plan regarding the status of 408.19 the client, the individual service plan, or the goals for the 408.20 client. These contacts must meet the minimum standards in 408.21 clauses (1) and (2): 408.22 (1) there must be a face-to-face contact at least once a 408.23 month except as provided in clause (2); and 408.24 (2) for a client placed outside of the county of financial 408.25 responsibility in an excluded time facility under section 408.26 256G.02, subdivision 6, or through the Interstate Compact on the 408.27 Placement of Children, section 257.40, and the placement in 408.28 either case is more than 60 miles beyond the county or 408.29 reservation boundaries, there must be at least one contact per 408.30 month and not more than two consecutive months without a 408.31 face-to-face contact. 408.32 (b) Except as provided in paragraph (c), the payment rate 408.33 is established using time study data on activities of provider 408.34 service staff and reports required under sections 245.482, 408.35 256.01, subdivision 2, paragraph (17), and 256E.08, subdivision 408.36 8. 409.1 (c) For tribes, payment may be in accordance with section 409.2 256B.0625 for child welfare targeted case management provided by 409.3 Indian health services and facilities operated by a tribe or 409.4 tribal organization. 409.5 (d) Payment for case management provided by vendors 409.6 contracted by the county or by tribal social services shall be 409.7 based on a monthly rate negotiated by the host county or tribal 409.8 social services. The negotiated rate must not exceed the rate 409.9 charged by the vendor for the same service to other payers. If 409.10 the service is provided by a team of contracted vendors, the 409.11 county or tribal social services may negotiate a team rate with 409.12 a vendor who is a member of the team. The team shall determine 409.13 how to distribute the rate among its members. No reimbursement 409.14 received by contracted vendors shall be returned to the county 409.15 or tribal social services, except to reimburse the county or 409.16 tribal social services for advance funding provided by the 409.17 county or tribal social services to the vendor. 409.18 (e) If the service is provided by a team that includes 409.19 contracted vendors and county or tribal social services staff, 409.20 the costs for county or tribal social services staff 409.21 participation in the team shall be included in the rate for 409.22 county or tribal social services-provided services. In this 409.23 case, the contracted vendor and the county or tribal social 409.24 services may each receive separate payment for services provided 409.25 by each entity in the same month. In order to prevent 409.26 duplication of services, each entity must document, in the 409.27 recipient's file, the need for team case management and a 409.28 description of the roles and services of the team members. 409.29 Separate payment rates may be established for different 409.30 groups of providers to maximize reimbursement as determined by 409.31 the commissioner. The payment rate will be reviewed annually 409.32 and revised periodically to be consistent with the most recent 409.33 time study and other data. Payment for services will be made 409.34 upon submission of a valid claim and verification of proper 409.35 documentation described in subdivision 7. Federal 409.36 administrative revenue earned through the time study or other 410.1 method of reimbursement under paragraph (c) shall be distributed 410.2 according to earnings, to counties, reservations, or groups of 410.3 counties or reservations which have the same payment rate under 410.4 this subdivision, and to the group of counties or reservations 410.5 which are not certified providers under section 256F.10. The 410.6 commissioner shall modify the requirements set out in Minnesota 410.7 Rules, parts 9550.0300 to 9550.0370, as necessary to accomplish 410.8 this. 410.9 Sec. 10. [256B.0945] [RESIDENTIAL SERVICES FOR CHILDREN 410.10 WITH SEVERE EMOTIONAL DISTURBANCE.] 410.11 Subdivision 1. [PROVIDER QUALIFICATIONS.] Counties must 410.12 arrange to provide residential services for children with severe 410.13 emotional disturbance according to section 245.4882 and this 410.14 section. Services must be provided by a facility that is 410.15 licensed according to section 245.4882 and administrative rules 410.16 promulgated thereunder, and under contract with the county. 410.17 Facilities providing services under subdivision 2, paragraph(a), 410.18 must be accredited as a psychiatric facility by the Joint 410.19 Commission on Accreditation of Healthcare Organizations, the 410.20 Commission on Accreditation of Rehabilitation Facilities, or the 410.21 Council on Accreditation. Accreditation is not required for 410.22 facilities providing services under subdivision 2, paragraph (b). 410.23 Subd. 2. [COVERED SERVICES.] All services must be included 410.24 in a child's individualized treatment or collaborative family 410.25 service plan as defined in chapter 245. 410.26 (a) For facilities that are institutions for mental 410.27 diseases according to statute and regulation or are not 410.28 institutions for mental diseases but choose to provide services 410.29 under this paragraph, medical assistance covers the full 410.30 contract rate, including room and board if the services meet the 410.31 requirements of Code of Federal Regulations, title 42, section 410.32 440.160. 410.33 (b) For facilities that are not institutions for mental 410.34 diseases according to federal statute and regulation and are not 410.35 providing services under paragraph (a), medical assistance 410.36 covers mental health related services that are required to be 411.1 provided by a residential facility under section 245.4882 and 411.2 administrative rules promulgated thereunder, except for room and 411.3 board. 411.4 Subd. 3. [CENTRALIZED DISBURSEMENT OF MEDICAL ASSISTANCE 411.5 PAYMENTS.] Notwithstanding section 256B.041, county payments for 411.6 the cost of residential services provided under this section 411.7 shall not be made to the state treasurer. 411.8 Subd. 4. [PAYMENT RATES.] (a) Notwithstanding sections 411.9 256.025, subdivision 2; 256B.19; and 256B.041, payments to 411.10 counties for residential services provided by a residential 411.11 facility shall only be made of federal earnings for services 411.12 provided under this section, and the nonfederal share of costs 411.13 for services provided under this section shall be paid by the 411.14 county from sources other than federal funds or funds used to 411.15 match other federal funds. Total annual payments for federal 411.16 earnings shall not exceed the federal medical assistance 411.17 percentage matching rate multiplied by the total county 411.18 expenditures for services provided under section 245.4882 for 411.19 either (1) the calendar year 1999 or (2) the average annual 411.20 expenditures for the calendar years 1995 to 1999, whichever is 411.21 greater. Payment to counties for services provided according to 411.22 subdivision 2, paragraph (a), shall be the federal share of the 411.23 contract rate. Payment to counties for services provided 411.24 according to subdivision 2, paragraph (b), shall be a proportion 411.25 of the per day contract rate that relates to rehabilitative 411.26 mental health services and shall not include payment for costs 411.27 or services that are billed to the IV-E program as room and 411.28 board. 411.29 (b) The commissioner shall set aside a portion of the 411.30 federal funds earned under this section to cover the state costs 411.31 of two staff positions and support costs necessary in 411.32 administering this section. Any unexpended funds from the 411.33 set-aside shall be distributed to the counties in proportion to 411.34 their earnings under this section. 411.35 Subd. 5. [QUALITY MEASURES.] Counties must collect and 411.36 report to the commissioner information on outcomes for services 412.1 provided under this section using standardized tools that 412.2 measure functioning, living stability, and parent and child 412.3 satisfaction consistent with the goals of sections 245.4876, 412.4 subdivision 1, and 256F.01. The commissioner shall designate 412.5 standardized tools to be used and shall collect and analyze 412.6 individualized outcome data on a statewide basis and report to 412.7 the legislature by December 1, 2003. The commissioner shall 412.8 provide standardized tools that measure child and adolescent 412.9 functional assessment for intake and discharge, child behavior, 412.10 residential living environment and placement stability, and 412.11 satisfaction for youth and family members. 412.12 Subd. 6. [FEDERAL EARNINGS.] Use of new federal funding 412.13 earned from services provided under this section is limited to: 412.14 (1) increasing prevention and early intervention and 412.15 supportive services to meet the mental health and child welfare 412.16 needs of the children and families in the system of care; 412.17 (2) replacing reductions in federal IV-E reimbursement 412.18 resulting from new medical assistance coverage; and 412.19 (3) paying the nonfederal share of additional provider 412.20 costs due to accreditation and new program standards necessary 412.21 for Medicaid reimbursement. 412.22 For purposes of this section, early intervention and supportive 412.23 services include alternative responses to child maltreatment 412.24 reports under chapter 626 and services outlined in sections 412.25 245.4875, subdivision 2, children's mental health, and 256F.05, 412.26 subdivision 8, family preservation services. 412.27 Subd. 7. [MAINTENANCE OF EFFORT.] (a) Counties that 412.28 receive payment under this section must maintain a level of 412.29 expenditures such that each year's county expenditures for early 412.30 intervention and supportive services is at least equal to that 412.31 county's average expenditures for those services for calendar 412.32 years 1998 and 1999. For purposes of this section, "county 412.33 expenditures" are the total expenditures for those services 412.34 minus the state and federal revenues specifically designated for 412.35 these services. 412.36 (b) The commissioner may waive the requirements in 413.1 paragraph (a) if any of the conditions specified in section 413.2 256F.13, subdivision 1, paragraph (a), clause (4), items (i) to 413.3 (iv), are met. 413.4 Subd. 8. [REPORTS.] The commissioner shall review county 413.5 expenditures annually using reports required under sections 413.6 245.482; 256.01, subdivision 2, clause (17); and 256E.08, 413.7 subdivision 8, to ensure that counties meet their obligation 413.8 under subdivision 7, and that the base level of expenditures for 413.9 mental health and child welfare early intervention and family 413.10 support services and children's mental health residential 413.11 treatment is continued from sources other than federal funds 413.12 earned under this section. 413.13 Subd. 9. [SANCTIONS.] The commissioner may suspend, 413.14 reduce, or terminate the federal reimbursement to a county that 413.15 does not meet one or all of the requirements of this section. 413.16 Subd. 10. [RECOMMENDATIONS.] The commissioner shall 413.17 provide recommendations to the legislature by January 15, 2000, 413.18 regarding any amendments to this section that may be necessary 413.19 or advisable prior to implementation. 413.20 (Effective Date: Section 10 (256B.0945) is effective July 413.21 1, 2000.) 413.22 Sec. 11. Minnesota Statutes 1998, section 256F.03, 413.23 subdivision 5, is amended to read: 413.24 Subd. 5. [FAMILY-BASED SERVICES.] "Family-based services" 413.25 means one or more of the services described in paragraphs (a) 413.26 to(f)(e) provided to families primarily in their own home for 413.27 a limited time. 413.28 (a) [CRISIS SERVICES.] "Crisis services" means 413.29 professional services provided within 24 hours of referral to 413.30 alleviate a family crisis and to offer an alternative to placing 413.31 a child outside the family home. The services are intensive and 413.32 time limited. The service may offer transition to other 413.33 appropriate community-based services. 413.34 (b) [COUNSELING SERVICES.] "Counseling services" means 413.35 professional family counseling provided to alleviate individual 413.36 and family dysfunction; provide an alternative to placing a 414.1 child outside the family home; or permit a child to return 414.2 home. The duration, frequency, and intensity of the service is 414.3 determined in the individual or family service plan. 414.4 (c) [LIFE MANAGEMENT SKILLS SERVICES.] "Life management 414.5 skills services" means paraprofessional services that teach 414.6 family members skills in such areas as parenting, budgeting, 414.7 home management, and communication. The goal is to strengthen 414.8 family skills as an alternative to placing a child outside the 414.9 family home or to permit a child to return home. A social 414.10 worker shall coordinate these services within the family case 414.11 plan. 414.12 (d)[CASE COORDINATION SERVICES.] "Case coordination414.13services" means professional services provided to an individual,414.14family, or caretaker as an alternative to placing a child414.15outside the family home, to permit a child to return home, or to414.16stabilize the long-term or permanent placement of a child.414.17Coordinated services are provided directly, are arranged, or are414.18monitored to meet the needs of a child and family. The414.19duration, frequency, and intensity of services is determined in414.20the individual or family service plan.414.21(e)[MENTAL HEALTH SERVICES.] "Mental health services" 414.22 means the professional services defined in section 245.4871, 414.23 subdivision 31. 414.24(f)(e) [EARLY INTERVENTION SERVICES.] "Early intervention 414.25 services" means family-based intervention services designed to 414.26 help at-risk families avoid crisis situations. 414.27 Sec. 12. Minnesota Statutes 1998, section 256F.05, 414.28 subdivision 8, is amended to read: 414.29 Subd. 8. [USES OF FAMILY PRESERVATION FUND GRANTS.] (a) A 414.30 county which has not demonstrated that year that its family 414.31 preservation core services are developed as provided in 414.32 subdivision 1a, must use its family preservation fund grant 414.33 exclusively for family preservation services defined in section 414.34 256F.03, subdivision 5, paragraphs (a), (b), (c), and(e)(d). 414.35 (b) A county which has demonstrated that year that its 414.36 family preservation core services are developed becomes eligible 415.1 either to continue using its family preservation fund grant as 415.2 provided in paragraph (a), or to exercise the expanded service 415.3 option under paragraph (c). 415.4 (c) The expanded service option permits an eligible county 415.5 to use its family preservation fund grant for child welfare 415.6 preventive services. For purposes of this section, child 415.7 welfare preventive services are those services directed toward a 415.8 specific child or family that further the goals of section 415.9 256F.01 and include assessments, family preservation services, 415.10 service coordination, community-based treatment, crisis nursery 415.11 services when the parents retain custody and there is no 415.12 voluntary placement agreement with a child-placing agency, 415.13 respite care except when it is provided under a medical 415.14 assistance waiver, home-based services, and other related 415.15 services. For purposes of this section, child welfare 415.16 preventive services shall not include shelter care or other 415.17 placement services under the authority of the court or public 415.18 agency to address an emergency. To exercise this option, an 415.19 eligible county must notify the commissioner in writing of its 415.20 intention to do sono later than 30 days into the quarter during415.21which it intends to beginor select this option in its county 415.22 plan, as provided in section 256F.04, subdivision 2. Effective 415.23 with the first day ofthat quarterthe grant period in which 415.24 this option is selected, the county must maintain its base level 415.25 of expenditures for child welfare preventive services and use 415.26 the family preservation fund to expand them. The base level of 415.27 expenditures for a county shall be that established under 415.28 section 256F.10, subdivision 7. For counties which have no such 415.29 base established, a comparable base shall be established with 415.30 the base year being the calendar year ending at least two 415.31 calendar quarters before the first calendar quarter in which the 415.32 county exercises its expanded service option. The commissioner 415.33 shall, at the request of the counties, reduce, suspend, or 415.34 eliminate either or both of a county's obligations to continue 415.35 the base level of expenditures and to expand child welfare 415.36 preventive services under extraordinary circumstances. 416.1 (d) Notwithstanding paragraph (a), a county that is 416.2 participating in the child protection assessments or 416.3 investigations community collaboration pilot program under 416.4 section 626.5560, or in the concurrent permanency planning pilot 416.5 program under section 257.0711, may use its family preservation 416.6 fund grant for those programs. 416.7 Sec. 13. Minnesota Statutes 1998, section 256F.10, 416.8 subdivision 1, is amended to read: 416.9 Subdivision 1. [ELIGIBILITY.] Persons under 21 years of 416.10 age who are eligible to receive medical assistance are eligible 416.11 for child welfare targeted case management services under 416.12 section 256B.094 and this section if they have received an 416.13 assessment and have been determined by the local county or 416.14 tribal social services agency to be: 416.15 (1) at risk of placement or in placement as described in 416.16 section 257.071, subdivision 1; 416.17 (2) at risk of maltreatment or experiencing maltreatment as 416.18 defined in section 626.556, subdivision 10e; or 416.19 (3) in need of protection or services as defined in section 416.20 260.015, subdivision 2a. 416.21 Sec. 14. Minnesota Statutes 1998, section 256F.10, 416.22 subdivision 4, is amended to read: 416.23 Subd. 4. [PROVIDER QUALIFICATIONS AND CERTIFICATION 416.24 STANDARDS.] The commissioner must certify each provider before 416.25 enrolling it as a child welfare targeted case management 416.26 provider of services under section 256B.094 and this section. 416.27 The certification process shall examine the provider's ability 416.28 to meet the qualification requirements and certification 416.29 standards in this subdivision and other federal and state 416.30 requirements of this service. A certified child welfare 416.31 targeted case management provider is an enrolled medical 416.32 assistance provider who is determined by the commissioner to 416.33 have all of the following: 416.34 (1) the legal authority to provide public welfare under 416.35 sections 393.01, subdivision 7, and 393.07 or a federally 416.36 recognized Indian tribe; 417.1 (2) the demonstrated capacity and experience to provide the 417.2 components of case management to coordinate and link community 417.3 resources needed by the eligible population; 417.4 (3) administrative capacity and experience in serving the 417.5 target population for whom it will provide services and in 417.6 ensuring quality of services under state and federal 417.7 requirements; 417.8 (4) the legal authority to provide complete investigative 417.9 and protective services under section 626.556, subdivision 10, 417.10 and child welfare and foster care services under section 393.07, 417.11 subdivisions 1 and 2, or a federally recognized Indian tribe; 417.12 (5) a financial management system that provides accurate 417.13 documentation of services and costs under state and federal 417.14 requirements; and 417.15 (6) the capacity to document and maintain individual case 417.16 records under state and federal requirements. 417.17 Sec. 15. Minnesota Statutes 1998, section 256F.10, 417.18 subdivision 6, is amended to read: 417.19 Subd. 6. [DISTRIBUTION OF NEW FEDERAL REVENUE.] (a) Except 417.20 for portion set aside in paragraph (b), the federal funds earned 417.21 under this section and section 256B.094 bycountiesproviders 417.22 shall be paid to eachcountyprovider based on its earnings, and 417.23 must be used by eachcountyprovider to expand preventive child 417.24 welfare services. 417.25 If a county or tribal social services agency chooses to be a 417.26 provider of child welfare targeted case management and if that 417.27 county or tribal social services agency also joins a local 417.28 children's mental health collaborative as authorized by the 1993 417.29 legislature, then the federal reimbursement received by the 417.30 county or tribal social services agency for providing child 417.31 welfare targeted case management services to children served by 417.32 the local collaborative shall be transferred by the county or 417.33 tribal social services agency to the integrated fund. The 417.34 federal reimbursement transferred to the integrated fund by the 417.35 county or tribal social services agency must not be used for 417.36 residential care other than respite care described under 418.1 subdivision 7, paragraph (d). 418.2 (b) The commissioner shall set aside a portion of the 418.3 federal funds earned under this section to repay the special 418.4 revenue maximization account under section 256.01, subdivision 418.5 2, clause (15). The repayment is limited to: 418.6 (1) the costs of developing and implementing this section 418.7 and sections 256.8711 and 256B.094; 418.8 (2) programming the information systems; and 418.9 (3) the lost federal revenue for the central office claim 418.10 directly caused by the implementation of these sections. 418.11 Any unexpended funds from the set aside under this 418.12 paragraph shall be distributed tocountiesproviders according 418.13 to paragraph (a). 418.14 Sec. 16. Minnesota Statutes 1998, section 256F.10, 418.15 subdivision 7, is amended to read: 418.16 Subd. 7. [EXPANSION OF SERVICES AND BASE LEVEL OF 418.17 EXPENDITURES.] (a) Counties and tribal social services must 418.18 continue the base level of expenditures for preventive child 418.19 welfare services from either or both of any state, county, or 418.20 federal funding source, which, in the absence of federal funds 418.21 earned under this section, would have been available for these 418.22 services. The commissioner shall review the county or tribal 418.23 social services expenditures annually using reports required 418.24 under sections 245.482, 256.01, subdivision 2, paragraph 17, and 418.25 256E.08, subdivision 8, to ensure that the base level of 418.26 expenditures for preventive child welfare services is continued 418.27 from sources other than the federal funds earned under this 418.28 section. 418.29 (b) The commissioner may reduce, suspend, or eliminate 418.30 either or both of a county's or tribal social services' 418.31 obligations to continue the base level of expenditures and to 418.32 expand child welfare preventive services if the commissioner 418.33 determines that one or more of the following conditions apply to 418.34 that county or reservation: 418.35 (1) imposition of levy limits that significantly reduce 418.36 available social service funds; 419.1 (2) reduction in the net tax capacity of the taxable 419.2 property within a county or reservation that significantly 419.3 reduces available social service funds; 419.4 (3) reduction in the number of children under age 19 in the 419.5 county or reservation by 25 percent when compared with the 419.6 number in the base year using the most recent data provided by 419.7 the state demographer's office; or 419.8 (4) termination of the federal revenue earned under this 419.9 section. 419.10 (c) The commissioner may suspend for one year either or 419.11 both of a county's or tribal social services' obligations to 419.12 continue the base level of expenditures and to expand child 419.13 welfare preventive services if the commissioner determines that 419.14 in the previous year one or more of the following conditions 419.15 applied to that county or reservation: 419.16 (1) the total number of children in placement under 419.17 sections 257.071 and 393.07, subdivisions 1 and 2, has been 419.18 reduced by 50 percent from the total number in the base year; or 419.19 (2) the average number of children in placement under 419.20 sections 257.071 and 393.07, subdivisions 1 and 2, on the last 419.21 day of each month is equal to or less than one child per 1,000 419.22 children in the county or reservation. 419.23 (d) For the purposes of this section, child welfare 419.24 preventive services are those services directed toward a 419.25 specific child or family that further the goals of section 419.26 256F.01 and include assessments, family preservation services, 419.27 service coordination, community-based treatment, crisis nursery 419.28 services when the parents retain custody and there is no 419.29 voluntary placement agreement with a child-placing agency, 419.30 respite care except when it is provided under a medical 419.31 assistance waiver, home-based services, and other related 419.32 services. For the purposes of this section, child welfare 419.33 preventive services shall not include shelter care placements 419.34 under the authority of the court or public agency to address an 419.35 emergency, residential services except for respite care, child 419.36 care for the purposes of employment and training, adult 420.1 services, services other than child welfare targeted case 420.2 management when they are provided under medical assistance, 420.3 placement services, or activities not directed toward a specific 420.4 child or family. Respite care must be planned, routine care to 420.5 support the continuing residence of the child with its family or 420.6 long-term primary caretaker and must not be provided to address 420.7 an emergency. 420.8 (e) For the counties and tribal social services beginning 420.9 to claim federal reimbursement for services under this section 420.10 and section 256B.094, the base year is the calendar year ending 420.11 at least two calendar quarters before the first calendar quarter 420.12 in which thecountyprovider begins claiming reimbursement. For 420.13 the purposes of this section, the base level of expenditures is 420.14 the level of county or tribal social services expenditures in 420.15 the base year for eligible child welfare preventive services 420.16 described in this subdivision. 420.17 Sec. 17. Minnesota Statutes 1998, section 256F.10, 420.18 subdivision 8, is amended to read: 420.19 Subd. 8. [PROVIDER RESPONSIBILITIES.] (a) Notwithstanding 420.20 section 256B.19, subdivision 1, for the purposes of child 420.21 welfare targeted case management under section 256B.094 and this 420.22 section, the nonfederal share of costs shall be provided by the 420.23 provider of child welfare targeted case management from sources 420.24 other than federal funds or funds used to match other federal 420.25 funds, except when allowed by federal law or agreement. 420.26 (b) Provider expenditures eligible for federal 420.27 reimbursement under this section must not be made from federal 420.28 funds or funds used to match other federal funds, except when 420.29 allowed by federal law or agreement. 420.30 (c) The commissioner may suspend, reduce, or terminate the 420.31 federal reimbursement to a provider that does not meet the 420.32 reporting or other requirements of section 256B.094 and this 420.33 section. The county or reservation is responsible for any 420.34 federal disallowances. The county or reservation may share this 420.35 responsibility with its contracted vendors. 420.36 Sec. 18. Minnesota Statutes 1998, section 256F.10, 421.1 subdivision 9, is amended to read: 421.2 Subd. 9. [PAYMENTS.] Notwithstanding section 256.025, 421.3 subdivision 2, payments to certified providers for child welfare 421.4 targeted case management expenditures under section 256B.094 and 421.5 this section shall only be made of federal earnings from 421.6 services provided under section 256B.094 and this 421.7 section. Payments to contracted vendors shall include both the 421.8 federal earnings and the nonfederal share. 421.9 Sec. 19. Minnesota Statutes 1998, section 256F.10, 421.10 subdivision 10, is amended to read: 421.11 Subd. 10. [CENTRALIZED DISBURSEMENT OF MEDICAL ASSISTANCE 421.12 PAYMENTS.] Notwithstanding section 256B.041,countyprovider 421.13 payments for the cost of child welfare targeted case management 421.14 services shall not be made to the state treasurer. For the 421.15 purposes of child welfare targeted case management services 421.16 under section 256B.094 and this section, the centralized 421.17 disbursement of payments to providers under section 256B.041 421.18 consists only of federal earnings from services provided under 421.19 section 256B.094 and this section. 421.20 Sec. 20. Minnesota Statutes 1998, section 257.071, 421.21 subdivision 1, is amended to read: 421.22 Subdivision 1. [PLACEMENT; PLAN.] (a) A case plan shall be 421.23 prepared within 30 days after any child is placed in a 421.24 residential facility by court order or by the voluntary release 421.25 of the child by the parent or parents. 421.26 For purposes of this section, a residential facility means 421.27 any group home, family foster home or other publicly supported 421.28 out-of-home residential facility, including any out-of-home 421.29 residential facility under contract with the state, county or 421.30 other political subdivision, or any agency thereof, to provide 421.31 those services or foster care as defined in section 260.015, 421.32 subdivision 7. 421.33 (b) When a child is in placement, the responsible local 421.34 social services agency shall make diligent efforts to identify, 421.35 locate, and, where appropriate, offer services to both parents 421.36 of the child. If a noncustodial or nonadjudicated parent is 422.1 willing and capable of providing for the day-to-day care of the 422.2 child, the local social services agency may seek authority from 422.3 the custodial parent or the court to have that parent assume 422.4 day-to-day care of the child. If a parent is not an adjudicated 422.5 parent, the local social services agency shall require the 422.6 nonadjudicated parent to cooperate with paternity establishment 422.7 procedures as part of the case plan. 422.8 (c) If, after assessment, the local social services agency 422.9 determines that the child cannot be in the day-to-day care of 422.10 either parent, the agency shall prepare a case plan addressing 422.11 the conditions that each parent must mitigate before the child 422.12 could be in that parent's day-to-day care. 422.13 (d) If, after the provision of services following a case 422.14 plan under this section and ordered by the juvenile court, the 422.15 child cannot return to the care of the parent from whom the 422.16 child was removed or who had legal custody at the time the child 422.17 was placed in foster care, the agency may petition on behalf of 422.18 a noncustodial parent to establish legal custody with that 422.19 parent under section 260.191, subdivision 3b. If paternity has 422.20 not already been established, it may be established in the same 422.21 proceeding in the manner provided for under this chapter. 422.22 The responsible social services agency may be relieved of 422.23 the requirement to locate and offer services to both parents by 422.24 the juvenile court upon a finding of good cause after the filing 422.25 of a petition under section 260.131. 422.26 (e) For the purposes of this section, a case plan means a 422.27 written document which is ordered by the court or which is 422.28 prepared by the socialserviceservices agency responsible for 422.29 the residential facility placement and is signed by the parent 422.30 or parents, or other custodian, of the child, the child's legal 422.31 guardian, the socialserviceservices agency responsible for the 422.32 residential facility placement, and, if possible, the child. 422.33 The document shall be explained to all persons involved in its 422.34 implementation, including the child who has signed the document, 422.35 and shall set forth: 422.36 (1) the specific reasons for the placement of the child in 423.1 a residential facility, including a description of the problems 423.2 or conditions in the home of the parent or parents which 423.3 necessitated removal of the child from home; 423.4 (2) the specific actions to be taken by the parent or 423.5 parents of the child to eliminate or correct the problems or 423.6 conditions identified in clause (1), and the time period during 423.7 which the actions are to be taken; 423.8 (3) the financial responsibilities and obligations, if any, 423.9 of the parents for the support of the child during the period 423.10 the child is in the residential facility; 423.11 (4) the visitation rights and obligations of the parent or 423.12 parents or other relatives as defined in section 260.181, if 423.13 such visitation is consistent with the best interest of the 423.14 child, during the period the child is in the residential 423.15 facility; 423.16 (5) the social and other supportive services to be provided 423.17 to the parent or parents of the child, the child, and the 423.18 residential facility during the period the child is in the 423.19 residential facility; 423.20 (6) the date on which the child is expected to be returned 423.21 to and safely maintained in the home of the parent or parents or 423.22 placed for adoption or otherwise permanently removed from the 423.23 care of the parent by court order; 423.24 (7) the nature of the effort to be made by the social 423.25serviceservices agency responsible for the placement to reunite 423.26 the family;and423.27 (8) notice to the parent or parents: 423.28 (i) that placement of the child in foster care may result 423.29 in termination of parental rights but only after notice and a 423.30 hearing as provided in chapter 260.; and 423.31 (ii) in cases where the agency has determined that both 423.32 reasonable efforts to reunify the child with the parents, and 423.33 reasonable efforts to place the child in a permanent home away 423.34 from the parent that may become legally permanent are 423.35 appropriate, notice of: 423.36 (A) time limits on the length of placement and of 424.1 reunification services; 424.2 (B) the nature of the services available to the parent; 424.3 (C) the consequences to the parent and the child if the 424.4 parent fails or is unable to use services to correct the 424.5 circumstances that led to the child's placement; 424.6 (D) the first consideration for relative placement; and 424.7 (E) the benefit to the child in getting the child out of 424.8 residential care as soon as possible, preferably by returning 424.9 the child home, but if that is not possible, through a permanent 424.10 legal placement of the child away from the parent; 424.11 (9) a permanency hearing under section 260.191, subdivision 424.12 3b, or a termination of parental rights hearing under sections 424.13 260.221 to 260.245, where the agency asks the court to find that 424.14 the child should be permanently placed away from the parent and 424.15 includes documentation of the steps taken by the responsible 424.16 social services agency to find an adoptive family or other 424.17 permanent legal placement for the child, to place the child with 424.18 an adoptive family, a fit and willing relative through an award 424.19 of permanent legal and physical custody, or in another planned 424.20 and permanent legal placement. The documentation must include 424.21 child specific recruitment efforts; and 424.22 (10) if the court has issued an order terminating the 424.23 rights of both parents of the child or of the only known, living 424.24 parent of the child, documentation of steps to finalize the 424.25 adoption or legal guardianship of the child. 424.26 (f) The parent or parents and the child each shall have the 424.27 right to legal counsel in the preparation of the case plan and 424.28 shall be informed of the right at the time of placement of the 424.29 child. The child shall also have the right to a guardian ad 424.30 litem. If unable to employ counsel from their own resources, 424.31 the court shall appoint counsel upon the request of the parent 424.32 or parents or the child or the child's legal guardian. The 424.33 parent or parents may also receive assistance from any person or 424.34 socialserviceservices agency in preparation of the case plan. 424.35 After the plan has been agreed upon by the parties 424.36 involved, the foster parents shall be fully informed of the 425.1 provisions of the case plan and shall be provided a copy of the 425.2 plan. 425.3 (g) When an agency accepts a child for placement, the 425.4 agency shall determine whether the child has had a physical 425.5 examination by or under the direction of a licensed physician 425.6 within the 12 months immediately preceding the date when the 425.7 child came into the agency's care. If there is documentation 425.8 that the child has had such an examination within the last 12 425.9 months, the agency is responsible for seeing that the child has 425.10 another physical examination within one year of the documented 425.11 examination and annually in subsequent years. If the agency 425.12 determines that the child has not had a physical examination 425.13 within the 12 months immediately preceding placement, the agency 425.14 shall ensure that the child has the examination within 30 days 425.15 of coming into the agency's care and once a year in subsequent 425.16 years. 425.17 Sec. 21. Minnesota Statutes 1998, section 257.071, 425.18 subdivision 1a, is amended to read: 425.19 Subd. 1a. [PLACEMENT DECISIONS BASED ON BEST INTEREST OF 425.20 THE CHILD.] (a) The policy of the state of Minnesota is to 425.21 ensure that the child's best interests are met by requiring an 425.22 individualized determination of the needs of the child and of 425.23 how the selected placement will serve the needs of the child 425.24 being placed. The authorized child-placing agency shall place a 425.25 child, released by court order or by voluntary release by the 425.26 parent or parents, in a family foster home selected by 425.27 considering placement with relatives and important friends 425.28 consistent with section 260.181, subdivision 3. 425.29 (b) Among the factors the agency shall consider in 425.30 determining the needs of the child are those specified under 425.31 section 260.181, subdivision 3, paragraph (b). 425.32 (c) Placement of a child cannot be delayed or denied based 425.33 on race, color, or national origin of the foster parent or the 425.34 child.Whenever possible,Siblings should be placed together 425.35 for foster care and adoption at the earliest possible time 425.36 unless it is determined not to be in the best interests of a 426.1 sibling or unless it is not possible after appropriate efforts 426.2 by the responsible social services agency. 426.3 Sec. 22. Minnesota Statutes 1998, section 257.071, 426.4 subdivision 1c, is amended to read: 426.5 Subd. 1c. [NOTICE BEFORE VOLUNTARY PLACEMENT.] The local 426.6 socialserviceservices agency shall inform a parent considering 426.7 voluntary placement of a child who is not developmentally 426.8 disabled or emotionally handicapped of the following: 426.9 (1) the parent and the child each has a right to separate 426.10 legal counsel before signing a voluntary placement agreement, 426.11 but not to counsel appointed at public expense; 426.12 (2) the parent is not required to agree to the voluntary 426.13 placement, and a parent who enters a voluntary placement 426.14 agreement may at any time request that the agency return the 426.15 child. If the parent so requests, the child must be returned 426.16 within 24 hours of the receipt of the request; 426.17 (3) evidence gathered during the time the child is 426.18 voluntarily placed may be used at a later time as the basis for 426.19 a petition alleging that the child is in need of protection or 426.20 services or as the basis for a petition seeking termination of 426.21 parental rights or other permanent placement of the child away 426.22 from the parent; 426.23 (4) if the local socialserviceservices agency files a 426.24 petition alleging that the child is in need of protection or 426.25 services or a petition seeking the termination of parental 426.26 rights or other permanent placement of the child away from the 426.27 parent, the parent would have the right to appointment of 426.28 separate legal counsel and the child would have a right to the 426.29 appointment of counsel and a guardian ad litem as provided by 426.30 law, and that counsel will be appointed at public expense if 426.31 they are unable to afford counsel; and 426.32 (5) the timelines and procedures for review of voluntary 426.33 placements under subdivision 3, and the effect the time spent in 426.34 voluntary placement on the scheduling of a permanent placement 426.35 determination hearing under section 260.191, subdivision 3b. 426.36 Sec. 23. Minnesota Statutes 1998, section 257.071, 427.1 subdivision 1d, is amended to read: 427.2 Subd. 1d. [RELATIVE SEARCH; NATURE.] (a) As soon as 427.3 possible, but in any event within six months after a child is 427.4 initially placed in a residential facility, the local social 427.5 services agency shall identify any relatives of the child and 427.6 notify them of the need for a foster care home for the child and 427.7 of the possibility of the need for a permanent out-of-home 427.8 placement of the child. Relatives should also be notified that 427.9 a decision not to be a placement resource at the beginning of 427.10 the case may affect the relative being considered for placement 427.11 of the child with that relative later. The relatives must be 427.12 notified that they must keep the local social services agency 427.13 informed of their current address in order to receive notice 427.14 that a permanent placement is being sought for the child. A 427.15 relative who fails to provide a current address to the local 427.16 social services agency forfeits the right to notice of the 427.17 possibility of permanent placement. If the child's parent 427.18 refuses to give the responsible social services agency 427.19 information sufficient to identify relatives of the child, the 427.20 agency shall determine whether the parent's refusal is in the 427.21 child's best interests. If the agency determines the parent's 427.22 refusal is not in the child's best interests, the agency shall 427.23 file a petition under section 260.131, and shall ask the 427.24 juvenile court to order the parent to provide the necessary 427.25 information. 427.26 (b) Unless relieved of this duty by the court because the 427.27 child is placed with an appropriate relative who wishes to 427.28 provide a permanent home for the child or the child is placed 427.29 with a foster home that has committed to being the permanent 427.30 legal placement for the child and the responsible social 427.31 services agency approves of that foster home for permanent 427.32 placement of the child, when the agency determines that it is 427.33 necessary to prepare for the permanent placement determination 427.34 hearing, or in anticipation of filing a termination of parental 427.35 rights petition, the agency shall send notice to the relatives, 427.36 any adult with whom the child is currently residing, any adult 428.1 with whom the child has resided for one year or longer in the 428.2 past, and any adults who have maintained a relationship or 428.3 exercised visitation with the child as identified in the agency 428.4 case plan. The notice must state that a permanent home is 428.5 sought for the child and that the individuals receiving the 428.6 notice may indicate to the agency their interest in providing a 428.7 permanent home. The notice must state that within 30 days of 428.8 receipt of the notice an individual receiving the notice must 428.9 indicate to the agency the individual's interest in providing a 428.10 permanent home for the child or that the individual may lose the 428.11 opportunity to be considered for a permanent placement. This 428.12 notice need not be sent if the child is placed with an 428.13 appropriate relative who wishes to provide a permanent home for 428.14 the child. 428.15 Sec. 24. Minnesota Statutes 1998, section 257.071, 428.16 subdivision 1e, is amended to read: 428.17 Subd. 1e. [CHANGE IN PLACEMENT.] If a child is removed 428.18 from a permanent placement disposition authorized under section 428.19 260.191, subdivision 3b, within one year after the placement was 428.20 made: 428.21 (1) the child must be returned to the residential facility 428.22 where the child was placed immediately preceding the permanent 428.23 placement; or 428.24 (2) the court shall hold a hearing within ten days after 428.25 the child istaken into custodyremoved from the permanent 428.26 placement to determine where the child is to be placed. A 428.27 guardian ad litem must be appointed for the child for this 428.28 hearing. 428.29 Sec. 25. Minnesota Statutes 1998, section 257.071, 428.30 subdivision 3, is amended to read: 428.31 Subd. 3. [REVIEW OF VOLUNTARY PLACEMENTS.] Except as 428.32 provided in subdivision 4, if the child has been placed in a 428.33 residential facility pursuant to a voluntary release by the 428.34 parent or parents, and is not returned home within 90 days after 428.35 initial placement in the residential facility, the social 428.36serviceservices agency responsible for the placement shall: 429.1 (1) return the child to the home of the parent or parents; 429.2 or 429.3 (2) file a petition according to section 260.131, 429.4 subdivision 1, which may: 429.5 (i) ask the court to review the placement and approve it 429.6 for up toextend the placement foran additional 90 days.; 429.7 (ii) ask the court to order continued out-of-home placement 429.8 according to sections 260.172 and 260.191; or 429.9 (iii) ask the court to terminate parental rights under 429.10 section 260.221. 429.11 The case plan must be updated when a petition is filed and 429.12 must include a specific plan for permanency, which may include a 429.13 time line for returning the child home or a plan for permanent 429.14 placement of the child away from the parent, or both. 429.15 If the court approvesthe extensioncontinued out-of-home 429.16 placement for up to 90 more days, at the end of the 429.17secondcourt-approved 90-day period, the child must be returned 429.18 to the parent's home, unless a petition is. If the child is not 429.19 returned home, the responsible social services agency must 429.20 proceed on the petition filedfor aalleging the child in need 429.21 of protection or services or the petition for termination of 429.22 parental rights. The court must find a statutory basis to order 429.23 the placement of the child under section 260.172; 260.191; or 429.24 260.241. 429.25 Sec. 26. Minnesota Statutes 1998, section 257.071, 429.26 subdivision 4, is amended to read: 429.27 Subd. 4. [REVIEW OF DEVELOPMENTALLY DISABLED AND 429.28 EMOTIONALLY HANDICAPPED CHILD PLACEMENTS.] If a developmentally 429.29 disabled child, as that term is defined in United States Code, 429.30 title 42, section 6001 (7), as amended through December 31, 429.31 1979, or a child diagnosed with an emotional handicap as defined 429.32 in section 252.27, subdivision 1a, has been placed in a 429.33 residential facility pursuant to a voluntary release by the 429.34 child's parent or parents because of the child's handicapping 429.35 conditions or need for long-term residential treatment or 429.36 supervision, the socialserviceservices agency responsible for 430.1 the placement shall bring a petition for review of the child's 430.2 foster care status, pursuant to section 260.131,subdivision 1a,430.3rather than aafter the child has been in placement for six 430.4 months. If a child is in placement due solely to the child's 430.5 handicapping condition and custody of the child is not 430.6 transferred to the responsible social services agency under 430.7 section 260.191, subdivision 1, paragraph (a), clause (2), no 430.8 petitionasis required by section 260.191, subdivision 3b,430.9after the child has been in foster care for six months or, in430.10the case of a child with an emotional handicap, after the child430.11has been in a residential facility for six months. Whenever a 430.12 petition for review is brought pursuant to this subdivision, a 430.13 guardian ad litem shall be appointed for the child. 430.14 Sec. 27. Minnesota Statutes 1998, section 257.85, 430.15 subdivision 2, is amended to read: 430.16 Subd. 2. [SCOPE.] The provisions of this section apply to 430.17 those situations in which the legal and physical custody of a 430.18 child is established with a relative or important friend with 430.19 whom the child has resided or had significant contact according 430.20 to section 260.191, subdivision 3b, by a court order issued on 430.21 or after July 1, 1997. 430.22 Sec. 28. Minnesota Statutes 1998, section 257.85, 430.23 subdivision 3, is amended to read: 430.24 Subd. 3. [DEFINITIONS.] For purposes of this section, the 430.25 terms defined in this subdivision have the meanings given them. 430.26 (a) "AFDC orMFIP standard" means themonthly standard of430.27need used to calculate assistance under the AFDC program, the430.28 transitional standard used to calculate assistance under the 430.29 MFIP-S program, or, ifneither of those is applicablepermanent 430.30 legal and physical custody of the child is given to a relative 430.31 custodian residing outside of Minnesota, the analogous 430.32 transitional standard or standard of need used to calculate 430.33 assistance under theMFIP or MFIP-R programsTANF program of the 430.34 state where the relative custodian lives. 430.35 (b) "Local agency" means the local socialserviceservices 430.36 agency with legal custody of a child prior to the transfer of 431.1 permanent legal and physical custodyto a relative. 431.2 (c) "Permanent legal and physical custody" means permanent 431.3 legal and physical custody ordered by a Minnesota juvenile court 431.4 under section 260.191, subdivision 3b. 431.5 (d) "Relative" means an individual, other than a parent, 431.6 who is related to a child by blood, marriage, or adoption. 431.7 (e) "Relative custodian" means arelative of a child for431.8whom the relativeperson who has permanent legal and physical 431.9 custody of a child. When siblings, including half-siblings and 431.10 step siblings, are placed together inthepermanent legal and 431.11 physical custodyof a relative of one of the siblings, the 431.12 person receiving permanent legal and physical custody of the 431.13 siblings is considered a relative custodian of all of the 431.14 siblings for purposes of this section. 431.15 (f) "Relative custody assistance agreement" means an 431.16 agreement entered into between a local agency andthe relative431.17ofachildperson who has been or will be awarded permanent 431.18 legal and physical custody ofthea child. 431.19 (g) "Relative custody assistance payment" means a monthly 431.20 cash grant made to a relative custodian pursuant to a relative 431.21 custody assistance agreement and in an amount calculated under 431.22 subdivision 7. 431.23 (h) "Remains in the physical custody of the relative 431.24 custodian" means that the relative custodian is providing 431.25 day-to-day care for the child and that the child lives with the 431.26 relative custodian; absence from the relative custodian's home 431.27 for a period of more than 120 days raises a presumption that the 431.28 child no longer remains in the physical custody of the relative 431.29 custodian. 431.30 Sec. 29. Minnesota Statutes 1998, section 257.85, 431.31 subdivision 4, is amended to read: 431.32 Subd. 4. [DUTIES OF LOCAL AGENCY.] (a) When a local agency 431.33 seeks a court order under section 260.191, subdivision 3b, to 431.34 establish permanent legal and physical custody of a child with a 431.35 relative or important friend with whom the child has resided or 431.36 had significant contact, or if such an order is issued by the 432.1 court, the local agency shall perform the duties in this 432.2 subdivision. 432.3 (b) As soon as possible after the local agency determines 432.4 that it will seek to establish permanent legal and physical 432.5 custody of the childwith a relativeor, if the agency did not 432.6 seek to establish custody, as soon as possible after the 432.7 issuance of the court order establishing custody, the local 432.8 agency shall inform the relative custodian about the relative 432.9 custody assistance program, including eligibility criteria and 432.10 payment levels. Anytime prior to, but not later than seven days 432.11 after, the date the court issues the order establishing 432.12 permanent legal and physical custody of the childwith a432.13relative, the local agency shall determine whether the 432.14 eligibility criteria in subdivision 6 are met to allow the 432.15 relative custodian to receive relative custody assistance. Not 432.16 later than seven days after determining whether the eligibility 432.17 criteria are met, the local agency shall inform the relative 432.18 custodian of its determination and of the process for appealing 432.19 that determination under subdivision 9. 432.20 (c) If the local agency determines that the relative 432.21 custodian is eligible to receive relative custody assistance, 432.22 the local agency shall prepare the relative custody assistance 432.23 agreement and ensure that it meets the criteria of subdivision 6. 432.24 (d) The local agency shall make monthly payments to the 432.25 relative custodian as set forth in the relative custody 432.26 assistance agreement. On a quarterly basis and on a form to be 432.27 provided by the commissioner, the local agency shall make claims 432.28 for reimbursement from the commissioner for relative custody 432.29 assistance payments made. 432.30 (e) For a relative custody assistance agreement that is in 432.31 place for longer than one year, and as long as the agreement 432.32 remains in effect, the local agency shall send an annual 432.33 affidavit form to the relative custodian of the eligible child 432.34 within the month before the anniversary date of the agreement. 432.35 The local agency shall monitor whether the annual affidavit is 432.36 returned by the relative custodian within 30 days following the 433.1 anniversary date of the agreement. The local agency shall 433.2 review the affidavit and any other information in its possession 433.3 to ensure continuing eligibility for relative custody assistance 433.4 and that the amount of payment made according to the agreement 433.5 is correct. 433.6 (f) When the local agency determines that a relative 433.7 custody assistance agreement should be terminated or modified, 433.8 it shall provide notice of the proposed termination or 433.9 modification to the relative custodian at least ten days before 433.10 the proposed action along with information about the process for 433.11 appealing the proposed action. 433.12 Sec. 30. Minnesota Statutes 1998, section 257.85, 433.13 subdivision 5, is amended to read: 433.14 Subd. 5. [RELATIVE CUSTODY ASSISTANCE AGREEMENT.] (a) A 433.15 relative custody assistance agreement will not be effective, 433.16 unless it is signed by the local agency and the relative 433.17 custodian no later than 30 days after the date of the order 433.18 establishing permanent legal and physical custodywith the433.19relative, except that a local agency may enter into a relative 433.20 custody assistance agreement with a relative custodian more than 433.21 30 days after the date of the order if it certifies that the 433.22 delay in entering the agreement was through no fault of the 433.23 relative custodian. There must be a separate agreement for each 433.24 child for whom the relative custodian is receiving relative 433.25 custody assistance. 433.26 (b) Regardless of when the relative custody assistance 433.27 agreement is signed by the local agency and relative custodian, 433.28 the effective date of the agreement shall be the date of the 433.29 order establishing permanent legal and physical custody. 433.30 (c) If MFIP-S is not the applicable program for a child at 433.31 the time that a relative custody assistance agreement is entered 433.32 on behalf of the child, when MFIP-S becomes the applicable 433.33 program, if the relative custodian had been receiving custody 433.34 assistance payments calculated based upon a different program, 433.35 the amount of relative custody assistance payment under 433.36 subdivision 7 shall be recalculated under the MFIP-S program. 434.1 (d) The relative custody assistance agreement shall be in a 434.2 form specified by the commissioner and shall include provisions 434.3 relating to the following: 434.4 (1) the responsibilities of all parties to the agreement; 434.5 (2) the payment terms, including the financial 434.6 circumstances of the relative custodian, the needs of the child, 434.7 the amount and calculation of the relative custody assistance 434.8 payments, and that the amount of the payments shall be 434.9 reevaluated annually; 434.10 (3) the effective date of the agreement, which shall also 434.11 be the anniversary date for the purpose of submitting the annual 434.12 affidavit under subdivision 8; 434.13 (4) that failure to submit the affidavit as required by 434.14 subdivision 8 will be grounds for terminating the agreement; 434.15 (5) the agreement's expected duration, which shall not 434.16 extend beyond the child's eighteenth birthday; 434.17 (6) any specific known circumstances that could cause the 434.18 agreement or payments to be modified, reduced, or terminated and 434.19 the relative custodian's appeal rights under subdivision 9; 434.20 (7) that the relative custodian must notify the local 434.21 agency within 30 days of any of the following: 434.22 (i) a change in the child's status; 434.23 (ii) a change in the relationship between the relative 434.24 custodian and the child; 434.25 (iii) a change in composition or level of income of the 434.26 relative custodian's family; 434.27 (iv) a change in eligibility or receipt of benefits under 434.28AFDC,MFIP-S,or other assistance program; and 434.29 (v) any other change that could affect eligibility for or 434.30 amount of relative custody assistance; 434.31 (8) that failure to provide notice of a change as required 434.32 by clause (7) will be grounds for terminating the agreement; 434.33 (9) that the amount of relative custody assistance is 434.34 subject to the availability of state funds to reimburse the 434.35 local agency making the payments; 434.36 (10) that the relative custodian may choose to temporarily 435.1 stop receiving payments under the agreement at any time by 435.2 providing 30 days' notice to the local agency and may choose to 435.3 begin receiving payments again by providing the same notice but 435.4 any payments the relative custodian chooses not to receive are 435.5 forfeit; and 435.6 (11) that the local agency will continue to be responsible 435.7 for making relative custody assistance payments under the 435.8 agreement regardless of the relative custodian's place of 435.9 residence. 435.10 Sec. 31. Minnesota Statutes 1998, section 257.85, 435.11 subdivision 6, is amended to read: 435.12 Subd. 6. [ELIGIBILITY CRITERIA.] A local agency shall 435.13 enter into a relative custody assistance agreement under 435.14 subdivision 5 if it certifies that the following criteria are 435.15 met: 435.16 (1) the juvenile court has determined or is expected to 435.17 determine that the child, under the former or current custody of 435.18 the local agency, cannot return to the home of the child's 435.19 parents; 435.20 (2) the court, upon determining that it is in the child's 435.21 best interests, has issued or is expected to issue an order 435.22 transferring permanent legal and physical custody of the child 435.23to the relative; and 435.24 (3) the child either: 435.25 (i) is a member of a sibling group to be placed together; 435.26 or 435.27 (ii) has a physical, mental, emotional, or behavioral 435.28 disability that will require financial support. 435.29 When the local agency bases its certification that the 435.30 criteria in clause (1) or (2) are met upon the expectation that 435.31 the juvenile court will take a certain action, the relative 435.32 custody assistance agreement does not become effective until and 435.33 unless the court acts as expected. 435.34 Sec. 32. Minnesota Statutes 1998, section 257.85, 435.35 subdivision 7, is amended to read: 435.36 Subd. 7. [AMOUNT OF RELATIVE CUSTODY ASSISTANCE PAYMENTS.] 436.1 (a) The amount of a monthly relative custody assistance payment 436.2 shall be determined according to the provisions of this 436.3 paragraph. 436.4 (1) The total maximum assistance rate is equal to the base 436.5 assistance rate plus, if applicable, the supplemental assistance 436.6 rate. 436.7 (i) The base assistance rate is equal to the maximum amount 436.8 that could be received as basic maintenance for a child of the 436.9 same age under the adoption assistance program. 436.10 (ii) The local agency shall determine whether the child has 436.11 physical, mental, emotional, or behavioral disabilities that 436.12 require care, supervision, or structure beyond that ordinarily 436.13 provided in a family setting to children of the same age such 436.14 that the child would be eligible for supplemental maintenance 436.15 payments under the adoption assistance program if an adoption 436.16 assistance agreement were entered on the child's behalf. If the 436.17 local agency determines that the child has such a disability, 436.18 the supplemental assistance rate shall be the maximum amount of 436.19 monthly supplemental maintenance payment that could be received 436.20 on behalf of a child of the same age, disabilities, and 436.21 circumstances under the adoption assistance program. 436.22 (2) The net maximum assistance rate is equal to the total 436.23 maximum assistance rate from clause (1) less the following 436.24 offsets: 436.25 (i) if the child is or will be part of an assistance unit 436.26 receiving anAFDC,MFIP-S, or other MFIPgrant or a grant from a 436.27 similar program of another state, the portion of theAFDC or436.28 MFIP standard relating to the child as calculated under 436.29 paragraph (b), clause (2); 436.30 (ii) Supplemental Security Income payments received by or 436.31 on behalf of the child; 436.32 (iii) veteran's benefits received by or on behalf of the 436.33 child; and 436.34 (iv) any other income of the child, including child support 436.35 payments made on behalf of the child. 436.36 (3) The relative custody assistance payment to be made to 437.1 the relative custodian shall be a percentage of the net maximum 437.2 assistance rate calculated in clause (2) based upon the gross 437.3 income of the relative custodian's family, including the child 437.4 for whom the relative custodian has permanent legal and physical 437.5 custody. In no case shall the amount of the relative custody 437.6 assistance payment exceed that which the child could qualify for 437.7 under the adoption assistance program if an adoption assistance 437.8 agreement were entered on the child's behalf. The relative 437.9 custody assistance payment shall be calculated as follows: 437.10 (i) if the relative custodian's gross family income is less 437.11 than or equal to 200 percent of federal poverty guidelines, the 437.12 relative custody assistance payment shall be the full amount of 437.13 the net maximum assistance rate; 437.14 (ii) if the relative custodian's gross family income is 437.15 greater than 200 percent and less than or equal to 225 percent 437.16 of federal poverty guidelines, the relative custody assistance 437.17 payment shall be 80 percent of the net maximum assistance rate; 437.18 (iii) if the relative custodian's gross family income is 437.19 greater than 225 percent and less than or equal to 250 percent 437.20 of federal poverty guidelines, the relative custody assistance 437.21 payment shall be 60 percent of the net maximum assistance rate; 437.22 (iv) if the relative custodian's gross family income is 437.23 greater than 250 percent and less than or equal to 275 percent 437.24 of federal poverty guidelines, the relative custody assistance 437.25 payment shall be 40 percent of the net maximum assistance rate; 437.26 (v) if the relative custodian's gross family income is 437.27 greater than 275 percent and less than or equal to 300 percent 437.28 of federal poverty guidelines, the relative custody assistance 437.29 payment shall be 20 percent of the net maximum assistance rate; 437.30 or 437.31 (vi) if the relative custodian's gross family income is 437.32 greater than 300 percent of federal poverty guidelines, no 437.33 relative custody assistance payment shall be made. 437.34 (b)This paragraph specifies the provisions pertaining to437.35the relationship between relative custody assistance and AFDC,437.36MFIP-S, or other MFIP programsThe following provisions cover 438.1 the relationship between relative custody assistance and 438.2 assistance programs: 438.3 (1) The relative custodian of a child for whom the relative 438.4 custodian is receiving relative custody assistance is expected 438.5 to seek whatever assistance is available for the child 438.6 throughthe AFDC,MFIP-S,orother MFIP, if the relative 438.7 custodian resides in a state other than Minnesota, similar 438.8 programs of that state. If a relative custodian fails to apply 438.9 for assistance throughAFDC,MFIP-S,or otherMFIPprogram for 438.10 which the child is eligible, the child's portion of theAFDC or438.11 MFIP standard will be calculated as if application had been made 438.12 and assistance received;. 438.13 (2) The portion of theAFDC orMFIP standard relating to 438.14 each child for whom relative custody assistance is being 438.15 received shall be calculated as follows: 438.16 (i) determine the totalAFDC orMFIP standard for the 438.17 assistance unit; 438.18 (ii) determine the amount that theAFDC orMFIP standard 438.19 would have been if the assistance unit had not included the 438.20 children for whom relative custody assistance is being received; 438.21 (iii) subtract the amount determined in item (ii) from the 438.22 amount determined in item (i); and 438.23 (iv) divide the result in item (iii) by the number of 438.24 children for whom relative custody assistance is being received 438.25 that are part of the assistance unit; or. 438.26 (3) If a child for whom relative custody assistance is 438.27 being received is not eligible for assistance throughthe AFDC,438.28 MFIP-S,orother MFIPsimilar programs of another state, the 438.29 portion ofAFDC orMFIP standard relating to that child shall be 438.30 equal to zero. 438.31 Sec. 33. Minnesota Statutes 1998, section 257.85, 438.32 subdivision 9, is amended to read: 438.33 Subd. 9. [RIGHT OF APPEAL.] A relative custodian who 438.34 enters or seeks to enter into a relative custody assistance 438.35 agreement with a local agency has the right to appeal to the 438.36 commissioner according to section 256.045 when the local agency 439.1 establishes, denies, terminates, or modifies the agreement. 439.2 Upon appeal, the commissioner may review only: 439.3 (1) whether the local agency has met the legal requirements 439.4 imposed by this chapter for establishing, denying, terminating, 439.5 or modifying the agreement; 439.6 (2) whether the amount of the relative custody assistance 439.7 payment was correctly calculated under the method in subdivision 439.8 7; 439.9 (3) whether the local agency paid for correct time periods 439.10 under the relative custody assistance agreement; 439.11 (4) whether the child remains in the physical custody of 439.12 the relative custodian; 439.13 (5) whether the local agency correctlycalculatedmodified 439.14 the amount of the supplemental assistance rate based on a change 439.15 in the child's physical, mental, emotional, or behavioral needs, 439.16 or based on the relative custodian's failure todocumentprovide 439.17 documentation, after the local agency has requested such 439.18 documentation, that thecontinuing need for the supplemental439.19assistance rate after the local agency has requested such439.20documentationchild continues to have physical, mental, 439.21 emotional, or behavioral needs that support the current amount 439.22 of relative custody assistance; and 439.23 (6) whether the local agency correctlycalculatedmodified 439.24 or terminated the amount of relative custody assistance based on 439.25 a change in the gross income of the relative custodian's family 439.26 or based on the relative custodian's failure to provide 439.27 documentation of the gross income of the relative custodian's 439.28 family after the local agency has requested such documentation. 439.29 Sec. 34. Minnesota Statutes 1998, section 257.85, 439.30 subdivision 11, is amended to read: 439.31 Subd. 11. [FINANCIAL CONSIDERATIONS.] (a) Payment of 439.32 relative custody assistance under a relative custody assistance 439.33 agreement is subject to the availability of state funds and 439.34 payments may be reduced or suspended on order of the 439.35 commissioner if insufficient funds are available. 439.36 (b) Upon receipt from a local agency of a claim for 440.1 reimbursement, the commissioner shall reimburse the local agency 440.2 in an amount equal to 100 percent of the relative custody 440.3 assistance payments provided to relative custodians. The local 440.4 agency may not seek and the commissioner shall not provide 440.5 reimbursement for the administrative costs associated with 440.6 performing the duties described in subdivision 4. 440.7 (c) For the purposes of determining eligibility or payment 440.8 amounts underthe AFDC,MFIP-S,and other MFIP programs,440.9 relative custody assistance payments shall beconsidered440.10 excluded in determining the family's available income. 440.11 Sec. 35. Minnesota Statutes 1998, section 259.29, 440.12 subdivision 2, is amended to read: 440.13 Subd. 2. [PLACEMENT WITH RELATIVEOR, FRIEND, OR MARRIED 440.14 COUPLE.] The authorized child-placing agency shall consider 440.15 placement, consistent with the child's best interests and in the 440.16 following order, with (1) a relative or relatives of the 440.17 child,or(2) an important friend with whom the child has 440.18 resided or had significant contact, or (3) a married 440.19 couple. Considering these placement options shall not delay the 440.20 placement of any child. Nothing in this section prohibits the 440.21 placement of a child with an unmarried person. In implementing 440.22 this section, an authorized child-placing agency may disclose 440.23 private or confidential data, as defined in section 13.02, to 440.24 relatives of the child for the purpose of locating a suitable 440.25 adoptive home. The agency shall disclose only data that is 440.26 necessary to facilitate implementing the preference. 440.27 If the child's birth parent or parents explicitly request 440.28 that placement with relatives or important friends not be 440.29 considered, the authorized child-placing agency shall honor that 440.30 request consistent with the best interests of the child. 440.31 If the child's birth parent or parents express a preference 440.32 for placing the child in an adoptive home of the same or a 440.33 similar religious background to that of the birth parent or 440.34 parents, the agency shall place the child with a family that 440.35 meets the birth parent's religious preference. 440.36 This subdivision does not affect the Indian Child Welfare 441.1 Act, United States Code, title 25, sections 1901 to 1923, and 441.2 the Minnesota Indian Family Preservation Act, sections 257.35 to 441.3 257.3579. 441.4 Sec. 36. Minnesota Statutes 1998, section 259.67, 441.5 subdivision 6, is amended to read: 441.6 Subd. 6. [RIGHT OF APPEAL.] (a) The adoptive parents have 441.7 the right to appeal to the commissioner pursuant to section 441.8 256.045, when the commissioner denies, discontinues, or modifies 441.9 the agreement. 441.10 (b) Adoptive parents who believe that their adopted child 441.11 was incorrectly denied adoption assistance, or who did not seek 441.12 adoption assistance on the child's behalf because of being 441.13 provided with inaccurate or insufficient information about the 441.14 child or the adoption assistance program, may request a hearing 441.15 under section 256.045. Notwithstanding subdivision 2, the 441.16 purpose of the hearing shall be to determine whether, under 441.17 standards established by the federal Department of Health and 441.18 Human Services, the circumstances surrounding the child's 441.19 adoption warrant making an adoption assistance agreement on 441.20 behalf of the child after the final decree of adoption has been 441.21 issued. The commissioner shall enter into an adoption 441.22 assistance agreement on the child's behalf if it is determined 441.23 that: (1) at the time of the adoption and at the time the 441.24 request for a hearing was submitted the child was eligible for 441.25 adoption assistance under United States Code, title 42, chapter 441.26 7, subchapter IV, part E, sections 670 to 679a, at the time of 441.27 the adoptionand at the time the request for a hearing was441.28submitted but, because of extenuating circumstances, did not441.29receiveor for state funded adoption assistance under 441.30 subdivision 4; and (2) an adoption assistance agreement was not 441.31 entered into on behalf of the child before the final decree of 441.32 adoption because of extenuating circumstances as the term is 441.33 used in the standards established by the federal Department of 441.34 Health and Human Services. An adoption assistance agreement 441.35 made under this paragraph shall be effective the date the 441.36 request for a hearing was received by the commissioner or the 442.1 local agency. 442.2 Sec. 37. Minnesota Statutes 1998, section 259.67, 442.3 subdivision 7, is amended to read: 442.4 Subd. 7. [REIMBURSEMENT OF COSTS.] (a) Subject to rules of 442.5 the commissioner, and the provisions of this subdivision 442.6 aMinnesota-licensedchild-placing agency licensed in Minnesota 442.7 or any other state, or local social services agency shall 442.8 receive a reimbursement from the commissioner equal to 100 442.9 percent of the reasonable and appropriate cost of providing 442.10 adoption services for a child certified as eligible for adoption 442.11 assistance under subdivision 4. Such assistance may include 442.12 adoptive family recruitment, counseling, and special training 442.13 when needed. AMinnesota-licensedchild-placing agency licensed 442.14 in Minnesota or any other state shall receive reimbursement for 442.15 adoption services it purchases for or directly provides to an 442.16 eligible child. A local social services agency shall receive 442.17 such reimbursement only for adoption services it purchases for 442.18 an eligible child. 442.19 (b) AMinnesota-licensedchild-placing agency licensed in 442.20 Minnesota or any other state or local social services agency 442.21 seeking reimbursement under this subdivision shall enter into a 442.22 reimbursement agreement with the commissioner before providing 442.23 adoption services for which reimbursement is sought. No 442.24 reimbursement under this subdivision shall be made to an agency 442.25 for services provided prior to entering a reimbursement 442.26 agreement. Separate reimbursement agreements shall be made for 442.27 each child and separate records shall be kept on each child for 442.28 whom a reimbursement agreement is made. Funds encumbered and 442.29 obligated under such an agreement for the child remain available 442.30 until the terms of the agreement are fulfilled or the agreement 442.31 is terminated. 442.32 (c) When a local social services agency uses a purchase of 442.33 service agreement to provide services reimbursable under a 442.34 reimbursement agreement, the commissioner may make reimbursement 442.35 payments directly to the agency providing the service if direct 442.36 reimbursement is specified by the purchase of service agreement, 443.1 and if the request for reimbursement is submitted by the local 443.2 social services agency along with a verification that the 443.3 service was provided. 443.4 Sec. 38. Minnesota Statutes 1998, section 259.73, is 443.5 amended to read: 443.6 259.73 [REIMBURSEMENT OF NONRECURRING ADOPTION EXPENSES.] 443.7 The commissioner of human services shall provide 443.8 reimbursement of up to $2,000 to the adoptive parent or parents 443.9 for costs incurred in adopting a child with special needs. The 443.10 commissioner shall determine the child's eligibility for 443.11 adoption expense reimbursement under title IV-E of the Social 443.12 Security Act, United States Code, title 42, sections 670 to 443.13 676. To be reimbursed, costs must be reasonable, necessary, and 443.14 directly related to the legal adoption of the child. 443.15 Sec. 39. Minnesota Statutes 1998, section 259.85, 443.16 subdivision 2, is amended to read: 443.17 Subd. 2. [ELIGIBILITY CRITERIA.] A child may be certified 443.18 by the local socialserviceservices agency as eligible for a 443.19 postadoption service grant after a final decree of adoptionand443.20before the child's 18th birthdayif: 443.21(a)(1) the child was a ward of the commissioner or a 443.22 Minnesota licensed child-placing agency before adoption; 443.23(b)(2) the child had special needs at the time of adoption. 443.24 For the purposes of this section, "special needs" means a child 443.25 who had a physical, mental, emotional, or behavioral disability 443.26 at the time of an adoption or has a preadoption background to 443.27 which the current development of such disabilities can be 443.28 attributed;and443.29(c)(3) the adoptive parents have exhausted all other 443.30 available resources. Available resources include public income 443.31 support programs, medical assistance, health insurance coverage, 443.32 services available through community resources, and any other 443.33 private or public benefits or resources available to the family 443.34 or to the child to meet the child's special needs; and 443.35 (4) the child is under 18 years of age or, if the child is 443.36 under 22 years of age and remains dependent on the adoptive 444.1 parent or parents for care and financial support and is enrolled 444.2 in a secondary education program as a full-time student. 444.3 Sec. 40. Minnesota Statutes 1998, section 259.85, 444.4 subdivision 3, is amended to read: 444.5 Subd. 3. [CERTIFICATION STATEMENT.] The local social 444.6serviceservices agency shall certify a child's eligibility for 444.7 a postadoption service grant in writing to the commissioner. 444.8 The certification statement shall include: 444.9 (1) a description and history of the special needs upon 444.10 which eligibility is based;and444.11 (2) separate certification for each of the eligibility 444.12 criteria under subdivision 2, that the criteria is met; and 444.13 (3) applicable supporting documentation including: 444.14 (i) the child's individual service plan; 444.15 (ii) medical, psychological, or special education 444.16 evaluations; 444.17 (iii) documentation that all other resources have been 444.18 exhausted; and 444.19 (iv) an estimate of the costs necessary to meet the special 444.20 needs of the child. 444.21 Sec. 41. Minnesota Statutes 1998, section 259.85, 444.22 subdivision 5, is amended to read: 444.23 Subd. 5. [GRANT PAYMENTS.] The amount of the postadoption 444.24 service grant payment shall be based on the special needs of the 444.25 child and the determination that other resources to meet those 444.26 special needs are not available. The amount of any grant 444.27 payments shall be based on the severity of the child's 444.28 disability and the effect of the disability on the family and 444.29 must not exceed $10,000 annually. Adoptive parents are eligible 444.30 for grant payments until their child's 18th birthday, or if the 444.31 child is under 22 years of age and remains dependent on the 444.32 adoptive parent or parents for care and financial support and is 444.33 enrolled in a secondary education program as a full-time student. 444.34 Permissible expenses that may be paid from grants shall be 444.35 limited to: 444.36 (1) medical expenses not covered by the family's health 445.1 insurance or medical assistance; 445.2 (2) therapeutic expenses, including individual and family 445.3 therapy; and 445.4 (3) nonmedical services, items, or equipment required to 445.5 meet the special needs of the child. 445.6 The grants under this section shall not be used for 445.7 maintenance for out-of-home placement of the child in substitute 445.8 care. 445.9 Sec. 42. Minnesota Statutes 1998, section 259.89, is 445.10 amended by adding a subdivision to read: 445.11 Subd. 6. [DETERMINATION OF ELIGIBILITY FOR ENROLLMENT OR 445.12 MEMBERSHIP IN A FEDERALLY RECOGNIZED AMERICAN INDIAN TRIBE.] The 445.13 state registrar shall provide a copy of an adopted person's 445.14 original birth certificate to an authorized representative of a 445.15 federally recognized American Indian tribe for the sole purpose 445.16 of determining the adopted person's eligibility for enrollment 445.17 or membership in the tribe. 445.18 Sec. 43. Minnesota Statutes 1998, section 260.011, 445.19 subdivision 2, is amended to read: 445.20 Subd. 2. (a) The paramount consideration in all 445.21 proceedings concerning a child alleged or found to be in need of 445.22 protection or services is the health, safety, and best interests 445.23 of the child. In proceedings involving an American Indian 445.24 child, as defined in section 257.351, subdivision 6, the best 445.25 interests of the child must be determined consistent with 445.26 sections 257.35 to 257.3579 and the Indian Child Welfare Act, 445.27 United States Code, title 25, sections 1901 to 1923. The 445.28 purpose of the laws relating to juvenile courts is to secure for 445.29 each child alleged or adjudicated in need of protection or 445.30 services and under the jurisdiction of the court, the care and 445.31 guidance, preferably in the child's own home, as will best serve 445.32 the spiritual, emotional, mental, and physical welfare of the 445.33 child; to provide judicial procedures which protect the welfare 445.34 of the child; to preserve and strengthen the child's family ties 445.35 whenever possible and in the child's best interests, removing 445.36 the child from the custody of parents only when the child's 446.1 welfare or safety cannot be adequately safeguarded without 446.2 removal; and, when removal from the child's own family is 446.3 necessary and in the child's best interests, to secure for the 446.4 child custody, care and discipline as nearly as possible 446.5 equivalent to that which should have been given by the parents. 446.6 (b) The purpose of the laws relating to termination of 446.7 parental rights is to ensure that: 446.8 (1) when required and appropriate, reasonable efforts have 446.9 been made by the socialserviceservices agency to reunite the 446.10 child with the child's parents in aplacementhome that is safe 446.11 and permanent; and 446.12 (2) if placement with the parents is not reasonably 446.13 foreseeable, to secure for the child a safe and permanent 446.14 placement, preferably with adoptive parents or a fit and willing 446.15 relative through transfer of permanent legal and physical 446.16 custody to that relative. 446.17 Nothing in this section requires reasonable efforts to be 446.18 made in circumstances where the court has determined that the 446.19 child has been subjected to egregious harm or the parental 446.20 rights of the parent to a sibling have been involuntarily 446.21 terminated. 446.22 The paramount consideration in all proceedings for the 446.23 termination of parental rights is the best interests of the 446.24 child. In proceedings involving an American Indian child, as 446.25 defined in section 257.351, subdivision 6, the best interests of 446.26 the child must be determined consistent with the Indian Child 446.27 Welfare Act of 1978, United States Code, title 25, section 1901, 446.28 et seq. 446.29 (c) The purpose of the laws relating to children alleged or 446.30 adjudicated to be delinquent is to promote the public safety and 446.31 reduce juvenile delinquency by maintaining the integrity of the 446.32 substantive law prohibiting certain behavior and by developing 446.33 individual responsibility for lawful behavior. This purpose 446.34 should be pursued through means that are fair and just, that 446.35 recognize the unique characteristics and needs of children, and 446.36 that give children access to opportunities for personal and 447.1 social growth. 447.2 (d) The laws relating to juvenile courts shall be liberally 447.3 construed to carry out these purposes. 447.4 Sec. 44. Minnesota Statutes 1998, section 260.012, is 447.5 amended to read: 447.6 260.012 [DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY 447.7 REUNIFICATION; REASONABLE EFFORTS.] 447.8 (a)IfOnce a child alleged to be in need of protection or 447.9 services is under the court's jurisdiction, the court shall 447.10 ensure that reasonable efforts including culturally appropriate 447.11 services by the socialserviceservices agency are made to 447.12 prevent placement or to eliminate the need for removal and to 447.13 reunite the child with the child's family at the earliest 447.14 possible time, consistent with the best interests, safety, and 447.15 protection of the child.The court may, upon motion and447.16hearing, order the cessation of reasonable efforts if the court447.17finds that provision of services or further services for the447.18purpose of rehabilitation and reunification is futile and447.19therefore unreasonable under the circumstances.In determining 447.20 reasonable efforts to be made with respect to a child and in 447.21 making those reasonable efforts, the child's health and safety 447.22 must be of paramount concern. Reasonable efforts for 447.23 rehabilitation and reunification are not requiredifupon a 447.24 determination by the courtdeterminesthat: 447.25 (1) a termination of parental rights petition has been 447.26 filed stating a prima facie case that: 447.27 (i) the parent has subjectedthea child to egregious harm 447.28 as defined in section 260.015, subdivision 29, or; 447.29 (ii) the parental rights of the parent toa siblinganother 447.30 child have been terminated involuntarily; or 447.31 (iii) the child is an abandoned infant under section 447.32 260.221, subdivision 1a, paragraph (a), clause (2); 447.33 (2) the county attorney has filed a determination not to 447.34 proceed with a termination of parental rights petition on these 447.35 grounds was made under section 260.221, subdivision 1b, 447.36 paragraph (b), and a permanency hearing is held within 30 days 448.1 of the determination.; or 448.2 (3) a termination of parental rights petition or other 448.3 petition according to section 260.191, subdivision 3b, has been 448.4 filed alleging a prima facie case that the provision of services 448.5 or further services for the purpose of reunification is futile 448.6 and therefore unreasonable under the circumstances. 448.7 In the case of an Indian child, in proceedings under 448.8 sections 260.172, 260.191, and 260.221 the juvenile court must 448.9 make findings and conclusions consistent with the Indian Child 448.10 Welfare Act of 1978, United States Code, title 25, section 1901 448.11 et seq., as to the provision of active efforts. If a child is 448.12 under the court's delinquency jurisdiction, it shall be the duty 448.13 of the court to ensure that reasonable efforts are made to 448.14 reunite the child with the child's family at the earliest 448.15 possible time, consistent with the best interests of the child 448.16 and the safety of the public. 448.17 (b) "Reasonable efforts" means the exercise of due 448.18 diligence by the responsible socialserviceservices agency to 448.19 use appropriate and available services to meet the needs of the 448.20 child and the child's family in order to prevent removal of the 448.21 child from the child's family; or upon removal, services to 448.22 eliminate the need for removal and reunite the family. 448.23 (1) Services may include those listed under section 448.24 256F.07, subdivision 3, and other appropriate services available 448.25 in the community. 448.26 (2) At each stage of the proceedings where the court is 448.27 required to review the appropriateness of the responsible social 448.28 services agency's reasonable efforts, the socialservice448.29 services agency has the burden of demonstrating that it has made 448.30 reasonable efforts, or that provision of services or further 448.31 services for the purpose of rehabilitation and reunification is 448.32 futile and therefore unreasonable under the circumstances.or 448.33 that reasonable efforts aimed at reunification are not required 448.34 under this section. The agency may meet this burden by stating 448.35 facts in a sworn petition filed under section 260.131, or by 448.36 filing an affidavit summarizing the agency's reasonable efforts 449.1 or facts the agency believes demonstrate there is no need for 449.2 reasonable efforts to reunify the parent and child. 449.3 (3) No reasonable efforts for reunification are required 449.4 when the court makes a determination under paragraph (a) unless, 449.5 after a hearing according to section 260.155, the court finds 449.6 there is not clear and convincing evidence of the facts upon 449.7 which the court based its prima facie determination. In this 449.8 case, the court may proceed under section 260.235. 449.9 Reunification of a surviving child with a parent is not required 449.10 if the parent has been convicted of: 449.11(1)(i) a violation of, or an attempt or conspiracy to 449.12 commit a violation of, sections 609.185 to 609.20; 609.222, 449.13 subdivision 2; or 609.223 in regard to another child of the 449.14 parent; 449.15(2)(ii) a violation of section 609.222, subdivision 2; or 449.16 609.223, in regard to the surviving child; or 449.17(3)(iii) a violation of, or an attempt or conspiracy to 449.18 commit a violation of, United States Code, title 18, section 449.19 1111(a) or 1112(a), in regard to another child of the parent. 449.20 (c) The juvenile court, in proceedings under sections 449.21 260.172, 260.191, and 260.221 shall make findings and 449.22 conclusions as to the provision of reasonable efforts. When 449.23 determining whether reasonable efforts have been made, the court 449.24 shall consider whether services to the child and family were: 449.25 (1) relevant to the safety and protection of the child; 449.26 (2) adequate to meet the needs of the child and family; 449.27 (3) culturally appropriate; 449.28 (4) available and accessible; 449.29 (5) consistent and timely; and 449.30 (6) realistic under the circumstances. 449.31 In the alternative, the court may determine that provision 449.32 of services or further services for the purpose of 449.33 rehabilitation is futile and therefore unreasonable under the 449.34 circumstances or that reasonable efforts are not required as 449.35 provided in paragraph (a). 449.36 (d) This section does not prevent out-of-home placement for 450.1 treatment of a child with a mental disability when the child's 450.2 diagnostic assessment or individual treatment plan indicates 450.3 that appropriate and necessary treatment cannot be effectively 450.4 provided outside of a residential or inpatient treatment program. 450.5 (e) If continuation of reasonable efforts described in 450.6 paragraph (b) is determined by the court to be inconsistent with 450.7 thepermanencypermanent plan for the child, or upon a 450.8 determination under paragraph (a), reasonable efforts must be 450.9 made to place the child in a timely manner in accordance with 450.10 thepermanencypermanent plan ordered by the court and to 450.11 complete whatever steps are necessary to finalize thepermanency450.12 permanent plan for the child. 450.13 (f) Reasonable efforts to place a child for adoption or in 450.14 another permanent placement may be made concurrently with 450.15 reasonable efforts as described in paragraphs (a) and (b). When 450.16 the responsible social services agency decides to concurrently 450.17 make reasonable efforts for both reunification and permanent 450.18 placement away from the parent under paragraphs (a) and (b), the 450.19 agency shall disclose its decision and both plans for concurrent 450.20 reasonable efforts to all parties and the court. When the 450.21 agency discloses its decision to proceed on both plans for 450.22 reunification and permanent placement away from the parent, the 450.23 court's review of the agency's reasonable efforts shall include 450.24 the agency's efforts under paragraphs (a) and (b). 450.25 Sec. 45. Minnesota Statutes 1998, section 260.015, 450.26 subdivision 2a, is amended to read: 450.27 Subd. 2a. [CHILD IN NEED OF PROTECTION OR SERVICES.] 450.28 "Child in need of protection or services" means a child who is 450.29 in need of protection or services because the child: 450.30 (1) is abandoned or without parent, guardian, or custodian; 450.31 (2)(i) has been a victim of physical or sexual abuse, (ii) 450.32 resides with or has resided with a victim of domestic child 450.33 abuse as defined in subdivision 24, (iii) resides with or would 450.34 reside with a perpetrator of domestic child abuse or child abuse 450.35 as defined in subdivision 28, or (iv) is a victim of emotional 450.36 maltreatment as defined in subdivision 5a; 451.1 (3) is without necessary food, clothing, shelter, 451.2 education, or other required care for the child's physical or 451.3 mental health or morals because the child's parent, guardian, or 451.4 custodian is unable or unwilling to provide that care; 451.5 (4) is without the special care made necessary by a 451.6 physical, mental, or emotional condition because the child's 451.7 parent, guardian, or custodian is unable or unwilling to provide 451.8 that care, including a child in voluntary placement according to 451.9 release of the parent under section 257.071, subdivision 4; 451.10 (5) is medically neglected, which includes, but is not 451.11 limited to, the withholding of medically indicated treatment 451.12 from a disabled infant with a life-threatening condition. The 451.13 term "withholding of medically indicated treatment" means the 451.14 failure to respond to the infant's life-threatening conditions 451.15 by providing treatment, including appropriate nutrition, 451.16 hydration, and medication which, in the treating physician's or 451.17 physicians' reasonable medical judgment, will be most likely to 451.18 be effective in ameliorating or correcting all conditions, 451.19 except that the term does not include the failure to provide 451.20 treatment other than appropriate nutrition, hydration, or 451.21 medication to an infant when, in the treating physician's or 451.22 physicians' reasonable medical judgment: 451.23 (i) the infant is chronically and irreversibly comatose; 451.24 (ii) the provision of the treatment would merely prolong 451.25 dying, not be effective in ameliorating or correcting all of the 451.26 infant's life-threatening conditions, or otherwise be futile in 451.27 terms of the survival of the infant; or 451.28 (iii) the provision of the treatment would be virtually 451.29 futile in terms of the survival of the infant and the treatment 451.30 itself under the circumstances would be inhumane; 451.31 (6) is one whose parent, guardian, or other custodian for 451.32 good cause desires to be relieved of the child's care and 451.33 custody, including a child in placement according to voluntary 451.34 release by the parent under section 257.071, subdivision 3; 451.35 (7) has been placed for adoption or care in violation of 451.36 law; 452.1 (8) is without proper parental care because of the 452.2 emotional, mental, or physical disability, or state of 452.3 immaturity of the child's parent, guardian, or other custodian; 452.4 (9) is one whose behavior, condition, or environment is 452.5 such as to be injurious or dangerous to the child or others. An 452.6 injurious or dangerous environment may include, but is not 452.7 limited to, the exposure of a child to criminal activity in the 452.8 child's home; 452.9 (10) is experiencing growth delays, which may be referred 452.10 to as failure to thrive, that have been diagnosed by a physician 452.11 and are due to parental neglect; 452.12 (11) has engaged in prostitution as defined in section 452.13 609.321, subdivision 9; 452.14 (12) has committed a delinquent act or a juvenile petty 452.15 offense before becoming ten years old; 452.16 (13) is a runaway; 452.17 (14) is an habitual truant; 452.18 (15) has been found incompetent to proceed or has been 452.19 found not guilty by reason of mental illness or mental 452.20 deficiency in connection with a delinquency proceeding, a 452.21 certification under section 260.125, an extended jurisdiction 452.22 juvenile prosecution, or a proceeding involving a juvenile petty 452.23 offense; 452.24 (16)is one whose custodial parent's parental rights to452.25another child have been involuntarily terminated within the past452.26five years; or452.27(17)has been found by the court to have committed domestic 452.28 abuse perpetrated by a minor under Laws 1997, chapter 239, 452.29 article 10, sections 2 to 26, has been ordered excluded from the 452.30 child's parent's home by an order for protection/minor 452.31 respondent, and the parent or guardian is either unwilling or 452.32 unable to provide an alternative safe living arrangement for the 452.33 child. 452.34 Sec. 46. Minnesota Statutes 1998, section 260.015, 452.35 subdivision 13, is amended to read: 452.36 Subd. 13. [RELATIVE.] "Relative" means a parent, 453.1 stepparent, grandparent, brother, sister, uncle, or aunt of the 453.2 minor. This relationship may be by blood or marriage. For an 453.3 Indian child, relative includes members of the extended family 453.4 as defined by the law or custom of the Indian child's tribe or, 453.5 in the absence of laws or custom, nieces, nephews, or first or 453.6 second cousins, as provided in the Indian Child Welfare Act of 453.7 1978, United States Code, title 25, section 1903. For purposes 453.8 ofdispositions, relative has the meaning given in section453.9260.181, subdivision 3.child in need of protection or services 453.10 proceedings, termination of parental rights proceedings, and 453.11 permanency proceedings under section 260.191, subdivision 3b, 453.12 relative means a person related to the child by blood, marriage, 453.13 or adoption, or an individual who is an important friend with 453.14 whom the child has resided or had significant contact. 453.15 Sec. 47. Minnesota Statutes 1998, section 260.015, 453.16 subdivision 29, is amended to read: 453.17 Subd. 29. [EGREGIOUS HARM.] "Egregious harm" means the 453.18 infliction of bodily harm to a child or neglect of a child which 453.19 demonstrates a grossly inadequate ability to provide minimally 453.20 adequate parental care. The egregious harm need not have 453.21 occurred in the state or in the county where a termination of 453.22 parental rights action is otherwise properly venued. Egregious 453.23 harm includes, but is not limited to: 453.24 (1) conduct towards a child that constitutes a violation of 453.25 sections 609.185 to 609.21, 609.222, subdivision 2, 609.223, or 453.26 any other similar law of any other state; 453.27 (2) the infliction of "substantial bodily harm" to a child, 453.28 as defined in section 609.02, subdivision 7a; 453.29 (3) conduct towards a child that constitutes felony 453.30 malicious punishment of a child under section 609.377; 453.31 (4) conduct towards a child that constitutes felony 453.32 unreasonable restraint of a child under section 609.255, 453.33 subdivision 3; 453.34 (5) conduct towards a child that constitutes felony neglect 453.35 or endangerment of a child under section 609.378; 453.36 (6) conduct towards a child that constitutes assault under 454.1 section 609.221, 609.222, or 609.223; 454.2 (7) conduct towards a child that constitutes solicitation, 454.3 inducement, or promotion of, or receiving profit derived from 454.4 prostitution under section 609.322; 454.5 (8) conduct toward a child that constitutes murder or 454.6 voluntary manslaughter as defined by United States Code, title 454.7 18, section 1111(a) or 1112(a);or454.8 (9) conduct toward a child that constitutes aiding or 454.9 abetting, attempting, conspiring, or soliciting to commit a 454.10 murder or voluntary manslaughter that constitutes a violation of 454.11 United States Code, title 18, section 1111(a) or 1112(a); or 454.12 (10) conduct toward a child that constitutes criminal 454.13 sexual conduct under sections 609.342 to 609.345. 454.14 Sec. 48. Minnesota Statutes 1998, section 260.131, 454.15 subdivision 1a, is amended to read: 454.16 Subd. 1a. [REVIEW OF FOSTER CARE STATUS.] The social 454.17serviceservices agency responsible for the placement of a child 454.18 in a residential facility, as defined in section 257.071, 454.19 subdivision 1, pursuant to a voluntary release by the child's 454.20 parent or parents may bring a petition in juvenile court to 454.21 review the foster care status of the child in the manner 454.22 provided in this section. The responsible social services 454.23 agency shall file either a petition alleging the child to be in 454.24 need of protection or services or a petition to terminate 454.25 parental rights. 454.26 (a) In the case of a child in voluntary placement according 454.27 to section 257.071, subdivision 3, the petition shall be filed 454.28 within 90 days of the date of the voluntary placement agreement 454.29 and shall state the reasons why the child is in placement, the 454.30 progress on the case plan required under section 257.071, 454.31 subdivision 1, and the statutory basis for the petition under 454.32 section 260.015, subdivision 2a, or 260.221. 454.33 (1) In the case of a petition filed under this paragraph, 454.34 if all parties agree and the court finds it is in the best 454.35 interests of the child, the court may find the petition states a 454.36 prima facie case that: 455.1 (i) the child's needs are being met; 455.2 (ii) the placement of the child in foster care is in the 455.3 best interests of the child; and 455.4 (iii) the child will be returned home in the next six 455.5 months. 455.6 (2) If the court makes findings under paragraph (1), the 455.7 court shall approve the voluntary arrangement and continue the 455.8 matter for up to six more months to ensure the child returns to 455.9 the parents' home. The responsible social services agency shall: 455.10 (i) report to the court when the child returns home and the 455.11 progress made by the parent on the case plan required under 455.12 section 257.071, in which case the court shall dismiss 455.13 jurisdiction; 455.14 (ii) report to the court that the child has not returned 455.15 home, in which case the matter shall be returned to the court 455.16 for further proceedings under section 260.155; or 455.17 (iii) if any party does not agree to continue the matter 455.18 under paragraph (1) and this paragraph, the matter shall proceed 455.19 under section 260.155. 455.20 (b) In the case of a child in voluntary placement according 455.21 to section 257.071, subdivision 4, the petition shall be filed 455.22 within six months of the date of the voluntary placement 455.23 agreement and shall state the date of the voluntary placement 455.24 agreement, the nature of the child's developmental delay or 455.25 emotional handicap, the plan for the ongoing care of the child, 455.26 the parents' participation in the plan, and the statutory basis 455.27 for the petition. 455.28 (1) In the case of petitions filed under this paragraph, 455.29 the court may find, based on the contents of the sworn petition, 455.30 and the agreement of all parties, including the child, where 455.31 appropriate, that the voluntary arrangement is in the best 455.32 interests of the child, approve the voluntary arrangement, and 455.33 dismiss the matter from further jurisdiction. The court shall 455.34 give notice to the responsible social services agency that the 455.35 matter must be returned to the court for further review if the 455.36 child remains in placement after 12 months. 456.1 (2) If any party, including the child, disagrees with the 456.2 voluntary arrangement, the court shall proceed under section 456.3 260.155. 456.4 Sec. 49. Minnesota Statutes 1998, section 260.133, 456.5 subdivision 1, is amended to read: 456.6 Subdivision 1. [PETITION.] The local welfare agency may 456.7 bring an emergency petition on behalf of minor family or 456.8 household members seeking relief from acts of domestic child 456.9 abuse. The petition shall be brought according to section 456.10 260.131 and shall allege the existence of or immediate and 456.11 present danger of domestic child abuse, and shall be accompanied456.12by an affidavit made under oath stating the specific facts and456.13circumstances from which relief is sought. The court has 456.14 jurisdiction over the parties to a domestic child abuse matter 456.15 notwithstanding that there is a parent in the child's household 456.16 who is willing to enforce the court's order and accept services 456.17 on behalf of the family. 456.18 Sec. 50. Minnesota Statutes 1998, section 260.133, 456.19 subdivision 2, is amended to read: 456.20 Subd. 2. [TEMPORARY ORDER.] (a) If it appears from the 456.21 notarized petitionor by sworn affidavitthat there are 456.22 reasonable grounds to believe the child is in immediate and 456.23 present danger of domestic child abuse, the court may grant an 456.24 ex parte temporary order for protection, pending afull456.25 hearing pursuant to section 260.135, which must be held not 456.26 later than 14 days after service of the ex parte order on the 456.27 respondent. The court may grant relief as it deems proper, 456.28 including an order: 456.29 (1) restraining any party from committing acts of domestic 456.30 child abuse; or 456.31 (2) excluding the alleged abusing party from the dwelling 456.32 which the family or household members share or from the 456.33 residence of the child. 456.34However,(b) No order excluding the alleged abusing party 456.35 from the dwelling may be issued unless the court finds that: 456.36 (1) the order is in the best interests of the child or 457.1 children remaining in the dwelling; and 457.2 (2) a parent remainingadult family orin the child's 457.3 householdmemberis able to care adequately for the child or 457.4 children in the absence of the excluded party and to seek 457.5 appropriate assistance in enforcing the provisions of the order. 457.6 (c) Before the temporary order is issued, the local welfare 457.7 agency shall advise the court and the other parties who are 457.8 present that appropriate social services will be provided to the 457.9 family or household members during the effective period of the 457.10 order. The petition shall identify the parent remaining in the 457.11 child's household under paragraph (b), clause (2). 457.12 An ex parte temporary order for protection shall be 457.13 effective for a fixed period not to exceed 14 days.Within five457.14days of the issuance of the temporary order, the petitioner457.15shall file a petition with the court pursuant to section457.16260.131, alleging that the child is in need of protection or457.17services and the court shall give docket priority to the457.18petition.457.19 The court may renew the temporary order for protection one 457.20 time for a fixed period not to exceed 14 daysif a petition457.21alleging that the child is in need of protection or services has457.22been filed with the court andif the court determines, upon 457.23 informal review of the case file, that the renewal is 457.24 appropriate. If the court determines that the petition states a 457.25 prima facie case that there are reasonable grounds to believe 457.26 that the child is in immediate danger of domestic child abuse or 457.27 child abuse without the court's order, at the hearing pursuant 457.28 to section 260.135, the court may continue its order issued 457.29 under this subdivision pending trial under section 260.155. 457.30 Sec. 51. Minnesota Statutes 1998, section 260.135, is 457.31 amended by adding a subdivision to read: 457.32 Subd. 1a. After a petition has been filed alleging a child 457.33 to be in need of protection or services and unless the persons 457.34 named in clauses (1) to (4) voluntarily appear or are summoned 457.35 according to subdivision 1, the court shall issue a notice to: 457.36 (1) an adjudicated or presumed father of the child; 458.1 (2) an alleged father of the child; 458.2 (3) a noncustodial mother; and 458.3 (4) a grandparent with the right to participate under 458.4 section 260.155, subdivision 1a. 458.5 Sec. 52. Minnesota Statutes 1998, section 260.172, 458.6 subdivision 1, is amended to read: 458.7 Subdivision 1. [HEARING AND RELEASE REQUIREMENTS.] (a) If 458.8 a child was taken into custody under section 260.165, 458.9 subdivision 1, clause (a) or (c)(2), the court shall hold a 458.10 hearing within 72 hours of the time the child was taken into 458.11 custody, excluding Saturdays, Sundays, and holidays, to 458.12 determine whether the child should continue in custody. 458.13 (b) In all other cases, the court shall hold a detention 458.14 hearing: 458.15 (1) within 36 hours of the time the child was taken into 458.16 custody, excluding Saturdays, Sundays, and holidays, if the 458.17 child is being held at a juvenile secure detention facility or 458.18 shelter care facility; or 458.19 (2) within 24 hours of the time the child was taken into 458.20 custody, excluding Saturdays, Sundays, and holidays, if the 458.21 child is being held at an adult jail or municipal lockup. 458.22 (c) Unless there is reason to believe that the child would 458.23 endanger self or others, not return for a court hearing, run 458.24 away from the child's parent, guardian, or custodian or 458.25 otherwise not remain in the care or control of the person to 458.26 whose lawful custody the child is released, or that the child's 458.27 health or welfare would be immediately endangered, the child 458.28 shall be released to the custody of a parent, guardian, 458.29 custodian, or other suitable person, subject to reasonable 458.30 conditions of release including, but not limited to, a 458.31 requirement that the child undergo a chemical use assessment as 458.32 provided in section 260.151, subdivision 1. In determining 458.33 whether the child's health or welfare would be immediately 458.34 endangered, the court shall consider whether the child would 458.35 reside with a perpetrator of domestic child abuse. In a 458.36 proceeding regarding a child in need of protection or services, 459.1 the court, before determining whether a child should continue in 459.2 custody, shall also make a determination, consistent with 459.3 section 260.012 as to whether reasonable efforts, or in the case 459.4 of an Indian child, active efforts, according to the Indian 459.5 Child Welfare Act of 1978, United States Code, title 25, section 459.6 1912(d), were made to prevent placement or to reunite the child 459.7 with the child's family, or that reasonable efforts were not 459.8 possible. The court shall also determine whether there are 459.9 available services that would prevent the need for further 459.10 detention. 459.11 If the court finds the social services agency's preventive 459.12 or reunification efforts have not been reasonable but further 459.13 preventive or reunification efforts could not permit the child 459.14 to safely remain at home, the court may nevertheless authorize 459.15 or continue the removal of the child. 459.16The court may determine(d) At the detention hearing, or at 459.17 any time prior to an adjudicatory hearing, that reasonable459.18efforts are not required because the facts, if proved, will459.19demonstrate that the parent has subjected the child to egregious459.20harm as defined in section 260.015, subdivision 29, or the459.21parental rights of the parent to a sibling of the child have459.22been terminated involuntarily.and upon notice and request of 459.23 the county attorney, the court shall make the following 459.24 determinations: 459.25 (1) whether a termination of parental rights petition has 459.26 been filed stating a prima facie case that: 459.27 (i) the parent has subjected a child to egregious harm as 459.28 defined in section 260.015, subdivision 29; 459.29 (ii) the parental rights of the parent to another child 459.30 have been involuntarily terminated; or 459.31 (iii) the child is an abandoned infant under section 459.32 260.221, subdivision 1a, paragraph (a), clause (2); 459.33 (2) that the county attorney has determined not to proceed 459.34 with a termination of parental rights petition under section 459.35 260.221, subdivision 1b; or 459.36 (3) whether a termination of parental rights petition or 460.1 other petition according to section 260.191, subdivision 3b, has 460.2 been filed alleging a prima facie case that the provision of 460.3 services or further services for the purpose of rehabilitation 460.4 and reunification is futile and therefore unreasonable under the 460.5 circumstances. 460.6 If the court determines that the county attorney is not 460.7 proceeding with a termination of parental rights petition under 460.8 section 260.221, subdivision 1b, but is proceeding with a 460.9 petition under section 260.191, subdivision 3b, the court shall 460.10 schedule a permanency hearing within 30 days. If the county 460.11 attorney has filed a petition under section 260.221, subdivision 460.12 1b, the court shall schedule a trial under section 260.155 460.13 within 90 days of the filing of the petition. 460.14 (e) If the court determines the child should be ordered 460.15 into out-of-home placement and the child's parent refuses to 460.16 give information to the responsible social services agency 460.17 regarding the child's father or relatives of the child, the 460.18 court may order the parent to disclose the names, addresses, 460.19 telephone numbers, and other identifying information to the 460.20 local social services agency for the purpose of complying with 460.21 the requirements of sections 257.071, 257.072, and 260.135. 460.22 Sec. 53. Minnesota Statutes 1998, section 260.172, is 460.23 amended by adding a subdivision to read: 460.24 Subd. 5. [CASE PLAN.] (a) A case plan required under 460.25 section 257.071 shall be filed with the court within 30 days of 460.26 the filing of a petition alleging the child to be in need of 460.27 protection or services under section 260.131. 460.28 (b) Upon the filing of the case plan, the court may approve 460.29 the case plan based on the allegations contained in the 460.30 petition. A parent may agree to comply with the terms of the 460.31 case plan filed with the court. 460.32 (c) Upon notice and motion by a parent who agrees to comply 460.33 with the terms of a case plan, the court may modify the case and 460.34 order the responsible social services agency to provide other or 460.35 additional services for reunification, if reunification efforts 460.36 are required, and the court determines the agency's case plan 461.1 inadequate under section 260.012. 461.2 (d) Unless the parent agrees to comply with the terms of 461.3 the case plan, the court may not order a parent to comply with 461.4 the provisions of the case plan until the court makes a 461.5 determination under section 260.191, subdivision 1. 461.6 Sec. 54. Minnesota Statutes 1998, section 260.181, 461.7 subdivision 3, is amended to read: 461.8 Subd. 3. [PROTECTION OF CHILD'S BEST INTERESTS.] (a) The 461.9 policy of the state is to ensure that the best interests of 461.10 children are met by requiring individualized determinations of 461.11 the needs of the child and of how the selected placement will 461.12 serve the needs of the child in foster care placements. 461.13 (b) Among the factors to be considered in determining the 461.14 needs of the child are: 461.15 (1) the child's current functioning and behaviors; 461.16 (2) the medical, educational, and developmental needs of 461.17 the child; 461.18 (3) the child's history and past experience; 461.19 (4) the child's religious and cultural needs; 461.20 (5) the child's connection with a community, school, and 461.21 church; 461.22 (6) the child's interests and talents; 461.23 (7) the child's relationship to current caretakers, 461.24 parents, siblings, and relatives; and 461.25 (8) the reasonable preference of the child, if the court, 461.26 or in the case of a voluntary placement the child-placing 461.27 agency, deems the child to be of sufficient age to express 461.28 preferences. 461.29 (c) The court, in transferring legal custody of any child 461.30 or appointing a guardian for the child under the laws relating 461.31 to juvenile courts, shall consider placement, consistent with 461.32 the child's best interests and in the following order, in the 461.33 legal custody or guardianship of an individual who (1) is 461.34 related to the child by blood, marriage, or adoption,or(2) is 461.35 an important friend with whom the child has resided or had 461.36 significant contact, or (3) is a married couple. Considering 462.1 these placement options shall not delay the placement of any 462.2 child. Nothing in this section prohibits the placement of a 462.3 child with an unmarried person. Placement of a child cannot be 462.4 delayed or denied based on race, color, or national origin of 462.5 the foster parent or the child. Whenever possible, siblings 462.6 should be placed together unless it is determined not to be in 462.7 the best interests of a sibling. 462.8 (d) If the child's birth parent or parents explicitly 462.9 request that a relative or important friend not be considered, 462.10 the court shall honor that request if it is consistent with the 462.11 best interests of the child. 462.12 If the child's birth parent or parents express a preference 462.13 for placing the child in a foster or adoptive home of the same 462.14 or a similar religious background to that of the birth parent or 462.15 parents, the court shall order placement of the child with an 462.16 individual who meets the birth parent's religious preference. 462.17 (e) This subdivision does not affect the Indian Child 462.18 Welfare Act, United States Code, title 25, sections 1901 to 462.19 1923, and the Minnesota Indian Family Preservation Act, sections 462.20 257.35 to 257.3579. 462.21 Sec. 55. Minnesota Statutes 1998, section 260.191, 462.22 subdivision 1, is amended to read: 462.23 Subdivision 1. [DISPOSITIONS.] (a) If the court finds that 462.24 the child is in need of protection or services or neglected and 462.25 in foster care, it shall enter an order making any of the 462.26 following dispositions of the case: 462.27 (1) place the child under the protective supervision of the 462.28 local social services agency or child-placing agency in the 462.29child's ownhome of a parent of the child under conditions 462.30 prescribed by the court directed to the correction of the 462.31 child's need for protection or services;, or: 462.32 (i) the court may order the child into the home of a parent 462.33 who does not otherwise have legal custody of the child, however, 462.34 an order under this section does not confer legal custody on 462.35 that parent; 462.36 (ii) if the court orders the child into the home of a 463.1 father who is not adjudicated, he must cooperate with paternity 463.2 establishment proceedings regarding the child in the appropriate 463.3 jurisdiction as one of the conditions prescribed by the court 463.4 for the child to continue in his home; 463.5 (iii) the court may order the child into the home of a 463.6 noncustodial parent with conditions and may also order both the 463.7 noncustodial and the custodial parent to comply with the 463.8 requirements of a case plan under subdivision 1a; 463.9 (2) transfer legal custody to one of the following: 463.10 (i) a child-placing agency; or 463.11 (ii) the local social services agency. 463.12 In placing a child whose custody has been transferred under 463.13 this paragraph, the agencies shall follow theorder of463.14preference stated inrequirements of section 260.181, 463.15 subdivision 3; 463.16 (3) if the child is in need of special treatment and care 463.17 for reasons of physical or mental health, the court may order 463.18 the child's parent, guardian, or custodian to provide it. If 463.19 the parent, guardian, or custodian fails or is unable to provide 463.20 this treatment or care, the court may order it provided. The 463.21 court shall not transfer legal custody of the child for the 463.22 purpose of obtaining special treatment or care solely because 463.23 the parent is unable to provide the treatment or care. If the 463.24 court's order for mental health treatment is based on a 463.25 diagnosis made by a treatment professional, the court may order 463.26 that the diagnosing professional not provide the treatment to 463.27 the child if it finds that such an order is in the child's best 463.28 interests; or 463.29 (4) if the court believes that the child has sufficient 463.30 maturity and judgment and that it is in the best interests of 463.31 the child, the court may order a child 16 years old or older to 463.32 be allowed to live independently, either alone or with others as 463.33 approved by the court under supervision the court considers 463.34 appropriate, if the county board, after consultation with the 463.35 court, has specifically authorized this dispositional 463.36 alternative for a child. 464.1 (b) If the child was adjudicated in need of protection or 464.2 services because the child is a runaway or habitual truant, the 464.3 court may order any of the following dispositions in addition to 464.4 or as alternatives to the dispositions authorized under 464.5 paragraph (a): 464.6 (1) counsel the child or the child's parents, guardian, or 464.7 custodian; 464.8 (2) place the child under the supervision of a probation 464.9 officer or other suitable person in the child's own home under 464.10 conditions prescribed by the court, including reasonable rules 464.11 for the child's conduct and the conduct of the parents, 464.12 guardian, or custodian, designed for the physical, mental, and 464.13 moral well-being and behavior of the child; or with the consent 464.14 of the commissioner of corrections, place the child in a group 464.15 foster care facility which is under the commissioner's 464.16 management and supervision; 464.17 (3) subject to the court's supervision, transfer legal 464.18 custody of the child to one of the following: 464.19 (i) a reputable person of good moral character. No person 464.20 may receive custody of two or more unrelated children unless 464.21 licensed to operate a residential program under sections 245A.01 464.22 to 245A.16; or 464.23 (ii) a county probation officer for placement in a group 464.24 foster home established under the direction of the juvenile 464.25 court and licensed pursuant to section 241.021; 464.26 (4) require the child to pay a fine of up to $100. The 464.27 court shall order payment of the fine in a manner that will not 464.28 impose undue financial hardship upon the child; 464.29 (5) require the child to participate in a community service 464.30 project; 464.31 (6) order the child to undergo a chemical dependency 464.32 evaluation and, if warranted by the evaluation, order 464.33 participation by the child in a drug awareness program or an 464.34 inpatient or outpatient chemical dependency treatment program; 464.35 (7) if the court believes that it is in the best interests 464.36 of the child and of public safety that the child's driver's 465.1 license or instruction permit be canceled, the court may order 465.2 the commissioner of public safety to cancel the child's license 465.3 or permit for any period up to the child's 18th birthday. If 465.4 the child does not have a driver's license or permit, the court 465.5 may order a denial of driving privileges for any period up to 465.6 the child's 18th birthday. The court shall forward an order 465.7 issued under this clause to the commissioner, who shall cancel 465.8 the license or permit or deny driving privileges without a 465.9 hearing for the period specified by the court. At any time 465.10 before the expiration of the period of cancellation or denial, 465.11 the court may, for good cause, order the commissioner of public 465.12 safety to allow the child to apply for a license or permit, and 465.13 the commissioner shall so authorize; 465.14 (8) order that the child's parent or legal guardian deliver 465.15 the child to school at the beginning of each school day for a 465.16 period of time specified by the court; or 465.17 (9) require the child to perform any other activities or 465.18 participate in any other treatment programs deemed appropriate 465.19 by the court. 465.20 To the extent practicable, the court shall enter a 465.21 disposition order the same day it makes a finding that a child 465.22 is in need of protection or services or neglected and in foster 465.23 care, but in no event more than 15 days after the finding unless 465.24 the court finds that the best interests of the child will be 465.25 served by granting a delay. If the child was under eight years 465.26 of age at the time the petition was filed, the disposition order 465.27 must be entered within ten days of the finding and the court may 465.28 not grant a delay unless good cause is shown and the court finds 465.29 the best interests of the child will be served by the delay. 465.30 (c) If a child who is 14 years of age or older is 465.31 adjudicated in need of protection or services because the child 465.32 is a habitual truant and truancy procedures involving the child 465.33 were previously dealt with by a school attendance review board 465.34 or county attorney mediation program under section 260A.06 or 465.35 260A.07, the court shall order a cancellation or denial of 465.36 driving privileges under paragraph (b), clause (7), for any 466.1 period up to the child's 18th birthday. 466.2 (d) In the case of a child adjudicated in need of 466.3 protection or services because the child has committed domestic 466.4 abuse and been ordered excluded from the child's parent's home, 466.5 the court shall dismiss jurisdiction if the court, at any time, 466.6 finds the parent is able or willing to provide an alternative 466.7 safe living arrangement for the child, as defined in Laws 1997, 466.8 chapter 239, article 10, section 2. 466.9 Sec. 56. Minnesota Statutes 1998, section 260.191, 466.10 subdivision 1a, is amended to read: 466.11 Subd. 1a. [WRITTEN FINDINGS.] Any order for a disposition 466.12 authorized under this section shall contain written findings of 466.13 fact to support the disposition and case plan ordered, and shall 466.14 also set forth in writing the following information: 466.15 (a) Why the best interests and safety of the child are 466.16 served by the disposition and case plan ordered; 466.17 (b) What alternative dispositions or services under the 466.18 case plan were considered by the court and why such dispositions 466.19 or services were not appropriate in the instant case; 466.20 (c) How the court's disposition complies with the 466.21 requirements of section 260.181, subdivision 3; and 466.22 (d) Whether reasonable efforts consistent with section 466.23 260.012 were made to prevent or eliminate the necessity of the 466.24 child's removal and to reunify the family after removal. The 466.25 court's findings must include a brief description of what 466.26 preventive and reunification efforts were made and why further 466.27 efforts could not have prevented or eliminated the necessity of 466.28 removal or that reasonable efforts were not required under 466.29 section 260.012 or 260.172, subdivision 1. 466.30 If the court finds that the social services agency's 466.31 preventive or reunification efforts have not been reasonable but 466.32 that further preventive or reunification efforts could not 466.33 permit the child to safely remain at home, the court may 466.34 nevertheless authorize or continue the removal of the child. 466.35 Sec. 57. Minnesota Statutes 1998, section 260.191, 466.36 subdivision 1b, is amended to read: 467.1 Subd. 1b. [DOMESTIC CHILD ABUSE.] (a) If the court finds 467.2 that the child is a victim of domestic child abuse, as defined 467.3 in section 260.015, subdivision 24, it may order any of the 467.4 following dispositions of the case in addition to or as 467.5 alternatives to the dispositions authorized under subdivision 1: 467.6 (1) restrain any party from committing acts of domestic 467.7 child abuse; 467.8 (2) exclude the abusing party from the dwelling which the 467.9 family or household members share or from the residence of the 467.10 child; 467.11 (3) on the same basis as is provided in chapter 518, 467.12 establish temporary visitation with regard to minor children of 467.13 the adult family or household members; 467.14 (4) on the same basis as is provided in chapter 518, 467.15 establish temporary support or maintenance for a period of 30 467.16 days for minor children or a spouse; 467.17 (5) provide counseling or other social services for the 467.18 family or household members; or 467.19 (6) order the abusing party to participate in treatment or 467.20 counseling services. 467.21 Any relief granted by the order for protection shall be for 467.22 a fixed period not to exceed one year. 467.23However,(b) No order excluding the abusing party from the 467.24 dwelling may be issued unless the court finds that: 467.25 (1) the order is in the best interests of the child or 467.26 children remaining in the dwelling; 467.27 (2) a remaining adult family or household member is able to 467.28 care adequately for the child or children in the absence of the 467.29 excluded party; and 467.30 (3) the local welfare agency has developed a plan to 467.31 provide appropriate social services to the remaining family or 467.32 household members. 467.33 (c) Upon a finding that the remaining parent is able to 467.34 care adequately for the child and enforce an order excluding the 467.35 abusing party from the home and that the provision of supportive 467.36 services by the responsible social services agency is no longer 468.1 necessary, the responsible social services agency may be 468.2 dismissed as a party to the proceedings. Orders entered 468.3 regarding the abusing party remain in full force and effect and 468.4 may be renewed by the remaining parent as necessary for the 468.5 continued protection of the child for specified periods of time, 468.6 not to exceed one year. 468.7 Sec. 58. Minnesota Statutes 1998, section 260.191, 468.8 subdivision 3b, is amended to read: 468.9 Subd. 3b. [REVIEW OF COURT ORDERED PLACEMENTS; PERMANENT 468.10 PLACEMENT DETERMINATION.] (a) Except for cases where the child 468.11 is in placement due solely to the child's status as 468.12 developmentally delayed under United States Code, title 42, 468.13 section 6001(7), or emotionally handicapped under section 252.27 468.14 and where custody has not been transferred to the responsible 468.15 social services agency, the court shall conduct a hearing to 468.16 determine the permanent status of a child not later than 12 468.17 months after the child is placed out of the home of the parent, 468.18 except that if the child was under eight years of age at the 468.19 time the petition was filed, the hearing must be conducted no 468.20 later than six months after the child is placed out of the home 468.21 of the parent. 468.22 For purposes of this subdivision, the date of the child's 468.23 placement out of the home of the parent is the earlier of the 468.24 first court-ordered placement or 60 days after the date on which 468.25 the child has been voluntarily placed out of the home. 468.26 For purposes of this subdivision, 12 months is calculated 468.27 as follows: 468.28 (1) during the pendency of a petition alleging that a child 468.29 is in need of protection or services, all time periods when a 468.30 child is placed out of the home of the parent are cumulated; 468.31 (2) if a child has been placed out of the home of the 468.32 parent within the previous five yearsin connection with one or468.33more prior petitions for a child in need of protection or468.34services, the lengths of all prior time periods when the child 468.35 was placed out of the home within the previous five yearsand468.36under the current petition,are cumulated. If a child under 469.1 this clause has been out of the home for 12 months or more, the 469.2 court, if it is in the best interests of the child and for 469.3 compelling reasons, may extend the total time the child may 469.4 continue out of the home under the current petition up to an 469.5 additional six months before making a permanency determination. 469.6 (b) Unless the responsible social services agency 469.7 recommends return of the child to the custodial parent or 469.8 parents, not later thanten30 days prior to this hearing, the 469.9 responsible socialserviceservices agency shall file pleadings 469.10 in juvenile court to establish the basis for the juvenile court 469.11 to order permanent placementdeterminationof the child 469.12 according to paragraph (d). Notice of the hearing and copies of 469.13 the pleadings must be provided pursuant to section 260.141. If 469.14 a termination of parental rights petition is filed before the 469.15 date required for the permanency planning determination and 469.16 there is a trial under section 260.155 scheduled on that 469.17 petition within 90 days of the filing of the petition, no 469.18 hearing need be conducted under this subdivision. 469.19 (c) At the conclusion of the hearing, the court shall 469.20determine whetherorder the childis to bereturned home or, if469.21not, whatorder a permanent placementis consistent within the 469.22 child's best interests. The "best interests of the child" means 469.23 all relevant factors to be considered and evaluated. 469.24(c)(d) At a hearing under this subdivision, if the child 469.25 was under eight years of age at the time the petition was filed 469.26 alleging the child in need of protection or services, the court 469.27 shall review the progress of the case and the case plan, 469.28 including the provision of services. The court may order the 469.29 local socialserviceservices agency to show cause why it should 469.30 not file a termination of parental rights petition. Cause may 469.31 include, but is not limited to, the following conditions: 469.32 (1) the parents or guardians have maintained regular 469.33 contact with the child, the parents are complying with the 469.34 court-ordered case plan, and the child would benefit from 469.35 continuing this relationship; 469.36 (2) grounds for termination under section 260.221 do not 470.1 exist; or 470.2 (3) the permanent plan for the child is transfer of 470.3 permanent legal and physical custody to a relative. When the 470.4 permanent plan for the child is transfer of permanent legal and 470.5 physical custody to a relative, a petition supporting the plan 470.6 shall be filed in juvenile court within 30 days of the hearing 470.7 required under this subdivision and a hearing on the petition 470.8 held within 30 days of the filing of the pleadings. 470.9(d)(e) If the child is not returned to the home, the court 470.10 must order one of the following dispositionsavailable for470.11permanent placement determination are: 470.12 (1) permanent legal and physical custody to a relative in 470.13 the best interests of the child. In transferring permanent 470.14 legal and physical custody to a relative, the juvenile court 470.15 shall follow the standards and procedures applicable under 470.16 chapter 257 or 518. An order establishing permanent legal or 470.17 physical custody under this subdivision must be filed with the 470.18 family court. A transfer of legal and physical custody includes 470.19 responsibility for the protection, education, care, and control 470.20 of the child and decision making on behalf of the child. The 470.21 socialserviceservices agency may petition on behalf of the 470.22 proposed custodian; 470.23 (2) termination of parental rightsand adoption; unless the 470.24 socialserviceservices agencyshall filehas already filed a 470.25 petition for termination of parental rights under section 470.26 260.231, the court may order such a petition filed and all the 470.27 requirements of sections 260.221 to 260.245 remain applicable. 470.28 An adoption completed subsequent to a determination under this 470.29 subdivision may include an agreement for communication or 470.30 contact under section 259.58; or 470.31 (3) long-term foster care; transfer of legal custody and 470.32 adoption are preferred permanency options for a child who cannot 470.33 return home. The court may order a child into long-term foster 470.34 care only if it finds that neither an award of legal and 470.35 physical custody to a relative, nor termination of parental 470.36 rights nor adoption is in the child's best interests. Further, 471.1 the court may only order long-term foster care for the child 471.2 under this section if it finds the following: 471.3 (i) the child has reached age 12 and reasonable efforts by 471.4 the responsible socialserviceservices agency have failed to 471.5 locate an adoptive family for the child; or 471.6 (ii) the child is a sibling of a child described in clause 471.7 (i) and the siblings have a significant positive relationship 471.8 and are ordered into the same long-term foster care home; or 471.9 (4) foster care for a specified period of time may be 471.10 ordered only if: 471.11 (i) the sole basis for an adjudication thatathe child is 471.12 in need of protection or services isthat the child is a471.13runaway, is an habitual truant, or committed a delinquent act471.14before age tenthe child's behavior; and 471.15 (ii) the court finds that foster care for a specified 471.16 period of time is in the best interests of the child. 471.17 (e) In ordering a permanent placement of a child, the court 471.18 must be governed by the best interests of the child, including a 471.19 review of the relationship between the child and relatives and 471.20 the child and other important persons with whom the child has 471.21 resided or had significant contact. 471.22 (f) Once a permanent placement determination has been made 471.23 and permanent placement has been established, further court 471.24 reviews and dispositional hearings are only necessary if the 471.25 placement is made under paragraph (d), clause (4), review is 471.26 otherwise required by federal law, an adoption has not yet been 471.27 finalized, or there is a disruption of the permanent or 471.28 long-term placement. 471.29 (g) An order under this subdivision must include the 471.30 following detailed findings: 471.31 (1) how the child's best interests are served by the order; 471.32 (2) the nature and extent of the responsible socialservice471.33 services agency's reasonable efforts, or, in the case of an 471.34 Indian child, active efforts, to reunify the child with the 471.35 parent or parents; 471.36 (3) the parent's or parents' efforts and ability to use 472.1 services to correct the conditions which led to the out-of-home 472.2 placement; and 472.3 (4) whether the conditions which led to the out-of-home 472.4 placement have been corrected so that the child can return home;472.5and472.6(5) if the child cannot be returned home, whether there is472.7a substantial probability of the child being able to return home472.8in the next six months. 472.9 (h) An order for permanent legal and physical custody of a 472.10 child may be modified under sections 518.18 and 518.185. The 472.11 socialserviceservices agency is a party to the proceeding and 472.12 must receive notice. An order for long-term foster care is 472.13 reviewable upon motion and a showing by the parent of a 472.14 substantial change in the parent's circumstances such that the 472.15 parent could provide appropriate care for the child and that 472.16 removal of the child from the child's permanent placement and 472.17 the return to the parent's care would be in the best interest of 472.18 the child. 472.19 (i) The court shall issue an order required under this 472.20 section within 15 days of the close of the proceedings. The 472.21 court may extend issuing the order an additional 15 days when 472.22 necessary in the interests of justice and the best interests of 472.23 the child. 472.24 Sec. 59. Minnesota Statutes 1998, section 260.192, is 472.25 amended to read: 472.26 260.192 [DISPOSITIONS; VOLUNTARY FOSTER CARE PLACEMENTS.] 472.27 Unless the court disposes of the petition under section 472.28 260.131, subdivision 1a, upon a petition for review of the 472.29 foster care status of a child, the court may: 472.30 (a)In the case of a petition required to be filed under472.31section 257.071, subdivision 3, find that the child's needs are472.32being met, that the child's placement in foster care is in the472.33best interests of the child, and that the child will be returned472.34home in the next six months, in which case the court shall472.35approve the voluntary arrangement and continue the matter for472.36six months to assure the child returns to the parent's home.473.1(b) In the case of a petition required to be filed under473.2section 257.071, subdivision 4, find that the child's needs are473.3being met and that the child's placement in foster care is in473.4the best interests of the child, in which case the court shall473.5approve the voluntary arrangement. The court shall order the473.6social service agency responsible for the placement to bring a473.7petition under section 260.131, subdivision 1 or 1a, as473.8appropriate, within 12 months.473.9(c)Find that the child's needs are not being met, in which 473.10 case the court shall order the socialserviceservices agency or 473.11 the parents to take whatever action is necessary and feasible to 473.12 meet the child's needs, including, when appropriate, the 473.13 provision by the socialserviceservices agency of services to 473.14 the parents which would enable the child to live at home, and 473.15 order a disposition under section 260.191. 473.16(d)(b) Find that the child has been abandoned by parents 473.17 financially or emotionally, or that the developmentally disabled 473.18 child does not require out-of-home care because of the 473.19 handicapping condition, in which case the court shall order the 473.20 socialserviceservices agency to file an appropriate petition 473.21 pursuant to sections 260.131, subdivision 1, or 260.231. 473.22 Nothing in this section shall be construed to prohibit 473.23 bringing a petition pursuant to section 260.131, subdivision 1 473.24 or 2, sooner than required by court order pursuant to this 473.25 section. 473.26 Sec. 60. Minnesota Statutes 1998, section 260.221, 473.27 subdivision 1, is amended to read: 473.28 Subdivision 1. [VOLUNTARY AND INVOLUNTARY.] The juvenile 473.29 court may upon petition, terminate all rights of a parent to a 473.30 child: 473.31 (a) with the written consent of a parent who for good cause 473.32 desires to terminate parental rights; or 473.33 (b) if it finds that one or more of the following 473.34 conditions exist: 473.35 (1) that the parent has abandoned the child; 473.36 (2) that the parent has substantially, continuously, or 474.1 repeatedly refused or neglected to comply with the duties 474.2 imposed upon that parent by the parent and child relationship, 474.3 including but not limited to providing the child with necessary 474.4 food, clothing, shelter, education, and other care and control 474.5 necessary for the child's physical, mental, or emotional health 474.6 and development, if the parent is physically and financially 474.7 able, and either reasonable efforts by the socialservice474.8 services agency have failed to correct the conditions that 474.9 formed the basis of the petition or reasonable efforts would be 474.10 futile and therefore unreasonable; 474.11 (3) that a parent has been ordered to contribute to the 474.12 support of the child or financially aid in the child's birth and 474.13 has continuously failed to do so without good cause. This 474.14 clause shall not be construed to state a grounds for termination 474.15 of parental rights of a noncustodial parent if that parent has 474.16 not been ordered to or cannot financially contribute to the 474.17 support of the child or aid in the child's birth; 474.18 (4) that a parent is palpably unfit to be a party to the 474.19 parent and child relationship because of a consistent pattern of 474.20 specific conduct before the child or of specific conditions 474.21 directly relating to the parent and child relationship either of 474.22 which are determined by the court to be of a duration or nature 474.23 that renders the parent unable, for the reasonably foreseeable 474.24 future, to care appropriately for the ongoing physical, mental, 474.25 or emotional needs of the child. It is presumed that a parent 474.26 is palpably unfit to be a party to the parent and child 474.27 relationship upon a showing that:474.28(i) the child was adjudicated in need of protection or474.29services due to circumstances described in section 260.015,474.30subdivision 2a, clause (1), (2), (3), (5), or (8); and474.31(ii)the parent's parental rights to one or more other 474.32 children were involuntarily terminatedunder clause (1), (2),474.33(4), or (7), or under clause (5) if the child was initially474.34determined to be in need of protection or services due to474.35circumstances described in section 260.015, subdivision 2a,474.36clause (1), (2), (3), (5), or (8); 475.1 (5) that followingupon a determination of neglect or475.2dependency, or of a child's need for protection or servicesthe 475.3 child's placement out of the home, reasonable efforts, under the 475.4 direction of the court, have failed to correct the conditions 475.5 leading to thedeterminationchild's placement. It is presumed 475.6 that reasonable efforts under this clause have failed upon a 475.7 showing that: 475.8 (i) a child has resided out of the parental home under 475.9 court order for a cumulative period ofmore than one year within475.10a five-year period following an adjudication of dependency,475.11neglect, need for protection or services under section 260.015,475.12subdivision 2a, clause (1), (2), (3), (6), (8), or (9), or475.13neglected and in foster care, and an order for disposition under475.14section 260.191, including adoption of the case plan required by475.15section 257.071;12 months within the preceding 22 months. In 475.16 the case of a child under age eight at the time the petition was 475.17 filed alleging the child to be in need of protection or 475.18 services, the presumption arises when the child has resided out 475.19 of the parental home under court order for six months unless the 475.20 parent has maintained regular contact with the child and the 475.21 parent is complying with the case plan; 475.22 (ii) the court has approved a case plan required under 475.23 section 257.071 and filed with the court under section 260.172; 475.24 (iii) conditions leading to thedetermination475.25willout-of-home placement have notbebeen correctedwithin475.26the reasonably foreseeable future. It is presumed that 475.27 conditions leading to a child's out-of-home placementwillhave 475.28 notbebeen correctedin the reasonably foreseeable futureupon 475.29 a showing that the parent or parents have not substantially 475.30 complied with the court's orders and a reasonable case plan, and475.31the conditions which led to the out-of-home placement have not475.32been corrected; and 475.33(iii)(iv) reasonable efforts have been made by the social 475.34serviceservices agency to rehabilitate the parent and reunite 475.35 the family. 475.36 This clause does not prohibit the termination of parental 476.1 rights prior to one year, or in the case of a child under age 476.2 eight, within six months after a child has been placed out of 476.3 the home. 476.4 It is also presumed that reasonable efforts have failed 476.5 under this clause upon a showing that: 476.6(i)(A) the parent has been diagnosed as chemically 476.7 dependent by a professional certified to make the diagnosis; 476.8(ii)(B) the parent has been required by a case plan to 476.9 participate in a chemical dependency treatment program; 476.10(iii)(C) the treatment programs offered to the parent were 476.11 culturally, linguistically, and clinically appropriate; 476.12(iv)(D) the parent has either failed two or more times to 476.13 successfully complete a treatment program or has refused at two 476.14 or more separate meetings with a caseworker to participate in a 476.15 treatment program; and 476.16(v)(E) the parent continues to abuse chemicals. 476.17Provided, that this presumption applies only to parents required476.18by a case plan to participate in a chemical dependency treatment476.19program on or after July 1, 1990;476.20 (6) that a child has experienced egregious harm in the 476.21 parent's care which is of a nature, duration, or chronicity that 476.22 indicates a lack of regard for the child's well-being, such that 476.23 a reasonable person would believe it contrary to the best 476.24 interest of the child or of any child to be in the parent's 476.25 care; 476.26 (7) that in the case of a child born to a mother who was 476.27 not married to the child's father when the child was conceived 476.28 nor when the child was born the person is not entitled to notice 476.29 of an adoption hearing under section 259.49 and the person has 476.30 not registered with the fathers' adoption registry under section 476.31 259.52; 476.32 (8) that the child is neglected and in foster care; or 476.33 (9) that the parent has been convicted of a crime listed in 476.34 section 260.012, paragraph (b), clauses (1) to (3). 476.35 In an action involving an American Indian child, sections 476.36 257.35 to 257.3579 and the Indian Child Welfare Act, United 477.1 States Code, title 25, sections 1901 to 1923, control to the 477.2 extent that the provisions of this section are inconsistent with 477.3 those laws. 477.4 Sec. 61. Minnesota Statutes 1998, section 260.221, 477.5 subdivision 1a, is amended to read: 477.6 Subd. 1a. [EVIDENCE OF ABANDONMENT.] For purposes of 477.7 subdivision 1, paragraph (b), clause (1): 477.8 (a) Abandonment is presumed when: 477.9 (1) the parent has had no contact with the child on a 477.10 regular basis and not demonstrated consistent interest in the 477.11 child's well-being for six months and the socialservice477.12 services agency has made reasonable efforts to facilitate 477.13 contact, unless the parent establishes that an extreme financial 477.14 or physical hardship or treatment for mental disability or 477.15 chemical dependency or other good cause prevented the parent 477.16 from making contact with the child. This presumption does not 477.17 apply to children whose custody has been determined under 477.18 chapter 257 or 518; or 477.19 (2) the child is an infant under two years of age and has 477.20 been deserted by the parent under circumstances that show an 477.21 intent not to return to care for the child. 477.22 The court is not prohibited from finding abandonment in the 477.23 absence of the presumptions in clauses (1) and (2). 477.24 (b) The following are prima facie evidence of abandonment 477.25 whereadoption proceedings are pending andthere has been a 477.26 showing that the person was not entitled to notice of an 477.27 adoption proceeding under section 259.49: 477.28 (1) failure to register with the fathers' adoption registry 477.29 under section 259.52; or 477.30 (2) if the person registered with the fathers' adoption 477.31 registry under section 259.52: 477.32 (i) filing a denial of paternity within 30 days of receipt 477.33 of notice under section 259.52, subdivision 8; 477.34 (ii) failing to timely file an intent to claim parental 477.35 rights with entry of appearance form within 30 days of receipt 477.36 of notice under section 259.52, subdivision 10; or 478.1 (iii) timely filing an intent to claim parental rights with 478.2 entry of appearance form within 30 days of receipt of notice 478.3 under section 259.52, subdivision 10, but failing to initiate a 478.4 paternity action within 30 days of receiving the fathers' 478.5 adoption registry notice where there has been no showing of good 478.6 cause for the delay. 478.7 Sec. 62. Minnesota Statutes 1998, section 260.221, 478.8 subdivision 1b, is amended to read: 478.9 Subd. 1b. [REQUIRED TERMINATION OF PARENTAL RIGHTS.] (a) 478.10 The county attorney shall file a termination of parental rights 478.11 petition within 30 days of the responsible social services 478.12 agency determining that achild's placement in out-of-home care478.13if thechild has been subjected to egregious harm as defined in 478.14 section 260.015, subdivision 29, is determined to be the sibling 478.15 of another child of the parent who was subjected to egregious 478.16 harm, or is an abandoned infant as defined in subdivision 1a, 478.17 paragraph (a), clause (2). The local social services agency 478.18 shall concurrently identify, recruit, process, and approve an 478.19 adoptive family for the child. If a termination of parental 478.20 rights petition has been filed by another party, the local 478.21 social services agency shall be joined as a party to the 478.22 petition. If criminal charges have been filed against a parent 478.23 arising out of the conduct alleged to constitute egregious harm, 478.24 the county attorney shall determine which matter should proceed 478.25 to trial first, consistent with the best interests of the child 478.26 and subject to the defendant's right to a speedy trial. 478.27 (b) This requirement does not apply if the county attorney 478.28 determines and files with the courtits determination that: 478.29 (1) a petition for transfer of permanent legal and physical 478.30 custody to a relativeis in the best interests of the child or478.31there isunder section 260.191, subdivision 3b, including a 478.32 determination that the transfer is in the best interests of the 478.33 child; or 478.34 (2) a petition alleging the child, and where appropriate, 478.35 the child's siblings, to be in need of protection or services 478.36 accompanied by a case plan prepared by the responsible social 479.1 services agency documenting a compelling reasondocumented by479.2the local social services agency thatwhy filingthea 479.3 termination of parental rights petition would not be in the best 479.4 interests of the child. 479.5 Sec. 63. Minnesota Statutes 1998, section 260.221, 479.6 subdivision 1c, is amended to read: 479.7 Subd. 1c. [CURRENT FOSTER CARE CHILDREN.] Except for cases 479.8 where the child is in placement due solely to the child's status 479.9 as developmentally delayed under United States Code, title 42, 479.10 section 6001(7), or emotionally handicapped under section 479.11 252.27, and where custody has not been transferred to the 479.12 responsible social services agency, the county attorney shall 479.13 file a termination of parental rights petition orothera 479.14 petition to support another permanent placement proceeding under 479.15 section 260.191, subdivision 3b, for all childrendetermined to479.16be in need of protection or serviceswho are placed in 479.17 out-of-home care for reasons other than care or treatment of the 479.18 child's disability, and who are in out-of-home placement on 479.19 April 21, 1998, and have been in out-of-home care for 15 of the 479.20 most recent 22 months. This requirement does not apply if there 479.21 is a compelling reason documented in a case plan filed with the 479.22 court for determining that filing a termination of parental 479.23 rights petition or other permanency petition would not be in the 479.24 best interests of the child or if the responsible social 479.25 services agency has not provided reasonable efforts necessary 479.26 for the safe return of the child, if reasonable efforts are 479.27 required. 479.28 Sec. 64. Minnesota Statutes 1998, section 260.221, 479.29 subdivision 3, is amended to read: 479.30 Subd. 3. [WHEN PRIOR FINDING REQUIRED.] For purposes of 479.31 subdivision 1, clause (b), no prior judicial finding of 479.32dependency, neglect,need for protection or services, or 479.33 neglected and in foster care is required, except as provided in 479.34 subdivision 1, clause (b), item (5). 479.35 Sec. 65. Minnesota Statutes 1998, section 260.221, 479.36 subdivision 5, is amended to read: 480.1 Subd. 5. [FINDINGS REGARDING REASONABLE EFFORTS.] In any 480.2 proceeding under this section, the court shall make specific 480.3 findings: 480.4 (1) regarding the nature and extent of efforts made by the 480.5 socialserviceservices agency to rehabilitate the parent and 480.6 reunite the family; or 480.7 (2)that provision of services or further services for the480.8purpose of rehabilitation and reunification is futile and480.9therefore unreasonable under the circumstances; or480.10(3)that reasonable efforts at reunification are not 480.11 required as provided under section 260.012. 480.12 Sec. 66. Minnesota Statutes 1998, section 518.158, 480.13 subdivision 1, is amended to read: 480.14 Subdivision 1. [FACTORS.] (a) It is presumed to be in the 480.15 best interests of the child for the court to grant temporary 480.16 custody to a relative under subdivision 2 if a minor child has 480.17 resided with the relative for a period of 12 months or more and 480.18 the following circumstances exist without good cause: 480.19 (1) the parent has had no contact with the child on a 480.20 regular basis and no demonstrated, consistent participation in 480.21 the child's well-being for six months; or 480.22 (2) the parent, during the time the child resided with the 480.23 relative, has refused or neglected to comply with the duties 480.24 imposed upon the parent by the parent and child relationship, 480.25 including but not limited to providing the child necessary food, 480.26 clothing, shelter, health care, education, and other care and 480.27 control necessary for the child's physical, mental, or emotional 480.28 health and development. 480.29 (b) It is also presumed to be in the best interests of the 480.30 child for the court to grant temporary custody to a relative 480.31 under subdivision 2 if the relative has permanent custody of a 480.32 sibling of the child and: 480.33 (1) the child is currently residing with the relative and a 480.34 factor in paragraph (a), clause (1) or (2), is present, 480.35 regardless of duration; or 480.36 (2) the application alleges an immediate and present danger 481.1 to the physical safety of the child in the home of the parent. 481.2 Sec. 67. Minnesota Statutes 1998, section 518.158, 481.3 subdivision 2, is amended to read: 481.4 Subd. 2. [EMERGENCY CUSTODY HEARING.] If the parent seeks 481.5 to remove the child from the home of the relative or if the 481.6 relative seeks to remove the child from the home of the parent 481.7 and the applicable factors in subdivision 1 exist, the relative 481.8 may apply for an ex parte temporary order for custody of the 481.9 child. The application must include an affidavit made under 481.10 oath that states with particularity the specific facts and 481.11 circumstances on which the application is based. The court 481.12 shall grant temporary custody if it finds, based on the 481.13 application, that the applicable factors in subdivision 1 481.14 exist. If it finds that the factors in subdivision 1 do not 481.15 exist, the court shall order that the child be returned to or 481.16 remain with the parent. An ex parte temporary custody order 481.17 under this subdivision is effective for a fixed period not to 481.18 exceed 14 days. A temporary custody hearing under this chapter 481.19 must be set for not later than seven days after issuance of the 481.20 ex parte temporary custody order, except that if the ex parte 481.21 temporary custody order is based on the grounds under 481.22 subdivision 1, paragraph (b), clause (2), the temporary custody 481.23 hearing must be set for not later than 72 hours, excluding 481.24 Saturdays, Sundays, and holidays, after issuance of the order. 481.25 The parent must be promptly served with a copy of the ex parte 481.26 order and the petition and notice of the date for the hearing. 481.27 Sec. 68. [626.5551] [ALTERNATIVE RESPONSE PROGRAMS FOR 481.28 CHILD PROTECTION ASSESSMENTS OR INVESTIGATIONS.] 481.29 Subdivision 1. [PROGRAMS AUTHORIZED.] (a) A county may 481.30 establish a program that uses alternative responses to reports 481.31 of child maltreatment under section 626.556, as provided in this 481.32 section. 481.33 (b) Alternative responses may include a family assessment 481.34 and services approach under which the local welfare agency 481.35 assesses the risk of abuse and neglect and the service needs of 481.36 the family and arranges for appropriate services, diversions, 482.1 referral for services, or other response identified in the plan 482.2 under subdivision 4. 482.3 (c) This section may not be used for reports of 482.4 maltreatment in facilities required to be licensed under 482.5 sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or 482.6 chapter 245B, or in a school as defined in sections 120A.05, 482.7 subdivisions 9, 11, and 13; and 124D.10, or in a nonlicensed 482.8 personal care provider association as defined in sections 482.9 256B.04, subdivision 16, and 256B.0625, subdivision 19a. 482.10 Subd. 2. [USE OF ALTERNATIVE RESPONSE OR 482.11 INVESTIGATION.] (a) Upon receipt of a report under section 482.12 626.556, the local welfare agency in a county that has 482.13 established an alternative response program under this section 482.14 shall determine whether to conduct an investigation under 482.15 section 626.556 or to use an alternative response as appropriate 482.16 to prevent or provide a remedy for child maltreatment. 482.17 (b) The local welfare agency may conduct an investigation 482.18 of any report, but shall conduct an investigation of reports 482.19 that, if true, would mean that the child has experienced, or is 482.20 at risk of experiencing, serious physical injury, sexual abuse, 482.21 abandonment, or neglect that substantially endangers the child's 482.22 physical or mental health, including growth delays, which may be 482.23 referred to as failure to thrive, that have been diagnosed by a 482.24 physician and are due to parental neglect, or conduct that would 482.25 be a violation of, or an attempt to commit a violation of: 482.26 (1) section 609.185; 609.19; or 609.195 (murder in the 482.27 first, second, or third degree); 482.28 (2) section 609.20 or 609.205 (manslaughter in the first or 482.29 second degree); 482.30 (3) section 609.221; 609.222; or 609.223 (assault in the 482.31 first, second, or third degree); 482.32 (4) section 609.322 (solicitation, inducement, and 482.33 promotion of prostitution); 482.34 (5) sections 609.342 to 609.3451 (criminal sexual conduct); 482.35 (6) section 609.352 (solicitation of children to engage in 482.36 sexual conduct); 483.1 (7) section 609.377 or 609.378 (malicious punishment or 483.2 neglect or endangerment of a child); or 483.3 (8) section 617.246 (use of minor in sexual performance). 483.4 (c) In addition, in all cases the local welfare agency 483.5 shall notify the appropriate law enforcement agency as provided 483.6 in section 626.556, subdivision 3. 483.7 (d) The local welfare agency shall begin an immediate 483.8 investigation under section 626.556 if at any time when it is 483.9 using an alternative response it determines that an 483.10 investigation is required under paragraph (b) or would otherwise 483.11 be appropriate. The local welfare agency may use an alternative 483.12 response to a report that was initially referred for an 483.13 investigation if the agency determines that a complete 483.14 investigation is not required. In determining that a complete 483.15 investigation is not required, the local welfare agency must 483.16 document the reason for terminating the investigation and 483.17 consult with: 483.18 (1) the local law enforcement agency, if the local law 483.19 enforcement is involved, and notify the county attorney of the 483.20 decision to terminate the investigation; or 483.21 (2) the county attorney, if the local law enforcement is 483.22 not involved. 483.23 Subd. 3. [DOCUMENTATION.] When a case in which an 483.24 alternative response was used is closed, the local welfare 483.25 agency shall document the outcome of the approach, including a 483.26 description of the response and services provided and the 483.27 removal or reduction of risk to the child, if it existed. 483.28 Records maintained under this section must contain the 483.29 documentation and must be retained for at least four years. 483.30 Subd. 4. [PLAN.] The county community social service plan 483.31 required under section 256E.09 must address the extent that the 483.32 county will use the alternative response program authorized 483.33 under this section, based on the availability of new federal 483.34 funding that is earned and other available revenue sources to 483.35 fund the additional cost to the county of using the program. To 483.36 the extent the county uses the program, the county must include 484.1 the program in the community social service plan and in the 484.2 program evaluation under section 256E.10. The plan must address 484.3 alternative responses and services that will be used for the 484.4 program and protocols for determining the appropriate response 484.5 to reports under section 626.556 and address how the protocols 484.6 comply with the guidelines of the commissioner under subdivision 484.7 5. 484.8 Subd. 5. [COMMISSIONER OF HUMAN SERVICES TO DEVELOP 484.9 GUIDELINES.] The commissioner of human services, in consultation 484.10 with county representatives, may develop guidelines defining 484.11 alternative responses and setting out procedures for family 484.12 assessment and service delivery under this section. The 484.13 commissioner may also develop guidelines for counties regarding 484.14 the provisions of section 626.556 that continue to apply when 484.15 using an alternative response under this section. The 484.16 commissioner may also develop forms, best practice guidelines, 484.17 and training to assist counties in implementing alternative 484.18 responses under this section. 484.19 Sec. 69. Minnesota Statutes 1998, section 626.556, 484.20 subdivision 2, is amended to read: 484.21 Subd. 2. [DEFINITIONS.] As used in this section, the 484.22 following terms have the meanings given them unless the specific 484.23 content indicates otherwise: 484.24 (a) "Sexual abuse" means the subjection of a child by a 484.25 person responsible for the child's care, by a person who has a 484.26 significant relationship to the child, as defined in section 484.27 609.341, or by a person in a position of authority, as defined 484.28 in section 609.341, subdivision 10, to any act which constitutes 484.29 a violation of section 609.342 (criminal sexual conduct in the 484.30 first degree), 609.343 (criminal sexual conduct in the second 484.31 degree), 609.344 (criminal sexual conduct in the third 484.32 degree),or609.345 (criminal sexual conduct in the fourth 484.33 degree), or 609.3451 (criminal sexual conduct in the fifth 484.34 degree). Sexual abuse also includes any act which involves a 484.35 minor which constitutes a violation of prostitution offenses 484.36 under sections 609.321 to 609.324 or 617.246. Sexual abuse 485.1 includes threatened sexual abuse. 485.2 (b) "Person responsible for the child's care" means (1) an 485.3 individual functioning within the family unit and having 485.4 responsibilities for the care of the child such as a parent, 485.5 guardian, or other person having similar care responsibilities, 485.6 or (2) an individual functioning outside the family unit and 485.7 having responsibilities for the care of the child such as a 485.8 teacher, school administrator, or other lawful custodian of a 485.9 child having either full-time or short-term care 485.10 responsibilities including, but not limited to, day care, 485.11 babysitting whether paid or unpaid, counseling, teaching, and 485.12 coaching. 485.13 (c) "Neglect" means: 485.14 (1) failure by a person responsible for a child's care to 485.15 supply a child with necessary food, clothing, shelteror, 485.16 health, medical, or other care required for the child's physical 485.17 or mental health when reasonably able to do so,; 485.18 (2) failure to protect a child from conditions or actions 485.19 which imminently and seriously endanger the child's physical or 485.20 mental health when reasonably able to do so, or; 485.21 (3) failure to provide for necessary supervision or child 485.22 care arrangements appropriate for a child after considering 485.23 factors as the child's age, mental ability, physical condition, 485.24 length of absence, or environment, when the child is unable to 485.25 care for the child's own basic needs or safety, or the basic 485.26 needs or safety of another child in their care; 485.27 (4) failureto take steps to ensure that a child is485.28educated in accordance with state law.to ensure that the child 485.29 is educated as defined in sections 120A.22 and 260.155, 485.30 subdivision 9; 485.31 (5) nothing in this section shall be construed to mean that 485.32 a child is neglected solely because the child's parent, 485.33 guardian, or other person responsible for the child's care in 485.34 good faith selects and depends upon spiritual means or prayer 485.35 for treatment or care of disease or remedial care of the child 485.36 in lieu of medical care; except that a parent, guardian, or 486.1 caretaker, or a person mandated to report pursuant to 486.2 subdivision 3, has a duty to report if a lack of medical care 486.3 may cause serious danger to the child's health. This section 486.4 does not impose upon persons, not otherwise legally responsible 486.5 for providing a child with necessary food, clothing, shelter, 486.6 education, or medical care, a duty to provide that care.; 486.7Neglect includes(6) prenatal exposure to a controlled 486.8 substance, as defined in section 253B.02, subdivision 2, used by 486.9 the mother for a nonmedical purpose, as evidenced by withdrawal 486.10 symptoms in the child at birth, results of a toxicology test 486.11 performed on the mother at delivery or the child at birth, or 486.12 medical effects or developmental delays during the child's first 486.13 year of life that medically indicate prenatal exposure to a 486.14 controlled substance.; 486.15Neglect also means(7) "medical neglect" as defined in 486.16 section 260.015, subdivision 2a, clause (5).; 486.17 (8) that the parent or other person responsible for the 486.18 care of the child: 486.19 (i) engages in violent behavior that demonstrates a 486.20 disregard for the well being of the child as indicated by action 486.21 that could reasonably result in serious physical, mental, or 486.22 threatened injury, or emotional damage to the child; 486.23 (ii) engages in repeated domestic assault that would 486.24 constitute a violation of section 609.2242, subdivision 2 or 4; 486.25 (iii) commits domestic assault that would constitute a 486.26 violation of section 609.2242 within sight or sound of the 486.27 child; or 486.28 (iv) subjects the child to ongoing domestic violence in the 486.29 home environment because of actions of an abuser that are likely 486.30 to have a detrimental effect on the well being of the child; 486.31 (9) chronic and severe use of alcohol or a controlled 486.32 substance by a parent or person responsible for the care of the 486.33 child that adversely affects the child's basic needs and safety; 486.34 or 486.35 (10) emotional harm from a pattern of behavior which 486.36 contributes to impaired emotional functioning of the child which 487.1 may be demonstrated by a substantial and observable effect in 487.2 the child's behavior, emotional response, or cognition that is 487.3 not within the normal range for the child's age and stage of 487.4 development, with due regard to the child's culture. 487.5 (d) "Physical abuse" means any physicalorinjury, mental 487.6 injury, or threatened injury, inflicted by a person responsible 487.7 for the child's care on a child other than by accidental means, 487.8 or any physical or mental injury that cannot reasonably be 487.9 explained by the child's history of injuries, or any aversive487.10and deprivation procedures that have not been authorized under487.11section 245.825. Abuse does not include reasonable and moderate 487.12 physical discipline of a child administered by a parent or legal 487.13 guardian which does not result in an injury. Actions which are 487.14 not reasonable and moderate include, but are not limited to: 487.15 (1) throwing, kicking, burning, biting, or cutting a child; 487.16 (2) striking a child with a closed fist; 487.17 (3) shaking a child under age three; 487.18 (4) striking or other actions which result in any 487.19 nonaccidental injury to a child under 18 months of age; 487.20 (5) unreasonable interference with a child's breathing; 487.21 (6) threatening a child with a weapon, as defined in 487.22 section 609.02, subdivision 6; 487.23 (7) striking a child under age one on the face or head; 487.24 (8) purposely giving a child poison, alcohol, or dangerous, 487.25 harmful, or controlled substances which were not prescribed for 487.26 the child by a practitioner, in order to control or punish the 487.27 child; or other substances that substantially affect the child's 487.28 behavior, motor coordination, or judgment or that results in 487.29 sickness or internal injury, or subjects the child to medical 487.30 procedures that would be unnecessary if the child were not 487.31 exposed to the substances; or 487.32 (9) unreasonable physical confinement or restraint not 487.33 permitted under section 609.379, including but not limited to 487.34 tying, caging, or chaining. 487.35 (e) "Report" means any report received by the local welfare 487.36 agency, police department, or county sheriff pursuant to this 488.1 section. 488.2 (f) "Facility" means a licensed or unlicensed day care 488.3 facility, residential facility, agency, hospital, sanitarium, or 488.4 other facility or institution required to be licensedpursuant488.5tounder sections 144.50 to 144.58, 241.021, or 245A.01 to 488.6 245A.16., or chapter 245B; or a school as defined in sections 488.7 120A.05, subdivisions 9, 11, and 13; and 124D.10; or a 488.8 nonlicensed personal care provider organization as defined in 488.9 sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a. 488.10 (g) "Operator" means an operator or agency as defined in 488.11 section 245A.02. 488.12 (h) "Commissioner" means the commissioner of human services. 488.13 (i) "Assessment" includes authority to interview the child, 488.14 the person or persons responsible for the child's care, the 488.15 alleged perpetrator, and any other person with knowledge of the 488.16 abuse or neglect for the purpose of gathering the facts, 488.17 assessing the risk to the child, and formulating a plan. 488.18 (j) "Practice of social services," for the purposes of 488.19 subdivision 3, includes but is not limited to employee 488.20 assistance counseling and the provision of guardian ad litem and 488.21 visitation expeditor services. 488.22 (k) "Mental injury" means an injury to the psychological 488.23 capacity or emotional stability of a child as evidenced by an 488.24 observable or substantial impairment in the child's ability to 488.25 function within a normal range of performance and behavior with 488.26 due regard to the child's culture or harm to a child's 488.27 psychological or intellectual functioning which now, or in the 488.28 future, is likely to be evidenced by serious mental, behavioral, 488.29 or personality disorder, including severe anxiety, depression, 488.30 withdrawal, severe aggressive behavior, seriously delayed 488.31 development or similarly serious dysfunctional behavior when 488.32 caused by a statement, overt act, omission, condition, or status 488.33 of the child's caretaker. 488.34 (l) "Threatened injury" means a statement, overt act, 488.35 condition, or status that represents a substantial risk of 488.36 physical or sexual abuse or mental injury. 489.1 (m) Persons who conduct assessments or investigations under 489.2 this section shall take into account accepted child-rearing 489.3 practices of the culture in which a child participates, which 489.4 are not injurious to the child's health, welfare, and safety. 489.5 Sec. 70. Minnesota Statutes 1998, section 626.556, 489.6 subdivision 3, is amended to read: 489.7 Subd. 3. [PERSONS MANDATED TO REPORT.] (a) A person who 489.8 knows or has reason to believe a child is being neglected or 489.9 physically or sexually abused, as defined in subdivision 2, or 489.10 has been neglected or physically or sexually abused within the 489.11 preceding three years, shall immediately report the information 489.12 to the local welfare agency, agency responsible for assessing or 489.13 investigating the report, police department, or the county 489.14 sheriff if the person is: 489.15 (1) a professional or professional's delegate who is 489.16 engaged in the practice of the healing arts, social services, 489.17 hospital administration, psychological or psychiatric treatment, 489.18 child care, education, or law enforcement; or 489.19 (2) employed as a member of the clergy and received the 489.20 information while engaged in ministerial duties, provided that a 489.21 member of the clergy is not required by this subdivision to 489.22 report information that is otherwise privileged under section 489.23 595.02, subdivision 1, paragraph (c). 489.24 The police department or the county sheriff, upon receiving 489.25 a report, shall immediately notify the local welfare agency or 489.26 agency responsible for assessing or investigating the report, 489.27 orally and in writing. The local welfare agency, or agency 489.28 responsible for assessing or investigating the report, upon 489.29 receiving a report, shall immediately notify the local police 489.30 department or the county sheriff orally and in writing. The 489.31 county sheriff and the head of every local welfare agency, 489.32 agency responsible for assessing or investigating reports, and 489.33 police department shall each designate a person within their 489.34 agency, department, or office who is responsible for ensuring 489.35 that the notification duties of this paragraph and paragraph (b) 489.36 are carried out. Nothing in this subdivision shall be construed 490.1 to require more than one report from any institution, facility, 490.2 school, or agency. 490.3 (b) Any person may voluntarily report to the local welfare 490.4 agency, agency responsible for assessing or investigating the 490.5 report, police department, or the county sheriff if the person 490.6 knows, has reason to believe, or suspects a child is being or 490.7 has been neglected or subjected to physical or sexual abuse. 490.8 The police department or the county sheriff, upon receiving a 490.9 report, shall immediately notify the local welfare agency or 490.10 agency responsible for assessing or investigating the report, 490.11 orally and in writing. The local welfare agency or agency 490.12 responsible for assessing or investigating the report, upon 490.13 receiving a report, shall immediately notify the local police 490.14 department or the county sheriff orally and in writing. 490.15 (c) A person mandated to report physical or sexual child 490.16 abuse or neglect occurring within a licensed facility shall 490.17 report the information to the agency responsible for licensing 490.18 the facility under sections 144.50 to 144.58; 241.021; 245A.01 490.19 to 245A.16; or 245B, or a school as defined in sections 120A.05, 490.20 subdivisions 9, 11, and 13; and 124D.10; or a nonlicensed 490.21 personal care provider organization as defined in sections 490.22 256B.04, subdivision 16; and 256B.0625, subdivision 19. A health 490.23 or corrections agency receiving a report may request the local 490.24 welfare agency to provide assistance pursuant to subdivisions 490.25 10, 10a, and 10b. 490.26 (d) Any person mandated to report shall receive a summary 490.27 of the disposition of any report made by that 490.28 reporter, including whether the case has been opened for child 490.29 protection or other services, or if a referral has been made to 490.30 a community organization, unless release would be detrimental to 490.31 the best interests of the child. Any person who is not mandated 490.32 to report shall, upon request to the local welfare agency, 490.33 receive a concise summary of the disposition of any report made 490.34 by that reporter, unless release would be detrimental to the 490.35 best interests of the child. 490.36 (e) For purposes of this subdivision, "immediately" means 491.1 as soon as possible but in no event longer than 24 hours. 491.2 Sec. 71. Minnesota Statutes 1998, section 626.556, is 491.3 amended by adding a subdivision to read: 491.4 Subd. 3b. [AGENCY RESPONSIBLE FOR ASSESSING OR 491.5 INVESTIGATING REPORTS OF MALTREATMENT.] 491.6 The following agencies are the administrative agencies 491.7 responsible for assessing or investigating reports of alleged 491.8 child maltreatment in facilities made under this section: 491.9 (1) the county local welfare agency is the agency 491.10 responsible for assessing or investigating allegations of 491.11 maltreatment in child foster care, family child care, and 491.12 legally unlicensed child care and in juvenile correctional 491.13 facilities licensed under section 241.021 located in the local 491.14 welfare agency's county; 491.15 (2) the department of human services is the agency 491.16 responsible for assessing or investigating allegations of 491.17 maltreatment in facilities licensed under chapters 245A and 491.18 245B, except for child foster care and family child care; and 491.19 (3) the department of health is the agency responsible for 491.20 assessing or investigating allegations of child maltreatment in 491.21 facilities licensed under sections 144.50 to 144.58, and in 491.22 unlicensed home health care. 491.23 Sec. 72. Minnesota Statutes 1998, section 626.556, 491.24 subdivision 4, is amended to read: 491.25 Subd. 4. [IMMUNITY FROM LIABILITY.] (a) The following 491.26 persons are immune from any civil or criminal liability that 491.27 otherwise might result from their actions, if they are acting in 491.28 good faith: 491.29 (1) any person making a voluntary or mandated report under 491.30 subdivision 3 or under section 626.5561 or assisting in an 491.31 assessment under this section or under section 626.5561; 491.32 (2) any person with responsibility for performing duties 491.33 under this section or supervisor employed by a local welfare 491.34 agencyor, the commissioner of an agency responsible for 491.35 operating or supervising a licensed or unlicensed day care 491.36 facility, residential facility, agency, hospital, sanitarium, or 492.1 other facility or institution required to be licensed under 492.2 sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or 245B, 492.3 or a school as defined in sections 120A.05, subdivisions 9, 11, 492.4 and 13; and 124D.10; or a nonlicensed personal care provider 492.5 organization as defined in sections 256B.04, subdivision 16; and 492.6 256B.0625, subdivision 19a, complying with subdivision 10d; and 492.7 (3) any public or private school, facility as defined in 492.8 subdivision 2, or the employee of any public or private school 492.9 or facility who permits access by a local welfare agency or 492.10 local law enforcement agency and assists in an investigation or 492.11 assessment pursuant to subdivision 10 or under section 626.5561. 492.12 (b) A person who is a supervisor or person with 492.13 responsibility for performing duties under this section employed 492.14 by a local welfare agency or the commissioner complying with 492.15 subdivisions 10 and 11 or section 626.5561 or any related rule 492.16 or provision of law is immune from any civil or criminal 492.17 liability that might otherwise result from the person's actions, 492.18 if the person is (1) acting in good faith and exercising due 492.19 care, or (2) acting in good faith and following the information 492.20 collection procedures established under subdivision 10, 492.21 paragraphs (h), (i), and (j). 492.22 (c) This subdivision does not provide immunity to any 492.23 person for failure to make a required report or for committing 492.24 neglect, physical abuse, or sexual abuse of a child. 492.25 (d) If a person who makes a voluntary or mandatory report 492.26 under subdivision 3 prevails in a civil action from which the 492.27 person has been granted immunity under this subdivision, the 492.28 court may award the person attorney fees and costs. 492.29 Sec. 73. Minnesota Statutes 1998, section 626.556, 492.30 subdivision 7, is amended to read: 492.31 Subd. 7. [REPORT.] An oral report shall be made 492.32 immediately by telephone or otherwise. An oral report made by a 492.33 person required under subdivision 3 to report shall be followed 492.34 within 72 hours, exclusive of weekends and holidays, by a report 492.35 in writing to the appropriate police department, the county 492.36 sheriff or local welfare agency, unless the appropriate agency 493.1 has informed the reporter that the oral information does not 493.2 constitute a report under subdivision 10. Any report shall be 493.3 of sufficient content to identify the child, any person believed 493.4 to be responsible for the abuse or neglect of the child if the 493.5 person is known, the nature and extent of the abuse or neglect 493.6 and the name and address of the reporter. If requested, the 493.7 local welfare agency shall inform the reporter within ten days 493.8 after the report is made, either orally or in writing, whether 493.9 the report was accepted for assessment or investigation. 493.10 Written reports received by a police department or the county 493.11 sheriff shall be forwarded immediately to the local welfare 493.12 agency. The police department or the county sheriff may keep 493.13 copies of reports received by them. Copies of written reports 493.14 received by a local welfare department shall be forwarded 493.15 immediately to the local police department or the county sheriff. 493.16 A written copy of a report maintained by personnel of 493.17 agencies, other than welfare or law enforcement agencies, which 493.18 are subject to chapter 13 shall be confidential. An individual 493.19 subject of the report may obtain access to the original report 493.20 as provided by subdivision 11. 493.21 Sec. 74. Minnesota Statutes 1998, section 626.556, 493.22 subdivision 10, is amended to read: 493.23 Subd. 10. [DUTIES OF LOCAL WELFARE AGENCY AND LOCAL LAW 493.24 ENFORCEMENT AGENCY UPON RECEIPT OF A REPORT.] (a) If the report 493.25 alleges neglect, physical abuse, or sexual abuse by a parent, 493.26 guardian, or individual functioning within the family unit as a 493.27 person responsible for the child's care, the local welfare 493.28 agency shall immediately conduct an assessment and screening for 493.29 substance abuse and offer protective social services for 493.30 purposes of preventing further abuses, safeguarding and 493.31 enhancing the welfare of the abused or neglected minor, and 493.32 preserving family life whenever possible. If the report alleges 493.33 a violation of a criminal statute involving sexual abuse, 493.34 physical abuse, or neglect or endangerment, under section 493.35 609.378, the local law enforcement agency and local welfare 493.36 agency shall coordinate the planning and execution of their 494.1 respective investigation and assessment efforts to avoid a 494.2 duplication of fact-finding efforts and multiple interviews. 494.3 Each agency shall prepare a separate report of the results of 494.4 its investigation. In cases of alleged child maltreatment 494.5 resulting in death, the local agency may rely on the 494.6 fact-finding efforts of a law enforcement investigation to make 494.7 a determination of whether or not maltreatment occurred. When 494.8 necessary the local welfare agency shall seek authority to 494.9 remove the child from the custody of a parent, guardian, or 494.10 adult with whom the child is living. In performing any of these 494.11 duties, the local welfare agency shall maintain appropriate 494.12 records. 494.13 If the screening for substance abuse indicates abuse of 494.14 alcohol or other drugs, the local welfare agency shall conduct a 494.15 chemical use assessment pursuant to Minnesota Rules, part 494.16 9530.6615. The local welfare agency shall report the 494.17 determination of the chemical use assessment, and the 494.18 recommendations and referrals for alcohol and other drug 494.19 treatment services to the state authority on alcohol and drug 494.20 abuse. 494.21 (b) When a local agency receives a report or otherwise has 494.22 information indicating that a child who is a client, as defined 494.23 in section 245.91, has been the subject of physical abuse, 494.24 sexual abuse, or neglect at an agency, facility, or program as 494.25 defined in section 245.91, it shall, in addition to its other 494.26 duties under this section, immediately inform the ombudsman 494.27 established under sections 245.91 to 245.97. 494.28 (c) Authority of the local welfare agency responsible for 494.29 assessing the child abuse or neglect report and of the local law 494.30 enforcement agency for investigating the alleged abuse or 494.31 neglect includes, but is not limited to, authority to interview, 494.32 without parental consent, the alleged victim and any other 494.33 minors who currently reside with or who have resided with the 494.34 alleged offender. The interview may take place at school or at 494.35 any facility or other place where the alleged victim or other 494.36 minors might be found or the child may be transported to, and 495.1 the interview conducted at, a place appropriate for the 495.2 interview of a child designated by the local welfare agency or 495.3 law enforcement agency. The interview may take place outside 495.4 the presence of the alleged offender or parent, legal custodian, 495.5 guardian, or school official. Except as provided in this 495.6 paragraph, the parent, legal custodian, or guardian shall be 495.7 notified by the responsible local welfare or law enforcement 495.8 agency no later than the conclusion of the investigation or 495.9 assessment that this interview has occurred. Notwithstanding 495.10 rule 49.02 of the Minnesota rules of procedure for juvenile 495.11 courts, the juvenile court may, after hearing on an ex parte 495.12 motion by the local welfare agency, order that, where reasonable 495.13 cause exists, the agency withhold notification of this interview 495.14 from the parent, legal custodian, or guardian. If the interview 495.15 took place or is to take place on school property, the order 495.16 shall specify that school officials may not disclose to the 495.17 parent, legal custodian, or guardian the contents of the 495.18 notification of intent to interview the child on school 495.19 property, as provided under this paragraph, and any other 495.20 related information regarding the interview that may be a part 495.21 of the child's school record. A copy of the order shall be sent 495.22 by the local welfare or law enforcement agency to the 495.23 appropriate school official. 495.24 (d) When the local welfare or local law enforcement agency 495.25 determines that an interview should take place on school 495.26 property, written notification of intent to interview the child 495.27 on school property must be received by school officials prior to 495.28 the interview. The notification shall include the name of the 495.29 child to be interviewed, the purpose of the interview, and a 495.30 reference to the statutory authority to conduct an interview on 495.31 school property. For interviews conducted by the local welfare 495.32 agency, the notification shall be signed by the chair of the 495.33 local social services agency or the chair's designee. The 495.34 notification shall be private data on individuals subject to the 495.35 provisions of this paragraph. School officials may not disclose 495.36 to the parent, legal custodian, or guardian the contents of the 496.1 notification or any other related information regarding the 496.2 interview until notified in writing by the local welfare or law 496.3 enforcement agency that the investigation or assessment has been 496.4 concluded. Until that time, the local welfare or law 496.5 enforcement agency shall be solely responsible for any 496.6 disclosures regarding the nature of the assessment or 496.7 investigation. 496.8 Except where the alleged offender is believed to be a 496.9 school official or employee, the time and place, and manner of 496.10 the interview on school premises shall be within the discretion 496.11 of school officials, but the local welfare or law enforcement 496.12 agency shall have the exclusive authority to determine who may 496.13 attend the interview. The conditions as to time, place, and 496.14 manner of the interview set by the school officials shall be 496.15 reasonable and the interview shall be conducted not more than 24 496.16 hours after the receipt of the notification unless another time 496.17 is considered necessary by agreement between the school 496.18 officials and the local welfare or law enforcement agency. 496.19 Where the school fails to comply with the provisions of this 496.20 paragraph, the juvenile court may order the school to comply. 496.21 Every effort must be made to reduce the disruption of the 496.22 educational program of the child, other students, or school 496.23 staff when an interview is conducted on school premises. 496.24 (e) Where the alleged offender or a person responsible for 496.25 the care of the alleged victim or other minor prevents access to 496.26 the victim or other minor by the local welfare agency, the 496.27 juvenile court may order the parents, legal custodian, or 496.28 guardian to produce the alleged victim or other minor for 496.29 questioning by the local welfare agency or the local law 496.30 enforcement agency outside the presence of the alleged offender 496.31 or any person responsible for the child's care at reasonable 496.32 places and times as specified by court order. 496.33 (f) Before making an order under paragraph (e), the court 496.34 shall issue an order to show cause, either upon its own motion 496.35 or upon a verified petition, specifying the basis for the 496.36 requested interviews and fixing the time and place of the 497.1 hearing. The order to show cause shall be served personally and 497.2 shall be heard in the same manner as provided in other cases in 497.3 the juvenile court. The court shall consider the need for 497.4 appointment of a guardian ad litem to protect the best interests 497.5 of the child. If appointed, the guardian ad litem shall be 497.6 present at the hearing on the order to show cause. 497.7 (g) The commissioner, the ombudsman for mental health and 497.8 mental retardation, the local welfare agencies responsible for 497.9 investigating reports, and the local law enforcement agencies 497.10 have the right to enter facilities as defined in subdivision 2 497.11 and to inspect and copy the facility's records, including 497.12 medical records, as part of the investigation. Notwithstanding 497.13 the provisions of chapter 13, they also have the right to inform 497.14 the facility under investigation that they are conducting an 497.15 investigation, to disclose to the facility the names of the 497.16 individuals under investigation for abusing or neglecting a 497.17 child, and to provide the facility with a copy of the report and 497.18 the investigative findings. 497.19 (h) The local welfare agency shall collect available and 497.20 relevant information to ascertain whether maltreatment occurred 497.21 and whether protective services are needed. Information 497.22 collected includes, when relevant, information with regard to 497.23 the person reporting the alleged maltreatment, including the 497.24 nature of the reporter's relationship to the child and to the 497.25 alleged offender, and the basis of the reporter's knowledge for 497.26 the report; the child allegedly being maltreated; the alleged 497.27 offender; the child's caretaker; and other collateral sources 497.28 having relevant information related to the alleged 497.29 maltreatment. The local welfare agency may make a determination 497.30 of no maltreatment early in an assessment, and close the case 497.31 and retain immunity, if the collected information shows no basis 497.32 for a full assessment or investigation. 497.33 Information relevant to the assessment or investigation 497.34 must be asked for, and may include: 497.35 (1) the child's sex and age, prior reports of maltreatment, 497.36 information relating to developmental functioning, credibility 498.1 of the child's statement, and whether the information provided 498.2 under this clause is consistent with other information collected 498.3 during the course of the assessment or investigation; 498.4 (2) the alleged offender's age, a record check for prior 498.5 reports of maltreatment, and criminal charges and convictions. 498.6 The local welfare agency must provide the alleged offender with 498.7 an opportunity to make a statement. The alleged offender may 498.8 submit supporting documentation relevant to the assessment or 498.9 investigation; 498.10 (3) collateral source information regarding the alleged 498.11 maltreatment and care of the child. Collateral information 498.12 includes, when relevant: (i) a medical examination of the 498.13 child; (ii) prior medical records relating to the alleged 498.14 maltreatment or the care of the child and an interview with the 498.15 treating professionals; and (iii) interviews with the child's 498.16 caretakers, including the child's parent, guardian, foster 498.17 parent, child care provider, teachers, counselors, family 498.18 members, relatives, and other persons who may have knowledge 498.19 regarding the alleged maltreatment and the care of the child; 498.20 and 498.21 (4) information on the existence of domestic abuse and 498.22 violence in the home of the child, and substance abuse. 498.23 Nothing in this paragraph precludes the local welfare 498.24 agency from collecting other relevant information necessary to 498.25 conduct the assessment or investigation. Notwithstanding the 498.26 data's classification in the possession of any other agency, 498.27 data acquired by the local welfare agency during the course of 498.28 the assessment or investigation are private data on individuals 498.29 and must be maintained in accordance with subdivision 11. 498.30 (i) In the initial stages of an assessment or 498.31 investigation, the local welfare agency shall conduct a 498.32 face-to-face observation of the child reported to be maltreated 498.33 and a face-to-face interview of the alleged offender. The 498.34 interview with the alleged offender may be postponed if it would 498.35 jeopardize an active law enforcement investigation. 498.36 (j) The local welfare agency shall use a question and 499.1 answer interviewing format with questioning as nondirective as 499.2 possible to elicit spontaneous responses. The following 499.3 interviewing methods and procedures must be used whenever 499.4 possible when collecting information: 499.5 (1) audio recordings of all interviews with witnesses and 499.6 collateral sources; and 499.7 (2) in cases of alleged sexual abuse, audio-video 499.8 recordings of each interview with the alleged victim and child 499.9 witnesses. 499.10 Sec. 75. Minnesota Statutes 1998, section 626.556, 499.11 subdivision 10b, is amended to read: 499.12 Subd. 10b. [DUTIES OF COMMISSIONER; NEGLECT OR ABUSE IN 499.13 FACILITY.] (a) This section applies to the commissioners of 499.14 human services and health. The commissioner of the agency 499.15 responsible for assessing or investigating the report shall 499.16 immediately investigate if the report alleges that: 499.17 (1) a child who is in the care of a facility as defined in 499.18 subdivision 2 is neglected, physically abused, or sexually 499.19 abused by an individual in that facility, or has been so 499.20 neglected or abused by an individual in that facility within the 499.21 three years preceding the report; or 499.22 (2) a child was neglected, physically abused, or sexually 499.23 abused by an individual in a facility defined in subdivision 2, 499.24 while in the care of that facility within the three years 499.25 preceding the report. 499.26 The commissioner of the agency responsible for assessing or 499.27 investigating the report shall arrange for the transmittal to 499.28 the commissioner of reports received by local agencies and may 499.29 delegate to a local welfare agency the duty to investigate 499.30 reports. In conducting an investigation under this section, the 499.31 commissioner has the powers and duties specified for local 499.32 welfare agencies under this section. The commissioner of the 499.33 agency responsible for assessing or investigating the report or 499.34 local welfare agency may interview any children who are or have 499.35 been in the care of a facility under investigation and their 499.36 parents, guardians, or legal custodians. 500.1 (b) Prior to any interview, the commissioner of the agency 500.2 responsible for assessing or investigating the report or local 500.3 welfare agency shall notify the parent, guardian, or legal 500.4 custodian of a child who will be interviewed in the manner 500.5 provided for in subdivision 10d, paragraph (a). If reasonable 500.6 efforts to reach the parent, guardian, or legal custodian of a 500.7 child in an out-of-home placement have failed, the child may be 500.8 interviewed if there is reason to believe the interview is 500.9 necessary to protect the child or other children in the 500.10 facility. The commissioner of the agency responsible for 500.11 assessing or investigating the report or local agency must 500.12 provide the information required in this subdivision to the 500.13 parent, guardian, or legal custodian of a child interviewed 500.14 without parental notification as soon as possible after the 500.15 interview. When the investigation is completed, any parent, 500.16 guardian, or legal custodian notified under this subdivision 500.17 shall receive the written memorandum provided for in subdivision 500.18 10d, paragraph (c). 500.19 (c) In conducting investigations under this subdivision the 500.20 commissioner or local welfare agency shall obtain access to 500.21 information consistent with subdivision 10, paragraphs (h), (i), 500.22 and (j). 500.23 (d) Except for foster care and family child care, the 500.24 commissioner has the primary responsibility for the 500.25 investigations and notifications required under subdivisions 10d 500.26 and 10f for reports that allege maltreatment related to the care 500.27 provided by or in facilities licensed by the commissioner. The 500.28 commissioner may request assistance from the local 500.29 socialserviceservices agency. 500.30 Sec. 76. Minnesota Statutes 1998, section 626.556, 500.31 subdivision 10d, is amended to read: 500.32 Subd. 10d. [NOTIFICATION OF NEGLECT OR ABUSE IN FACILITY.] 500.33 (a) When a report is received that alleges neglect, physical 500.34 abuse, or sexual abuse of a child while in the care of a 500.35facility required to be licensed pursuant to chapter 245A,500.36 licensed or unlicensed day care facility, residential facility, 501.1 agency, hospital, sanitarium, or other facility or institution 501.2 required to be licensed according to sections 144.50 to 144.58; 501.3 241.021; or 245A.01 to 245A.16; or chapter 245B, or a school as 501.4 defined in sections 120A.05, subdivisions 9, 11, and 13; and 501.5 124D.10; or a nonlicensed personal care provider organization as 501.6 defined in section 256B.04, subdivision 16, and 256B.0625, 501.7 subdivision 19a, the commissioner of the agency responsible for 501.8 assessing or investigating the report or local welfare agency 501.9 investigating the report shall provide the following information 501.10 to the parent, guardian, or legal custodian of a child alleged 501.11 to have been neglected, physically abused, or sexually abused: 501.12 the name of the facility; the fact that a report alleging 501.13 neglect, physical abuse, or sexual abuse of a child in the 501.14 facility has been received; the nature of the alleged neglect, 501.15 physical abuse, or sexual abuse; that the agency is conducting 501.16 an investigation; any protective or corrective measures being 501.17 taken pending the outcome of the investigation; and that a 501.18 written memorandum will be provided when the investigation is 501.19 completed. 501.20 (b) The commissioner of the agency responsible for 501.21 assessing or investigating the report or local welfare agency 501.22 may also provide the information in paragraph (a) to the parent, 501.23 guardian, or legal custodian of any other child in the facility 501.24 if the investigative agency knows or has reason to believe the 501.25 alleged neglect, physical abuse, or sexual abuse has occurred. 501.26 In determining whether to exercise this authority, the 501.27 commissioner of the agency responsible for assessing or 501.28 investigating the report or local welfare agency shall consider 501.29 the seriousness of the alleged neglect, physical abuse, or 501.30 sexual abuse; the number of children allegedly neglected, 501.31 physically abused, or sexually abused; the number of alleged 501.32 perpetrators; and the length of the investigation. The facility 501.33 shall be notified whenever this discretion is exercised. 501.34 (c) When the commissioner of the agency responsible for 501.35 assessing or investigating the report or local welfare agency 501.36 has completed its investigation, every parent, guardian, or 502.1 legal custodian notified of the investigation by the 502.2 commissioner or local welfare agency shall be provided with the 502.3 following information in a written memorandum: the name of the 502.4 facility investigated; the nature of the alleged neglect, 502.5 physical abuse, or sexual abuse; the investigator's name; a 502.6 summary of the investigation findings; a statement whether 502.7 maltreatment was found; and the protective or corrective 502.8 measures that are being or will be taken. The memorandum shall 502.9 be written in a manner that protects the identity of the 502.10 reporter and the child and shall not contain the name, or to the 502.11 extent possible, reveal the identity of the alleged perpetrator 502.12 or of those interviewed during the investigation. The 502.13 commissioner or local welfare agency shall also provide the 502.14 written memorandum to the parent, guardian, or legal custodian 502.15 of each child in the facility if maltreatment is determined to 502.16 exist. 502.17 Sec. 77. Minnesota Statutes 1998, section 626.556, 502.18 subdivision 10e, is amended to read: 502.19 Subd. 10e. [DETERMINATIONS.] Upon the conclusion of every 502.20 assessment or investigation it conducts, the local welfare 502.21 agency shall make two determinations: first, whether 502.22 maltreatment has occurred; and second, whether child protective 502.23 services are needed. When maltreatment is determined in an 502.24 investigation involving a facility, the investigating agency 502.25 shall also determine whether the facility or individual was 502.26 responsible for the maltreatment using the mitigating factors in 502.27 paragraph (d). Determinations under this subdivision must be 502.28 made based on a preponderance of the evidence. 502.29 (a) For the purposes of this subdivision, "maltreatment" 502.30 means any of the following acts or omissions committed by a 502.31 person responsible for the child's care: 502.32 (1) physical abuse as defined in subdivision 2, paragraph 502.33 (d); 502.34 (2) neglect as defined in subdivision 2, paragraph (c); 502.35 (3) sexual abuse as defined in subdivision 2, paragraph 502.36 (a); or 503.1 (4) mental injury as defined in subdivision 2, paragraph 503.2 (k). 503.3 (b) For the purposes of this subdivision, a determination 503.4 that child protective services are needed means that the local 503.5 welfare agency has documented conditions during the assessment 503.6 or investigation sufficient to cause a child protection worker, 503.7 as defined in section 626.559, subdivision 1, to conclude that a 503.8 child is at significant risk of maltreatment if protective 503.9 intervention is not provided and that the individuals 503.10 responsible for the child's care have not taken or are not 503.11 likely to take actions to protect the child from maltreatment or 503.12 risk of maltreatment. 503.13 (c) This subdivision does not mean that maltreatment has 503.14 occurred solely because the child's parent, guardian, or other 503.15 person responsible for the child's care in good faith selects 503.16 and depends upon spiritual means or prayer for treatment or care 503.17 of disease or remedial care of the child, in lieu of medical 503.18 care. However, if lack of medical care may result in serious 503.19 danger to the child's health, the local welfare agency may 503.20 ensure that necessary medical services are provided to the child. 503.21 (d) When determining whether the facility or individual is 503.22 the responsible party for determined maltreatment in a facility, 503.23 the investigating agency shall consider at least the following 503.24 mitigating factors: 503.25 (1) whether the actions of the facility or the individual 503.26 caregivers were according to, and followed the terms of, an 503.27 erroneous physician order, prescription, individual care plan, 503.28 or directive; however, this is not a mitigating factor when the 503.29 facility or caregiver was responsible for the issuance of the 503.30 erroneous order, prescription, individual care plan, or 503.31 directive or knew or should have known of the errors and took no 503.32 reasonable measures to correct the defect before administering 503.33 care; 503.34 (2) comparative responsibility between the facility, other 503.35 caregivers, and requirements placed upon an employee, including 503.36 the facility's compliance with related regulatory standards and 504.1 the adequacy of facility policies and procedures, facility 504.2 training, an individual's participation in the training, the 504.3 caregiver's supervision, and facility staffing levels and the 504.4 scope of the individual employee's authority and discretion; and 504.5 (3) whether the facility or individual followed 504.6 professional standards in exercising professional judgment. 504.7(e) The commissioner shall work with the maltreatment of504.8minors advisory committee established under Laws 1997, chapter504.9203, to make recommendations to further specify the kinds of504.10acts or omissions that constitute physical abuse, neglect,504.11sexual abuse, or mental injury. The commissioner shall submit504.12the recommendation and any legislation needed by January 15,504.131999.Individual counties may implement more detailed 504.14 definitions or criteria that indicate which allegations to 504.15 investigate, as long as a county's policies are consistent with 504.16 the definitions in the statutes and rules and are approved by 504.17 the county board. Each local welfare agency shall periodically 504.18 inform mandated reporters under subdivision 3 who work in the 504.19 county of the definitions of maltreatment in the statutes and 504.20 rules and any additional definitions or criteria that have been 504.21 approved by the county board. 504.22 Sec. 78. Minnesota Statutes 1998, section 626.556, 504.23 subdivision 10f, is amended to read: 504.24 Subd. 10f. [NOTICE OF DETERMINATIONS.] Within ten working 504.25 days of the conclusion of an assessment, the local welfare 504.26 agency or agency responsible for assessing or investigating the 504.27 report shall notify the parent or guardian of the child, the 504.28 person determined to be maltreating the child, and if 504.29 applicable, the director of the facility, of the determination 504.30 and a summary of the specific reasons for the determination. 504.31 The notice must also include a certification that the 504.32 information collection procedures under subdivision 10, 504.33 paragraphs (h), (i), and (j), were followed and a notice of the 504.34 right of a data subject to obtain access to other private data 504.35 on the subject collected, created, or maintained under this 504.36 section. In addition, the notice shall include the length of 505.1 time that the records will be kept under subdivision 11c. The 505.2 investigating agency shall notify the parent or guardian of the 505.3 child who is the subject of the report, and any person or 505.4 facility determined to have maltreated a child, of their appeal 505.5 rights under this section. 505.6 Sec. 79. Minnesota Statutes 1998, section 626.556, 505.7 subdivision 10j, is amended to read: 505.8 Subd. 10j. [RELEASE OF DATA TO MANDATED REPORTERS.] A 505.9 local socialserviceservices or child protection agency may 505.10 provide relevant private data on individuals obtained under this 505.11 section to mandated reporters who have an ongoing responsibility 505.12 for the health, education, or welfare of a child affected by the 505.13 data, in the best interests of the child.The commissioner505.14shall consult with the maltreatment of minors advisory committee505.15to develop criteria for determining which records may be shared505.16with mandated reporters under this subdivision.Mandated 505.17 reporters with ongoing responsibility for the health, education, 505.18 or welfare of a child affected by the data include the child's 505.19 teachers or other appropriate school personnel, foster parents, 505.20 health care providers, respite care workers, therapists, social 505.21 workers, child care providers, residential care staff, crisis 505.22 nursery staff, probation officers, and court services 505.23 personnel. Under this section, a mandated reporter need not 505.24 have made the report to be considered a person with ongoing 505.25 responsibility for the health, education, or welfare of a child 505.26 affected by the data. 505.27 Sec. 80. Minnesota Statutes 1998, section 626.556, 505.28 subdivision 11, is amended to read: 505.29 Subd. 11. [RECORDS.] (a) Except as provided in paragraph 505.30 (b) and subdivisions 10b, 10d, 10g, and 11b, all records 505.31 concerning individuals maintained by a local welfare agency or 505.32 agency responsible for assessing or investigating the report 505.33 under this section, including any written reports filed under 505.34 subdivision 7, shall be private data on individuals, except 505.35 insofar as copies of reports are required by subdivision 7 to be 505.36 sent to the local police department or the county sheriff. 506.1 Reports maintained by any police department or the county 506.2 sheriff shall be private data on individuals except the reports 506.3 shall be made available to the investigating, petitioning, or 506.4 prosecuting authority, including county medical examiners or 506.5 county coroners. Section 13.82, subdivisions 5, 5a, and 5b, 506.6 apply to law enforcement data other than the reports. The local 506.7 social services agency or agency responsible for assessing or 506.8 investigating the report shall make available to the 506.9 investigating, petitioning, or prosecuting authority, including 506.10 county medical examiners or county coroners or their 506.11 professional delegates, any records which contain information 506.12 relating to a specific incident of neglect or abuse which is 506.13 under investigation, petition, or prosecution and information 506.14 relating to any prior incidents of neglect or abuse involving 506.15 any of the same persons. The records shall be collected and 506.16 maintained in accordance with the provisions of chapter 13. In 506.17 conducting investigations and assessments pursuant to this 506.18 section, the notice required by section 13.04, subdivision 2, 506.19 need not be provided to a minor under the age of ten who is the 506.20 alleged victim of abuse or neglect. An individual subject of a 506.21 record shall have access to the record in accordance with those 506.22 sections, except that the name of the reporter shall be 506.23 confidential while the report is under assessment or 506.24 investigation except as otherwise permitted by this 506.25 subdivision. Any person conducting an investigation or 506.26 assessment under this section who intentionally discloses the 506.27 identity of a reporter prior to the completion of the 506.28 investigation or assessment is guilty of a misdemeanor. After 506.29 the assessment or investigation is completed, the name of the 506.30 reporter shall be confidential. The subject of the report may 506.31 compel disclosure of the name of the reporter only with the 506.32 consent of the reporter or upon a written finding by the court 506.33 that the report was false and that there is evidence that the 506.34 report was made in bad faith. This subdivision does not alter 506.35 disclosure responsibilities or obligations under the rules of 506.36 criminal procedure. 507.1 (b) Upon request of the legislative auditor, data on 507.2 individuals maintained under this section must be released to 507.3 the legislative auditor in order for the auditor to fulfill the 507.4 auditor's duties under section 3.971. The auditor shall 507.5 maintain the data in accordance with chapter 13. 507.6 Sec. 81. Minnesota Statutes 1998, section 626.556, 507.7 subdivision 11b, is amended to read: 507.8 Subd. 11b. [DATA RECEIVED FROM LAW ENFORCEMENT.] Active 507.9 law enforcement investigative data received by a local welfare 507.10 agency or agency responsible for assessing or investigating the 507.11 report under this section are confidential data on individuals. 507.12 When this data become inactive in the law enforcement agency, 507.13 the data are private data on individuals. 507.14 Sec. 82. Minnesota Statutes 1998, section 626.556, 507.15 subdivision 11c, is amended to read: 507.16 Subd. 11c. [WELFARE, COURT SERVICES AGENCY, AND SCHOOL 507.17 RECORDS MAINTAINED.] Notwithstanding sections 138.163 and 507.18 138.17, records maintained or records derived from reports of 507.19 abuse by local welfare agencies, agencies responsible for 507.20 assessing or investigating the report, court services agencies, 507.21 or schools under this section shall be destroyed as provided in 507.22 paragraphs (a) to (d) by the responsible authority. 507.23 (a) If upon assessment or investigation there is no 507.24 determination of maltreatment or the need for child protective 507.25 services, the records must be maintained for a period of four 507.26 years. Records under this paragraph may not be used for 507.27 employment, background checks, or purposes other than to assist 507.28 in future risk and safety assessments. 507.29 (b) All records relating to reports which, upon assessment 507.30 or investigation, indicate either maltreatment or a need for 507.31 child protective services shall be maintained for at least ten 507.32 years after the date of the final entry in the case record. 507.33 (c) All records regarding a report of maltreatment, 507.34 including any notification of intent to interview which was 507.35 received by a school under subdivision 10, paragraph (d), shall 507.36 be destroyed by the school when ordered to do so by the agency 508.1 conducting the assessment or investigation. The agency shall 508.2 order the destruction of the notification when other records 508.3 relating to the report under investigation or assessment are 508.4 destroyed under this subdivision. 508.5 (d) Private or confidential data released to a court 508.6 services agency under subdivision 10h must be destroyed by the 508.7 court services agency when ordered to do so by the local welfare 508.8 agency that released the data. The local welfare agency or 508.9 agency responsible for assessing or investigating the report 508.10 shall order destruction of the data when other records relating 508.11 to the assessment or investigation are destroyed under this 508.12 subdivision. 508.13 Sec. 83. Minnesota Statutes 1998, section 626.558, 508.14 subdivision 1, is amended to read: 508.15 Subdivision 1. [ESTABLISHMENT OF THE TEAM.] A county shall 508.16 establish a multidisciplinary child protection team that may 508.17 include, but not be limited to, the director of the local 508.18 welfare agency or designees, the county attorney or designees, 508.19 the county sheriff or designees, representatives of health and 508.20 education, representatives of mental health or other appropriate 508.21 human service or community-based agencies, and parent groups. 508.22 As used in this section, a "community-based agency" may include, 508.23 but is not limited to, schools, social service agencies, family 508.24 service and mental health collaboratives, early childhood and 508.25 family education programs, Head Start, or other agencies serving 508.26 children and families. A member of the team must be designated 508.27 as the lead person of the team responsible for coordinating its 508.28 activities with battered women's programs and services. 508.29 Sec. 84. [AMEND CHEMICAL DEPENDENCY ASSESSMENT CRITERIA.] 508.30 Subdivision 1. [CHILD PROTECTION.] The commissioner of 508.31 human services shall amend the assessment criteria under 508.32 Minnesota Rules, part 9530.6600, specifically Minnesota Rules, 508.33 part 9530.6615, to include assessment criteria that addresses 508.34 issues related to parents who have open child protection cases 508.35 due, in part, to chemical abuse. In amending this rule part, 508.36 the commissioner shall use the expedited rulemaking process 509.1 under Minnesota Statutes, section 14.389, and assure that 509.2 notification provisions are in accordance with federal law. 509.3 Subd. 2. [PREGNANCY.] The commissioner of human services 509.4 shall amend Minnesota Rules, part 9530.6605, to address 509.5 pregnancy as a risk factor in determining the need for chemical 509.6 dependency treatment. 509.7 Sec. 85. [REHABILITATION SERVICES OPTION FOR ADULTS WITH 509.8 MENTAL ILLNESS OR OTHER CONDITIONS.] 509.9 The commissioner of human services, in consultation with 509.10 the association of Minnesota counties and other stakeholders, 509.11 shall design a proposal to add rehabilitation services to the 509.12 state medical assistance plan for adults with mental illness or 509.13 other debilitating conditions, including, but not limited to, 509.14 chemical dependency. 509.15 Sec. 86. [TARGETED CASE MANAGEMENT FOR VULNERABLE ADULTS.] 509.16 The commissioner of human services, in consultation with 509.17 the association of Minnesota counties and other stakeholders, 509.18 shall design a proposal to provide medical assistance coverage 509.19 for targeted case management service activities for adults 509.20 receiving services through a county or state agency that are in 509.21 need of service coordination, including, but not limited to, 509.22 people age 65 and older; people in need of adult protective 509.23 services; people applying for financial assistance; people who 509.24 have chemical dependency; and other people who require community 509.25 social services under Minnesota Statutes, chapter 256E. 509.26 Sec. 87. [RECOMMENDATIONS TO THE LEGISLATURE.] 509.27 The commissioner of human services shall submit to the 509.28 legislature design and implementation recommendations for the 509.29 proposals required in sections 85 and 86, including draft 509.30 legislation, by January 15, 2000, for implementation by July 1, 509.31 2000. The proposals shall not include requirements for 509.32 maintenance of effort and expanded expenditures concerning 509.33 federal reimbursements earned in these programs. 509.34 Sec. 88. [INSTRUCTION TO REVISOR.] 509.35 The revisor of statutes shall delete the references to 509.36 Minnesota Statutes, section 260.181, and substitute a reference 510.1 to Minnesota Statutes, section 260.015, subdivision 13, in the 510.2 following sections: Minnesota Statutes, sections 245A.035, 510.3 subdivision 1; 257.071, subdivision 1; 260.191, subdivision 1d; 510.4 and 260.191, subdivision 1e. 510.5 Sec. 89. [REPEALER.] 510.6 Minnesota Statutes 1998, section 257.071, subdivisions 8 510.7 and 10, are repealed. 510.8 Sec. 90. [EFFECTIVE DATE.] 510.9 When preparing the conference committee report for adoption 510.10 by the legislature, the revisor shall combine all effective date 510.11 notations in this article into this effective date section. 510.12 ARTICLE 9 510.13 HEALTH OCCUPATIONS 510.14 Section 1. Minnesota Statutes 1998, section 13.99, 510.15 subdivision 38a, is amended to read: 510.16 Subd. 38a. [AMBULANCE SERVICE DATA.] Data required to be 510.17 reported by ambulance services under section144E.17,510.18subdivision 1,144E.123 are classified under that section. 510.19 Sec. 2. Minnesota Statutes 1998, section 13.99, is amended 510.20 by adding a subdivision to read: 510.21 Subd. 39b. [EMT, EMT-I, EMT-P, OR FIRST RESPONDER 510.22 MISCONDUCT.] Reports of emergency medical technician, emergency 510.23 medical technician-intermediate, emergency medical 510.24 technician-paramedic, or first responder misconduct are 510.25 classified under section 144E.305, subdivision 3. 510.26 Sec. 3. Minnesota Statutes 1998, section 144A.46, 510.27 subdivision 2, is amended to read: 510.28 Subd. 2. [EXEMPTIONS.] The following individuals or 510.29 organizations are exempt from the requirement to obtain a home 510.30 care provider license: 510.31 (1) a person who is licensed as a registered nurse under 510.32 sections 148.171 to 148.285 and who independently provides 510.33 nursing services in the home without any contractual or 510.34 employment relationship to a home care provider or other 510.35 organization; 510.36 (2) a personal care assistant who provides services to only 511.1 one individual under the medical assistance program as 511.2 authorized under sections 256B.0625, subdivision 19, and 511.3 256B.04, subdivision 16; 511.4 (3) a person or organization that exclusively offers, 511.5 provides, or arranges for personal care assistant services to 511.6 only one individual under the medical assistance program as 511.7 authorized under sections 256B.0625, subdivision 19, and 511.8 256B.04, subdivision 16; 511.9 (4) a person who isregisteredlicensed under sections 511.10 148.65 to 148.78 and who independently provides physical therapy 511.11 services in the home without any contractual or employment 511.12 relationship to a home care provider or other organization; 511.13 (5) a provider that is licensed by the commissioner of 511.14 human services to provide semi-independent living services under 511.15 Minnesota Rules, parts 9525.0500 to 9525.0660 when providing 511.16 home care services to a person with a developmental disability; 511.17 (6) a provider that is licensed by the commissioner of 511.18 human services to provide home and community-based services 511.19 under Minnesota Rules, parts 9525.2000 to 9525.2140 when 511.20 providing home care services to a person with a developmental 511.21 disability; 511.22 (7) a person or organization that provides only home 511.23 management services, if the person or organization is registered 511.24 under section 144A.461; or 511.25 (8) a person who is licensed as a social worker under 511.26 sections 148B.18 to 148B.289 and who provides social work 511.27 services in the home independently and not through any 511.28 contractual or employment relationship with a home care provider 511.29 or other organization. 511.30 An exemption under this subdivision does not excuse the 511.31 individual from complying with applicable provisions of the home 511.32 care bill of rights. 511.33 Sec. 4. Minnesota Statutes 1998, section 144E.001, is 511.34 amended by adding a subdivision to read: 511.35 Subd. 1a. [ADVANCED AIRWAY MANAGEMENT.] "Advanced airway 511.36 management" means insertion of an endotracheal tube or creation 512.1 of a surgical airway. 512.2 Sec. 5. Minnesota Statutes 1998, section 144E.001, is 512.3 amended by adding a subdivision to read: 512.4 Subd. 1b. [ADVANCED LIFE SUPPORT.] "Advanced life support" 512.5 means rendering basic life support and rendering intravenous 512.6 therapy, drug therapy, intubation, and defibrillation as 512.7 outlined in the United States Department of Transportation 512.8 emergency medical technician-paramedic curriculum or its 512.9 equivalent, as approved by the board. 512.10 Sec. 6. Minnesota Statutes 1998, section 144E.001, is 512.11 amended by adding a subdivision to read: 512.12 Subd. 3a. [AMBULANCE SERVICE PERSONNEL.] "Ambulance 512.13 service personnel" means individuals who are authorized by a 512.14 licensed ambulance service to provide emergency care for the 512.15 ambulance service and are: 512.16 (1) EMTs, EMT-Is, or EMT-Ps; 512.17 (2) Minnesota registered nurses who are: (i) EMTs, are 512.18 currently practicing nursing, and have passed a paramedic 512.19 practical skills test, as approved by the board and administered 512.20 by a training program approved by the board; (ii) on the roster 512.21 of an ambulance service on or before January 1, 2000; or (iii) 512.22 after petitioning the board, deemed by the board to have 512.23 training and skills equivalent to an EMT, as determined on a 512.24 case-by-case basis; or 512.25 (3) Minnesota registered physician assistants who are: (i) 512.26 EMTs, are currently practicing as physician assistants, and have 512.27 passed a paramedic practical skills test, as approved by the 512.28 board and administered by a training program approved by the 512.29 board; (ii) on the roster of an ambulance service on or before 512.30 January 1, 2000; or (iii) after petitioning the board, deemed by 512.31 the board to have training and skills equivalent to an EMT, as 512.32 determined on a case-by-case basis. 512.33 Sec. 7. Minnesota Statutes 1998, section 144E.001, is 512.34 amended by adding a subdivision to read: 512.35 Subd. 4a. [BASIC AIRWAY MANAGEMENT.] "Basic airway 512.36 management" means: 513.1 (1) resuscitation by mouth-to-mouth, mouth-to-mask, bag 513.2 valve mask, or oxygen powered ventilators; or 513.3 (2) insertion of an oropharyngeal, nasal pharyngeal, 513.4 esophageal obturator airway, esophageal tracheal airway, or 513.5 esophageal gastric tube airway. 513.6 Sec. 8. Minnesota Statutes 1998, section 144E.001, is 513.7 amended by adding a subdivision to read: 513.8 Subd. 4b. [BASIC LIFE SUPPORT.] "Basic life support" means 513.9 rendering basic-level emergency care, including, but not limited 513.10 to, basic airway management, cardiopulmonary resuscitation, 513.11 controlling shock and bleeding, and splinting fractures, as 513.12 outlined in the United States Department of Transportation 513.13 emergency medical technician-basic curriculum or its equivalent, 513.14 as approved by the board. 513.15 Sec. 9. Minnesota Statutes 1998, section 144E.001, is 513.16 amended by adding a subdivision to read: 513.17 Subd. 5a. [CLINICAL TRAINING SITE.] "Clinical training 513.18 site" means a licensed health care facility. 513.19 Sec. 10. Minnesota Statutes 1998, section 144E.001, is 513.20 amended by adding a subdivision to read: 513.21 Subd. 5b. [DEFIBRILLATOR.] "Defibrillator" means an 513.22 automatic, semiautomatic, or manual device that delivers an 513.23 electric shock at a preset voltage to the myocardium through the 513.24 chest wall and that is used to restore the normal cardiac rhythm 513.25 and rate when the heart has stopped beating or is fibrillating. 513.26 Sec. 11. Minnesota Statutes 1998, section 144E.001, is 513.27 amended by adding a subdivision to read: 513.28 Subd. 5c. [EMERGENCY MEDICAL TECHNICIAN OR EMT.] 513.29 "Emergency medical technician" or "EMT" means a person who has 513.30 successfully completed the United States Department of 513.31 Transportation emergency medical technician-basic course or its 513.32 equivalent, as approved by the board, and has been issued valid 513.33 certification by the board. 513.34 Sec. 12. Minnesota Statutes 1998, section 144E.001, is 513.35 amended by adding a subdivision to read: 513.36 Subd. 5d. [EMERGENCY MEDICAL TECHNICIAN-INTERMEDIATE OR 514.1 EMT-I.] "Emergency medical technician-intermediate" or "EMT-I" 514.2 means a person who has successfully completed the United States 514.3 Department of Transportation emergency medical 514.4 technician-intermediate course or its equivalent, as approved by 514.5 the board, and has been issued valid certification by the board. 514.6 Sec. 13. Minnesota Statutes 1998, section 144E.001, is 514.7 amended by adding a subdivision to read: 514.8 Subd. 5e. [EMERGENCY MEDICAL TECHNICIAN-PARAMEDIC OR 514.9 EMT-P.] "Emergency medical technician-paramedic" or "EMT-P" 514.10 means a person who has successfully completed the United States 514.11 Department of Transportation emergency medical technician 514.12 course-paramedic or its equivalent, as approved by the board, 514.13 and has been issued valid certification by the board. 514.14 Sec. 14. Minnesota Statutes 1998, section 144E.001, is 514.15 amended by adding a subdivision to read: 514.16 Subd. 5f. [EMERGENCY MEDICAL TECHNICIAN INSTRUCTOR.] 514.17 "Emergency medical technician instructor" means a person who has 514.18 been certified by the board to teach an EMT, EMT-I, or EMT-P 514.19 course. 514.20 Sec. 15. Minnesota Statutes 1998, section 144E.001, is 514.21 amended by adding a subdivision to read: 514.22 Subd. 8a. [MEDICAL CONTROL.] "Medical control" means 514.23 direction by a physician or a physician's designee of 514.24 out-of-hospital emergency medical care. 514.25 Sec. 16. Minnesota Statutes 1998, section 144E.001, is 514.26 amended by adding a subdivision to read: 514.27 Subd. 9a. [PART-TIME ADVANCED LIFE SUPPORT.] "Part-time 514.28 advanced life support" means rendering basic life support and 514.29 advanced life support for less than 24 hours of every day. 514.30 Sec. 17. Minnesota Statutes 1998, section 144E.001, is 514.31 amended by adding a subdivision to read: 514.32 Subd. 9b. [PHYSICIAN.] "Physician" means a person licensed 514.33 to practice medicine under chapter 147. 514.34 Sec. 18. Minnesota Statutes 1998, section 144E.001, is 514.35 amended by adding a subdivision to read: 514.36 Subd. 9c. [PHYSICIAN ASSISTANT.] "Physician assistant" 515.1 means a person registered to practice as a physician assistant 515.2 under chapter 147A. 515.3 Sec. 19. Minnesota Statutes 1998, section 144E.001, is 515.4 amended by adding a subdivision to read: 515.5 Subd. 9d. [PREHOSPITAL CARE DATA.] "Prehospital care data" 515.6 means information collected by ambulance service personnel about 515.7 the circumstances related to an emergency response and patient 515.8 care activities provided by the ambulance service personnel in a 515.9 prehospital setting. 515.10 Sec. 20. Minnesota Statutes 1998, section 144E.001, is 515.11 amended by adding a subdivision to read: 515.12 Subd. 11. [PROGRAM MEDICAL DIRECTOR.] "Program medical 515.13 director" means a physician who is responsible for ensuring an 515.14 accurate and thorough presentation of the medical content of an 515.15 emergency care training program; certifying that each student 515.16 has successfully completed the training course; and in 515.17 conjunction with the program coordinator, planning the clinical 515.18 training. 515.19 Sec. 21. Minnesota Statutes 1998, section 144E.001, is 515.20 amended by adding a subdivision to read: 515.21 Subd. 12. [REGISTERED NURSE.] "Registered nurse" means a 515.22 person licensed to practice professional nursing under chapter 515.23 148. 515.24 Sec. 22. Minnesota Statutes 1998, section 144E.001, is 515.25 amended by adding a subdivision to read: 515.26 Subd. 13. [STANDING ORDER.] "Standing order" means a type 515.27 of medical protocol that provides specific, written orders for 515.28 actions, techniques, or drug administration when communication 515.29 has not been established for direct medical control. 515.30 Sec. 23. Minnesota Statutes 1998, section 144E.001, is 515.31 amended by adding a subdivision to read: 515.32 Subd. 14. [TRAINING PROGRAM COORDINATOR.] "Training 515.33 program coordinator" means an individual who serves as the 515.34 administrator of an emergency care training program and who is 515.35 responsible for planning, conducting, and evaluating the 515.36 program; selecting students and certified instructors; 516.1 documenting and maintaining records; developing a curriculum; 516.2 and assisting in the coordination of examination sessions and 516.3 clinical training. 516.4 Sec. 24. Minnesota Statutes 1998, section 144E.10, 516.5 subdivision 1, is amended to read: 516.6 Subdivision 1. [LICENSE REQUIRED.] No natural person, 516.7 partnership, association, corporation, or unit of government may 516.8 operate an ambulance service within this state unless it 516.9 possesses a valid license to do so issued by the board. The 516.10 license shall specify the base of operations, the primary 516.11 service area, and the type or types of ambulance service for 516.12 which the licensee is licensed. The licensee shall obtain a new 516.13 license if it wishes to expand its primary service area, or to 516.14 provide a new type or types of service.The cost of licenses516.15shall be in an amount prescribed by the board pursuant to516.16section 144E.05. Licenses shall expire and be renewed in516.17accordance with rules adopted by the board.516.18 Sec. 25. [144E.101] [AMBULANCE SERVICE REQUIREMENTS.] 516.19 Subdivision 1. [PERSONNEL.] (a) No publicly or privately 516.20 owned ambulance service shall be operated in the state unless 516.21 its ambulance service personnel are certified, appropriate to 516.22 the type of ambulance service being provided, according to 516.23 section 144E.28 or meet the staffing criteria specific to the 516.24 type of ambulance service. 516.25 (b) An ambulance service shall have a medical director as 516.26 provided under section 144E.265. 516.27 Subd. 2. [PATIENT CARE.] When a patient is being 516.28 transported, at least one of the ambulance service personnel 516.29 must be in the patient compartment. If advanced life support 516.30 procedures are required, an EMT-P, a registered nurse qualified 516.31 under section 144E.001, subdivision 3a, clause (2), item (i), or 516.32 a physician assistant qualified under section 144E.001, 516.33 subdivision 3a, clause (3), item (i), shall be in the patient 516.34 compartment. 516.35 Subd. 3. [CONTINUAL SERVICE.] An ambulance service shall 516.36 offer service 24 hours per day every day of the year, unless 517.1 otherwise authorized under subdivisions 8 and 9. 517.2 Subd. 4. [DENIAL OF SERVICE PROHIBITED.] An ambulance 517.3 service shall not deny prehospital care to a person needing 517.4 emergency ambulance service because of inability to pay or 517.5 because of the source of payment for services if the need 517.6 develops within the licensee's primary service area or when 517.7 responding to a mutual aid call. Transport for the patient may 517.8 be limited to the closest appropriate emergency medical facility. 517.9 Subd. 5. [TYPES OF SERVICE.] The board shall regulate the 517.10 following types of ambulance service: 517.11 (1) basic life support; 517.12 (2) advanced life support; 517.13 (3) part-time advanced life support; and 517.14 (4) specialized life support. 517.15 Subd. 6. [BASIC LIFE SUPPORT.] (a) A basic life support 517.16 ambulance shall be staffed by at least two ambulance service 517.17 personnel, at least one of which must be an EMT, who provide a 517.18 level of care so as to ensure that: 517.19 (1) life-threatening situations and potentially serious 517.20 injuries are recognized; 517.21 (2) patients are protected from additional hazards; 517.22 (3) basic treatment to reduce the seriousness of emergency 517.23 situations is administered; and 517.24 (4) patients are transported to an appropriate medical 517.25 facility for treatment. 517.26 (b) A basic life support service shall provide basic airway 517.27 management. 517.28 (c) By January 1, 2001, a basic life support service shall 517.29 provide automatic defibrillation, as provided in section 517.30 144E.103, subdivision 1, paragraph (b). 517.31 (d) A basic life support service licensee's medical 517.32 director may authorize the ambulance service personnel to carry 517.33 and to use medical antishock trousers and to perform intravenous 517.34 infusion if the ambulance service personnel have been properly 517.35 trained. 517.36 Subd. 7. [ADVANCED LIFE SUPPORT.] (a) An advanced life 518.1 support ambulance shall be staffed by at least: 518.2 (1) one EMT and one EMT-P; 518.3 (2) one EMT and one registered nurse who is an EMT, is 518.4 currently practicing nursing, and has passed a paramedic 518.5 practical skills test approved by the board and administered by 518.6 a training program; or 518.7 (3) one EMT and one physician assistant who is an EMT, is 518.8 currently practicing as a physician assistant, and has passed a 518.9 paramedic practical skills test approved by the board and 518.10 administered by a training program. 518.11 (b) An advanced life support service shall provide basic 518.12 life support, as specified under subdivision 6, paragraph (a), 518.13 advanced airway management, manual defibrillation, and 518.14 administration of intravenous fluids and pharmaceuticals. 518.15 (c) In addition to providing advanced life support, an 518.16 advanced life support service may staff additional ambulances to 518.17 provide basic life support according to subdivision 6. When 518.18 routinely staffed and equipped as a basic life support service 518.19 according to subdivision 6 and section 144E.103, subdivision 1, 518.20 the vehicle shall not be marked as advanced life support. 518.21 (d) An ambulance service providing advanced life support 518.22 shall have a written agreement with its medical director to 518.23 ensure medical control for patient care 24 hours a day, seven 518.24 days a week. The terms of the agreement shall include a written 518.25 policy on the administration of medical control for the 518.26 service. The policy shall address the following issues: 518.27 (i) two-way communication for physician direction of 518.28 ambulance service personnel; 518.29 (ii) patient triage, treatment, and transport; 518.30 (iii) use of standing orders; and 518.31 (iv) the means by which medical control will be provided 24 518.32 hours a day. 518.33 The agreement shall be signed by the licensee's medical 518.34 director and the licensee or the licensee's designee and 518.35 maintained in the files of the licensee. 518.36 (e) When an ambulance service provides advanced life 519.1 support, the authority of an EMT-P, Minnesota registered 519.2 nurse-EMT, or Minnesota registered physician assistant-EMT to 519.3 determine the delivery of patient care prevails over the 519.4 authority of an EMT. 519.5 Subd. 8. [PART-TIME ADVANCED LIFE SUPPORT.] (a) A 519.6 part-time advanced life support service shall meet the staffing 519.7 requirements under subdivision 7, paragraph (a); provide service 519.8 as required under subdivision 7, paragraph (b), for less than 24 519.9 hours every day; and meet the equipment requirements specified 519.10 in section 144E.103. 519.11 (b) A part-time advanced life support service shall have a 519.12 written agreement with its medical director to ensure medical 519.13 control for patient care during the time the service offers 519.14 advanced life support. The terms of the agreement shall include 519.15 a written policy on the administration of medical control for 519.16 the service and address the issues specified in subdivision 7, 519.17 paragraph (d). 519.18 Subd. 9. [SPECIALIZED LIFE SUPPORT.] A specialized life 519.19 support service shall provide basic or advanced life support as 519.20 designated by the board, and shall be restricted by the board to: 519.21 (1) operation less than 24 hours of every day; 519.22 (2) designated segments of the population; 519.23 (3) certain types of medical conditions; or 519.24 (4) air ambulance service that includes fixed-wing and 519.25 rotor-wing. 519.26 Subd. 10. [DRIVER.] A driver of an ambulance must possess 519.27 a current driver's license issued by any state and must have 519.28 attended an emergency vehicle driving course approved by the 519.29 licensee. The emergency vehicle driving course must include 519.30 actual driving experience. 519.31 Subd. 11. [PERSONNEL ROSTER AND FILES.] (a) An ambulance 519.32 service shall maintain: 519.33 (1) at least two ambulance service personnel on a written 519.34 on-call schedule; 519.35 (2) a current roster of its ambulance service personnel, 519.36 including the name, address, and qualifications of its ambulance 520.1 service personnel; and 520.2 (3) files documenting personnel qualifications. 520.3 (b) A licensee shall maintain in its files the name and 520.4 address of its medical director and a written statement signed 520.5 by the medical director indicating acceptance of the 520.6 responsibilities specified in section 144E.265, subdivision 2. 520.7 Subd. 12. [MUTUAL AID AGREEMENT.] A licensee shall have a 520.8 written agreement with at least one neighboring licensed 520.9 ambulance service for coverage during times when the licensee's 520.10 ambulances are not available for service in its primary service 520.11 area. The agreement must specify the duties and 520.12 responsibilities of the agreeing parties. A copy of each mutual 520.13 aid agreement shall be maintained in the files of the licensee. 520.14 Subd. 13. [SERVICE OUTSIDE PRIMARY SERVICE AREA.] A 520.15 licensee may provide its services outside of its primary service 520.16 area only if requested by a transferring physician or ambulance 520.17 service licensed to provide service in the primary service area 520.18 when it can reasonably be expected that: 520.19 (1) the response is required by the immediate medical need 520.20 of an individual; and 520.21 (2) the ambulance service licensed to provide service in 520.22 the primary service area is unavailable for appropriate response. 520.23 Sec. 26. [144E.103] [EQUIPMENT.] 520.24 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Every ambulance 520.25 in service for patient care shall carry, at a minimum: 520.26 (1) oxygen; 520.27 (2) airway maintenance equipment in various sizes to 520.28 accommodate all age groups; 520.29 (3) splinting equipment in various sizes to accommodate all 520.30 age groups; 520.31 (4) dressings, bandages, and bandaging equipment; 520.32 (5) an emergency obstetric kit; 520.33 (6) equipment to determine vital signs in various sizes to 520.34 accommodate all age groups; 520.35 (7) a stretcher; 520.36 (8) a defibrillator; and 521.1 (9) a fire extinguisher. 521.2 (b) A basic life support service has until January 1, 2000, 521.3 to equip each ambulance in service for patient care with a 521.4 defibrillator. 521.5 Subd. 2. [ADVANCED LIFE SUPPORT REQUIREMENTS.] In addition 521.6 to the requirements in subdivision 1, an ambulance used in 521.7 providing advanced life support must carry drugs and drug 521.8 administration equipment and supplies as approved by the 521.9 licensee's medical director. 521.10 Subd. 3. [STORAGE.] All equipment carried in an ambulance 521.11 must be securely stored. 521.12 Subd. 4. [SAFETY RESTRAINTS.] An ambulance must be 521.13 equipped with safety straps for the stretcher and seat belts in 521.14 the patient compartment for the patient and ambulance personnel. 521.15 Sec. 27. Minnesota Statutes 1998, section 144E.11, is 521.16 amended by adding a subdivision to read: 521.17 Subd. 9. [RENEWAL REQUIREMENTS.] An ambulance service 521.18 license expires two years from the date of licensure. An 521.19 ambulance service must apply to the board for license renewal at 521.20 least one month prior to the expiration date of the license and 521.21 must submit: 521.22 (1) an application prescribed by the board specifying any 521.23 changes from the information provided for prior licensure and 521.24 any other information requested by the board to clarify 521.25 incomplete or ambiguous information presented in the 521.26 application; and 521.27 (2) the appropriate fee as required under section 144E.29. 521.28 Sec. 28. [144E.121] [AIR AMBULANCE SERVICE REQUIREMENTS.] 521.29 Subdivision 1. [AVIATION COMPLIANCE.] An air ambulance 521.30 service must comply with the regulations of the Federal Aviation 521.31 Administration and the rules of the Minnesota department of 521.32 transportation, aeronautics division. 521.33 Subd. 2. [PERSONNEL.] (a) With the exception of pilots, 521.34 each of the air ambulance emergency medical personnel must: 521.35 (1) possess current certification, appropriate to the type 521.36 of ambulance service being provided, according to section 522.1 144E.28, be a registered nurse, or be a physician assistant; and 522.2 (2) be trained to use the equipment on the air ambulance. 522.3 (b) Emergency medical personnel for an air ambulance 522.4 service must receive training approved by the licensee's medical 522.5 director that includes instruction in the physiological changes 522.6 due to decreased atmospheric pressure, acceleration, vibration, 522.7 and changes in altitude; medical conditions requiring special 522.8 precautions; and contraindications to air transport. 522.9 (c) A licensee's medical director must sign and file a 522.10 statement with the licensee that each of its emergency medical 522.11 personnel has successfully completed the training under 522.12 paragraph (b). 522.13 (d) A licensee shall retain documentation of compliance 522.14 with this subdivision in its files. 522.15 Subd. 3. [EQUIPMENT.] An air ambulance must carry 522.16 equipment appropriate to the level of service being provided. 522.17 Equipment that is not permanently stored on or in an air 522.18 ambulance must be kept separate from the air ambulance in a 522.19 modular prepackaged form. 522.20 Sec. 29. [144E.123] [PREHOSPITAL CARE DATA.] 522.21 Subdivision 1. [COLLECTION AND MAINTENANCE.] A licensee 522.22 shall collect and provide prehospital care data to the board in 522.23 a manner prescribed by the board. At a minimum, the data must 522.24 include items identified by the board that are part of the 522.25 National Uniform Emergency Medical Services Data Set. A 522.26 licensee shall maintain prehospital care data for every response. 522.27 Subd. 2. [COPY TO RECEIVING HOSPITAL.] If a patient is 522.28 transported to a hospital, a copy of the ambulance report 522.29 delineating prehospital medical care given shall be provided to 522.30 the receiving hospital. 522.31 Subd. 3. [REVIEW.] Prehospital care data may be reviewed 522.32 by the board or its designees. The data shall be classified as 522.33 private data on individuals under chapter 13, the Minnesota 522.34 Government Data Practices Act. 522.35 Subd. 4. [PENALTY.] Failure to report all information 522.36 required by the board under this section shall constitute 523.1 grounds for license revocation. 523.2 Sec. 30. [144E.125] [OPERATIONAL PROCEDURES.] 523.3 A licensee shall establish and implement written procedures 523.4 for responding to ambulance service complaints, maintaining 523.5 ambulances and equipment, procuring and storing drugs, and 523.6 controlling infection. The licensee shall maintain the 523.7 procedures in its files. 523.8 Sec. 31. [144E.127] [INTERHOSPITAL TRANSFER.] 523.9 When transporting a patient from one licensed hospital to 523.10 another, a licensee may substitute for one of the required 523.11 ambulance service personnel, a physician, a registered nurse, or 523.12 physician's assistant who has been trained to use the equipment 523.13 in the ambulance and is knowledgeable of the licensee's 523.14 ambulance service protocols. 523.15 Sec. 32. Minnesota Statutes 1998, section 144E.16, 523.16 subdivision 4, is amended to read: 523.17 Subd. 4. [TYPES OF SERVICES TO BE REGULATED.](a)The 523.18 board may adopt rules needed to regulate ambulance services in 523.19 the following areas: 523.20 (1) applications for licensure; 523.21 (2) personnel qualifications and staffing standards; 523.22 (3) quality of life support treatment; 523.23 (4) restricted treatments and procedures; 523.24 (5) equipment standards; 523.25 (6) ambulance standards; 523.26 (7) communication standards, equipment performance and 523.27 maintenance, and radio frequency assignments; 523.28 (8) advertising; 523.29 (9) scheduled ambulance services; 523.30 (10) ambulance services in time of disaster; 523.31 (11) basic, intermediate, advanced, and refresher emergency 523.32 care course programs; 523.33 (12) continuing education requirements; 523.34 (13) trip reports; 523.35 (14) license fees, vehicle fees, and expiration dates; and 523.36 (15) waivers and variances. 524.1(b) These rules shall apply to the following types of524.2ambulance service:524.3(1) basic ambulance service that provides a level of care524.4to ensure that life-threatening situations and potentially524.5serious injuries can be recognized, patients will be protected524.6from additional hazards, basic treatment to reduce the524.7seriousness of emergency situations will be administered, and524.8patients will be transported to an appropriate medical facility524.9for treatment;524.10(2) intermediate ambulance service that provides (i) basic524.11ambulance service, and (ii) intravenous infusions or524.12defibrillation or both;524.13(3) advanced ambulance service that provides (i) basic524.14ambulance service, and (ii) advanced airway management,524.15defibrillation, and administration of intravenous fluids and524.16pharmaceuticals. Vehicles of advanced ambulance service524.17licensees not equipped or staffed at the advanced ambulance524.18service level shall not be identified to the public as capable524.19of providing advanced ambulance service;524.20(4) specialized ambulance service that provides basic,524.21intermediate, or advanced service as designated by the board,524.22and is restricted by the board to (i) less than 24 hours of524.23every day, (ii) designated segments of the population, or (iii)524.24certain types of medical conditions; and524.25(5) air ambulance service, that includes fixed-wing and524.26helicopter, and is specialized ambulance service.524.27Until rules are promulgated, the current provisions of524.28Minnesota Rules shall govern these services.524.29 Sec. 33. Minnesota Statutes 1998, section 144E.18, is 524.30 amended to read: 524.31 144E.18 [INSPECTIONS.] 524.32 The board may inspect ambulance services as frequently as 524.33 deemed necessary to determine whether an ambulance service is in 524.34 compliance with sections 144E.001 to 144E.33 and rules adopted 524.35 under those sections.These inspections shall be for the524.36purpose of determining whether the ambulance and equipment is525.1clean and in proper working order and whether the operator is in525.2compliance with sections 144E.001 to 144E.16 and any rules that525.3the board adopts related to sections 144E.001 to 144E.16.The 525.4 board may review at any time documentation required to be on 525.5 file with a licensee. 525.6 Sec. 34. [144E.19] [DISCIPLINARY ACTION.] 525.7 Subdivision 1. [SUSPENSION; REVOCATION; NONRENEWAL.] The 525.8 board may suspend, revoke, refuse to renew, or place conditions 525.9 on the license of a licensee upon finding that the licensee has 525.10 violated a provision of this chapter or rules adopted under this 525.11 chapter or has ceased to provide the service for which the 525.12 licensee is licensed. 525.13 Subd. 2. [NOTICE; CONTESTED CASE.] (a) Before taking 525.14 action under subdivision 1, the board shall give notice to a 525.15 licensee of the right to a contested case hearing under chapter 525.16 14. If a licensee requests a contested case hearing within 30 525.17 days after receiving notice, the board shall initiate a 525.18 contested case hearing according to chapter 14. 525.19 (b) The administrative law judge shall issue a report and 525.20 recommendation within 30 days after closing the contested case 525.21 hearing record. The board shall issue a final order within 30 525.22 days after receipt of the administrative law judge's report. 525.23 Subd. 3. [TEMPORARY SUSPENSION.] (a) In addition to any 525.24 other remedy provided by law, the board may temporarily suspend 525.25 the license of a licensee after conducting a preliminary inquiry 525.26 to determine whether the board believes that the licensee has 525.27 violated a statute or rule that the board is empowered to 525.28 enforce and determining that the continued provision of service 525.29 by the licensee would create an imminent risk to public health 525.30 or harm to others. 525.31 (b) A temporary suspension order prohibiting a licensee 525.32 from providing ambulance service shall give notice of the right 525.33 to a preliminary hearing according to paragraph (d) and shall 525.34 state the reasons for the entry of the temporary suspension 525.35 order. 525.36 (c) Service of a temporary suspension order is effective 526.1 when the order is served on the licensee personally or by 526.2 certified mail, which is complete upon receipt, refusal, or 526.3 return for nondelivery to the most recent address provided to 526.4 the board for the licensee. 526.5 (d) At the time the board issues a temporary suspension 526.6 order, the board shall schedule a hearing, to be held before a 526.7 group of its members designated by the board, that shall begin 526.8 within 60 days after issuance of the temporary suspension order 526.9 or within 15 working days of the date of the board's receipt of 526.10 a request for a hearing from a licensee, whichever is sooner. 526.11 The hearing shall be on the sole issue of whether there is a 526.12 reasonable basis to continue, modify, or lift the temporary 526.13 suspension. A hearing under this paragraph is not subject to 526.14 chapter 14. 526.15 (e) Evidence presented by the board or licensee may be in 526.16 the form of an affidavit. The licensee or the licensee's 526.17 designee may appear for oral argument. 526.18 (f) Within five working days of the hearing, the board 526.19 shall issue its order and, if the suspension is continued, 526.20 notify the licensee of the right to a contested case hearing 526.21 under chapter 14. 526.22 (g) If a licensee requests a contested case hearing within 526.23 30 days after receiving notice under paragraph (f), the board 526.24 shall initiate a contested case hearing according to chapter 14. 526.25 The administrative law judge shall issue a report and 526.26 recommendation within 30 days after the closing of the contested 526.27 case hearing record. The board shall issue a final order within 526.28 30 days after receipt of the administrative law judge's report. 526.29 Sec. 35. [144E.265] [MEDICAL DIRECTOR.] 526.30 Subdivision 1. [REQUIREMENTS.] A medical director shall: 526.31 (1) be currently licensed as a physician in this state; 526.32 (2) have experience in, and knowledge of, emergency care of 526.33 acutely ill or traumatized patients; and 526.34 (3) be familiar with the design and operation of local, 526.35 regional, and state emergency medical service systems. 526.36 Subd. 2. [RESPONSIBILITIES.] Responsibilities of the 527.1 medical director shall include, but are not limited to: 527.2 (1) approving standards for training and orientation of 527.3 personnel that impact patient care; 527.4 (2) approving standards for purchasing equipment and 527.5 supplies that impact patient care; 527.6 (3) establishing standing orders for prehospital care; 527.7 (4) approving triage, treatment, and transportation 527.8 protocols; 527.9 (5) participating in the development and operation of 527.10 continuous quality improvement programs including, but not 527.11 limited to, case review and resolution of patient complaints; 527.12 (6) establishing procedures for the administration of 527.13 drugs; and 527.14 (7) maintaining the quality of care according to the 527.15 standards and procedures established under clauses (1) to (6). 527.16 Subd. 3. [ANNUAL ASSESSMENT; AMBULANCE SERVICE.] Annually, 527.17 the medical director or the medical director's designee shall 527.18 assess the practical skills of each person on the ambulance 527.19 service roster and sign a statement verifying the proficiency of 527.20 each person. The statements shall be maintained in the 527.21 licensee's files. 527.22 Sec. 36. Minnesota Statutes 1998, section 144E.27, is 527.23 amended by adding a subdivision to read: 527.24 Subd. 5. [DENIAL, SUSPENSION, REVOCATION.] (a) The board 527.25 may deny, suspend, revoke, place conditions on, or refuse to 527.26 renew the registration of an individual who the board determines: 527.27 (1) violates sections 144E.001 to 144E.33 or the rules 527.28 adopted under those sections; 527.29 (2) misrepresents or falsifies information on an 527.30 application form for registration; 527.31 (3) is convicted or pleads guilty or nolo contendere to any 527.32 felony; any gross misdemeanor relating to assault, sexual 527.33 misconduct, or the illegal use of drugs or alcohol; or any 527.34 misdemeanor relating to sexual misconduct or the illegal use of 527.35 drugs or alcohol; 527.36 (4) is actually or potentially unable to provide emergency 528.1 medical services with reasonable skill and safety to patients by 528.2 reason of illness, use of alcohol, drugs, chemicals, or any 528.3 other material, or as a result of any mental or physical 528.4 condition; 528.5 (5) engages in unethical conduct, including, but not 528.6 limited to, conduct likely to deceive, defraud, or harm the 528.7 public, or demonstrating a willful or careless disregard for the 528.8 health, welfare, or safety of the public; or 528.9 (6) maltreats or abandons a patient. 528.10 (b) Before taking action under paragraph (a), the board 528.11 shall give notice to an individual of the right to a contested 528.12 case hearing under chapter 14. If an individual requests a 528.13 contested case hearing within 30 days after receiving notice, 528.14 the board shall initiate a contested case hearing according to 528.15 chapter 14. 528.16 (c) The administrative law judge shall issue a report and 528.17 recommendation within 30 days after closing the contested case 528.18 hearing record. The board shall issue a final order within 30 528.19 days after receipt of the administrative law judge's report. 528.20 (d) After six months from the board's decision to deny, 528.21 revoke, place conditions on, or refuse renewal of an 528.22 individual's registration for disciplinary action, the 528.23 individual shall have the opportunity to apply to the board for 528.24 reinstatement. 528.25 Sec. 37. Minnesota Statutes 1998, section 144E.27, is 528.26 amended by adding a subdivision to read: 528.27 Subd. 6. [TEMPORARY SUSPENSION.] (a) In addition to any 528.28 other remedy provided by law, the board may temporarily suspend 528.29 the registration of an individual after conducting a preliminary 528.30 inquiry to determine whether the board believes that the 528.31 individual has violated a statute or rule that the board is 528.32 empowered to enforce and determining that the continued 528.33 provision of service by the individual would create an imminent 528.34 risk to public health or harm to others. 528.35 (b) A temporary suspension order prohibiting an individual 528.36 from providing emergency medical care shall give notice of the 529.1 right to a preliminary hearing according to paragraph (d) and 529.2 shall state the reasons for the entry of the temporary 529.3 suspension order. 529.4 (c) Service of a temporary suspension order is effective 529.5 when the order is served on the individual personally or by 529.6 certified mail, which is complete upon receipt, refusal, or 529.7 return for nondelivery to the most recent address provided to 529.8 the board for the individual. 529.9 (d) At the time the board issues a temporary suspension 529.10 order, the board shall schedule a hearing, to be held before a 529.11 group of its members designated by the board, that shall begin 529.12 within 60 days after issuance of the temporary suspension order 529.13 or within 15 working days of the date of the board's receipt of 529.14 a request for a hearing from the individual, whichever is 529.15 sooner. The hearing shall be on the sole issue of whether there 529.16 is a reasonable basis to continue, modify, or lift the temporary 529.17 suspension. A hearing under this paragraph is not subject to 529.18 chapter 14. 529.19 (e) Evidence presented by the board or the individual may 529.20 be in the form of an affidavit. The individual or the 529.21 individual's designee may appear for oral argument. 529.22 (f) Within five working days of the hearing, the board 529.23 shall issue its order and, if the suspension is continued, 529.24 notify the individual of the right to a contested case hearing 529.25 under chapter 14. 529.26 (g) If an individual requests a contested case hearing 529.27 within 30 days after receiving notice under paragraph (f), the 529.28 board shall initiate a contested case hearing according to 529.29 chapter 14. The administrative law judge shall issue a report 529.30 and recommendation within 30 days after the closing of the 529.31 contested case hearing record. The board shall issue a final 529.32 order within 30 days after receipt of the administrative law 529.33 judge's report. 529.34 Sec. 38. [144E.28] [CERTIFICATION OF EMT, EMT-I, AND 529.35 EMT-P.] 529.36 Subdivision 1. [REQUIREMENTS.] To be eligible for 530.1 certification by the board as an EMT, EMT-I, or EMT-P, an 530.2 individual shall: 530.3 (1) successfully complete the United States Department of 530.4 Transportation course, or its equivalent as approved by the 530.5 board, specific to the EMT, EMT-I, or EMT-P classification; 530.6 (2) pass the written and practical examinations approved by 530.7 the board and administered by the board or its designee, 530.8 specific to the EMT, EMT-I, or EMT-P classification; and 530.9 (3) submit the appropriate fee as required under section 530.10 144E.29. 530.11 Subd. 2. [EXPIRATION DATES.] Certification expiration 530.12 dates are as follows: 530.13 (1) for initial certification granted between January 1 and 530.14 June 30 of an even-numbered year, the expiration date is March 530.15 31 of the next even-numbered year; 530.16 (2) for initial certification granted between July 1 and 530.17 December 31 of an even-numbered year, the expiration date is 530.18 March 31 of the second odd-numbered year; 530.19 (3) for initial certification granted between January 1 and 530.20 June 30 of an odd-numbered year, the expiration date is March 31 530.21 of the next odd-numbered year; and 530.22 (4) for initial certification granted between July 1 and 530.23 December 31 of an odd-numbered year, the expiration date is 530.24 March 31 of the second even-numbered year. 530.25 Subd. 3. [RECIPROCITY.] The board may certify an 530.26 individual who possesses a current National Registry of 530.27 Emergency Medical Technicians registration from another 530.28 jurisdiction and submits the appropriate fee as required under 530.29 section 144E.29. The board certification classification shall 530.30 be the same as the National Registry's classification. 530.31 Certification shall be for the duration of the applicant's 530.32 registration period in another jurisdiction, not to exceed two 530.33 years. 530.34 Subd. 4. [FORMS OF DISCIPLINARY ACTION.] When the board 530.35 finds that a person certified under this section has violated a 530.36 provision or provisions of subdivision 5, it may do one or more 531.1 of the following: 531.2 (1) revoke the certification; 531.3 (2) suspend the certification; 531.4 (3) refuse to renew the certification; 531.5 (4) impose limitations or conditions on the person's 531.6 performance of regulated duties, including the imposition of 531.7 retraining or rehabilitation requirements; the requirement to 531.8 work under supervision; or the conditioning of continued 531.9 practice on demonstration of knowledge or skills by appropriate 531.10 examination or other review of skill and competence; 531.11 (5) order the person to provide unremunerated professional 531.12 service under supervision at a designated public hospital, 531.13 clinic, or other health care institution; or 531.14 (6) censure or reprimand the person. 531.15 Subd. 5. [DENIAL, SUSPENSION, REVOCATION.] (a) The board 531.16 may take any action authorized in subdivision 4 against an 531.17 individual who the board determines: 531.18 (1) violates sections 144E.001 to 144E.33 or the rules 531.19 adopted under those sections; 531.20 (2) misrepresents or falsifies information on an 531.21 application form for certification; 531.22 (3) is convicted or pleads guilty or nolo contendere to any 531.23 felony; any gross misdemeanor relating to assault, sexual 531.24 misconduct, or the illegal use of drugs or alcohol; or any 531.25 misdemeanor relating to sexual misconduct or the illegal use of 531.26 drugs or alcohol; 531.27 (4) is actually or potentially unable to provide emergency 531.28 medical services with reasonable skill and safety to patients by 531.29 reason of illness, use of alcohol, drugs, chemicals, or any 531.30 other material, or as a result of any mental or physical 531.31 condition; 531.32 (5) engages in unethical conduct, including, but not 531.33 limited to, conduct likely to deceive, defraud, or harm the 531.34 public or demonstrating a willful or careless disregard for the 531.35 health, welfare, or safety of the public; or 531.36 (6) maltreats or abandons a patient. 532.1 (b) Before taking action under paragraph (a), the board 532.2 shall give notice to an individual of the right to a contested 532.3 case hearing under chapter 14. If an individual requests a 532.4 contested case hearing within 30 days after receiving notice, 532.5 the board shall initiate a contested case hearing according to 532.6 chapter 14 and no disciplinary action shall be taken at that 532.7 time. 532.8 (c) The administrative law judge shall issue a report and 532.9 recommendation within 30 days after closing the contested case 532.10 hearing record. The board shall issue a final order within 30 532.11 days after receipt of the administrative law judge's report. 532.12 (d) After six months from the board's decision to deny, 532.13 revoke, place conditions on, or refuse renewal of an 532.14 individual's certification for disciplinary action, the 532.15 individual shall have the opportunity to apply to the board for 532.16 reinstatement. 532.17 Subd. 6. [TEMPORARY SUSPENSION.] (a) In addition to any 532.18 other remedy provided by law, the board may temporarily suspend 532.19 the certification of an individual after conducting a 532.20 preliminary inquiry to determine whether the board believes that 532.21 the individual has violated a statute or rule that the board is 532.22 empowered to enforce and determining that the continued 532.23 provision of service by the individual would create an imminent 532.24 risk to public health or harm to others. 532.25 (b) A temporary suspension order prohibiting an individual 532.26 from providing emergency medical care shall give notice of the 532.27 right to a preliminary hearing according to paragraph (d) and 532.28 shall state the reasons for the entry of the temporary 532.29 suspension order. 532.30 (c) Service of a temporary suspension order is effective 532.31 when the order is served on the individual personally or by 532.32 certified mail, which is complete upon receipt, refusal, or 532.33 return for nondelivery to the most recent address provided to 532.34 the board for the individual. 532.35 (d) At the time the board issues a temporary suspension 532.36 order, the board shall schedule a hearing, to be held before a 533.1 group of its members designated by the board, that shall begin 533.2 within 60 days after issuance of the temporary suspension order 533.3 or within 15 working days of the date of the board's receipt of 533.4 a request for a hearing from the individual, whichever is 533.5 sooner. The hearing shall be on the sole issue of whether there 533.6 is a reasonable basis to continue, modify, or lift the temporary 533.7 suspension. A hearing under this paragraph is not subject to 533.8 chapter 14. 533.9 (e) Evidence presented by the board or the individual may 533.10 be in the form of an affidavit. The individual or individual's 533.11 designee may appear for oral argument. 533.12 (f) Within five working days of the hearing, the board 533.13 shall issue its order and, if the suspension is continued, 533.14 notify the individual of the right to a contested case hearing 533.15 under chapter 14. 533.16 (g) If an individual requests a contested case hearing 533.17 within 30 days of receiving notice under paragraph (f), the 533.18 board shall initiate a contested case hearing according to 533.19 chapter 14. The administrative law judge shall issue a report 533.20 and recommendation within 30 days after the closing of the 533.21 contested case hearing record. The board shall issue a final 533.22 order within 30 days after receipt of the administrative law 533.23 judge's report. 533.24 Subd. 7. [RENEWAL.] (a) Before the expiration date of 533.25 certification, an applicant for renewal of certification as an 533.26 EMT shall: 533.27 (1) successfully complete a course in cardiopulmonary 533.28 resuscitation that is approved by the board or the licensee's 533.29 medical director; 533.30 (2) take the United States Department of Transportation EMT 533.31 refresher course and successfully pass the practical skills test 533.32 portion of the course, or successfully complete 48 hours of 533.33 continuing education in EMT programs that are consistent with 533.34 the United States Department of Transportation National Standard 533.35 Curriculum or its equivalent as approved by the board or as 533.36 approved by the licensee's medical director and pass a practical 534.1 skills test approved by the board and administered by a training 534.2 program approved by the board. Twenty-four of the 48 hours must 534.3 include at least four hours of instruction in each of the 534.4 following six categories: 534.5 (i) airway management and resuscitation procedures; 534.6 (ii) circulation, bleeding control, and shock; 534.7 (iii) human anatomy and physiology, patient assessment, and 534.8 medical emergencies; 534.9 (iv) injuries involving musculoskeletal, nervous, 534.10 digestive, and genito-urinary systems; 534.11 (v) environmental emergencies and rescue techniques; and 534.12 (vi) emergency childbirth and other special situations; and 534.13 (3) submit the appropriate fee as required under section 534.14 144E.29. 534.15 (b) Before the expiration date of certification, an 534.16 applicant for renewal of certification as an EMT-I or EMT-P 534.17 shall: 534.18 (1) for an EMT-I, successfully complete a course in 534.19 cardiopulmonary resuscitation that is approved by the board or 534.20 the licensee's medical director and for an EMT-P, successfully 534.21 complete a course in advanced cardiac life support that is 534.22 approved by the board or the licensee's medical director; 534.23 (2) successfully complete 48 hours of continuing education 534.24 in emergency medical training programs, appropriate to the level 534.25 of the applicant's EMT-I or EMT-P certification, that are 534.26 consistent with the United States Department of Transportation 534.27 National Standard Curriculum or its equivalent as approved by 534.28 the board or as approved by the licensee's medical director. An 534.29 applicant may take the United States Department of 534.30 Transportation Emergency Medical Technician refresher course or 534.31 its equivalent without the written or practical test as approved 534.32 by the board, and as appropriate to the applicant's level of 534.33 certification, as part of the 48 hours of continuing education. 534.34 Each hour of the refresher course counts toward the 48-hour 534.35 continuing education requirement; and 534.36 (3) submit the appropriate fee required under section 535.1 144E.29. 535.2 (c) Certification shall be renewed every two years. 535.3 (d) If the applicant does not meet the renewal requirements 535.4 under this subdivision, the applicant's certification expires. 535.5 Subd. 8. [REINSTATEMENT.] (a) Within four years of a 535.6 certification expiration date, a person whose certification has 535.7 expired under subdivision 7, paragraph (d), may have the 535.8 certification reinstated upon submission of evidence to the 535.9 board of training equivalent to the continuing education 535.10 requirements of subdivision 7 and upon payment of the 535.11 certification fee. 535.12 (b) If more than four years have passed since a certificate 535.13 expiration date, an applicant must complete the initial 535.14 certification process required under subdivision 1. 535.15 Sec. 39. [144E.283] [EMT INSTRUCTOR CERTIFICATION.] 535.16 Subdivision 1. [QUALIFICATIONS.] The board shall grant 535.17 certification as an emergency medical technician instructor to 535.18 an applicant who files a completed application and furnishes 535.19 evidence satisfactory to the board that the applicant: 535.20 (1) possesses valid certification, registration, or 535.21 licensure as an EMT, EMT-I, EMT-P, physician, physician's 535.22 assistant, or registered nurse; 535.23 (2) has two years of active emergency medical practical 535.24 experience; 535.25 (3) is recommended by a medical director of a licensed 535.26 hospital, ambulance service, or training program approved by the 535.27 board; 535.28 (4) successfully completes the United States Department of 535.29 Transportation Emergency Medical Services Instructor Training 535.30 Program or its equivalent as approved by the board; and 535.31 (5) submits the appropriate fee as required under section 535.32 144E.29. 535.33 Subd. 2. [EXPIRATION.] Certification expires two years 535.34 from the date of the initial certification and must be renewed 535.35 every two years. 535.36 Subd. 3. [RENEWAL.] (a) An applicant shall submit an 536.1 application to the board for renewal at least three months prior 536.2 to the expiration date of the certification and must furnish 536.3 evidence satisfactory to the board that the applicant: 536.4 (1) complies with the requirements of subdivision 1; 536.5 (2) has at least 40 hours of experience as an instructor in 536.6 an emergency medical technician course approved by the board 536.7 under section 144E.285; and 536.8 (3) has attended at least eight hours of continuing 536.9 education encompassing the course topics of the United States 536.10 Department of Transportation National Standard Curriculum for an 536.11 Emergency Medical Services Instructor Training Program or its 536.12 equivalent as approved by the board. 536.13 (b) An emergency medical technician instructor whose 536.14 certification expires for nonrenewal must obtain a new 536.15 certification by applying to the board and meeting the 536.16 requirements of subdivision 1. 536.17 Sec. 40. [144E.285] [TRAINING PROGRAMS.] 536.18 Subdivision 1. [APPROVAL REQUIRED.] (a) All training 536.19 programs for an EMT, EMT-I, or EMT-P must be approved by the 536.20 board. 536.21 (b) To be approved by the board, a training program must: 536.22 (1) submit an application prescribed by the board that 536.23 includes: 536.24 (i) type and length of course to be offered; 536.25 (ii) names, addresses, and qualifications of the program 536.26 medical director, program training coordinator, and certified 536.27 instructors; 536.28 (iii) names and addresses of clinical sites, including a 536.29 contact person and telephone number; 536.30 (iv) admission criteria for students; and 536.31 (v) materials and equipment to be used; 536.32 (2) for each course, implement the most current version of 536.33 the United States Department of Transportation curriculum or its 536.34 equivalent as determined by the board applicable to EMT, EMT-I, 536.35 or EMT-P training; 536.36 (3) have a program medical director and a program 537.1 coordinator; 537.2 (4) utilize instructors certified under section 144E.283 537.3 for teaching at least 50 percent of the course content. The 537.4 remaining 50 percent of the course may be taught by guest 537.5 lecturers approved by the training program coordinator or 537.6 medical director; 537.7 (5) have at least one instructor for every ten students at 537.8 the practical skill stations; 537.9 (6) maintain a written agreement with a licensed hospital 537.10 or licensed ambulance service designating a clinical training 537.11 site; 537.12 (7) retain documentation of program approval by the board, 537.13 course outline, and student information; 537.14 (8) notify the board of the starting date of a course prior 537.15 to the beginning of a course; and 537.16 (9) submit the appropriate fee as required under section 537.17 144E.29. 537.18 Subd. 2. [EMT-P REQUIREMENTS.] (a) In addition to the 537.19 requirements under subdivision 1, paragraph (b), a training 537.20 program applying for approval to teach EMT-P curriculum must be 537.21 administered by an educational institution accredited by the 537.22 Commission of Accreditation of Allied Health Education Programs 537.23 (CAAHEP). 537.24 (b) An EMT-P training program that is administered by an 537.25 educational institution not accredited by CAAHEP, but that is in 537.26 the process of completing the accreditation process, may be 537.27 granted provisional approval by the board upon verification of 537.28 submission of its self-study report and the appropriate review 537.29 fee to CAAHEP. 537.30 (c) An educational institution that discontinues its 537.31 participation in the accreditation process must notify the board 537.32 immediately and provisional approval shall be withdrawn. 537.33 Subd. 3. [EXPIRATION.] Training program approval shall 537.34 expire two years from the date of approval. 537.35 Subd. 4. [REAPPROVAL.] A training program shall apply to 537.36 the board for reapproval at least three months prior to the 538.1 expiration date of its approval and must: 538.2 (1) submit an application prescribed by the board 538.3 specifying any changes from the information provided for prior 538.4 approval and any other information requested by the board to 538.5 clarify incomplete or ambiguous information presented in the 538.6 application; and 538.7 (2) comply with the requirements under subdivision 1, 538.8 paragraph (b), clauses (2) to (8). 538.9 Subd. 5. [DISCIPLINARY ACTION.] (a) The board may deny, 538.10 suspend, revoke, place conditions on, or refuse to renew 538.11 approval of a training program that the board determines: 538.12 (1) violated subdivisions 1 to 4 or rules adopted under 538.13 sections 144E.001 to 144E.33; or 538.14 (2) misrepresented or falsified information on an 538.15 application form provided by the board. 538.16 (b) Before taking action under paragraph (a), the board 538.17 shall give notice to a training program of the right to a 538.18 contested case hearing under chapter 14. If a training program 538.19 requests a contested case hearing within 30 days after receiving 538.20 notice, the board shall initiate a contested case hearing 538.21 according to chapter 14. 538.22 (c) The administrative law judge shall issue a report and 538.23 recommendation within 30 days after closing the contested case 538.24 hearing record. The board shall issue a final order within 30 538.25 days after receipt of the administrative law judge's report. 538.26 (d) After six months from the board's decision to deny, 538.27 revoke, place conditions on, or refuse approval of a training 538.28 program for disciplinary action, the training program shall have 538.29 the opportunity to apply to the board for reapproval. 538.30 Subd. 6. [TEMPORARY SUSPENSION.] (a) In addition to any 538.31 other remedy provided by law, the board may temporarily suspend 538.32 approval of the training program after conducting a preliminary 538.33 inquiry to determine whether the board believes that the 538.34 training program has violated a statute or rule that the board 538.35 is empowered to enforce and determining that the continued 538.36 provision of service by the training program would create an 539.1 imminent risk to public health or harm to others. 539.2 (b) A temporary suspension order prohibiting the training 539.3 program from providing emergency medical care training shall 539.4 give notice of the right to a preliminary hearing according to 539.5 paragraph (d) and shall state the reasons for the entry of the 539.6 temporary suspension order. 539.7 (c) Service of a temporary suspension order is effective 539.8 when the order is served on the training program personally or 539.9 by certified mail, which is complete upon receipt, refusal, or 539.10 return for nondelivery to the most recent address provided to 539.11 the board for the training program. 539.12 (d) At the time the board issues a temporary suspension 539.13 order, the board shall schedule a hearing, to be held before a 539.14 group of its members designated by the board, that shall begin 539.15 within 60 days after issuance of the temporary suspension order 539.16 or within 15 working days of the date of the board's receipt of 539.17 a request for a hearing from the training program, whichever is 539.18 sooner. The hearing shall be on the sole issue of whether there 539.19 is a reasonable basis to continue, modify, or lift the temporary 539.20 suspension. A hearing under this paragraph is not subject to 539.21 chapter 14. 539.22 (e) Evidence presented by the board or the individual may 539.23 be in the form of an affidavit. The training program or counsel 539.24 of record may appear for oral argument. 539.25 (f) Within five working days of the hearing, the board 539.26 shall issue its order and, if the suspension is continued, 539.27 notify the training program of the right to a contested case 539.28 hearing under chapter 14. 539.29 (g) If a training program requests a contested case hearing 539.30 within 30 days of receiving notice under paragraph (f), the 539.31 board shall initiate a contested case hearing according to 539.32 chapter 14. The administrative law judge shall issue a report 539.33 and recommendation within 30 days after the closing of the 539.34 contested case hearing record. The board shall issue a final 539.35 order within 30 days after receipt of the administrative law 539.36 judge's report. 540.1 Subd. 7. [AUDIT.] The board may audit training programs 540.2 approved by the board. The audit may include, but is not 540.3 limited to, investigation of complaints, course inspection, 540.4 classroom observation, review of instructor qualifications, and 540.5 student interviews. 540.6 Sec. 41. [144E.286] [EXAMINER QUALIFICATIONS FOR EMERGENCY 540.7 MEDICAL TECHNICIAN TESTING.] 540.8 Subdivision 1. [EMT TESTING.] An examiner testing basic 540.9 level EMT practical skills must: 540.10 (1) be certified as an EMT, EMT-I, or EMT-P; 540.11 (2) have two years or 4,000 hours' experience in emergency 540.12 medical care; 540.13 (3) be certified in basic cardiac life support; and 540.14 (4) be approved by the board. 540.15 Subd. 2. [EMT-I OR EMT-P TESTING.] (a) An examiner testing 540.16 EMT-I or EMT-P level practical skills must be approved by the 540.17 board and: 540.18 (1) be a physician or registered nurse; or 540.19 (2) be a certified EMT-P, have two years or 4,000 hours' 540.20 experience in emergency medical care and be certified in basic 540.21 cardiac life support. 540.22 (b) A physician must be available to answer questions 540.23 relating to the evaluation of skill performance at the practical 540.24 examination. 540.25 Sec. 42. [144E.29] [FEES.] 540.26 (a) The board shall charge the following fees: 540.27 (1) initial application for and renewal of an ambulance 540.28 service license, $150; 540.29 (2) each ambulance operated by a licensee, $96. The 540.30 licensee shall pay an additional $96 fee for the full licensing 540.31 period or $8 per month for any fraction of the period for each 540.32 ambulance added to the ambulance service during the licensing 540.33 period; 540.34 (3) initial application for and renewal of certification as 540.35 an EMT instructor, $10; 540.36 (4) initial application for and renewal of approval for a 541.1 training program, $100; and 541.2 (5) duplicate of an original license, certification, or 541.3 approval, $25. 541.4 (b) With the exception of paragraph (a), clause (5), all 541.5 fees are for a two-year period. All fees are nonrefundable. 541.6 (c) Fees collected by the board shall be deposited as 541.7 nondedicated receipts in the trunk highway fund. 541.8 Sec. 43. [144E.305] [REPORTING MISCONDUCT.] 541.9 Subdivision 1. [VOLUNTARY REPORTING.] A person who has 541.10 knowledge of any conduct constituting grounds for discipline 541.11 under section 144E.27, subdivision 5, or 144E.28, subdivision 4, 541.12 may report the alleged violation to the board. 541.13 Subd. 2. [MANDATORY REPORTING.] (a) A licensee shall 541.14 report to the board conduct by a first responder, EMT, EMT-I, or 541.15 EMT-P that they reasonably believe constitutes grounds for 541.16 disciplinary action under section 144E.27, subdivision 5, or 541.17 144E.28, subdivision 4. 541.18 (b) A licensee shall report to the board any dismissal from 541.19 employment of a first responder, EMT, EMT-I, or EMT-P. A 541.20 licensee shall report the resignation of a first responder, EMT, 541.21 EMT-I, or EMT-P before the conclusion of any disciplinary 541.22 proceeding or before commencement of formal charges but after 541.23 the first responder, EMT, EMT-I, or EMT-P has knowledge that 541.24 formal charges are contemplated or in preparation. 541.25 Subd. 3. [IMMUNITY.] (a) An individual, licensee, health 541.26 care facility, business, or organization is immune from civil 541.27 liability or criminal prosecution for submitting in good faith a 541.28 report to the board under subdivision 1 or 2 or for otherwise 541.29 reporting in good faith to the board violations or alleged 541.30 violations of sections 144E.001 to 144E.33. Reports are 541.31 classified as confidential data on individuals or protected 541.32 nonpublic data under section 13.02 while an investigation is 541.33 active. Except for the board's final determination, all 541.34 communications or information received by or disclosed to the 541.35 board relating to disciplinary matters of any person or entity 541.36 subject to the board's regulatory jurisdiction are confidential 542.1 and privileged and any disciplinary hearing shall be closed to 542.2 the public. 542.3 (b) Members of the board, persons employed by the board, 542.4 persons engaged in the investigation of violations and in the 542.5 preparation and management of charges of violations of sections 542.6 144E.001 to 144E.33 on behalf of the board, and persons 542.7 participating in the investigation regarding charges of 542.8 violations are immune from civil liability and criminal 542.9 prosecution for any actions, transactions, or publications, made 542.10 in good faith, in the execution of, or relating to, their duties 542.11 under sections 144E.001 to 144E.33. 542.12 (c) For purposes of this section, a member of the board is 542.13 considered a state employee under section 3.736, subdivision 9. 542.14 Sec. 44. [144E.31] [CORRECTION ORDER AND FINES.] 542.15 Subdivision 1. [CORRECTION ORDER.] (a) If the board finds 542.16 that a licensee or training program has failed to comply with an 542.17 applicable law or rule and the violation does not imminently 542.18 endanger the public's health or safety, the board may issue a 542.19 correction order to the licensee or training program. 542.20 (b) The correction order shall state: 542.21 (1) the conditions that constitute a violation of the law 542.22 or rule; 542.23 (2) the specific law or rule violated; and 542.24 (3) the time allowed to correct the violation. 542.25 Subd. 2. [RECONSIDERATION.] (a) If the licensee or 542.26 training program believes that the contents of the board's 542.27 correction order are in error, the licensee or training program 542.28 may ask the board to reconsider the parts of the correction 542.29 order that are alleged to be in error. 542.30 (b) The request for reconsideration must: 542.31 (1) be in writing; 542.32 (2) be delivered by certified mail; 542.33 (3) specify the parts of the correction order that are 542.34 alleged to be in error; 542.35 (4) explain why they are in error; and 542.36 (5) include documentation to support the allegation of 543.1 error. 543.2 (c) A request for reconsideration does not stay any 543.3 provision or requirement of the correction order. The board's 543.4 disposition of a request for reconsideration is final and not 543.5 subject to appeal under chapter 14. 543.6 Subd. 3. [FINE.] (a) The board may order a fine 543.7 concurrently with the issuance of a correction order, or after 543.8 the licensee or training program has not corrected the violation 543.9 within the time specified in the correction order. 543.10 (b) A licensee or training program that is ordered to pay a 543.11 fine shall be notified of the order by certified mail. The 543.12 notice shall be mailed to the address shown on the application 543.13 or the last known address of the licensee or training program. 543.14 The notice shall state the reasons the fine was ordered and 543.15 shall inform the licensee or training program of the right to a 543.16 contested case hearing under chapter 14. 543.17 (c) A licensee or training program may appeal the order to 543.18 pay a fine by notifying the board by certified mail within 15 543.19 calendar days after receiving the order. A timely appeal shall 543.20 stay payment of the fine until the board issues a final order. 543.21 (d) A licensee or training program shall pay the fine 543.22 assessed on or before the payment date specified in the board's 543.23 order. If a licensee or training program fails to fully comply 543.24 with the order, the board shall suspend the license or cancel 543.25 approval until there is full compliance with the order. 543.26 (e) Fines shall be assessed as follows: 543.27 (1) $150 for violation of section 144E.123; 543.28 (2) $400 for violation of sections 144E.06, 144E.07, 543.29 144E.101, 144E.103, 144E.121, 144E.125, 144E.265, 144E.285, and 543.30 144E.305; 543.31 (3) $750 for violation of rules adopted under section 543.32 144E.16, subdivision 4, clause (8); and 543.33 (4) $50 for violation of all other sections under this 543.34 chapter or rules adopted under this chapter that are not 543.35 specifically enumerated in clauses (1) to (3). 543.36 (f) Fines collected by the board shall be deposited as 544.1 nondedicated receipts in the trunk highway fund. 544.2 Subd. 4. [ADDITIONAL PENALTIES.] This section does not 544.3 prohibit the board from suspending, revoking, placing conditions 544.4 on, or refusing to renew a licensee's license or a training 544.5 program's approval in addition to ordering a fine. 544.6 Sec. 45. [144E.33] [PENALTY.] 544.7 A person who violates a provision of sections 144E.001 to 544.8 144E.33 is guilty of a misdemeanor. 544.9 Sec. 46. Minnesota Statutes 1998, section 144E.50, is 544.10 amended by adding a subdivision to read: 544.11 Subd. 6. [AUDITS.] (a) Each regional emergency medical 544.12 services board designated by the emergency medical services 544.13 regulatory board shall be audited biennially by an independent 544.14 auditor who is either a state or local government auditor or a 544.15 certified public accountant who meets the independence standards 544.16 specified by the General Accounting Office for audits of 544.17 governmental organizations, programs, activities, and 544.18 functions. The audit shall cover all funds received by the 544.19 regional board, including but not limited to, funds appropriated 544.20 under this section, section 144E.52, and section 169.686, 544.21 subdivision 3. Expenses associated with the audit are the 544.22 responsibility of the regional board. 544.23 (b) The audit specified in paragraph (a) shall be performed 544.24 within 60 days following the close of the biennium. Copies of 544.25 the audit and any accompanying materials shall be filed by 544.26 October 1 of each odd-numbered year, beginning in 1999, with the 544.27 emergency medical services regulatory board, the legislative 544.28 auditor, and the state auditor. 544.29 (c) If the audit is not conducted as required in paragraph 544.30 (a) or copies filed as required in paragraph (b), or if the 544.31 audit determines that funds were not spent in accordance with 544.32 this chapter, the emergency medical services regulatory board 544.33 shall immediately reduce funding to the regional emergency 544.34 medical services board as follows: 544.35 (1) if an audit was not conducted or if an audit was 544.36 conducted but copies were not provided as required, funding 545.1 shall be reduced by 100 percent; and 545.2 (2) if an audit was conducted and copies provided, and the 545.3 audit identifies expenditures made that are not in compliance 545.4 with this chapter, funding shall be reduced by the amount in 545.5 question plus ten percent. 545.6 A funding reduction under this paragraph is effective for the 545.7 fiscal year in which the reduction is taken and the following 545.8 fiscal year. 545.9 (d) The emergency medical services regulatory board shall 545.10 distribute any funds withheld from a regional board under 545.11 paragraph (c) to the remaining regional boards on a pro rata 545.12 basis. 545.13 Sec. 47. Minnesota Statutes 1998, section 145A.02, 545.14 subdivision 10, is amended to read: 545.15 Subd. 10. [EMERGENCY MEDICAL CARE.] "Emergency medical 545.16 care" means activities intended to protect the health of persons 545.17 suffering a medical emergency and to ensure rapid and effective 545.18 emergency medical treatment. These activities include the 545.19 coordination or provision of training, cooperation with public 545.20 safety agencies, communications, life-support transportationas545.21definedundersection 144E.16sections 144E.06 to 144E.19, 545.22 public information and involvement, and system management. 545.23 Sec. 48. Minnesota Statutes 1998, section 148.66, is 545.24 amended to read: 545.25 148.66 [STATE BOARD OFMEDICAL PRACTICEPHYSICAL THERAPY, 545.26 DUTIES.] 545.27 The state board ofmedical practice, as now or hereafter545.28constituted, hereinafter termed "the board," in the manner545.29hereinafter provided,physical therapy established under section 545.30 148.67 shall administerthe provisions of this lawsections 545.31 148.65 to 148.78. As used in sections 148.65 to 148.78, "board" 545.32 means the state board of physical therapy. 545.33 The board shall: 545.34 (1) adopt rules necessary to administer and enforce 545.35 sections 148.65 to 148.78; 545.36 (2) administer, coordinate, and enforce sections 148.65 to 546.1 148.78; 546.2 (3) evaluate the qualifications of applicants; 546.3 (4) issue subpoenas, examine witnesses, and administer 546.4 oaths; 546.5 (5) conduct hearings and keep records and minutes necessary 546.6 to the orderly administration of sections 148.65 to 148.78; 546.7 (6) investigate persons engaging in practices that violate 546.8 sections 148.65 to 148.78; and 546.9 (7) adopt rules under chapter 14 prescribing a code of 546.10 ethics for licensees. 546.11 Sec. 49. Minnesota Statutes 1998, section 148.67, is 546.12 amended to read: 546.13 148.67 [STATE BOARD OF PHYSICAL THERAPYCOUNCIL; MEMBERSHIP 546.14 APPOINTMENTS, VACANCIES, REMOVALS.] 546.15 Subdivision 1. [BOARD OF PHYSICAL THERAPY APPOINTED.] The 546.16board of medical practice shallgovernor shall appoint a state 546.17 board of physical therapycouncil in carrying out the provisions546.18of this lawto administer sections 148.65 to 148.78, regarding 546.19 the qualifications and examination of physical therapists. 546.20 Thecouncilboard shall consist ofsevennine members, citizens 546.21 and residents of the state of Minnesota, composed ofthreefour 546.22 physical therapists,twoone licensed and registereddoctors546.23 doctor of medicineand surgery, one being a professor or546.24associate or assistant professor from a program in physical546.25therapy approved by the board of medical practice, one aide or546.26assistant to a physical therapist and one public member. The546.27council shall expire, and the terms, compensation and removal of546.28members shall be as provided in section 15.059., one physical 546.29 therapy assistant and three public members. The four physical 546.30 therapist members must be licensed physical therapists in this 546.31 state. Each of the four physical therapist members must have at 546.32 least five years' experience in physical therapy practice, 546.33 physical therapy administration, or physical therapy education. 546.34 The five years' experience must immediately precede appointment. 546.35 Membership terms, compensation of members, removal of members, 546.36 filling of membership vacancies, and fiscal year and reporting 547.1 requirements shall be as provided in sections 214.07 to 214.09. 547.2 The provision of staff, administrative services, and office 547.3 space; the review and processing of complaints; the setting of 547.4 board fees; and other provisions relating to board operations 547.5 shall be as provided in chapter 214. Each member of the board 547.6 shall file with the secretary of state the constitutional oath 547.7 of office before beginning the term of office. 547.8 Subd. 2. [RECOMMENDATIONS FOR APPOINTMENT.] Prior to the 547.9 end of the term of a member of the board, or within 60 days 547.10 after a position on the board becomes vacant, the Minnesota 547.11 Chapter of the American Physical Therapy Association and other 547.12 interested persons and organizations may recommend to the 547.13 governor members qualified to serve on the board. The governor 547.14 may appoint members to the board from the list of persons 547.15 recommended or from among other qualified candidates. 547.16 Sec. 50. [148.691] [OFFICERS; EXECUTIVE DIRECTOR.] 547.17 Subdivision 1. [OFFICERS OF THE BOARD.] The board shall 547.18 elect from its members a president, a vice-president, and a 547.19 secretary-treasurer. Each shall serve for one year or until a 547.20 successor is elected and qualifies. The board shall appoint and 547.21 employ an executive secretary. A majority of the board, 547.22 including one officer, constitutes a quorum at a meeting. 547.23 Subd. 2. [BOARD AUTHORITY TO HIRE.] The board may employ 547.24 persons needed to carry out its work. 547.25 Subd. 3. [DISCLOSURE.] Subject to the exceptions listed in 547.26 this subdivision, all communications or information received by 547.27 or disclosed to the board relating to any person or matter 547.28 subject to its regulatory jurisdiction are confidential and 547.29 privileged and any disciplinary hearing shall be closed to the 547.30 public. 547.31 (a) Upon application of a party in a proceeding before the 547.32 board, the board shall produce and permit the inspection and 547.33 copying, by or on behalf of the moving party, of any designated 547.34 documents or papers relevant to the proceedings, in accordance 547.35 with the provisions of rule 34, Minnesota Rules of Civil 547.36 Procedure. 548.1 (b) If the board imposes disciplinary measures of any kind, 548.2 whether by contested case or by settlement agreement, the name 548.3 and business address of the licensee, the nature of the 548.4 misconduct, and the action taken by the board are public data. 548.5 If disciplinary action is taken by settlement agreement, the 548.6 entire agreement is public data. The board shall decide 548.7 disciplinary matters, whether by settlement or by contested 548.8 case, by roll call vote. The votes are public data. 548.9 (c) The board shall exchange information with other 548.10 licensing boards, agencies, or departments within the state, as 548.11 required under section 214.10, subdivision 8, paragraph (d), and 548.12 may release information in the reports required under section 548.13 214.10, subdivision 8, paragraph (b). 548.14 (d) The board shall upon request furnish to a person who 548.15 made a complaint, a description of the activities and actions of 548.16 the board relating to that complaint, a summary of the results 548.17 of an investigation of that complaint, and the reasons for 548.18 actions taken by the board. 548.19 Sec. 51. Minnesota Statutes 1998, section 148.70, is 548.20 amended to read: 548.21 148.70 [APPLICANTS, QUALIFICATIONS.] 548.22It shall be the duty ofThe board ofmedical practice with548.23the advice and assistance of the physical therapy council to548.24pass uponphysical therapy must: 548.25 (1) establish the qualifications of applicants for 548.26registration,licensing and continuing education requirements 548.27 forreregistration,relicensing; 548.28 (2) provide for and conduct all examinations following 548.29 satisfactory completion of all didactic requirements,; 548.30 (3) determine the applicants who successfully pass the 548.31 examination,; and 548.32 (4) dulyregister such applicantslicense an applicant 548.33 after the applicant has presented evidence satisfactory to the 548.34 board that the applicant has completedaan accredited physical 548.35 therapy educational program of education or continuing education 548.36 approved by the board. 549.1 The passing score for examinations taken after July 1, 549.2 1995, shall be based on objective, numerical standards, as 549.3 established by a nationally recognized board approved testing 549.4 service. 549.5 Sec. 52. Minnesota Statutes 1998, section 148.705, is 549.6 amended to read: 549.7 148.705 [APPLICATION.] 549.8 An applicant forregistrationlicensing as a physical 549.9 therapist shall file a written application on forms provided by 549.10 the board together with a fee in the amount set by the board, no549.11portion of which shall be returned. No portion of the fee is 549.12 refundable. 549.13 An approved program for physical therapists shall include 549.14 the following: 549.15(a)(1) a minimum of 60 academic semester credits or its 549.16 equivalent from an accredited college, including courses in the 549.17 biological and physical sciences; and 549.18(b)(2) an accredited course in physical therapy education 549.19 which has provided adequate instruction in the basic sciences, 549.20 clinical sciences, and physical therapy theory and procedures, 549.21 as determined by the board. In determining whether or not a 549.22 course in physical therapy is approved, the board may take into 549.23 consideration the accreditation of such schools by the 549.24 appropriate council of the American Medical Association, the 549.25 American Physical Therapy Association, or the Canadian Medical 549.26 Association. 549.27 Sec. 53. Minnesota Statutes 1998, section 148.71, is 549.28 amended to read: 549.29 148.71 [REGISTRATIONLICENSING.] 549.30 Subdivision 1. [QUALIFIED APPLICANT.] The state board 549.31 ofmedical practicephysical therapy shallregisterlicense as a 549.32 physical therapist and shall furnish acertificate of549.33registrationlicense toeachan applicant who successfully 549.34 passes an examination provided for in sections 148.65 to 148.78 549.35 forregistrationlicensing as a physical therapist and who is 549.36 otherwise qualified as requiredhereinin sections 148.65 to 550.1 148.78. 550.2 Subd. 2. [TEMPORARY PERMIT.] (a) The board may, upon 550.3 payment of a fee set by the board, issue a temporary permit to 550.4 practice physical therapy under supervision to a physical 550.5 therapist who is a graduate of an approved school of physical 550.6 therapy and qualified for admission to examination for 550.7registrationlicensing as a physical therapist. A temporary 550.8 permit to practice physical therapy under supervision may be 550.9 issued only once and cannot be renewed. It expires 90 days 550.10 after the next examination forregistrationlicensing given by 550.11 the board or on the date on which the board, after examination 550.12 of the applicant, grants or denies the applicant aregistration550.13 license to practice, whichever occurs first. A temporary permit 550.14 expires on the first day the board begins its next examination 550.15 forregistrationlicense after the permit is issued if the 550.16 holder does not submit to examination on that date. The holder 550.17 of a temporary permit to practice physical therapy under 550.18 supervision may practice physical therapy as defined in section 550.19 148.65 if the entire practice is under the supervision of a 550.20 person holding a validregistrationlicense to practice physical 550.21 therapy in this state. The supervision shall be direct, 550.22 immediate, and on premises. 550.23 (b) A physical therapist from another state who is licensed 550.24 or otherwise registered in good standing as a physical therapist 550.25 by that state and meets the requirements forregistration550.26 licensing under section 148.72 does not require supervision to 550.27 practice physical therapy while holding a temporary permit in 550.28 this state. The temporary permit remains valid only until the 550.29 meeting of the board at which the application forregistration550.30 licensing is considered. 550.31 Subd. 3. [FOREIGN-TRAINED PHYSICAL THERAPISTS; TEMPORARY 550.32 PERMITS.] (a) The board of medical practice may issue a 550.33 temporary permit to a foreign-trained physical therapist who: 550.34 (1) is enrolled in a supervised physical therapy 550.35 traineeship that meets the requirements under paragraph (b); 550.36 (2) has completed a physical therapy education program 551.1 equivalent to that under section 148.705 and Minnesota Rules, 551.2 part 5601.0800, subpart 2; 551.3 (3) has achieved a score of at least 550 on the test of 551.4 English as a foreign language or a score of at least 85 on the 551.5 Minnesota battery test; and 551.6 (4) has paid a nonrefundable fee set by the board. 551.7 A foreign-trained physical therapist must have the 551.8 temporary permit before beginning a traineeship. 551.9 (b) A supervised physical therapy traineeship must: 551.10 (1) be at least six months; 551.11 (2) be at a board-approved facility; 551.12 (3) provide a broad base of clinical experience to the 551.13 foreign-trained physical therapist including a variety of 551.14 physical agents, therapeutic exercises, evaluation procedures, 551.15 and patient diagnoses; 551.16 (4) be supervised by a physical therapist who has at least 551.17 three years of clinical experience and isregisteredlicensed 551.18 under subdivision 1; and 551.19 (5) be approved by the board before the foreign-trained 551.20 physical therapist begins the traineeship. 551.21 (c) A temporary permit is effective on the first day of a 551.22 traineeship and expires 90 days after the next examination for 551.23registrationlicensing given by the board following successful 551.24 completion of the traineeship or on the date on which the board, 551.25 after examination of the applicant, grants or denies the 551.26 applicant aregistrationlicense to practice, whichever occurs 551.27 first. 551.28 (d) A foreign-trained physical therapist must successfully 551.29 complete a traineeship to beregisteredlicensed as a physical 551.30 therapist under subdivision 1. The traineeship may be waived 551.31 for a foreign-trained physical therapist who is licensed or 551.32 otherwise registered in good standing in another state and has 551.33 successfully practiced physical therapy in that state under the 551.34 supervision of a licensed or registered physical therapist for 551.35 at least six months at a facility that meets the requirements 551.36 under paragraph (b), clauses (2) and (3). 552.1 (e) A temporary permit will not be issued to a 552.2 foreign-trained applicant who has been issued a temporary permit 552.3 for longer than six months in any other state. 552.4 Sec. 54. Minnesota Statutes 1998, section 148.72, 552.5 subdivision 1, is amended to read: 552.6 Subdivision 1. [ISSUANCE OFREGISTRATIONLICENSE WITHOUT 552.7 EXAMINATION.] On payment to the board of a fee in the amount set 552.8 by the board and on submission of a written application on forms 552.9 provided by the board, the board shall issueregistrationa 552.10 license without examination to a person who is licensed or 552.11 otherwise registered as a physical therapist by another state of 552.12 the United States of America, its possessions, or the District 552.13 of Columbia, if the board determines that the requirements for 552.14licensurelicensing or registration in the state, possession, or 552.15 District are equal to, or greater than, the requirementsset552.16forthin sections 148.65 to 148.78. 552.17 Sec. 55. Minnesota Statutes 1998, section 148.72, 552.18 subdivision 2, is amended to read: 552.19 Subd. 2. [CERTIFICATE OF REGISTRATIONLICENSE.] The board 552.20 may issue acertificate of registration to a physical therapist552.21 license without examination to an applicant who presents 552.22 evidence satisfactory to the board of having passed an 552.23 examination recognized by the board, if the board determines the 552.24 standards of the other state or foreign country aredetermined552.25by the board to be as high asequal to those of this state.At552.26the time of making anUpon application, the applicant shall pay 552.27 to the board a fee in the amount set by the board,. No portion 552.28 ofwhich shall be returnedthe fee is refundable. 552.29 Sec. 56. Minnesota Statutes 1998, section 148.72, 552.30 subdivision 4, is amended to read: 552.31 Subd. 4. [ISSUANCE OFREGISTRATIONLICENSE AFTER 552.32 EXAMINATION.] The board shall issue acertificate of552.33registrationlicense toeachan applicant who passes the 552.34 examinationin accordance withaccording to standards 552.35 established by the board and who is not disqualified to 552.36 receiveregistrationa license underthe provisions ofsection 553.1 148.75. 553.2 Sec. 57. Minnesota Statutes 1998, section 148.73, is 553.3 amended to read: 553.4 148.73 [RENEWALS.] 553.5 Everyregisteredlicensed physical therapist shall, during 553.6 each January, apply to the board for an extension 553.7 ofregistrationa license and pay a fee in the amount set by the 553.8 board. The extension ofregistrationthe license is contingent 553.9 upon demonstration that the continuing education requirements 553.10 set by the board under section 148.70 have been satisfied. 553.11 Sec. 58. Minnesota Statutes 1998, section 148.74, is 553.12 amended to read: 553.13 148.74 [RULES.] 553.14 The boardis authorized tomay adopt rulesas may be553.15necessaryneeded to carry outthe purposes ofsections 148.65 to 553.16 148.78. Thesecretarysecretary-treasurer of the board shall 553.17 keep a record of proceedings under these sections and a register 553.18 of all personsregisteredlicensed under it. The register shall 553.19 show the name, address, date and number ofregistrationthe 553.20 license, and the renewalthereofof the license. Any other 553.21 interested person in the state may obtain a copy ofsuchthe 553.22 list on request to the board uponpayment ofpaying an amountas553.23may befixed by the board, which. The amount shall not exceed 553.24 the cost of the listsofurnished. The board shall provide 553.25 blanks, books, certificates, and stationery and assistanceas is553.26 necessaryfor the transaction of theto transact business of the 553.27 boardand the physical therapy council hereunder, and. All 553.28 money received by the board under sections 148.65 to 148.78 553.29 shall be paid into the state treasury as provided for by law. 553.30 The board shall set by rule the amounts of the application fee 553.31 and the annualregistrationlicensing fee. The fees collected 553.32 by the board must be sufficient to cover the costs of 553.33 administering sections 148.65 to 148.78. 553.34 Sec. 59. [148.745] [MALPRACTICE HISTORY.] 553.35 Subdivision 1. [SUBMISSION.] A person desiring to practice 553.36 physical therapy in this state who has previously practiced in 554.1 another state shall submit the following additional information 554.2 with the license application for the five-year period of active 554.3 practice preceding the date of filing such application: 554.4 (a) The name and address of the person's professional 554.5 liability insurer in the other state. 554.6 (b) The number, date, and disposition of any malpractice 554.7 settlement or award made to the plaintiff relating to the 554.8 quality of services provided. 554.9 Subd. 2. [BOARD ACTION.] The board shall give due 554.10 consideration to the information submitted pursuant to section 554.11 148.72 and this section. An applicant who willfully submits 554.12 incorrect information shall be subject to disciplinary action 554.13 pursuant to section 148.75. 554.14 Sec. 60. Minnesota Statutes 1998, section 148.75, is 554.15 amended to read: 554.16 148.75 [CERTIFICATESLICENSES; DENIAL, SUSPENSION, 554.17 REVOCATION.] 554.18 (a) The state board ofmedical practicephysical therapy 554.19 may refuse to grantregistrationa license to any physical 554.20 therapist, or may suspend or revoke theregistrationlicense of 554.21 any physical therapist for any of the following grounds: 554.22(a)(1) using drugs or intoxicating liquors to an extent 554.23 which affects professional competence; 554.24(b) been convicted(2) conviction of a felony; 554.25(c)(3) conviction for violating any state or federal 554.26 narcotic law; 554.27(d) procuring, aiding or abetting a criminal abortion;554.28(e) registration(4) obtaining a license orattempted554.29registrationattempting to obtain a license by fraud or 554.30 deception; 554.31(f)(5) conduct unbecoming a personregisteredlicensed as 554.32 a physical therapist or conduct detrimental to the best 554.33 interests of the public; 554.34(g)(6) gross negligence in the practice of physical 554.35 therapy as a physical therapist; 554.36(h)(7) treating human ailments by physical therapy after 555.1 an initial 30-day period of patient admittance to treatment has 555.2 lapsed, except by the order or referral of a person licensed in 555.3 this statetoin the practice of medicine as defined in section 555.4 147.081, the practice of chiropractic as defined in section 555.5 148.01, the practice of podiatry as defined in section 153.01, 555.6 or the practice of dentistry as defined in section 150A.05 and 555.7 whose license is in good standing; or when a previous diagnosis 555.8 exists indicating an ongoing condition warranting physical 555.9 therapy treatment, subject to periodic review defined by board 555.10 ofmedical practicephysical therapy rule; 555.11(i)(8) treating human ailments, without referral, by 555.12 physical therapy treatment without first having practiced one 555.13 year under a physician's orders as verified by the board's 555.14 records; 555.15(j) failure(9) failing to consult with the patient's 555.16 health care provider who prescribed the physical therapy 555.17 treatment if the treatment is altered by the physical therapist 555.18 from the original written order. The provision does not include 555.19 written ordersspecifying ordersto "evaluate and treat"; 555.20(k)(10) treating human ailments other than by physical 555.21 therapy unless duly licensed or registered to do so under the 555.22 laws of this state; 555.23(l)(11) inappropriate delegation to a physical therapist 555.24 assistant or inappropriate task assignment to an aide or 555.25 inadequate supervision of either level of supportive personnel; 555.26(m) treating human ailments other than by performing555.27physical therapy procedures unless duly licensed or registered555.28to do so under the laws of this state;555.29(n)(12) practicing as a physical therapist performing 555.30 medical diagnosis, the practice of medicine as defined in 555.31 section 147.081, or the practice of chiropractic as defined in 555.32 section 148.01; 555.33(o) failure(13) failing to comply with a reasonable 555.34 request to obtain appropriate clearance for mental or physical 555.35 conditionswhichthat would interfere with the ability to 555.36 practice physical therapy, andwhichthat may be potentially 556.1 harmful to patients; 556.2(p)(14) dividing fees with, or paying or promising to pay 556.3 a commission or part of the fee to, any person who contacts the 556.4 physical therapist for consultation or sends patients to the 556.5 physical therapist for treatment; 556.6(q)(15) engaging in an incentive payment arrangement, 556.7 other than that prohibited by clause(p)(14), that tends to 556.8 promote physical therapyoverutilizationoveruse,wherebythat 556.9 allows the referring person or person who controls the 556.10 availability of physical therapy services to a clientprofitsto 556.11 profit unreasonably as a result of patient treatment; 556.12(r)(16) practicing physical therapy and failing to refer 556.13 to a licensed health care professionalanya patient whose 556.14 medical condition at the time of evaluation has been determined 556.15 by the physical therapist to be beyond the scope of practice of 556.16 a physical therapist; and 556.17(s) failure(17) failing to report to the board other 556.18registeredlicensed physical therapists who violate this section. 556.19 (b) Acertificate of registrationlicense to practice as a 556.20 physical therapist is suspended if (1) a guardian of the person 556.21 of the physical therapist is appointed by order of a court 556.22 pursuant to sections 525.54 to 525.61, for reasons other than 556.23 the minority of the physical therapist; or (2) the physical 556.24 therapist is committed by order of a court pursuant to chapter 556.25 253B. Thecertificate of registrationlicense remains suspended 556.26 until the physical therapist is restored to capacity by a court 556.27 and, upon petition by the physical therapist, the suspension is 556.28 terminated by the board ofmedical practicephysical therapy 556.29 after a hearing. 556.30 Sec. 61. Minnesota Statutes 1998, section 148.76, is 556.31 amended to read: 556.32 148.76 [PROHIBITED CONDUCT.] 556.33 Subdivision 1. No person shall: 556.34 (1) provide physical therapy unless the person is licensed 556.35 as a physical therapist under sections 148.65 to 148.78; 556.36(a)(2) use the title of physical therapist without a 557.1certificate of registrationlicense as a physical therapist 557.2 issuedpursuant to the provisions ofunder sections 148.65 to 557.3 148.78; 557.4(b)(3) in any manner hold out as a physical therapist, or 557.5 use in connection with the person's name the words or letters 557.6 Physical Therapist, Physiotherapist, Physical Therapy 557.7 Technician, Registered Physical Therapist, Licensed Physical 557.8 Therapist, P.T., P.T.T., R.P.T., L.P.T., or any letters, words, 557.9 abbreviations or insignia indicating or implying that the person 557.10 is a physical therapist, without acertificate of registration557.11 license as a physical therapist issuedpursuant to the557.12provisions ofunder sections 148.65 to 148.78. To do so is a 557.13 gross misdemeanor; 557.14(c)(4) employ fraud or deception in applying for or 557.15 securing acertificate of registrationlicense as a physical 557.16 therapist. 557.17 Nothingcontainedin sections 148.65 to 148.78shall557.18prohibit anyprohibits a person licensed or registered in this 557.19 state under another law from carrying out the therapy or 557.20 practice for which the person is duly licensed or registered. 557.21 Subd. 2. No physical therapist may: 557.22(a)(1) treat human ailments by physical therapy after an 557.23 initial 30-day period of patient admittance to treatment has 557.24 lapsed, except by the order or referral of a person licensed in 557.25 this state to practice medicine as defined in section 147.081, 557.26 the practice of chiropractic as defined in section 148.01, the 557.27 practice of podiatry as defined in section 153.01, the practice 557.28 of dentistry as defined in section 150A.05, or the practice of 557.29 advanced practice nursing as defined in section 62A.15, 557.30 subdivision 3a, when orders or referrals are made in 557.31 collaboration with a physician, chiropractor, podiatrist, or 557.32 dentist, and whose license is in good standing; or when a 557.33 previous diagnosis exists indicating an ongoing condition 557.34 warranting physical therapy treatment, subject to periodic 557.35 review defined by board ofmedical practicephysical therapy 557.36 rule; 558.1(b)(2) treat human ailments by physical therapy treatment 558.2 without first having practiced one year under a physician's 558.3 orders as verified by the board's records; 558.4(c) utilize(3) use any chiropractic manipulative technique 558.5 whose end is the chiropractic adjustment of an abnormal 558.6 articulation of the body; and 558.7(d)(4) treat human ailments other than by physical therapy 558.8 unless duly licensed or registered to do so under the laws of 558.9 this state. 558.10 Sec. 62. Minnesota Statutes 1998, section 148.78, is 558.11 amended to read: 558.12 148.78 [PROSECUTION, ALLEGATIONS.] 558.13 In the prosecution of any person for violation of sections 558.14 148.65 to 148.78 as specified in section 148.76, it shall not be 558.15 necessary to allege or prove want of a validcertificate of558.16registrationlicense as a physical therapist, but shall be a 558.17 matter of defense to be established by the accused. 558.18 Sec. 63. Minnesota Statutes 1998, section 148B.32, 558.19 subdivision 1, is amended to read: 558.20 Subdivision 1. [UNLICENSED PRACTICE PROHIBITED.] After 558.21 adoption of rules by the board implementing sections 148B.29 to 558.22 148B.39, no individual shall engage in marriage and family 558.23 therapy practice unless that individual holds a valid license 558.24 issued under sections 148B.29 to 148B.39. 558.25Marriage and family therapists may not be reimbursed under558.26medical assistance, chapter 256B, except to the extent such care558.27is reimbursed under section 256B.0625, subdivision 5, or when558.28marriage and family therapists are employed by a managed care558.29organization with a contract to provide mental health care to558.30medical assistance enrollees, and are reimbursed through the558.31managed care organization.558.32 Sec. 64. Minnesota Statutes 1998, section 150A.10, 558.33 subdivision 1, is amended to read: 558.34 Subdivision 1. [DENTAL HYGIENISTS.] (a) Any licensed 558.35 dentist, public institution, or school authority may obtain 558.36 services from a licensed dental hygienist. Such licensed dental 559.1 hygienist may provide those services defined in section 150A.05, 559.2 subdivision 1a. Such services shall not include the 559.3 establishment of a final diagnosis or treatment plan for a 559.4 dental patient. Such services shall be provided under 559.5 supervision of a licensed dentist. Any licensed dentist who 559.6 shall permit any dental service by a dental hygienist other than 559.7 those authorized by the board of dentistry, shall be deemed to 559.8 be violating the provisions of sections 150A.01 to 150A.12, and 559.9 any such unauthorized dental service by a dental hygienist shall 559.10 constitute a violation of sections 150A.01 to 150A.12. 559.11 (b) Notwithstanding paragraph (a), a licensed dental 559.12 hygienist may provide those services defined in section 150A.05, 559.13 subdivision 1a, clauses (1) and (2), and in Minnesota Rules, 559.14 part 3100.8700, subpart 1, without the supervision of a licensed 559.15 dentist if the following circumstances are met: 559.16 (1) the services are authorized by a licensed dentist; 559.17 (2) the services are performed on a limited access patient; 559.18 and 559.19 (3) a licensed dentist reviews the dental hygienist's 559.20 findings. 559.21 For purposes of this paragraph, "limited access patient" means a 559.22 patient who, due to age, disability, or geographic location, is 559.23 unable to receive regular dental services in a dental office. 559.24 Services that are authorized by a licensed dentist under this 559.25 paragraph may be performed by a licensed dental hygienist 559.26 without the presence of a dentist and may be performed at a 559.27 location other than the usual place of practice of the dentist 559.28 or dental hygienist. 559.29 Sec. 65. Minnesota Statutes 1998, section 214.01, 559.30 subdivision 2, is amended to read: 559.31 Subd. 2. [HEALTH-RELATED LICENSING BOARD.] "Health-related 559.32 licensing board" means the board of examiners of nursing home 559.33 administrators established pursuant to section 144A.19, the 559.34 board of medical practice created pursuant to section 147.01, 559.35 the board of nursing created pursuant to section 148.181, the 559.36 board of chiropractic examiners established pursuant to section 560.1 148.02, the board of optometry established pursuant to section 560.2 148.52, the board of physical therapy established pursuant to 560.3 section 148.67, the board of psychology established pursuant to 560.4 section 148.90, the board of social work pursuant to section 560.5 148B.19, the board of marriage and family therapy pursuant to 560.6 section 148B.30, the office of mental health practice 560.7 established pursuant to section 148B.61, the alcohol and drug 560.8 counselors licensing advisory council established pursuant to 560.9 section 148C.02, the board of dietetics and nutrition practice 560.10 established under section 148.622, the board of dentistry 560.11 established pursuant to section 150A.02, the board of pharmacy 560.12 established pursuant to section 151.02, the board of podiatric 560.13 medicine established pursuant to section 153.02, and the board 560.14 of veterinary medicine, established pursuant to section 156.01. 560.15 Sec. 66. [INITIAL APPOINTMENTS TO BOARD.] 560.16 Notwithstanding Minnesota Statutes, section 148.67, the 560.17 first physical therapist members appointed to the board may be 560.18 registered physical therapists. 560.19 Sec. 67. [REVISOR'S INSTRUCTION.] 560.20 In each section of Minnesota Statutes referred to in column 560.21 A, the revisor of statutes shall delete the reference in column 560.22 B and insert the reference in column C. 560.23 Column A Column B Column C 560.24 144E.10, subd. 2 144E.16 144E.101 to 144E.127 560.25 144E.12 144E.16 144E.121 to 144E.127 560.26 144E.13 144E.16 144E.101 to 144E.127 560.27 144E.14 144E.16 144E.101 to 144E.127 560.28 144E.35, subd. 1 144E.16 144E.285 560.29 144E.41 144E.16 144E.265 or 144E.28 560.30 353.64, subd. 10 144E.16 144E.28 560.31 147A.09, subd. 2 144E.16, 144E.127 560.32 subd. 2, 560.33 para. (c) 560.34 Sec. 68. [REPEALER.] 560.35 Minnesota Statutes 1998, sections 144E.16, subdivisions 1, 560.36 2, 3, and 6; 144E.17; 144E.25; and 144E.30, subdivisions 1, 2, 561.1 and 6, are repealed. Minnesota Rules, parts 4690.0100, subparts 561.2 4, 13, 15, 19, 20, 21, 22, 23, 24, 26, 27, and 29; 4690.0300; 561.3 4690.0400; 4690.0500; 4690.0600; 4690.0700; 4690.0800, subparts 561.4 1 and 2; 4690.0900; 4690.1000; 4690.1100; 4690.1200; 4690.1300; 561.5 4690.1600; 4690.1700; 4690.2100; 4690.2200, subparts 1, 3, 4, 561.6 and 5; 4690.2300; 4690.2400, subparts 1, 2, and 3; 4690.2500; 561.7 4690.2900; 4690.3000; 4690.3700; 4690.3900; 4690.4000; 561.8 4690.4100; 4690.4200; 4690.4300; 4690.4400; 4690.4500; 561.9 4690.4600; 4690.4700; 4690.4800; 4690.4900; 4690.5000; 561.10 4690.5100; 4690.5200; 4690.5300; 4690.5400; 4690.5500; 561.11 4690.5700; 4690.5800; 4690.5900; 4690.6000; 4690.6100; 561.12 4690.6200; 4690.6300; 4690.6400; 4690.6500; 4690.6600; 561.13 4690.6700; 4690.6800; 4690.7000; 4690.7100; 4690.7200; 561.14 4690.7300; 4690.7400; 4690.7500; 4690.7600; 4690.7700; 561.15 4690.7800; 4690.8300, subparts 1, 2, 3, 4, and 5; and 4735.5000, 561.16 are repealed. 561.17 ARTICLE 10 561.18 TOBACCO SETTLEMENT PAYMENTS 561.19 Section 1. [10.57] [MINNESOTA FAMILIES FOUNDATION.] 561.20 Subdivision 1. [ESTABLISHMENT.] The legislature finds that 561.21 the Minnesota families foundation will foster a public-private 561.22 partnership that will provide improved services to clients, a 561.23 more effective coordination of services, and a more efficient 561.24 allocation of resources. The Minnesota families foundation is a 561.25 nonprofit foundation established to support self-sufficiency and 561.26 reduce long-term dependency on government. The foundation shall 561.27 operate as a supporting organization under chapter 317A and the 561.28 Internal Revenue Code, section 509(a). The foundation is not 561.29 subject to chapters 13, 14, 16A, 16B, 16C, 43A, and 179A. 561.30 Subd. 2. [BOARD MEMBERSHIP.] The foundation shall be 561.31 governed by a 15-member board of directors consisting of: 561.32 (1) four members who are not state employees, appointed by 561.33 the governor; 561.34 (2) four members who are not members of the legislature, 561.35 two of whom are appointed by the senate and two of whom are 561.36 appointed by the house of representatives; and 562.1 (3) seven members appointed by the board itself. 562.2 Subd. 3. [TERMS; COMPENSATION; REMOVAL.] (a) Board members 562.3 appointed by the governor and the legislature shall serve during 562.4 the term of the appointing authority. The governor and the 562.5 legislature shall make initial appointments of board members, as 562.6 specified in subdivision 2, as soon as possible after the 562.7 effective date of this section. Initially appointed board 562.8 members' terms shall begin on July 1, 1999. Two of the 562.9 governor's initial appointments shall be for two-year terms. 562.10 Subsequent appointments shall be made at the beginning of each 562.11 regular session of the legislature. The board members appointed 562.12 by the governor and the legislature shall appoint seven board 562.13 members no later than January 1, 2000. Board members appointed 562.14 by the board shall serve four-year terms. A vacancy on the 562.15 board shall be filled for the unexpired portion of the term in 562.16 the same manner as the original appointment. 562.17 (b) Board members shall be reimbursed for reasonable 562.18 out-of-pocket expenses actually incurred. 562.19 (c) Board members must disclose fully to the board of 562.20 directors whenever they may have a conflict of interest within 562.21 the meaning of section 317A.255, subdivision 2. 562.22 (d) Liability of board members shall be governed by section 562.23 317A.257. 562.24 Subd. 4. [ORGANIZATION.] The board of directors shall 562.25 adopt bylaws necessary for the conduct of the business of the 562.26 foundation. The board shall select a chairperson from its 562.27 members, and any other officers the board deems necessary. 562.28 Board meetings shall be open to the public, and all grants, 562.29 contracts, and meeting minutes of the foundation shall be 562.30 available to the public. 562.31 Subd. 5. [EXECUTIVE DIRECTOR; EMPLOYEES OF THE 562.32 FOUNDATION.] (a) The board members appointed by the governor and 562.33 the legislature shall convene prior to January 1, 2000, and hire 562.34 an executive director. The executive director shall serve at 562.35 the pleasure of the board of directors. The executive director 562.36 shall serve as a nonvoting member of the board. The executive 563.1 director's compensation shall be capped at 95 percent of the 563.2 governor's salary. 563.3 (b) The executive director shall oversee the daily 563.4 operations of the foundation, including the hiring of necessary 563.5 staff. Employees of the foundation are not state employees. 563.6 (c) The executive director shall prepare an annual budget 563.7 for the foundation for review and approval by the board of 563.8 directors. 563.9 (d) To the extent that the board of directors makes funds 563.10 available, the commissioner of finance shall provide 563.11 administrative support to the foundation until June 30, 2000, 563.12 including but not limited to processing of payroll for the 563.13 executive director and foundation staff, payment of expenses to 563.14 board members, and payment of rent. The board of directors 563.15 shall make up to $200,000 available to the commissioner of 563.16 finance to cover payroll, expenses of board members, rent, and 563.17 other administrative expenses incurred to support the foundation 563.18 in fiscal year 2000. 563.19 Subd. 6. [FOUNDATION FUNDS.] (a) The board of directors 563.20 shall be responsible for managing the investment of the 563.21 foundation funds as follows: 563.22 (1) the foundation funds shall be audited annually by an 563.23 independent certified public accountant in accordance with 563.24 generally accepted accounting principles; 563.25 (2) the foundation funds shall be invested and managed 563.26 according to rules applicable to trust investments, as provided 563.27 in the Minnesota Prudent Investor Act, sections 501B.151 and 563.28 501B.152; 563.29 (3) reasonable and necessary administrative and investment 563.30 expenses directly associated with the management and investment 563.31 of the foundation funds may be paid from the foundation trusts; 563.32 and 563.33 (4) according to limits established by the board and 563.34 consistent with the limitations in the Uniform Management of 563.35 Institutional Funds Act, sections 309.62 to 309.71, earnings on 563.36 foundation funds shall be expended to cover administrative 564.1 expenses of the foundation and grant awards under subdivision 7. 564.2 (b) The board may contract with a third party, including 564.3 the state board of investment, to carry out the provisions of 564.4 paragraph (a). 564.5 (c) The foundation may accept gifts from private donors. 564.6 Such gifts to the foundation must be accounted for and expended 564.7 in a manner consistent with this section. 564.8 Subd. 7. [FOUNDATION GRANTS.] (a) Beginning July 1, 2000, 564.9 the foundation shall provide grants to nonprofit, 564.10 community-based organizations for activities that: 564.11 (1) are flexible and innovative and that close the gap 564.12 between dependence on government and independence from 564.13 government programs; 564.14 (2) support the efforts of working families and working 564.15 individuals to remain self-sufficient by building assets that 564.16 promote healthy family functioning and stability; 564.17 (3) will ensure that core public sector efforts to 564.18 encourage self-sufficiency have every opportunity to succeed; 564.19 (4) focus resources in a way that can demonstrate impact on 564.20 a single goal or a single set of goals; 564.21 (5) have demonstrated success in reducing future government 564.22 expenditures; 564.23 (6) contribute to increasing the understanding of the 564.24 development of young children's brains or to developing new 564.25 methods to increase the effectiveness of stimulation and 564.26 educational activities that will improve brain development in 564.27 young children; or 564.28 (7) enhance public education, awareness, and understanding 564.29 necessary for the promotion and encouragement of activities and 564.30 decisions that protect and stimulate young children's 564.31 development. 564.32 (b) All grantees must match funds received from the 564.33 foundation, dollar for dollar. The match may include up to 25 564.34 percent in kind. The match cannot be made with federal, state, 564.35 or local government funds except in collaborative projects 564.36 between governmental entities and the private sector. 565.1 (c) The foundation grants must not be used as a substitute 565.2 for traditional state or local sources of funding activities for 565.3 families and young children, but the endowment fund may be used 565.4 to supplement traditional state or local sources, including 565.5 sources used to support the activities described in this 565.6 subdivision. 565.7 Subd. 8. [REPORTS TO THE LEGISLATURE.] (a) The foundation 565.8 shall annually report to the governor and the legislature on 565.9 January 15 of each year. The report must include: 565.10 (1) a financial report that details the foundation's 565.11 earnings; 565.12 (2) an expense report detailing the amounts and purposes 565.13 for which funds were expended; 565.14 (3) a list of grant awards; 565.15 (4) a report on the performance results of these grants; 565.16 and 565.17 (5) a copy of the independent audit reports for the two 565.18 previous years. 565.19 (b) The foundation shall also report to the governor and 565.20 the legislature on January 15, 2000. This report shall include 565.21 a copy of the foundation's mission statement, bylaws, and 565.22 policies adopted by the board of directors; and a financial 565.23 report that details the foundation's returns and the amounts and 565.24 purposes for which funds were expended. 565.25 Subd. 9. [DISSOLUTION OF THE FOUNDATION.] By June 30, 565.26 2009, the foundation shall transfer all foundation assets to the 565.27 commissioner of finance, who shall record them as assets of the 565.28 general fund and cause them to be liquidated or invested, as 565.29 appropriate, by the state board of investment. On June 30, 565.30 2009, the foundation is dissolved. If the legal status of the 565.31 foundation or the foundation funds is successfully challenged in 565.32 state or federal court, the foundation must be dissolved and the 565.33 assets likewise returned to commissioner of finance for credit 565.34 to the general fund and investment by the state board of 565.35 investment. 565.36 (Effective Date: Section 1 (10.57) is effective the day 566.1 following final enactment.) 566.2 Sec. 2. Minnesota Statutes 1998, section 62J.69, is 566.3 amended to read: 566.4 62J.69 [MEDICAL EDUCATIONAND RESEARCH TRUST FUND.] 566.5 Subdivision 1. [DEFINITIONS.] For purposes of this 566.6 section, the following definitions apply: 566.7 (a) "Medical education" means the accredited clinical 566.8 training of physicians (medical students and residents), doctor 566.9 of pharmacy practitioners, doctors of chiropractic, dentists, 566.10 advanced practice nurses (clinical nurse specialist, certified 566.11 registered nurse anesthetists, nurse practitioners, and 566.12 certified nurse midwives), and physician assistants. 566.13 (b) "Clinical training" means accredited training for the 566.14 health care practitioners listed in paragraph (a) that is funded 566.15 in part by patient care revenues and that occurs in either an 566.16 inpatient or ambulatory patient care training site. 566.17 (c) "Trainee" means students involved in an accredited 566.18 clinical training program for medical education as defined in 566.19 paragraph (a). 566.20 (d) "Eligible trainee" means a student involved in an 566.21 accredited training program for medical education as defined in 566.22 paragraph (a), which meets the definition of clinical training 566.23 in paragraph (b), who is in a training site that is located in 566.24 Minnesota and which has a medical assistance provider number. 566.25 (e)"Health care research" means approved clinical,566.26outcomes, and health services investigations that are funded by566.27patient out-of-pocket expenses or a third-party payer.566.28(f)"Commissioner" means the commissioner of health. 566.29(g)(f) "Teaching institutions" means any hospital, medical 566.30 center, clinic, or other organization that currently sponsors or 566.31 conducts accredited medical education programs or clinical 566.32 research in Minnesota. 566.33(h)(g) "Accredited training" means training provided by a 566.34 program that is accredited through an organization recognized by 566.35 the department of education or the health care financing 566.36 administration as the official accrediting body for that program. 567.1(i)(h) "Sponsoring institution" means a hospital, school, 567.2 or consortium located in Minnesota that sponsors and maintains 567.3 primary organizational and financial responsibility for an 567.4 accredited medical education program in Minnesota and which is 567.5 accountable to the accrediting body. 567.6 Subd. 1a. [ADVISORY COMMITTEE.] The commissioner shall 567.7 appoint an advisory committee to provide advice and oversight on 567.8 the distribution of funds from the medical education and 567.9 research endowment fund. If a committee is appointed, the 567.10 commissioner shall: 567.11 (1) consider the interest of all stakeholders when 567.12 selecting committee members; 567.13 (2) select members that represent both urban and rural 567.14 interests; and 567.15 (3) select members that include ambulatory care as well as 567.16 inpatient perspectives. 567.17 The commissioner shall appoint to the advisory committee 567.18 representatives of the following groups: medical researchers; 567.19 public and private academic medical centers, including a 567.20 representative from each academic center offering an accredited 567.21 training program for physicians, pharmacists, chiropractors, 567.22 dentists, and nurses; managed care organizations; Blue Cross and 567.23 Blue Shield of Minnesota; commercial carriers; Minnesota Medical 567.24 Association; Minnesota Nurses Association; Minnesota 567.25 Chiropractic Association; medical product manufacturers; 567.26 employers; and other relevant stakeholders, including 567.27 consumers. The advisory committee is governed by section 15.059 567.28 for membership terms and removal of members, and expires on June 567.29 30, 2001. 567.30 Subd. 2. [ALLOCATION AND FUNDING FOR MEDICAL EDUCATIONAND567.31RESEARCH.] (a)The commissioner may establish a trust fund for567.32the purposes of funding medical education and research567.33activities in the state of Minnesota.567.34(b) By January 1, 1997, the commissioner may appoint an567.35advisory committee to provide advice and oversight on the567.36distribution of funds from the medical education and research568.1trust fund. If a committee is appointed, the commissioner568.2shall: (1) consider the interest of all stakeholders when568.3selecting committee members; (2) select members that represent568.4both urban and rural interest; and (3) select members that568.5include ambulatory care as well as inpatient perspectives. The568.6commissioner shall appoint to the advisory committee568.7representatives of the following groups: medical researchers,568.8public and private academic medical centers, managed care568.9organizations, Blue Cross and Blue Shield of Minnesota,568.10commercial carriers, Minnesota Medical Association, Minnesota568.11Nurses Association, medical product manufacturers, employers,568.12and other relevant stakeholders, including consumers. The568.13advisory committee is governed by section 15.059, for membership568.14terms and removal of members and will sunset on June 30, 1999.568.15(c)Eligible applicants for funds are accredited medical 568.16 education teaching institutions, consortia, and programs 568.17 operating in Minnesota. Applications must be submitted by the 568.18 sponsoring institution on behalf of the teaching program, and 568.19 must be received by September 30 of each year for distribution 568.20 in January of the following year. An application for funds must 568.21 include the following: 568.22 (1) the official name and address of the sponsoring 568.23 institution and the official name and address of the facility or 568.24 programs on whose behalf the institution is applying for 568.25 funding; 568.26 (2) the name, title, and business address of those persons 568.27 responsible for administering the funds; 568.28 (3) for each accredited medical education program for which 568.29 funds are being sought the type and specialty orientation of 568.30 trainees in the program, the name, address, and medical 568.31 assistance provider number of each training site used in the 568.32 program, the total number of trainees at each site, and the 568.33 total number of eligible trainees at each training site; 568.34 (4) audited clinical training costs per trainee for each 568.35 medical education program where available or estimates of 568.36 clinical training costs based on audited financial data; 569.1 (5) a description of current sources of funding for medical 569.2 education costs including a description and dollar amount of all 569.3 state and federal financial support, including Medicare direct 569.4 and indirect payments; 569.5 (6) other revenue received for the purposes of clinical 569.6 training; and 569.7 (7) other supporting information the commissioner, with 569.8 advice from the advisory committee, determines is necessary for 569.9 the equitable distribution of funds. 569.10(d)(b) The commissioner shall distribute medical education 569.11 funds to all qualifying applicants based on the following basic 569.12 criteria: (1) total medical education funds available; (2) 569.13 total eligible trainees in each eligible education program;and569.14 (3) the statewide average cost per trainee, by type of trainee, 569.15 in each medical education program; (4) the degree to which the 569.16 applicant's training programs are funded with patient care 569.17 revenues; (5) the degree to which the training of eligible 569.18 trainees takes place in patient care settings that face 569.19 increased financial pressure as a result of competition with 569.20 nonteaching patient care entities; and (6) whether the eligible 569.21 education program emphasizes primary care or specialties that 569.22 are in undersupply in Minnesota. Funds distributed shall not be 569.23 used to displace current funding appropriations from federal or 569.24 state sources. Funds shall be distributed to the sponsoring 569.25 institutions indicating the amount to be paid to each of the 569.26 sponsor's medical education programs based on the criteria in 569.27 this paragraph. Sponsoring institutions which receive funds 569.28 from thetrustfund must distribute approved funds to the 569.29 medical education program according to the commissioner's 569.30 approval letter. Further, programs must distribute funds among 569.31 the sites of training as specified in the commissioner's 569.32 approval letter. Any funds not distributed as directed by the 569.33 commissioner's approval letter shall be returned to the medical 569.34 education and researchtrustfund within 30 days of a notice 569.35 from the commissioner. The commissioner shall distribute 569.36 returned funds to the appropriate entities in accordance with 570.1 the commissioner's approval letter. 570.2(e)(c) Medical education programs receiving funds from the 570.3trustfund must submit a medical education and research grant 570.4 verification report (GVR) through the sponsoring institution 570.5 based on criteria established by the commissioner. If the 570.6 sponsoring institution fails to submit the GVR by the stated 570.7 deadline, or to request and meet the deadline for an extension, 570.8 the sponsoring institution is required to return the full amount 570.9 of the medical education and researchtrustfund grant to the 570.10 medical education and researchtrustfund within 30 days of a 570.11 notice from the commissioner. The commissioner shall distribute 570.12 returned funds to the appropriate entities in accordance with 570.13 the commissioner's approval letter. The reports must include: 570.14 (1) the total number of eligible trainees in the program; 570.15 (2) the programs and residencies funded, the amounts of 570.16trustfund payments to each program, and within each program, 570.17 the dollar amount distributed to each training site; and 570.18 (3) other information the commissioner, with advice from 570.19 the advisory committee, deems appropriate to evaluate the 570.20 effectiveness of the use of funds for clinical training. 570.21 The commissioner, with advice from the advisory committee, 570.22 will provide an annual summary report to the legislature on 570.23 program implementation due February 15 of each year. 570.24(f)(d) The commissioner is authorized to distribute funds 570.25 made available through: 570.26 (1) voluntary contributions by employers or other entities; 570.27 (2) allocations for the department of human services to 570.28 support medical education and research; and 570.29 (3) other sources as identified and deemed appropriate by 570.30 the legislaturefor inclusion in the trust fund. 570.31(g) The advisory committee shall continue to study and make570.32recommendations on:570.33(1) the funding of medical research consistent with work570.34currently mandated by the legislature and under way at the570.35department of health; and570.36(2) the costs and benefits associated with medical571.1education and research.571.2Subd. 3. [MEDICAL ASSISTANCE AND GENERAL ASSISTANCE571.3SERVICE.] The commissioner of health, in consultation with the571.4medical education and research costs advisory committee, shall571.5develop a system to recognize those teaching programs which571.6serve higher numbers or high proportions of public program571.7recipients and shall report to the legislative commission on571.8health care access by January 15, 1998, on an allocation formula571.9to implement this system.571.10 Subd. 4. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 571.11 SERVICES.] (a) The amount transferred according to section 571.12 256B.69, subdivision 5c, shall be distributed by the 571.13 commissioner to qualifying applicants based on a distribution 571.14 formula that reflects a summation of two factors: 571.15 (1) an education factor, which is determined by the total 571.16 number of eligible trainees and the total statewide average 571.17 costs per trainee, by type of trainee, in each program; and 571.18 (2) a public program volume factor, which is determined by 571.19 the total volume of public program revenue received by each 571.20 training site as a percentage of all public program revenue 571.21 received by all training sites in thetrustfundpool. 571.22 In this formula, the education factor shall be weighted at 571.23 50 percent and the public program volume factor shall be 571.24 weighted at 50 percent. 571.25 (b) Public program revenue for the formula in paragraph (a) 571.26 shall include revenue from medical assistance, prepaid medical 571.27 assistance, general assistance medical care, and prepaid general 571.28 assistance medical care. 571.29 (c) Training sites that receive no public program revenue 571.30 shall be ineligible for payments from the prepaid medical 571.31 assistance program transfer pool. 571.32 Subd. 5. [REVIEW OF ELIGIBLE PROVIDERS.](a) Provider571.33groups added after January 1, 1998, to the list of providers571.34eligible for the trust fund shall not receive funding from the571.35trust fund without prior evaluation by the commissioner and the571.36medical education and research costs advisory committee. The572.1evaluation shall consider the degree to which the training of572.2the provider group:572.3(1) takes place in patient care settings, which are572.4consistent with the purposes of this section;572.5(2) is funded with patient care revenues;572.6(3) takes place in patient care settings, which face572.7increased financial pressure as a result of competition with572.8nonteaching patient care entities; and572.9(4) emphasizes primary care or specialties, which are in572.10undersupply in Minnesota.572.11Results of this evaluation shall be reported to the572.12legislative commission on health care access. The legislative572.13commission on health care access must approve funding for the572.14provider group prior to their receiving any funding from the572.15trust fund. In the event that a reviewed provider group is not572.16approved by the legislative commission on health care access,572.17trainees in that provider group shall be considered ineligible572.18trainees for the trust fund distribution.572.19(b)The commissioner and the medical education and research 572.20 costs advisory committee mayalsoreview the eligible list of 572.21 provider groups, which were added to the eligible list of572.22provider groups prior to January 1, 1998,to assure that the 572.23trustfund moneycontinues to beis distributed consistent with 572.24 the purpose of this section. The results of any such reviews 572.25 must be reported to the legislative commission on health care 572.26 access. Trainees in provider groups,which were added prior to572.27January 1, 1998, andwhich are reviewed by the commissioner and 572.28 the medical education and research costs advisory committee, 572.29 shall be considered eligible trainees for purposes of thetrust572.30 fund distribution unless and until the legislative commission on 572.31 health care access disapproves their eligibility, in which case 572.32 they shall be considered ineligible trainees. 572.33 (Effective Date: Section 2 (62J.69) is effective the day 572.34 following final enactment.) 572.35 Sec. 3. [62J.691] [MEDICAL EDUCATION AND RESEARCH 572.36 ENDOWMENT FUND.] 573.1 Subdivision 1. [CREATION.] The medical education and 573.2 research endowment fund is created as an account in the state 573.3 treasury. The commissioner of finance shall credit to the fund 573.4 20.25 percent of the tobacco settlement payments received by the 573.5 state on January 3, 2000, January 2, 2001, January 2, 2002, and 573.6 January 2, 2003, as a result of the settlement of the lawsuit 573.7 styled as State v. Philip Morris Inc., No. C1-94-8565 (Minnesota 573.8 District Court, Second Judicial District). The state board of 573.9 investment shall invest the fund under section 11A.24. All 573.10 earnings of the fund must be credited to the fund. The 573.11 principal of the fund must be maintained inviolate. 573.12 Subd. 2. [ENDOWMENT FUND EXPENDITURES.] (a) Earnings of 573.13 the fund, up to five percent of the fair market value of the 573.14 fund on the preceding July 1, shall be spent for medical 573.15 education and research activities in the state of Minnesota. 573.16 (b) Beginning July 1, 2000, and on July 1 of each year 573.17 thereafter, 50 percent of the amount in paragraph (a) is 573.18 appropriated from the fund to the commissioner of health to be 573.19 distributed for medical education under section 62J.69. 573.20 (c) Beginning July 1, 2000, and July 1 of each year 573.21 thereafter, 25 percent of the amount in paragraph (a) is 573.22 appropriated from the fund to the commissioner of health to be 573.23 distributed for medical research according to the 573.24 recommendations submitted under section 62J.692. 573.25 (d) Beginning July 1, 2000, and on July 1 of each year 573.26 thereafter, 25 percent of the amount in paragraph (a) may be 573.27 appropriated by another law for the instructional costs of 573.28 health professional programs at publicly funded academic health 573.29 centers. 573.30 Subd. 3. [AUDITS REQUIRED.] The legislative auditor shall 573.31 audit endowment fund expenditures to ensure that the money is 573.32 spent for the purposes set out in this section. 573.33 Subd. 4. [SUNSET.] The medical education and research 573.34 endowment fund expires June 30, 2015. Upon expiration, the 573.35 commissioner of finance shall transfer the principal and any 573.36 remaining interest to the general fund. 574.1 (Effective Date: Section 3 (62J.691) is effective the day 574.2 following final enactment.) 574.3 Sec. 4. [62J.692] [MEDICAL RESEARCH.] 574.4 The commissioner of health, in consultation with the 574.5 medical education and research costs advisory committee, shall 574.6 make recommendations for a process for the submission, review, 574.7 and approval of research grant applications. The process shall 574.8 give priority for grants to applications that are intended to 574.9 gather preliminary data for submission for a subsequent proposal 574.10 for funding from a federal agency or foundation, which awards 574.11 research money on a competitive, peer-reviewed basis. Grant 574.12 recipients must be able to demonstrate the ability to comply 574.13 with federal regulations on human subjects research in 574.14 accordance with Code of Federal Regulations, title 45, section 574.15 46, and shall conduct the proposed research. Grants may be 574.16 awarded to the University of Minnesota, the Mayo clinic, or any 574.17 other public or private organization in the state involved in 574.18 medical research. The commissioner shall report to the 574.19 legislature by January 15, 2000, with recommendations. 574.20 (Effective Date: Section 4 (62J.692) is effective the day 574.21 following final enactment.) 574.22 Sec. 5. [62J.82] [HEALTH CARE FUND.] 574.23 The health care fund is created as an account in the state 574.24 treasury. The commissioner of finance shall credit to the fund 574.25 $38,000,000 of each tobacco settlement payment received by the 574.26 state in the month of December, beginning December 2003, as a 574.27 result of the settlement of the lawsuit styled as State v. 574.28 Philip Morris Inc., No. C1-94-8565 (Minnesota District Court, 574.29 Second Judicial District). The state board of investment shall 574.30 invest the fund under section 11A.24. All earnings of the fund 574.31 must be credited to the fund. 574.32 (Effective Date: Section 5 (62J.82) is effective the day 574.33 following final enactment.) 574.34 Sec. 6. [137.44] [HEALTH PROFESSIONAL EDUCATION BUDGET 574.35 PLAN.] 574.36 The board of regents is requested to adopt a biennial 575.1 budget plan for making expenditures from the medical education 575.2 and research endowment fund dedicated for the instructional 575.3 costs of health professional programs at publicly funded 575.4 academic health centers. The budget plan may be submitted as 575.5 part of the University of Minnesota's biennial budget request. 575.6 (Effective Date: Section 6 (137.44) is effective the day 575.7 following final enactment.) 575.8 Sec. 7. [144.395] [TOBACCO PREVENTION ENDOWMENT FUND.] 575.9 Subdivision 1. [CREATION.] The tobacco prevention 575.10 endowment fund is created as an account in the state treasury. 575.11 The commissioner of finance shall credit to the fund 50 percent 575.12 of the tobacco settlement payments received by the state on 575.13 January 3, 2000, January 2, 2001, January 2, 2002, and January 575.14 2, 2003, as a result of the settlement of the lawsuit styled as 575.15 State v. Philip Morris Inc., No. C1-94-8565 (Minnesota District 575.16 Court, Second Judicial District). The state board of investment 575.17 shall invest the fund under section 11A.24. All earnings of the 575.18 fund must be credited to the fund. The principal of the fund 575.19 must be maintained inviolate. 575.20 Subd. 2. [ENDOWMENT FUND EXPENDITURES.] (a) Earnings from 575.21 the fund shall be spent to reduce the human and economic 575.22 consequences of tobacco use through tobacco prevention 575.23 measures. Beginning July 1, 2000, and on July 1 of each year 575.24 thereafter, earnings from the fund, up to five percent of the 575.25 fair market value of the fund on the preceding July 1 and up to 575.26 a prorated five percent of deposits received during the 575.27 preceding year, are appropriated from the fund to the 575.28 commissioner of health, who shall pay that amount to the 575.29 Minnesota partnership for action against tobacco. 575.30 (b) Minnesota partnership for action against tobacco shall 575.31 use the amounts received for tobacco use prevention measures, 575.32 except that a maximum of $200,000 of the first year's 575.33 appropriation and $300,000 of each annual appropriation 575.34 thereafter may be used for staffing and other expenses related 575.35 to this section. Members of the board of directors of the 575.36 partnership, and members of any advisory committees appointed by 576.1 the board to make recommendations for implementing tobacco use 576.2 prevention efforts, may be reimbursed for reasonable expenses 576.3 actually incurred in connection with activities related to 576.4 carrying out this section, but not for expenses reimbursed from 576.5 any other source. 576.6 (c) The Minnesota partnership for action against tobacco 576.7 shall not award any grants from the annual appropriations 576.8 received under this subdivision to any project in which a 576.9 partnership board member or staff member has a substantial 576.10 financial interest. 576.11 Subd. 3. [AUDITS REQUIRED.] The legislative auditor shall 576.12 audit endowment fund expenditures to ensure that the money is 576.13 spent for tobacco prevention measures. 576.14 Subd. 4. [REPORT.] (a) The Minnesota partnership for 576.15 action against tobacco must submit an annual report to the 576.16 legislature by January 15 of each year, beginning in 2001, on 576.17 prevention measures and initiatives undertaken during the 576.18 preceding year. The report must include: 576.19 (1) an accounting of expenses, detailing the amounts and 576.20 purposes for which money was spent; 576.21 (2) a list of grant awards; 576.22 (3) a report on the results of the tobacco prevention 576.23 measures; 576.24 (4) a copy of the legislative auditor's report; and 576.25 (5) how the statewide prevention efforts have been 576.26 coordinated and delivered through local public health agencies. 576.27 (b) The initial report submitted under this subdivision 576.28 must include a copy of the partnership's bylaws and tobacco 576.29 prevention policies or plans adopted by the board of directors. 576.30 Subd. 5. [SUNSET.] The tobacco prevention endowment fund 576.31 expires on June 30, 2010. Upon expiration, the commissioner of 576.32 finance shall transfer the principal and any remaining interest 576.33 to the general fund. 576.34 (Effective Date: Section 7 (144.395) is effective the day 576.35 following final enactment.) 576.36 Sec. 8. [256.956] [SENIOR PRESCRIPTION DRUG ENDOWMENT 577.1 FUND.] 577.2 Subdivision 1. [CREATION.] The senior prescription drug 577.3 endowment fund is created as an account in the state treasury. 577.4 The commissioner of finance shall credit to the fund 6.75 577.5 percent of the tobacco settlement payments received by the state 577.6 on January 3, 2000, January 2, 2001, January 2, 2002, and 577.7 January 2, 2003, as a result of the settlement of the lawsuit 577.8 styled as State v. Philip Morris Inc., No. C1-94-8565 (Minnesota 577.9 District Court, Second Judicial District). The state board of 577.10 investment shall invest the fund under section 11A.24. All 577.11 earnings of the fund must be credited to the fund. 577.12 Subd. 2. [EXPENDITURES.] (a) As part of each biennial and 577.13 supplemental budget, the commissioner of finance shall forecast 577.14 the cost of providing coverage to the enrollees of the senior 577.15 citizen drug program under section 256.955 whose income is 577.16 between 120 percent and 200 percent of the federal poverty 577.17 guidelines and for the disabled. The commissioner of finance 577.18 shall recognize the projected costs of the program in the fund 577.19 balance. 577.20 (b) Beginning July 1, 2000, and on July 1 of each year 577.21 thereafter, a sum equal to the projected costs as determined in 577.22 paragraph (a) for the following fiscal year is appropriated from 577.23 the fund to the commissioner of human services to be used for 577.24 the senior citizen drug program. 577.25 (Effective Date: Section 8 (256.956) is effective the day 577.26 following final enactment.) 577.27 Sec. 9. [APPROPRIATIONS.] 577.28 (a) $93,312,000 is appropriated from the general fund to 577.29 the commissioner of finance for transfer to the medical 577.30 education and research endowment fund in the fiscal year ending 577.31 June 30, 1999. 577.32 (b) $105,984,000 is appropriated from the general fund to 577.33 the commissioner of finance for payment to the Minnesota 577.34 families foundation in the fiscal year ending June 30, 1999. 577.35 (c) $230,400,000 is appropriated from the general fund to 577.36 the commissioner of finance for transfer to the tobacco 578.1 prevention endowment fund in the fiscal year ending June 30, 578.2 1999. 578.3 (d) $31,104,000 is appropriated from the general fund to 578.4 the commissioner of finance for transfer to the senior 578.5 prescription drug endowment fund in the fiscal year ending June 578.6 30, 1999. 578.7 (e) Of the tobacco settlement payments received by the 578.8 state on January 3, 2000, January 2, 2001, January 2, 2002, and 578.9 January 2, 2003, as a result of the settlement of the lawsuit 578.10 styled as State v. Philip Morris Inc., No. C1-94-8565 (Minnesota 578.11 District Court, Second Judicial District), 23 percent is 578.12 appropriated to the commissioner of finance for payment to the 578.13 Minnesota families foundation. 578.14 Sec. 10. [EFFECTIVE DATE.] 578.15 When preparing the conference committee report for adoption 578.16 by the legislature, the revisor shall combine all effective date 578.17 notations in this article into this effective date section. 578.18 ARTICLE 11 578.19 MISCELLANEOUS 578.20 Section 1. Minnesota Statutes 1998, section 62E.11, is 578.21 amended by adding a subdivision to read: 578.22 Subd. 13. [STATE FUNDING; EFFECT ON PREMIUM RATES OF 578.23 MEMBERS.] In approving the premium rates as required in sections 578.24 62A.65, subdivision 3; and 62L.08, subdivision 8, the 578.25 commissioners of health and commerce shall ensure that any 578.26 appropriation to reduce the annual assessment made on the 578.27 contributing members to cover the costs of the Minnesota 578.28 comprehensive health insurance plan as required under this 578.29 section is reflected in the premium rates charged by each 578.30 contributing member. 578.31 Sec. 2. Minnesota Statutes 1998, section 116L.02, is 578.32 amended to read: 578.33 116L.02 [JOB SKILLS PARTNERSHIP PROGRAM.] 578.34 (a) The Minnesota job skills partnership program is created 578.35 to act as a catalyst to bring together employers with specific 578.36 training needs with educational or other nonprofit institutions 579.1 which can design programs to fill those needs. The partnership 579.2 shall work closely with employers to train and place workers in 579.3 identifiable positions as well as assisting educational or other 579.4 nonprofit institutions in developing training programs that 579.5 coincide with current and future employer requirements. The 579.6 partnership shall provide grants to educational or other 579.7 nonprofit institutions for the purpose of training displaced 579.8 workers. A participating business must match the grant-in-aid 579.9 made by the Minnesota job skills partnership. The match may be 579.10 in the form of funding, equipment, or faculty. 579.11 (b) The partnership program shall administer the health 579.12 care and human services worker training and retention program 579.13 under sections 116L.10 to 116L.15. 579.14 Sec. 3. [116L.10] [PROGRAM ESTABLISHED.] 579.15 A health care and human services worker training and 579.16 retention program is established to: 579.17 (1) alleviate critical worker shortages confronting 579.18 specific geographical areas of the state, specific health care 579.19 and human services industries, or specific providers when 579.20 employers are not currently offering sufficient worker training 579.21 and retention options and are unable to do so because of the 579.22 limited size of the employer, economic circumstances, or other 579.23 limiting factors described in the grant application and verified 579.24 by the board; and 579.25 (2) increase opportunities for current and potential direct 579.26 care employees to qualify for advanced employment in the health 579.27 care or human services fields through experience, training, and 579.28 education. 579.29 Sec. 4. [116L.11] [DEFINITIONS.] 579.30 Subdivision 1. [SCOPE.] For the purposes of sections 579.31 116L.10 to 116L.15, the terms defined in this section have the 579.32 meanings given them unless the context clearly indicates 579.33 otherwise. 579.34 Subd. 2. [ELIGIBLE EMPLOYER.] "Eligible employer" means a 579.35 nursing facility, small rural hospital, intermediate care 579.36 facility for persons with mental retardation or related 580.1 conditions, waivered services provider, home health services 580.2 provider, personal care assistant services provider, 580.3 semi-independent living services provider, day training and 580.4 habilitation services provider, or similar provider of health 580.5 care or human services. 580.6 Subd. 3. [POTENTIAL EMPLOYEE TARGET GROUPS.] "Potential 580.7 employee target groups" means high school students, past and 580.8 present recipients of Minnesota family investment program 580.9 benefits, immigrants, senior citizens, current health care and 580.10 human services workers, and persons who are underemployed or 580.11 unemployed. 580.12 Subd. 4. [QUALIFYING CONSORTIUM.] "Qualifying consortium" 580.13 means an entity that may include a public or private institution 580.14 of higher education, work force center, county, and one or more 580.15 eligible employers, but must include a public or private 580.16 institution of higher education and one or more eligible 580.17 employers. 580.18 Sec. 5. [116L.12] [FUNDING MECHANISM.] 580.19 Subdivision 1. [APPLICATIONS.] A qualifying consortium 580.20 shall apply to the board in the manner specified by the board. 580.21 Subd. 2. [FISCAL REQUIREMENTS.] The application must 580.22 specify how the consortium will make maximum use of available 580.23 federal and state training, education, and employment funds to 580.24 minimize the need for training and retention grants. A 580.25 consortium must designate a lead agency as the fiscal agent for 580.26 reporting, claiming, and receiving payments. An institution of 580.27 higher learning may be designated as a lead agency, but the 580.28 governing board of a multicampus higher education system may not 580.29 be given that designation. 580.30 Subd. 3. [PROGRAM TARGETS.] Applications for grants must 580.31 describe targeted employers or types of employers and must 580.32 describe the specific critical work force shortage the program 580.33 is designed to alleviate. Programs may be limited 580.34 geographically or be statewide. The application must include 580.35 verification that in the process of determining that a critical 580.36 work force shortage exists in the target area, the applicant has: 581.1 (1) consulted available data on worker shortages; 581.2 (2) conferred with other employers in the target area; and 581.3 (3) compared shortages in the target area with shortages at 581.4 the regional or statewide level. 581.5 Subd. 4. [GRANTS.] Within the limits of available 581.6 appropriations, the board shall make grants to qualifying 581.7 consortia to operate local, regional, or statewide training and 581.8 retention programs. Grant awards must establish specific, 581.9 measurable outcomes and timelines for achieving those outcomes. 581.10 Subd. 5. [LOCAL MATCH REQUIREMENTS.] A consortium must 581.11 provide at least a 50 percent match from local resources for 581.12 money appropriated under this section. The local match 581.13 requirement may be reduced for consortia that include a 581.14 relatively large number of small employers whose financial 581.15 contribution has been reduced in accordance with section 116L.15. 581.16 In-kind services and expenditures under section 116L.13, 581.17 subdivision 2, may be used to meet this local match 581.18 requirement. The grant application must specify the financial 581.19 contribution from each member of the consortium. 581.20 Subd. 6. [INELIGIBLE WORKER CATEGORIES.] Grants shall not 581.21 be made to alleviate shortages of physicians, physician 581.22 assistants, or advanced practice nurses. 581.23 Subd. 7. [EVALUATION.] The board shall evaluate the 581.24 success of consortia that receive grants in achieving expected 581.25 outcomes and shall report to the legislature annually. The 581.26 report must compare consortia in terms of overall program costs, 581.27 costs per client, retention rates, advancement rates, and other 581.28 outcome measurements established in the grantmaking process. 581.29 The first report shall be due on March 15, 2000, and on January 581.30 15 annually in succeeding years. The report shall include any 581.31 recommendations from the board to modify the grant program. 581.32 Sec. 6. [116L.13] [PROGRAM REQUIREMENTS.] 581.33 Subdivision 1. [MARKETING AND RECRUITMENT.] A qualifying 581.34 consortium must implement a marketing and outreach strategy to 581.35 recruit into the health care and human services fields persons 581.36 from one or more of the potential employee target groups. 582.1 Recruitment strategies must include a screening process to 582.2 evaluate whether potential employees may be disqualified as the 582.3 result of a required background check or are otherwise unlikely 582.4 to succeed in the position for which they are being recruited. 582.5 Subd. 2. [RECRUITMENT AND RETENTION INCENTIVES.] Employer 582.6 members of a consortium must provide incentives to train and 582.7 retain employees. These incentives may include, but are not 582.8 limited to: 582.9 (1) paid salary during initial training periods, but only 582.10 if specifically approved by the board, which must certify that 582.11 the employer has not formerly paid employees during the initial 582.12 training period and is unable to do so because of the employer's 582.13 limited size, financial condition, or other factors; 582.14 (2) scholarship programs under which a specified amount is 582.15 deposited into an educational account for the employee for each 582.16 hour worked, which may include contributions on behalf of an 582.17 employee to an Edvest account under Minnesota Statutes, sections 582.18 136A.241 to 136A.245; 582.19 (3) the provision of advanced education to employees so 582.20 that they may qualify for advanced positions in the health care 582.21 or human services fields. This education may be provided at the 582.22 employer's site, at the site of a nearby employer, or at a local 582.23 educational institution or other site. Preference shall be 582.24 given to grantees that offer flexible advanced training to 582.25 employees at convenient sites, allow workers time off with pay 582.26 during the work day to participate, and provide education at no 582.27 cost to students or through employer-based scholarships that pay 582.28 expenses prior to the start of classes rather than upon 582.29 completion; 582.30 (4) work maturity or soft skills training, adult basic 582.31 education, English as a second language instruction, and basic 582.32 computer orientation for persons with limited previous 582.33 attachment to the work force due to a lack of these skills; 582.34 (5) child care subsidies during training or educational 582.35 activities; 582.36 (6) transportation to training and education programs; and 583.1 (7) programs to coordinate efforts by employer members of 583.2 the consortium to share staff among employers where feasible, to 583.3 pool employee and employer benefit contributions in order to 583.4 enhance benefit packages, and to coordinate education and 583.5 training opportunities for staff in order to increase the 583.6 availability and flexibility of education and training programs. 583.7 Subd. 3. [WORK HOUR LIMITS.] High school students 583.8 participating in a training and retention program shall not be 583.9 permitted to work more than 20 hours per week when school is in 583.10 session. 583.11 Sec. 7. [116L.14] [CAREER ENHANCEMENT REQUIREMENTS.] 583.12 All consortium members must work cooperatively to establish 583.13 and maintain a career ladder program under which direct care 583.14 staff have the opportunity to advance along a career development 583.15 path that includes regular educational opportunities, 583.16 coordination between job duties and educational opportunities, 583.17 and a planned series of promotions for which qualified employees 583.18 will be eligible. 583.19 Sec. 8. [116L.15] [SMALL EMPLOYER PROTECTION.] 583.20 Grantees must guarantee that small employers, including 583.21 licensed personal care assistant organizations, be allowed to 583.22 participate in consortium programs. The financial contribution 583.23 required from a small employer must be adjusted to reflect the 583.24 employer's financial circumstances. 583.25 Sec. 9. [REPEALER.] 583.26 Laws 1997, chapter 225, article 6, section 8, is repealed. 583.27 Sec. 10. [EFFECTIVE DATE.] 583.28 Section 9 is effective the day following final enactment.